By Michael J. Rosen MD FACS
An vital evaluation on belly wall reconstruction for the overall physician! subject matters will comprise preoperative optimization of a ventral hernia sufferer, prevention of incisional hernias, laparoscopic ventral hernia fix, open ventral hernia fix, odd hernias, epigastric and umbilical hernias, parastomal hernia fix, flap reconstruction, man made mesh, medical results of biologic mesh, pediatric hernias, takedown of enterocutaneous fistula, a evaluation of laparoscopic as opposed to open inguinal hernia, and extra!
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Additional info for Abdominal Wall Reconstruction, an Issue of Surgical Clinics,
The trainees have changed as well. Unless one has been working as a member of a medical student faculty or a resident training faculty, it might not be as apparent. Having the opportunity to work in both of those roles, I would suggest that the changes to medical student education, particularly in regard to ability to assume responsibility and participate significantly in patient care, have been more dramatic than the changes in resident education. This has led to a concerted effort to create “surgical boot camps” and led in part to the diminution of the PGY-1 resident role by the ACGME.
This has led to a concerted effort to create “surgical boot camps” and led in part to the diminution of the PGY-1 resident role by the ACGME. Whether one agrees or disagrees with the changes, one fact remains incontrovertible: some things that used to be learned by most students in medical school now have to be taught in residency. And we have less time in residency to cover the same, or more, ground than we used to. Technology has changed on multiple fronts, although this is certainly not news.
We were also wrong then because that assumption that each patient presents without variations that may markedly increase the complexity of repair is intellectually flawed. We are more wrong today if we claim that these are “intern cases” for multiple reasons: changes in training, changes in trainees, changes in technology, and changes in technique. The training changes are among the most significant. In 2003 the Institute of Medicine released its “To Err is Human” report that formed the basis for a major and unprecedented impact on resident work hours regulation.
Abdominal Wall Reconstruction, an Issue of Surgical Clinics, by Michael J. Rosen MD FACS