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In This Issue of JAMA Surgery
April 2017


JAMA Surg. 2017;152(4):313. doi:10.1001/jamasurg.2016.3422


Traditionally, surgical trainees acquire technical and nontechnical skills in the operating room, but resident operative time is decreasing. Hu and colleagues developed a coaching intervention in which 10 senior residents reviewed an intraoperative video post hoc with the operative attending surgeon. Qualitative and quantitative analyses demonstrated that teaching during coaching was more individualized to each resident and focused on higher-level concepts such as decision making.

Invited Commentary


It is unknown whether pancreatic fistula rates and other major outcomes are different between robotic vs open pancreatoduodenectomies (PDs). McMillan et al compared 185 robotic PDs from 1 institution with 2661 open PDs from 17 institutions worldwide using propensity score matching in a noninferiority study. Patients undergoing a robotic PD demonstrated similar clinically relevant fistula and other major complication rates compared with patients in the open PD cohort.

Invited Commentary

Gastric banding and bypasses show differences in weight loss and the secretion of gut hormones, including glucagon-like peptide 1. This study by Egeberg et al was composed of 13 435 Danish patients undergoing bariatric surgery from 1997 to 2011. Gastric bypass surgery, but not gastric banding, showed a decreased risk and improved prognosis of psoriatic disease. This may be because of postoperative weight loss differences as well as differences in the secretion of anti-inflammatory hormones.

Invited Commentary


Recent randomized clinical trials questioned the oncological safety of laparoscopy for rectal cancer. Martínez-Pérez et al conducted a systematic review and meta-analysis of randomized clinical trials comparing pathological outcomes of laparoscopic vs open rectal resections for rectal cancer. Based on 14 randomized clinical trials including 4034 patients, a significantly higher rate of noncomplete mesorectal excisions was found following laparoscopic vs open surgery.

Clinical Review & Education

With an increase in the demand for gender confirmation surgery, surgeons need to be part of a health care team familiar with the comprehensive needs of transgender individuals. This review article, based on the global education initiative of the World Professional Association for Transgender Health, provides valuable information to surgeons of all disciplines and other health care clinicans to help guide the treatment and management of transgender individuals.

CME and Author Audio Interview