Claim OwnershipReally Rural Surgery and Obstetrics podcast
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Description
Really Rural Surgery and Obstetrics is an educational medical podcast series. The show's intention is to analyze relevant surgical and obstetrical studies in the context of rural surgery and obstetrics. While its intended audience is Enhanced Surgical Skills family physicians and rural obstetrics providers, the content is relevant to anyone participating in surgery and OB in rural and remote areas.
63 Episodes
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In this episode, Dr. Kermode and Dr. Batchelor look into whether we need sterile gloves, or whether we can simply use clean gloves for ambulatory care procedures.
In this episode, Dr. Kermode and Dr. Batchelor discuss the environmental footprint of disposable gowns vs. reusable (washable) gowns. We discuss some complex topics and mathematical equations that we don't really understand, but in the end we do come to a conclusion.Vozzola E, Overcash M, Griffing E. An Environmental Analysis of Reusable and Disposable Surgical Gowns. AORN J. 2020 Mar;111(3):315-325. doi: 10.1002/aorn.12885. PMID: 32128776.Link to article: https://pubmed.ncbi.nlm.nih.gov/32128776/
In this episode, Dr. Kermode and Dr. Batchelor discuss a new hot topic in the OR, the environment. We start with comparing disposable gowns to reusable gowns in regard to their ability to repel what they claim they will repel. In the next episode, we'll discuss which has less of an environmental impact.
Resources for this episode:
McQuerry M, Easter E, Cao A. Disposable versus reusable medical gowns: A performance comparison. Am J Infect Control. 2021 May;49(5):563-570. doi: 10.1016/j.ajic.2020.10.013. Epub 2020 Oct 20. PMID: 33091509; PMCID: PMC7572274.
Vozzola E, Overcash M, Griffing E. An Environmental Analysis of Reusable and Disposable Surgical Gowns. AORN J. 2020 Mar;111(3):315-325. doi: 10.1002/aorn.12885. PMID: 32128776.
In this episode I am joined by the legend that is Dr. Cameron Molder and his studious medical student, Callum Hicks, to discuss whether leaving the testicular end of the vas deferens open during a vasectomy prevents congestive epididymitis.
Resources for this episode:
Moss WM. A comparison of open-end versus closed-end vasectomies: a report on 6220 cases. Contraception. 1992 Dec;46(6):521-5. doi: 10.1016/0010-7824(92)90116-b. PMID: 1493712.
Dr. Kermode and Dr. Batchelor discuss fecal calprotectin in the office for those patients who have chronic diarrhea. Is it a useful test to rule in or rule out IBD?
Resources for this episode:
Freeman K, Willis BH, Fraser H, Taylor-Phillips S, Clarke A. Faecal calprotectin to detect inflammatory bowel disease: a systematic review and exploratory meta-analysis of test accuracy. BMJ Open. 2019 Mar 8;9(3):e027428. doi: 10.1136/bmjopen-2018-027428. PMID: 30852550; PMCID: PMC6429840.
In this episode, we dive into hernia fixation techniques.
Resources for this episode:
Jiang WR, Zhang XB, Wang R, Cao D, Yu YJ. Mesh fixation techniques in Lichtenstein tension-free repair: a network meta-analysis. ANZ J Surg. 2022 Oct;92(10):2442-2447. doi: 10.1111/ans.17730. Epub 2022 Apr 16. PMID: 35429222.
In this episode, we delve into the age old practice of putting tape on your string when closing incisions vs just using string itself.
Resources for this episode:
Raja BS, Choudhury AK, Paul S, Gowda AKS, Kalia RB. No Additional Benefits of Tissue Adhesives for Skin Closure in Total Joint Arthroplasty: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Arthroplasty. 2022 Jan;37(1):186-202. doi: 10.1016/j.arth.2021.07.012. Epub 2021 Jul 31. PMID: 34419313.
Custis T, Armstrong AW, King TH, Sharon VR, Eisen DB. Effect of Adhesive Strips and Dermal Sutures vs Dermal Sutures Only on Wound Closure: A Randomized Clinical Trial. JAMA Dermatol. 2015 Aug;151(8):862-7. doi: 10.1001/jamadermatol.2015.0174. PMID: 25875131; PMCID: PMC4982140.
In this episode, Dr. Batchelor and Dr. Kermode discuss if you burn someone, does it hurt more than if you simply just cut them?
Resources for this episode:
Elbohoty AE, Gomaa MF, Abdelaleim M, Abd-El-Gawad M, Elmarakby M. Diathermy versus scalpel in transverse abdominal incision in women undergoing repeated cesarean section: A randomized controlled trial. J Obstet Gynaecol Res. 2015 Oct;41(10):1541-6. doi: 10.1111/jog.12776. PMID: 26446416.
Ismail A, Abushouk AI, Elmaraezy A, Menshawy A, Menshawy E, Ismail M, Samir E, Khaled A, Zakarya H, El-Tonoby A, Ghanem E. Cutting electrocautery versus scalpel for surgical incisions: a systematic review and meta-analysis. J Surg Res. 2017 Dec;220:147-163. doi: 10.1016/j.jss.2017.06.093. Epub 2017 Jul 26. PMID: 29180177.
Image credit: "Dragon-forged" by billrdio is licensed under CC BY-NC-SA 2.0.
In this episode, Dr. Batchelor and Dr. Kermode try to figure out whether, in light of advances in optics (see what I did there?), does the Seattle Protocol still remain supreme?
Resources for this episode:
Nachiappan A, Ragunath K, Card T, Kaye P. Diagnosing dysplasia in Barrett's oesophagus still requires Seattle protocol biopsy in the era of modern video endoscopy: results from a tertiary centre Barrett's dysplasia database. Scand J Gastroenterol. 2020 Jan;55(1):9-13. doi: 10.1080/00365521.2019.1706762. Epub 2019 Dec 27. PMID: 31880176.
Alves JR, Graffunder FP, Rech JVT, Ternes CMP, Koerich-Silva I. DIAGNOSIS, TREATMENT AND FOLLOW-UP OF BARRETT'S ESOPHAGUS: A SYSTEMATIC REVIEW. Arq Gastroenterol. 2020 Jul-Sep;57(3):289-295. doi: 10.1590/S0004-2803.202000000-53. PMID: 33027480.
In this episode, Dr. Kermode and Dr. Batchelor try to answer a clinical question about diagnosing microscopic colitis, but end up answering a different question.
Resources for this episode:
Kamp EJ, Kane JS, Ford AC. Irritable Bowel Syndrome and Microscopic Colitis: A Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol. 2016 May;14(5):659-68.e1; quiz e54-5. doi: 10.1016/j.cgh.2015.09.031. Epub 2015 Nov 19. PMID: 26453949.
Kagueyama FM, Nicoli FM, Bonatto MW, Orso IR. Importance of biopsies and histological evaluation in patients with chronic diarrhea and normal colonoscopies. Arq Bras Cir Dig. 2014 Jul-Sep;27(3):184-7. doi: 10.1590/s0102-67202014000300006. PMID: 25184768; PMCID: PMC4676365.
In this episode, Dr. Batchelor and Dr. Kermode discuss the eternal question—whether to leave a hemorrhoidectomy open, or to close it.
Resources for this episode:
Arroyo A, Pérez F, Miranda E, Serrano P, Candela F, Lacueva J, Hernández H, Calpena R. Open versus closed day-case haemorrhoidectomy: is there any difference? Results of a prospective randomised study. Int J Colorectal Dis. 2004 Jul;19(4):370-3. doi: 10.1007/s00384-003-0573-1. Epub 2004 Mar 25. PMID: 15170517.
Bhatti MI, Sajid MS, Baig MK. Milligan-Morgan (Open) Versus Ferguson Haemorrhoidectomy (Closed): A Systematic Review and Meta-Analysis of Published Randomized, Controlled Trials World J Surg. 2016 Jun;40(6):1509-19. doi: 10.1007/s00268-016-3419-z. PMID: 26813541.
In this episode, Dr. Batchelor and Dr. Kermode discuss the optimal location of biopsy and how many biopsy specimens are required to make a diagnosis for Celiac disease.
Resources for this episode:
McCarty TR, O'Brien CR, Gremida A, Ling C, Rustagi T. Efficacy of duodenal bulb biopsy for diagnosis of celiac disease: a systematic review and meta-analysis. Endosc Int Open. 2018 Nov;6(11):E1369-E1378. doi: 10.1055/a-0732-5060. Epub 2018 Nov 7. PMID: 30410959; PMCID: PMC6221829.
Pais WP, Duerksen DR, Pettigrew NM, Bernstein CN. How many duodenal biopsy specimens are required to make a diagnosis of celiac disease? Gastrointest Endosc. 2008 Jun;67(7):1082-7. doi: 10.1016/j.gie.2007.10.015. Epub 2008 Mar 4. PMID: 18308317.
The ARRIVE Trial (A Randomized Trial of Induction Versus Expectant Management) has arrived on Really Rural Surgery and Obstetrics! This week, Dr. Bret Batchelor is joined by Dr. Nicole Ebert and Alexa Stang to discuss this ground-breaking, breath-taking, earth-quaking article.
Resources for this episode:
https://pubmed.ncbi.nlm.nih.gov/30089070/
In this episode Dr. David Kermode and Dr. Bret Batchelor discuss whether medical or surgical treatment is better for chronic anal fissures.
Resources for this episode:
Acar T, Acar N, Güngör F, Kamer E, Genç H, Atahan K, et. al. 2020. Comparative efficacy of medical treatment versus surgical sphincterotomy in the treatment of chronic anal fissure. Niger J Clin Prac 23: 539-44.
In this episode, Dr. David Kermode and Dr. Bret Batchelor try to figure out if ultrasound is good when a person presents with symptoms of an inguinal hernia, but no hernia on palpation.
Resources for this episode:
Kwee, RM and Kwee, TC. 2018. Ultrasonography in diagnosing clinically occult groin hernia: systematic review and meta-analysis. European Radiology 28(11): 4550-4560. DOI: 10.1007/s00330-018-5489-9
In this episode, Dr. Batchelor discusses COVID19, the novel coronavirus at the heart of the current global pandemic, with Revelstoke, BC jouralist, Shaun Aquiline
In this episode, Dr. Batchelor is joined by an astute resident, Dr. Lauren Galbraith, to discuss whether there is any benefit from the use of local anaesthetic for post-operative pain reduction in elective caesarean sections.
Resources for this episode:
Fouladi, RF, Navali, N. and Abbassi, A. 2013. Pre-incisional, post-incisional and combined pre- and post-incisional local wound infiltrations with lidocaine in elective caesarean section delivery: a randomised clinical trial. J Obstet Gynaecol 33(1):54-9. doi: 10.3109/01443615.2012.719945.
Bamigboye, AA and Hoffmeyer, JG. 2009. Local anaesthetic wound infiltration and abdominal nerves block during caesarean section for postoperative pain relief. Cochrane Database Syst Rev. (3):CD006954. doi: 10.1002/14651858.CD006954.pub2.
In this episode, Dr. Batchelor and Dr. Fine try to figure out what to do for term PROM (prelabour rupture of membranes): Something? Nothing? Something now? Something later? Nothing now? Nothing later? A bit now? A bit later...
Resources for this episode:
PROM CPG Working Group. Association of Ontario Midwives. Management of Prelabour Rupture of Membranes at Term. Clinical Practice Guideline No. 13, May 2014.
Middleton P, Shepherd E, Flenady V, McBain RD, and Crowther CA. 2017. Planned early birth versus expectant management (waiting) for prelabour rupture of membranes at term (37 weeks or more). Cochrane Database of Systematic Reviews (1): Art. No.: CD005302. doi: 10.1002/14651858.CD005302.pub3
In this episode, Dr. Batchelor, Dr. Wells and Dr. Kermode discuss the option of salpingectomy at caesarean section as opposed to tubal ligation for sterilization. Can this harrowing procedure be performed routinely and safely in the future?
Resources for this episode:
Ferrari F, Forte S, Prefumo F, Sartori E, and Odicino F. 2019. Opportunistic salpingectomy during postpartum contraception procedures at elective and unscheduled cesarean delivery. Contraception 99(6): 373-376. doi: 10.1016/j.contraception.2019.03.041.
Subramaniam A, Blanchard CT, Erickson BK, Szychowski J, Leath CA, Biggio JR, and Huh WK. 2018. Feasibility of Complete Salpingectomy Compared With Standard Postpartum Tubal Ligation at Cesarean Delivery: A Randomized Controlled Trial. Obstet Gynecol 132(1): 20-27. doi: 10.1097/AOG.0000000000002646
In this episode, Dr. Kermode and Dr. Batchelor attempt to determine whether the tried and true (open) reigns supreme for inguinal hernia repairs, or whether tech (laparoscopic) has taken the lead.
Resources for this episode:
Scheuermann U, Niebisch S, Lyros O, Jansen-Winkeln B and Gockel I. 2017. Transabdominal Preperitoneal (TAPP) versus Lichtenstein operation for primary inguinal hernia repair – A systematic review and meta-analysis of randomized controlled trials. BMC Surgery 17:55. doi: 10.1186/s12893-017-0253-7
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