Stacey is a writer, editor, researcher and communications professional. In her current position at Stanford Biodesign, she is responsible for writing and editing across various academic projects, and managing communications.
Prior to joining Stanford, she was a writer and editor for Sutter Health. She has also worked as a freelance medical writer, and owned her own public relations firm.
Current Role at Stanford
Manager of Academic Projects and Communications, Stanford Biodesign.
Education & Certifications
BA, UCLA, Communication Studies (1988)
Analysis of a Standardized Technique for Laparoscopic Cuff Closure following 1924 Total Laparoscopic Hysterectomies.
Minimally invasive surgery
2016; 2016: 1372685
Objective. To review the vaginal cuff complications from a large series of total laparoscopic hysterectomies in which the laparoscopic culdotomy closure was highly standardized. Methods. Retrospective cohort study (Canadian Task Force Classification II-3) of consecutive total and radical laparoscopic hysterectomy patients with all culdotomy closures performed laparoscopically was conducted using three guidelines: placement of all sutures 5 mm deep from the vaginal edge with a 5 mm interval, incorporation of the uterosacral ligaments with the pubocervical fascia at each angle, and, whenever possible, suturing the bladder peritoneum over the vaginal cuff edge utilizing two suture types of comparable tensile strength. Four outcomes are reviewed: dehiscence, bleeding, infection, and adhesions. Results. Of 1924 patients undergoing total laparoscopic hysterectomy, 44 patients (2.29%) experienced a vaginal cuff complication, with 19 (0.99%) requiring reoperation. Five patients (0.26%) had dehiscence after sexual penetration on days 30-83, with 3 requiring reoperation. Thirteen patients (0.68%) developed bleeding, with 9 (0.47%) requiring reoperation. Twenty-three (1.20%) patients developed infections, with 4 (0.21%) requiring reoperation. Three patients (0.16%) developed obstructive small bowel adhesions to the cuff requiring laparoscopic lysis. Conclusion. A running 5 mm deep × 5 mm apart culdotomy closure that incorporates the uterosacral ligaments with the pubocervical fascia, with reperitonealization when possible, appears to be associated with few postoperative vaginal cuff complications.
View details for DOI 10.1155/2016/1372685
View details for PubMedID 27579179
Infrarenal lymphadenectomy for gynecological malignancies: Two laparoscopic approaches
2015; 139 (2): 330-337
Compare two approaches for laparoscopic infrarenal lymphadenectomy.Retrospective chart review. Statistical analyses with SPSS.4 stage II/III cervical carcinoma, 75 clinical stage I/II endometrial carcinoma, 36 clinically stage I/II tubal/ovarian cancer. 36 transperitoneal approaches; 79 extraperitoneal approaches. Both groups had similar age, 58years (range 29-80), BMI of 25 (range 18-41), blood loss, 150cm(3) (range 25-1500), and hospital stay, 1day (range 1-6). The extraperitoneal surgery took longer (240 v 202min; p=.001); yielded more nodes (50 v 41; p=.004). Extraperitoneal approach yielded more inframesenteric (14 v 10; p=.036), and infrarenal nodes (14 v 9; p=.001). 25% of cervical, 19% of endometrial and 14% of ovarian cancer patients had metastases in radiographically negative infrarenal nodes. 50% of cervical, 33% of endometrial and 17% of ovarian cancer patients had therapy altered by aortic lymphadenectomy. When the inframesenteric nodes were positive, 63% of endometrial and 80% of ovarian cancer patients had infrarenal metastases. More metastases were identified with increasing aortic node count. Extraperitoneal lymphadenectomy had no learning curve (p=0.320), while transperitoneal lymphadenectomy did (p=0.016). Higher BMI patients had lower aortic node yields by transperitoneal (p=.057) but not extraperitoneal approach (p=.578). Among the 14 patients whose BMI was 35-41, mean extraperitoneal total aortic nodal yield was 30; transperitoneal yield was 6.Infrarenal aortic lymphadenectomy may offer higher aortic nodal yields, even in patients with BMI's of 45. Larger prospective studies are needed to confirm whether this dissection in high-risk patients ensures more accurate therapy, and possibly improves cure rates.
View details for DOI 10.1016/j.ygyno.2015.09.019
View details for Web of Science ID 000364619300021
View details for PubMedID 26407477
Sustaining pressure ulcer best practices in a high-volume cardiac care environment.
American journal of nursing
2014; 114 (8): 34-44
\Narayana Hrudayalaya Cardiac Hospital (NHCH) in Bangalore, India (now known as the Narayana Institute of Cardiac Sciences), is one of the world's largest and busiest cardiac hospitals. In early 2009, NHCH experienced a sharp increase in the number of surgical procedures performed and a corresponding rise in hospital-acquired pressure ulcers. The hospital sought to reduce pressure ulcer prevalence by implementing a portfolio of quality improvement strategies. Baseline data showed that, over the five-month observation period, an average of 6% of all adult and pediatric surgical patients experienced a pressure ulcer while recovering in the NHCH intensive therapy unit (ITU). Phase 1 implementation efforts, which began in January 2010, focused on four areas: raising awareness, increasing education, improving documentation and communication, and implementing various preventive practices. Phase 2 implementation efforts, which began the following month, focused on changing operating room practices. The primary outcome measure was the weekly percentage of ITU patients with pressure ulcers. By July 2010, that percentage was reduced to zero; as of April 1, 2014, the hospital has maintained this result. Elements that contributed significantly to the program's success and sustainability include strong leadership, nurse and physician involvement, an emphasis on personal responsibility, improved documentation and communication, ongoing training and support, and a portfolio of low-tech changes to core workflows and behaviors. Many of these elements are applicable to U.S. acute care environments.
View details for DOI 10.1097/01.NAJ.0000453041.16371.16
View details for PubMedID 25036664
Sustaining Pressure Ulcer Best Practices in a High-Volume Cardiac Care Environment How one hospital reduced the incidence of hospital-acquired pressure ulcers to zero
AMERICAN JOURNAL OF NURSING
2014; 114 (8): 34-44
View details for Web of Science ID 000340557800018
Single-Field Sterile-Scrub, Preparation, and Dwell for Laparoscopic Hysterectomy
JOURNAL OF MINIMALLY INVASIVE GYNECOLOGY
2012; 19 (2): 220-224
Type VII laparoscopic hysterectomy is classified as a "clean-contaminated" procedure because the surgery involves contact with both the abdominal and vaginal fields. Because the vulva has traditionally been perceived as a separate but contaminated field, operating room guidelines have evolved to require that surgeons gloved and gowned at the abdominal field either avoid contact with the urethral catheter, the uterine manipulator, and the introitus or change their gloves and even re-gown after any contact with those fields. In the belief that the perception of the vaginal field as contaminated stems from inadequate preoperative preparation instructions, we have developed a rigorous abdomino-perineo-vaginal field preparation technique to improve surgical efficiency and prevent surgical site infections. This thorough scrub, preparation, and dwell technique enables the entire abdomino-perineo-vaginal field to be safely treated as a single sterile field while maintaining a low rate of surgical site infection, and should be further investigated in randomized studies.
View details for DOI 10.1016/j.jmig.2011.12.005
View details for Web of Science ID 000301465000016
View details for PubMedID 22239998
Laparoscopic Hysterectomy: Impact of Uterine Size
JOURNAL OF MINIMALLY INVASIVE GYNECOLOGY
2011; 18 (1): 85-91
To analyze surgical results of women having Type VII laparoscopic hysterectomy to determine whether differences in outcomes exist on the basis of uterine size.This is an analysis of data from 983 cases of type VII laparoscopic hysterectomy performed from September 1996 through August 2010. Demographic and surgical data were stratified by uterine weight (range 14-3,131 g) less than 250 g (n = 720) and 250 g or more (n = 263). Analyses were done by Pearson's χ(2), Wilcoxon rank-sum, and Kruskal-Wallis tests with significance set at 2-sided (p <.05). Outcomes examined include estimated blood loss, skin-to-skin operative time, complications (non-reoperative and reoperative), and duration of hospital stay. Estimated blood loss, skin-to-skin operative time, and length of hospital stay were further analyzed using backwards, stepwise, multivariable, linear regression to control for and identify independent predictors affecting these outcomes. Baseline demographic data were included in the multivariable model. Only covariates that were significant in both multivariable and univariable analyses are presented as statistically significant.A case-controlled, retrospective study (Canadian Task Force Classification II-2).Median operating time varied by uterine weight, with a shorter duration of surgery in patients with uteri less than 250 g at 97 minutes (range 29-330), and patients with uteri greater than 250 g at 135 minutes (range 45-345) (p <.001). Median estimated blood loss was also less in patients with uteri less than 250 g at 50 mL, (range 0-1400), than in patients with uteri weighing 250 g or more, at 150 mL, (range 0-2100) (p <.001). There was no significant difference by uterine weight in median duration of hospital stay of 1 day (range 0-13), total complication rate (7.0%), reoperative complications (3.7%), or non-reoperative complications (3.4%). Duration of surgery, volume of blood lost, and length of hospital stay all decreased with the surgeon's increasing experience.Laparoscopic hysterectomy is feasible and safe, resulting in a short hospital stay, minimal blood loss, minimal operating time, and few complications for patients regardless of uterine weight.
View details for DOI 10.1016/j.jmig.2010.09.016
View details for Web of Science ID 000286286100017
View details for PubMedID 21195958