Shannon A Fraser

McGill University | McGill · Division of General Surgery

We consider a surgical case scheduling problem with the objective of minimizing the expected time span of the schedule subject to a prespecified upper bound on the expected waiting time for each patient. The problem is challenging due to its combinatorial and nonlinear nature, and we focus on developing approximate methods to solve the problem. Spe...

Background The objective of this study is to explore the association between frailty and surgical recovery over a 6-month period, in elderly patients undergoing elective abdominal surgery. Methods A total of 144 patients were categorized as frail, pre-frail, and non-frail based on five criteria: weight loss, exhaustion, weakness, slowness, and low...

Background: Malnutrition among elderly surgical patients has been associated with poor postoperative outcomes and reduced functional status. Although previous studies have shown that nutrition contributes to patient outcomes, its long-term impact on functional status requires better characterization. This study examines the effect of nutrition on...

While the negative impact of postoperative complications on hospital costs, survival, and cancer recurrence is well known, few studies have quantified the impact of postoperative complications on patient-centered outcomes such as functional status. The objective of this study was to estimate the impact of postoperative complications on recovery of...

The objective of this randomized, controlled trial was to assess whether voluntary participation in a proctored, proficiency-based, virtual reality robotic suturing curriculum using the da Vinci® Skills Simulator™ improves robotic suturing performance. Residents and attending surgeons were randomized to participation or non-participation during a 5...

The purpose of this study was to determine the proportion of symptomatic recurrence following initial non-operative management of gallstone disease in the elderly and to test possible predictors. This is a single institution retrospective chart review of patients 65 years and older with an initial hospital visit (V1) for symptomatic gallstone disea...

Post-operative delirium in elderly patients is associated with higher mortality and longer lengths of stay. This prospective observational study investigated the incidences of preoperative mild cognitive impairment (MCI) and post-operative delirium among elderly patients undergoing elective surgery at the authors’ institution, the relationship betw...

The ability to measure surgical quality of care is important and can lead to improvements in patient safety. As such, processes should be carried out in an identical fashion for all patients, regardless of how vulnerable or complex they are. Our objectives were to assess quality of surgical care delivered to elderly patients and to determine the as...

In this paper, we evaluate face, content and construct validity of the da Vinci Surgical Skills Simulator (dVSSS) across 3 surgical disciplines. In total, 48 participants from urology, gynecology and general surgery participated in the study as novices (0 robotic cases performed), intermediates (1-74) or experts (≥75). Each participant completed 9...

Background Measuring quality of surgical care is essential to identifying areas of weakness in the delivery of effective surgical care and to improving patient outcomes. Our objectives were 1) to assess the quality of surgical care delivered to adult patients and 2) to determine the association between quality of surgical care and post-operative co...

What is the source of inadequate performance in the operating room? Is it a lack of technical skills, poor judgment or a lack of procedural knowledge? We created a surgical procedural knowledge (SPK) assessment tool and evaluated its use. We interviewed medical students, residents and training program staff on SPK assessment tools developed for 3 d...

The purpose of this study was to describe Canadian general surgery residents' perceptions regarding potential implementation of work-hour restrictions. An ethics review board-approved, Web-based survey was submitted to all Canadian general surgery residency programs between April and July 2009. Questions evaluated the perceived effects of an 80-hou...

New surgical techniques should be formally evaluated for feasibility and safety. As a model for this evaluation, this study examines the authors' institution's experience with splenectomy for benign and malignant hematologic disease since the introduction of laparoscopic splenectomy (LS) in 1996. The authors present the evaluation of the recognized...

This study aimed to describe the differences in the management of symptomatic gallstone disease within different elderly groups and to evaluate the association between older age and surgical treatment. This single-institution retrospective chart review included all patients 65 years old and older with an initial hospital visit for symptomatic galls...

Convict cichlids (Cichlasoma nigrofasciatum) exhibit extended biparental care of their young. Parents will adopt unrelated (foreign) conspecific young of similar size to or smaller than their own but reject larger foreign young. Adoption of smaller foreign young may benefit the parents by reducing loss of their own young to predators by the dilutio...

Gastrectomy or truncal vagotomy is known to increase the incidence of cholelithiasis. Many of these patients will become symptomatic, and the adhesions from their gastric resection may make laparoscopic cholecystectomy much more difficult. We prospectively assessed the data for the 15-year cumulative laparoscopic cholecystectomy experience of 1 sur...

Although the "learning curve" is commonly analyzed by splitting the data into arbitrary chunks of experience, this does not allow for precise estimation of where the curve plateaus or the rate at which learning is achieved. Our objective was to describe a simple way to characterize the learning curve for a fundamental laparoscopic task. Sixteen med...

The Global Operative Assessment of Laparoscopic Skill (GOALS) has been shown to meet high standards for direct observation. The purpose of this study was to investigate the reliability and validity of GOALS when applied to blinded, videotaped performances. Five novice surgeons and 5 experienced surgeons were each evaluated by 2 observers during a l...

Although pneumoperitoneum (PP) decreases renal blood flow, it remains unclear whether this impacts renal function. Our aim was to characterize the effects of PP on renal perfusion and function using two fluid strategies for intravenous fluid administration. Twelve 30-kg pigs were randomized into two groups: maintenance (3 cc/kg/h of normal saline (...

Hobnail hemangioendothelioma is a rare vascular neoplasm that belongs to the category of vascular neoplasms of borderline (or low-grade) malignancy, defined by a significant potential for local recurrence but very low numbers of metastatic or fatal events. It is typically found in the skin, and rarely in the oral mucosa of children and young adults...

The psychomotor challenges inherent in laparoscopic surgery are evident by the steep procedural "learning curves" documented throughout the literature. Few methods have been described to evaluate learning curves. The cumulative summation (CUSUM) method is a criterion-based evaluation of the learning process. The purpose of this study is to describe...

To assess the McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS) physical laparoscopic simulator for construct and predictive validity and for its educational utility. MISTELS is the physical simulator incorporated by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) in their Fundamentals of...

The McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS) was developed to assess laparoscopic skills and to score them objectively. This system has been described previously. The purpose of the current study was to determine a pass/fail threshold. In this study, 165 individuals were tested and grouped according to th...

Small bowel obstruction (SBO) is a particularly vexing problem in the postoperative period. The goal of this study was to compare the results of operative versus nonoperative treatment. A secondary goal was to explore risk factors for necessitating reoperation in the immediate postoperative period. We conducted a historical cohort retrospective cha...

The adoption of unrelated young by brood-guarding convict cichlid (Cichlasoma nigrofasciatum) parents is influenced by several factors. Three of these are the risk of intrabrood aggression, the risk of differential predation of their own young, and the trade-off between the benefits of brood dilution and the costs of differential predation. This st...

Convict cichlids (Cichlasoma nigrofasciatum) are substrate-brooding fish, native to Central America, with extended biparental care of young. Parents in the field and laboratory readily adopt foreign young of similar size to or smaller than their own, but usually reject larger foreign young. Under certain circumstances, the adoption of unrelated you...

A physical surgical simulator, the McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS) is used to examine the acquisition of laparoscopic skills, as well as to determine a summative evaluation of these skills. The cumulative summation method (CUSUM) is used to characterize individual and group learning curves for a...