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Thu Mar 29 19:23:26 BST 2007

Really? That's not my understanding of "acute care surgery."  The acute care
surgeon (which is all I've ever known since graduating from Univ of Miami's
program in 1980) would essentially become the surgical hospitalist as part
of an "emergency surgical service" that does trauma, manages the ICU and
covers emergency general surgery. I sincerely doubt that the current concept
would also lead to expertise in advanced laparoscopic surgery. Those that
chose the laparoscopic route won't immerse themselves in our world and we
won't be part of theirs. This will all lead to further compartmentalization
and balkanization of surgery. Frankly, I am not a proponent of this trend.

Jeffrey Hammond MD, MPH
Chief, Trauma/Surgical Critical Care
Robert Wood Johnson Medical School
New Brunswick, NJ
ph: 732-235-7920
e-mail: hammond at umdnj.edu

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Kashuk, Jeffry
Sent: Thursday, March 29, 2007 10:58 AM
To: Trauma &amp; Critical Care mailing list
Subject: RE: Extinction of Non laparoscopic surgeons

This is precisely why the Acute Care Surgery paradigm is so important.
The comprehensive surgeon in this arena needs to know "maximally invasive"
as well as minimally invasive techniques... 
Jeffry L. Kashuk, M.D, FACS
Surgery, Trauma, Surgical Critical Care
Denver Health Medical Center
777 Bannock St, MC 0206
Denver, CO 80204
Ph 303-436-6558
Fax 303-436-6572

-----Original Message-----
From: Jeffrey Hammond [mailto:hammond at umdnj.edu]
Sent: Wednesday,March 28,2007 11:28 AM
To: 'Trauma &amp; Critical Care mailing list'
Subject: RE: Extinction of Non laparoscopic surgeons

Those of us over 50 are beginning to joke that we'll soon need a Fellowship
in "Open Surgery." Meanwhile, we are now graduating residents who have had
limited experience in things we once considered not only bread and butter
(e.g. gastric surgery) but also a required skill set (e.g.CBD explorations).
I wonder how they'll get out of trouble when we're old and they're operating
on us!

Jeffrey Hammond MD, MPH
Chief, Trauma/Surgical Critical Care
Robert Wood Johnson Medical School
New Brunswick, NJ
ph: 732-235-7920
e-mail: hammond at umdnj.edu

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org]
On Behalf Of Ronald Gross
Sent: Wednesday, March 28, 2007 9:28 AM
To: Trauma &amp; Critical Care mailing list
Subject: RE: Extinction of Non laparoscopic surgeons

Tim,

Not even in elective surgery - someone is going to have to know how to
operate on the complications encountered by the video-laparoscopic surgeon
who doesn't know how to operate under direct vision, or how to open the
cavity he/she has placed a scope into!  

Geez - did I really say what I was thinking???

Best wishes,
Ron

>>> "Hardcastle, Tim, Dr <tch at sun.ac.za>" <tch at sun.ac.za> 3/28/2007
>>> 10:14 AM >>>
Dr Khattar

Extinct in elective surgery maybe......Trauma and emergency general surgery
and in countries where the socio-economic conditions are poor - not likely!
We need to have surgeons who can feel comfortable in all cavities and with
all techniques; this is the palce of the Trauma/Acute Care general surgeon.

Regards
Tim
Dr T C Hardcastle
M.B.,Ch.B.(Stell); M.Med(Chir); FCS(SA)
Senior Surgeon / Senior Lecturer: Surgery (Trauma and ICU) ATLS instructor
and DSTC Cape Town Course Director Intern program Coordinator: Surgery M.Med
(Emergency Medicine) Executive Committee member Clinical Head
(Director):
Diana Princess of Wales Trauma Unit Division of Surgery (General) Room
4064
Department of Surgical Sciences Tygerberg Hospital / University of
Stellenbosch PO Box 19063 Tygerberg 7505 Western Cape South Africa
e-mail: tch at sun.ac.za
Cell: +27824681615
Office: +27219389281 or 4911 pager 0302

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org]On Behalf Of rm khattar
Sent: Wednesday, March 28, 2007 2:46 PM
To: trauma-list at trauma.org
Subject: Extinction of Non laparoscopic surgeons

I recently came across  book on laparoscpy in Urologic malignancies in which
authors claimed that non laparoscopic surgeons would become history.What is
the opinion of leaders in trauma surgery like Karim,Ken,ERF,Tim on this
issue? I am and doing predominantly open surgery and do not see this
happening at least in next 20 years.

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Extinction of Non laparoscopic surgeons