Collin Creange

Free medical advice since 2009. No guarantees on accuracy.

[Collin Creange @CollinMD]

@SeanLangenfeld Hmm this is a problem with the survey data... maybe I'm stingy but it's few and far between that I mark people "practice ready" in any surgery, let alone colons. If I'm on the console the whole case and pointing out planes, where to divide... isn't that direct supervision?

[Collin Creange @CollinMD]

@DouglasAdlerMD @Olympus Tell me more about this lithocrush- breaking up CBD stones?

[Collin Creange @CollinMD]

@EleahPorterMD @EricKnauerMD @MBosleyMD @SAGES_Updates Good stuff Eleah! Maybe one day I'll make it out to SAGES.

[Collin Creange @CollinMD]

@DouglasAdlerMD Balloon sphincteroplasty has become much more common in the LCBDE space, same concept. Waist sign always a pleasure to see

[Collin Creange @CollinMD]

@cremieuxrecueil Thanks for the reply! But not what I meant. I'm more curious if we expect a tachyphylaxis to happen over time, like we see with other medications. For my patient who loses 70 lbs maxed out on tirz, in 5 years will the effect begin to wane?

[Collin Creange @CollinMD]

@EzraTeitelbaum currently completing the Boston Sci CBDE course (ironically as a pre-req for teaching the course). The images and descriptions you provided are excellent!

[Collin Creange @CollinMD]

@ericpaulimd Never stand when you can sit. And any flat surface is a seat.

[Collin Creange @CollinMD]

@DrSalihTokmak @rbarbosa91 Very cool! Esophageal stent? Looks similar to one I used to create an ostomy after a leak in a frozen abdomen:

[Collin Creange @CollinMD]

@DrSalihTokmak @rbarbosa91 Not all collections accessible via EUS unfortunately. Question though- do you use lap instruments at all? When I have to do VARDS I can rarely reach far enough with just open instruments.

[Collin Creange @CollinMD]

@DouglasAdlerMD Do you see this as a bridge to surgery for revision or in your experience has this provided definitive treatment? And how long do you typically leave the stent in?

[Mihir S. Shah, MD @MihirShahMD]

@UHC @askUHC is denying a testis prosthesis for pt with testis mass sched for Orch. No option for P2P. Told “it won’t improve his fxn”. Submitted letter of necessity. Haven’t reviewed it. Surgery is in few days. All this despite @NCCN recommend it be offered to pt. Unacceptable!!

[Collin Creange @CollinMD]

@ericpaulimd Now I feel like a monster for using stratafix to close all my laparotomies... thanks.

[Collin Creange @CollinMD]

@ReubenR80027912 Florham Park*

[Collin Creange @CollinMD]

@SeanLangenfeld @rbarbosa91 Think you're both right about stereotypes that shouldn't exist. My judgment is way simpler though- if you do a case faster than me you're a reckless cowboy and if you're slower than me you have no idea what you're doing. Same speed means you stole my moves.

[Collin Creange @CollinMD]

@EricKnauerMD @EzraTeitelbaum @EleahPorterMD @jennifermov @MBosleyMD @IswantoSucandy @SAGES_Updates @DouglasAdlerMD @EmorySurgery @PipeCabreraV @rbarbosa91 Based on that one image? 100% stones. Would be sad if the live fluoro makes a fool out of me.

[Collin Creange @CollinMD]

@DouglasAdlerMD @aribindi @JAMASurgery @Dr_Chris_Brown Also agreed that a LAMS from duodenum into gallbladder is a future surgical nightmare and not something I'd ever ask GI to do. Chole after C tube is miserable but manageable, taking down a cholecystoduodenal fistula is way worse than that

[Collin Creange @CollinMD]

@DouglasAdlerMD @aribindi @JAMASurgery @Dr_Chris_Brown I've been following your account for awhile and I admire the various interventions you perform, but some of them aren't as mainstream as you might think. I work at a large tertiary care center with about 5 advanced GI providers, and none of them do transcystic stenting

[Collin Creange @CollinMD]

@spartywrx @rbarbosa91 No one is doing a 6 hour lap or robo appy. Whole story a bit questionable.

[Collin Creange @CollinMD]

@SAGES_Updates @ericpaulimd how much work went into finding the perfect acronym?