George Ferzli

Places I’ve lectured, places I’ve operated… … and I think to myself, what a wonderful world

General surgery!

Concurrent abdominal wall hernia repair occurs in only 1.3% of bariatric cases. • Most concurrent repairs are performed for primary, small-to-medium sized, reducible hernias. • Medium hernia size, advanced age, venous thromboembolism, and Roux-en-Y gastric bypass independently predict serious complications. • Reoperation and mortality rates are higher for concurrent surgery. Characterization of concurrent bariatric surgery and abdominal wall hernia repair prevalence and outcomes: a multi-centered study of 180,544 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program patients - Surgery for Obesity and Related Diseases soard.org/article/S1550-…

General surgery!

CMS unveils $50 GLP-1 prescriptions for Medicare patients The Centers for Medicare & Medicaid Servicesannounced Wednesday that it has developed a framework for Medicare beneficiaries to seek the benefits of GLP-1 diabetes and weight loss medications and have the costs covered—albeit for an additional monthly premium above and beyond the standard cost of insurance. Beginning on July 1, seniors on Medicare can pay $50 a month to access GLP-1 medications similar to brand names like Wegovy and Ozempic, benefitting them whether they’re looking to shed pounds or control their blood glucose levels. Notably, the $50 option only applies to Medicare beneficiaries who have signed up for Part D, the federal government’s prescription drug coverage program.

A century ago, the Flexner Report highlighted profit orientation as one of many maladies of U.S. medical schools, triggering structural reform. Today, the profit motive and business priorities again overshadow the patient primacy for which medicine strove for millennia. Corporatization has polluted the training environment. These three reordering remedies could help launch a renaissance of academic medicine’s time-honored troika of patient care, education, and research. From Mission to Margin in Academic Medicine — The Impact of Corporate Medicine on Medical Training | New England Journal of Medicine nejm.org/doi/full/10.10…

“La Traviata” — magnificent!

Le Liban n’est pas juridiquement occupé par l’Iran, mais il est devenu un État à souveraineté confisquée, où le Hezbollah — milice politico-militaire libanaise soutenue, armée et orientée par Téhéran, dont la force Radwan incarne l’appareil militaire autonome — agit comme un État dans l’État, situation que les gouvernements libanais successifs et une partie de la classe politique ont tolérée, institutionnalisée et parfois exploitée, tandis que le peuple libanais, loin d’être uniformément complice, reste divisé entre soutien, peur, résignation, opposition et survie. Le Liban ne redeviendra un pays libre que lorsqu’il cessera d’être l’otage armé de l’Iran et du Hezbollah, et qu’il choisira enfin la souveraineté, la paix et l’avenir avec Israël : 🇱🇧❤️🇮🇱.

Fundamentals of Surgery: The 3 Ms Mastery of anatomy Meticulous dissection Modus operandi — choosing the safest and most reproducible approach in your hands. Surgery is knowledge, precision, and method.

General surgery!

If laparoscopy is “straight-stick surgery,” then robotic surgery is just “wristed-stick surgery.”

In this cohort study among Medicare beneficiaries, robotic-assisted groin hernia repair was associated with a higher long-term cumulative incidence of operative recurrence compared to open and laparoscopic approaches. Surgical Approach and Long-Term Operative Recurrence Following Groin Hernia Repair jamanetwork.com/journals/jamas…

Robotic cholecystectomy shows no clinical advantage over laparoscopic surgery in mortality or complications, questioning its cost-effectiveness for routine gallbladder procedures. Comparison Between Open, Laparoscopic, and robotic Cholecystectomy: a Systematic Review and Meta-Analysis - The American Journal of Surgery americanjournalofsurgery.com/article/S0002-…

General surgery!

Happy St George’s Day!

In this randomized clinical trial, in patients with a nutritional risk screening score of 3 or more, EEN after pancreatoduodenectomy permitted to decrease the burden and incidence of postoperative complications compared with ON. Early Enteral vs Oral Postoperative Nutrition After Pancreatoduodenectomy jamanetwork.com/journals/jamas…

These findings support the use of a funnel-shaped mesh as an effective and safe preventive strategy to reduce the risk of parastomal hernia after permanent colostomy Prevention of Parastomal Hernia With Funnel-Shaped Intra-Abdominal Mesh vs No Mesh for Rectal Adenocarcinoma Surgery jamanetwork.com/journals/jamas…

Among critically ill patients undergoing mechanical ventilation, SDD did not result in a lower incidence of in-hospital death than standard care. Selective Decontamination of the Digestive Tract during Ventilation in the ICU | New England Journal of Medicine nejm.org/doi/full/10.10…

From General Surgery News, April 1, 2026: “There are no great data on any procedure that we do, especially in general surgery, that say the robot is better than a straight stick. … “I’m not familiar with any paper with Level 1 evidence showing the robot is better. … “They’re more comfortable using the robot. They’re more comfortable with the visualization. They’re more comfortable operating while sitting down. … “But in terms of data, it hasn’t been borne out; however, the reality is surgeons don’t care; they’ll do it anyway. …” Dr. Ballecer is a consultant for Intuitive Surgical and Medtronic.

Evaluating the impact of GLP-1 receptor agonists in combination with total neoadjuvant therapy for locally advanced rectal cancer | BJS | Oxford Academic academic.oup.com/bjs/article/11…