Surgery Commons^™

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 …

Are Orthopaedic Trauma Surgeons At Risk Of Occupational Noise-Induced Hearing Loss?, Vincent W. Lau, Stephanie A. Kwan, Jack Graham, Gregory K. Deirmengian

Rothman Institute Papers

OBJECTIVES: Orthopaedic surgeons are at risk of occupational, noise-induced hearing loss due to exposure to instruments in the operating room. The primary objective of this study was to determine whether orthopaedic trauma procedures exceed recommended decibel (dB) limits. The secondary objective was to demonstrate which actions during a case create the highest sound levels.

METHODS: Intraoperative recordings were taken during orthopaedic trauma surgeries and classified into open reduction internal fixation (ORIF), intramedullary nailing, closed reduction percutaneous pinning, external fixation, soft tissue procedures, or a combination thereof. Recordings were taken of drilling, screw insertion, suctioning, saw use, and mallet striking. Decibel …

Temporary Intravascular Shunting Using A Carotid Shunt For Traumatic Femoral Artery And Vein Injury In A Hemodynamically Unstable Patient, Nicola Habash, Fari Fall, Jin Park, Babak Abai, Michael Nooromid

Department of Surgery Faculty Papers

Vascular trauma involving the peripheral arteries of the extremities can lead to limb loss and, in severe cases, death. The use of intravascular shunts can help to temporarily perfuse the limb, while allowing for resuscitation of a critically injured patient. Here we present a case of a concomitant complex injury of the common femoral artery and common femoral vein, and the complementary vascular strategies used to achieve limb salvage.

Efficacy Of Submuscular Transposition For Revision Cubital Tunnel Release: Comparative Outcomes Analysis, Joshua Riklan, Alexzandra Mattia, Markos Mardourian, Harvey Chim

School of Medicine Faculty Publications

Purpose: To assess outcomes after revision cubital tunnel release and submuscular transposition and compare these to a cohort of patients undergoing primary release with in situ decompression. Methods: Patients who underwent revision cubital tunnel release and submuscular transposition (n = 16) were enrolled. Mean follow-up was 21.4 months (range 12.8–55.6). Patients were evaluated in person using the Michigan Hand Outcomes Questionnaire (MHQ) and Disabilities of the Arm, Shoulder and Hand (DASH). Dellon stage, McGowan grade, visual analog scale for pain, and improvement of symptoms using the Messina's criteria and Modified Bishop score were assessed. Comparative analysis was performed with a …

Racial And Socioeconomic Disparities In Long Term Survival After Surgery And Radiation For Spinal Cord Hemangioblastoma, Abdul Karim Ghaith, Xinlan Yang, Joshua Weinberg, Shaan Bhandarkar, Taha Khalilullah, Abdel-Hameed Al-Mistarehi, Khaled Zaitoun, Meghana Bhimreddy, Arjun K. Menta, Antony A. Fuleihan, Kamel Chebaro, Jawad Khalifeh, Andrew Grossbach, Nicholas Theodore, Daniel Lubelski

Department of Medicine Faculty Papers

Spinal cord hemangioblastomas are rare, benign, intradural tumors that, despite their nonmalignant histopathology, can lead to substantial neurological morbidity. While disparities in outcomes based on race and socioeconomic status have been well-documented in other spinal tumor populations, their role in spinal cord hemangioblastoma remains poorly understood. In this study, we utilize the National Cancer Database (NCDB) to evaluate the influence of race, socioeconomic factors, and healthcare access on survival outcomes in patients with spinal cord hemangioblastoma. Additionally, we explore the utility of machine learning-based survival models to improve individualized risk prediction and to identify key clinical and sociodemographic determinants of …

Summary Of The 2024 Brano Heart Failure Forum, Igor D. Gregoric, Milovan Bojic, Bojan Vrtovec, Rajko Radovancevic

The VAD Journal

Since 2007, the Branislav “Brano” Radovancevic Heart Failure Forum (BHFF) has been held annually to provide a venue for experts to present and discuss “Innovations and New Treatment Strategies in Heart Failure.” Clinicians and researchers gather yearly in a different Eastern European city to discuss the latest in heart failure diagnostics and therapeutics. The 2024 BHHF was held on the 18^th through the 20^th of September 2024 in Belgrade, Serbia. It was attended by over 100 faculty from 16 countries. In addition, participation through online streaming was available. Throughout the forum, 17 sessions focused on challenges and solutions …

Dissatisfaction And Residual Symptoms In Younger And Older Adult Patients After Total Knee Arthroplasty, Nicholas Pohl, Parker Brush, Adrian Santana, Sebastian Fras, Eleanor Jenkins, Arjun Saxena

Department of Orthopaedic Surgery Faculty Papers

INTRODUCTION: Total knee arthroplasty (TKA) is an increasingly used treatment option for younger patients with osteoarthritis. Previous research has found only 66% patients < 60 years who underwent TKA postoperatively reported that their knees felt normal. However, the prior studies did not compare underlying causes for dissatisfaction based on age. This study compared the satisfaction and residual symptom rates between patients ages < 60 and ≥60 years and identified specific reasons for their dissatisfaction between the age groups.

METHODS: Patients who underwent unilateral TKA for osteoarthritis from 2014 to 2016 were electronically sent a 15-question survey pertaining to surgery satisfaction. Following patient identification and survey completion, patient demographics, medical history, surgical time, and length of stay were collected through manual review of medical records. Patients who completed surveys were grouped by age (< 60 years or ≥60 years) for analysis.

RESULTS: In total, 1189 ≥ 60-year-old patients and 388 < 60-year-old patients were included. Most patients in both cohorts reported satisfaction with overall knee function (< 60: 68.6%; ≥60: 71.8%; P = 0.175). Fewer < 60-year patients reported normal knee function (66.5% vs. 75.2%; P < 0.001). The most common residual symptom in both cohorts was continued pain.

CONCLUSION: Patients younger than 60 years reported less satisfaction with performing normal activities …

Oncoplastic Nipple-Sparing Mastectomy And Immediate Reconstruction In Non-Ideal Candidates, Aaron Dadzie, Yossef Alsabawi, Sonia Y. Khan, Paul Berry

School of Medicine Publications

Mastectomies have long been used as a surgical treatment for malignant and benign disorders of the breast, both as a therapy and prophylaxis in high-risk patients. A nipple-sparing mastectomy (NSM) allows for the removal of most of the glandular and ductal tissues while preserving the surface architecture of the nipple-areola complex (NAC). This report summarizes the current mastectomy practices and suggests an expansion of the established surgical selection criteria for NSM in the context of immediate implant-based breast reconstruction. We present two cases in which a novel hybrid oncoplastic approach was used and discuss its safety and efficacy when performing …

Operative Trends In Endovascular And Open Procedures Among Vascular Fellows, Jin Park, Nicola Habash, Dawn Salvatore, Michael Nooromid, Paul J. Dimuzio, Babak Abai

Department of Surgery Faculty Papers

Objective: Over the past decade, there has been a growing adoption of endovascular approaches for treating vascular pathologies. This shift toward minimally invasive techniques has raised concerns about declining open surgical case volumes for vascular surgery fellows, particularly in procedures such as aortic aneurysm repair. This study aimed to analyze trends in both open and endovascular case volumes across major vascular procedure categories, including aortic aneurysm, lower extremity arterial disease, abdominal occlusive disease, and cerebrovascular disease, among graduating vascular surgery fellows. Methods: National case log data from the Accreditation Council for Graduate Medical Education were collected for 5 + 2 …

Clinical Outcomes Following Endoscopic Carpal Tunnel Release With The Arthrex Nanoscopic Release System-A Single Surgeon Experience, Sina Ramtin, Asif M. Ilyas

Department of Orthopaedic Surgery Faculty Papers

PURPOSE: Endoscopic carpal tunnel release (ECTR) is a minimally invasive alternative to open release, offering faster recovery and reduced postoperative discomfort. The Arthrex NanoScopic ECTR system, a novel single-use device using chip-on-tip digital imaging and designed for use under local anesthesia without arthroscopic equipment, may further streamline care and expand surgical access.

METHODS: A retrospective review was conducted of the first 50 consecutive ECTR procedures performed using the Arthrex NanoScopic system by a single hand fellowship-trained hand surgeon. All procedures were completed under wide-awake local anesthesia no tourniquet technique in an outpatient surgical center. Outcomes included operative times, adverse events, …

Spontaneous Closure Of A Patent Processus Vaginalis: A Case Report, Haley Kittle, Amber Lee Geng, Loren Berman, Erin Teeple

Department of Surgery Faculty Papers

Introduction: Patent process vaginalis and inguinal hernia are prolific in infants, and their repair is a common pediatric surgical procedure. However, there is a paucity of direct evidence detailing the spontaneous closure of patent processus vaginalis.

Case presentation: A 4-month-old boy born prematurely at 34-weeks with low gestational birth weight, underwent laparoscopic gastrostomy tube placement for oropharyngeal dysphagia and was incidentally found to have bilateral patent processes vaginalis. Due to his lack of symptoms, he was managed under the watchful waiting approach. His parents were educated about signs and symptoms of inguinal hernia and were instructed to contact the team …

Cultural And Socioeconomic Determinants Of Hip And Knee Arthroplasty In The Medically Underserved Rio Grande Valley Community, Blake C. Martin, Juan C. Lopez Alvarenga, John M. Gaddis

School of Medicine Publications

Introduction: Joint arthroplasty is a common procedure that is increasing worldwide. In this study, we aimed to discover if there were differences in demographics and social factors associated with individuals undergoing total knee arthroplasty (TKA) and total hip arthroplasty (THA) in the Rio Grande Valley (RGV). We hypothesized that older individuals and those with higher body mass index (BMI) would have an increased risk of TKA.

Methods: We conducted a retrospective chart review using the University of Texas Rio Grande Valley UTHealth electronic database from January 1, 2018, to July 1, 2024. Individuals were selected using Current Procedural Terminology codes …

Hardware And Software Design For A Portable Surgical Training Simulator, Victoria Nelson

Department of Mechanical and Materials Engineering: Dissertations, Theses, and Student Research

More than 51 million surgeries are performed on patients annually in the United States. That number grows to 310 million surgeries performed globally each year. Most surgeons go through a minimum of five years of residency – where they train and hone their surgical skills. It is important during this time, and throughout their careers, that they get plenty of practice. Surgical training is time intensive, expensive, and frequently under-resourced. There are finite amounts of surgical training modules for students to share at their facilities. The problem of getting adequate surgical training time continues to exist after surgeons begin their …

Identifying Critical Evidence Gaps In Wound Closure And Incision Management After Total Hip Arthroplasty: Delphi Panel Insights, Margaret Ainslie-Garcia, Lucas Anderson, Benjamin Bloch, Tim N Board, Antonia Chen, Samantha Craigie, Walter Danker, Najmuddin Gunja, James Harty, Victor Hernandez, Kate Lebedeva, Mitchell Ng, Daniel Hameed, Michael Mont, Ryan Nunley, Javad Parvizi, Sean Sequeira, Carsten Perka, Nicolas Piuzzi, Ola Rolfson, Joshua Rychlik, Emilio Romanini, Pablo Sanz-Ruiz, Rafael Sierra, Linda Suleiman, Eleftherios Tsiridis, Pascal-André Vendittoli, Helge Wangen, Luigi Zagra

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: In total hip arthroplasty (THA), proper management of surgical incisions is essential for optimal wound healing and patient outcomes. Despite advances in surgical techniques, significant challenges remain in preventing complications and infections. This study aimed to identify evidence gaps in THA wound care, including presurgical preparation, intraoperative practices, and postsurgical complications.

METHODS: Using a modified Delphi method, 20 expert orthopedic surgeons from Europe and North America participated in a 3-phase consensus process from April 1 to September 30, 2023. This included a preliminary questionnaire, a remote conference, and a final online survey. The panel reviewed literature and achieved agreement …

2024 Eacts/Eactaic Guidelines On Patient Blood Management In Adult Cardiac Surgery In Collaboration With Ebcp, Filip Casselman, Marcus Lance, Aamer Ahmed, Alice Ascari, Juan Blanco-Morillo, Daniel Bolliger, Maroua Eid, Gabor Erdoes, Renard Haumann, Anders Jeppsson

Anaesthesiology, East Africa

No abstract provided.

Emotional Safety In Pediatrics: The Impact Of Child Life Services On Healthcare Professionals’ Perceptions Of Their Own, Patients’, And Families’ Outpatient Experiences, Jenni Davis

All Dissertations

Medical visits, regardless of setting, are stressful for children and their families. Care that focuses on the emotional safety of children and families can help reduce this stress. However, not all staff feel prepared to provide emotionally safe care. Child life specialists (CLSs) are specifically trained to support emotional needs during healthcare encounters. Their presence may help staff stress as well, not just stress for children and families.

This study used three surveys to understand stress among healthcare staff working in pediatric outpatient clinics and surgery settings, and how support from a CLS affects staff, children, and families. All staff …

Angioedema: Is Icu Admission Warranted? A Single Institution Assessment, Madeleine Brill-Edwards, W. Chase Hamilton, Erika J. Yoo, Jennifer Costello, George J. Koenig, Murray J. Cohen, Joshua A. Marks

Department of Surgery Faculty Papers

INTRODUCTION: Angioedema has potential for rapid airway decompensation requiring intervention. Patients are often admitted to an ICU for "airway watch." There is a lack of evidence to support which patients require this.

AIM: We aimed to characterize admission patterns and outcomes of angioedema patients at our institution to assess resource utilization and necessity of ICU use. We hypothesized that patients not requiring intubation upon presentation are safe to manage outside the ICU.

MATERIALS AND METHODS: Retrospective chart review of patients admitted to our urban academic quaternary referral institution with angioedema ICD-10 codes between 2017 and 2020. Charts reviewed for demographics, …

The Sodium-Glutamate Antagonist Riluzole Improves Outcome After Acute Spinal Cord Injury: Results From The Riscis Randomised Controlled Trial Analysed Using A Global Statistical Analytic Technique, Michael G. Fehlings, Karlo M. Pedro, Mohammed Ali Alvi, Ali Moghaddamjou, James S. Harrop, Ralph Stanford, Jonathon Ball, Bizhan Aarabi, Paul M. Arnold, James D. Guest, Shekar N. Kurpad, James M. Schuster, Ahmad N. Nassr, Karl M. Schmitt, Jefferson R. Wilson, Darrel S. Brodke, Faiz U. Ahmad, Albert Yee, Wilson Z. Ray, Nathaniel P. Brooks, Jason Wilson, Diana S-L Chow, Elizabeth G. Toups, Kevin E. Thorpe, Jiaxin Huang, Peng Huang

Department of Neurosurgery Faculty Papers

BACKGROUND: Spinal cord injury (SCI) clinical trials typically rely on a single primary endpoint to assess drug efficacy. This strategy fails to adequately capture the full impact of treatment in heterogenous neurological conditions like SCI. A more patient-centric analysis requires assessment of neurological function, functional capacity, and quality of life, incorporating meaningful patient-reported outcomes. The global statistical test (GST) addresses this challenge using a unified statistical conclusion regarding the superiority of a treatment strategy over another by evaluating multiple trial endpoints simultaneously.

METHODS: The RISCIS trial (Safety and Efficacy of Riluzole in Acute Spinal Cord Injury Study) data was analysed …