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Self-Assessment Questions

General Surgery

Minimally Invasive Surgery: Review Questions

S. Mahmood Zare, MD

Dr. Zare is director of minimally invasive surgery, Boston VA Healthcare System,
and assistant professor of surgery, Boston University, Boston, MA.

Choose the single best answer for each question.

1. Which of the following statements regarding surgery for morbid obesity is correct?
  1. Average 30-day mortality ranges from 0.1% to 1.1%
  2. Among major comorbidities that are resolved or improved by surgery, obstructive sleep apnea is least frequently affected
  3. Compared with an open approach, laparoscopic gastric bypass is associated with lower incidence of incisional hernias and higher excess weight loss achieved after 3 years
  4. Biliopancreatic diversion is associated with significant postoperative morbidity and mortality and should be reserved for patients who fail to achieve weight loss with restrictive operations
  5. Adjustable gastric banding results in 60% to 70% excess weight loss and is an effective alternative to gastric bypass
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2. All of the following statements regarding laparoscopic inguinal hernia repair are correct EXCEPT

  1. Systemic antibiotic prophylaxis given within 60 minutes of incision does not significantly reduce the incidence of surgical site infection (SSI) postsurgery
  2. Postsurgical complications correlate with surgeon’s level of frustration during surgery but not with the level of satisfaction at completion of surgery
  3. Laparoscopic repair as compared with open repair is associated with a higher recurrence rate after 2 years regardless of the surgeon’s age
  4. Surgeon inexperience is an independent risk factor for recurrence of hernia
  5. As compared with transabdominal preperitoneal (TAPP) repair, totally extraperitoneal (TEP) repair is associated with lower rates of port-site hernias and visceral injuries
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3. Which of the following statements regarding laparoscopic-assisted colectomy is correct?
  1. Quality-of-life outcomes measured 2 months postsurgery are improved as compared with open colectomy
  2. Although the average number of lymph nodes dissected with the laparoscopic approach is lower than that of open colectomy, survival at 3 years is similar between the 2 approaches
  3. The rate of cancer recurrence in surgical wounds is similar to that of the open approach
  4. Although many outcomes are similar, the cost of surgery and the total cost to society are higher for the laparoscopic-assisted versus the open approach
  5. Operating times are similar for laparoscopic-assisted and open colectomy
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