Surgery resident @AaronGilani asked why people close the fascia of trocar sites with a figure-of-eight suture instead of a horizontal mattress. Let us look at these briefly via one of my experiments. (1/ )

There has been a lot of buzz after @elonmusk said @Tesla Optimus robots could replace surgeons in 2 to 3 years. The timeline is unrealistic but the direction is not wrong. Let us be honest. Surgical technical skill is replaceable. There is enormous variability across humans and robotics has the potential to level that playing field by offering consistency endurance and precision that humans simply cannot match at scale. That excites me. And this is not just about hands. There is also real variability in surgical decision making. When to proceed when to pause when to stop. AI driven systems can help here too by integrating data pattern recognition and probabilistic guidance in ways humans do not always do well under pressure. In many ways that could make surgery better and safer. Where the hype still gets ahead of reality is full autonomy in the face of true uncertainty. Surgery is filled with moments that are hard to model. Unexpected bleeding anomalous anatomy subtle tissue cues and the judgment of when risk has crossed a line. We are likely decades away if we ever get there from fully outsourcing that responsibility. So no surgeons are not disappearing anytime soon. But surgical skill absolutely is becoming more replaceable. The future is robotics doing more and humans remaining accountable. @EricTopol @grahamwalker @daniel_kraft

The dying specialty of “General Surgery”, as noted by authors from each and every decade over the last 100 years.

A statue of The Predator from ‘PREDATOR: KILLER OF KILLERS’ at the film’s premiere.

I’m sharing an actual recent peer-to-peer call that shows what physicians and patients face when trying to get a surgery approved. This call felt as absurd as it sounds. The peer-to-peer call was to advocate for surgery to prevent and treat lymphedema for a patient with breast cancer. Her risk is high and we can perform a surgery to lower it. The doctors from the insurance company on the call were an ophthalmologist with a subspecialty in oculoplastic surgery and a plastic surgeon who currently has a cosmetic practice. Neither doctor has ever performed lymph venous bypass…the surgery I was trying to get approved for my patient. Neither doctor would provide their name or license number. At the conclusion of the call, the doctors told me that they didn’t have the power to make a determination or decision to perform the surgery. They were just there to inform me of United’s decision to deny it. The Medical Decision was not up to the doctors on the call. It had already been made by United. So here I am, appealing again. Medical decisions should be made by doctors who are well informed and patient-centered. Patients deserve access to the care that they paid for with their premiums.

How long do foods stay in your stomach?

Open cholecystectomy