Roux-en-Y gastric bypass is an effective treatment for severe obesity and obesity-related comorbi... more Roux-en-Y gastric bypass is an effective treatment for severe obesity and obesity-related comorbidities. Presently, gastric bypass is performed most often laparoscopically, although a robotic-assisted procedure is the preferred approach for an increasing number of bariatric surgeons. This retrospective study compared the results of 100 Roux-en-Y gastric bypass operations using the da Vinci robot and 100 laparoscopic Roux-en-Y gastric bypasses performed laparoscopically. Short-term outcomes were determined by evaluating mortality, length of stay, length of operation, return to the operating room within 90 days of operation, conversions to open procedure, leaks, strictures, transfusions, and hospital readmissions. There was no mortality, pulmonary embolus, or conversion to open procedure in either group. Both the laparoscopic and robotic operative times decreased progressively, although the robotic operation time was longer (mean, 144 versus 87 min, P < 0.001). The length of stay was shorter for the robotic-assisted group (37 versus 52 h, P < 0.001), and 60% of these patients were discharged after one night's stay (P < 0.001). There were fewer transfusions (P = 0.005) and readmissions (P = .560) in the robotic group. The stricture rate was higher in the first 50 robotic procedures (17 mm gastrotomy) but resolved in the second 50 procedures (21 mm gastrotomy). There was no difference in the rate of leak and return to the operating room between groups (both P > 0.05). These results indicate that Roux-en-Y gastric bypass can be performed safely with robotic assistance, even during the first 100 cases.
Past experience has shown that introducing new Information Technologies can have unintended and u... more Past experience has shown that introducing new Information Technologies can have unintended and undesirable consequences, such as new forms of errors and a narrowing of data search activities. Eight Incident Commanders (ICs) took part in a simulated disaster response exercise to determine how the availability of real-time image feeds from a UAV impact on situation assessment and decision-making. The exercise simulated the video feed from an unmanned aerial vehicle (UAV) that allows incident command centers to monitor developments at a crisis site. The results showed that information from the video image channel dominated information available from other channels or in other forms. Nearly all of the ICs failed to detect important changes in the situation that were not captured in the imaging channel but that were available via other, more traditional data sources. The dominance of the image feed resulted in ICs narrowing their data search activities and reducing cross-checking across diverse data sources. This study confirms anecdotal reports that users can over-rely on video feeds from UAVs.
Roux-en-Y gastric bypass is an effective treatment for severe obesity and obesity-related comorbi... more Roux-en-Y gastric bypass is an effective treatment for severe obesity and obesity-related comorbidities. Presently, gastric bypass is performed most often laparoscopically, although a robotic-assisted procedure is the preferred approach for an increasing number of bariatric surgeons. This retrospective study compared the results of 100 Roux-en-Y gastric bypass operations using the da Vinci robot and 100 laparoscopic Roux-en-Y gastric bypasses performed laparoscopically. Short-term outcomes were determined by evaluating mortality, length of stay, length of operation, return to the operating room within 90 days of operation, conversions to open procedure, leaks, strictures, transfusions, and hospital readmissions. There was no mortality, pulmonary embolus, or conversion to open procedure in either group. Both the laparoscopic and robotic operative times decreased progressively, although the robotic operation time was longer (mean, 144 versus 87 min, P < 0.001). The length of stay was shorter for the robotic-assisted group (37 versus 52 h, P < 0.001), and 60% of these patients were discharged after one night's stay (P < 0.001). There were fewer transfusions (P = 0.005) and readmissions (P = .560) in the robotic group. The stricture rate was higher in the first 50 robotic procedures (17 mm gastrotomy) but resolved in the second 50 procedures (21 mm gastrotomy). There was no difference in the rate of leak and return to the operating room between groups (both P > 0.05). These results indicate that Roux-en-Y gastric bypass can be performed safely with robotic assistance, even during the first 100 cases.
Past experience has shown that introducing new Information Technologies can have unintended and u... more Past experience has shown that introducing new Information Technologies can have unintended and undesirable consequences, such as new forms of errors and a narrowing of data search activities. Eight Incident Commanders (ICs) took part in a simulated disaster response exercise to determine how the availability of real-time image feeds from a UAV impact on situation assessment and decision-making. The exercise simulated the video feed from an unmanned aerial vehicle (UAV) that allows incident command centers to monitor developments at a crisis site. The results showed that information from the video image channel dominated information available from other channels or in other forms. Nearly all of the ICs failed to detect important changes in the situation that were not captured in the imaging channel but that were available via other, more traditional data sources. The dominance of the image feed resulted in ICs narrowing their data search activities and reducing cross-checking across diverse data sources. This study confirms anecdotal reports that users can over-rely on video feeds from UAVs.
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The exercise simulated the video feed from an unmanned aerial vehicle (UAV) that allows incident command centers to monitor developments at a crisis site. The results showed that information from the video image channel dominated information available from other channels or in other forms. Nearly all of the ICs failed to detect important changes in the situation that were not captured in the imaging channel but that were available via other, more traditional data sources. The dominance of the image feed resulted in ICs narrowing their data search activities and reducing cross-checking across diverse data sources. This study confirms anecdotal reports that users can over-rely on video feeds from UAVs.
The exercise simulated the video feed from an unmanned aerial vehicle (UAV) that allows incident command centers to monitor developments at a crisis site. The results showed that information from the video image channel dominated information available from other channels or in other forms. Nearly all of the ICs failed to detect important changes in the situation that were not captured in the imaging channel but that were available via other, more traditional data sources. The dominance of the image feed resulted in ICs narrowing their data search activities and reducing cross-checking across diverse data sources. This study confirms anecdotal reports that users can over-rely on video feeds from UAVs.