Surgery Commons^™

Rate Of Intraoperative Proximal Femoral Fractures With Automated Broaching, Tyler Radack, Hope Skibicki, Julian Zangrilli, Ruchir Nanavati, Cole Kleinman, Michael Harrer

Rowan-Virtua Research Day

Intraoperative proximal femur fractures (PFF) occur in 3.7% of total hip arthroplasties (THA) using the standard mallet broaching technique and increase a patient’s risk of revision surgery from 3.4% to 10%. The Depuy KINCISE automatic broaching system is designed to attenuate the risk of these fractures by applying consistent co-linear force to the broach. The aim of this study is to determine if the KINCISE system decreases the rate of intraoperative PFF fracture during THA compared to the standard mallet technique.

Perforating Gastric/Duodenal Ulcer Development Following Roux-En-Y Gastric Bypass Surgery: A Case Series, Sugosh Anur, Michael A. Coscia Iii, Louis Balsama

Rowan-Virtua Research Day

Roux-en-Y gastric bypass is a well-studied procedure resulting in long term weight loss. Due to countless years of study, the morbidity and mortality associated with a Roux en Y gastric bypass has been greatly decreased. However, there are still several rare, yet serious, complications that may arise in the post-operative period. Anastomotic leaks and ulcers are just two of those complications. We describe a case of a 41 year old female developing postoperative perforated duodenal ulcer. A laparoscopic repair was performed using a Graham patch technique. This review aims to identify factors contributing to the ulcer development as well as …

A Rare Case Of Acute Appendicitis In A 21-Year-Old Male With Midsternal Chest Pain, Muhammad Noman, James Espinosa, Alan Lucerna, Andrew Caravello

Rowan-Virtua Research Day

Acute appendicitis is inflammation of the vestigial vermiform appendix. It is one of the leading causes of emergency department visits due to abdominal pain. The vermiform appendix is located at the base of cecum. The attachment does not change; however the tip may migrate to the retrocecal, subcecal, preileal, postileal and pelvic positions. Considering these normal anatomical positions, the pain presentation may vary in patients.

Even though this patient presented with midsternal chest pain, which was suspicious for GERD, it was crucial to perform a thorough head-to-toe exam to discover incidental findings that the patient did not report. In this …

The Use Of Computerized Tomography Scans In Elective Knee And Hip Arthroplasty-What Do They Tell Us And At What Risk?, Taylor D'Amore, Gregg R Klein, Jess H. Lonner

Rothman Institute Papers

The average background radiation exposure in the United States has nearly doubled over the previous quarter century, with almost all the increase derived from medical imaging. Nearly 2% of all cancers in the United States may be attributable to radiation from computerized tomography (CT) scans. Given the nondiagnostic nature of CT scans that are used in elective knee and hip arthroplasty today, special consideration should be given to the inherent risk of radiation exposure with routine use of this technology. Methods to decrease radiation exposure including modulating the settings of the CT machine and using alternative non-CT-based systems can decrease …

The Utilization Of Osteoarticular Transfer System In The Treatment Of Distal Femur Osteoid Osteoma: A Case Report, Nikki A. Doerr, Efstratios A. Papadelis, Alec S. Kellish, Matthew T. Kleiner, Christina Gutowski

Rowan-Virtua Research Day

We describe a technique for excision of subchondral epiphyseal bone lesions in the distal femur in skeletally immature patients that mitigates risk of complications associated with physeal injury, incomplete tumor resection, and iatrogenic injury to the overlying cartilage.

The Impact Of Racial Disparities And Outcomes On Urinary Anastomotic Leak In Radical Prostatectomy, Young Son, Benjamin A. Fink, Lance Earnshaw, Brian Thomas, Fred Okoye, Ryan Moriarty, Kathryn Goettle, Thomas Mueller

Rowan-Virtua Research Day

Prostate cancer is the leading malignancy and third most common cause of cancer death among men. In the United States, racial disparities exist in prostate cancer incidence and mortality rates. According to the National Cancer Institute, African American (AA) men have a significantly increased incidence of prostate cancer compared to Caucasians or Asians. Urinary leak at the urethrovesical anastomosis has been cited as a complication of radical prostatectomy (RP), with incidence rates as high as 23%. Urinary anastomotic leak is associated with increased rates of ileus, prolonged hospitalization rates, and longer time to achieve continence. The etiology of risk factors …

Complications Of Fitz-Hugh-Curtis Syndrome In A Teenage Female: A Case Presentation, Marina Cugliari, Trupti Pandit

Rowan-Virtua Research Day

Fitz-Hugh-Curtis Syndrome is a manifestation of Pelvic Inflammatory Disease (PID) associated with Chlamydia trachomatis infections and less frequently with Neisseria gonorrhea.

PID affects sexually active women (15-30 years old) and accounts for 750,000 cases each year.

The case presented illustrates a female who presented with a small bowel obstruction and appendicitis, who was incidentally found to have Fitz-Hugh-Curtis Syndrome on laparoscopic exam.

Appendiceal Diverticulum Masquerading As Acute Appendicitis, Aesha Patel, Asad Abbas, Ratul Bhattacharyya, Dana Galaktionova

Rowan-Virtua Research Day

Appendiceal diverticula present as rare clinical findings and are most often confused with acute appendicitis due to similar presentation. The incidence in such cases is reported at a rate no greater than 1%.

We present a rare case of a 65-year-old female treated for acute appendicitis who was instead found to have acute sequelae of appendiceal diverticulosis.

Celiac Artery Aneurysm: A Rare Cause Of Abdominal Pain, Duwayne Campbell, Wayne Tamaska, Kevin Dwyer

Rowan-Virtua Research Day

Celiac artery aneurysm is a very rare vascular lesion accounting for only 5.1% of all splanchnic artery aneurysms. Etiology for celiac artery aneurysm includes, but not limited to, infectious diseases, atherosclerosis, trauma, congenital conditions such as median arcuate ligament syndrome and iatrogenic causes.

Etiology for abdominal pain is extensive. Patients should be evaluated for both intra-abdominal and extra-abdominal causes for pain, as presentations of a different pathophysiology vary widely. CT scan has become a mainstay part of the work for abdominal pain in the Emergency department, and often elicit pathologies that would otherwise be missed on blood work and other …

Lung Hernia: An Uncommon Cause Of Pleuritic Chest Pain, Brittany Fera

Rowan-Virtua Research Day

Lung hernia is a rare but important consideration in the differential diagnosis of chest pain in patients with recent thoracic trauma or a history of thoracic surgery. Patients who undergo an anterior approach to thoracotomy, as was the case with our patient, are at a higher risk for developing lung herniation as a result of inherent anatomical weakness and wider intercostal spaces anteriorly and inferiorly.

Comparison Of Clinical Outcomes Following Osteochondral Allograft Transplantation For Osteochondral Versus Chondral Defects In The Knee, John Reza Matthews, Joseph Brutico, Jeremy Heard, Kashyap Chauhan, Bradford Tucker, Kevin Freedman

Rothman Institute Papers

Purpose: Osteochondral allograft (OCA) transplantation is a restorative technique for addressing articular cartilage defects by transferring mature viable chondrocytes with subchondral bone into size-matched lesions. The purpose of this study was to compare differences in clinical and functional outcomes in patients treated with OCA for osteochondral defects compared with isolated chondral pathology.

Methods: A retrospective review identified patients who underwent OCA transplantation and grouped them into osteochondral or isolated chondral pathology. Demographic data, surgical history, lesion characteristics, complications, and rate of subsequent surgery were reviewed. The review included 86 patients (24 osteochondral, 62 chondral) with a mean follow-up of 5.4 …

How Program Directors Understand General Surgery Resident Wellness, Darci C. Foote, Julie Evans, Tedi Engler, Alisha Lussiez

Conference Presentation Abstracts

No abstract provided.

The Impact Of Contact Sports: A Marker Of Grit Among General Surgery Residents, Darci C. Foote, John N. Donkersloot, Bridger Rodoni, Samantha Baker, Niki Matusko, Quintin Solano

Conference Presentation Abstracts

No abstract provided.

Resident Labor Unions: A Mechanism For Agency Or Conflict, Darci C. Foote, Daniela Amórtegui, Carlos Diaz, Brian Brajcich, Karl Y. Bilimoria, Yue-Yung Hu, Julie K. Johnson

Conference Presentation Abstracts

No abstract provided.

Clearance Of The Cervical Spine In Obtunded Pediatric Blunt Trauma Patients: Quality Assessment Of An Existing Clearance Pathway, Rachel Kalthoff, Elizabeth Boudiab, Diane Studzinski, Nathan Novotny, Pavan Brahmamdam, Begum Akay

Posters

INTRODUCTION
Obtunded patients following blunt trauma need clearance of the cervical spine (c-spine) that cannot depend on a clinical exam. Our center’s current pediatric c-spine evaluation pathway includes both Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). The objective of this study was to review our use of both CT and MRI for obtunded pediatric trauma patients to assess the quality of our pathway and utility of MRI.

Relationship Between Smoking And Triple-Negative Breast Cancer: A Retrospective Analysis, Anna Jahshan, Mariam Aoun, Nayana Dekhne, Varna Taranikanti

Posters

INTRODUCTION
Breast cancer is currently the most common cancer by incidence among women in the United States with high mortality. Compared to other specific types, triple-negative breast cancer (TNBC) is considered to be an aggressive cancer with poor prognosis. Hence, it is important to study the risk factors associated with it. Smoking has been implicated in many cancers, including breast cancer. However, there is no evidence in literature that has shown a relationship between smoking and a specific type of breast cancer. The goal of this study is to analyze the relationship between smoking and TNBC so that we may …

Prospective Qualitative Analysis Of Minimally Invasive Repair Of Pectus Excavatum, Timothy Elton, Diane Studzinski, Robert S. Morden, Pavan Brahmamdam

Posters

INTRODUCTION
Pectus Excavatum is the most common chest wall deformity and is frequently corrected with the Nuss procedure. Although this procedure has existed for several decades, new strategies are being adapted to reduce complications and improve efficiency. The aim of this study is to perform a qualitative review of the patient experience after minimally invasive repair of Pectus Excavatum.

Blunt Trauma And Diaphragm Injury In Children: An Analysis Of The National Trauma Data Bank, Sammie Lai, Patrick Karabon, Patrick Modren, Begum Akay, Anthony Stallion, Pavan Brahmamdam

Posters

INTRODUCTION
Trauma is the leading cause of mortality and morbidity in children. Traumatic diaphragm rupture (TDR) is a rare but serious injury that can be difficult to identify. The current literature includes individual case reports and single center case series only, which limits our ability to generalize those findings. The purpose of this study is to use the National Trauma Data Bank (NTDB) in order to examine the clinical outcomes of blunt TDR in the pediatric population.

Let Them Play: A Prospective Study Of Postoperative Activity Restrictions In Children, Rachel Harvey, Begum Akay, Diane Studzinski, Nathan Novotny, Anthony Stallion, Pavan Brahmamdam

Posters

INTRODUCTION
We aim to compare time to resume full activity, postoperative outcomes, and describe family preferences of self-directed activity restrictions (SDAR) and physician-directed activity restrictions (PDAR) following routine pediatric surgeries.

Perioperative Antibiotic Use In Neonatal Surgery, Lior Kopel, Patrick Karabon, Nathan Novotny, Begum Akay, Pavan Brahmamdam

Posters

INTRODUCTION
The ideal duration of perioperative antibiotic prophylaxis to prevent surgical site infection (SSI) in neonates is undetermined. The aim of this study is to evaluate the association between the duration of perioperative antibiotics and SSIs in the neonatal surgical population.