Surgery Commons^™

Agenda (Pdf), Department Of Surgery

Surgery Research Symposium

Agenda for the 4th Annual Surgery Research Symposium held May 7, 2026.

A Neck Too Tight: Emergent Cricothyrotomy For Airway Collapse From Expanding Post Anterior Cervical Discectomy And Fusion (Acdf) Hematoma, Nicole R. Eregha, Kishan Patel, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Anterior cervical discectomy and fusion (ACDF) is a commonly performed surgical procedure used to treat cervical spine pathology including radiculopathy and spinal cord compression. Although generally safe, postoperative complications can occur. One of the most feared complications is expanding neck hematoma, which may lead to rapid airway obstruction due to tracheal compression and soft tissue swelling. The reported incidence of postoperative hematoma after ACDF ranges from 0.2–1.9%, with a subset of patients requiring emergent airway intervention or surgical evacuation [1]. Patients with postoperative hematoma typically present with neck swelling, dysphagia, hoarseness, dyspnea, and inability to tolerate secretions, symptoms that may …

Mid- To Long-Term Durability Of Thoracic Endovascular Aortic Repair For Blunt Thoracic Aortic Injury: Outcomes In ≥ 45 Comparator Cohort, Andrew Lawrence Frankini, Gianna Rose Zanghi, Margaret Schwab, Valentina Sara Sica, Larry Andrew Frankini Md

Rowan-Virtua Research Day

Blunt traumatic thoracic aortic injury (BTAI) is a primary cause of mortality in blunt trauma injuries, with motor vehicle collisions representing the majority of cases.^1-4 Thoracic endovascular aortic repair (TEVAR) is the standard of care for managing this vascular emergency.⁵ While TEVAR demonstrates favorable short-term outcomes, there is an insufficient characterization of cumulative mid- to long-term reinterventions and device-related complications in BTAI patients.

We conducted a meta-analysis/systematic review of studies reporting outcomes after TEVAR for BTAI in patients ≥45 years. This review was conceptualized as a comparator to the previously reviewed outcomes in younger patients (< 45 years) performed by Frankini et al. (2026)⁶, …

Delay In Care Due To High Number Of Provider Evaluations In Hip Arthroscopy, Kaylin Knapsack, Wynn Bastianelli, Alexander Cabrera, Stewart Meridian, Sean Mcmillan

Rowan-Virtua Research Day

Background: Diagnosing hip pain in young and middle-aged adults remains challenging due to overlapping intra- and extra-articular pathology. Femoroacetabular impingement syndrome (FAIS) and acetabular labral tears are increasingly recognized as major contributors to pain, mechanical symptoms, and functional limitation. Despite growing awareness of hip preservation surgery, delays in referral to arthroscopy-trained specialists persist and may contribute to disease progression and inferior outcomes.

Purpose: To evaluate delays in surgical management among patients undergoing hip arthroscopy for labral pathology and identify factors contributing to delayed referral to hip preservation specialists.

Methods: A retrospective cohort study was conducted on patients undergoing hip arthroscopy …

Improving Anesthesia Provider Confidence In The Identification, Management, And Treatment Of Postoperative Delirium, Brittany M. Whistle, Charles Dustin Phelps

Scholars Week

Purpose: Postoperative Delirium (POD) is a potentially devastating complication of anesthesia that is poorly understood by clinical staff leading to poor outcomes for surgical patients. This study is meant to determine if a focused knowledge presentation accompanied by visual aids could increase anesthesia providers confidence in identifying, diagnosing, and treating Postoperative Delirium.

Methodology: Utilizing a statistical model to analyze respondents results on a standardized test administered before and after an informational presentation with visual aids on the topic of Postoperative Delirium.

Results: Results indicated a statistically significant difference between pretest and posttest scores, with a p-value of .002, t(11) = …

Predicting Trauma Admission In Anticoagulated Geriatric Patients Presenting With A Ground Level Fall, Y-Nhi H. Bui Ms, Trevor Glad Bmus, Dylan Jack Bs, Michael Martyak

Knowledge and Creativity Expo

Our study undertook a rigorous investigation into an expanding trauma patient population, tackling some of the significant challenges with this patient population in trauma triage. Our research has not only addressed key questions, but has also paved the way for future inquiries by offering innovative perspectives. This presentation is particularly important given the current advancements and interests in geriatric trauma. We hope that our findings will influence ongoing projects and spark collaborations among diverse research communities.

Concomitant Subacromial Decompression Remains Commonly Performed During Rotator Cuff Repair: A Trinetx Study, Madison Baldauf, Zachary Krumm, Savannah Ward, Katherine Worcester, Kevin Bonner Md

Knowledge and Creativity Expo

Introduction:

Arthroscopic rotator cuff repair (RCR) is among the most frequently performed shoulder procedures in the US and is often accompanied by concomitant subacromial decompression (SAD). In recent years some studies have called into question the benefit of SAD in this setting. The topic is controversial as many surgeons still feel SAD is indicated. This study aims to characterize the changes in proportion of SAD performed concomitantly with RCR over recent years using TriNetX.

Methods:

The TriNetX database was queried for all patients undergoing arthroscopic rotator cuff repair from 2013 to 2025. Cohorts were established using the Current Procedural Terminology …

Extracorporeal Membrane Oxygenation In Trauma Before And After Covid-19: Associations Of Utilization, Timing, And Outcomes, Ryan Mancoll, William Rice, Theodore Chin, Grayson Mast M.D, Samantha Olafson M.D.

Knowledge and Creativity Expo

Objectives:

The COVID-19 pandemic expanded and altered general ECMO utilization and provider experience; however, any impact on trauma-specific ECMO practice following this shift remains unclear. We hypothesize that trauma ECMO utilization patterns, timing of initiation, and outcomes have differed following COVID-19.

Methods:

We conducted a retrospective cohort study of trauma patients receiving ECMO (2017-2024) using the American College of Surgeons Trauma Quality Improvement Program (TQIP) Participant Use Files. The primary exposure was the COVID era (2017-2019 vs. 2021-2024). Primary outcomes included ECMO utilization, time to initiation, and in-hospital mortality; secondary outcomes included discharge disposition, major complications, and length of stay …

2. Impact Of Gum Chewing On Postoperative Ileus Following Open Heart Surgery, Jacinta Smith

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Reducing Surgical Site Infections Post Cesarean Section Through Multi-Modal Standardized Education, Ari Meyers, Fereshteh Pirayesh, Tracie Tolme

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Patient Geographical Area As A Risk Factor For Postoperative Outcomes Following Lumbar Fusion Surgery, Brady Stillman, Bs

Alpha Omega Alpha Research Symposium

Introduction: Rural communities have limited spine surgery care, which disproportionately affects older adults. Research has evaluated how hospital location affects patient outcomes; however, minimal work has investigated the impact of home location. This work’s purpose was evaluating the impact of patient geographical classification (rural/suburban/urban) on lumbar fusion outcomes.

Methods: Adult patients who underwent elective lumbar fusion (2017-2022) at a single tertiary center were identified via Structured Query Language search. Patient demographic/surgical characteristics, surgical outcomes, and patient-reported outcome measures (PROMs) were collected. Rural/urban/suburban was assigned by zip code.

Results: 461 patients were included (11.9% urban [U], 78.3% suburban [S], 9.8% rural …

Challenging Case: Acute Type A Aortic Dissection With Multi-Organ Malperfusion, Rishab Agarwal, Allebelle Bradshaw Md, Jennifer S. Lawton Md

Cardiovascular Research Symposium

Description of case: A 57-year-old male with hypertension and obesity presented with acute, severe chest pain. He developed a cold, numb right leg with motor deficits. He was hypotensive with a lactate of 7.4. CT imaging revealed an acute Type A aortic dissection (TAAD) with malperfusion involving the right internal carotid, right subclavian, and right coronary arteries, as well as the superior mesenteric artery, and right iliac artery (Fig 1A/B). He was transferred to our tertiary center for emergent surgery.

Five hours after presentation, he underwent emergent ascending aortic replacement, deep hypothermic circulatory arrest, and retrograde cerebral perfusion. The …

Inferior Vena Cava Thrombosis In Nephrotic Syndrome: Two Cases Managed With Endovascular Thrombectomy, Rishab Agarwal, Benjamin Samberg, David Dexter Md

Cardiovascular Research Symposium

Background: Nephrotic syndrome (NS) confers a hypercoagulable state that can precipitate venous thromboembolism (VTE), rarely involving the inferior vena cava (IVC).

Cases: We describe two patients with NS who developed IVC thrombosis. One underwent mechanical thrombectomy using the ClotTriever®/Protrieve™ system (Inari Medical, Irvine, CA, USA); the other underwent aspiration thrombectomy using the AngioVac® system (AngioDynamics, Latham, NY, USA), with adjunct balloon maneuvers for renal vein thrombus.

Outcomes: Both patients achieved immediate IVC recanalization with symptom improvement and patent IVC on short‑term duplex follow‑up.

Conclusions: In NS‑associated IVC thrombosis, device‑based endovascular thrombectomy can be performed safely with restoration of caval patency. …

Comparing Immediate And Short-Term Outcomes And Success In Conservative Versus Surgical Treatment Of Pulmonary Embolism (Pe), Madison Baldauf, Animesh Rathore Md

Cardiovascular Research Symposium

BACKGROUND:

Pulmonary embolism (PE) is a dangerous and life-threatening medical condition which significantly increases risk of cardiovascular fatality. Although each PE treatment strategy has shown to be effective to some degree, there is limited data on they compare. The objective of this study is to evaluate the outcomes of PE treatment with anticoagulation versus interventional treatments.

METHODS:

A Retrospective chart review was performed of all patients identified as having a PE at Sentara Norfolk General Hospital from January 1, 2021 to December 31, 2022. Using Redcap, patient information was recorded, including age, sex, race, body mass index, and pertinent history. …

Staged Cervical Laminoplasty And Pulmonary Endarterectomy In A Patient With Concomitant Cervical Stenosis And Severe Pulmonary Hypertension, Jacob C. Chen, Gustavo A. Heresi, Nakul S. Kumar, Andrej Alfirevic, Anand Mehta, Haytham Elgharably

Cardiovascular Research Symposium

No abstract provided.

A 16-Year Experience Of Popliteal Artery Aneurysm Repair: Endovascular Stent Grafting Matches Surgical Bypass At A Cost Of Much Higher Reintervention Rates, Thomas A. Cook, David J. Dexter, Hosam F. El Sayed, Nicholas L. Bandy, Benjamin B. Samberg, Emily D. Burnett, Jacob A. Hoffman, Jean M. Panneton

Cardiovascular Research Symposium

Objective: To compare long-term outcomes of popliteal artery aneurysm (PAA) repair via open surgical bypass and endovascular stenting, focusing on patency, freedom from major amputation, and reintervention rate.

Methods: A retrospective review of all limbs treated for PAA from 2008–2024 across a single healthcare system was conducted. Baseline demographics, clinical presentation, operative details, and postoperative outcomes were collected. Long-term outcomes (≥ 5 years) included primary, primary assisted, and secondary patency, reintervention rate, major adverse cardiac events (MACE), major adverse limb events (MALE), freedom from major amputation, and all-cause mortality. Statistical analyses were done as appropriate utilizing SPSS.

Results: We identified …

Iatrogenic Aortic Coarctation Physiology After Elephant Trunk Procedure For Type A Aortic Dissection, Khushie Matharoo, Emidio Germano Md, Animesh Rathore Md

Cardiovascular Research Symposium

Introduction: Surgical management of type A aortic dissections has evolved, with growing adoption of extended aortic repairs into the descending aorta. Despite accumulating experience in complex aortic repairs, morbidity and mortality remain high. We present a case of iatrogenic aortic coarctation post-elephant trunk procedure that was ultimately repaired via a thoracic endovascular aortic repair (TEVAR).

Methods: The patient is a 40-year-old male with a medical history of hypertension and cigarette smoking who presented with acute onset of dizziness, hypotension, acute kidney injury (AKI) (Cr 1.4, baseline 0.9) and type 2 myocardial infarction. Echocardiogram showed severe aortic insufficiency, and CTA evidenced …

From Rags To Riches: Ai-Powered Retrieval Augmented Generation (Rag) For Just-In-Time Learning And Accelerated Onboarding In High Turnover Icus, Celestino Castanon Md, Alison A. Smith Md, Phd, Patrick Greiffenstein Md, Jennifer M. Brewer Md, Roslyn Alexander Md

Quality Improvement & Patient Safety Forum

No abstract provided.

Switching Lanes: Leaving Behind Discharge Antibiotics And Laboratory Testing In Perforated Appendicitis, Seth Saylors, Cory Nonnemacher, Meredith Elman, Pablo Aguayo, Richard Hendrickson, David Juang, Irene Isabel P. Lim, Rebecca Rentea, Charles Snyder, Shawn St. Peter, Tolulope Oyetunji

Research Days

Purpose: Appendicitis is the most common surgical emergency in children with approximately 30% of patients presenting with perforation, defined as a hole in the appendix or a fecalith found in the abdomen, at time of surgery. Our previous protocol at time of discharge, with an 11% intraabdominal abscess (IAA) rate, included checking a white blood cell count (WBC) on day of discharge, with a value ≥10 serving as a trigger for additional outpatient oral antibiotics course. Beginning in May, 2023 we changed our protocol to no longer obtain WBC or prescribe outpatient antibiotics at time of discharge. The purpose of …

The Impact Of Cultures On Treating Abscesses Associated With Appendicitis, Cory Nonnemacher, Seth Saylors, Meredith Elman, Tolulope A. Oyetunji Md Mph, Shawn D. St Peter

Research Days

Background/Purpose

Perforated appendicitis is associated with elevated risk of post-operative intra-abdominal abscess (PIAA) formation. Small PIAAs can be successfully treated without drainage, while larger ones warrant Interventional Radiology drainage. Routine culture of drained abscesses occurs at most institutions, with some prior studies showing resistance rates of 40-50%, prompting change of post-drainage antibiotics. The purpose of our study is to evaluate if culture results impact the antimicrobial therapy chosen for patients with PIAA, with our hypothesis being that routine culture does not have a significant impact on patient outcomes.

Methods

Patients < 18 years of age who were treated for perforated appendicitis at a standalone tertiary children’s hospital from 2011 to 2024 were retrospectively evaluated for abscess formation and extracted those who underwent drainage procedures with abscess cultures to assess the need for antibiotic adjustments from the standard of care based on culture results.

Results

A total of 1736 patients treated for perforated appendicitis …

Post-Operative Management Of Chronic Subdural Hematomas, Steven R. Glener, Md

Health Equity and Quality Improvement (HEQI) Summit

Primary Objective & Outcome Measures

Objective: Identify standard of care for post-operative subacute to chronic subdural hematomas (cSDH) that undergo burr hole evacuation

Primary outcomes:

• Rate of SDH recurrence requiring re-evacuation or MMA embolization

Secondary outcomes:

• LOS
• Readmission for a medical problem related to chronic subdural evacuation

Future Of Transplant Centers: Leveraging Integration Of Transplant Institutes To Mitigate The Impact Of Transplant Professional Shortages And Enhance Patient Outcomes, Kiran Goli, Prashamsa Shenoy, Paula Martinez-Cantarin, Maitreyee Gupta, Rakesh Gulati, Pooja Singh

Health Equity and Quality Improvement (HEQI) Summit

Background

The Increasing Organ Transplant Access (IOTA) Model introduced by the Centers for Medicare & Medicaid Services (CMS) emphasizes increasing transplant volumes, reducing disparities, and enhancing care efficiency. Transplant centers face unique challenges, including workforce shortages, growing demand for organ transplants, care delivery inefficiencies, and the need to align with the achievement, efficiency, and quality domains of the IOTA model while fostering health equity. Integration, whether through mergers, acquisitions, or strategic alliances, offers transplant centers a competitive advantage in optimizing resources, expanding access, and meeting CMS metrics.

Improving Deep Vein Thrombosis Rates In Spine Surgery Patients, Arbaz A. Momin, Md, James Harrop, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

- DVT/PEs are sources of morbidity and mortality in hospitalized patients
- Spine surgery patients are immobile postop and tend to be obese
- For spine surgery patients DVT rates reported to range from 0.3% to 15.5%
- DVT propagation to PE can lead to significant mortality

• 30-day case fatality rate of PE is 3.9%

- Quality metric that hospitals are evaluated

• Patient safety indicator (PSI)

Optimizing Intraoperative Parathyroid Hormone Testing Protocols To Improve Efficiency And Outcomes In Parathyroid Surgeries, Andrew Neeson, Bs, Hani Samarah, Bs, Bryan Renslo, Md, Eric Fei, Ba, Kalena Liu, Bs, Harleen K. Sethi, Do, Elizabeth E. Cottrill, Md

Health Equity and Quality Improvement (HEQI) Summit

Background:

• Intraoperative PTH (ioPTH) helps confirm the removal of hyperfunctioning glands by leveraging its short half-life (~3-5 minutes).
• Timely results are critical for minimizing unnecessary bilateral neck exploration and operative time.
• Delays in ioPTH processing can increase anesthesia time, OR costs, and patient risk.
• Anecdotal reports have suggested variation in ioPTH processing speeds across Jefferson Health surgical sites.

Problem Statement: Significant delays in ioPTH turnaround time at one surgical site may prolong operative and anesthesia times, compromising patient safety.

Project Aim: To identify and compare ioPTH processing times across three surgical sites to pinpoint workflow inefficiencies and propose future improvements.

The Need For Innovative Changes In The Jackson-Pratt (Jp) Drain, Elizabeth Goldstein, Bs, Spencer Haber, Krishna Koka, Bs, Devin Williams, Bs, Andrew Newman, Md

Health Equity and Quality Improvement (HEQI) Summit

Purpose

The JP drain is a closed suction drain used in surgeries throughout the body. This design, introduced by Dr. Frederick Jackson and Dr. Richard Pratt in 1971, prevents seroma formation through continual negative pressure drainage while resisting drain collapse and obstruction. Through a focused literature review, we summarized findings on JP drain-related complications in breast reconstruction and mastectomy. Though the JP drain effectively reduces seroma formation, there has been a profound lack of innovation in how its design addresses Surgical Site Infection (SSI), Surgical Site Pain (SSP), and Quality of Life (QOL). In addition, there is no standardized, evidence-based …

Resumption Of Anti-Platelet/Anticoagulation Therapy Following Lumbar Spine Surgery, Stephanie Serva, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

• Problem: There is data on AC/AP use in perioperative period for patients undergoing spine surgery and no formal established guidelines on when to resume AC/AP medications after surgery
• Aim: To determine standardized protocol for resuming antiplatelet/anticoagulation therapy following lumbar surgery and to reduce combined post-operative cardiac/cerebrovascular/thrombotic events, and post- operative hematomas by 10% in 5 years
• Population: Patients undergoing elective lumbar spine surgery who take AC/AP at home

Readmission For Picc Line Placement In Spine Surgery, Joseph Schaefer, Md, Joshua Heller, Md, James Harrop, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

• Pseudoarthrosis is failure of adequate bony fusion after a spinal fusion
• Prior literature has implicated occult C. acnes infection in cases of pseudoarthrosis
• Intraoperative cultures are often sent in cases of pseudoarthrosis at Jefferson
• C. acnes cultures often result after discharge requiring readmission

Agenda (Pdf), Department Of Surgery

Surgery Research Symposium

Agenda for the 3rd Annual Surgery Research Symposium held May 15, 2025.

Delaying Infant Inguinal Hernia Repair Does Not Increase Incarceration Rate, Seth Saylors, Cory Nonnemacher, Charles Snyder, Pablo Aguayo, Richard Hendrickson, Bhargava Mullapudi, Irene Lim-Beutel, Rebecca Rentea, Shawn St. Peter, David Juang, Tolulope Oyetunji

Research Days

Introduction: Inguinal hernia repair is one of the most common pediatric surgical procedures performed with an estimated incidence of 1-5% in children. Patients can present with or without symptoms, with symptomatic hernias (incarcerated or strangulated) that may require emergent or urgent operative intervention. During the Covid-19 pandemic, restrictions, and shutdowns of elective surgeries at our institution resulted in delaying elective inguinal hernia repair unless presenting with more emergent symptoms, with no apparent increase in complication. In our institution, this practice was continued even after COVID restrictions were lifted, with elective repairs delayed until patients were older before completing elective inguinal …

Single-Incision Laparoscopic Ileocecectomy In Pediatric Crohn’S Disease: A 15-Year Experience, Seth Saylors, Cory Nonnemacher, Meredith Elman, Shawn St. Peter

Research Days

Purpose: In refractory Crohn’s disease, the terminal ileum is a common site requiring excision. Laparoscopic ileocecectomy is the procedure of choice and we use a single-incision laparoscopic technique (SILS). We have previously reported our experience with SILS ileocecectomy with a sizeable cohort compared to other series. This project aims to expand on our single institutional experience with SILS ileocecectomy and evaluate the impact of experience.

Methods: We completed a retrospective review of patients who underwent single-incision laparoscopic (SILS) ileocecectomy for Crohn’s disease from 1/1/2009-3/31/2024 at a single institution by a single surgeon. Operative and inpatient characteristics were collected to determine …