Surgery Commons^™

Robotic Cholecystectomy Versus Laparoscopic Cholecystectomy: A Modern Analysis Of Outcomes And Efficiency, Samuel Durham, Aziz Sadiq

Rowan-Virtua Research Day

Introduction/Purpose

Laparoscopic cholecystectomy was first performed in the United States in 1982, and by 1992 it became standard practice. The first robotic cholecystectomy was performed in 1997, yet it still has not been widely accepted as the standard of care. Many research papers early on in the development of robotic-assisted surgery concluded that robotically removing gallbladders would be more costly and less time efficient. We aim to compare the costs and operative time between laparoscopic and robotic cholecystectomy.

Methods

A study was performed on patients who underwent an elective robotic cholecystectomy over one year by a single primary surgeon. Operative …

Perioperative Ketamine Use For Post Mastectomy Pain, Alessia Cooney, Jaylyn Thompson, Naomi Watkins-Granville

Rowan-Virtua Research Day

PMPS is defined as chronic neuropathic pain following breast cancer procedures in the ipsilateral arm, chest wall, axilla or shoulder.1-3 Approximately 20 to 50% of post mastectomy patients suffer from Post Mastectomy Pain Syndrome (PMPS).1 With more than 3.8 million breast cancer survivors, due to advances in treatment, there is increased importance in findings ways to better manage the quality of life of breast cancer survivors.1,4 Ketamine induces analgesic effects through its non-competitive antagonism of NDMA receptors.5 Low doses of ketamine infusion (20–30 mg x h−1) have been shown to produce analgesia in neuropathic pain states with benefits lasting up …

Bibliometric Analysis Of Academic Journal Recommendations And Requirements For Surgical And Anesthesiologic Adverse Events Reporting, Tamir N. Sholklapper, Jorge Ballon, Aref S. Sayegh, Anibal La Riva, Laura C. Perez, Sherry Huang, Michael Eppler, Gregg Nelson, Giovanni Marchegiani, Robert Hinchliffe, Luca Gordini, Marc Furrer, Michael J. Brenner, Salome Dell-Kuster, Chandra Shekhar Biyani, Nader Francis, Haytham M.A. Kaafarani, Matthias Siepe, Des Winter, Julie A. Sosa, Francesco Bandello, Robert Siemens, Jochen Walz, Alberto Briganti, Christian Gratzke, Andre L. Abreu, Mihir M. Desai, Rene Sotelo, Riaz Agha, Keith D. Lillemoe, Steven Wexner, Gary S. Collins, Inderbir Gill, Giovanni E. Cacciamani

Einstein Health Papers

BACKGROUND: Standards for reporting surgical adverse events (AEs) vary widely within the scientific literature. Failure to adequately capture AEs hinders efforts to measure the safety of healthcare delivery and improve the quality of care. The aim of the present study is to assess the prevalence and typology of perioperative AE reporting guidelines among surgery and anesthesiology journals.

MATERIALS AND METHODS: In November 2021, three independent reviewers queried journal lists from the SCImago Journal & Country Rank (SJR) portal (www.scimagojr.com), a bibliometric indicator database for surgery and anesthesiology academic journals. Journal characteristics were summarized using SCImago, a bibliometric indicator database extracted …

Cancer Stem Cell Assay-Guided Chemotherapy Improves Survival Of Patients With Recurrent Glioblastoma In A Randomized Trial, Tulika Ranjan, Soma Sengupta, Michael J. Glantz, Richard M. Green, Alexander Yu, Dawit Aregawi, Rekha Chaudhary, Ricky Chen, Mario Zuccarello, Christine Lu-Emerson, Hugh D. Moulding, Neil Belman, Jon Glass, Aaron Mammoser, Mark Anderson, Jagan Valluri, Nicholas Marko, Jason Schroeder, Steven Jubelirer, Frances Chow, Pier Paolo Claudio, Anthony M. Alberico, Seth T. Lirette, Krista L. Denning, Candace M. Howard

Department of Neurosurgery Faculty Papers

Therapy-resistant cancer stem cells (CSCs) contribute to the poor clinical outcomes of patients with recurrent glioblastoma (rGBM) who fail standard of care (SOC) therapy. ChemoID is a clinically validated assay for identifying CSC-targeted cytotoxic therapies in solid tumors.

In a randomized clinical trial (NCT03632135), the ChemoID assay, a personalized approach for selecting the most effective treatment from FDA-approved chemotherapies, improves the survival of patients with rGBM (2016 WHO classification) over physician-chosen chemotherapy. In the ChemoID assay-guided group, median survival is 12.5 months (95% confidence interval [CI], 10.2-14.7) compared with 9 months (95% CI, 4.2-13.8) in the physician-choice group (p = …

Smartphone-Based Fundus Imaging For Evaluation Of Retinopathy Of Prematurity In A Low-Income Country: A Pilot Study, Roha Ahmad Choudhary, Shiraz Hashmi, Haroon Tayyab

Department of Ophthalmology & Visual Sciences

Objectives: To evaluate the feasibility of a novel and simple smart phone-based Retinopathy of Prematurity (ROP) screening approach in a resource-constrained setting.
Methods: This cross-sectional validation study was conducted at the Department of Ophthalmology and Neonatal Intensive Care Unit (NICU) of The Aga Khan University Hospital, Pakistan, from January 2022 to April 2022. A total of 63 images of eyes with active ROP (stage-1, 2, 3, 4 and/or plus or pre-plus disease) were included in this study. The stage of ROP was documented by the principal investigator using an indirect ophthalmoscope and retinal images were obtained using this novel technique. …

Shortening The Postoperative Length Of Stay Following Total Knee Arthroplasty Does Not Negatively Impact Short-Term Patient Outcomes; A Retrospective Review Of The Response To The Covid-19 Pandemic, Bailey Shevenell, Johanna Mackenzie, Cassandra Lieblein, Brian J. Mcgrory, Michael Becker, Nicholas Colacchio, Adam Rana

Costas T. Lambrew Research Retreat 2023

Safely Decreasing Postoperative Length of Stay for Total Knee Arthroplasty (TKA) Patients Following the COVID-19 Pandemic

Conversion Total Hip Arthroplasty: Perioperative And Postoperative Outcomes With The Able Approach, Bailey Shevenell, Johanna Mackenzie, Sarah Hearns, George Babikian, Brian J. Mcgrory, Adam Rana

Costas T. Lambrew Research Retreat 2023

The ABLE™ Approach for Conversion Total Hip Arthroplasty decreases surgical duration and length of stay

The Use Of The Ipack Block With The Adductor Canal Block (Acb) Decreases 48-Hour Narcotic Usage And Postoperative Pain Following Total Knee Arthroplasty, Bailey Shevenell, Johanna Mackenzie, Matthew Hersch, Michael Becker, Brian J. Mcgrory, Nicholas Colacchio, Adam Rana, Ryan Mountjoy, Rob Hubbs

Costas T. Lambrew Research Retreat 2023

Adductor Canal and iPACK Blocks reduce pain levels and narcotic consumption following Total Knee Arthroplasty

Biportal Endoscopic Spine Surgery For Lumbar Laminectomy And Discectomy: Post-Operative Outcomes And Surgical Learning Curve, Matthew Lipphardt, Philip Zakko, Ali Jawad, Daniel Park, Maximillian Lee

Conference Presentation Abstracts

Background/Introduction

Biportal endoscopic spine surgery (BESS) is a minimally invasive spinal surgery which has gained increased traction for lumbar laminectomy and discectomy. To justify the transition from tubular or open surgery to BESS, BESS outcomes and surgical learning curve should be known. The primary goal of this study is to evaluate rates of complications with BESS as well as how these rates change with increased surgeon experience, especially in the US environment.

Materials/Methods

A United States Fellowship trained orthopaedic surgeon's clinical practice database was interrogated for consecutive patients who underwent BESS at a single institution. Patients aged greater than 18 …

Osteoporosis Is Underdiagnosed And Undertreated In Patients With Fragility Femoral Neck And Vertebral Compression Fractures, Philip Zakko, Lauren Eberhardt, Madeline Declercq, Ahyoung Park, Megan Audet, Daniel Park

Conference Presentation Abstracts

Background/Introduction

Femoral neck (FNF) and vertebral compression fractures (VCF) are common fragility fractures (FF) in the elderly population. Defined as fractures from low-energy trauma, FF are diagnostic of osteoporosis and require treatment. The purpose of this study was to assess whether patients were appropriately diagnosed and treated for osteoporosis following fragility FNF and VCF.

Materials/Methods

A retrospective chart review was performed at a single-institution from 1/1/2017 to 12/31/2020 on consecutive patients who sustained fragility FNF treated with closed reduction percutaneous pinning, hemiarthroplasty, or total hip arthroplasty or VCF treated with kyphoplasty. Patients <50 years of age, who sustained a high-energy or a non-osteoporotic pathologic fracture, were treated non-operatively, or deceased within one-year post-op were excluded. Preoperative demographics, ASA, CCI, smoking, alcohol, and glucocorticoid use were obtained. Diagnosis and treatment of osteoporosis, including dual-energy X-ray absorptiometry (DEXA) scans, calcium, vitamin D, bisphosphonates, denosumab, and alternative treatments (teriparatide, calcitonin, raloxifene, estrogen) were assessed pre-op and within one-year post-op. Subsequent FF were recorded.

Results

Of 593 patients, 276 FNF and 94 …

The Association Of 1-Year Weight Loss From Bariatric Surgery And Self-Reported Sleep: A Prospective Cohort, Salman S Hasan, Elena E Skaribas, Elaijah Islam, David Z Allen, Sancak Yuksel

Faculty, Staff and Student Publications

Hypoplastic left heart syndrome (HLHS) is a congenital diagnosis that necessitates immediate intervention at the beginning of life to ensure survival past infancy and to optimize left-side cardiac function. Often, these required procedures can lead to deleterious side effects and resultant complications. In this case report, we present a 15-month-old patient with HLHS who underwent multiple procedures, including two aortic arch surgeries. After the interventions, the patient experienced left main pulmonary bronchus compression along with pulmonary artery stenosis. In this case, we outline an approach to performing vascular dilation without compromise of airway patency.

Patient With Genital Lymphedema, Pain, And Rash, Resa G Magill, Dylan Supak, Rachel Pham, Dustin Luse, Cooper R Benson

Faculty, Staff and Student Publications

No abstract provided.

Neuroendocrine Tumor Of The Ampulla Of Vater: A Case Report, Mohammad S Aman, Bidhan C Das, Aminul Islam, Murshidul Arefin, Satya N Gupta

Faculty, Staff and Student Publications

Neuroendocrine tumors (NETs) of the ampulla of Vater are extremely rare. Here, we discuss the clinical presentation, diagnostic challenges, and treatment options of a recently experienced case of NET of the ampulla of Vater in light of the literature. A 56-year-old woman presented with recurrent upper abdominal pain. Ultrasonography (USG) of the whole abdomen showed multiple gallstones along with a dilated common bile duct (CBD). For evaluating the dilated CBD, a magnetic resonance cholangiopancreatography was performed, which revealed the double-duct sign. Subsequently, an upper gastrointestinal endoscopy showed a bulged-out ampulla of the Vater. Biopsy and histopathological examination of the growth …

Brain Engagement During A Cognitive Flexibility Task Relates To Academic Performance In English Learners, Tehila Nugiel, Mackenzie E Mitchell, Damion V Demeter, Annacarolina Garza, Paul T Cirino, Arturo E Hernandez, Jenifer Juranek, Jessica A Church

Faculty, Staff and Student Publications

English Learners (ELs), students from non-English-speaking backgrounds, are a fast-growing, understudied, group of students in the U.S. with unique learning challenges. Cognitive flexibility—the ability to switch between task demands with ease—may be an important factor in learning for ELs as they have to manage learning in their non-dominant language and access knowledge in multiple languages. We used functional MRI to measure cognitive flexibility brain activity in a group of Hispanic middle school ELs (N = 63) and related it to their academic skills. We found that brain engagement during the cognitive flexibility task was related to both out-of-scanner reading …

Adapting Elements Of Cleft Care Protocols In Low- And Middle-Income Countries During And After Covid-19: A Process-Driven Review With Recommendations, Matthew Fell, Michael Goldwasser, B S Jayanth, Rui Manuel Rodrigues Pereira, Christian Tshisuz Nawej, Rachel Winer, Neeti Daftari, Hugh Brewster, Karen Goldschmied, Collaborators Fernando Almas, Mekonen Eshete, George W Galiwango, Larry H Hollier, Akhter Hussain, Lun-Jou Lo, Paul Salins, Debbie Sell, Amanuel Tafase, Ronald M Zuker

Faculty, Staff and Students Publications

A consortium of global cleft professionals, predominantly from low- and middle-income countries, identified adaptations to cleft care protocols during and after COVID-19 as a priority learning area of need. A multidisciplinary international working group met on a videoconferencing platform in a multi-staged process to make consensus recommendations for adaptations to cleft protocols within resource-constrained settings. Feedback was sought from a roundtable discussion forum and global organizations involved in comprehensive cleft care. Foundational principles were agreed to enable recommendations to be globally relevant and two areas of focus within the specified topic were identified. First the safety aspects of cleft surgery …

Endogenous Interleukin-10 Contributes To Wound Healing And Regulates Tissue Repair, Walker D Short, Meredith Rae, Thomas Lu, Benjamin Padon, Tanuj J Prajapati, Fayiz Faruk, Oluyinka O Olutoye, Ling Yu, Paul Bollyky, Sundeep G Keswani, Swathi Balaji

Faculty, Staff and Students Publications

INTRODUCTION: Interleukin-10 (IL-10) is essential in fetal regenerative wound healing and likewise promotes a regenerative phenotype in adult dermal wounds. However, the role of endogenous IL-10 in postnatal dermal wound healing is not well-established. We sought to determine the function of endogenous IL-10 in murine full thickness excisional wounds that are splinted to prevent contracture and mimic human patterns of wound closure.

METHODS: Full-thickness excisional wounds were made in wildtype (WT) and IL-10

RESULTS: We observed no difference in wound healing rate between WT and IL-10

CONCLUSIONS: These data suggest that endogenous IL-10 expression does not alter closure of full …

Surgical Reconstruction Of Stage 3 And 4 Pressure Injuries: A Literature Review And Proposed Algorithm From An Interprofessional Working Group, Samir S Awad, James D Stern, Cathy T Milne, Shane G Dowling, Ron Sotomayor, Elizabeth A Ayello, Leandro J Feo Aguirre, Basil Z Khalaf, Lisa J Gould, Michael N Desvigne, Abigail E Chaffin

Faculty, Staff and Students Publications

OBJECTIVE: Stage 3 and 4 pressure injuries (PIs) present an enormous societal burden with no clearly defined interventions for surgical reconstruction. The authors sought to assess, via literature review and a reflection/evaluation of their own clinical practice experience (where applicable), the current limitations to the surgical intervention of stage 3 or 4 PIs and propose an algorithm for surgical reconstruction.

METHODS: An interprofessional working group convened to review and assess the scientific literature and propose an algorithm for clinical practice. Data compiled from the literature and a comparison of institutional management were used to develop an algorithm for the surgical …

Accidental Extravasation Of Mitomycin C Into The Subcutaneous Tissue, Johnathon Chung, Brooke Walterscheid, Jose Lopez-Vera, Hytham Rashid, Mike K. Liang

HCA Healthcare Journal of Medicine

Introduction

Mitomycin C (MMC) is a common chemotherapeutic agent used to treat a variety of solid tumors. Cutaneous adverse events are rare, but MMC is a known vesicant reported to cause tissue necrosis and sloughing, erythema, and ulceration if incorrectly infused into the subcutaneous tissue. Definitive treatment of extravasation injuries due to MMC depends on the severity of the cutaneous manifestation, which includes stopping the infusion, removing the catheter, or possible debridement.

Case Presentation

We present the case of a 70-year-old female with extensive soft-tissue injury secondary to extravasation of MMC that required hospital admission and surgical intervention to remove …

Low-Grade Adenosquamous Carcinoma Of The Breast In A Pregnant Patient: Case Report And Literature Review, David Bassa, Makenzie Morrissey, Adewuni Ojo, Adeel Raza

North Texas GME Research Forum 2023

Low-grade Adenosquamous Carcinoma of the Breast: Case Report and Literature Review Authors: David Bassa DO, MaKenzie Morrissey MD, Adewuni Ojo MD, Adeel Raza MD Abstract: Introduction: Low-grade adenosquamous carcinoma (LGASC) is a rare variant of metaplastic carcinomas of the breast. It is characterized by its clinical indolence and low-grade cytomorphology. Presentation is typically asymptomatic with indeterminate imaging characteristics with diagnosis dependent solely on histopathology findings. We herein describe a case of LGASC presenting in a young premenopausal female, an extremely rare occurrence. Case presentation: A 23-year-old woman presented to the breast clinic with a left breast ultrasound demonstrating a heterogeneous …

Hepatitis B Virus Screening In Asian Immigrants: Community-Based Campaign To Increase Screening And Linkage To Care, Aziza Win

South Atlantic Division GME Research Day 2023

No abstract provided.