Surgical Procedures, Operative Commons^™

Differences In C-Section Times With Resident Involvement Vs No Resident Involvement, Samantha Mclean, Kimberly Swan, Rabiya Suleman, Jeffery Durbin

Continental, MidAmerica, & Mountain Divisions GME Research Day 2024

No abstract provided.

Comminuted Talar Neck And Body Fracture: A Case Report, Chris Zimmer, Roshni Patel, Warren Windram

East Florida Division GME Research Day 2024

Format: Case study

Length of follow up: 12 months

Level of evidence: IV

Classification: Trauma

Purpose: A combination of talar neck and body fractures are extremely rare which make up approximately <1% of all fractures in the body. They are most commonly associated with high energy trauma such as falling from a great height, motor vehicle accident, etc. Talar fractures are challenging problems to treat in terms of fixation, rates of avascular necrosis and much more. The purpose of this case report is to demonstrate that even with a severe talar fracture salvage is possible with proper surgical technique and understanding of the unique fracture pattern.

Case study: One patient underwent ORIF of a comminuted talar neck and body fracture with a lateral bridge plate and medial based interfragmentary compression screw.

Procedures: Open reduction internal fixation of talar neck and body fracture.

Results: 1 patient who demonstrated clinical and radiographic signs of healing of a talar neck and body fracture.

Analysis & Discussions: The rates of avascular necrosis of talar neck and body fractures varies …

Nail-Plate Fixation Vs Distal Femoral Replacement For Periprosthetic Distal Femur Fractures, Matthew Mccrosson, Mamun Al Rashid

East Florida Division GME Research Day 2024

No abstract provided.

From Angiogram To Fasciotomy: Rare Occurrence Of Compartment Syndrome In An Elderly Patient With Dvt, Maya Itani, Bita Crystal Behaeddin, Alan Patrus, Rafael Bustamante

East Florida Division GME Research Day 2024

No abstract provided.

Use Of An Antibiotic Spacer And Pedicled Groin Flap In The Treatment Of Chronic Osteomyelitis Of The Forearm: A Case Study, Nathan Elder, Christopher Morford, Alexander Selsky, William Judson Iv

West Florida Division GME Research Day 2024

No abstract provided.

Retrospective Analysis Of Surgical Time Proficiency During Laparoscopic Myomectomies, Jeffrey Johnson, Kimberly Swan, Errick Arroyo

Continental, MidAmerica, & Mountain Divisions GME Research Day 2024

No abstract provided.

Recurrent Intussusception In Child Despite Repeated Surgical Correction, Carlos Cordova, Alexandra Lawlor, Tillie Schumann, Sydney Solomon, Lily Wiedrich

East Florida Division GME Research Day 2024

No abstract provided.

Foreign Body Removed Through Laparotomy: A Case Report And Literature Review, Kayla Nguyen, Duyen Quach, David Ortiz, Dominique Norris, Srinivas Ramireddy, Jody Smith

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Deficiency In Detail Among Ventral Hernia Repair Operative Notes And The Impact On Patient Outcomes, Alexys N. Ramos, Duyen Quach, Kayla Nguyen, Said Maldonado, Nicole B. Lyons, Jonathan S. Lall, Scott Zimmerle, Brendan Rosamond, Ashlynn Mills, Yoolim Alex Seo, Angelica C. Rodriguez, Mike Liang

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Unusual Delayed Invasive Infection With Staphylococcus Capitis Following Coronary Artery Bypass Grafting: A Case Report And Literature Review, Suhas Tatapudi, Daniel J. Avila Castillo, Ibrahim Yazji

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Improving Awareness And Identifying Risks For Emergence Delirium In Military Veterans, Hannah E. Pino

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Emergence delirium (ED) is an acute state of confusion during the recovery phase from anesthesia that may be life-threatening, especially in the veteran population. Military veteran status may be explored by the Have You Ever Served questionnaire that was developed by the American Academy of Nursing to identify veterans upon admission to the hospital and thus be able to better care for them during their stay. This campaign has been in effect at the hospital site of this project for nearly 10 years. The questionnaire identifies military history risk factors such as combat history or a diagnosis of post-traumatic …

Utilizing Ai Integrated Neuroimaging Technology To Expand Upon Machine Learning In Positron Emission Tomography Technology With The Aim Of Detecting Amyloid Beta Biomarkers Early In The Onset Of Alzheimer's., Ethan S. Terman

UROP Posters

Early intervention in Alzheimer's is vital for treatment. The earlier a professional can detect symptoms and make a diagnosis the earlier a prognosis can be implemented. With the prevalence of data in our day-to-day world combined with Artificial intelligence (AI), utilizing both for machine learning can pave the way for more accurate and efficient detection of Alzheimer's and other neurodegenerative diseases. AI combined with Machine learning (ML) increases diagnostic efficiency and reduces human errors, making it a valuable resource for physicians and clinicians alike. With the increasing amount of data processing and image interpretation required, the ability to use AI …

Biomechanical Outcomes Of Distinct Tka Surgical Alignments And Implant Designs, Alexis Kathleen Nelson-Tranum

Theses and Dissertations (ETD)

Introduction. Total knee arthroplasty (TKA) has advanced over the past two decades from traditional post-operative neutral alignment methods with an overall goal of implant longevity to ones that are more personalized to better replicate individual native knee kinematics. Personalizing TKA knee kinematics to better replicate a patient’s native knee kinematics has evolved in response to a reported 20% dissatisfaction by patients with their TKA. These personalization advancements include innovations in surgical alignment techniques include the kinematic alignment (KA) and joint line obliquity (JLO) restoration, in contrast to the mechanical alignment (MA) technique that places everyone into the same mold. Additionally, …

Early Outcome Of Mini-Mvs Surger Y Elsherif Et Al., Mahmoud Abdullghany Amin Elsherif, Rasha Hosny, Mohamed Ramadan Mohamed

Journal of Medicine in Scientific Research

Background: The conventional incision adopted to for mitral valve replacement is the full sternotomy, with proved over time and experience to be a simple and safe method. Minimal invasive mitral valve surgery (Mini-MVS) is an alternative approach for elective mitral surgeries that proved over the last years to be a promising option.

Aim of the study: Assessment of the early outcome of minimally invasive mitral valve surgery with or without tricuspid surgery.

Methods: A retrospective study on 100 consecutive patients who underwent minimal invasive mitral valve surgery from January 2021 to June 2023 at National Heart Institute in Egypt.

Results: …

Preoperative Computed Tomography Scan In Distal Radius Fractures And The Effect On Preoperative Planning, Adam L. Haydel, Ryan C. Roubion, Cristina T. Graphia, Corinne E. Cloud, Claudia Leonardi, Christopher E. Marrero

School of Medicine Faculty Publications

Purpose: It is unclear whether computed tomography (CT) scans alter the surgical plan when ordered before surgery for fixation of intra-articular distal radius fractures (DRFs). The purpose of this study was to determine whether a preoperative CT scan alters the planned approach (PA) or planned fixation strategy (PFS) for open reduction internal fixation of intra-articular DRFs. Methods: Radiology records were retrospectively reviewed by one trauma surgeon and two hand surgeons for 33 intra-articular DRFs that met the inclusion criteria and previously underwent open reduction internal fixation. Surgeons were initially provided only preoperative radiographs; they were asked for their PA and …

Alt Free Flap Coverage After Carotid Endarterectomy In The Setting Of Severe Radiation Changes, Richard F. Guidry, Hannah E. Doran, Mark W. Stalder

School of Medicine Faculty Publications

Carotid endarterectomy with patch angioplasty is commonly performed for severe atherosclerotic disease to reduce stroke risk. After neck radiation, loss of tissue planes; reactive fibrosis of skin; contraction; and rarely, necrosis of skin may occur, leading to severe wound complications and possible exposure of carotid artery reconstruction. Historically, local myocutaneous flaps have been performed to provide soft tissue coverage; however, these procedures may be associated with increased donor site morbidity and can be affected by radiation changes. This report describes the novel use of a fasciocutaneous free flap for durable vascularized soft tissue, and the associated secondary benefit of improved …

Slow Surgical Correction Affects More Than Just The Bowels, Emilia M. Clementi

Clinical Research in Practice: The Journal of Team Hippocrates

Reflection on how delayed colostomy reversal affects a patient's mental and physical well-being.

Robotic First Rib Resection In Thoracic Outlet Syndrome: A Systematic Review Of Current Literature, Maikerly Reyes, Sneha Alaparthi, Johannes B. Roedl, Marisa Moreta, Nathaniel R. Evans, Tyler Grenda, Olugbenga T. Okusanya

Department of Surgery Faculty Papers

Thoracic outlet syndrome (TOS) involves the compression of neurovascular structures in the thoracic outlet. TOS subtypes, including neurogenic (nTOS), venous (vTOS), and arterial (aTOS) are characterized by distinct clinical presentations and diagnostic considerations. This review explores the incidence, diagnostic challenges, and management of TOS with a focus on the innovative approach of Robotic First Rib Resection (R-FRR). Traditional management of TOS includes conservative measures and surgical interventions, with various open surgical approaches carrying risks of complications. R-FRR, a minimally invasive technique, offers advantages such as improved exposure, reduced injury risk to neurovascular structures, and shorter hospital stays. A comprehensive literature …

Undescended Superior Parathyroid: A Case Report, Elliott M. Sina, Chihun J. Han, Elizabeth E. Cottrill

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Aberrant migration of parathyroid glands from their embryologic origin may result in undescended parathyroid glands. We present a case of an ectopic parathyroid adenoma at the level of the pyriform sinus. A 41-year-old female was evaluated for primary hyperparathyroidism. Following non-localizing ultrasound and planar sestamibi imaging, the patient underwent SPECT/CT and 4-D computed tomography demonstrating evidence of an ectopic parathyroid adenoma. The surgical approach was modified based on the location. Following extirpation, PTH fell from 80 to 16 pg/mL, and the 15-min post-excision level remained stable at 14pg/mL, indicating a biochemical cure. While rare, undescended parathyroid adenoma should be considered …

Surgical Stabilization Of Multiple Rib Fractures In An Asian Population: A Systematic Review And Meta-Analysis, Weiwei He, Yi Yang, Raymark Salonga, Ledford Powell, Patrick Greiffenstein, Jonne T.H. Prins, Stephen Patrick Abella

School of Medicine Faculty Publications

Background: There is no consensus on the effectiveness of surgical stabilization in multiple rib fractures in Asia, especially among patients with a non-flail rib fracture pattern. We aim to synthesize the evidence on the effectiveness of surgical stabilization of rib fractures (SSRF) in an Asian population with multiple nonflail rib fractures. Methods: The MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Cochrane Database of Systematic Reviews were searched in this systematic literature review and meta-analysis to identify studies conducted in Asia that included patients with multiple non-flail rib fractures in at least one of their treatment groups. The …

Peripheral Arterial Disease And Complications Of Total Knee Arthroplasty: Indications For Advanced Vascular Imaging And Minimally Invasive Soft Tissue Coverage Procedures, Kristopher Katira, Antony Martin, Anna Garbuzov, James Ferrer, Brian Chuong, Ross Parkerson, George Chimento

School of Medicine Faculty Publications

Soft tissue coverage of knee wounds can be challenging, in particular in the setting of peripheral arterial disease and knee arthroplasty complications. Options for soft-tissue coverage range from conservative wound care to invasive pedicled and free flaps. Unlike traditional wound coverage problems in plastic surgery patients, arthroplasty coverage decisions oblige surgeons to take into account the possibility of secondary orthopedic procedures. The two cases presented in this manuscript demonstrate the importance of vascular imaging, in particular angiography. In both cases, the workhorse medial gastrocnemius flap harvest could have resulted in critical limb ischemia. When secondary orthopedic revision is required at …

A Survey Of Microvascular Technique Preferences Among American Head Neck Society Members, Ramez Philips, Keisha A. Best, Aarti Agarwal, Hamad Sagheer, Yamil Selman, Larissa Sweeney, Mark Wax, Howard Krein, Ryan Heffelfinger, Adam Luginbuhl, Joseph Curry

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVE: To identify practices in microvascular techniques in routine and challenging scenarios.

STUDY DESIGN: Cross-sectional study.

METHODS: A national survey addressing practices related to microvascular free flap reconstruction was distributed to AHNS members between October and November 2021.

RESULTS: The respondents encompassed 95 microvascular surgeons. Median years of practice was 6 (interquartile range, 2-13) and median flaps per year was 35 (22-50). Common practices in arterial anastomosis included limited cleaning of artery (84.2%), use of a double approximating clamp (64.2%), and use of interrupted suture (88.4%). Common practices in venous anastomosis included limited cleaning (89.5%), downsizing the coupler (53.7%), and …

Minoxidil Weakens Newly Synthesized Collagen In Fibrotic Synoviocytes From Osteoarthritis Patients, Stefan Sarkovich, Peter P. Issa, Andrew Longanecker, Davis Martin, Kaitlyn Redondo, Patrick Mcternan, Jennifer Simkin, Luis Marrero

School of Medicine Faculty Publications

Purpose: Synovial fibrosis (SFb) formation and turnover attributable to knee osteoarthritis (KOA) can impart painful stiffness and persist following arthroplasty. To supplement joint conditioning aimed at maximizing peri-operative function, we evaluated the antifibrotic effect of Minoxidil (MXD) on formation of pyridinoline (Pyd) cross-links catalyzed by Plod2-encoded lysyl hydroxylase (LH)2b that strengthen newly synthesized type-I collagen (COL1) in fibroblastic synovial cells (FSCs) from KOA patients. MXD was predicted to decrease Pyd without significant alterations to Col1a1 transcription by FSCs stimulated with transforming growth factor (TGF)β1. Methods: Synovium from 10 KOA patients grouped by SFb severity was preserved for picrosirius and LH2b …

The Safety Of Robotic Pneumonectomy, Shale J. Mack, Micaela L. Collins, Brian M. Till, Greg L. Whitehorn, Jonathan Martin, Hamza Rshaidat, Tyler Grenda, Nathaniel R. Evans, Olugbenga T. Okusanya

Jefferson Hospital Staff Papers and Presentations

BACKGROUND: Pneumonectomy remains among the most morbid procedures in thoracic surgery. Increasingly, robotic approaches are being adopted for a range of thoracoscopic procedures. The safety profile of robot-assisted thoracoscopic pneumonectomy remains poorly described, as do outcomes compared with traditional approaches.

METHODS: The National Cancer Database was used for a retrospective cohort analysis for patients with non-small cell lung cancer undergoing pneumonectomy from 2014 to 2018. Robotic approach was compared with open and thoracoscopic pneumonectomy. Descriptive and outcomes analyses, and 5-year overall survival were assessed.

RESULTS: Robot-assisted approach was completed in 269 (5.56%) cases, 3671 (75.88%) by open resection, and 898 …

Systematic Review Of Needlestick Injuries In The Operating Room: A Case For Surgical Glove Redesigning, Shalmali Mirajkar, Zachary Bauman, Bethany Lowndes

EMET Projects

Background: Sharps or needlestick injuries (NSI) occur in roughly 15% of surgeries and are largely preventable. With such injuries, healthcare workers have a high risk of exposure to blood borne pathogens. Despite the implementation of several prevention measures such as double gloving and using blunt suture needles, there is still a high prevalence of NSIs. The aim of the current study is to conduct a systematic review to identify the most vulnerable parts of the hand for needlestick injuries, the most common tasks during which injuries occurred, and the most common instrument associated with the injury.

Methods: A …

Optimizing The Timing Of Biologic And Surgical Therapy For Patients With Refractory Chronic Rhinosinusitis With Nasal Polyposis (Crswnp), Emily Garvey, Bita Naimi, Alexander Duffy, Paavali Hannikainen, Chase Kahn, Douglas Farquhar, Marc Rosen, Mindy R. Rabinowitz, Elina Toskala, Gurston G. Nyquist

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

INTRODUCTION: Chronic rhinosinusitis with nasal polyposis (CRSwNP) is often treated with endoscopic sinus surgery (ESS); however, patients may require revision surgery due to recurrence. To date, no studies have compared outcomes for combined surgery and biologic therapy for CRSwNP compared with biologic therapy alone.

METHODS: Retrospective case-control study of CRSwNP patients who underwent ESS while on dupilumab or mepolizumab (ESS-biologic cohort) compared with CRSwNP patients on biologic therapy (biologic-only controls). Cohorts were matched according to indication, aspirin-exacerbated respiratory disease (AERD), sinonasal outcome test-22 (SNOT-22), and total polyp scores.

RESULTS: Sixteen patients underwent ESS while on biologic therapy (13 dupilumab and …

Targeted Muscle Reinnervation To Reduce Postoperative Pain In Patients Undergoing Hindquarter Resections, Mikaela H. Sullivan, Gavin L. Mills, Hiba Saifuddin, Elyse J. Brinkman, Brian T. Carlsen, Steven L. Moran, Matthew T. Houdek

School of Medicine Faculty Publications

Background/Aim: Pre-emptive targeted muscle reinnervation (TMR) at the time of amputation results in less phantom limb pain (PLP) compared with untreated amputee controls. There is limited literature describing the technique in patients undergoing hindquarter amputation despite up to 90% of these patients reporting PLP and 50% presenting with painful neuroma. The purpose of the current study was to describe the motor nerves accessible through a primary hind-quarter amputation to be used for TMR and review pain outcomes in clinical case correlates of patients with TMR. Patients and Methods: Six limbs were obtained from three fresh adult cadavers and proximal sensory …

Is Wedge A Dirty Word? Demographic And Facility-Level Variables Associated With High-Quality Wedge Resection, Micaela L. Collins, Greg L. Whitehorn, Shale J. Mack, Brian M. Till, Hamza Rshaidat, Tyler R. Grenda, Nathaniel R. Evans, Olugbenga T. Okusanya

Jefferson Hospital Staff Papers and Presentations

OBJECTIVES: Although sublobar resections have gained traction, wedge resections vary widely in quality. We seek to characterize the demographic and facility-level variables associated with high-quality wedge resections.

METHODS: The National Cancer Database was queried from 2010 to 2018. Patients with T1/T2 N0 M0 non-small cell lung cancer 2 cm or less who underwent wedge resection without neoadjuvant therapy were included. A wedge resection with no nodes sampled or with positive margins was categorized as a low-quality wedge. A wedge resection with 4 or more nodes sampled and negative margins was categorized as a high-quality wedge. Facility-specific variables were investigated via …

Analysis Of Graft Types Used With Internal Brace Augmentation For Acl Reconstruction: A Systematic Review, Connor Maginnis, Cooper Root, Julie H. Schiavo, Bryan Vopat, Mary K. Mulcahey

School of Medicine Faculty Publications

International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine Congress 2023, June 18 - 21, 2023, Boston, MA

Intracept Technique At Adjacent Levels To Fusions With Pedicle Screws, David Stolzenberg, Paul Kitei, David Tran, Ryan Pfeifer

Rothman Institute Papers

No abstract provided.