Restricting proteins and amino acids from patients' diets in the days leading up to surgery may lower complication risks, say researchers at the Harvard School of Public Health in Boston.

About 40% of mice that ate normally 6 to 14 days before being subjected to surgical stress died, according to their study, which appears in the Jan. 25 issue of the journal Science Translational Medicine. All of the mice that ate a diet free of proteins and amino acids survived, however.

"Food restriction as a way to increase stress resistance may seem counterintuitive, but in fact our data indicate that the well-fed state is the one more susceptible to (complications)," says James Mitchell, one of the study's authors and assistant professor of genetics and complex diseases at HSPH.

In addition, the researchers determined that the pathway responsible for sensing amino acid deficiencies was responsible for the purported benefits of an amino acid-free diet. They believe drugs that target the pathway - not limiting amino acid intake - could help lower complication risks.

Mr. Mitchell and his fellow researchers have made plans with colleagues at Boston's Brigham and Women's Hospital to see if their study's results translate to human patients. If the benefits of a restrictive diet are confirmed, say the researchers, surgical complication risks could be significantly reduced.

Daniel Cook

Men expecting quicker returns to physical activity after robotic prostate surgery may have unrealistic expectations for the procedure, according to research from Duke University Medical Center.

The researchers surveyed 171 men about their expectations heading into prostate cancer surgery. Of the 97 men who had opted for robotic surgery, 89% said they expected to stay just 1 night in the hospital, versus 37% of men having traditional surgery. The robotic surgery group also thought they would be back to exercising in about 5 weeks, compared to 6 weeks in the other group. The study's authors noted that robotic surgery may have short-term advantages such as somewhat shorter hospital stays, but there's no real evidence that robotic-surgery patients fare better in terms of cancer recurrence or long-term side effects like urine leakage and erectile dysfunction.

Compared to the type of surgery, a surgeon's experience performing prostate surgeries is typically a better indicator of the procedure's likelihood for success, according to Judd Moul, MD, prostate surgeon at Duke and the study's lead researcher. A surgeon's experience with prostate surgery "is what drives the long-term outcomes of urinary and sexual recovery of function," says Dr. Moul. A doctor who performs at least 40 to 75 prostate procedures of a specific kind - robotic or traditional - annually would be considered "experienced," he adds.

Mark McGraw

"Today more than ever, you need to be certain you're getting your money's worth for every minute your staff are on the clock," says Donna Ferguson, RN, MBA, the outpatient surgery and GI lab director at Henry Mayo Newhall Memorial Hospital in Valencia, Calif.

She shares some advice on fiscally efficient workflow that has worked for her in the "Staffing" column of January's issue of Outpatient Surgery Magazine, including ideas for optimizing schedules, multitasking and budgeting salary costs.

David Bernard

Which of the Republican presidential candidates - Newt Gingrich, Mitt Romney, Ron Paul or Rick Santorum - will face incumbent Barack Obama in the general election later this year? Cast your vote in this week's InstaPoll.

A recent study of female nurses found that more than half (55%) were overweight or obese. We asked last week which work-related factor is most to blame for nursing's weight problem. Nearly 60% of 583 respondents cited a combination of such factors as long work hours shift work and job stress.