Biomedical subjects
Publications and source records attributed to Robert J Hamilton.
The most common cause of a retained Foley catheter is failure of the balloon to deflate. If noninvasive means are unsuccessful, balloon puncture is required. We present a safe and efficient technique using flexible video cystoscopy for balloon puncture and removal of any free fragments formed.
Wait times for radical prostatectomy are increasing in Canada. However, the impact of adopting a new surgical technique, such as laparoscopic radical prostatectomy (LRP), is not known. We outline the determinants of surgical wait time, the potential impact of adopting LRP and ways to minimize the impact. Surgical wait time is determined by surgical demand (number of people wanting surgery) relative to supply (number of surgeries a centre is able to offer). The introduction of any new technique will at first prolong operative times, but the degree to which it does is dependent on the learning curve of the surgeon and perioperative team. The influence of this learning curve on wait times depends on surgeon-level factors including case selection, triaging and scheduling tendencies, as well as hospital-level factors such as the amount and flexibility of operating room and hospital resources. The impact of adopting new technology may be minimized by the following: one surgeon per group initially learns the new procedure; the group and learning surgeon continue to offer the conventional procedure; early procedural experiences with the new technique are made as homogenous as possible; and a constant, dedicated team is created. Thus, the potential benefits of new techniques like LRP may be realized when adopted in a way that minimizes a negative impact on surgical wait times.
OBJECTIVE: To assess the readiness of the Canadian otolaryngology community for an on-line continuing medical education (CME) program. METHODS: Data were obtained through surveys mailed to members of the Canadian Society of Otolaryngology-Head and Neck Surgery. RESULTS: Two hundred and eight of 321 (65%) surveys were returned. Seventy-six percent of the respondents indicated that they would be interested in participating in an on-line CME course. A greater proportion of younger otolaryngologists and those with community-based practices were interested in participating. A greater number of those with an academic practice were found to have convenient access to the Internet, the ability to post images on-line, and encountered cases they felt worthy of discussion and were willing to instruct/facilitate future on-line CME. Ninety-three percent of respondents described having easy access to the Internet, but only 32% said that they have the equipment necessary to post computed tomographic scans/audiograms on-line. Twenty-three percent had previous computer-based CME experience. Sinusitis and related topics were of greatest interest, with hearing loss/ear surgery and oncology following respectively. CONCLUSIONS: The data suggest that on-line CME would be welcomed and are feasible in the Canadian otolaryngology community.