Surgery Commons^™

Bladder Perforation Presenting As Perforated Appendicitis: A Case Report, Alexander Knippenberg, Erica Romo, Jeffrey Gordon

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.

Bridging The Gap: A Review Of Gender Disparity In General Surgery, Christine Castillo, Rachael Wong, Mike Liang, Julie Holihan, Devi Bavishi, Kush Brahmbhatt, Rebecca Franks, Karla Bernardi, Michele Loor

Gulf Coast Division GME Research Day 2026

No abstract provided.

A Unified Finite Element Framework For Cardiac Growth And Remodeling In Mitral Regurgitation Incorporating Fiber Reorientation And Baroreflex, Mohammad Mehri, Jonathan F. Wenk

Mechanical Engineering Faculty Publications

Mitral regurgitation (MR) triggers complex cardiac remodeling responses that alter the structure and function of the left ventricle (LV). While several models have been developed to predict myocardial growth in MR, they often neglect key concurrent adaptive mechanisms that influence both the pattern and severity of LV dilation. This study presents a unified finite element framework to systematically evaluate the individual and combined contributions of fiber reorientation (FR) and baroreflex regulation to LV growth and remodeling, along with the effects of myocardial material property changes associated with the acute and chronic phases of MR. A healthy baseline model and multiple …

Thoracolumbar Fractures: Historical Systems And Advancements With The Ao Spine Classification, Barry Ting Sheen Kweh, Alex R. Vaccaro, Gregory D. Schroeder, Jose A. Canseco, Maximilian Reinhold, Mohamed M. Aly, Sebastian Bigdon, Mohammad El-Skarkawi, Richard J. Bransford, Andrei Fernandes Joaquim, Harvinder Singh Chhabra, Emiliano Vialle, Rishi M. Kanna, Charlotte Dandurand, Cumhur Öner, Jin Wee Tee

Rothman Institute Papers

Study Design: Systematic Review. Objective: To describe the historical classifications of thoracolumbar injuries and their evolution into the AO Spine Thoracolumbar Injury Classification System. Methods: A systematic review of MEDLINE, EMBASE and Cochrane Databases was performed in keeping with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Results: 445 articles were crystallized to 14 included studies. Simple categorization systems offered by Bohler or Watson-Jones merely identify fracture morphology. Holdsworth and Denis conveyed a sense of the stability of injuries by noting columns of stability, but still failed to take into consideration important factors such as neurological status or …

Histopathological Effects Of The Intrathecal Chondroitinase Abc Administration In Spinal Cord Injured Rats: A Systematic Review, Mohammad Amin Habibi, Ali Anjomshoa, Mohsen Sadeghi-Naini, Zahra Ghodsi, Samuel Berchi Kankam, Erfan Razavi, Armin Aryannejad, Seyed Mohammad Piri, Akam Ramezani, Rasha Atlasi, Kawthar Mohamed, Sina Shoo, Meysam Kaveh, Akbar Fotouhi, Arman Zeinaddini, James S. Harrop, Alex R. Vaccaro, Michael G. Fehlings, Vafa Rahimi-Movaghar

Department of Orthopaedic Surgery Faculty Papers

Introduction: Chondroitinase ABC (ChABC) has been considered a potential treatment for spinal cord injury (SCI). We aim to identify and evaluate the histopathological effects of intrathecal ChABC administration in SCI rat models.

Methods: We searched PubMed/MEDLINE, Scopus, Web of Science, Embase, and Cochrane Library for studies published from the inception of each database until November 22, 2022.

Results: Of 3857 screened citations, 17 studies met eligibility criteria and were entered into the qualitative analysis. Sixteen studies were of high quality, and one study was of medium quality. The four main rat strains used in studies were Sprague-Dawley, Wistar, Lister hooded, …

Accuracy Of The Nestlé Mini Nutritional Assessment® (Mna®) Screen In Identifying Prealbumin–Defined Malnutrition Amongst Spine Surgery Patients, Stylianos Mysirlidis, Luke Fischbach, Matthew Giammanco, Alex Zhang, Phillip Alexeev, Ryan Snowden

SPARK Symposium Presentations

Abstract:

Background:

Malnutrition is a significant risk factor for patients undergoing surgery, including those receiving spine surgery. These patients are at greater risk of adverse postoperative outcomes, impaired wound healing, and spinal fusion failure. Therefore, it is essential to identify at-risk, malnourished patients prior to intervention to mitigate any complications such as surgical site infections, unplanned readmissions, and reoperations. The primary focus of this study was to assess the accuracy of the Nestlé Mini Nutritional Assessment® (MNA®) on identifying true malnutrition amongst those patients undergoing spine surgery.

Methods:

We conducted a retrospective cohort study of 674 consecutive …

Radial And Carotid Arterial Pulse Signals For Assessing Cardiovascular Function At Rest And During Post-Exercise Recovery In A Heart Transplant Patient: A Case Study, Md Mahfuzur Rahman, Mamun Hasan, Jennifer F. May, John M. Herre, Leryn Reynolds, Zhili Hao

Mechanical & Aerospace Engineering Faculty Publications

Aim: This study investigates the feasibility of using radial and carotid arterial pulse signals to assess cardiovascular (CV) function at rest and during post-exercise recovery in a heart transplant (HTx) patient. Method: Two micro-fabricated tactile sensors were used to simultaneously acquire arterial pulse signals at the radial artery (RA) and carotid artery (CA). Measurements were taken at rest and at multiple time points post-exercise on three subjects: an HTx patient, a percutaneous coronary intervention (PCI; coronary stent) patient and a healthy control. An SDOF-TF-based time-frequency analysis algorithm was applied to extract a comprehensive set of CV parameters, including heart rate …

Durable Left-Ventricular Assist Device Inflow Thrombosis Following External Outflow Graft Obstruction, Mohammad J. Malik, Jin Woo Chung, Matthias Loebe, John C. Gurley, Emma J. Birks, Dhruv Kothari, Masashi Kawabori

Surgery Faculty Publications

Background: External outflow graft obstruction (EOGO) is an emerging complication due to improved pump durability. We experienced a rare sequence of complications, inflow thrombus formation following EOGO with reduced left-ventricular assist device flow.

Case Summary: A 41-year-old man, 2 years post HeartMate 3 (HM3) implantation, presented with low-flow from EOGO. Outflow graft stenting resulted in improvement but returned 1 month later with persistent low flow. Pump thrombosis was excluded. Flow had minimal response to RPM increase. Outflow graft was widely patent. Inflow obstruction was suspected, and HM3-to-HM3 exchange revealed extensive thrombus formation within the inflow cannula. Left-ventricular assist device flow …

Indirect Treatment Comparison Of Tezepelumab Versus Other Biologics In Severe Chronic Rhinosinusitis With Nasal Polyps: A Systematic Literature Review And Network Meta-Analysis, Joseph K. Han, Joaquim Mullol, Claire Hopkins, Oliver Pfaar, Martin Desrosiers, Jason Steenkamp, Danny Gibson, Santiago Zuluaga Sanchez, Andrew Foster, Christopher S. Ambrose

Department of Otolaryngology (ENT) Faculty Publications

Introduction

This study compared the efficacy of tezepelumab with other approved biologics and endoscopic sinus surgery (ESS) using indirect treatment comparisons (ITCs) in adults with severe, uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP).

Methods

Randomized controlled trials (RCTs) identified via a systematic literature review (SLR) were synthesized in a network meta-analysis (NMA). Outcomes included change from baseline in nasal polyp score (NPS), nasal congestion/obstruction score (NCS/NOS), difficulty with sense of smell (DSS), Sino-Nasal Outcome Test-22 (SNOT-22) score, Lund Mackay score (LMS), time to nasal polyposis (NP) surgery decision, proportions requiring NP surgery or systemic corticosteroids (SCS), time to SCS use, …

Literature Review On Osteoarthritis Management, Robert A. Weinberg

MEDI 9331 Scholarly Activities Clinical Years

Knee osteoarthritis (OA) is the most common cause of long-term knee pain in adults over 45, and a leading cause of disability worldwide. About one in two people will develop it in their lifetime. This review brings together current evidence on how knee OA is diagnosed and treated, using the main clinical guidelines and the most important trials of the past ten years. The evidence points to a simple, step-by-step plan. Exercise, weight loss, and patient education are the strongly recommended first steps. Oral and topical non-steroidal anti-inflammatory drugs (NSAIDs) are the first-choice medicines. Steroid injections into the joint help …

Literature Review On The Effectiveness Of Surgical Vs Non-Surgical Management In Elderly Patients With Distal Radius Fractures, Robert A. Weinberg

MEDI 9331 Scholarly Activities Clinical Years

Distal radius fractures are common in patients aged sixty years and older. The best management strategy remains debated, particularly in elderly patients where complications risk, radiological outcomes and functional recovery need to be considered. Several studies have compared surgical interventions including open reduction and internal fixation with conservative management including closed reduction and immobilization. The aim of this literature review is to synthesize current evidence on these outcomes for elderly patients with a distal radius fracture who were treated with surgical treatment or non-surgical treatment.

Outcomes After Orif Of Closed Bimalleolar And Trimalleolar Ankle Fractures In Patients With Autoimmune Disease, Mckenna Box, Troy B. Puga, Lachlan Anderson, Alyssa Kozlowski, John T. Riehl

North Texas GME Research Forum 2026

Background: Autoimmune disease is associated with chronic systemic inflammation, immunosuppressive therapy, and increased medical comorbidity, which may influence postoperative outcomes following fracture fixation. Data evaluating outcomes after ankle fracture surgery in this population remain limited. We hypothesized that autoimmune disease would be associated with higher postoperative complication rates following open reduction and internal fixation (ORIF) of closed ankle fractures.

Methods: We performed a retrospective cohort study using a multi-hospital dataset (2017-2025) to identify adult patients undergoing ORIF for closed bimalleolar or trimalleolar ankle fractures. Patients with autoimmune disease were propensity score matched 1:2 to patients without autoimmune disease based on …

Internal Jugular Injuries: Outcomes From The American Association For The Surgery Of Trauma Prospective Observational Vascular Injury Treatment (Proovit) Multicenter Registry, April Miller, Pranay Arora, Devika Pavuluri, John Bini

North Texas GME Research Forum 2026

Introduction: Since March 2013, the PROOVIT database has been a prospective, multi-center observational trial established for the study of vascular trauma. Here we present the data for the management of internal jugular vein injuries due to blunt and penetrating trauma.

Methods: Inclusion criteria for the PROOVIT study included patients age >2 years with radiologic or clinical/operative diagnosis of injury to named vessels in trauma patients at participating facilities. The database was reviewed to examine injury presentation, surgical management, postprocedural medical management with antiplatelet or anticoagulant therapy, and mortality. SPSS software was used to perform the descriptive and exploratory analysis for …

Surgical Management Of A Giant Colonic Diverticulum, Courtney Koplyay, Mason Workman, Michael Truitt, Muhammad T. Siddique

North Texas GME Research Forum 2026

INTRODUCTION: Giant colonic diverticulum (GCD), defined as a diverticulum >4 cm, is a rare manifestation of diverticular disease with less than 200 reported case reports. CT imaging is the preferred imaging modality to identify and confirm the presence of a GCD, which provides an accurate depiction of the size, location, and contents of the diverticulum GCD can present with nonspecific abdominal symptoms, abdominal pain, bloody stools, or an enlarging mass. Given the risk of serious complications, including diverticulitis, bowel obstruction, and perforation, early recognition and management are essential to prevent further complications. Surgical management with diverticulectomy or partial colectomy is …

Gastroduodenal Artery Coil Erosion Causing Pyloric Obstruction And Upper Gi Bleeding, Corey Newman, Mahad Rehman, Cody Beltran, Michael Carrick

North Texas GME Research Forum 2026

Background Trans-arterial embolization (TAE) of the gastroduodenal artery (GDA) is a well-established and effective treatment for peptic ulcer bleeding and visceral pseudoaneurysms. Although generally safe, delayed migration or erosion of embolization coils into the gastrointestinal lumen is a rare but recognized complication that may occur months to years after the procedure. Proposed mechanisms include ischemic mucosal injury, mechanical pressure from the coil mass, and chronic inflammation. Clinical manifestations vary widely, ranging from occult bleeding and ulceration to perforation or gastric-outlet obstruction. Only a limited number of cases describing GDA coil erosion presenting with both bleeding and obstruction have been reported. …

Occupational Human Papillomavirus Exposure Risks For Laryngeal Surgeons And Phoniatricians: A Joint European Laryngological Society (Els) And Union Of European Phoniatricians (Uep) Delphi Clinical Consensus Statement, Shiying Hey, Alberto Maria Saibene, Milan Amin, Jennifer Anderson, Christoph Arens, Simon Best, Guillermo Campos, Craig Derkay, Gauthier Desuter, Frederik G. Dikkers, Isabel Garcia-Lopez, Ahmed Geneid, Anastasios Hantzakos, Markus Hess, Yakubu Karagama, Marina Mat Baki, Napur Kapoor Nerurkar, Daniel Novakovic, Haldun Oguz, Shazia Peer, Jasmine Prasad, Carlo Robotti, David Vokes, Chi-Te Wang, Malgorzata Wierzbicka, Michal Zabrodsky, Nicolien Van Der Poel

Department of Otolaryngology (ENT) Faculty Publications

Purpose

Laser surgical management of human papillomavirus (HPV)-related disease, such as recurrent respiratory papillomatosis (RRP), in the upper aerodigestive tract generates surgical smoke, which may represent a source of occupational viral exposure for laryngeal surgeons, phoniatricians, anesthesia providers and scrub nurses. Despite growing awareness, protective measures remain inconsistently implemented. This study aimed to develop an evidence-informed clinical consensus statement (CCS) to guide occupational HPV risk management in laryngology.

Methods

A modified Delphi consensus process was conducted under the auspices of the European Laryngological Society (ELS) and the Union of the European Phoniatricians (UEP). A panel of 26 international experts undertook …

Real-World Outcomes Of Combined Goniotomy And Canaloplasty Using The Streamline Surgical System, Taylor N. Drake, Kush Shah, Siddharth Bhargava, Constance O. Okeke

Department of Ophthalmology Faculty Publications

Purpose: To evaluate real-world outcomes of combined goniotomy and canaloplasty, performed with the Streamline Surgical System, on intraocular pressure (IOP) and medication burden in patients with ocular hypertension and open-angle glaucoma in a US-based clinical practice.
Patients and Methods: This retrospective, single-center chart review included patients who underwent the Streamline procedure either as standalone or in combination with cataract surgery between January 2022 and December 2023. Outcome measures included change in mean IOP and number of IOP-lowering medications from baseline through 12 months, analyzed in the overall cohort, with exploratory subgroup analyses stratified by race and glaucoma severity (mild, moderate, …

Leveraging Virtual Reality And Haptics To Teach Surgical Skills: A Usability Study On Retropubic Midurethral Slings, Lauren Siff, Ginger S. Watson, Jerome Dixon, Moshe Feldman, Franklin Bost, Philippe J. Giabbanelli

VMASC Publications

Traditional methods to learn soft-tissue surgical procedures rely on cadaver labs or patient-based learning, which are costly and geographically limited, and raise ethical questions. Virtual reality (VR) with haptic feedback offers a scalable alternative, but most current platforms emphasize bone-based rather than soft-tissue procedures learned by feel. We developed a VR+haptic simulation for preoperative training of retropubic midurethral sling (MUS) surgery. This study examines the usability of this platform with thirteen expert urogynecologic surgeons and subsequently makes improvements (e.g., in haptics) to evaluate the platform with twelve trainees based on the NASA Task Load Index for workload and a UTAUT-informed …

The Impact Of Gastric Sleeve And Roux-En-Y Gastric Bypass On Chief Cell Function And Protein Digestion In Obese Patients, Garikoitz Mikel Gainza

Honors Undergraduate Theses

Obesity has become one of the largest global health concerns of the 21^st century, correlating with numerous associated diseases. To help address the growing prevalence and burden of obesity, sleeve gastrectomy and Roux-en-Y gastric bypass have become two commonly performed surgical procedures done to promote weight loss by altering the anatomical structure of the stomach and surrounding organs of the gastrointestinal system. Although the benefits of improved metabolism linked to these surgical procedures are well studied, their impact on the physiology of gastric cells, and more specifically chief cells as they relate to protein digestion post-surgery, is yet to …

Smarca4-Deficient Carcinoma Of The Gastroesophageal Junction, Hanna Riga, Austin Lehr

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.