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Colorectal resections for malignancy: A pilot study comparing conventional vs freehand robot-assisted laparoscopic colectomy

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World Journal of Clinical Cases 2024年第3期12卷 488-494页

作者： shamir.o cawich Joseph Martin Plummer Sahle Griffith Vijay Naraynsingh Department of Surgery University of the West IndiesSt AugustineTrinidad and Tobago Department of General Surgery and Consultant General and Colorectal Surgeon Department of SurgeryUniversity of the West IndiesKingstonKIN7Jamaica Department of Surgery Queen Elizabeth HospitalBridgetownBarbados Department of Surgery Port of Spain General HospitalPort of SpainTrinidad and Tobago

BACKGRoUND Laparoscopic colectomy is widely accepted as a safe operation for colorectal cancer,but we have experienced resistance to the introduction of the FreeHandffrobotic camera holder to augment laparoscopic colorectal *** To compare the initial results between conventional and FreeHandffrobot-assisted laparoscopic colectomy in Trinidad and *** This was a prospective study of outcomes from all laparoscopic colectomies per-formed for colorectal carcinoma from November 29,2021 to May 30,*** following data were recorded:operating time,conversions,estimated blood loss,hospitalization,morbidity,surgical resection margins and number of nodes *** data were entered into an excel database and the data were analyzed using SPSS ver *** There were 23 patients undergoing colectomies for malignant disease:8(35%)FreeHandff-assisted and 15(65%)conventional laparoscopic *** were no *** time was significantly lower in patients under-going robot-assisted laparoscopic colectomy(95.13±9.22 vs 105.67±11.48 min;P=0.045).otherwise,there was no difference in estimated blood loss,nodal harvest,hospitalization,morbidity or *** The FreeHandffrobot for colectomies is safe,provides some advantages over conventional laparoscopy and does not compromise oncologic standards in the resource-poor Caribbean setting.

关键词： Laparoscopic Colectomy Robot Surgery Minimally invasive

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Liver surface depressions in the presence of diaphragmatic muscular bands on trans-illumination

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World Journal of Experimental Medicine 2024年第2期14卷 5-10页

作者： shamir.o cawich Michael T Gardner Ramanand Shetty Jean Pierre Louboutin Zenica Dabichan Shaneeta Johnson Department of Surgery University of the West IndiesSt AugustineTrinidad and Tobago Section of Anatomy Department of Basic Medical SciencesUniversity of the West IndiesKingston KIN7Jamaica Department of Surgery Morehouse School of MedicineAtlantaGA 30310United States

Traditional descriptions of liver anatomy refer to a smooth,convex surface contacting the *** depressions are recognized anatomic *** are many theories to explain the cause of the *** discuss the theory that these are... 详细信息

关键词： Liver Anatomy Depressions Fissure Groove Sulcus Variant

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Hepatic grooves:An observational study at laparoscopic surgery

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World Journal of Experimental Medicine 2024年第2期14卷 97-102页

作者： shamir.o cawich Dexter A Thomas Fawwaz Mohammed Michael T Gardner Marlene Craigie Shaneeta Johnson Ramnanand S Kedambady Department of Surgery University of the West IndiesSt Augustine 000000Trinidad and Tobago Department of Surgery Port of Spain General HospitalPort of Spain 000000Trinidad and Tobago Section of Anatomy Basic Medical SciencesUniversity of the West IndiesKingston 000000Jamaica Department of Radiology University of the West IndiesKingston 000000Jamaica Department of Surgery Morehouse School of MedicineAtlantaGA 30310United States Section of Anatomy Department of Basic Medical SciencesUniversity of the West IndiesKingston KIN7Jamaica

BACKGRoUND In traditional descriptions,the upper surface of the liver is smooth and convex,but deep depressions are variants that are present in 5%-40%of *** sought to determine the relationship between surface depressions and the *** To use exploratory laparoscopy to determine the relationship between surface depressions and the *** An observational study was performed in all patients undergoing laparoscopic upper gastro-intestinal operations between January 1,2023 and January 20,2024.A thirty-degree laparoscope was used to inspect the liver and *** surface depressions were present,we recorded patient demographics,presence of diaphragmatic bands,rib protrusions and/or any other source of compression during *** of 394 patients,343 had normal surface anatomy,and 51(12.9%)had prominent surface depressions on the *** was no significant relationship between the presence of surface depressions and gender nor the presence of rib ***,there was significant association between the presence of surface depressions and diaphragmatic muscular bands(PoNCLUSIoN With these data,the diaphragmatic-band theory has gained increased importance over other theories for surface *** studies are warranted using cross sectional imaging to confirm relationships with intersectional planes as well as beta-catenin assays in the affected liver parenchyma.

关键词： Liver Variant Vein Hepatic Surgery

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Rescue from complications after pancreaticoduodenectomies at a low-volume Caribbean center:Value of tailored peri-pancreatectomy protocols

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 681-688页

作者： shamir.o cawich Elijah Dixon Parul J Shukla Shailesh V Shrikhande Rahul R Deshpande Fawwaz Mohammed Neil W Pearce Wesley Francis Shaneeta Johnson Johann Bujhawan Department of Surgery University of the West IndiesSt Augustine 000000Trinidad and Tobago Department of Surgery Faculty of MedicineUniversity of CalgaryCalgaryAlberta T2N2T9Canada Department of Surgery Weill Cornell Medical CollegeNew YorkNY 10065United States Department of Surgical oncology Tata Memorial CenterHomi Bhabha National UniversityMumbai 400012India Department of Surgery Manchester Royal InfirmaryManchester M139WLUnited Kingdom University Surgical Unit Southampton General HospitalSouthampton SO166YDUnited Kingdom Department of Surgery University of the West IndiesNassau N-1184Bahamas Department of Surgery Morehouse School of MedicineAtlantaGA 30310United States Department of Surgery General Hospital in Port of SpainPort of Spain 000000Trinidad and Tobago

BACKGRoUND Pancreaticoduodenectomy(PD)is a technically complex operation,with a re-latively high risk for *** ability to rescue patients from post-PD complications is as a recognized quality *** protocols were instituted at our low volume facility in the year *** To document the rate of rescue from post-PD complications with tailored protocols in place as a measure of *** A retrospective audit was performed to collect data from patients who experienced major post-PD complications at a low volume pancreatic surgery unit in Trinidad and Tobago between January 1,2013 and June 30,***-dardized definitions from the International Study Group of Pancreatic Surgery were used to define post-PD complications,and the modified Clavien-Dindo classification was used to classify post-PD *** over the study period,113 patients at a mean age of 57.5 years(standard deviation[SD]±9.23;range:30-90;median:56)underwent PDs at this *** complications were recorded in 33(29.2%)patients at a mean age of 53.8 years(SD:±7.9).Twenty-nine(87.9%)patients who experienced major morbidity were salvaged after aggre-ssive treatment of their ***(3.5%)died from bleeding pseudoaneurysm(1),septic shock secondary to a bile leak(1),anastomotic leak(1),and myocardial infarction(1).There was a significantly greater salvage rate in patients with American Society of Anesthesiologists scores≤2(93.3%vs 25%;P=0.0024).CoNCLUSIoN This paper adds to the growing body of evidence that volume alone should not be used as a marker of quality for patients requiring *** low volumes at our facility,we demonstrated that 87.9%of patients were rescued from major *** attributed this to several factors including development of rescue protocols,the competence of the pancreatic surgery teams and continuous,and adaptive learning by the entire institution,cul-minating in the development of tailored peri-pancreatectomy protoc

关键词： Pancreas Complication Rescue Failure Morbidity Mortality Pancreaticoduodenectomy

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Acceleration of solar wind particles due to inertial Alfvén waves

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Communications in Theoretical Physics 2024年第6期76卷 137-141页

作者： Kiran Batool Imran A Khan M shamir Abdul Kabir S Ayaz Theoretical Physics Department National Centre for PhysicsIslamabad 44000Pakistan Department of Space Sciences Institute of Space TechnologyIslamabad 44000Pakistan Space and Astrophysics Research Lab(SARL) National Center of GIS and Space Applications(NCGSA)Islamabad 44000Pakistan Salam Chair Department of PhysicsGC University LahoreKatchery RoadLahorePunjab 54000Pakistan Department of Space Science and CSPAR University of Alabama in HuntsvilleHuntsvilleAL 35899United States of America

Gaining an understanding of the effects and dynamics of the solar wind is crucial for the study of space weather,Earth's magnetosphere,spacecraft protection,the dynamics of the Solar System,and various other *** show that Alfvén waves effectively transfer energy to resonant *** study demonstrates how inertial Alfvén waves deliver their energy to resonant plasma particles in different solar environments under certain *** analysis shows that inertial Alfvén waves experience more rapid damping with increasing parallel wavenumber,ambient magnetic field strength,and particle number density,coupled with a decrease in *** rate of energy transfer to resonant particles intensifies with higher temperatures and reduced parallel wavenumber and particle number *** with higher initial velocities actively participate in Landau damping,especially in regions with a stronger ambient magnetic field.

关键词： solar wind inertial Alfven waves resonant particles

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A simple method for pulse contrast enhancement via self-focusing

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High Power Laser Science and Engineering 2024年第2期12卷 51-61页

作者： Zaharit Refaeli Gilad Marcus Yariv shamir Applied Physics Division Soreq NRCYavneIsrael Applied Physics Institute The Hebrew UniversityThe Edmond J.Safra Campus-Givat RamJerusalemIsrael

Here we report on a simple-to-implement and cost-effective approach for laser pulse contrast enhancement,based on the χ(3)nonlinear self-focusing *** intentionally induced and gently controlled self-focusing in a thin glass transforms the time-dependent intensity into variation in beam *** by a spatial discriminating filter,only the strongly focused fraction traverses the setup,at the expense of efficiency.A numerical model,accounting for the pulse and material parameters via a Gaussian ABCD matrix,provides an estimate for the instantaneous beam waist and transmission efficiency,which enables us to evaluate the resulting contrast *** estimated contrast enhancement spans between 0.5 and 2.5 orders of magnitude,in conjunction with approximately 25%–90%estimated efficiency,depending on the pulse *** a preliminary experiment we demonstrated the effect with 10s-μJ sub GW regime with approximately 40%efficiency and a contrast improvement of more than or equal to 20 dB.

关键词： nonlinear optics pulse contrast self-focusing ultrafast laser

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Role of oral antibiotics for prophylaxis against surgical site infections after elective colorectal surgery

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World Journal of Gastrointestinal Surgery 2017年第12期9卷 246-255页

作者： shamir.o cawich Sachin Teelucksingh Samara Hassranah Vijay Naraynsingh Department of Clinical Surgical Sciences University of the West IndiesSt.Augustine CampusTrinidad and TobagoWest Indies

over the past few decades, surgeons have made many attempts to reduce the incidence of surgical site infections(SSI) after elective colorectal surgery. Routine faecal diversion is no longer practiced in elective colonic surgery and mechanical bowel preparation is on the verge of being eliminated altogether. Intravenous antibiotics have become the standard of care as prophylaxis against SSI for elective colorectal operations. However, the role of oral antibiotics is still being debated. We review the available data evaluating the role of oral antibiotics as prophylaxis for SSI in colorectal surgery.

关键词： Colorectal Anastomosis Leak Antibiotics Bowel preparation

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Whipple’s operation with a modified centralization concept:A model in low-volume Caribbean centers

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World Journal of Clinical Cases 2022年第22期10卷 7620-7630页

作者： shamir.o cawich Neil W Pearce Vijay Naraynsingh Parul Shukla Rahul R Deshpande Department of Clinical Surgical Sciences University of the West IndiesSt Augustine 000000Trinidad and Tobago University Surgical Unit Southampton General HospitalSouthampton SO166YDUnited Kingdom Department of Surgery Weill Cornell Medical CollegeNew YorkNY 10065United States Department of Surgery Manchester Royal InfirmaryManchester M139WLUnited Kingdom

Conventional data suggest that complex operations,such as a pancreaticoduodenectomy(PD),should be limited to high volume ***,this is not practical in small,resource-poor countries in the *** these settings,patients have no option but to have their PDs performed locally at low volumes,occasionally by general *** this paper,we review the evolution of the concept of the high-volume center and discuss the feasibility of applying this concept to low and middle-income ***,we discuss a modification of this concept that may be considered when incorporating PD into low-volume and resource-poor countries,such as those in the *** paper has two ***,we performed a literature review evaluating studies published on outcomes after PD in high volume *** data in the Caribbean is then examined and we discuss the incorporation of this operation into resource-poor hospitals with modifications of the centralization *** the authors’opinions,most patients who require PD in the Caribbean do not have realistic opportunities to have surgery in high-volume centers in developed *** these settings,their only options are to have their operations in the resource-poor,low-volume settings in the ***,post-operative outcomes may be improved,despite low-volumes,if a modified centralization concept is encouraged.

关键词： Pancreas Surgery Pancreatectomy Whipple’s Pancreaticoduodenectomy

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Clinical outcomes after major hepatectomy are acceptable in low-volume centers in the Caribbean

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World Journal of Hepatology 2019年第2期11卷 199-207页

作者： shamir.o cawich Ravi Maharaj Vijay Naraynsingh Neil Pearce Wesley Francis Kimon o Bonadie Dexter A Thomas Department of Clinical Surgical Sciences University of the West Indies Department of Surgery University Hospital Southampton NHS Trust Department Surgery University of the West Indies Department Surgery Cayman Islands Health Service Authority

BACKGRoUND Major hepatectomies are routinely performed because they are often the only curative treatment for metastatic liver *** has been a trend to concentrate major hepatectomies in referral hospitals that perform these operations at high *** high volume referral centers are usually located in developed countries,but many patients in developing nations are not able to access these centers because of financial limitations,lack of social support and/or travel ***,local hospitals are often the only options many of these patients have for surgical treatment of metastatic liver *** is the situation in many Caribbean *** To determine the clinical outcomes after major liver resections in a low-resource hepatobiliary center in the *** We prospectively studied all patients who underwent major liver resections over five *** following data were extracted:patient demographics,diagnoses,ECoG status,operation performed,post-operative morbidity and *** analyses were performed using SPSS ver 16.0 RESULTSThere were 69 major liver resections performed by two teams at a mean case volume of 13.8 major resections/***-nine major hepatic resections were performed for:colorectal liver metastases 40(58%),non-colorectal metastases 9(13%),hepatocellular carcinoma 8(11.6%),ruptured adenomas 4(5.8%),hilar cholangiocarcinomas 4(5.8%),hemangiomata 2(2.9%),trauma 1(1.5%) and hepatoblastoma 1(1.5%).Twenty-one patients had at least one complication,for an overall morbidity rate of 30.4%.There were minor complications in 17(24.6%)patients,major complications in 11(15.9%) patients and 4(5.8%) *** There are unique geographic,political and financial limitations to healthcare delivery in the ***,clinical outcomes are acceptable in the established,low-volume hepatobiliary centers in the Eastern Caribbean.

关键词： Liver Surgery Resection Caribbean Volume outcomes

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Review of minimally invasive pancreas surgery and opinion on its incorporation into low volume and resource poor centres

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World Journal of Gastrointestinal Surgery 2021年第10期13卷 1122-1135页

作者： shamir.o cawich Michael D Kluger Wesley Francis Rahul R Deshpande Fawwaz Mohammed Kimon o Bonadie Dexter A Thomas Neil W Pearce Beth A Schrope Clinical Surgical Sciences University of the West IndiesTunapuna 331333Trinidad and Tobago Department of Surgery New York Presbyterian Hospital/Columbia University Medical CenterNew YorkNY 10032United States Department of Surgery University of the West IndiesNassau N-1184Bahamas Department of Surgery Manchester Royal InfirmaryManchester M139WLUnited Kingdom Department of Clinical Surgical Sciences University of the West IndiesTunapuna 331333Trinidad and Tobago Department of Surgery Health Service AuthorityGeorgetown 915 GTCayman Islands Department of Surgery Southampton General HospitalSouthampton SO166YDUnited Kingdom Department of Surgery Columbia University College of Physicians and SurgeonsNew YorkNY 10032United States

Pancreatic surgery has been one of the last areas for the application of minimally invasive surgery(MIS)because there are many factors that make laparoscopic pancreas resections *** concept of service centralization has also limited expertise to a small cadre of high-volume centres in resource rich ***,this is not the environment that many surgeons in developing countries work *** patients often do not have the opportunity to travel to high volume centres for ***,we sought to review the existing data on MIS for the pancreas and to *** this paper,we review the evolution of MIS on the pancreas and discuss the incorporation of this service into low-volume and resource-poor countries,such as those in the *** paper has two ***,we performed a literature review evaluating all studies published on laparoscopic and robotic surgery of the *** data in the Caribbean is examined and we discuss tips for incorporating this operation into resource poor hospital *** pancreatic case volume in the Caribbean,and financial barriers to MIS in general,laparoscopic distal pancreatectomy,enucleation and cystogastrostomy are feasible operations to integrate in to a resource-limited healthcare *** is because they can be performed with minimal to no consumables and require an intermediate MIS skillset to complement an open pancreatic surgeon’s peri-operative experience.

关键词： Pancreas Surgery Laparoscopic Minimally invasive Pancreatectomy Whipple’s Pancreaticoduidenectomy

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