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Arishi AA, Hakami IA, Mashbari HN, Hobani AH, Al-Musawa HI, Abuhadi RI, Maslouf AH, Matari MH, Albrahim HT, Algarni MA, Iskander O, Alyahyawi K. Knowledge, attitude, and perception of robotic-assisted surgery among the general population in Saudi Arabia: a cross-sectional study. J Robot Surg 2024; 18:196. [PMID: 38703278 DOI: 10.1007/s11701-024-01892-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 02/28/2024] [Indexed: 05/06/2024]
Abstract
Minimally invasive surgery (MIS) has revolutionized surgical practices, with robotic-assisted surgery (RAS) significantly advancing. However, the understanding and acceptance of RAS vary, impacting its widespread adoption. This study aims to assess Saudi Arabians' attitudes and comprehension of RAS, which is crucial for promoting its integration into surgical procedures. A cross-sectional study was conducted in various Saudi Arabian cities. A total of 1449 participants were included, while participants with cognitive issues were excluded. Demographic information, knowledge, technology experience, attitudes, and perceptions about RAS were collected using an online self-administered questionnaire. Data were analyzed using descriptive and inferential statistics. Of the participants, 51.1% demonstrated awareness of RAS, mainly through social media (36.9%). Factors influencing awareness included gender, education, income, occupation, computer literacy, and technology comfort. Gender disparities were evident in attitudes and perceptions toward RAS. Concerns about RAS included robot malfunction (62.0%), surgical errors (45.4%), and surgeon competency (44.7%). 36.4% of the participants believe RAS is faster, 29.9% believe RAS is less painful, and 25.3% believe RAS has fewer complications. Positive perceptions encompassed the belief that robot-using surgeons are more skilled (44.5%) and hospitals offering RAS are better (54.3%). Notably, 47.7% expressed willingness to consider RAS as a treatment option. The study underscores the significance of promoting awareness and informed decisions to ensure the successful integration of RAS in surgical practices. Addressing concerns and misconceptions and enhancing public comprehension are pivotal for facilitating informed decision-making and fostering RAS acceptance within Saudi Arabia's surgical landscape.
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Affiliation(s)
- Abdulaziz A Arishi
- General Surgery Department, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia.
| | - Ibrahim A Hakami
- General Surgery Department, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Hassan N Mashbari
- General Surgery Department, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | | | | | - Rana I Abuhadi
- Faculty of Medicine, Jazan University, 45142, Jazan, Saudi Arabia
| | - Atheer H Maslouf
- Faculty of Medicine, Jazan University, 45142, Jazan, Saudi Arabia
| | | | | | - Maram A Algarni
- Faculty of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Othamn Iskander
- General Surgery Department, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Khalid Alyahyawi
- General Surgery Department, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
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Abstract
Robotic-assisted surgery (RAS) presents unique teamwork challenges for perioperative team members, including anesthesia professionals. The purpose of this study was to explore anesthesiologists' and nurse anesthetists' teamwork experiences during RAS using an exploratory qualitative study design involving individual semistructured interviews. Study participants expressed that teamwork during RAS is both positive and challenging, and the start-up phase is the most demanding phase of RAS in terms of teamwork. Anesthesia professionals believe that both technical and nontechnical skills are necessary to provide excellent patient care and maintain patient safety during RAS. Furthermore, they believe that a more concentrated focus on nontechnical skills than is traditional is an essential component of teamwork.
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Zhao B, Lam J, Hollandsworth HM, Lee AM, Lopez NE, Abbadessa B, Eisenstein S, Cosman BC, Ramamoorthy SL, Parry LA. General surgery training in the era of robotic surgery: a qualitative analysis of perceptions from resident and attending surgeons. Surg Endosc 2020; 34:1712-1721. [PMID: 31286248 PMCID: PMC6946889 DOI: 10.1007/s00464-019-06954-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 06/26/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND The use of the surgical robot has increased annually since its introduction, especially in general surgery. Despite the tremendous increase in utilization, there are currently no validated curricula to train residents in robotic surgery, and the effects of robotic surgery on general surgery residency training are not well defined. In this study, we aim to explore the perceptions of resident and attending surgeons toward robotic surgery education in general surgery residency training. METHODS We performed a qualitative thematic analysis of in-person, one-on-one, semi-structured interviews with general surgery residents and attending surgeons at a large academic health system. Convenient and purposeful sampling was performed in order to ensure diverse demographics, experiences, and opinions were represented. Data were analyzed continuously, and interviews were conducted until thematic saturation was reached, which occurred after 20 residents and seven attendings. RESULTS All interviewees agreed that dual consoles are necessary to maximize the teaching potential of the robotic platform, and the importance of simulation and simulators in robotic surgery education is paramount. However, further work to ensure proper access to simulation resources for residents is necessary. While most recognize that bedside-assist skills are essential, most think its educational value plateaus quickly. Lastly, residents believe that earlier exposure to robotic surgery is necessary and that almost every case has a portion that is level-appropriate for residents to perform on the robot. CONCLUSIONS As robotic surgery transitions from novelty to ubiquity, the importance of effective general surgery robotic surgery training during residency is paramount. Through in-depth interviews, this study provides examples of effective educational tools and techniques, highlights the importance of simulation, and explores opinions regarding the role of the resident in robotic surgery education. We hope the insights gained from this study can be used to develop and/or refine robotic surgery curricula.
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Affiliation(s)
- Beiqun Zhao
- Department of Surgery, University of California, San Diego, 9300 Campus Point Drive, Mail Code 7220, La Jolla, CA, 92037, USA.
| | - Jenny Lam
- Department of Surgery, University of California, San Diego, 9300 Campus Point Drive, Mail Code 7220, La Jolla, CA, 92037, USA
| | - Hannah M Hollandsworth
- Department of Surgery, University of California, San Diego, 9300 Campus Point Drive, Mail Code 7220, La Jolla, CA, 92037, USA
| | - Arielle M Lee
- Department of Surgery, University of California, San Diego, 9300 Campus Point Drive, Mail Code 7220, La Jolla, CA, 92037, USA
| | - Nicole E Lopez
- Department of Surgery, University of California, San Diego, 9300 Campus Point Drive, Mail Code 7220, La Jolla, CA, 92037, USA
| | - Benjamin Abbadessa
- Department of Surgery, University of California, San Diego, 9300 Campus Point Drive, Mail Code 7220, La Jolla, CA, 92037, USA
| | - Samuel Eisenstein
- Department of Surgery, University of California, San Diego, 9300 Campus Point Drive, Mail Code 7220, La Jolla, CA, 92037, USA
| | - Bard C Cosman
- Department of Surgery, University of California, San Diego, 9300 Campus Point Drive, Mail Code 7220, La Jolla, CA, 92037, USA
| | - Sonia L Ramamoorthy
- Department of Surgery, University of California, San Diego, 9300 Campus Point Drive, Mail Code 7220, La Jolla, CA, 92037, USA
| | - Lisa A Parry
- Department of Surgery, University of California, San Diego, 9300 Campus Point Drive, Mail Code 7220, La Jolla, CA, 92037, USA
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Rodrigues RC, Rodrigues MRK, Freitas NDO, Rudge MVC, Lima SAM. Quality of life in patients who undergo conventional or robotic-assisted total laparoscopic hysterectomy: Protocol for a systematic review of randomized controlled trials. Medicine (Baltimore) 2019; 98:e15974. [PMID: 31169730 PMCID: PMC6571212 DOI: 10.1097/md.0000000000015974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Hysterectomy for benign gynecologic diseases, especially dysfunctional uterine bleeding, is one of the most common gynecologic interventions. The uterus can be removed using abdominal, vaginal, laparoscopic, or robotic-assisted laparoscopic hysterectomy. In a robotic-assisted procedure, the surgeon directs the robot while seated at a console in the operating room. This differs from laparoscopic hysterectomy because a "robot" performs the operation, while the surgeon watches a monitor. This systematic review will compare quality of life (QOL) in patients who undergo total robotic-assisted laparoscopic hysterectomy for benign indications and those who undergo conventional laparoscopic surgery. METHODS We will perform a systematic review according to the Cochrane Methodology for randomized controlled trials. The review will include studies reporting use of QOL metrics to assess patients who undergo total hysterectomy for benign indications using robotic-assisted technique or conventional laparoscopic surgery. QOL will be the primary outcome and will be measured using validated instruments. An overall search strategy will be developed and adapted for Embase, MEDLINE, LILACS, and CENTRAL databases. Two reviewers will independently select the eligible studies, assess the risk of bias, and extract the data from included studies. Similar outcomes measured in at least 2 trials will be plotted in the meta-analysis using Review Manager 5.3. The quality of evidence will be determined using the GRADE approach. RESULTS This systematic review is designed to provide high quality evidence on QOL in patients undergoing total hysterectomy for benign indications using either robotic-assisted or conventional laparoscopic surgery. CONCLUSION It is expected that high-quality evidence on QOL can be used to guide decision-making by institutions and clinicians to improve health care; the evidence can also be used in future studies. PROSPERO REGISTRATION NUMBER PROSPERO CRD 42019129913.
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Affiliation(s)
| | - Meline Rossetto Kron Rodrigues
- Department of Nursing, São Paulo State University (UNESP), Medical School, Botucatu
- Postgraduate Program in Nursing, University of Guarulhos (UNG)
| | | | - Marilza Vieira Cunha Rudge
- Department of Gynecology, Obstetrics and Mastology, São Paulo State University (UNESP), Medical School, Botucatu, São Paulo, Brazil
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McBride KE, Steffens D, Duncan K, Bannon PG, Solomon MJ. Knowledge and attitudes of theatre staff prior to the implementation of robotic-assisted surgery in the public sector. PLoS One 2019; 14:e0213840. [PMID: 30870503 PMCID: PMC6417692 DOI: 10.1371/journal.pone.0213840] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 03/02/2019] [Indexed: 11/18/2022] Open
Abstract
Background The use of robotic-assisted surgery (RAS) is becoming increasingly prevalent across a range of surgical specialties within public hospitals around Australia. As a result, it is critical that organisations consider workplace factors such as staff knowledge, attitudes and behaviours prior to the implementation of such new technology. This study aimed to describe the knowledge and attitudes of operating theatre staff from a large public tertiary referral hospital prior to the commencement of an RAS program. Methods A cross-sectional survey of nursing, medical and support staff working in the operating theatre complex of a large public tertiary referral hospital was completed over a one-week period in June 2016. A 23-item questionnaire was utilised for data collection. Results 164 (66%) theatre staff returned the surveys and were included in this study. The majority of medical staff reported being knowledgeable about RAS, whilst the majority of nursing and support staff did not. Overall the theatre staff were neutral about the potential benefits of RAS to patients. The majority of medical staff believed the implementation of RAS will increase the value of staff roles and job satisfaction, while nursing and support staff were uncertain about these benefits. All three staff groups were concerned about the impact of an RAS program on Workplace Health and Safety, and care and handling. Conclusion Operating theatre staff presented different knowledge and attitudes prior to the introduction of RAS. Whilst theatre staff were more favourable towards RAS than negative, they largely reserved their judgement about the new system prior to their own experiences. Collectively, these findings should be taken into consideration for training and support strategies prior to the implementation of a RAS program.
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Affiliation(s)
- Kate E. McBride
- RPA Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital and University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- * E-mail:
| | - Daniel Steffens
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Kylie Duncan
- RPA Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital and University of Sydney, Sydney, New South Wales, Australia
| | - Paul G. Bannon
- RPA Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital and University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- The Baird Institute, Sydney, New South Wales, Australia
| | - Michael J. Solomon
- RPA Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital and University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
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Ginsburg KB, Pape K, Heilbronn C, Levin M, Cher ML. Prospective assessment of positioning-related pain in robotic urologic surgery. J Robot Surg 2017; 12:97-101. [PMID: 28470407 DOI: 10.1007/s11701-017-0701-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Accepted: 04/24/2017] [Indexed: 11/27/2022]
Abstract
This was a prospective study to assess positioning-related pain in 20 awake volunteers in the dorsal lithotomy (DL) and lateral decubitus (LD) positions. Each volunteer was put through the series of discrete, sequential steps used to achieve a final position; each step had two options. The Wong-Baker scale (WB) was used to rate pain for each option and the preferred option and ad lib comments were recorded. We found that awake volunteers could clearly and immediately distinguish differences in pain levels between position options. For the DL position, volunteers favored having the arms slightly flexed and pronated as opposed to being straight and supinated reflected by statistically less painful WB scores and option preference. Volunteers preferred having the neck flexed as opposed to being flat. For the LD position, volunteers reported statistically lower pain scores and preference for a foam roll for axilla support as opposed to a rolled blanket, the table flexed without the kidney rest as opposed to a raised kidney rest, and the over arm board as oppose to stacked blankets for contralateral arm support. Ad lib comments from the volunteers supported the above findings. To our knowledge, ours is the first study to demonstrate objective preferences for variations in surgical positioning using awake volunteers. This exercise with awake volunteers resulted in immediate changes in positioning for real robotic surgery patients in our practice.
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Affiliation(s)
- Kevin B Ginsburg
- Department of Urology, University Health Center, Wayne State University School of Medicine, 4201 St. Antoine, Ste 7-C, Detroit, MI, 48201, USA.
| | - Kelsey Pape
- Wayne State University School of Medicine, 540 E. Canfield, Detroit, MI, 48201, USA
| | - Chase Heilbronn
- Wayne State University School of Medicine, 540 E. Canfield, Detroit, MI, 48201, USA
| | - Michael Levin
- Department of Urology, University Health Center, Wayne State University School of Medicine, 4201 St. Antoine, Ste 7-C, Detroit, MI, 48201, USA
| | - Michael L Cher
- Department of Urology, University Health Center, Wayne State University School of Medicine, 4201 St. Antoine, Ste 7-C, Detroit, MI, 48201, USA
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Abstract
Effective teamwork in the operating theatre is important for safe patient care. In robotic surgery, the surgeon is physically separated from the operating theatre team, which could potentially have an impact on teamwork. With robotic surgery increasing internationally, this article reviews relevant published literature on teamwork in the operating theatre and reflects on how this might be impacted by robotic surgery. We conclude by describing a research study we are currently undertaking on this topic.
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Roman A, Ahmed K, Challacombe B. Robotic partial nephrectomy - Evaluation of the impact of case mix on the procedural learning curve. Int J Surg 2016; 29:132-6. [PMID: 26975427 DOI: 10.1016/j.ijsu.2016.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 01/31/2016] [Accepted: 03/02/2016] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Although Robotic partial nephrectomy (RPN) is an emerging technique for the management of small renal masses, this approach is technically demanding. To date, there is limited data on the nature and progression of the learning curve in RPN. AIMS To analyse the impact of case mix on the RPN LC and to model the learning curve. METHODS The records of the first 100 RPN performed, were analysed at our institution that were carried out by a single surgeon (B.C) (June 2010-December 2013). Cases were split based on their Preoperative Aspects and Dimensions Used for an Anatomical (PADUA) score into the following groups: 6-7, 8-9 and >10. Using a split group (20 patients in each group) and incremental analysis, the mean, the curve of best fit and R(2) values were calculated for each group. RESULTS Of 100 patients (F:28, M:72), the mean age was 56.4 ± 11.9 years. The number of patients in each PADUA score groups: 6-7, 8-9 and >10 were 61, 32 and 7 respectively. An increase in incidence of more complex cases throughout the cohort was evident within the 8-9 group (2010: 1 case, 2013: 16 cases). The learning process did not significantly affect the proxies used to assess surgical proficiency in this study (operative time and warm ischaemia time). CONCLUSIONS Case difficulty is an important parameter that should be considered when evaluating procedural learning curves. There is not one well fitting model that can be used to model the learning curve. With increasing experience, clinicians tend to operate on more difficult cases.
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Affiliation(s)
- A Roman
- MRC Centre for Transplantation, King's College London, Urology Centre, Guy's Hospital, London UK
| | - K Ahmed
- MRC Centre for Transplantation, King's College London, Urology Centre, Guy's Hospital, London UK
| | - B Challacombe
- MRC Centre for Transplantation, King's College London, Urology Centre, Guy's Hospital, London UK.
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Collin C, Bellas N, Haddock P, Wagner J. Pre-Operative Education Classes Prior to Robotic Prostatectomy Benefit Both Patients and Clinicians. Urol Nurs 2015; 35:281-285. [PMID: 26821448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
As part of a process improvement initiative, we designed, implemented, and assessed the impact of pre-surgical education classes for patients scheduled to undergo robotic prostatectomy. Our aim was to both enhance patient access to important procedural information related to their surgery, and also limit the need for the repeated dissemination of information during patient calls to the office.
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Cundy TP, Gattas NE, White AD, Najmaldin AS. Learning curve evaluation using cumulative summation analysis-a clinical example of pediatric robot-assisted laparoscopic pyeloplasty. J Pediatr Surg 2015; 50:1368-73. [PMID: 25783405 DOI: 10.1016/j.jpedsurg.2014.12.025] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 10/22/2014] [Accepted: 12/28/2014] [Indexed: 02/06/2023]
Abstract
BACKGROUND The cumulative summation (CUSUM) method for learning curve analysis remains under-utilized in the surgical literature in general, and is described in only a small number of publications within the field of pediatric surgery. This study introduces the CUSUM analysis technique and applies it to evaluate the learning curve for pediatric robot-assisted laparoscopic pyeloplasty (RP). METHODS Clinical data were prospectively recorded for consecutive pediatric RP cases performed by a single-surgeon. CUSUM charts and tests were generated for set-up time, docking time, console time, operating time, total operating room time, and postoperative complications. Conversions and avoidable operating room delay were separately evaluated with respect to case experience. Comparisons between case experience and time-based outcomes were assessed using the Student's t-test and ANOVA for bi-phasic and multi-phasic learning curves respectively. Comparison between case experience and complication frequency was assessed using the Kruskal-Wallis test. RESULTS A total of 90 RP cases were evaluated. The learning curve transitioned beyond the learning phase at cases 10, 15, 42, 57, and 58 for set-up time, docking time, console time, operating time, and total operating room time respectively. All comparisons of mean operating times between the learning phase and subsequent phases were statistically significant (P=<0.001-0.01). No significant difference was observed between case experience and frequency of post-operative complications (P=0.125), although the CUSUM chart demonstrated a directional change in slope for the last 12 cases in which there were high proportions of re-do cases and patients <6 months of age. CONCLUSIONS The CUSUM method has a valuable role for learning curve evaluation and outcome quality monitoring. In applying this statistical technique to the largest reported single surgeon series of pediatric RP, we demonstrate numerous distinctly shaped learning curves and well-defined learning phase transition points.
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Affiliation(s)
- Thomas P Cundy
- Department of Pediatric Surgery, Leeds General Infirmary, Leeds, United Kingdom; The Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, London,United Kingdom.
| | - Nicholas E Gattas
- Department of Pediatric Surgery, Leeds General Infirmary, Leeds, United Kingdom
| | - Alan D White
- Department of Pediatric Surgery, Leeds General Infirmary, Leeds, United Kingdom
| | - Azad S Najmaldin
- Department of Pediatric Surgery, Leeds General Infirmary, Leeds, United Kingdom
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