💬 Viewpoint: Required transportation escorts after outpatient surgery may delay care and worsen access for patients with limited social support, transportation insecurity, or privacy concerns. ja.ma/4rT57DB

Among patients with #GastricCancer and positive peritoneal lavage cytology or localized peritoneal metastasis, #chemotherapy plus #gastrectomy was associated with better survival than gastrectomy alone or chemotherapy alone. ja.ma/47pUOxL

New #NationalInstitutesOfHealth awards to surgeon-scientists declined in 2025, driven mainly by fewer new R01 awards, while K awards remained stable. ja.ma/4rFZfxD

Among injured patients, Black patients were less likely to receive some #PrehospitalCare interventions, and these disparities were not significantly explained by neighborhood social determinants of health. ja.ma/3ThUvl8

For benign and low-grade #PancreaticHead tumors, enucleation was associated with more clinically relevant postoperative pancreatic fistula vs pancreatoduodenectomy, but fewer major complications and shorter hospitalization. ja.ma/3ThIZpT

In resectable #EsophagealCancer, robotic minimally invasive esophagectomy yielded more resected lymph nodes vs conventional minimally invasive esophagectomy, with similar postoperative complications and 1-year survival. ja.ma/4xXO2Kq

In prospective hepatobiliary #LaparoscopicSurgery videos, automated skill scores aligned more closely with expert ratings than scores from resident and attending surgeons. ja.ma/4iPemlO

AI-Driven Video-Based Surgical Skill Assessment in Hepatobiliary Laparoscopic Surgery

This quality improvement study evaluates the use of a video-based artificial intelligence framework that uses multi-instrument tracking and clinically informed spatiotemporal kinematic features to provide objective, granular assessment of laparoscopic cholecystectomy skill.

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In #AI-generated letters for surgical trainees, 4 large language models used more agentic descriptors for male-gendered vs female-gendered names based on the same curriculum vitae. ja.ma/3VLFNU4

In private payer data, complex procedures in The Transforming Episode Accountability Model by @CMSGov were associated with more intensive care unit use, readmissions, and postacute care, but hospital payments often did not increase proportionally. ja.ma/4x5kDNL

Operative Complexity and Surgical Episode Payments Among Private Payers

This cohort study analyzes the rate of paid claims for Transforming Episode Accountability Model procedures coded as having increased operative services and their associated payments to evaluate the need for operative complexity risk adjustment.

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Among surgical faculty at 10 US medical centers, 41.1% reported seriously considering leaving, most often associated with unhappiness with leadership or governance, lacking work-life balance, and burnout. ja.ma/47dOYz7

Older age, elective surgery, open approach, and longer operative time were associated with greater likelihood of #Opioid prescribing at discharge in pediatric surgical care. ja.ma/3TgraHx

Pediatric Opioid Prescribing at Discharge by Surgical Subspecialty

This cohort study examines postoperative opioid prescribing across pediatric surgical subspecialties and identifies the groups most likely to receive opioids after undergoing a surgical procedure.

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In academic #Surgery, about 4 in 10 faculty surveyed were considering leaving their current job. Departmental governance, work-life balance, and burnout were leading factors, discussed in the latest JAMA Surgery Author Interviews podcast. 🎧 Listen now: edhub.ama-assn.org/jn-learning/...

In #TuboOvarianAbscess, transvaginal drainage did not establish noninferiority vs #laparoscopy for 6-week cure and required reintervention more often. ja.ma/4dwuGEC

Among women with #BRCA1 or #BRCA2 pathogenic variants, the projected benefit of bilateral salpingo-oophorectomy declined with age but remained present into older age. ja.ma/3To6iy5

In youths after sleeve gastrectomy, early reinitiation of obesity medication was associated with greater 12-month weight loss vs surgery alone, without higher postoperative morbidity. ja.ma/4qZ4ecf

Early Reinitiation of Medication After Sleeve Gastrectomy in Youths

This cohort study explores changes in weight and eating behaviors following postoperative pharmacotherapy among pediatric bariatric patients.

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More than one-third of older adults at extreme risk for early mortality died within 48 hours of high-risk #EGS, highlighting a substantial rate of nonbeneficial surgery. ja.ma/4x7Qy00

Nonbeneficial Emergency Surgery in Older Adults at Risk for Early Mortality

This cross-sectional study examines the incidence of and factors associated with early mortality among older adults undergoing emergency general surgery as a marker of nonbeneficial surgery.

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Compared with nonoperative management, surgical stabilization of rib fractures was associated with lower risk of pulmonary complications, even when performed >3 days after blunt chest trauma. ja.ma/4zUX7G1

Benefits of Surgical Stabilization of Rib Fractures and Delayed Operation

This cohort study compares respiratory outcomes of early, intermediate, and late surgical stabilization of rib fractures vs nonoperative management among patients with blunt chest trauma.

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#WholeBlood transfusion delivers red cells, plasma, and platelets in physiologic proportions and may reduce transfusion burden and improve early outcomes in trauma, but definitive guidance awaits adequately powered randomized trials. ja.ma/4qWhZZj

Whole-Blood Transfusion From Empiricism to Evidence

This narrative review discusses the historic and modern roles of whole blood vs component therapy in early hemostatic resuscitation, describing evidence from military, civilian, and prehospital literature that supports a whole-blood strategy.

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Among patients with #PrimaryHyperparathyroidism without baseline end-organ damage, 32% developed osteoporosis, kidney stones, fractures, or chronic kidney disease during follow-up, indicating progression under usual care. ja.ma/3VeFjpe

End-Organ Damage Associated With Primary Hyperparathyroidism

This cohort study examines electronic health record data for patients with primary hyperparathyroidism who are receiving usual care to evaluate the frequency and timing of skeletal and kidney end-organ damage.

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In patients receiving massive #transfusion, survival differed by exposure to ABO nonidentical blood components, with poorer outcomes observed when larger numbers of ABO-mismatched transfusions were given. ja.ma/4xuYzfJ

During laparoscopic cholecystectomy, #IndocyanineGreen fluorescent cholangiography was associated with lower rates of #BileDuctInjury, biliary intervention, conversion to open surgery, and 30-day nonbiliary complications. ja.ma/4qXEaOQ

Indocyanine Green Fluorescent Cholangiography and Bile Duct Injury

This cohort study examines data from a large multicenter dataset to evaluate the association between intraoperative use of indocyanine green and common bile duct injury among patients who had laparoscopic cholecystectomy.

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Congratulations to JAMA Surgery Editor in Chief Melina Kibbe, MD, who was invested today as the seventh president, and the first woman president, of @uthealthhouston.bsky.social. Additionally, the city of Houston named September 17, 2026, as Melina Kibbe Day.

🩺 #PigtailCatheters are used as first-line treatment for pneumothorax and a range of pleural effusions. This Review summarizes indications, Seldinger technique insertion, daily management, removal, and complications. ja.ma/3TBr4KK

📊 Spanish-speaking injured patients received less #TraumaInformedCare communication and were less likely to receive a complete examination than English-speaking patients, highlighting an equity gap in trauma resuscitation. ja.ma/4xmDG6s

Perioperative FLOT chemotherapy was linked to better survival and lower recurrence risk than CROSS chemoradiotherapy among esophageal adenocarcinoma patients achieving #pCR. ja.ma/4hcASDZ

FLOT vs CROSS in Esophageal Adenocarcinoma

This cohort study evaluates survival outcomes following FLOT chemotherapy vs CROSS chemoradiotherapy in patients with esophageal adenocarcinoma achieving pathological complete response.

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💬 Editorial: In rare surgical adverse event studies, confounding, sparse outcomes, and clustering can distort associations. #Cholecystectomy research on #intraoperativecholangiography shows that analyses must account for rare events and clustering. ja.ma/4rnO2le

📊 Among patients undergoing minimally invasive #Cholecystectomy, #RoboticSurgery was associated with fewer adverse outcomes than #Laparoscopy in high-risk cases. A preoperative risk calculator may help match operative approach to patient risk. ja.ma/3Vzl2uH

Robotic-assisted #cholecystectomy for complex cases reduced postoperative interventions and complications, with no increase in overall health care cost compared to laparoscopy. ja.ma/4gBjUPw

Robotic vs Laparoscopic Approach for Complex Elective Cholecystectomy

This cohort study analyzes data for patients undergoing complex elective cholecystectomy to consider whether a robotic approach is associated with improved clinical outcomes and altered total hospital cost as compared with a laparoscopic approach.

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In 2022, the mean cost of #OperatingRoom time in California hospitals was $57.71 per minute, while mean charges were $295 and mean revenue was $66 per minute, establishing updated benchmarks for surgical cost analyses. ja.ma/4gG7jKQ

Costs, Charges, and Revenue of Hospital Operating Rooms in California

This cross-sectional study estimates the cost of 1 minute of operating room time in in California hospitals for fiscal years 2014 to 2022 and assesses trends for costs, charges, and revenue by hospital ownership and teaching status.

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📝 #Review from @jama.com: #Idiopathic normal pressure hydrocephalus is a progressive neurologic disorder in older adults associated with gait impairment and often urinary dysfunction and cognitive decline. 🔗 Learn more: ja.ma/3Tuhut6