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There was only one recurrence, which was also reduced by the “RIGHT” technique. Thus, our success rate in idiopathic (without lead point) intussusception was 97.7%. The biggest advantage of the “RIGHT” technique is that in the eventuality of a complication, which is life threatening, precious time can be saved in conversion to surgical exploration. Since this technique requires the simultaneous involvement of the pediatric surgeon, radiologist, and the anesthesiologist and is to be performed in the OR, the technique may not be feasible at a primary or secondary level hospital where availability of the OR and the presence of all three specialists at the same time in an emergency may be difficult. The study has been carried out in a single center. A multi-centric study is recommended to confirm the findings and increase generalizability of the “RIGHT” technique. Conclusions “RIGHT” (Reduction of Intussusception under General anesthesia using Hydrostatic Technique) method is a combination of the best available techniques of nonoperative reduction of intussusception. It ensures utmost patient safety and comfort by being performed in the controlled environment of the OR, being pain free, avoiding radiation exposure, avoiding the risk of aspiration associated with sedation, and also being able to immediately address a failure of reduction or a complication like perforation by surgical exploration without any delay. Abbreviations USG: Ultrasonography; GA: General anesthesia; OR: Operating room; NS: Normal saline Acknowledgements Not applicable Authors’ contributions KC was involved in the diagnosis and performed the procedures alternatively with RP. He also wrote the manuscript. RP performed the procedure alternatively with KC He searched the literature and reviewed the manuscript. BP provided anesthesia during the procedures and where surgical intervention was done and also collected clinical data. AKY analyzed the data and did the statistical analysis. All authors discussed and contributed to the final manuscript. All authors have read and approved the manuscript. Funding No funding received from any source Availability of data and materials All data generated or analyzed during this study are included in this published article. Ethics approval and consent to participate Institutional Ethics Committee of Army Hospital (Research & Referral), New Delhi approval was obtained with the IEC Registration No: 113/2020. Written informed consent was obtained from the parent of each of the patients who underwent the procedure. Consent for publication Consent for publication was obtained from the parent of the patients in the study. Competing interests The authors declare that they have no competing interests. Author details 1 Department of Pediatric Surgery, Army Hospital (Research & Referral), New Delhi 110010, India. 2 Department of Anesthesiology, Army Hospital (Research & Referral), New Delhi 110010, India. 3 Department of Community Medicine, Armed Forces Medical College, Pune 411040, India. Received: 23 September 2020 Accepted: 4 February 2021 References 1. Draus JM Jr, Shelgikar CS, Buchino JJ, et al. Lipoma as a pathological lead point in a child with ileocolic intussusception. J Pediatr Gastroenterol Nutr. 2008;47:372–4. 2. Chandrasekharam V, Gazula S, Gorthi RP. Laparoscopy-assisted hydrostatic in situ reduction of intussusception: a reasonable alternative? J Indian Assoc Pediatr Surg. 2011;16:8. 3. Ravitch MM, Morgan RH. Reduction of intussusception by barium enema. Ann Surg. 1952;135:596. 4. Flaum V, Schneider A, Ferreira CG, et al. Alsarraf, M.D., M.P.H. Seattle, Washington, USA Abstract. Outcomes research is a fast-growing field of study that focuses on patient-related aspects of medical or surgical outcomes such as satisfaction and quality of life. In the realm of facial plastic surgery, many outcomes are subjective evaluations based on the patient and physician’s judgment as to the surgical result, but little has been done to quantify these qualitative results in an objective manner. This paper discusses the basis for outcomes research and suggests its application to the field of facial plastic surgery. Four new facial plastic outcomes instruments have been developed and are provided for the potential use in measuring the quality of life results of rhytidectomy, rhinoplasty, blepharoplasty, and skin rejuvenation procedures. Key words: Outcomes research—Facial plastic surgery— Quality of life “. . . plastic surgeons have arrived at a vital crossroads. By taking an active part in outcomes research and in . . . health-care policy . . . we can assist in keeping medical decisions where they belong—in the hands of patients and their physicians” [1]. Outcomes research is characterized by the evaluation of the patient-related results of medical interventions, with an emphasis on both the effectiveness of outcomes in terms of patient satisfaction or quality of life, and the costs of attaining these positive results [2,3]. There has been an increasing interest in this form of outcomes evaluation in many of the surgical subspecialties in the last decade. For instance, in Otolaryngology-Head and Neck Surgery, outcomes research has primarily been the focus of the field of head and neck oncology or specific illnesses such as otitis media, acute sinusitis, or obstructive sleep apnea [4–8]. However, there are few specific outcomes studies in the field of facial plastic and reconstructive surgery, despite the fact that patient satisfaction is the ultimate goal of most facial plastic surgery procedures. Wilkins et al. [1] have highlighted the importance of outcomes research for the plastic surgeon, yet there is little evidence that the quantification of the costs and effectiveness of plastic surgery procedures has been further emphasized in recent years. The outcomes of any surgical procedure can be defined in a myriad of ways. Surgical results may be measured in quantitative or qualitative terms. Unlike the realm of head and neck oncology, measurements such as the morbidity or mortality of a given intervention mean little in the field of facial plastic surgery, where many procedures are elective or cosmetic in nature. Often the only means of assessing outcome in this setting is the subjective analysis of the patient as well as the evaluation of the operating surgeon. Thus, in many cases the facial plastic surgeon is left with no quantitative evaluation of the results of his or her procedure. This lack of quantitative data makes comparing different techniques difficult. Similarly, it may be difficult for different surgeons to compare their results when each is measuring surgical outcome by his or her own subjective endpoints. In facial plastic and reconstructive surgery, particularly aesthetic facial plastic surgery, patient satisfaction remains the yardstick by which a successful surgical outcome is measured. A given surgeon may be satisfied with his or her results, but if the patients themselves are not similarly pleased then the intervention cannot totally be considered a success. Certainly there are various aspects of each individual patient’s character and personality that will influence his or her own assessment of the surgical outcome. However, in a population of patients one would expect that patient satisfaction should define the success of a series of procedures. This paper reviews the basic foundations of outcomes Correspondence to author at Department of OtolaryngologyHead and Neck Surgery, University of Washington School of Medicine, Seattle, WA 98195, USA Aesth. Plast. Surg. 24:192–197, 2000 DOI: 10.1007/s002660010031 © 2000 Springer-Verlag New York Inc. research and evaluates the application of these concepts to the field of facial plastic surgery. In order to provide a framework for further studies focusing on patientrelated outcomes, several new procedure-specific quality of life instruments have been developed and are provided for the reader to use in his or her own practice. Outcomes Research: Background All surgeons are interested in patient outcomes. Outcomes research is the field of study that focuses on these results in terms of patient-related measures such as satisfaction, functionality, and quality of life, rather than solely traditional clinical measures of treatment efficacy [1–3]. In contrast to clinical trials, outcomes research applies new methods of measuring and validating the subjective experience of the patient in order to determine the effectiveness of a given procedure in the real-life setting [9]. Several studies in recent years have evaluated patient-related outcomes for a variety of Otolaryngology-Head and Neck Surgery issues. The majority of this work has been done in the field of head and neck cancer therapy, as clinicians have realized that it is not only survival or length of life, but in addition, the quality of that remaining life that is most important to patients and their loved ones [5,6]. In facial plastic and reconstructive surgery, a
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