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Surgeons perform first aortic valve surgery without opening the chest
Surgeons in France report that they have performed the first total endoscopic aortic valve replacement (TEAVR) in 2 human patients. Their paper has been published in the the Journal of Thoracic and Cardiovascular Surgery. In recent years the development of TAVR (transcatheter aortic valve replacement) has attracted enormous attention. But TAVR, which is performed by an interventional cardiologist, is generally restricted to patients who are either not suitable for surgery or at very high risk for surgery. The new paper is the latest indication that surgeons too are now working to limit as much as possible the trauma of aortic valve surgery.
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More breast cancer survivors opting for reconstruction
USA Today
Six weeks after her mother died of ovarian cancer, Elizabeth Stower, then 21, was diagnosed with Stage 3 breast cancer. According to the American Cancer Society, 235,030 women will be diagnosed with breast cancer this year, and 40,430 will die from the disease. For survivors who undergo a mastectomy, life after cancer can be especially hard, mentally and physically, as they deal with a new body image. A new study by researchers from private practices and academic medical centers shows that more women are receiving breast reconstruction after mastectomies, but the rates also vary dramatically based on geographic location.
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Surgeons, Duke and CMS to launch mashup database
Modern Healthcare
The Society of Thoracic Surgeons will team its clinical database and analytics capabilities at the Duke Clinical Research Institute with Medicare claims data from the CMS to create more effective risk models and survival probabilities for various procedures as well as other insights. The new collaboration will affect two of the society's three databases that are components of the STS National Database, launched in 1989 — the adult cardiac surgery database containing data on more than 5.2 million heart surgery procedures, and the general thoracic surgery database with more than 360,000 procedures, including lobectomy and esophagectomy. Excluded is the congenital heart surgery database, which contains data on patients typically younger than Medicare age.
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Stanford surgeon shows us the future of medicine with augmented reality & Google Glass
MedCity News
With his Google Glass, Stanford University physician Dr. Homero Rivas pinpoints a target on the skin of an anatomical human model. The surgeon and his assistant then direct their Glass at the target to reveal an augmented reality display on their screens. To their eyes, looking through the Glass, they can see the procedure illustrated step by step with images superimposed over the skin of the model. Stanford University live-streamed that demonstration to physicians around the world. It wasn’t a particularly complicated procedure, but it was one of the first times that augmented reality has been introduced to Glassware for the benefit of surgeons.
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The future of face and hand transplants
The Boston Globe
Transplant leaders are debating national rules for the distribution of deceased donors’ faces and hands, tackling ethically challenging questions such as which disfigured patients across the country should get priority for these surgeries as they become more common. The thorny issues are likely to include whether certain patients, such as children or the most severely maimed, should go to the top of waiting lists for donor faces and hands.
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Number of people with new joints tops 7 million
USA Today
More than 7 million Americans who would otherwise be disabled walk, work and play on artificial knees or hips, new data shows. The figure, released at the 2014 Annual Meeting of the American Academy of Orthopaedic Surgeons in New Orleans, marks the first time researchers have estimated the number of people living with artificial joints, instead of just tabulating the roughly 1 million annual operations.
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The latest motivation for plastic surgery: Selfies
Selfies are having a huge impact on the facial plastic surgery industry, according to a study by one of the largest plastic surgery associations. One in three facial plastic surgeons said more people are asking for procedures due to more self-awareness of their looks on social media. The results of the annual poll conducted by The American Academy of Facial Plastic and Reconstructive Surgery come just a week after daytime talk show host Ellen Degeneres tweeted a photo of herself with a handful of other stars.

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Ear-tube procedures moving out of operating room
Knoxville News
Preceptis Medical is a small company that has big designs to clip the costs and boost the safety for the 1.3 million young children who undergo ear-tube surgeries each year. “This is a simple story,” said Preceptis CEO Steve Anderson. “We’ve come up with an effective tool that allows us to do the procedure under conscious sedation, avoiding the expense of the operating room, and avoiding the risk to young children of general anesthesia.”

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Some patients may benefit from hip resurfacing over replacement
Medical Xpress
When a person loses mobility because of arthritis, surgeons can replace the faulty hip joint with a new one. A new study led by researchers at Washington University School of Medicine in St. Louis suggests that a different procedure called hip resurfacing may be a better option for some patients, particularly those who are young and active.

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Rating sites becoming an important tool for patients
By Pamela Lewis Dolan
Despite physicians' dislike of online rating sites, a survey finds patients are increasingly relying on them when shopping for a new doctor. A survey conducted by researchers at the University of Michigan Medical School found that when choosing a doctor, physician rating sites weren't ranked as high as other factors such as word of mouth from family and friends or whether a physician accepts the patient's insurance. But there is evidence the rating sites have become an important tool. And use of them is likely to continue growing.
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Allergies to joint replacement implants problematic
Medscape (free subscription)
Patient discomfort with some joint replacements could be related to allergies to common implant materials, a new study shows. "If you have had a skin reaction, you should be patch-tested before having an implant," said lead investigator Karin Pacheco, M.D., assistant professor of medicine at the University of Colorado Denver. Although many patients test positive for allergies to implant materials, orthopedic surgeons usually don't take those allergies into account when recommending implants to their patients.
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Surgeons perform first auditory brainstem implant operation in Ohio
Surgeons at University Hospitals Case Medical Center have completed the first auditory brainstem implant (ABI) operation in Northeast Ohio on a woman who has lost most of her hearing due to benign tumors on her auditory nerves. The procedure was performed on March 11 by ear, nose and throat surgeons Cliff Megerian, M.D., and Maroun Semaan, MD, and neurosurgeon Nicholas Bambakidis, M.D. It will be about six to eight weeks before it is known if the implant provides benefit to the patient and to what extent. The patient has a relatively rare genetic condition known as Neurofibromatosis Type 2 (NF2). The incidence is estimated to be one in 40,000.
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A surgical procedure's risks, unmentioned
The New York Times (opinion)
Many patients assume that, like prescription drugs, surgical procedures and instruments undergo extensive testing and must be government-approved. It’s not necessarily so. Developers, of course, do test new instruments, and practitioners often train with an expert before using them unsupervised to treat patients. And the Food and Drug Administration must confirm an instrument’s safety and effectiveness before it can be marketed — but only if the device is deemed significantly different from others already approved.
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Missed last week's issue? See which articles your colleagues read most.

    New guideline provides recommendations for breast cancer surgeons (Health Canal)
2 gloves are better than one (Outpatient Surgery)
Research benefits surgeons making decisions on how to help their patients breathe easier (Science Codex)
A revolutionary surgery, now as typical as a sinker (The New York Times)
Pediatric surgeons develop standards for children's surgical care in the US (Medical Xpress)

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