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Female Surgeon Speaks Out Against Sexual Harassment in the OR
Christina Jenkins SPEAKING OUT Christina Jenkins, MD, says she was subjected to suggestive comments throughout her surgical residency.

Christina Jenkins, MD, was mortified when an attending surgeon leaned in close over the OR table and said she knew "how to spread good." At the time, she was expanding a surgical clamp underneath a skin graft during one of the first cases she performed as a surgical resident.

It was the first, but unfortunately not the last, time Dr. Jenkins would be subjected to sexually suggestive comments and advances from her superiors. Her chief resident allegedly said he could ease some of her workplace demands if she agreed to have sex with him. Dr. Jenkins, who says she was subjected to numerous other lewd comments during her residency, didn't report the incidences because she was afraid speaking up would lead to more stress during an extremely stressful time in her training and prevent her from receiving recommendation letters she needed to further her career.

Dr. Jenkins, who is now a colorectal surgeon and faculty member at Loma Linda (Calif.) University Medical Center, is one of several surgeons and nurses who shared their sexual harassment stories with NBC News. She's now wondering, along with countless other women in health care, when medicine's #MeToo moment will happen.

Elizabeth Raskin, MD, a colorectal surgeon who works with Dr. Jenkins at Loma Linda Medical Center, says she also put up with lewd comments when she began working in the OR as a surgical tech. She's now determined to be part of a revolution that ends surgery's male-dominated culture and wants to protect all female healthcare workers from sexual harassment.

"In the wrong hands, power manifests as overreaching power, which will dictate what's going on outside of the operating room," she told NBC News. "It's made me realize what I don't want to be like and to be an advocate for women."

Daniel Cook

Not 1, But 2 Sponges Left Inside Woman From Separate Surgeries 3 Years Apart
Two Sponges BLOATING A woman felt abdominal bloating for 3 years because of 2 retained sponges.

Doctors who were investigating the cause of a patient's bloating made a shocking discovery recently — 2 surgical sponges that had been left in the woman's abdomen from 2 separate C-sections.

The first sponge was left in the 42-year-old woman's abdomen 9 years ago, when she had a cesarean section at a Japanese hospital, according to a study on the finding, which was published in the February edition of the New England Journal of Medicine. Three years later, she went back to the same hospital for another cesarean section and again, a surgical sponge was left in her abdomen. The study did not name the hospital where the procedures took place or who was responsible for the retained objects.

For 6 and 9 years those sponges stayed inside the woman, until she went to Chiba University Hospital, in Chiba, Japan, complaining of abdominal bloating, which she'd been experiencing for 3 years, the study said.

Doctors did abdominal radiographs and computed tomography of the woman's abdomen and found 2 dense, stringy objects. When they performed a laparotomy, they found the sponges, which were smooth and partially adhered to the colon and greater omentum. Doctors removed the sponges and the patient recovered, relieved of her bloating, in 5 days.

Anna Merriman

Surgical Site Infections Often Follow Gastrointestinal Surgery
Infection RESIST Researchers found that about one-fifth of SSIs from GI surgery were resistant to pre-op antibiotics.

More than 10% of patients worldwide who underwent gastrointestinal surgeries ended up with surgical site infections (SSI), according to a study published in The Lancet Infectious Diseases.

Patients in 66 countries were surveyed between January and July of 2016 following emergency or elective gastrointestinal surgery. Gallbladder and appendix removal were the most common surgeries performed in the study. Respondents were organized into high-, middle- and low-income countries and tracked to see if they developed an SSI within 30-days of surgery.

The results varied with the country's income status. Patients from 30 high-income countries had fewer instances of SSIs (9%) whereas; patients from 18 low-income countries had 23% of SSIs. On average, patients with SSIs had hospital stays 3 times longer than those without infections.

The study also found that 22% of all the reported SSIs were resistant to the antibiotics given during pre-op. Patients in low-income countries had the highest incidence of resistance (36%) while high-income countries had the lowest rate (17%).

When researchers looked into possible causes of the disparity they found that patients in low-income countries were given antibiotics at a much higher rate pre- and post-op (96% and 86%, respectively) than in high-income countries (88% and 46%, respectively).

"These findings begin to characterize the relationship between surgical site infections and global antimicrobial resistance," says Ewen M. Harrison, MB ChB, PhD, FRCS, National Institute of Health Research Unit on Global Surgery at the University of Edinburgh, United Kingdom. "Worldwide, large amounts of antibiotics were consumed to prevent and treat surgical site infections, yet in a fifth of cases the causative microorganism was resistant to the pre-surgery antibiotics given, and this increased to 1 of 3 cases in low-income countries. This high prevalence illustrates a potentially important area for improvement worldwide."

JoEllen McBride

Instapoll: How Many Surgical Publications Do You Read Each Month?

There are lots of perioperative print publications out there. Tell us in this week's InstaPoll how many you read each month.

More than two-thirds (67%) of the 449 respondents to last week's poll use "wheels in the room" to measure on-time starts. "Surgeon cut time" was next at 24%. The results:

How do you define an on-time start?

  • wheels in the room 67%
  • induction of anesthesia 7%
  • surgeon cut time 24%
  • we don't track late starts 2%

Dan O'Connor

News & Notes
  • Surgeon cleared of strangling nurse A New York district court judge has dropped criminal charges against New York bariatric surgeon Venkatesh Sasthakonar, MD, who was accused of strangling a nurse with a drawstring from his sweatshirt. The judge dismissed the case after witness interviews and surveillance video did not provide enough evidence that a crime had occurred.
  • Ophthalmologist gets 17 years in prison for Medicare fraud Florida ophthalmologist Salomon Melgen, MD, was sentenced to 17 years in prison for falsely diagnosing and treating dozens of elderly patients for wet macular degeneration in what the judge called, "one of the biggest Medicare fraud cases in the nation." Prosecutors say Dr. Melgen, 63, stole $73 million from Medicare by persuading elderly patients to undergo painful eye procedures that they didn't need. A judge also ordered Dr. Melgen to pay $42.6 million in restitution to Medicare. If his name sounds familiar, it's likely because Dr. Melgen was Sen. Bob Menendez's co-defendant on separate bribery charges.
  • Standardized protocols for complex surgeries lead to better outcomes A written, standardized protocol helped a safety-net hospital in Florida perform a highly complex surgery with fewer complications and shorter hospital stays than the national average. The University of Florida Health in Jacksonville's protocol details everything necessary to perform an esophagectomy, from planning and scheduling of the operation to the post-op follow-up. Of the 78 esophagectomies performed over 3.5 years, the center had a an average hospital stay almost 3 days shorter than the national average and a complication rate of 16.7% compared to 33.3% nationally.