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We found 119 results for General Surgery in video, leadership, management, webinar & news

video (87)

Pediatric Tracheostomy
video

Paediatric Tracheostomy Position the child with chin extension appropriately Drape the child as shown in the video Mark the incision line Use 15 number blade for skin incision Remove the excessive subcutaneous fat tissue Find the median raphe and strap muscles Retract the strap muscles laterally Identify the tracheal ring Create the impression of tube for appropriate size incision Place the stay sutures as shown in the video incise the trachea with 11 number blade Secure the maturation sutures Insert the tracheostomy tube Confirm the position and then inflate the cuff Secure the ties and dressing at the end.

Stapler-assisted Loop Ileostomy Stoma Prolapse Repair
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Stoma prolapse is an increase in the size of the stoma secondary to intussusception of the proximal bowel segment. Strangulation and ischemia of the prolapsed segment have been reported as complications. This is the case of a 58-year-old man with multiple comorbidities who was diagnosed with an adenocarcinoma of the ascending colon with hepatic metastasis. He was considered unable to start conversion chemotherapy because of his cardiovascular comorbidities and was therefore under paliative chemotherapy. Patient came into emergency room with an acute bowel obstruction and underwent a loop ileostomy as a diversion procedure. Following up the procedure, the patient developed an acute on chronic kidney failure because of dehydration from high output ileostomy. In the postoperative day 17, patient presented with an acutely incarcerated prolapsed afferent limb of the loop ileostomy. Attempts at reduction were unsuccessful. Herein we present a simple, safe, and fast approach for correcting a prolapsed loop or terminal stoma using a step-wise application of linear staplers. When laparotomy and/or stoma reversal is not appropriate, local revision of stoma prolapse provides a low-risk and high-benefit alternative solution.

A Novel Technique for Reconstruction of Right and Left Hepatic Arteries in Pancreaticoduodenectomy
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A 55yo lady undergoing open pancreaticoduodenectomy for duodenal adenocarcinoma was intra-operatively found to have macroscopic tumour involvement of the proper hepatic artery and its bifurcation. The diseased segment was resected and a novel technique for reconstruction was performed- the remnant common hepatic artery was anastomosed to the remnant right hepatic artery, and the left gastric to the remnant left hepatic artery. Doppler ultrasound confirmed  patency of all anastomoses prior to closure. Synthetic function of the liver and bilirubin recovered to appropriate levels postoperatively, and the patient was planned for adjuvant chemotherapy.

Two Layered End-to-side Duct to Mucosa Pancreaticojejunostomy
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Contributors: David Caba-Molina, MD and Mark S. Talamonti, MD The following video depicts our technique for performing a two layered end-to-side duct to mucosa pancreaticojejunostomy without the use of a pancreatic duct stent, following the resection phase of a standard Whipple operation. DOI: http://dx.doi.org/10.17797/wvi4b33r6r Editor Recruited By: Jeffrey Matthews, MD

Robotic Abdominoperineal Resection with en Bloc Prostatectomy
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Rectal cancer with local invasion presents a particular operative challenge. The standard procedure for locally advanced rectal cancer is a total pelvic exenteration (TPE), which is a highly morbid procedure. For select patients, the literature has demonstrated that bladder-sparing techniques involving en bloc resection of the prostate are safe and oncologically acceptable.1 Additionally, case studies have demonstrated the success of combined approaches using laparoscopic techniques.2,3 However, little has been published concerning the combined robotic-assisted approach of an abdominoperineal resection (APR) and en bloc prostatectomy with vesicourethral anastomosis. Robotic assistance offers several advantages for pelvic surgery, including better visualization using 3D technology and wristed instruments. Furthermore, research has shown the advantages of robotic surgery for rectal cancer resections.4,5 Our video presents a case of T4N0M0 rectal cancer, 1 cm from the dentate line, in a 63 year old male with invasion anteriorly into the prostate. After completing chemotherapy and radiation, a combined approach with a colorectal surgeon and a urologist was done using the daVinci Xi robot (Intuitive Surgical Inc, Sunnyvale, CA). The important steps of the procedure are demonstrated in the attached video. Pathology revealed a 5 cm mucinous adenocarcinoma with treatment effect and negative margins. The patient did well post-operatively with no complications. He was discharged on post-operative day 5. Robotic-assisted procedures offer the advantage of precision and visualization for pelvic operations. For locally invasive rectal cancer, robotic surgery allows the opportunity to create novel techniques for select patients in order to reduce the number of TPEs.

Laparoscopic Pancreatico-Jejunostomy
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Critical elements of the technique for Laparoscopic Pancreatic anastamosis for MIS Whipple procedure are demonstrated. This shows a 2 layered duct to mucosa anastamosis. DOI:http://dx.doi.org/10.17797/xe556mv1e9

Laparoscopic Adjustable Gastric Band Removal and Conversion to Sleeve Gastrectomy
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Contributors: Melissa Beitner and Christine Ren-Fielding This video shows the one-stage conversion of an adjustable gastric band to a sleeve gastrectomy. DOI: http://dx.doi.org/10.17797/ygruogodll

Robotic Inferior Mesenteric Artery, Common Iliac Artery, and Retroperitoneal Lymph Node Dissection
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David Schwartzberg MD, Tushar Samdani MD, FASCRS, Mario M. Leitao MD, FACOG, FACS, Garrett M. Nash MD, MPH, FACS, FASCRS Recent data has shown an improved survival with metastasectomy for metastatic rectal cancer. Metastasectomy on a minimally invasive plateform (robotic) can be used for an R0 resection in patients who have retroperitoneal metastasis from rectal cancer after control of the primary tumor. DOI # http://dx.doi.org/10.17797/wd7d09sjgc

Robotic Assisted Right Hemicolectomy with Intracorporeal Anastomosis
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Contributors: Nell Maloney Patel We present a case of a seventy-two year old female found on colonoscopy to have multiple polyps and an ascending colon mass that was biopsy proven adenocarcinoma who underwent a robotic assisted right hemicolectomy with intracorporeal anastomosis. DOI# http://dx.doi.org/10.17797/54hba94993 Editor Recruited by: Vincent Obias

Reoperative Laparoscopic Anti-Reflux Surgery
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Contributors: Marco P. Fisichella 65 year old man who underwent a laparoscopic Nissen fundoplication in August 2015. Preoperative manometry was normal and DeMeester score was 25. Two months later he began to experience difficulty of swallowing solid foods, then liquids. After 2 dilatations, dysphagia persisted. DOI#: http://dx.doi.org/10.17797/egw2097cpq Referred By: Jeffrey B. Matthews

Per Oral Endoscopic Myotomy (POEM) for Zenker's Diverticulum
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In contrast to major thoracic operations, per oral endoscopic myotomy for Zenker's diverticulum offers the possiblity to resect a symptomatic Zenker's under monitored anesthesia care (MAC) for patients to ill to undergo general anesthesia. Patients have similar functional results when compared to small Zenker's treated with traditional operative approaches. DOI# http://dx.doi.org/10.17797/f3gyzc3k95

LINX Procedure for GERD
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This video depicts the procedure for the implantation of a LINX implant for augmentation of the LES for refractory GERD. DOI:http://dx.doi.org/10.17797/69av5w723r Editor Recruited by: Dr. H. Leon Pachter

Laparoscopic Paraesophageal Hernia Repair
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Contributors: Reza Salabat and Marco P. Fisichella Preoperative work-up and surgical technique of laparoscopic paraesophageal hernia repair. DOI#: http://dx.doi.org/10.17797/c2kvm64ru5

Laparoscopic Portal Vein Resection
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Key aspects of vascular isolation and control for en bloc PV resection during laparoscopic whipple. Xenograft vein patch is used for reconstruction DOI: http://dx.doi.org/10.17797/ee9p182opy Editor Recruited by: H. Leon Pachter

Laparoscopic Adrenalectomy
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Laparoscopic adrenalectomy (LA) was first described by Gagner et al. in the early 1990s, and has since become the gold standard for removal of small and medium sized adrenal tumors. Most commonly, LA is performed for unilateral benign adrenal lesions, however the minimally invasive technique is also routinely used for bilateral disease, as well as myelolipomas, adrenal cysts, adrenal hemorrhage and androgen-secreting tumors.  Compared with the open approach, LA offers shorter hospital stay, improved patient satisfaction, decrease post-operative pain and markedly improved cosmesis.  Even more, the difficulty in obtaining adequate open surgical exposure, combined with the diminutive size of the adrenal gland make laparoscopy an especially attractive option. Given this, we decided to proceed with LA approach for our patient who presented with NSCLC metastasis to his right adrenal. DOI# http://dx.doi.org/10.17797/4ek02iupxd Mellon MJ, Sethi A, Sundaram CP. Laparoscopic adrenalectomy: Surgical techniques. Indian Journal of Urology : IJU : Journal of the Urological Society of India. 2008;24(4):583-589. doi:10.4103/0970-1591.44277. Gagner M, Lacroix A, Bolte E. Laparoscopic adrenalectomy in Cushing's syndrome and pheochromocytoma. N Engl J Med. 1992;327:1033.

Irreversible Electroporation for Treatment of Locally Advanced Pancreatic Cancer
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Contributors: Robert C.G. Martin, II Locally advanced pancreatic cancer (Stage 3) is defined by encasement or abutment of vital venous and arterial structures.  Irreversible electroporation (IRE) represents an effective local non-thermal ablation modality for treatment of solid tumors involving critical vascular and biliary structures.  Electroporation creates pores in the cell membrane and disrupts the ionic gradients while sparing the extracellular matrix, resulting in preservation of blood vessel and biliary scaffolding. DOI: http://dx.doi.org/10.17797/yonbav6fdz Editor Recruited by: Jeffrey B. Matthews

Gastric Sleeve Obstruction From Adjustable Gastric Band Capsule
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The field of metabolic and bariatric surgery has recently switched from laparoscopic gastric banding (LGB) to laparoscopic sleeve gastrectomy (LSG) as the procedure of choice for weight loss surgery. As LGB has been replaced with LSG many patients who had complications with LGB or failed to loose a satisfactory amount of weight with LGB have had a conversation from their band to a sleeve gastrectomy. Meticulous dissection takes place when removing a band, as the fibrotic scar capsule that surrounds the band must be resected in its entirety to avoid staple firings across fibrotic tissue rather than healthy gastric tissue. In addition to ensuring a healthy staple line by resecting the fibrotic capsule, we present a case where the band capsule was thought to be removed however was incompletely dissected and caused a postoperative strictured proximal stomach with complete PO intolerance. For this reason, we routinely perform intra-operative endoscopy to ensure the lumen of the stomach is patent prior to staple firing to complete the sleeve gastrectomy in band to sleeve patients. DOI#: http://dx.doi.org/10.17797/19tn2xjdda

Combined Modality: Laparoscopic Assisted Colonoscopic Polypectomy
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Laparoscopic assisted colonoscopic polypectomy aids in the safe excision of otherwise unresectable polyps with colonoscopy alone due to unfavorable locations or polyp charicteristics. A combined procedure allows for laparoscopy to assist in polypectomy by providing traction on the luminal wall, the ability to recognize a full thickness perforation and perform a segmental resection without delay and to spare the patient from multiple exposures to anesthesia. DOI# http://dx.doi.org/10.17797/d04no64kyu

da Vinci Total Abdominal Colectomy for Ulcerative Colitis
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Contributors: Craig Rezac, MD This video demonstrates the basic steps of a Robotic-Assisted Total Abdominal Colectomy for Ulcerative Colitis using the da Vinci Xi Robotic System. DOI: http://dx.doi.org/10.17797/zr41dcfdmt

da Vinci Robot Assisted Right Hemicolectomy with Intracorporeal Anastamosis
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Contributors: Jimmy Lin and Craig Rezac This procedure is a da Vinci Robot assisted Right hemicolectomy with intracorporeal anastomosis performed on a 52 year-old male who was found to have a cecal adenocarcinoma on screening colonoscopy. Metastatic work-up was negative. DOI:http://dx.doi.org/10.17797/gb6xh7cx7u Editor Recruited by: Vincent Obias

da Vinci Robot Assisted Low Anterior Resection with Diverting Loop Ileostomy
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Contributors: Jimmy Lin and Craig Rezac This procedure is a da Vinci Xi Robot assisted low anterior resection with diverting loop ileostomy performed on a 64 year old male patient who on work-up of hematochezia and change in bowel habits was found to have a locally advanced rectal adenocarcinoma approximately 5-6cm from the anal verge. The patient was found to have a single subcentimeter metastatic liver lesion, which was treated with radiofrequency ablation. He was treated with neoadjuvant chemoradiation prior to undergoing surgery. DOI: http://dx.doi.org/10.17797/vk8yonl7gj Editor Recruited By: Vincent Obias, MD, MS

da Vinci Assisted Take Down of a Rectovaginal Fistula Through a Posterior Vaginectomy
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A rectovaginal fistula (RVF) is an epithelial lined tract between the rectum and vagina. This can result in recurrent urinary tract or vaginal infections, but also creates a significant psychosocial burden for the patient. Unfortunately, due to the individual complexities of these patients, they are difficult to manage despite the numerous surgical options presently described.1 Generally RVFs are classified as low, middle or high, due to the location of the rectal and vaginal opening. Due to this, both low and middle RVFs may be approached via anal, perineal or vaginal routes. Where as high RVFs, which have their vaginal opening near the cervix, generally require an abdominal approach for repair.2 Traditionally for high RVFs patients underwent open surgery; however, minimally invasive surgery has recently been widely accepted as the preferred approach. Although surgeons are becoming more facile with these approaches, both pelvic surgery and a reoperative abdomen still impose significant technical difficulties.3,4 Here, we present the video of a female with a complex surgical history including a hysterectomy, bilateral salpingo-oopherectomy, creation and reversal of a Hartmann’s colostomy as well as a loop ileostomy due to a locally advanced recto-sigmoid cancer, who subsequently developed a rectovaginal fistula and was managed minimally invasively with a multidisciplinary novel approach through a posterior vaginectomy; an approach that utilized the enhanced magnification of the Robot, which improved visualization and allowed access into an uninflamed, virgin plane, resulting in minimal loss of vaginal length. Contributors: Milind D. Kachare, M.D. Osvaldo Zumba, M.D. Lorna Rodriguez-Rodriguez, M.D., Ph.D. Nell Maloney-Patel, M.D. Rutgers Robert Wood Johnson Medical School, Hackensack University Medical Center, City of Hope National Medical Center

da Vinci Assisted Low Anterior Resection and Colovesical Fistula Repair
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Contributors: Jimmy Lin and Craig Rezac Robotic surgery offers benefits to both patient and surgeon by allowing smaller incisions and faster recovery time, to better accuracy, flexibility and control.  Many procedures which had previously been conducted with laparoscopy, or open surgery, are becoming further improved upon in robotic surgery. This video demonstrates two such procedures, from different specialities, being performed; the low anterior resection and colovesical fistula repair. DOI#: http://dx.doi.org/10.17797/f1frvag53q

da Vinci Assisted Extended Right Hemicolectomy and End Ileostomy
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Contributors: Jimmy Lin and  Craig Rezac Robotic surgery offers benefits to both patient and surgeon by allowing smaller incisions and faster recovery time, to better accuracy, flexibility and control.  Many procedures which have previously been conducted with laparoscopy, or open surgery, are becoming further improved in robotic surgery. This video demonstrates once such procedure, the extended right hemicolectomy. DOI# http://dx.doi.org/10.17797/rv3nkbech0 Authors Recruited By: Vincent Obias. MD. MS

Endoscopic Balloon Dilation of Tracheal Stenosis
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A 16 year old presented with stridor three after being intubated for a week following a head injury. Endoscopy revealed a long segment tracheal stenosis in a subacute phase. The airway was sized with a uncuffed 3.5 endotracheal tube with a leak at 20cm of water.This stenosis was Grade 3 Cotton-Myer classification. A 12 mm Vascular balloon (Boston Scientific-Blue Max) was placed in the in the airway with direct visualization and was dilated at 20 atmospheres for about a minute. The patient was under general anaesthesia but spontaneously breathing throughout the procedure. The patient was sized to a 6.5 endotracheal tube with a free leak after the dilation. DOI: http://dx.doi.org/10.17797/n35d0ug41t

Hemangioma Excision
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Infantile hemangiomas are vascular tumors composed of proliferating endothelial cells. They uniquely undergo rapid expansion from birth to 6-8 months of age and subsequent slow dissolution over several years thereafter. Some hemangiomas are at risk of causing functional problems during their growth phase as seen in this upper eyebrow lesion obstructing the visual axis. Laser, surgical and medical treatment options are available for problematic hemangiomas. This patient was elected to undergo excision to completely remove the lesion and forego a long course of medical therapy (propranolol). Because of the their vascular nature, excision of hemangiomas requires careful planning and hemostasis. The hemangioma is marked in elliptical fashion along natural aesthetic facial lines along the brow. The inferior mark in incised first. Careful subdermal dissection is critical to completely excise to the hemangioma near the surface and find the appropriate plane. Control of bleeding is maintained by monopolar and bipolar electrocautery as well as dissecting the lesion from one side and alternating to the other. The plane of deep dissection is rarely below the subcutaneous layer thus protecting important nerves and vessels. Complete removal is possible. Closure is performed with dissolvable monocryl or PDS suture with dermabond superficially. A plastic eyeshield (blue) is placed at the beginning of case to protect the patient's cornea during the procedure. DOI: http://dx.doi.org/10.17797/zlvhux8afu

Laparoscopic Nissen Fundoplication
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A 51-year-old man seeks medical attention for intermittent chest pain. He describes the pain as “burning” and it has become increasingly frequent after meals over the last 4 to 6 months. In addition, he experiences regurgitation, and often wakes up at night with a feeling of choking. He has also noted hoarseness and cough. Proton pump inhibitors are very helpful for the heartburn and chest pain but do not improve the regurgitation. Long-term results have shown that a fundoplication provides control of reflux in about 90% of patients. To achieve these results the surgeon should focus on the technical elements of the operation, rather than on the eponyms. The technical elements of the operation are the following: (1) division of the short gastric vessels to achieve complete fundic mobilization; (2) extensive dissection of the distal esophagus in the posterior mediastinum to bring the gastroesophageal junction at least 3 cm below the diaphragm; (3) meticulous closure of the right and left pillar of the crus with non-absorbable sutures; (4) use of a bougie to decrease postoperative dysphagia; (5) a short fundoplication with three interrupted stitches placed at 1 cm of distance from each other (2-2.5 cm long). All these technical elements have been shown to positively impact long-term outcomes. Patients who are still symptomatic postoperatively must be thoroughly evaluated to identify the cause of failure, and treatment must be individualized. by Ciro Andolfi (The University of Chicago Medicine) Marco G. Patti (The University of Chicago Medicine) DOI: http://dx.doi.org/10.17797/287pfs38ls Editor Recruited By: Jeffrey Matthews, MD

Laparoscopic Paraesophageal/Hiatal Hernia Repair
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Contributor: Ciro Andolfi (University of Chicago), Marco G. Patti (University of Chicago) We describe our preoperative work-up and the surgical technique of Laparoscopic paraesophageal/hiatal hernia repair. DOI: http://dx.doi.org/10.17797/56by9lqzf5 Editor Recruited By: Dr. Jeffrey Matthews

Robotic Rectal Dissection; Total Mesorectal Excision (TME)
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Robotic rectal dissection begins posteriorly in total mesorectal excision plane (TME) using 30° down-viewing scope. Posterior dissection in a TME plane provides a relatively bloodless plane of dissection and creates an anatomical reference point from which lateral and anterior dissection can proceed. With an assistant retracting the rectum anteriorly and cephalad, the robotic single fenestrated grasper retracts the posterior aspect of the mesorectum anteriorly and slightly caudally. When performed correctly the surgeon can visualize a “cotton candy”-like areolar tissue between the fascia propria of the rectum and presacral fascia. The hook cautery is used to divide the tissue in a U-shaped fashion. The dissection is taken to the level of Waldeyer’s fascia. Lateral Dissection and Division of Lateral Stalks The lateral dissection proceeds initially on the right side where the surgeon has a safer plane of dissection (away from left ureter). A monopolar hook moves from posterior to anterior at a deliberate pace while applying current. If the right and posterior dissection was performed correctly, the only structures that need to be divided on the left side are a layer of peritoneum and a small amount of remaining lateral stalks. The left lateral side is dissected by dividing the peritoneum over the left pararectal sulcus. The left ureter must be visualized during this step. It is important to control all vessels, even the ones that appear to be only mildly oozing. Failure to do so may result in the field becoming bloody and dark. In this video, a vessel, encounterd within the left stalk is coagulated using a bipolar grasper while retracting the mesorectum with the hook. After the vessel is sealed it is divided with hook cautery. Anterior Dissection As the dissection advances inferiorly, the right and left lateral peritoneal incisions that are created during lateral dissection at this point are connected in front of the rectum. At this stage in operation, with the switch to a 0° scope and change of the retraction of the rectum from anterior and cephalad to posterior and cephalad, the rectum is pulled straight out of the pelvis. Because the posterior dissection has now released the mesorectum, the rectum can be easily stretched placing under tension the anterior plane of dissection. Circumferential Dissection of the Rectum If the rectal cancer is distal within the rectum, the mobilization proceeds to the level of pelvic floor and occasionally performing some dissection within the levator muscle complex. As the surgeon advances towards the pelvic floor, the dissection alternates between the posterior, lateral and interior planes as the tissue tension changes based on dissection performed. One of the signs that the dissection is at the level of pelvic floor is observation of levator ani skeletal muscle fibers that contract upon contact with electrocautery and the tapering of the mesorectum. As it narrows at the level of pelvic floor, the rectum can be carefully grasped with a robotic grasper and retracted to obtain the necessary tension to provide dissection. Editor Recruited By: Jeffrey B. Matthews, MD DOI: http://dx.doi.org/10.17797/4bvv6oyrym

Fully Laparoscopic Total Gastrectomy with Double Staple Anastomosis
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Contributor: Joseph Kim This video demonstrates a fully laparoscopic total gastrectomy using a double-staple technique that facilitates the safe and effective creation of an esophagojejunal anastomosis. Fully laparoscopic total gastrectomy provides distinct advantages over the open laparotomy technique. An elderly gentleman was found to be anemic on routine bloodwork exam. Subsequent upper endoscopy revealed gastric cancer of the cardia, necessitating complete gastric resection. This video demonstrates a fully laparoscopic total gastrectomy using a double staple technique that facilitates the safe and effective creation of an esophagojejunal anastomosis. DOI: http://dx.doi.org/10.17797/i3nfwwigio Editor Recruited By: Jeffrey B. Matthews, MD

Spleen Preserving Laparoscopic Distal Pancreatectomy for a Solid Pseudopapillary Tumor
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Contributors: Bestoun Ahmed Spleen preservation is advisable if feasible during distal pancreatectomy for benign pancreatic tumors. A 31 year old patient had a blunt abdominal injury. Computed Tomography (CT) scan showed an incidental tumor in the body of the pancreas. EUS-guided cytology revealed a solid pseudopapillary tumor with benign features.This video demonstrates the technical details during a minimally invasive excision of a rare tumor of the pancreas in a male patient. Very few cases have been reported in males. Editor Recruited By: Jeffrey B. Matthews, MD DOI: http://dx.doi.org/10.17797/cc7ot3ymd8

Laparoscopic Transgastric Pancreatic Necrosectomy and Cystgastrostomy
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Contributors: Michael Nussbaum Pancreatic necrosectomy is a necessary operation for necrotizing pancreatitis. The traditional open approach has been associated with difficult access and significant negative outcomes including wound complications, pancreatic fistula and prolonged hospital stay. A 57-y-old female patient presented with mild abdominal pain and epigastric fullness.She had a history of multiple episodes of acute pancreatitis and pseudocyst formation. Abdominal computed tomography (CT )scan showed a large pseudocyst of 12x15 cm size compressing the posterior wall of the stomach. Following cystgastrostomy, a large amount of necrotic pancreatic tissue is found and so necrosectomty step was added to the operation.This video demonstrates the technical details during a minimally invasive necrosectomy of the pancreas with an expedited recovery. DOI: http://dx.doi.org/10.17797/1ms9xzjz24 Editor Recruited By: Jeffrey B. Matthews, MD

Routine Laparoscopic Ultrasound During Laparoscopic Cholecystectomy
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Laparoscopic ultrasound (LUS) is a simple and reliable method for evaluating the common bile duct (CBD) during laparoscopic cholecystectomy. It is particularly useful for identifying the location of the CBD and common hepatic duct (CHD) during difficult operative circumstances when the anatomy is obscured. LUS can be performed prior to any potentially hazardous dissection and can easily be repeated as necessary to safely guide dissection. This brief video demonstrates the technique of LUS during routine LC. A flexible tip probe with a multi-frequency, side viewing, curvilinear transducer is used. Scanning is typically performed at a frequency of 10 MHz. During intraoperative applications, the ability to place the transducer in close contact with the tissue being examined allows use of a higher frequency transducer. Higher frequency ultrasound waves yield better resolution than the lower frequencies that are necessary for adequate depth of penetration during transabdominal imaging. Fluid is instilled over the hepatoduodenal ligament to improve acoustic coupling. The ultrasound probe, covered by a sterile sheath, is introduced through a 10 mm sub-xiphoid port. The probe is extended to the patients’ right side and then angled to 90 degrees. The bend is maneuvered under the lateral segment of the left liver so that the transducer can be positioned over the hepatoduodenal ligament with light contact. Scanning is started in a plane transverse to the hepatoduodenal structures. The normal anatomic landmarks are described as depicted in the sonographic image on the video. The junction of the cystic duct with the CBD is identified. The proper hepatic artery (HA) is to the right of the CBD on the screen. The portal vein (PV) is dorsal (“posterior”). The cross sectional image of the PV, HA and CBD together create a “Mickey Mouse” pattern with the cartoon characters’ circular head (PV) below and ears (CBD & HA) on top. The CBD is traced caudally to the duodenal ampulla which is well seen. This is accomplished by subtle rotation of the operators’ wrist. The internal diameter of the CBD is measured to be 4 mm (normal upper limit 6-7 mm). If present, stones are readily visualized as echogenic structures with posterior acoustic shadowing and sludge as echogenic material without shadowing. The CBD is traced cephalad and the transducer is rotated to yield a longitudinal view of the CBD and PV which appear as parallel tubular structures. In this plane, the right hepatic artery appears as a round structure and is most typically located dorsal to the CHD. Doppler can demonstrate the characteristic waveforms of the vascular structures, although it is not usually necessary for identification. The PV has a low velocity, continuous forward flow with minor undulations due to cardiac activity. Flow in the inferior vena cava is bi-directional due to the cardiac cycle and respirations. The HA demonstrates features of a low resistance type vessel with a bi-phasic spectral waveform that continues forward during diastole. The CBD has no Doppler signal other than the interference from respiratory excursion. The aorta and right renal artery are also seen at the inferior aspect of the sonographic images. When the examination has been completed, the flexible probe is straightened and withdrawn under direct vision. DOI: http://dx.doi.org/10.17797/njy9uc14u2 Editor Recruited By: Jeffrey B. Matthews, MD

Laparoscopic Sigmoid Colectomy for Complicated Diverticulitis
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Contributors: Justin A. Maykel MD The following video demonstrates a laparoscopic sigmoid colectomy for the treatment of complicated sigmoid diverticulitis. The patient was initially managed with intravenous antibiotics and allowed three months for the acute inflammatory process to resolve. Subsequently she was taken to operating room electively for an uncomplicated sigmoid colectomy with a primary anastomosis. DOI: http://dx.doi.org/10.17797/xq6fosqsh3 Editor Recruited By: Jeffrey B. Matthews, MD

Laparoscopic Hepatic Left Lateral Sectionectomy
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Contributors: David A Geller Laparoscopic left lateral sectionectomy performed for a 14 cm hypervascular left lobe liver mass which is hypervascular during arterial phase and isodense to liver during venous phasem consistent with giant Focal Nodular Hyperplasia. DOI: http://dx.doi.org/10.17797/yjare8xwt2 Editor Recruited By: Jeffrey B. Matthews, MD

Right Hepatic Lobectomy with Intraparenchymal Vascular Control
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Contributors: Amy D. Lu and Diego Di Sabato A right hepatic lobectomy with laparoscopic mobolization and division of the short hepatic veins and intraparenchymal division of the vasculature is depiected in this video. Editor Recruited By: Jeffrey Matthews, MD DOI: http://dx.doi.org/10.17797/i04zpfb2x3

Stapled Ileoanal Reservoir for Restorative Ileal Pouch Anal Anastomosis
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Contributors: Roger Hurst and Neil Hyman This video demonstrates the approach to stapled ileoanal reservoir (Ileal pouch anal anastomosis (IPAA)) construction initiated utilizing enterotomy at the future reservoir inlet. This approach has the advantage of permitting reservoir eversion during construction to ensure hemostasis and limiting the apical enterotomy to a stab puncture for the sharp anvil trochar. Dr. F. Michelassi and Dr. G.E. Block originally described this technique in 1993, and the authors have made minor adaptations (1) DOI: http://dx.doi.org/10.17797/4gf38v9mw2 Editor Recruited By: Jeffrey B. Matthews, MD

Laparoscopic Roux-En-Y Gastric Bypass with Circular Stapled Gastrojejunostomy
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Contributors: Ranjan Sudan This video depicts a laparoscopic Roux-en-Y gastric bypass performed with a linear stapled jejunojejunostomy and a circular stapled gastrojejunostomy. DOI: http://dx.doi.org/10.17797/4mc50uaz8e Editor Recruited By: Jeffrey B. Matthews, MD

Heineke - Mikulicz Strictureplasty in Crohn's Disease
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This video shows the performance of a Heineke - Mikulicz Strictureplasty in the treatment of stricturing Crohn's disease of the small bowel. DOI: http://dx.doi.org/10.17797/jj8ee1q3mr Editor Recruited By: Jeffrey B. Matthews, MD

Endoscopic Ampullectomy
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Contributor: Darin L. Dufault This video illustrates two cases of ampullary adenoma treated with endoscopic papillectomy (a.k.a. endoscopic ampullectomy in many manuscripts). Along with local surgical ampullectomy and pancreaticoduodenectomy, endoscopic papillectomy is an established treatment option for benign lesions of the ampulla of Vater. For the majority of benign ampullary lesions, complete endoscopic resection of ampullary lesions is usually feasible. Limitations to endoscopic therapy include deep extension into the bile or pancreatic duct, > 50% lateral extension along the duodenal wall, and carcinomatous transformation. In general, endoscopic resection should be considered equivalent to local surgical ampullectomy in terms of its depth of dissection. In the first case, the patient was noted to have adenomatous appearing change of the ampulla on endoscopy. An electrocautery snare is used to remove the entire papilla. When technically feasible, cholangiopancreatography should precede tissue resection to evaluate for intraductal extension and identify the orifices for post-resection therapy. Since this was unsuccessful prior to resection, the pancreatic duct is then cannulated and a pancreatogram is obtained. A pancreatic duct stent is then placed after pancreatic sphincterotomy to minimize the risk of post-ampullectomy and ERCP pancreatitis, and to prevent stenosis of the pancreatic orifice long-term. Then, a cholangiogram is performed, confirming no intraductal extension and to facilitate a biliary sphincterotomy. The second case is a patient referred for further evaluation of cholestatic liver function tests and a dilated bile duct. Endoscopically, they were noted to have a protuberant papilla. Endoscopic ultrasound (EUS) showed a mass between the bile and pancreatic ducts and within the ampulla of Vater, along with a significantly dilated bile duct. The mass did not invade the duodenal wall, as showed by preservation of the muscularis propria. In cases where malignancy is not suspected and in smaller lesions, EUS may not be required. Prior to papillectomy, the pancreatic duct was cannulated and methylene blue injected into the duct to allow easier identification of the duct following papillectomy. The mass was also able to be seen on cholangiogram (green circle). It is preferred to remove the papilla en bloc, as shown in case one, although this is not always possible. There was a small amount of residual tissue at the core of the lesion that was further resected in piecemeal fashion using a hot snare with blended cut and coagulation current. Biliary and pancreatic stents were then placed to minimize the risk of post-ERCP pancreatitis, delayed post-ampullectomy bleeding, and orifice stenosis. These stents are typically removed after 1-2 months, at which time the resection site may be surveyed for residual adenomatous tissue. Last, a small amount of residual abnormal appearing tissue was ablated using APC. Editor Recruited By: Jeffrey Matthews, MD DOI: http://dx.doi.org/10.17797/ju7gthra0v

Technique of Pancreaticojejunostomy
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Contributors: Emily Gross and Mark Callery This video demonstrates an end-to-side duct-to-mucosa pancreaticojejunostomy as part of a pancreaticoduodenectomy to resect a pancreatic head neoplasm. The patient is a 69 year-old female who experienced months of right upper quadrant abdominal pain and had labs consistent with biliary obstruction. Work-up with endoscopic retrograde cholangiopancreatography (ERCP) identified an ampullary mass that was biopsied and returned as ampullary carcinoma. DOI: http://dx.doi.org/10.17797/dyb8dqxxnr Editor Recruited By: Jeffrey B. Matthews, MD

Robotic Pelvic Lymph Node Dissection
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Contributors: Kristina Butler, MD and Javier Magrina, MD Pelvic lymphadenectomy is part of most gynecologic malignancy staging procedures. Knowledge of the retroperitoneal anatomy is key to safely completing this procedure. DOI: http://dx.doi.org/10.17797/5xzrp8fuk3 Editor Recruited By: Dennis S. Chi, MD, FACOG, FACS

Laparoscopic-assisted Small Bowel Resection for Retained Endoscopic Capsule
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Contributors: Anna Sabih and Edward Auyang This video depicts a laparoscopic-assisted approach for the retrieval of an endoscopic capsule retained within the small bowel. DOI: http://dx.doi.org/10.17797/prub9rczs1 Editor Recruited By: Jeffrey B. Matthews, MD

Laparoscopic Choledochoduodenostomy for the Management of Post Gastric Bypass Biliary Stricture
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Contributors: Jessica Cioffi

Laparoscopic hepatoduodenostomy is an excellent option for post-gastric-bypass patients with benign biliary tract disease as an indication for biliary bypass. It involves minimal dissection, but does require complex intracorporial suturing.

DOI: http://dx.doi.org/10.17797/5aizaeub3p

Editor Recruited By: Jeffrey B. Matthews, MD

Endoscopic Assisted Laparoscopic Transgastric Resection of GE Junction Gastrointestinal Stromal Tumor (GIST)
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Contributors: Irving Waxman and John C. Alverdy Laparoscopic intragastric resection of a gastrointestinal stromal tumor 0.5cm distal to the gastroesophageal junction performed with oral endoscopic assistance. Related External Links: http://www.wjgnet.com/1948-5190/full/v7/i1/53.htm http://www.ncbi.nlm.nih.gov/pubmed/21224608 DOI: http://dx.doi.org/10.17797/5v0bdou315 Editor Recruited By: Jeffrey Matthews, MD

Laparoscopic Choledocotomy for Common Bile Duct Exploration
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Contributor: Manish Parikh The patient is a 50 year-old man with a history of gallstone pancreatitis treated with endoscopic retrograde cholangiopancreatography (ERCP) and common bile duct stent at an outside hospital. The patient subsequently had migration of the stent into the stomach and recurrent choledocholithiasis. This is a video demonstrating techniques used for laparoscopic common bile duct (CBD) exploration via choledochotomy with primary closure of the duct. The intraoperative cholangiogram revealed the “meniscus sign” consistent with a large stone at the ampulla. Attempts at transcystic CBD exploration failed due to a tortuous duct and inability to pass the fogarty balloon. A laparoscopic choledochotomy was then made for stone extraction. A longitudinal choledochotomy was performed sharply after exposing the anterior aspect of the common bile duct. Intraoperative choledochoscopy confirmed the stone at the ampulla. A 4Fr fogarty catheter was used to extract the stone. Repeat choledochoscopy confirmed clearance of the duct. The choledochotomy was closed with 4-0 PDS sutures in interrupted fashion. The patient’s stent was removed from the stomach via intra-operative Esophagogastroduodenoscopy (EGD) at the conclusion of the procedure. If the surgeon confirms that the common duct is cleared, the evidence supports primary closure of the duct. In scenarios where the duct is not completely cleared of stones or if there is doubt, closure over a 14-16Fr t-tube is performed. A 10 Fr. JP is routinely left in the right upper quadrant when a choledochotomy is performed. DOI: http://dx.doi.org/10.17797/hawlc80i6c Editor Recruited By: H. Leon Pachter, MD

Totally Laparoscopic Total Proctocolectomy for Ulcerative Colitis
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Contributor: Linda Ferrari Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is today considered the gold standard and, in experienced hands, can now be performed safely for UC with a low postoperative complication rate and a long-term pouch failure rate reported less than 10%6-8. The introduction of minimally invasive techniques might further decrease postoperative morbidity and improve patients’ satisfaction, with reduced impact on body image and better cosmesis9-11. Unfortunately not every patient is a candidate for a restorative operation and, like in the case of our patient, a total proctocolectomy (TPC) with a permanent Brook ileostomy is performed with a laparoscopic approach. Laparoscopic TPC offers significant advantages over the open conventional procedure in terms of body image and cosmesis, important factors in the acceptance of surgery in this young patient population, while conflicting results have been reported in terms of postoperative recovery. Faster return of bowel function after laparoscopy and decreased use of narcotics have been reported by some authors, not always translating into shorter hospital stay. DOI: http://dx.doi.org/10.17797/ukm5thekea Editor Recruited By: Jeffrey B. Matthews, MD

Invaginated Pancreaticojejunostomy (Whipple Reconstruction)
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Contributor: Charles J Yeo Overview:The invaginated pancreaticojejunostomy is a method of reconstructing the pancreatic remnant to the intestinal tract during the Whipple operation. DOI: http://dx.doi.org/10.17797/ouyyb9jyj1 Editor Recruited By: Jeffrey B. Matthews, MD

Hybrid Laparoscopic and Robotic Pancreaticoduodenectomy
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Contributors: Sricharan Chalikonda and R. Matthew Walsh Two separate general approaches are described to perform minimally invasive pancreaticoduodenectomy (PD): pure laparoscopic and robotic. The technique shown is a hybrid utilizing laparoscopy for the resection and surgical robot for the reconstruction. We feel that this technique combines the advantages of both laparoscopic and robotic surgery.

Open Transhiatal Esophagectomy
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Contributors: Mitchell C. Posner Open transhiatal esophagectomy DOI: http://dx.doi.org/10.17797/6ob5owtokl Editor Recruited By: Jeffrey Matthews, MD

Robotic Sigmoid Resection and Intracorporeal Anastomosis
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This is a 60 yo woman with diverticulitis not responsive to medical management. Open, laparoscopic, and robotic operative options were discussed. We agreed on robotic sigmoid resection in the Enhanced Recovery Pathway. This video demonstrates an intracorporeal colorectal anastomosis between the descending colon and upper rectum. Sigmoid colectomies are typically characterized by by specimen extraction through an open incision after minimally invasive mobilization of the colon and mesentery, placement of an anvil into the descending colon through this open incision, and then laparoscopic or robotic colorectal anastomosis with a circular stapler after re-establishing pneumoperitoneum. This intracorporeal anastomosis does not require stretching colon and mesentery to an open extraction site with the possible need for extending the open incision. There is less visceral manipulation and potentially less ileus and quicker return to gastrointestinal activity. The extraction site can be anywhere the surgeon chooses and the extraction incision size is limited only by the sixe of the pathology. DOI # http://dx.doi.org/10.17797/p11gskfc90 Recruited By: Vincent Obias

Laparoscopic Transanal Total Mesorectal Excision: Rectal Cancer
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Contributors: Justin A. Maykel MD The following video demonstrates a laparoscopic transanal total mesorectal excision (taTME) for the treatment of a locally advanced mid-rectal tumor. Eight weeks following neoadjuvant chemotherapy and radiation she was brought to the operating room for radical resection. DOI#: https://doi.org/10.17797/wvn5h86w7l Referred by Jeffrey B. Matthews

Laparoscopic Ligation of a Type II Endoleak from the Inferior Mesenteric Artery
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Contributors: Gregory Westin and Paresh Shah Endovascular stent grafting (EVAR) is now the preferred approach to repair of abdominal aortic aneurysms for many patients. One of the most common complications associated with EVAR is the development of an endoleak, or continued flow of blood into the aneurysm sac outside the graft. Type II endoleaks, those due to retrograde flow through a branch vessel such as the inferior mesenteric artery (IMA) or a lumbar artery, are the most common. Options for treatment include transarterial embolization, translumbar embolization, and laparoscopic ligation. Embolization techniques require reintervention in approximately 20%, with less than half free from aneurysm sac growth at five years, though current evidence is insufficient to determine a clear threshold for intervention or optimal technique.[1,2] DOI#: http://dx.doi.org/10.17797/wu4visdfw2

Laparoscopic Extracorporeal Repair of a Morgagni Diaphragmatic Hernia
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Contributors: Anahita Jalilvand and Marco P. Fisichella This video describes a laparoscopic-extracorporeal repair with mesh of a Morgagni diaphragmatic hernia in an 81 year old female. We used Ventralight™ ST Mesh which is an uncoated lightweight monofilament polypropylene mesh on the anterior side with an absorbable hydrogel barrier based on Sepra® Technology on the posterior side for laparoscopic ventral hernia repair. The posterior side mesh does not cause adhesion with the abdominal organs. DOI: https://doi.org/10.17797/k8ktfjncgn A quick review of the literature of laparoscopic cases has shown that in a substantial amount of cases the hernia was reduced and the defect repaired with mesh placement without hernia sac resection . Therefore, non-resecting the sac is an acceptable option.

Laparoscopic Right Hemicolectomy with Isoperistaltic Intracorporeal Anastomosis
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Authors: David Schwartzberg, Noah Cohen, Jordan Schwartzberg, Paresh C. Shah Oncologic outcomes of laparoscopic and open colectomy have been demonstrated to be equivalent, with similar three-year disease-free survival and overall survival rates for any stage. Compared to patients who undergo open colectomy, patients who undergo laparoscopic colectomy benefit from a shorter median length of hospital stay and decreased post-operative use of pain medication. Intraoperative and post-operative complications are similar between open and laparoscopic colectomy. A Comparison of Laparoscopically Assisted and Open Colectomy for Colon Cancer. The Clinical Outcomes of Surgical Therapy Study Group. N Engl J Med 2004;350:2050-9 DOI: https://doi.org/10.17797/fdschc17au

Laparoscopic Heller Myotomy and Anterior Partial Fundoplication
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Contributors: Marco G. Patti Laparoscopic Heller Myotomy and Anterior Partial Fundoplication DOI: http://dx.doi.org/10.17797/m5v0f8xzp3

Laparoscopic Heller Myotomy and Dor Fundoplication for Achalasia
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Contributors: Marco P. Fisichella Laparoscopic Heller myotomy and Dor fundoplication for a patient with type 2 achalasia. DOI: http://dx.doi.org/10.17797/seyyttx9lk

Laparoscopic loop duodenal switch
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Contributors: Jeremy Slawin and George Fielding Revisional surgery after laparoscopic sleeve gastrectomy (LSG) is sometimes needed to manage complications of the procedure, in particular, weight loss failure. Several surgical options exist for revision including repeat sleeve gastrectomy (“re-sleeve”), placement of an adjustable gastric band around the sleeve, conversion to Roux-en-Y gastric bypass or conversion to biliopancreatic diversion-duodenal switch. The loop duodenal switch is a modification of the duodenal switch procedure whereby a malabsorptive component is added to improve weight loss but the procedure is simplified by having only one intestinal anastomosis. The patient presented is a 63-year-old male with a past medical history of coronary artery disease, diabetes mellitus type II, hyperlipidemia and morbid obesity. He had undergone LSG over a 36 French bougie at an outside institution two years prior. His past surgical history was also notable for previous laparoscopic ventral hernia repair and laparoscopic transabdominal inguinal hernia repair. The patient had lost weight after his LSG but had regained a significant amount, with worsening of his diabetes. His Body Mass Index (BMI) at revision is 37.7kg/m2.

Vagal Nerve Blocking Therapy for Weight Loss: Laparoscopic Technique for Placing Neuroregulator and Leads
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Contributors: Shaina Eckhouse, Daniel Guerron, Keri Seymour, Ranjan Sudan , Jin Yoo, Chan Park , and Dana Portenier. The present video illustrates the technique utilized to place a vagal nerve stimulator for weight loss in a morbidly obese patient. As most surgical trainees do not routinely perform truncal vagotomy, laparoscopic or otherwise, the technical goal of this video is to depict the surgical technique needed to laparoscopically identify and work with the anterior and posterior vagus nerves. Vagal nerve blocking therapy is one of many procedures used for surgical weight loss. In the present case, the weight loss achieved was less than that seen with a gastric bypass or sleeve gastrectomy over a comparable time period.

Use of Mini-Laparoscopic Percutaneous Graspers During Laparoscopic Cholecystectomy
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Contributors: Jin Yoo Percutaneous instrumentation is a new area of development within minimally invasive surgery. This video demonstrates the use of 2.3mm low profile percutaneous graspers during an elective laparoscopic cholecystectomy.

Thoracoscopic resection of a mature anterior mediastinal teratoma
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This video is a step by step depiction of the diagnostic tools and the thoracoscopic mobilization and resection of a mature mediastinal teratoma.

Robotic Assisted Small Bowel Resection for Meckel's Diverticulum
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We present a case of a 21-year-old male with a one-day history of right lower quadrant pain and CT scan findings suspicious for a perforated Meckel’s Diverticulum who underwent a robotic assisted small bowel resection with an intracorporeal anastomosis. Contributors: Milind D. Kachare, M.D. Nisha Dhir, M.D., FACS University Medical Center of Princeton at Plainsboro, Rutgers - Robert Wood Johnson Medical School

Laparoscopic Common Bile Duct Exploration for Mirizzi Syndrome: Technical Tips
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Mirizzi syndrome, the mechanical obstruction of the common hepatic duct secondary to extrinsic compression of stones impacted in the gallbladder neck or the cystic duct, is a rare complication of cholelithiasis (0.2% to 1.5% of patients). Up to 50% of patients are diagnosed intra-operatively.

We describe technical tips of laparoscopic treatement of Mirizzi Syndrome, including laparoscopic cholecystectomy, common bile duct exploration and stone extraction. Often it is best to fashion the ductotomy over the palpable stone. T tube cholangiogram is also invaluable.

In conclusion, laparoscopic treatment may be used for Mirizzi Syndrome.

Contributor:Dr. Manish Parikh

Modified Martius Flap for Rectovaginal Fistula
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Contributors: Dr. Jimmy Lin, Dr. Juana Hutchinson-Colas, Dr. Nell Maloney-Patel

Rectovaginal fistulas can occur for a number of reasons, including obstetric trauma, iatrogenic, radiation damage and Crohn’s disease. Symptoms range from asymptomatic to uncontrollable passage of gas or feces from the vagina leading to poor quality of life for some patients. For those patients whom surgery is indicated, there are several different approaches depending on the fistula etiology and previous attempts at repair. These range from simple fistulectomy to transabdominal repair with tissue interposition to Martius flap interposition. Our patient in the video had previously underwent multiple various repairs which failed to provide adequate resolution of her fistula and therefore presented for a Modified Martius flap repair. The benefit of such a repair is to provide neovascularity at the site of repair with minimal cosmetic effect.

Robotic-assisted Low Anterior Resection with Proximal Colotomy
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Contributors: Dr. Jimmy Lin and Dr. Craig Rezac Robotic surgery offers benefits to both patient and surgeon by allowing smaller incisions with faster recovery time, as well as better accuracy, flexibility and control. Many procedures which had previously been conducted with laparoscopy, or open surgery, are further improved upon with robotic surgery. This is a video of a robotic-assisted LAR in a male with a T4N2M0 rectal cancer with concern for invasion into the prostate and seminal vesicles. The patient also has a synchronous proximal tubulovillous adenoma which had been biopsied but not completely resected during a previous colonoscopy. He therefore also underwent an intra-operative colotomy and colon polyp resection. This video demonstrates the advantages of robotic-assisted surgery in conjunction with more traditional procedures in order to provide the best care possible for the patient.

Difficult Dissection during a Low Anterior Resection
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It is well-accepted that recurrent or complicated diverticulitis is an indication for surgical resection. Minimally invasive techniques, like the daVinci robot, have been developed to enable better visualization of the pelvis with articulating instruments. However, many times, the minimally invasive approach is deferred for cases of severe disease and adhesions. This video demonstrates the dissection of a significantly diseased sigmoid colon during a robotic-assisted low anterior resection. As you can see, with surgeon experience and patience, even complicated cases can be done successfully using the robot. The patient is a 65-year-old male with a history of multiple episodes of diverticulitis. The most recent episode was complicated by a pericolonic abscess, which was treated non-operatively with drainage and antibiotics. He presents 2 months later for an elective resection.

Laparoscopic single anastomosis gastric bypass
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We present a laparoscopic single anastomosis gastric bypass with hand-sewn gastrojejunostomy for the treatment of obesity.

Laparoscopic Management of Hemoperitoneum Occurring As A Complication of Sleeve Gastrectomy
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A laparoscopic approach was used to evaluate and manage hemoperitoneum that occurred in a 50 year-old woman who had undergone recent sleeve gastrectomy complicated by pulmonary embolism and hemoperitoneum. This case illustrates an important complication of laparoscopic sleeve gastrectomy, the usefulness of laparoscopy for managing complications of bariatric surgery, and the challenge of laparoscopy in an peritoneum filled with a significant quantity of blood. Authors: Donald Q Brubaker, BA - West Virginia University. Nova Szoka, MD - West Virginia University.

Sleeve gastrectomy to roux-en-y conversion
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Laparoscopic conversion of sleeve gastrectomy to roux-en-y gastric bypass

Laparoscopic Treatment for Hydatid Cyst of the Liver
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Authors: Maja Odovic M.D, Dider Roulin M.D, Nermin Halkic PD MER Correspondence to: Maja Odovic M.D. Department of Visceral Surgery University Hospital of Lausanne (CHUV) E-mail: Maja.Odovic@chuv.ch Didier Roulin M.D Department of Visceral Surgery University Hospital of Lausanne (CHUV) E-mail: Dider.Roulin@chuv.ch Nermin Halkic PD MER Department of Visceral Surgery University Hospital of Lausanne (CHUV) E-mail: Nermin. Halkic@chuv.ch This is a video of surgical technique for laparoscopic pericystectomie. The video describes all the steps of the procedure and pays special attention to the pitfalls.

Robotic Loop Ileostomy Closure
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71 yrs old male s/p robotic low anterior resection with primary coloproctostomy and diverting loop ileostomy for bulky, locally advanced rectal cancer. Robotic approach for loop ileostomy closure was planned due to obese body habitus. We utilized DaVinci Xi robotic platform. The set up consisted in 4-port placement, with ports # 2, 3 and 4 positioned starting in the left upper abdominal quadrant along MCL and port # 1 in suprapubic area. After docking and insertion of robotic instruments, the RLQ ileostomy was visualized. Appropriate orientation of efferent and afferent limbs was confirmed. Two enterotomies were created with electrocautery at the antimesenteric border of each limb, approximately 10 cm from the fascia. Head and anvil components of a robotic 60 mm stapler were then inserted in each enterotomy and the stapler fired in order to create a common channel between the lumens. After stay suture with 3-0 Vicryl was placed at the crotch of the anastomosis, common enterotomy defect was approximated with running 3-0 V-Lock suture in two layers. The matured portions of the loop ileostomy were then divided right below the fascia level with robotic 60 mm stapler after gentle dissection of the mesenteric border of each limb, while the mesentery was divided with robotic vessel sealer. The robotic system was then undocked and the ports removed. The remaining portion of the loop ileostomy was finally dissected from the abdominal wall at the mucocutaneous junction and the fascia defect approximated in the usual fashion (not included in the video).

Closure of H-type tracheoesophageal fistula
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We present the case of a 20 months old boy with developmental delay and chromosomal abnormality, who presented with a history of chronic aspiration. He was found to have a laryngeal cleft, which was injected with Prolaryn, then formally repaired, twice. Despite an initial a negative swallow study, the patient had persistent aspiration. A repeat direct laryngoscopy and bronchoscopy finally revealed the presence of an H-type tracheoesophageal fistula (TEF). We describe here the steps of the surgical repair of an H-type tracheoesophageal fistula.

RESECTION OF THE POSTERIOR GASTRIC WALL: ANOTHER STRATEGY AGAINST GIST WITH ENDOLUMINAL GROWTH
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Gastrointestinal stromal tumors (GIST) occur most frequently at the gastric level. Surgical resection is the mainstay of treatment and can usually be performed using laparoscopic approaches (1). The resection strategy must be adjusted to each case, the selection of location, size and growth pattern of the tumor (2). We present the case of a 78-year-old female patient who, after going to the Emergency Department due to symptoms of upper gastrointestinal bleeding, showed a 5 cm heterogeneous tumor depending on the muscular layer itself in a posterior gastric wall, endoluminal growth, and without objectifying others injuries in the study of extension. A wide posterior resection of the gastric posterior wall and primary closure with a barbed suture was performed laparoscopically. The postoperative evolution was satisfactory. The histopathological study shows low-risk GIST (5 mitosis / 50 CGA) with free margins; during follow-up, no recurrence was observed. Simple laparoscopic resection of gastric GIST tumors seems to be a useful strategy in terms of oncological safety, reducing excessive resection of tumor-free tissue and increasing gastric remnant.

TENT TECHNIQUE OF LAPAROSCOPIC RETROPERITONEAL LYMPHADENECTOMY- TRANSPERITONEAL APPROACH
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Authors: First author: Dr. Thammineedi Subramanyeshwar Rao, M.S, MCh, FMAS Corresponding author: Dr. R Rajagopalan Iyer, DNB,FSOG,MNAMS,FMAS Third author: Dr. Srijan Shukla, M.S,FMAS Affiliation of all authors: Basavatarakam Indo-American Cancer Institute and Research Centre, Road no. 10, Banjara Hills, Hyderabad, Telangana, India; PIN: 500034 Corresponding author’s mailing address: Department of Surgical Oncology, 4th floor, Block 1, Basavatarakam Indo American Cancer Hospital, Road no. 10, Banjara Hills, Hyderabad, Telangana, India; PIN: 500034 Corresponding author's email address: rajagopalan99@hotmail.com Disclosure/ Conflict of interest: The authors whose names are listed above certify that they have NO affiliations with or involvement in any organisation or entity with any financial interest (such as honoraria; educational grants; participation in speakers ’bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript. NO FUNDING SOURCES .

Totally Robotic Sigmoidectomy with Trans-anal Specimen Extraction and Intra- corporeal, Single Stapler, End-to-End Anastomosis
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As technique and technology have evolved in the modern age, surgical emphasis has shifted steadily towards minimally invasive alternatives. In colon surgery, laparoscopy has been shown to improve multiple outcome metrics, including reductions in post-operative morbidity, pain, and hospital length of stay, while maintaining surgical success rates. Unfortunately, despite the minimally invasive approach, elective laparoscopic sigmoidectomy typically requires an abdominal wall extraction site, leaving a large incision in addition to the laparoscopic port sites. It also utilizes three different types of intestinal staplers, leading to an anastomosis that may have multiple intersecting staple lines, thereby potentially influencing the anastomotic integrity, as well as increasing procedural costs substantially. We present a case of a totally robotic sigmoidectomy utilizing a single stapler technique and natural orifice specimen extraction in a patient with multiple, severe, recurrent episodes of sigmoid diverticulitis over a 2-year period.

Open Tracheotomy in Ventilated COVID-19 Patients
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Authors Carol Li, MD1*, Apoorva T. Ramaswamy, MD1*, Sallie M. Long, MD 1 , Alexander Chern, MD 1 , Sei Chung, MD 1 , Brendon Stiles, MD 2 , Andrew B. Tassler, MD 1 1Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, NY 2Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY *Co-First authors Overview The COVID-19 pandemic is an unprecedented global healthcare emergency. The need for prolonged invasive ventilation is common amid this outbreak. Despite initial data suggesting high mortality rates among those requiring intubation, United States data suggests better outcomes for those requiring invasive ventilation. Thus, many of these patients requiring prolonged ventilation have become candidates for tracheotomy. Considered aerosol generating procedures (AGP), tracheotomies performed on COVID-19 patients theoretically put health care workers at high risk for contracting the virus. In this video, we present our institution’s multidisciplinary team-based methodology for the safe performance of tracheotomies on COVID-19 patients. During the month of April 2020, 32 tracheotomies were performed in this manner with no documented cases of COVID-19 transmission with nasopharyngeal swab and antibody testing among the surgical and anesthesia team. Procedure Details The patient is positioned with a shoulder roll to place the neck in extension. The neck is prepped and draped in a sterile fashion with a clear plastic drape across the jawline extending superiorly to cover the head. An institutional timeout is performed. The patient is pre-oxygenated on 100% FiO2. A 2-cm vertical incision is made extending inferiorly from the lower border of the palpated cricoid cartilage. Subcutaneous tissues and strap muscles are divided in the midline. When the thyroid isthmus is encountered, it is either retracted out of the field or divided using electrocautery. The remaining fascia is then cleared off the anterior face of the trachea. Prior to airway entry, the anesthesiologist pauses all ventilation and turns off oxygen flow. The endotracheal tube (ETT) is advanced distally past the planned tracheotomy incision, without deflating the cuff, if possible. If necessary, the endotracheal cuff is deflated partially to advance the tube, with immediate reinflation once in position. The surgical team then creates a tracheotomy using cold steel instruments. The cricoid hook is placed in the tracheotomy incision and retracted superiorly for exposure of the lumen. The tube is withdrawn under direct visual guidance, without deflating the endotracheal cuff if possible. The tracheotomy tube is placed, and to minimize aerosolization of respiratory secretions, the cuff is inflated prior to re-initiation of ventilation. The tracheotomy tube is then sewn to the skin using 2-0 prolene suture. A total of five simple stitches are placed around the tube to prevent accidental decannulation. Indications/Contraindications Candidacy for tracheotomy was determined on a case by case basis with consideration for progression of ventilator weaning, viral load, and overall prognosis. All patients who underwent tracheotomy were intubated prior to the surgery for a minimum of 14 days, able to tolerate a 90-second period of apnea without significant desaturation or hemodynamic instability, and expected to recover. Optimal ventilator settings included FiO2

A Safe Stepwise Approach to the Critical View of Safety During Laparoscopic Cholecystectomy
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Contributors: Eric Zimmerman and Pierre F Saldinger After the introduction of laparoscopic cholecystectomy bile duct injury rates have increased (3 per 1,000 cholecystectomies). Bile duct injuries after cholecystectomies are unfortunate events that can lead to significant morbidity, high cost and impair in quality of life. The purpose of this video is to demonstrate a safe stepwise approach to the critical view of safety described by Strasberg during laparoscopic cholecystectomy. DOI: http://dx.doi.org/10.17797/ce9i07jf03 Editor Recruited By: Jeffrey B. Matthews, MD

Single Incision Laparoscopic Surgical (SILS) Placement of an Adjustable Gastric Band
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Contributors: Melissa Beitner and George Fielding This video shows a single incision laparoscopic surgical placement of an adjustable gastric band. DOI: https://doi.org/10.17797/jdzx4zu6s8

Donghang Huang’s procedure for thyroidectomy
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Donghang Huang’s procedure, also termed as direct-access single-port endoscopy assisted mini-incision thyroidectomy, is a hybrid surgery conducted in the following 3 major steps: 1.A mini-incision of approximately 2.5-3 cm long on the central neck is made. A working space under the platysmal muscle or strap muscles for single-port endoscopic surgery is constructed with carbon dioxide insufflation (performed under direct vision). 2.Mobilization of the superior and inferior pole of the thyroid lobe, and exposure of the recurrent laryngeal nerve (performed under single-port endoscopy). 3.Extraction and resection of the thyroid lobe. (performed under direct vision). Donghang Huang's procedure can provide shorter incision and better cosmetic results while maintaining adequate exposure.

How to Correctly Place the Pelvic Binder - A Life-Saving Technique
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This video demonstrates how to place the pelvic binder quickly and correctly, which may be life-saving in cases of pelvic ring fractures with associated potential massive bleeding. Proper pelvic binder placement technique requires attention to some details, including the 5Ps (pulses, penis, pockets, pain and pulses), horizontal force application in opposing vectors and ensuring the pelvic binder is locked.

Rectovaginal Fistula Repair with a Vascularized Gracilis Muscle Interposition Flap
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The surgical management of rectovaginal fistulas remains difficult, as they tend to be recurrent and vary widely in location and complexity. We present a case of a 63-year-old woman with a low-lying rectovaginal fistula who initially underwent chemoradiation and a Low Anterior Resection for a low-lying rectal cancer. Her course was uneventful until two years post-operatively, at which time her anastomotic staple line became stenotic with associated bleeding. This was initially addressed by Gastroenterology who executed a dilation and achieved hemostasis with Argon Plasma Coagulation. This remedied the stenosis, however, it was complicated by the formation of a rectovaginal fistula. Due to the low-lying location and its presence in an irradiated field, a transvaginal approach with an interposed gracilis flap was elected for repair.

Robotic-Assisted Transanal Polyp Resection
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Contributors: Benjamin Biteman and Vincent Obias Robotic Transanal minimally invasive surgical removal of 1.8cm villous adenoma with high grade dysplasia at 22cm. DOI#:https://doi.org/10.17797/kzimoid3xj Editor Recruited By: Vincent Obias

Robotic Sigmoid resection for Colovesicular Fistula and use of Firefly
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Contributors: Ben Biteman, MD 61 year old male with diverticulitis and colovesicular fistula. Patient underwent robotic sigmoid colectomy with takedown of fistula. Firefly used to help identify if fistula still present. Editor Recruited By: Vincent Obias, MD, MS DOI# http://dx.doi.org/10.17797/9qxwhlr1q5

Robotic Assisted Redo Rectopexy and Low Anterior Resection
video

Contributors: Craig Rezac, MD Low anterior resection and rectopexy is the optimal treatment for well functioning patients with rectal prolapse. Reoperations for rectal prolapse may be challenging due to significant adhesions. Use of the robot for low anterior resection and rectopexy is safe, feasible and may be more useful than laparoscopy especially in challenging cases. DOI:http://dx.doi.org/10.17797/vkp7axh60l

Low Anterior Resection for Diverticulitis
video

Contributors: Craig Rezac, MD Treatment for recurrent or complicated diverticulitis is surgical resection. Minimally invasive techniques are associated with decreased length of stay and decreased post operative pain. However, laparoscopic low anterior resection is challenging especially in the narrow pelvis. Robotic surgery may overcome these obstacles and allow more surgery for divertiuclitis to be performed minimally invasively. These surgeons always do a LAR for diverticulitis because they transect on the proximal rectum. They take down the lateral stalks in order to mobilize the rectum and get the eea stapler through the rectum easier. Bilateral ureteral stents are routinely placed to better identify the ureters. This is especially important in cases of chronic/active diverticulitis or diverticulitis that has been complicated by abscess or fistula. This is the preference of the surgeon. DOI# http://dx.doi.org/10.17797/y1f1omu3mt

Completely Robotic Total Proctocolectomy and Ileal Pouch Anal Anastomosis
video

Contributors: Nell Maloney Patel, MD and Craig Rezac, MD There is little role for the use of minimally invasive techniques in the emergent setting for ulcerative colitis. However, for elective procedures, studies have shown that laparoscopic restorative proctocolectomy with IPAA is equivalent to open IPAA with regards to safety and feasibility, and that laparoscopic IPAA is associated with shorter recovery times, earlier return to bowel function, less post operative pain and a better cosmetic result. However laparoscopic approaches are difficult especially in the narrow pelvis. These challenges maybe overcome with the daVinci robotic system. DOI:http://dx.doi.org/10.17797/r1oi8fx5c2 Editor Recruited by: Neil Tanna

Robotic Assisted Repair of Morgagni Hernia
video

Contributors: Thomas Bauer, MD and Glenn Parker, MD Up to 25 % of diaphragmatic hernias may be incidentally diagnosed in adulthood. If symptomatic, patients often present with epigastric pain, chest pain or persistent cough. When found, they should be repaired to prevent incarceration and strangulation. DOI #: http://dx.doi.org/10.17797/wy2y9m77gv

leadership (21)

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Faisal Aziz, MD
leadership

Penn State University
  • Assistant Professor of Surgery and Interim Chief of Vascular Surgery

Dr. Faisal Aziz completed his General Surgery Residency at New York Medical College in Valhalla, New York and his Vascular Surgery Fellowship at Jobst Vascular Center in Toledo, Ohio. He currently works as an Assistant Professor of Surgery and Interim Chief of Vascular Surgery at Penn State University. Dr. Aziz has authored numerous book chapters and peer-reviewed publications, and was awarded the Servier Traveling Fellowship Award by American Venous Forum. Dr. Aziz also serves as the Section Editor for Venous Disorders, VESAP-4 and Examination Consultant for the American Board of Surgery.

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Shadi Abu-Halimah, MD
leadership

West Virginia University, Charleston Division
  • Assistant Professor of Surgery

Shadi J. Abu-Halimah, M.D. FACS is a Vascular/Endovascular Surgeon. He is Double Boarded in Vascular and General surgery. He was born in Riyadh, Saudi Arabia and currently resides in Charleston, WV. Dr. Abu-Halimah received his doctorate degree in 2000 from the University of Jordan in Amman, Jordan with Honors. He is licensed to practice in the state of West Virginia.

Currently, Dr. Abu-Halimah serves as Assistant Professor of Surgery at the Robert C. Byrd Health Science Center, West Virginia University (WVU), Charleston Division, as well as Clinical Assistant Professor of Surgery at WVU SOM in Lewisburg, WV.

Since 2000, Dr. Abu-Halimah has completed extensive post-doctoral training, as follows: (2000-2001) General Surgery Internship at the Ministry of Health Hospitals in Amman, Jordan; (2001 – 2003) General Surgery Residency at Ministry of Health Hospitals in Amman, Jordan; (2003 – 2004) General Surgery Prelim at WVU in Charleston, WV; (2004 – 2009) General Surgery Residency at WVU in Charleston, WV; and (2009 – 2011) Vascular Surgery Fellowship at University of North Carolina in Chapel Hill, NC.

Dr. Abu-Halimah currently belongs to several professional societies, including the Eastern Vascular Society, the Southern Association for Vascular Surgery, the Society for Vascular Surgery, and the American College of Surgeons. Moreover, from 2011 to present day, Dr. Abu-Halimah has served on numerous medical committees ranging from national, departmental, and institutional levels across the country.

Dr. Abu-Halimah’s previous teaching responsibilities include undergraduate medical education and supervision of medical trainees in a weekly outpatient clinic; at the graduate level, he was Attending Physician for the University V2 Vascular Surgery Service and delivered presentations at various conferences in areas of general surgery and vascular education.

He is a consultant for various medical/device companies involved in developing and teaching new technologies across the country. This involves case reviews, monitoring, and proctoring physicians at the national, local, and institutional levels.

Dr. Abu-Halimah has participated extensively in numerous lectures around the world where he was invited to deliver presentations on various topics of general and vascular surgery. He has been widely published in peer-reviewed articles, and research and clinical trials where he served as primary investigator and sub-investigator, as well as numerous book chapters around the world.

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Jack Elder, MD, FACS
leadership

Massachusetts General Hospital
  • Chief of Pediatric Urology

Jack S. Elder, M.D., FACS, is Chief of Pediatric Urology, Mass General. Dr. Elder received an M.D. with distinction from the University of Oklahoma College of Medicine, and was Vice President of Alpha Omega Alpha. He completed general surgery training at Yale-New Haven Hospital and a residency in urology, including chief resident, at The Johns Hopkins Hospital. Dr. Elder completed a pediatric urology fellowship at Johns Hopkins and at Children’s Hospital of Philadelphia. He was Director of Pediatric Urology at Rainbow Babies and Children’s Hospital for 21 years, and tenured Carter Kissell Professor of Urology at Case Western University School of Medicine. Subsequently, Dr. Elder was appointed Chief of Urology and Chief of Pediatric Urology, Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI.

Dr. Elder was the Pediatric Urology Section Editor of The Journal of Urology from 1998-2007. Currently, he is on the editorial board of European Urology, Pediatric Surgery International, BJU International, Annals of Urology, and International Scholarly Research Notices. Dr. Elder served as President of the Society for Pediatric Urology and the American Academy of Pediatric Urologists. He was the Chairman of the first American Urological Association Pediatric Vesicoureteral Reflux Guidelines Committee, and was the facilitator of the second AUA Reflux Guidelines Committee, which published updated recommendations in 2010. He also is the Section Head, Pediatric Urology, AUA Online Robotic Surgery Handbook and is an annual reviewer for the European Association of Urology Paediatric Urology Guidelines. Dr. Elder has been Visiting Professor or Visiting Surgeon at 54 U.S. and international medical centers. Dr. Elder has > 160 peer-reviewed publications, edited or authored 6 books, 150 book chapters, and writes the pediatric urology section of the Nelson Textbook of Pediatrics. He is listed in Boston Magazine 2016 Top Docs.

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Craig Rezac, MD
leadership

Rutgers Robert Wood Johnson Medical School
  • Associate Professor of Surgery
  • Section Chief, Colon and Rectal Surgery

Craig Rezac, M.D., is a Double Board Certified Surgeon with clinical interest in Colon and Rectal Surgery. American-born, Dr. Rezac received his doctorate degree from Pisa Medical School in Pisa, Italy in 1995, and his undergraduate degree from Adelphi University in Long Island, NY in 1981. Dr. Rezac is licensed to practice in New Jersey and the Republic of Italy.

Currently, Dr. Rezac serves as Associate Professor of Surgery, Section Chief Colon and Rectal Surgery at Rutgers Robert Wood Johnson Medical School (RWJMS) in New Brunswick, NJ. He also serves as Staff Physician, General Surgery at Somerset Medical Center in Somerville, NJ.

After receiving his medical degree, Dr. Rezac completed a Surgical Externship at La Spezia Hospital in La Spezia, Italy. He then completed a General Surgery Internship at the Monmouth Hospital in Long Branch, NJ. This was followed by a General Surgery Residency at UMDNJ-Robert Wood Johnson Medical School in New Brunswick, NJ, and a Colorectal Surgery Fellowship at UMDNJ-Robert Wood Johnson Medical School in Edison, NJ. Lastly, Dr. Rezac completed a Laparoscopic Fellowship at Hackensack University Hospital in Hackensack, NJ.

Dr. Rezac holds numerous medical certifications as follows: Cyberknife, Davinci Laparoscopic Robotic Surgery, Davinci Advanced Laparoscopic Robotic Surgery for Colon and Rectal Surgery, American Heart Association (BLS/CPR), Trans Anal Endoscopic Microsurgery (TEM), and Stapled Trans Anal Rectal Resection (STARR). Dr. Rezac has the distinct honour of being the first doctor in New Jersey to be certified in both TEM and STARR.

Dr. Rezac is a member of several professional associations, including: American College of Surgeons (Fellowship), American Society of Colon and Rectal Surgeons, Society of Laparoendoscopic Surgeons, American College of Surgeons, New Jersey Chapter, and the New Jersey Chapter of American Society of Colon and Rectal Surgeons (past-President).

Dr. Rezac has received a number of honors and awards for outstanding performance both academically and professionally. He currently serves on several major committees, in addition to school and hospital committees, while continuing to meet various teaching and clinical responsibilities.

Dr. Rezac has received substantial grant support for medical studies and has been widely published in national and international medical journals, books, monographs, chapters, and articles. Dr. Rezac has generously shared his time and talents to deliver over 30 scientific and clinical presentations around the world.

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Anand R. Kumar, MD, FACS, FAAP
leadership

Johns Hopkins University School of Medicine
  • Associate Professor, Departments of Plastic Surgery and Pediatrics

Anand R. Kumar, MD, FACS, FAAP is an Associate Professor in the Departments of Plastic Surgery and Pediatrics at the Johns Hopkins University School of Medicine. A pediatric plastic/craniofacial surgeon and basic science researcher, he conducts investigation into the cellular biology of muscle derived progenitor cells as a source of pathologic heterotopic ossification and for novel regenerative medicine applications. His clinical practice focuses on craniofacial surgery including craniosynostosis, correction of hypertelorism(wide eyes), pediatric and adolescent facial skeletal deformities (Pierre Robin Sequence) with airway obstruction using traditional orthognathic (jaw) surgery and distraction osteogenesis.

Dr. Kumar established the center for facial skeletal surgery and the center for pediatric craniofacial surgery at the University of Pittsburgh Medical Center and now at Johns Hopkins respectively with an emphasis on multidisciplinary care for dentofacial anomalies. He has led efforts to improve outcomes in pediatric sleep apnea using skeletal surgery and distraction osteogenesis for multilevel airway obstruction. In addition, he has participated in multi-institutional trials for improvement of clinical outcomes in neonatal tongue base collapse (Pierre-Robin Sequence).

Dr. Kumar as authored over 30 original scientific publications in peer-reviewed journals and contributed to multiple plastic and orthopedic surgery textbooks over the last 10 years. He serves as a reviewer for many plastic surgery and basic science journals and has been invited as a speaker or panelist to many institutions and at organizational meetings across the United States. He currently serves as Vice President of Communications on the board of the American Society of Maxillofacial Surgeons (ASMS). In addition, he serves on multiple committees in the American Society of Plastic Surgeons and the ASMS.

As an honor student in the biological sciences at the University of California, Irvine, Dr. Kumar received his medical degree from the Albert Einstein College of Medicine. He completed his general surgery residency at the Mayo Clinic Rochester and later completed a second residency in plastic and reconstructive surgery at the University of California, Los Angeles (UCLA). He subsequently completed a pediatric plastic/craniofacial surgery fellowship after his residency at UCLA. In 2004, prior to his academic appointment, Dr. Kumar volunteered for military service and joined the United States Navy until 2010. In Bethesda, MD, he served as director and staff pediatric plastic surgeon of the Military Craniofacial Unit at Walter Reed National Military Medical Center. He served as division chief in plastic and reconstructive surgery at the National Naval Medical Center in Bethesda and on board the United States Naval Support Hospital Ship Comfort. In 2010, Dr. Kumar was recruited to the University of Pittsburgh as the director of facial skeletal surgery until 2013 when he was recruited to Johns Hopkins.

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Michael Golinko, MD
leadership

University of Arkansas for Medical Sciences
  • Medical Director of Craniofacial Program, Arkansas Children’s Hospital
  • Assistant Professor of Plastic Surgery, UAMS

Dr. Michael Golinko, M.D., is a Board Certified General Surgeon with clinical interests in Craniofacial, Cleft & Paediatric Plastic Surgery. Dr. Golinko is also Board Eligible with the American Board of Plastic Surgery, and is licensed in the states of Arkansas, and Georgia. Currently, Dr. Golinko serves as one of the Medical Directors of Arkansas Children’s Hospital Craniofacial Program, and is Assistant Professor of Plastic Surgery at the University of Arkansas Medical Sciences.

Dr. Golinko received his M.D. degree from University of South Florida (USF) in 2004, preceded by a M.A. in Medical Anthropology from Universiteit van Amsterdam (UVA) in 2002, and a B.Sc. in Physics from Massachusetts Institute of Technology (MIT) in 1998.

Dr. Golinko’s professional training includes General Surgery residencies at State University of New York (SUNY) and New York University (NYU), as well as a residency in Plastic & Reconstructive Surgery at Emory University School of Medicine, and he most recently served as a Fellow in Craniofacial Surgery/Pediatric Plastic Surgery at New York University (NYU).

From 1998 to 2008, Dr. Golinko held medical research positions at MIT, Massachusetts General Hospital, and completed Post-Doctoral Research Fellowships in the Department of Surgery, Division of Wound Healing at both Columbia University and New York University.

Dr. Golinko has contributed extensively to numerous peer-reviewed publications, book chapters, and abstracts. Moreover, Dr. Golinko has travelled the world to deliver numerous presentations, co-chair lectures and conferences, and media appearances.

Dr. Golinko has been awarded and recognized for the following: Operation Smile Regan Fellowship Recipient (2012), National Institute of Health (NIH) Loan Repayment Program Recipient (2007 – 2009), and Columbia University College of Physicians & Surgeons, Department of Surgery, Startup Grant (2006).

In the spirit of a true leader, Dr. Golinko served as past-President and Mission Leader of Project World Health, Managing Trustee of the Barry Golinko Trust of the Jewish Communal Fund, past-Surgery Department Representative of the Committee on Interns and Residents (CIR) and currently was selected to participate in the Arkansas Children’s Hospital Physician Leadership Development course.

Dr. Golinko currently belongs to several professional societies as follows: American Cleft Palate-Craniofacial Association, American Association of Wound Care, American College of Surgeons, and the Southeastern Society Of Reconstructive Plastic Surgeons.
In 2016, Dr. Golinko served on the American Society of Maxillofacial Surgeons/Plastic Surgery Foundation Combined Pilot Research Grant Committee. In addition to his professional work, Dr. Golinko has generously donated his time and many talents to numerous volunteer and humanitarian efforts all over the world.

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Dov Goldenberg, MD
leadership

University of Sao Paulo Medical School
  • Coordinator of Pediatric Plastic Surgery
  • Supervisor (Residency Program in Plastic Surgery at the Division of Plastic Surgery), Hospital das Clinicas – University of Sao Paulo Medical School
  • Attending Cranio-facial Surgeon – Division of Head and Neck Surgery and Otorhiolaryngology, Hospital A.C. Camargo
  • Senior Surgeon and head of Cranio-maxillo-facial Surgery Team, Hospital Albert Einstein
  • Chief of Pediatric Plastic Surgery Group, Hospital Municipal Infantil Menino Jesus

Residing in São Paulo, Brazil, Dr. Goldenberg graduated from the University of São Paulo Medical School. He then continued his studies with Postdoctoral Training and completed the Residency Program in General Surgery, followed by the Residency Program in Plastic Surgery at the Hospital of the Faculty of Medicine, University of São Paulo, Brazil.

Soon thereafter, Dr. Goldenberg earned his PhD in Plastic Surgery at the University of São Paulo Medical School, where he also gained his title as Full Professor of the Department of Surgery.

Dr. Goldenberg is the Editor-In-Chief for the Brazilian Journal of Plastic, International Associate Editor of Plastic and Reconstructive Surgery Journal (PRS), and past President of the Brazilian Association of Craniomaxillofacial Surgery.

His areas of interest in plastic surgery include Pediatric Plastic Surgery, Cranio-facial Surgery and Vascular Anomalies.

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Steven Scot Rothenberg, MD
leadership

Columbia University College of Physicians and Surgeons
  • Chief of Pediatric Surgery, Rocky Mountain Hospital for Children
  • Clinical Professor of Surgery, Columbia University College of Physicians and Surgeons

Dr. Rothenberg is the Chief of Pediatric Surgery at the Rocky Mountain Hospital for Children at PSL in Denver, Co. He is also a Clinical Professor of Surgery at Columbia University College of Physicians and Surgeons. He is a world leader in the field of endoscopic surgery in infants and children and has pioneered many of the procedures using minimally invasive techniques.

Dr. Rothenberg completed medical school and general surgery residency at the University of Colorado in Denver. He then spent a year in England doing a fellowship in General Thoracic Surgery prior to returning to the states where he completed a two year Pediatric Surgery fellowship at Texas Children’s Hospital in Houston. He returned to Colorado in 1992 where he has been in practice for over the last 20 years.

Dr. Rothenberg was one of the founding members of the International Pediatric Surgical Group (IPEG) and is a past-president. He was also the Chair of the Pediatric Committee and on the Board of Directors for SAGES (The Society of American Gastro-intestinal Endoscopic Surgeons). He has authored over 180 publications on minimally invasive surgery in children and has given over 300 lectures on the subject nationally and internationally. In 2015 He received “The Pioneer in Surgical Endoscopy Award” from SAGES. He is also on the editorial board for the Journal of Laparoendoscopic Surgery and Advanced Surgical Technique, The Journal of Pediatric Surgery, and Pediatric Surgery International.

Dr. Rothenberg has been married to his wife Susan for over 30 years and has three children Jessica, Catherine, and Zachary. He is an avid outdoorsman and spends most of his free time in the mountains of Colorado skiing, hiking, biking, and fishing.

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George W. Holcomb, III, MD, MBA
leadership

Children’s Mercy Hospital
  • Surgeon-in-Chief
  • Director of the Center for Minimally Invasive Surgery

Dr. George W. Holcomb, III was born in Osaka, Japan on December 11, 1953. He was raised in Nashville, Tennessee and attended elementary and high school in Nashville. He attended the University of Virginia for college and then Vanderbilt Medical School. His general surgery training was at Vanderbilt University Medical School and his pediatric surgery training was at the Children’s Hospital of Philadelphia. He began his pediatric surgery practice in 1988 as an Assistant and subsequently Associate Professor of Surgery in the Department of Pediatric Surgery at Vanderbilt University School of Medicine. In 1999, he was recruited to replace Dr. Keith Aschraft as Surgeon-in-Chief at Children’s Mercy Hospital in Kansas City, Missouri. In addition to being the Surgeon-in-Chief, he is also the Director of the Center for Minimally Invasive Surgery.

Dr. Holcomb is best known for his interest in minimally invasive surgery in infants and children and his emphasis on evidence-based medicine. He is the author of over 240 peer-reviewed publications and 50 book chapters, and has been the editor of 5 textbooks.

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Stefan Scholz, MD
leadership

Assistant Professor of Surgery, University of Pittsburgh
Director of Minimal Invasive Surgery, Children’s Hospital Pittsburgh

Stefan Scholz, M.D., is a Double Board Certified Surgeon born in Marburg, Germany and currently resides in Pittsburgh, PA. Dr. Scholz received his M.D. degree in 1997 from Philipps-Universitat Marburg school of Medicine in Marburg, Germany. In 2000, Dr. Scholz received his Dr. Med. Degree in Comparative Endocrinology at the Thomas Jefferson University in Philadelphia, PA.

Dr. Scholz currently serves as Assistant Professor of Surgery at University of Pittsburgh as well as Director of Minimal Invasive Surgery at Children’s Hospital Pittsburgh. Previous positions held include Clinical Fellow of Surgery at Harvard Medical School (2004-2008), and Clinical Instructor of Surgery at Johns Hopkins University (2008-2010). Dr. Scholz is currently licensed to practice medicine in Germany, Maryland, and Pennsylvania.

Dr. Scholz has completed extensive post-graduate work from 2000-2011 in the fields of pediatric surgery, endoscopic and laparoscopic surgery, and general surgery at various institutions in Germany, Tennessee, Georgia, Massachusetts, Maryland, and UK.

Dr. Scholz has received numerous certifications as follows: The American Board of Surgery – General Surgery (2009) and Pediatric Surgery (2011); Fundamentals of Laparoscopic Surgery (2007); Ultrasound Instructor, American College of Surgeons (2007); Basic Life Support (2006); Advanced Cardiac Life Support (2006); Advanced Trauma Life Support (2011/2015); Pediatric Advanced Life Support (2011); and daVinci Surgical System Console Surgeon (2011).

Since 2008, Dr. Scholz held various hospital administrative positions, committee appointments, and committee leadership roles at the following institutions: Johns Hopkins Hospital, Johns Hopkins University (2008-2010), Diana, Princess of Wales Children’s Hospital, University of Birmingham (2010-2011), Magee Women’s Hospital (2011), and Children’s Hospital of Pittsburgh of UPMC (2011-2016).

Since 1999, Dr. Scholz has been a member of several professional and scientific societies. Special honors include a Teaching Award – Best Resident at Beth Israel Deaconess Medical Center (2008), and SAGES Service Award Medal (2016).

Dr. Scholz has been extensively published around the world in various articles, reviews, invited papers, abstracts, monographs, books, and book chapters. Professional activities include formal teaching of resident students, grand rounds presentations, and peer teaching. Dr. Scholz has served on numerous national and international committees, panels, and boards.

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H. Leon Pachter, MD
leadership

George David Stewart Professor of Surgery, Chair of the Department of Surgery at NYU Langone Medical Center

Known for his passion, energy, and skill, Dr. Pachter has perfected a number of life-saving techniques over the years, including a multidisciplinary approach to treating tumors of the adrenal gland. By introducing advances in minimally invasive surgical techniques, Dr. Pachter has played a key role in making NYU Langone’s surgical service one of the finest in the country. Dr. Pachter is also a world-renowned educator, whose mentees have become national leaders at other prestigious medical centers.

Dr. Pachter’s roots to NYU Langone stretch back to his days as a student and chief resident in the early 1970s. After completing his MD, residency, and American Cancer Society Fellowship at NYU School of Medicine, Dr. Pachter has had an unbroken record of outstanding contributions—as director of the Trauma Service at Bellevue Hospitals Center from 1978 to 1998; as executive director from 1999 to 2006; as director of Bellevue’s Surgical Intensive Care Unit from 1978 to 1997; as chairman of the Medical Board of Tisch Hospital; as vice chairman for Faculty Affairs; as division chief of General Surgery; and as author, clinical scientist, master laparoscopic surgeon, and world-class mentor. Additionally, Dr. Pachter was instrumental in garnering significant support from the city council to build the Ranson laboratory at Bellevue Hospital, a site of important cancer research investigations.

The author of more than 100 peer-reviewed publications and numerous book chapters, Dr. Pachter serves on the Editorial Board for the American Journal of Surgery, Annals of Surgery and The Journal of Trauma and Critical Care. He also served on the American Board of Surgery as a consultant for the written boards for 8 years and is currently serving on the membership committee of the American Surgical Association. The American College of Surgeons has also designated him a mentor for young female academic surgeons in the U.S. This year Dr. Pachter was chosen by the Society of Black Academic Surgeons for its 2015 fellowship award for his efforts to diversify his department and his seminal contributions to surgery.

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Vincent Obias, MD, MS
leadership

Chief, Division of Colon and Rectal Surgery, George Washington University, Department of Surgery, Washington, DC

Dr. Obias is an Associate Professor of Surgery at George Washington University and Chief of the Division of Colon and Rectal Surgery.  Dr. Obias received his Bachelor’s Degree in Biology from James Madison University, his Masters degree in Physiology at the Medical College of Virginia, and his Doctorate in Medicine at the Medical College of Virginia.  He performed his internship and general surgery residency at Eastern Virginia Medical School in Norfolk, VA. Dr. Obias next undertook a fellowship in colon and rectal surgery at the Cleveland Clinic in Ohio. He further specialized in Advanced Laparoscopic colon and rectal surgery by undergoing a fellowship at University Hospitals Case Medical Center the following year. He is board certified in both general surgery and colon and rectal surgery.  Dr. Obias’s specialties include robotic and minimally invasive colon and rectal surgery. His interest include robotic single incision surgery, robotic transanal surgery, and clinical outcomes of robotic colorectal surgery.

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Danny Chu, MD, PhD
leadership

University of Pittsburgh Medical Center
  • Director of Cardiac Surgery, Veterans Affairs Pittsburgh Healthcare System
  • Associate Professor of Cardiothoracic Surgery, University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center Heart and Vascular Institute

Dr. Chu received his undergraduate degree from the California Institute of Technology and his M.D. degree from the Tufts University School of Medicine. He completed general surgery residency at the University of California, San Diego School of Medicine. Dr. Chu has authored over 70 peer-reviewed articles, 50 abstracts, 4 book chapters, and 4 invited editorials during his career thus far. He currently serves as an editorial board member of 13 peer-review journals and has been an invited reviewer of over 20 other journals. He has also been elected membership to the prestigious Society of University Surgeons. Currently, he is the Director of Cardiac Surgery at the Veterans Affairs Pittsburgh Healthcare System and an Associate Professor of Cardiothoracic Surgery at the University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center (UPMC) Heart and Vascular Institute.

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Samir Pandya, MD
leadership

New York Medical College
  • Assistant Professor
  • Department of Surgery and Pediatrics

Dr. Samir Pandya was awarded his Bachelor’s of Science with honors in Biomedical Engineering at the University of Miami. He subsequently pursued medicine to be on the front lines of patient care and medical device development. He completed his medical training at the Medical College of Virginia and then General Surgery residency at the Westchester Medical Center Campus of New York Medical College in Valhalla, NY. He went on to train in Pediatric General and Thoracic Surgery at Children’s Healthcare of Atlanta at Emory University in Atlanta. Upon completion of his fellowship training in 2011 he joined joined the faculty at New York Medical College as Assistant Professor in the Department of Surgery and Pediatrics.

He has a very strong interest in minimally invasive pediatric surgery with expertise in mini-laparoscopy and single-incision procedures. He is currently the Surgical Director for Newborn Surgery, Pediatric and Neonatal Extracorporeal Life Support programs at the Maria Fareri Children’s Hospital. He has a strong interest in thoracic diseases as related at to pediatric patients such as chest wall anomalies, congenital lung lesions as well as surgical oncology.

Academically he enjoys working with medical students, residents and fellows. He has received numerous teaching awards during his career. He currently also serves as the Associate Program Director of the General Surgery Residency at New York Medical College. Dr. Pandya is an active member on numerous committees in the American Pediatric Surgery Association as well as the International Pediatric Endosurgery Group. Outside of pediatric surgery, Dr. Pandya enjoys running, skiing, diving, digital photography and target shooting.

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Joseph W. Turek, MD, PhD
leadership

University of Iowa
  • Chief of Pediatric Cardiac Surgery
  • Co-Director, University of Iowa Stead Family Congenital Cardiac Center
  • Director of Extracorporeal Membrane Oxygenation Services
  • Program Director of the Thoracic Surgery Fellowship and Thoracic Integrated Six-Year Residency Programs

Joseph William Turek, MD, PhD graduated from Northwestern University with a BA in Biochemistry in 1994 and received his MD/PhD (Pharmacology) from the University of Illinois – Chicago in 2002.  He completed his general surgery education at Duke University in 2007, where he also completed a cardiothoracic residency in 2010.  During this time he served as a visiting congenital fellow at Texas Children’s Hospital.  He completed a congenital cardiac fellowship at the Children’s Hospital of Philadelphia in 2011.  Dr. Turek was the third John H. Gibbon Jr. Research Scholarship Recipient awarded by the American Association for Thoracic Surgery (2014-2016).  Dr. Turek is Chief of Pediatric Cardiac Surgery and Co-Director, University of Iowa Stead Family Congenital Cardiac Center.  He is also the Director of Extracorporeal Membrane Oxygenation Services and serves as the Program Director of the Thoracic Surgery Fellowship and Thoracic Integrated Six-Year Residency Programs at the University of Iowa Hospitals and Clinics.  His specialties include congenital heart surgery, pediatric heart transplantation and assist devices.  Dr. Turek is quite active nationally, holding board positions and serving on varies committees.  Dr. Turek can be reached at his office number (319) 384-8365 or by e-mail at joseph-turek@uiowa.edu with any questions.

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Jose M Marchena DMD, MD, FACS
leadership

  • Associate Professor of Oral and Maxillofacial Surgery - University of Texas Health Science Center
  • Chief of Oral and Maxillofacial Surgery - Ben Taub Hospital

Dr. Jose Marchena obtained his dental degree magna cum laude from Harvard School of Dental Medicine and his medical degree from Harvard Medical School. He completed internships in oral and maxillofacial surgery and general surgery at Massachusetts General Hospital in Boston and his residency training at Louisiana State University Medical Center in New Orleans. Dr. Marchena is an associate professor of oral and maxillofacial surgery at the University of Texas Health Science Center in Houston. He also serves as chief of oral and maxillofacial surgery at Ben Taub Hospital in Houston and as vice president of Smile Bangladesh, a nonprofit organization dedicated to providing cleft lip and palate repair operations in rural Bangladesh.

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Inderpal S. Sarkaria, MD, FACS
leadership

University of Pittsburgh Medical Center
  • Vice Chairman for Clinical Affairs
  • Director of Thoracic Robotic Surgery
  • Co-Director of the Esophageal and Lung Surgery Institute
  • Department of Cardiothoracic Surgery  

Dr. Sarkaria is an expert in minimally invasive approaches to benign and neoplastic diseases of the esophagus, mediastinum, and lung. He is a recognized leader in robotic assisted approaches to these operations, and developed the minimally invasive esophageal program at Memorial Sloan Kettering Cancer Center prior to moving to UPMC. Dr. Sarkaria has one of the largest international experiences with robotic assisted minimally invasive esophagectomy (RAMIE) and other esophageal operations. Dr. Sarkaria has lectured, published, and presented his research and experience nationally and internationally and is a member of the major national and international thoracic surgical societies.

Board-certified in general surgery and thoracic surgery, Dr. Sarkaria earned his medical degree from the University of Medicine and Dentistry of New Jersey in Newark. He completed a residency in general surgery and cardiac surgery fellowship at New York Presbyterian Hospital – Weill Cornell Medical Center. He also completed fellowships in thoracic surgical oncology and cancer research at Memorial Sloan Kettering Cancer Center and in minimally invasive thoracic surgery at the University of Pittsburgh Medical Center.

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L.D. Britt, MD, MPH, D.Sc (Hon), FACS, FCCM
leadership

Eastern Virginia Medical School
  • Henry Ford Professo
  • Edward J. Brickhouse Chairman
  • Department of Surgery

L.D. Britt, MD, MPH, D.Sc (Hon), FACS, FCCM, FRCSEng (Hon), FRCSEd (Hon), FWACS (Hon), FRCSI (Hon), FCS(SA) (Hon), FRCS(Glasg) (Hon) is a proud native of Suffolk, Virginia, has strong southern roots and is the product of the public school system. He attended the University of Virginia and was named to the Dean’s List each of the eight semesters. He received his Baccalaureate of Arts with Distinction.

Dr. L. D. Britt, a graduate of Harvard Medical School and Harvard School of Public Health, is the Brickhouse Professor and Chairman of the Department of Surgery at Eastern Virginia Medical School. He is the author of more than 220 peer-reviewed publications, more than 50 book chapters and non-peer-reviewed articles, and three books, including a recent edition of the highly touted Acute Care Surgery (Lippincott, Williams & Wilkens, Medford, NJ).

He serves on numerous editorial boards, including the Annals of Surgery, Archives of Surgery, World Journal of Surgery, Journal of the American College of Surgeons, the American Journal of Surgery (Associate Editor), the Journal of Trauma, Shock, Journal of Surgical Education, the American Surgeon, and others. In addition, he is a reviewer for the New England Journal of Medicine.

Dr. Britt, a member of Alpha Omega Alpha, is the recipient of the nation’s highest teaching award in medicine the Robert J. Glaser Distinguished Teaching Award, which is given by the AAMC in conjunction with AOA. He was honored by the Association of Surgical Education with its lifetime achievement award the Distinguished Educator Award given annually to one person considered by his peers to be a true master.

More than 180 institutions throughout the world have invited him to be their distinguished visiting professor. Dr. Britt is the past President of the Society of Surgical Chairs and the past Chairman of the ACGME Residency Review Committee for Surgery. Also, he is past Secretary of the Southern Surgical Association, the past Recorder/Program Chair for the American Association for the Surgery of Trauma, and past President of the Southeastern Surgical Congress, the Halsted Society, and the Southern Surgical Association. Dr. Britt is the past Chairman of the Board of Regents of the American College of Surgeons. He is also past President of the American College of Surgeons, the American Association for the Surgery of Trauma, and the American Surgical Association.

At the inaugural presidential ceremony held in Washington, D.C., during the 96th annual Clinical Congress of the American College of Surgeons, Dr. Britt was awarded the U.S. Surgeon Generals medallion for his outstanding achievements in medicine. The Honorable Regina Benjamin, MD, the 18th U.S. Surgeon General, presented this award at a formal ceremony. Dr. Britt was also appointed to the Robert Wood Johnson Clinical Scholar Program National Advisory Committee. The National Library of Medicine of the National Institutes of Medicine (in collaboration with the Reginald F. Lewis Museum of Maryland African American History and Culture) featured Dr. Britt for his contributions to academic surgery. President George W. Bush recognized Dr. Britts leadership role in medicine and nominated him to the Board of Regents of the Uniformed Services University (confirmed by the United States Senate).

At the end of his tenure, Dr. Britt was awarded the coveted Distinguished Service Medal. The National Board of Medical Examiners (NBME) also awarded him the Edithe J. Levit Distinguished Service Award.

An active participant in the community, Dr. Britt has received numerous awards for public service. Dr. Britt is the recipient of the 2010 Colgate Darden Citizen of the Year Award and the 2011 Dr. Martin Luther King, Jr. Community Award. Atlanta Post recently highlighted him as one of the top 21 black doctors in America. Ebony magazine recently listed him as one of the most influential African Americans in the nation.

At the 2012 annual meeting of the American Surgical Association, Dr. Britt became the 132nd President of the organization. He was conferred an Honorary Doctorate by the President of Tuskegee University. Dr. Britt was also elected to the position of Commissioner of the Joint Commission (formerly JACHO). In 2012, he was conferred an Honorary Fellowship in the French Academy of Surgery, and the Colleges of Medicine of South Africa.

Having recently been awarded an Honorary Fellowship in the Royal College of Surgeons of Glasgow, Dr. Britt now has the distinction of receiving the highest honor given by each of the four Royal Colleges in the United Kingdom England, Edinburg, Ireland, and Glasgow.

Dr. Britt, author of the term Acute Care Surgery and one of the principal architects of this emerging specialty, was the 2013 recipient of the prestigious Roswell Park Medal. He was honored for his major contributions to American surgery. At the 2015 annual meeting of the Society of Critical Care Medicine, Dr. Britt was bestowed the coveted title of Master of Critical Care Medicine (MCCM) by the American College of Critical Care Medicine. Recently, Virginia Governor Terry McAuliffe appointed Dr. Britt to the Board of Visitors of the University of Virginia.

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Sudhen B. Desai, MD, FSIR
leadership

Baylor College of Medicine
  • Department of Interventional Radiology  

Dr. Desai earned his Doctorate of Medicine with Distinction in Research and Alpha Omega Alpha honors from Albany Medical College, after completing the six-year BS/MD program in conjunction with Rensselaer Polytechnic Institute. During his latter years of medical school, he was selected as a scholar of the Clinical Research Training Program at the National Cancer Institute of the National Institutes of Health, a clinical fellowship geared towards the development of translational researchers. He then went on to residency at Stanford University (General Surgery) and UCSF (Diagnostic Radiology), followed by fellowship in Vascular and Interventional Radiology at Northwestern University. He was a private practice adult Interventional and Diagnostic Radiologist for ten years.  In July 2016, he returned to fellowship for an advanced training year with a focus on Pediatric Interventional Radiology, at Children’s Hospital of Boston. Subsequently, he joined Baylor College of Medicine (Houston, TX), on the staff at Texas Children’s Hospital.  He currently provides interventional care to adult and pediatric patients.

In his time outside of the clinic, he serves as a consultant to multiple established and start-up medical companies (TVA Medical, Exit BD/Bard 2018), Scientific Advisor to Santé Ventures (Austin, TX) and Chief Editor for Interventional Radiology CSurgeries.com.  Previously he was an invited advisor to the Rice University Jones School of Business (Technology Entrepreneurship). He was a member of the Advisory Council for the Masters in Clinical Translation Management at the St. Thomas (Houston, TX) University Cameron School of Business as well.  He has been appointed to multiple committees for the Society of Interventional Radiology and has lectured at multiple SIR annual meetings. He is the Chief Editor for IR Quarterly, a distribution of the SIR.

As Past-President/Founder of the Houston chapter of the Society of Physician Entrepreneurs, and a Member of the SoPE International Board of Directors, Dr. Desai works to engage physicians interested in innovation and idea development, as well as to provide mechanisms and insights to assist early-stage companies in tackling the many challenges to successful exits.

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Umamaheswar Duvvuri, MD, PhD
leadership

University of Pittsburgh Medical Center
  • Director of Robotic Surgery, Division of Head and Neck Surgery
  • Director of the Center for Advanced Robotics Training (CART)
  • University of Pittsburgh School of Medicine

Umamaheswar Duvvuri, MD, PhD, is a graduate of the University of Pennsylvania obtaining his Medical Degree in 2000 and his PhD in Biophysics in 2002. He completed an internship in General Surgery in 2003 and residency training in Otolaryngology in 2007 at the University of Pittsburgh Medical Center. He completed fellowship training in Head and Neck Surgery in 2008 at the University of Texas MD Anderson Cancer Center.

He joined the University of Pittsburgh in August 2008 as an Assistant Professor in the Department of Otolaryngology, Head and Neck Surgery Division and is also a staff physician in the VA Pittsburgh Healthcare System.

He serves as the Director of Robotic Surgery, Division of Head and Neck Surgery, at the University Of Pittsburgh School Of Medicine and is the current Director of the Center for Advanced Robotics Training (CART) at the University of Pittsburgh Medical Center. He directs the Cart Training Courses which provide technical and circumstantial resources to initiate and optimize robotic surgery programs.

He has authored numerous research publications and book chapters and is an invited guest lecturer/speaker on the subject of robotic surgery both nationally and internationally.

A Fulbright scholar, his research interests include minimally invasive endoscopic and robotic surgery of the head and neck, tumors of the thyroid and parathyroid glands and molecular oncology of head and neck cancer.

He directs a federally funded laboratory that studies the biology of head and neck cancer. He holds funding from the National Institute of Health, Department of Veterans Affairs and the “V” foundation.

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Nitin Garg, MD
leadership

Wake Forest University School of Medicine
  • Assistant Professor, Vascular & Endovascular Surgery

Dr. Nitin Garg is an Assistant Professor in Vascular & Endovascular Surgery at Wake Forest University School of Medicine in Winston Salem, North Carolina. He graduated from the prestigious All India Institute of Medical Sciences (AIIMS) in New Delhi and pursued a Master’s in Public Health at Johns Hopkins Bloomberg School of Public Health in Baltimore. Dr. Garg completed General Surgery internship and residency at Creighton University in Omaha and Vascular Surgery Fellowship at the Mayo Clinic in Rochester.

Dr. Garg has a strong interest in clinical education and firmly believes that the adequate training of the next generation of surgeons is the responsibility of the surgeons in practice. He also believes that education of patients is critical for their buy in into their own health. Dr. Garg’s clinical interests include complex arterial and venous reconstructions, using both open and endovascular (or hybrid) techniques.

management (1)

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Deanne King, M.D., Ph.D.
management

  • Assistant Professor, University of Arkansas for Medical Sciences
  • Director of Clinical Research, Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences

King has a Bachelor of Science in biochemistry from the Texas A&M University in College Station. She has an M.D./Ph.D. in molecular and cellular biology and pathobiology from the Medical University of South Carolina in Charleston. She completed an internship in general surgery and a surgery residency in otolaryngology-head and neck surgery, both at UAMS.

King said she enjoys helping researchers make connections.

“Research can sometimes be an isolating pursuit, but collaboration and idea-sharing is so important to the overall process,” King said. “I’m also looking forward to helping our students and residents. Otolaryngology-head and neck surgery is a highly competitive field. Having published research to your name early in your career is not only a valuable experience, but, increasingly, a necessity for medical students to successfully match into an otolaryngology residency.”

Faculty in the Department of Otolaryngology-Head and Neck Surgery are fellowship-trained in their specialty and cover all the sub-specialties in the field (otology, endocrine, head and neck, rhinology, laryngology, pediatric and vascular anomalies). The faculty consistently receive high scores on patient satisfaction, and six faculty are listed in “Best Doctors in America.” They practice at UAMS Medical Center, Arkansas Children’s Hospital and the Central Arkansas Veterans Health Care System.

webinar (8)

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Basics of Blunt Force Trauma: ZMC Fractures
webinar

This webinar will address the definition of zygomaticomaxillary complex (ZMC) fractures, will review pertinent literature, mechanisms of injury, classification, surgical approaches and complications. The presenter will make use of clinical photos and will allow an opportunity to answer questions.


Jose M Marchena DMD, MD, FACS

Jose M Marchena DMD, MD, FACS

Associate Professor of Oral and Maxillofacial Surgery / Chief of Oral and Maxillofacial Surgery

University of Texas Health Science Center / Ben Taub Hospital

Dr. Jose Marchena obtained his dental degree magna cum laude from Harvard School of Dental Medicine and his medical degree from Harvard Medical School. He completed internships in oral and maxillofacial surgery and general surgery at Massachusetts General Hospital in Boston and his residency training at Louisiana State University Medical Center in New Orleans. Dr. Marchena is an associate professor of oral and maxillofacial surgery at the University of Texas Health Science Center in Houston. He also serves as chief of oral and maxillofacial surgery at Ben Taub Hospital in Houston and as vice president of Smile Bangladesh, a nonprofit organization dedicated to providing cleft lip and palate repair operations in rural Bangladesh.


Alfredo R. Arribas DDS, MS, FACS

Assistant Professor in Department of Oral and Maxillofacial Surgery

University of Texas Health Sciences Center at Houston

Alfredo R. Arribas DDS, MS, FACS

Received his Bachelor of Science (BS) and Doctor in Dental Surgery (DDS) Degrees from Universidad Peruana Cayetano Heredia in Lima, Peru, in 1996, certificates in Advanced Education in General Dentistry (AEGD) at University of Maryland School of Dentistry, in 1998, two - year General Practice Residency (GPR) Program at LSU Health Sciences Center in 2000 and Oral, Maxillofacial Surgery internship at LSU Health Sciences Center in 2001, and Oral and Maxillofacial Surgery Residency at LSU Health Sciences Center, New Orleans in 2012, where he was trained in full scope Oral & Maxillofacial Surgery. Obtained a Master of Science (MS) degree in Health Care Management from University of New Orleans in 2004. Fields of interests includes: maxillofacial trauma, facial reconstructive surgery, dental implants, dentoalveolar surgery and orthognathic surgery.

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Basics of Blunt Force Trauma: NOE Fractures
webinar

This webinar will address the definition of naso-orbito-ethmoidal (NOE) fractures, relevant anatomy, prevalence and etiology, diagnosis, classification, goals and timing of surgery, surgical sequence and complications. The presenter will make use of clinical photos and will allow an opportunity to answer questions.


Jose M Marchena DMD, MD, FACS

Jose M Marchena DMD, MD, FACS

Associate Professor of Oral and Maxillofacial Surgery / Chief of Oral and Maxillofacial Surgery

University of Texas Health Science Center / Ben Taub Hospital

Dr. Jose Marchena obtained his dental degree magna cum laude from Harvard School of Dental Medicine and his medical degree from Harvard Medical School. He completed internships in oral and maxillofacial surgery and general surgery at Massachusetts General Hospital in Boston and his residency training at Louisiana State University Medical Center in New Orleans. Dr. Marchena is an associate professor of oral and maxillofacial surgery at the University of Texas Health Science Center in Houston. He also serves as chief of oral and maxillofacial surgery at Ben Taub Hospital in Houston and as vice president of Smile Bangladesh, a nonprofit organization dedicated to providing cleft lip and palate repair operations in rural Bangladesh.


Alfredo R. Arribas DDS, MS, FACS

Assistant Professor in Department of Oral and Maxillofacial Surgery

University of Texas Health Sciences Center at Houston

Alfredo R. Arribas DDS, MS, FACS

Received his Bachelor of Science (BS) and Doctor in Dental Surgery (DDS) Degrees from Universidad Peruana Cayetano Heredia in Lima, Peru, in 1996, certificates in Advanced Education in General Dentistry (AEGD) at University of Maryland School of Dentistry, in 1998, two - year General Practice Residency (GPR) Program at LSU Health Sciences Center in 2000 and Oral, Maxillofacial Surgery internship at LSU Health Sciences Center in 2001, and Oral and Maxillofacial Surgery Residency at LSU Health Sciences Center, New Orleans in 2012, where he was trained in full scope Oral & Maxillofacial Surgery. Obtained a Master of Science (MS) degree in Health Care Management from University of New Orleans in 2004. Fields of interests includes: maxillofacial trauma, facial reconstructive surgery, dental implants, dentoalveolar surgery and orthognathic surgery.

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Surgical Pitfalls, Early Career Advancement and Leadership
webinar

In this last Cardiothoracic DocTalk session of the Pathway to Independence for Junior Surgeons we will discuss early career mistakes and how to avoid them. Viewers of this webinar will learn tips and tricks learned from senior partners and knowing when to call for help.


Lawrence Greiten, MD

Assistant Professor in Division of Congenital Cardiac Surgery
Arkansas Children's Hospital (ACH) and the University of Arkansas for Medical Sciences (UAMS)

Lawrence Greiten, M.D., is an Assistant Professor in the Division of Congenital Cardiac Surgery at Arkansas Children’s Hospital (ACH) and the University of Arkansas for Medical Sciences (UAMS). Dr. Greiten received his undergraduate degree from Kansas Wesleyan University and his medical degree from the University Of Arizona College Of Medicine. He completed both his General Surgery training and Cardiovascular and General Thoracic Surgery fellowship at the Mayo School of Graduate Medical Education, where he also earned a Masters in Biomedical Sciences, Clinical and Translational Science. He did an advanced Fellowship in Congenital Cardiac Surgery at Children’s Hospital Los Angeles, Keck Medical School at the University of Southern California.

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Surgical Exposure, Minimal Incision Surgical Option for ASD Repair
webinar


In this second Cardiothoracic DocTalk session of the Pathway to Independence for Junior Surgeons we plan to discuss the approach to a Minimal Incision ASD. Our panel will discuss the merits of offering this approach along with the potential pitfalls. Viewers of this webinar will gain insight into optimizing surgical exposure and understanding when it is safe to proceed with less invasive techniques.


Lawrence Greiten, MD

Assistant Professor in Division of Congenital Cardiac Surgery
Arkansas Children's Hospital (ACH) and the University of Arkansas for Medical Sciences (UAMS)

Lawrence Greiten, M.D., is an Assistant Professor in the Division of Congenital Cardiac Surgery at Arkansas Children’s Hospital (ACH) and the University of Arkansas for Medical Sciences (UAMS). Dr. Greiten received his undergraduate degree from Kansas Wesleyan University and his medical degree from the University Of Arizona College Of Medicine. He completed both his General Surgery training and Cardiovascular and General Thoracic Surgery fellowship at the Mayo School of Graduate Medical Education, where he also earned a Masters in Biomedical Sciences, Clinical and Translational Science. He did an advanced Fellowship in Congenital Cardiac Surgery at Children’s Hospital Los Angeles, Keck Medical School at the University of Southern California.

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Pre-Operative Planning, Intraoperative Considerations and Troubleshooting
webinar

In this first Cardiothoracic DocTalk session of the Pathway to Independence for Junior Surgeons we will discuss Redo Sternotomy and Pulmonary Valve Replacement in a patient who had prior TOF repair. We plan to highlight the pre-operative strategy which will include necessary imaging and testing along with how to manage an intra-operative complication of air embolism. Viewers of this webinar will gain valuable insight into a stepwise approach to managing a very complex surgical scenario.


Lawrence Greiten, MD

Assistant Professor in Division of Congenital Cardiac Surgery
Arkansas Children's Hospital (ACH) and the University of Arkansas for Medical Sciences (UAMS)

Lawrence Greiten, M.D., is an Assistant Professor in the Division of Congenital Cardiac Surgery at Arkansas Children’s Hospital (ACH) and the University of Arkansas for Medical Sciences (UAMS). Dr. Greiten received his undergraduate degree from Kansas Wesleyan University and his medical degree from the University Of Arizona College Of Medicine. He completed both his General Surgery training and Cardiovascular and General Thoracic Surgery fellowship at the Mayo School of Graduate Medical Education, where he also earned a Masters in Biomedical Sciences, Clinical and Translational Science. He did an advanced Fellowship in Congenital Cardiac Surgery at Children’s Hospital Los Angeles, Keck Medical School at the University of Southern California.

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Transoral Approach to Mandibular Fractures: Tips and Tricks
webinar

This webinar will address factors relative to case selection and various tips and tricks that will help simplify trans-oral approaches to mandibular fractures. The presenter will make use of clinical photos and video and will allow an opportunity to answer questions.

Associate Professor of Oral and Maxillofacial Surgery / Chief of Oral and Maxillofacial Surgery
@ University of Texas Health Science Center / Ben Taub Hospital Hospital

Dr. Jose Marchena obtained his dental degree magna cum laude from Harvard School of Dental Medicine and his medical degree from Harvard Medical School. He completed internships in oral and maxillofacial surgery and general surgery at Massachusetts General Hospital in Boston and his residency training at Louisiana State University Medical Center in New Orleans. Dr. Marchena is an associate professor of oral and maxillofacial surgery at the University of Texas Health Science Center in Houston. He also serves as chief of oral and maxillofacial surgery at Ben Taub Hospital in Houston and as vice president of Smile Bangladesh, a nonprofit organization dedicated to providing cleft lip and palate repair operations in rural Bangladesh.

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Three Stage Management of the Single Ventricle
webinar

In this session our team of experts will discuss the three stages of single ventricle palliation including the Norwood procedure, the bidirectional Glenn shunt and the Fontan procedure.  Included in this webinar will be single ventricle pathophysiology, diagnostic studies/imaging, indications and contraindications for palliation, timing of surgical intervention, and overview of surgical goals and associated mortality.


Lawrence Greiten, MD
Sophia Tyrer, Pre-Med

Assistant Professor in Division of Congenital Cardiac Surgery
Arkansas Children's Hospital (ACH) and the University of Arkansas for Medical Sciences (UAMS)

Lawrence Greiten, M.D., is an Assistant Professor in the Division of Congenital Cardiac Surgery at Arkansas Children’s Hospital (ACH) and the University of Arkansas for Medical Sciences (UAMS). Dr. Greiten received his undergraduate degree from Kansas Wesleyan University and his medical degree from the University Of Arizona College Of Medicine. He completed both his General Surgery training and Cardiovascular and General Thoracic Surgery fellowship at the Mayo School of Graduate Medical Education, where he also earned a Masters in Biomedical Sciences, Clinical and Translational Science. He did an advanced Fellowship in Congenital Cardiac Surgery at Children’s Hospital Los Angeles, Keck Medical School at the University of Southern California.

Research Intern
Arkansas Children’s Research Institution / University of Arkansas for Medical Sciences

Sophia is a Pre-Medical Track student that recently graduated with a traditional BA-Biology degree and a minor in Medical Humanities. She is always seeking to expand her knowledge and gain exposure to pediatric research in hopes of bettering herself as an aspiring physician and continuing research in the future.

Christian M Eisenring, ACNP-BC
Brian Reemtsen, M.D.

CVOR Surgical Assistant Chief
Arkansas Children's Hospital

Over 28 years of adult and congenital heart surgery experience. I have helped develop a minimally invasive and robotic surgery program at UCLA. In addition, I have been involved with Ex-Vivo heart and lung preservation trials and several drug trials.

Professor, Department of Surgery / Director, Heart Institute
UAMS College of Medicine / Arkansas Children’s Hospital

Brian Reemtsen, M.D. is a Professor at the University of Arkansas for Medical Sciences in the Division of Pediatric Cardiothoracic Surgery at Arkansas Children’s Hospital. He is also Director of the Heart Institute at Arkansas Children’s Hospital. He received his undergraduate degree from the University of California at Los Angeles (UCLA), and his medical degree from New York Medical College. He completed his internship and residency at UCLA School of Medicine. He then completed fellowships at the University of Washington, as well as the Great Ormond Street Hospital in London, England.

Dr. Dala Zakaria

Pediatric Cardiologist
Arkansas Children's Hospital

After completion of her formal training, Dala Zakaria, M.D., joined the faculty of the University of Arkansas for Medical Sciences in 2013, practicing at Arkansas Children’s. Her primary clinical interests are transesophageal and fetal echocardiography, and advanced imaging, including 3D. Dr. Zakaria performs and interprets transthoracic and transesophageal echocardiograms in our outpatient, inpatient and telemedicine programs. She is an integral part of the Fetal Echocardiography program, providing fetal echocardiogram interpretation and consultation.

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Ventricular Septal Defects
webinar

As one of the most common congenital cardiac anomalies managed by pediatric cardiac teams, VSD’s often may present a challenge in optimal management.  Our team of experts will discuss pathophysiology, diagnostic studies, indications and timing of surgery, surgical management; along with the technical challenges/considerations of repairing each of the different anatomic variants of ventricular septal defects: perimembranous, conoventricular, supracristal (subpulmonary), inlet (atrioventricular canal type), and muscular.


Lawrence Greiten, MD
Sophia Tyrer, Pre-Med

Assistant Professor in Division of Congenital Cardiac Surgery
Arkansas Children's Hospital (ACH) and the University of Arkansas for Medical Sciences (UAMS)

Lawrence Greiten, M.D., is an Assistant Professor in the Division of Congenital Cardiac Surgery at Arkansas Children’s Hospital (ACH) and the University of Arkansas for Medical Sciences (UAMS). Dr. Greiten received his undergraduate degree from Kansas Wesleyan University and his medical degree from the University Of Arizona College Of Medicine. He completed both his General Surgery training and Cardiovascular and General Thoracic Surgery fellowship at the Mayo School of Graduate Medical Education, where he also earned a Masters in Biomedical Sciences, Clinical and Translational Science. He did an advanced Fellowship in Congenital Cardiac Surgery at Children’s Hospital Los Angeles, Keck Medical School at the University of Southern California.

Research Intern
Arkansas Children’s Research Institution / University of Arkansas for Medical Sciences

Sophia is a Pre-Medical Track student that recently graduated with a traditional BA-Biology degree and a minor in Medical Humanities. She is always seeking to expand her knowledge and gain exposure to pediatric research in hopes of bettering herself as an aspiring physician and continuing research in the future.

Christian M Eisenring, ACNP-BC
Brian Reemtsen, M.D.

CVOR Surgical Assistant Chief
Arkansas Children's Hospital

Over 28 years of adult and congenital heart surgery experience. I have helped develop a minimally invasive and robotic surgery program at UCLA. In addition, I have been involved with Ex-Vivo heart and lung preservation trials and several drug trials.

Professor, Department of Surgery / Director, Heart Institute
UAMS College of Medicine / Arkansas Children’s Hospital

Brian Reemtsen, M.D. is a Professor at the University of Arkansas for Medical Sciences in the Division of Pediatric Cardiothoracic Surgery at Arkansas Children’s Hospital. He is also Director of the Heart Institute at Arkansas Children’s Hospital. He received his undergraduate degree from the University of California at Los Angeles (UCLA), and his medical degree from New York Medical College. He completed his internship and residency at UCLA School of Medicine. He then completed fellowships at the University of Washington, as well as the Great Ormond Street Hospital in London, England.

Shae A. Merves, MD
Josh Daily, MD, MEd

Assistant Professor, Pediatric Cardiology & Radiology
University of Arkansas for Medical Sciences / Arkansas Children’s Hospital

Dr. Merves is a pediatric cardiologist with a specific interest and additional training in cardiac imaging. In clinical practice, she cares for patients across all age ranges from fetal life through adulthood and performs and interprets fetal echocardiograms, transthoracic and transesophageal echocardiograms, cardiac MRIs and cardiac CTs. She has an interest in imaging related research and education.

Pediatric Cardiologist / Associate Professor of Pediatrics / Pediatric Cardiology Fellowship Program Director
University of Arkansas for Medical Sciences / Arkansas Children’s Hospital

Dr. Daily is a non-invasive pediatric cardiologist who serves as the Pediatric Cardiology Fellowship Program Director at Arkansas Children’s Hospital. His interests include echocardiography, adult education, and physician personal finance.

news (2)

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Csurgeries Through The Eyes Of A Future Surgeon
news

Congratulations to our GoPro Contest winner, Akshay Krishan!  As a medical student, he shares his personal experience with CSurgeries and the value it provides to fellow students who may be interested in pursuing a career in surgery.   

Tell me little bit about yourself.

I am currently a 2nd year medical student at UAMS. I received my undergraduate degree from the University of North Carolina at Chapel Hill, but decided to come back home for my medical training.

I was initially introduced to CSurgeries through a “Summer in Surgery” Program I completed through UAMS last summer—a one month program that was started by the General Surgery Department at the hospital. The goal of the program is to introduce students to General Surgery, recruit them to the field and introduce them to what General Surgery has to offer.  Through that program, I met Dr. Golinko. He gave me the opportunity to film one of the procedures (Fronto-Orbital Advancement and Cranial Vault Remodeling for Metopic Craniosynostosis) and publish to the site.

Were you always interested in surgery? Was surgery what you had in mind when you were accepted to medical school?

Yes. I’ve always been interested in surgery. Going into medical school, I was interested in orthopedic surgery. But completing the Summer in Surgery Program has broadened my view of the surgical field, so I am definitely interested in other areas as well. I’m excited to start my third year and get on the surgery rotation to see what else the field has to offer.

How has CSurgeries contributed to your education at UAMS?

CSurgeries has been beneficial. After I filmed the surgery with Dr. Golinko, he gave me free rein to do my own research, edit the video as I pleased, and add in the necessary content. In doing so, I got to do quite a bit of research on various medical topics that I had no experience with previously. I learned so much by doing this first-hand research and also developed a deeper appreciation for various medical concepts that I had learned in class.

How were you able to determine the surgical steps to focus on when putting together your video for peer-reviewed publication?

The procedure itself was between 7-8 hours. I didn’t film it in entirety, but I did film a good amount to make sure I got all the footage I would need later on.  Before I began distilling my footage down to the main components, I talked with Dr. Golinko and created an outline of the key points to focus my video on. From there, I did plenty of research and made sure to include/explain every key step in the craniosynostosis procedure.    

How long did it take to find that information and put it all together?

As a whole, the project did not take very long. Doing the research was pretty easy, so most of my time was spent going through all the footage and editing the clips to fit into the 5 minute limit.

How did you film the procedure?

For the majority of the surgery, I used one of Dr. Golinko’s cameras. For the last portion, I used my iPhone (Dr. Golinko’s camera had run out of memory).

What would you like to see CSurgeries do in the future? How can we help medical students who are interested in surgery?

I was introduced to CSurgeries through the Summer in Surgery Program. If medical students knew more about CSurgeries and knew that they could actively contribute to the site and get some publications for their own resumes, that would be extremely beneficial.

For those who are interested in the surgical field (or those who never really considered surgery as an option), giving them the opportunity to watch the videos on the site would be really beneficial. It can get more people involved in surgery and is also a great educational tool. Every medical student is going to have to go into their third year and do some kind of surgical rotation, so just watching some of the more common surgical procedures on the site would give students a basic understanding of the things they are going to see. Students would also gain a better appreciation of things the surgeon must do throughout each surgery.

Do medical students get any education in regards to video education in class and/or lecture?

I myself have not received any formal education on video education or projects. I wasn’t aware that video publications are a type of publication that is commonly used until I was introduced to CSurgeries.  

As far as video and teaching is concerned, our in-class lectures are recorded, so we can go back and re-watch things if we need to. Outside of that, a lot of the video educational tools we use are primarily geared towards Step 1 preparation.  

What advice would you give medical students who are thinking about surgical residency?

Surgical residency and the quality of life of surgeons have a reputation of being very difficult, time intensive and exhausting. While that’s all true, the positives of surgery need to be detailed to the students.  It’s honestly a very rewarding field to get into. Just by shadowing various surgeons and participating in the Summer in Surgery Program, I gained an appreciation of how these kinds of procedures really changed patients’ lives. Introducing medical students to the field and showing them the positives of surgery would be immensely beneficial both for them and the surgical field as a whole.

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The People Behind CSurgeries: Dr. Gerald Healy, CSurgeries Chief Surgical Officer
news

Meet Dr. Gerald Healy –
accomplished otolaryngologist and dedicated family man.
Learn more about his recipe for success and
how all surgeons can benefit from what he calls a
“House of Surgery”.

Q: What can you tell me about your role as Chief Surgical Officer, of CSurgeries? What are your main areas of focus?

A: First and foremost this really is a unique opportunity! There isn’t any other publication vehicle where all of the “House of Surgery” (as I like to call the surgical groups that are represented on CSurgeries) can present a compendium of information acceptable to all surgeons of all disciplines. As a specialty surgeon, I feel strongly that the surgical disciplines do not interact enough with each other. We have developed a silo mentality in medicine where we’re so focused on our own discipline, we fail to learn from the others. With CSurgeries, we have the ability to learn from surgeons in other disciplines. Even during my tenure as president of the American College of Surgeons, I worked to promote this “House of Surgery” concept ─a place where everyone lives and works together for the common goals of patient safety and quality care.

My primary role as Chief Surgical Officer, is to recruit the very best people we can find in the various surgical disciplines to be the Section Editors. We’ve welcomed some very well-known, accomplished surgeons (such as Dr. Britt who is our General Surgery editor and Dr. Shamberger who is our Pediatric Surgical Section Editor). The idea is to reach out to surgical leaders like these who can then go out and recruit the best videos. Our Section Editors are extremely well respected, recognizable names in their field. So much so that when they pick up the phone, you listen to what they have to say. People recognize that these individuals would only be affiliated with a valid journal that has something worthwhile to offer.

Q: What does CSurgeries have to offer learners of every type (trainees, patients, families, experienced surgeons) compared to other channels of surgical education?

A: CSurgeries is dedicated to serving all of those groups, and we will have to pay special attention to the development of a video library/process that addresses every viewer group. For example, the video presented to a lay person about a laparoscopic cholecystectomy might be completely different from the video we show an advanced surgeon who wants to simply see, “How does Dr. X take out gall bladder? I’d like to see the little tricks he uses when he’s in there”. Paying close attention to the viewing audience is critically important as we move forward- ensuring the production of educationally appropriate videos geared towards each viewer group or learner group.

Similarly, if we’re addressing a medical student audience, it would be acceptable to show them the same video of the gall bladder removal that we might also show a senior surgical professor. However, the audio portion (author explanation/narration) might be very different. Simply stated, the senior professor doesn’t need me telling him, “Put the scope here and look 30 degrees there”. He or she already knows that. What they want to know is, “What kind of a clamp does Dr. X use?” or “What kind of a clip, does he put on the gall bladder when he’s finished?” I expect those nuances would be differentiated through the video narration itself.

Q: Dr. Healy, your list of accomplishments are endless…You are an author, lecturer, scholar, and honorary society member (just to name a few). Where do find this motivation, what fuels you?

A: Like many people in many walks of life, I had a role model that I wanted to emulate. The short version is that when I was a small kid, I have this memory of my pediatrician who would come out in the middle of the night, in the snow, in the rain, and in the ice to see me because I was sick. Those visions stayed with me for my early life and drove me with a passion. I wanted to be like this guy. His name was Eli Friedman – an incredibly unique human being who actually has a lectureship at Boston Medical Center named in his honor because so many of his students over the years were so adoring of him. He’s what drove me.

I always knew I wanted to become a physician, but the question was whether or not I could achieve it. Could I get there? And once I got there, what was I going to do with it? The driving force behind my career really unfolded in three phases:

  1. The first third of my career, I was a learner. I tried to absorb everything I could from everyone I met because I wanted to be the best surgeon I could be-helping patients with the very best of my ability.
  2. The second part of my career, I made a concerted effort to try and share my experiences with others. I spent a lot of time giving talks, writing papers, presenting my material at various meetings and listening to the critiques.
  3. The final third of my career, I decided to help as many as I could by becoming involved in medical organizations focused on driving the agenda so that we were always focused on what’s best for the patient and their quality of care.

*I’m also a passionate guy, who loves his family, always makes time for my wife and daughters and am driven to do the very best I can in all things.

Q: What advice would you give a medical student thinking about becoming a surgeon?

A: First and foremost, DO NOT look at medicine as a job. It’s a profession. Too many students today are looking at lifestyle choices. Being a surgeon is not an easy lifestyle. So, if you’re about working 8 am to 4pm and having all your nights and weekends off, don’t become a surgeon. But if you’re passionate about helping others, easing suffering, and changing things for the better, there is no part of our profession that’s more rewarding than surgery.

I often address medical students in and around Boston, and I let them know they are being given a unique privilege- the privilege of holding the life of another human being in their hands. It is an immense responsibility that you cannot take lightly. Once that person puts their trust in you and says, “Doctor, I need your help…” they need your help until the problem is solved. It’s not a job. It’s a profession and a calling.

  1. How has medical teaching and surgical learning evolved over the years? Where do you see it going years from now?

Well, when I went to medical school, everything was pictures, book and journal reading and so forth. Now the electronic world has taken over. Visual learning, e-learning and interactive learning is the new norm. When it comes to surgery, people want to talk less and see more. That’ simply the world we live in. Today, simulation and the use of simulators is also extremely important.

I believe we are going to be heavily into robotic surgery. That’s a very important issue to think about because surgeons can easily make the mistake of becoming technicians and not doctors. By that I mean, operating, but having no relationship with the patient. Robots will replace you in the future if you enter surgery solely focused on being a technician and not an empathizing doctor. Let’s not forget about the importance of positive doctor-patient relationships…the very human side of surgery.

Have a question you would like to ask Dr. Healy? Feel free to post a comment or send him an email at Gerald.Healy@csurgeries.com

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