General Surgery
After a postoperative complication, new mental health disorders were more common for a year
An Ontario study of over a million operations links complications to later mental health disorders, mostly in patients with no prior history. Emergency cholecystectomy got safer over a decade, but organ-space infection more than doubled, and robotic surgery for acute cholecystitis bailed out slightly more often at higher cost.
A physiology-only score separated the emergency laparotomies likely to die
PESAS discriminated 30-day mortality well in an external cohort of 1086 emergency laparotomies; single-stage rendezvous cleared the duct in 95% of anticipated-difficult stones; and robotic surgery in older adults showed fewer conversions but no clear recovery benefit.
A rod and a tighter fascial opening cut parastomal hernia after loop ileostomy
The UNSEAL trial favours an unsutured composite technique at the extraction site; delirium after emergency laparotomy arrives with the day's worst complications; and endoscopy within six hours adds nothing for most upper GI bleeds.
Transvaginal drainage of tubo-ovarian abscess fails non-inferiority to laparoscopy — but spares a day in hospital
A French multicentre trial puts a number on the trade-off, robotic appendicectomy adds time and conversions without a visible benefit, and a small trial questions routine suction for traumatic pneumothorax.
Fluorescence angiography cuts colorectal anastomotic leak by about a third; WSES moves colon trauma further from routine diversion
A trial-sequential meta-analysis of eight RCTs finds ICG angiography prevents one leak for about every 24 colorectal anastomoses, WSES sets out a physiology-led approach to colon and rectal injury, and three analyses cover laparoscopy in severe COPD, Braun enteroenterostomy and missed same-admission cholecystectomy.
A laparoscopic TAP block improved next-day recovery after colorectal surgery
A three-arm trial favours surgeon-placed dual TAP over rectus sheath block; leaving a normal appendix looks safe; robotic and laparoscopic ventral hernia repair leave fewer unhappy scars; a reoperated oesophageal leak costs survival; and EUS gallbladder drainage is not yet proven superior.
Mesh at subcostal closure cut hernia from 38% to 8% in one trial; a transanal tube may help only without a stoma
A double-blind trial of prophylactic mesh after open hepatobiliary surgery, a Cochrane review that splits the transanal tube by stoma status, and two observational studies on leak training and robotic complex cholecystectomy.
Fluorescence during cholecystectomy tracks with a 38% lower bile duct injury rate across 1.27 million operations
The largest dataset yet on indocyanine green cholangiography finds less common bile duct injury, less conversion and fewer biliary reinterventions — though it is a cohort, not a trial. Robotic cholecystectomy earns its place in the difficult gallbladder rather than the easy one, at about $2,200 a case. And a single 0.2 mg intrathecal injection matches a wound catheter after Whipple.