Biomedical subjects

B Pinard

Publications and source records attributed to B Pinard.

5 recordsLinked to original sources

PubMed2001

Surgeon-specific factors in the acquisition of laparoscopic surgical skills.

BACKGROUND: Training and experience vary widely among surgeons performing laparoscopic surgery (LS). Visual perceptual demands are greater for LS than for traditional surgery, necessitating greater understanding of surgeon variables in skill acquisition and performance. METHODS: During an LS skills course incorporating didactic and simulator-based instruction, 94 surgeons completed an experience/demographic questionnaire, a test of course-specific knowledge acquisition, 10 trials of three dexterity drills, 15 suturing trials using course-specific methods, and 3 standardized tests of visual perception. RESULTS: Age, years posttraining, and visual perception correlated significantly with time required to complete drills and suturing trials (Pearson correlations ranged from r = 0.21, P <0.05, to r = 0.51, P <0.001) even after statistically controlling for variations in knowledge acquisition, which correlated (r = 0.30, P <0.01) with suturing speed. CONCLUSIONS: Surgeon variables play a significant role in speed of acquisition and performance of LS skills. Further studies need to elucidate their role in quality of LS performance.

Adult↗

PubMed2000

Experience and visual perception in resident acquisition of laparoscopic skills.

Assess the role of experience and visual perception (VP) in resident acquisition of laparoscopic surgical skills (LSS).Thrity-nine residents (20 PGY-1s tested just before starting residency; 19 PGY 3+) completed an LSS course, including examination of course-specific knowledge before and after didactic tutorials, 10 trials of 3 dexterity drills and suturing, and 3 standardized VP tests.Mean speed increased significantly (p < 0.001) across trials for all dexterity drills and suturing. Senior residents performed suturing trials 1 to 4 significantly faster (p < 0.05) than did PGY 1's (M +/- SD averaged across trials 1 to 4: 166.5 +/- 59.9 vs 252.3 +/- 108.2 seconds, p < 0.01). Group differences on later trials were progressively smaller and nonsignificant, as were all group differences on dexterity drills. Significant correlations between VP and speed on drills ranged from (r = -0.41, p < 0.01) to (r = -0.71, p < 0.001). Visual perception did not correlate significantly with suturing speed; neither pretest nor posttest scores correlated significantly with drill or suturing speeds.Residents at all levels can significantly increase LSS performance speed to comparable levels during a brief intensive skills course. Proficiency in specific aspects of VP is directly associated with performance speed on dexterity drills, shown in previous studies to be fundamental in the development of intracorporeal suturing skill. (Curr Surg 57:368-372. Copyright 2000 by the Association of Program Directors in Surgery.)

Journal Article↗

PubMed1995

Nutritional support during pulmonary failure.

Malnutrition is both a cause and a result of pulmonary failure. A successful outcome to the treatment of pulmonary failure often hinges on appropriate and aggressive nutritional therapy. Metabolic stresses caused by nutritional therapeutic intervention in the patient with pulmonary failure must be anticipated.

Humans↗

PubMed1994

Abdominal wall hernias in ESRD patients receiving peritoneal dialysis.

The study was designed to investigate the incidence of abdominal wall hernias (AWH) and related outcome in all end-stage renal disease (ESRD) patients who started peritoneal dialysis (PD) from January 1989 to December 1993. Between January 1989 and December 1993, a total of 158 ESRD patients (93 male, 65 female) entered our home program and were treated with peritoneal dialysis (PD) over 2789 patient-months. All PD catheters were placed in the lateral by two dedicated surgeons. AWH detected at the time of PD catheter placement was repaired simultaneously. The hernia repair was done using a polypropylene mesh. Inguinal hernias were noted by patients as a mass or discomfort. Umbilical and incisional hernias were observed during clinic visits. Twenty-one (13.3%) abdominal wall hernias were observed in 20 patients (12.7%). Eight (38.1%) inguinal hernias occurred in 8 male patients. Six inguinal hernias were repaired. PD was resumed after a mean of 12 days of hernia repair. Two patients resumed PD in 8 and 14 days without dialysis. One patient transferred to hemodialysis (HD) due to catheter malfunction. No complications occurred related to inguinal hernias. Ten (47.6%) umbilical hernias were observed in 10 patients (7 male, 3 female). The strangulation of umbilical hernias occurred in 2 patients, which required emergency small bowel resection and hernia repair. Both cases were complicated by candida peritonitis and enterobacter peritonitis, requiring PD catheter removal, and patients were then transferred to HD. Three (14.3%) incisional hernias were observed in 3 male patients. Two incisional hernias were repaired. No relation between AWH and PD modalities (CAPD/CCPD/IPD) was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗

PubMed1986

The fate of transposed immature muscle and its clinical application.

Transposition of muscles with their intact neurovascular bundles is a well-accepted procedure in the adult with a predictable outcome. The fate of transposed immature muscle, however, has not been studied. For this reason, muscles were transposed in three 6-week-old puppies and harvested when the puppies were 6 months old. The developing normal and transposed muscles were studied using serial biopsies, electromyography, and histochemical methods, and the growth in bulk was assessed by serial radiography and measurements of length, breadth, height, and weight of the muscles at death. As judged by these criteria, the transposed muscle developed normally. A patient with prune-belly syndrome, treated by muscle transpositions from thigh to abdomen with satisfactory results, is also described.

Aging↗