Filippo Filicori's research while affiliated with Lenox Hill Hospital and other places
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Publications (24)
Background
Surgical video recording provides the opportunity to acquire intraoperative data that can subsequently be used for a variety of quality improvement, research, and educational applications. Various recording devices are available for standard operating room camera systems. Some allow for collateral data acquisition including activities of...
Background: Prior studies on technical skills use small collections of videos for assessment. However, there is likely heterogeneity of performance among surgeons and likely improvement after training. If technical skill explains these differences, then it should vary among practicing surgeons and improve over time. Materials and Methods: Sleeve ga...
Background:
The Global Evaluative Assessment of Robotic Skills (GEARS) rubric provides a measure of skill in robotic surgery. We hypothesize surgery performed by more experienced operators will be associated with higher GEARS scores.
Method:
Patients undergoing sleeve gastrectomy from 2016 to 2020 were analyzed. Three groups were defined by time...
Introduction
The relationship between intraoperative surgical performance scores and patient outcomes has not been demonstrated at a single-case level. The GEARS score is a Likert-based scale that quantifies robotic surgical proficiency in 5 domains. Given that even highly skilled surgeons can have variability in their skill among their cases, we h...
Background
Evaluation of robotic surgical skill has become increasingly important as robotic approaches to common surgeries become more widely utilized. However, evaluation of these currently lacks standardization. In this paper, we aimed to review the literature on robotic surgical skill evaluation.
Methods
A review of literature on robotic surgi...
Background
Recording intraoperative videos has become commonplace during surgery, with applications in video-based assessment, education and research. These videos can be both manually and automatically analyzed for performance analysis. A number of commercial entities providing video acquisition and processing has flourished over the recent years....
Introduction
Gender bias has been identified consistently in written performance evaluations. Qualitative tools may provide a standardized way to evaluate surgical skill and minimize gender bias. We hypothesized that there is no difference in operative time or GEARS scores in robotic hysterectomy for men vs women surgeons.
Methods
Patients undergo...
Background: The growing interest in analysis of surgical video through machine learning has led to increased research efforts; however, common methods of annotating video data are lacking. There is a need to establish recommendations on the annotation of surgical video data to enable assessment of algorithms and multi-institutional collaboration. M...
Introduction
Operative time has been traditionally used as a proxy for surgical skill and is commonly utilized to measure the learning curve, assuming that faster operations indicate a more skilled surgeon. The Global Evaluative Assessment of Robotic Skills (GEARS) rubric is a validated Likert scale for evaluating technical skill. We hypothesize th...
Bariatric surgery allows for rapid, often sustained weight loss and effective treatment of the comorbidities associated with morbid obesity. Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are the most common bariatric surgical procedures performed in the United States. Leaks, fistulas, and strictures are complications that can occur in...
Introduction
Laparoscopic paraesophageal hernia (PEH) is associated with a low morbidity and mortality but an objective hernia recurrence rate in excess of 50% at 5 years. Biologic mesh has not been shown to reduce hernia recurrence rates. Recently, a new bioresorbable mesh made with poly-4-hydroxybutyrate with a Sepra-Technology coating on one sid...
Background
Optimal treatment for symptomatic patients with non-achalasia motility disorders (NAD) such as diffuse esophageal spasm, esophagogastric junction outlet obstruction, and hypercontractile disorder is not well established. POEM has been offered to these patients since it is a less invasive and less morbid procedure but long-term outcomes r...
Background
Little is known about the initial development and natural history of a hiatal hernia.
Methods
A database containing 12,050 upper gastrointestinal (UGI) studies dating from 1991 to 2013 was queried to identify patients that had more than one study a minimum of 5 years apart showing a hernia. The x-ray films or digital images were reviewe...
Citations
... The relative paucity of imaging data of Esophagectomy cases, compared to previously investigated procedures, force the community to look creatively at related procedures and investigate similar target features to address. Moreover, the definition of target features and appropriate annotation guidelines for such procedures require careful consideration to be simultaneously clinically relevant as well as applicable to ML algorithms [17]. ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/272535820435488-1441989011837_Q64/Guy-Rosman.jpg)
![[object Object]](https://i1.rgstatic.net/ii/profile.image/287173954818048-1445479014349_Q64/Maria-Altieri.jpg)
... Whilst the use of robotic surgery is increasing in clinical practice, training in robotic surgery and robotic skill assessments continue to require fundamental standardisation [20,21]. For efficiency purposes, standardised robotic skill assessments should be readily available, operation-specific, objective and reproducible [20]. ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/731431168905217-1551398188284_Q64/Paul-Chung.jpg)
... Patients younger than 18 years old were also excluded. GEARS scores were assigned through crowd-sourced evaluators by a third party; the methodology has been previously described by this group [10,11]. Patient identifying information is captured and encrypted with a one-way hashing algorithm. ...
... While common sense suggests that better skilled surgeons will have better postoperative outcomes, there is surprisingly little literature that tests this hypothesis [1]. Given the constraints of data sharing and patient privacy [2], currently available studies tend to summarize a surgeon's technical skill and correlate that score with their overall outcomes [1,3]. We hypothesized that at a patient level, how well a particular operation is performed will correlate with their postoperative outcomes. ...
... 14 While operative time is the most common intra-operative proxy measure of operative skill currently used in learning curve studies, 2 the relationship between these two variables is less than certain. 15 Rather than focusing on intra-operative patient outcomes or error rates, observed performance rated using validated assessment tools is a feasible approach to learning curve generation. Such data has been generated using the Procedure-Based Assessment (PBA) tool in the United Kingdom 16e18 ; the development of Entrustable Professional Activity (EPA) assessments should allow for similar data collection in the United States. ...
... In this context, the significance of synthetic long-term absorbable materials remains unclear. Recent retrospective cohort studies have shown promising results, but long-term follow-up is currently not available [18][19][20]. Augmentation of the lower esophageal sphincter is a frequently performed adjunct to pHH repair and was formally "recommended" by our participants. Our results confirm recent data from the multi-institutional HERNIAMED registry reporting additional sphincter augmentation in paraesophageal hernia repair in 60-70% [8,21]. ...
... Surgical intervention is the standard of care with a myotomy. A laparoscopic Heller myotomy (LHM) has been used for over 30 years, but there has been a surge of Per-oral Endoscopic Myotomy (POEM). These procedures have proven to have comparable symptomatic improvement in recent studies [9][10][11][12]. ...
... Peroral endoscopic myotomy (POEM) is an accepted treatment modality for achalasia [1]. However, postoperative pain, mainly related to CO 2 insufflation causing pneumothorax, pneumomediastinum, and pneumoperitoneum, occurs in 25 % -85 % of patients [2,3]. ...
Reference: Underwater peroral endoscopic myotomy
