Surgery Commons^™

Real-World Clinical Outcomes Of Robotic-Assisted Total Knee Arthroplasty: A Propensity-Matched Comparative Study, Hassan Yassine, Amir Ghafarian, Jawad Saad, Abdel Kareem Hilo, Muaaz Wajahath, Khaled Saleh

Medical Student Research Symposium

Background:

Robotic-assisted total knee arthroplasty (RA-TKA) is increasingly utilized to improve component alignment and soft-tissue balance, yet its impact on clinically meaningful outcomes in large real-world populations remains uncertain. Although prior studies demonstrate improved radiographic accuracy, whether robotic assistance reduces postoperative complications, opioid utilization, or midterm mechanical failure has not been established at scale.

Methods:

We conducted a retrospective, propensity-matched cohort study using the TriNetX US Collaborative Network to identify adults undergoing primary TKA from 2018–2023. Robotic-assisted procedures were defined by CPT 27447 with concurrent robotic navigation codes. Propensity score matching (1:1) was performed to balance demographics and comorbidities, yielding …

Childcare Challenges Among Surgical Trainees And Faculty: A Single-Institution Study, Emma G Burke, Sarah Peiffer, Melissa Koci, Lindsay Dean, Kristy L Rialon, Michele Loor, Alice King

Faculty, Staff and Students Publications

Background: Previous studies have demonstrated the challenges of parenthood in surgical training and careers. However, certain aspects of childrearing for surgeons remain understudied. We aim to leftacterize the complexity and costs of childcare amongst surgical trainees and faculty.

Methods: An anonymous, self-administered survey was conducted within the Department of Surgery at a large academic medical center. Both male and female trainees and faculty were included in the analysis. Chi-square or Fisher's Exact test was performed.

Results: Forty-six respondents provided information about childcare costs, with 37% of respondents being residents or fellows. Trainees worked longer workhours (p = 0.003) than their …

Human Papillomavirus Vaccine Discourse And Sentiment On Reddit Before And After Covid-19: Mixed Methods Retrospective Cross-Sectional Study, Marcin Marciniak, Sean A Setzen, Deeya Bhattacharya, Jamie Masliah, Robin Powszok, Erich M Sturgis, Vanessa C Stubbs, Mihir K Bhayani

Faculty, Staff and Students Publications

Background: Human papillomavirus (HPV) is a sexually transmitted virus that causes various oropharyngeal and anogenital cancers. The HPV vaccine provides protection against several strains of HPV and is a key preventative tool against HPV-related cancers; however, vaccination rates remain suboptimal in the United States due to variable state mandates and misperceptions of vaccine efficacy and risks. As social media becomes an increasingly popular avenue for health discussions, platforms such as Reddit offer opportunities to understand public vaccine discourse, particularly among underrepresented groups. Furthermore, vaccine hesitancy and mistrust generally increased during the COVID-19 pandemic, potentially impacting HPV vaccination rates.

Objective: This …

Elongin B Orchestrates Chromatin And Transcriptional Programs In H3k27m-Mutant Diffuse Midline Glioma, Alan L Jiao, Rebecca L Murdaugh, Adam F Kebede, Claudia A Mimoso, Barry M Zee, Rosemary U Richard, Kwanha Yu, Caitlin L Bagnetto, Karen Adelman, Mariella G Filbin, Yang Shi, Jamie N Anastas

Faculty, Staff and Students Publications

Recurrent driver mutations in genes encoding histone H3 (H3.3K27M and H3.1K27M) are observed in ~80% of diffuse midline gliomas (DMG), which lead to aberrant gene regulation, yet the specific RNA polymerase II (Pol2) regulators that induce transcriptional dysregulation in DMG are not fully defined. We identified multiple regulators of Pol2 elongation as DMG genetic dependencies in a chromatin-focused CRISPR screen. Additional studies confirm that knockout (KO) of the Pol2 SIII complex gene elongin B (ELOB) inhibits DMG cell proliferation in tissue culture and tumor growth in xenograft models. Further genomic analyses reveal that ELOB binding sites are enriched in H3K27M …

Cohort Study Of Opioid Utilization In Post-Tonsillectomy Pediatric Patients, Sainiteesh Maddineni, Varun Vendra, Hareem Khan, Noor Ali, Tulio Valdez, Anna Messner, Iram Ahmad

Faculty, Staff and Students Publications

Objectives: Prospective observational cohort study at a tertiary care academic center to evaluate the post-operative use of oxycodone in pediatric tonsillectomy patients and caregiver knowledge of opioid disposal.

Methods: Pediatric patients 6-18 years old undergoing tonsillectomy were enrolled. Patients were excluded if they required prolonged inpatient care, had a history of organ transplantation, chronic pain or narcotic use, congenital or chromosomal disorders, inability to take acetaminophen or ibuprofen, and other significant medical diagnoses that could potentially alter postoperative pain management. All patients were prescribed a standard amount of oxycodone to be used for breakthrough pain in addition to ibuprofen and …

Investigating Racial Differences In The Receipt Of Antenatal Interventions Prior To Periviable Delivery, Niurka Monteserin, Whitney Bender

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: The Society for Maternal Fetal Medicine (SMFM) provides guidance on the use of antenatal corticosteroids, antibiotics, and cesarean delivery in the periviable period. Although racial differences exist in postnatal active management of periviable neonates have been described, less is known about racial differences in antenatal interventions preceding delivery.

OBJECTIVE: To evaluate differences in the receipt of antenatal interventions before periviable delivery by birthing parent race.

METHODS:  We conducted a population-based cohort study using the National Center for Health Statistics database including periviable deliveries (20w0d-25w6d) from 2016-2021. Individuals delivering a non-anomalous live singleton gestation in a hospital were included. Births …

Factors Influencing Outcomes In Neonatal Abdominal Surgery: Surgeons’ Perspectives, Nimmita Srisan, Kanyarat Olarachin, Pattamon Sutthatarn, Katawaetee Decharun, Prapapan Rajatapiti, Somboon Reukvibunsi, Paisarn Vejchapipat

Chulalongkorn Medical Journal

Neonatal abdominal surgery was often indicated by congenital conditions, presenting significant risks of morbidity and mortality. However, comprehensive surgical data and identification of complication-related risk factors still receive little attention.

Purpose: Our objectives were to characterize neonatal patients undergoing abdominal surgery and to identify prognostic factors influencing complications and mortality in those patients.

Methods: A retrospective study was conducted on newborn patients aged between 0-30 days undergoing index surgery at a university hospital from 2013 to 2021. Categorical data were compared between the without-complication group and the with-complication group using the Chi-square tests and Fisher-Exact tests. Continuous data were analyzed …

Frailty Is A Predictor Of Inpatient Mortality And Unplanned Icu Admission Following Early Fixation Of Intertrochanteric Fractures., Victor Koltenyuk, Jared Sasaki, Nithin Gupta, Zachary Chanmin, Ruby G Patel, Taylor Manes, Jack W Weick

Surgery Articles

Purpose: This study sought to examine the role of frailty in predicting inpatient mortality following early surgical fixation of intertrochanteric (IT) fractures.

Methods: The ACS-TQIP (2017-21) database was queried for patients with intertrochanteric fractures undergoing surgical fixation within 48 h. Frailty status was determined using the 5-item modified frailty index (mFI-5) (0 = nonfrail, 1 = prefrail, and, 2 = frail, and > 2 = severely frail). The primary end point was inpatient mortality. Secondary end points were unplanned ICU admission and thromboembolic events (DVT or PE). Significance was considered a p-value < 0.05.

Results: Frailty, as determined by the mFI-5, was …

Clinical Outcomes Of A Non-Diffractive Extended Depth Of Focus Intraocular Lens In Post-Refractive Eyes, Collin Olevson, John P. Berdahl, Tanner J. Ferguson

Scholarship Pathways Program

Clinical outcomes of a non-diffractive extended depth of focus intraocular lens in post-refractive eyes

 Collin Olevson, MD¹ | John Berdahl, MD^1,2 and Tanner Ferguson, MD^1,2

¹University of South Dakota Sanford School of Medicine, Vermillion, SD

²Vance Thompson Vision, Sioux Falls, SD

Introduction: Eyes with prior corneal refractive surgery (i.e laser-assisted in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK)) pose challenges during cataract surgery due to altered corneal curvature. The AcrySof IQ Vivity intraocular lens (IOL) is a non-diffractive extended depth-of-focus (EDOF) IOL designed to provide a broader range of vision. Limited data exists on its …

Visual Outcomes And Quality Of Life In A Randomized Trial Of Topography-Guided Lasik With Novel Gis-Software Versus Wavefront Optimized Lasik, Elise V.H. Meide, Tanner J. Ferguson, John P. Berdahl, Vance M. Thompson, Daniel C. Terveen

Scholarship Pathways Program

Visual Acuity and Quality of Life Results in a Randomized Trial of Topography-Guided with GIS-Software Versus Wavefront Optimized LASIK

Elise V.H. Meide, MD | Daniel C. Terveen, MD

Purpose: To compare post-operative visual acuity, refractive outcomes and patient-reported visual quality of life between topography-guided (TG) laser-assisted in situ keratomileusis (LASIK) with novel geographic imaging system (GIS) based software versus wavefront-optimized (WFO) LASIK. Main outcome measures included the rate of patients with uncorrected distance visual acuity (UDVA) of 20/16 or better 3 months post-operatively. Secondary and exploratory endpoints include best corrected visual acuity (BCVA), residual refractive error, low contrast visual acuity, …

Multi-Site Dms Probing Reveals Higher-Order Structure Of Rna-Protein Complexes In Living Cells, Irfana Saleem, Thomas Miller, Lucas Kearns, Anthony Hoang, Joshua Meehan, Ritwika Bose, David Mitchell, David H Price, Calla M Olson, Chase A Weidmann, Anthony M Mustoe

Faculty, Staff and Students Publications

Identifying tertiary structures and protein binding sites in RNA molecules remains a key challenge in RNA biology. We describe multi-site dimethyl sulfate (DMS)-mutational profiling (MaP) (msDMS-MaP), a strategy that enables simultaneous measurement of RNA secondary, tertiary, and quaternary structures via a single DMS chemical probing experiment. Optimized reverse transcription decodes typically invisible DMS N7-methylguanine (N7-G) modifications via a tautomer-induced mutational signature concurrent with N1 and N3 modifications. We show that N7-G reactivity reports on higher-order RNA structures, revealing key functional motifs such as pseudoknots and protein binding sites. Using msDMS-MaP, we find that E. coli ribosomal RNAs encode numerous independently …

Agenda (Pdf), Department Of Surgery

Surgery Research Symposium

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

Machine Learning-Based Prediction Of Proximal Junctional Pathology After Adult Spinal Deformity Surgery: A Systematic Review And Diagnostic Test Accuracy Meta-Analysis, Shaan Patel, Shiva A. Nischal, Yi Hein Chai, Kush M. Kale, Kevin Hines, Joshua Pelta-Heller, Jack Jallo, James S. Harrop, Srinivas K. Prasad

Department of Neurosurgery Faculty Papers

BACKGROUND: Proximal junctional kyphosis (PJK) and failure (PJF) remain challenging and incompletely predictable adverse event following adult spinal deformity (ASD) surgery. Machine learning (ML) models have been proposed to improve risk stratification, but performance varies and clinical applicability remains uncertain. A systematic review and diagnostic test accuracy meta-analysis was performed to synthesize the predictive performance of ML-based models for proximal junctional pathology after ASD surgery.

METHODS: PubMed, Embase, and CENTRAL were searched from inception to February 2026. Studies developing or validating ML models predicting PJK or PJF following ASD surgery were included. Diagnostic performance was synthesized using random-effects models, pooling …

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 …

Cpt1a Loss Promotes Lung Metastasis In Immune-Competent Mice Via A Mechanism Of Mtdna Release And Chronic Activation Of Sting Pathway, Xiaoyong Wang, Shu-Ting Chou, Yoonha Hwang, Jin Chen, Deanna N Edwards

Faculty, Staff and Students Publications

The metastatic progression of breast cancer involves complex interactions between tumor cells and immune cells, including T cells that exert cytotoxic pressure to limit metastasis. Tumor cells reprogram their metabolism to evade immune surveillance, a critical step to achieving metastatic outgrowth. Using an unbiased CRISPR screen targeting metabolism-related genes and a clinically relevant spontaneous metastasis mouse model, we identified CPT1A, the rate-limiting enzyme in fatty acid β-oxidation, as a suppressor of immune-dependent metastasis. Loss of CPT1A enhances lung metastasis in immunocompetent mice, but not Rag1 KO mice that lack mature lymphocytes. Loss of CPT1A triggers cytosolic mitochondrial DNA (mtDNA) release …

Timing Isn't Everything: Rethinking Mortality Risk In Type A Aortic Dissection Surgery, Anna H Xue, Joseph S Coselli

Faculty, Staff and Students Publications

No abstract provided.

Isass Brave New Continuing Medical Education World: The Stifling Of Innovation In Spine Surgery Through Overrestriction Of Collaboration, Morgan P. Lorio, Kai-Uwe Lewandrowski, Óscar L. Alves, Avelino Parajón, Matthew Scott-Young, Hansen A. Yuan, Alex R. Vaccaro

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: in 2020, the accreditation Council for Continuing Medical education (aCCMe) released the Standards for Integrity and Independence in Accredited Continuing Medical Education, effective january 1, 2022, to ensure that accredited activities are accurate, balanced, evidence-based, and clearly separated from marketing and sales. although these aims are broadly supported, implementation may have unintended consequences in procedure-intensive specialties such as spine surgery, where surgeon–industry collaboration often drives device innovation, clinical trials, and dissemination of new techniques.

OBJECTIVE: To examine how current interpretations of ACCME eligibility and financial-relationship standards may affect continuing medical education in spine surgery and to propose practical adaptations …

Impact Of Intracranial Pressure Monitoring On 30-Day Mortality In Severe Traumatic Brain Injury: A Retrospective Cohort Study In Kenya, George Ongas, Idris Chikophe, Jacqueline Mavuti, David Olunya, Mubashir Qureshi, Beverly Cheserem, Edwin Mogere

General Surgery, East Africa

OBJECTIVE The objective of this study was to evaluate 15-year trends in epidemiology, baseline severity, management, and outcomes of severe traumatic brain injury (sTBI) at a Kenyan tertiary center, and to determine the impact of invasive intracranial pressure (ICP) monitoring on 30-day mortality in a low- and middle-income country (LMIC) context.

METHODS A retrospective quasi-experimental cohort analysis of consecutive sTBI admissions (postresuscitation Glasgow Coma Scale [GCS] score ≤ 8, age ≥ 13 years) from January 1, 2010, to December 31, 2024, was conducted. This time period was divided into two eras: era 1 (2010–2014), premonitoring, and era 2 (2015–2024), routine …