Search Results

Search Results

We found 53 results for Minimally Invasive in video, leadership, webinar & news

video (32)

Robotic Abdominoperineal Resection with en Bloc Prostatectomy
video

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.

Minimally Invasive Radioguided Parathyroidectomy
video

Minimally Invasive Radioguided Parathyroidectomy Author: Joshua Hagood Performing surgeon/coauthor: Brendan C. Stack, Jr., M.D., FACS, FACE Department of Otolaryngology - Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA Overview: Primary hyperparathyroidism is a disease caused by overproduction of parathyroid hormone (PTH). This condition is most commonly caused by a solitary, hyperfunctioning, adenoma among one of the four parathyroid glands. The hallmark finding of hyperparathyroidism is hypercalcemia which can manifest symptomatically as nephrolithiasis, diabetes insipidus, renal insufficiency, bone pathology, gastrointestinal symptoms, and neuropsychiatric disturbances (remembered as “Stones, Bones, Groans, and Psychiatric overtones”). Minimally invasive Radio guided Parathyroidectomy (MIRP) is a curative procedure for primary hyperparathyroidism that can use both radionuclide guidance and intraoperative PTH measurements to confirm the removal of the offending adenoma. Radionuclide guidance is performed via the injection of 99mTc-sestamibi, which is a radiomarker that sequesters within adenomatous/hypermetabolic parathyroid tissue. Intraoperatively, the amount of 99mTc-sestamibi within excised tissue can be measured with the use of a handheld gamma probe. Instrumentation: -Endotracheal Nerve Integrity Monitoring System (NIMS) -Gamma Probe -Intraoperative PTH assay equipment

Endoscopic Management of a Duodenal Web
video

From the APSA 2016 Annual Meeting proceedings ENDOSCOPIC MANAGEMENT OF A DUODENAL WEB Lauren Wood, BS1, Zach Kastenberg, MD2, Tiffany Sinclair, MD2, Stephanie Chao, MD2, James Wall, MD2. 1Stanford School of Medicine, Palo Alto, CA, USA, 2Lucile Packard Children’s Hospital Stanford, Palo Alto, CA, USA. Introduction: Surgical intervention for duodenal atresia most commonly entails duodenoduodenostomy in the neonatal period. Occasionally, type I duodenal atresia with incomplete obstruction may go undiagnosed until later in life. Endoscopic approach to dividing intestinal webs has been reported in rare select cases. Methods: A two-year old female with a history of trisomy 21 and tetralogy of Fallot underwent laparoscopic and endoscopic exploration of intestinal obstruction as visualized on upper gastrointestinal series for symptoms of recurrent emesis and weight loss. After laparoscopy confirmed a duodenal web as the cause of intestinal obstruction, endoscopic division of the membrane was carried out with a triangle tip electrocautery knife followed by dilation with a 15 mm balloon. Results: The procedure took 210 minutes and the patient tolerated it well. Post-op Upper GI showed rapid passage of contents without leak and a diet was started. The patient was discharged on post-operative day 2 without narcotics. The patient had gained 2 pounds at 4 week follow-up and remains asymptomatic six months after the procedure. Conclusions: Endoscopic management of a duodenal web is feasible in children. Pediatric surgeons are ideally suited to offer the hybrid approach including laparoscopy to confirm no extraluminal obstructive process or complication from endoscopy. Endoscopy enables minimal recovery time and should be embraced as another tool in the minimally invasive toolbox of pediatric surgeons. DOI: https://doi.org/10.17797/pknxvd91zf

Robotic Inferior Mesenteric Artery, Common Iliac Artery, and Retroperitoneal Lymph Node Dissection
video

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

LAPAROSCOPIC REPAIR OF DIAPHRAGM EVENTRATION
video

Contributors: Oliver B. Lao, MD, MPH We demonstrate the use of an endostapler in a minimally invasive eventration repair in a pediatric patient. In contradiction to most other reported repairs, we approach the repair in a minimally invasive fashion through the abdomen. We invert the redundant diaphragm downward for our plication given this approach. We feel that this allows for better visualization of the intra-abdominal organs, avoids the pain and thoracostomy tube associated with a thoracoscopic procedure and gives a much more reliable and reproducible result. In addition the procedure can be done, on average, in less than 30 minutes, and it can be done as an outpatient procedure.

Laparoscopic Adrenalectomy
video

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.

da Vinci Assisted Take Down of a Rectovaginal Fistula Through a Posterior Vaginectomy
video

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

Spleen Preserving Laparoscopic Distal Pancreatectomy for a Solid Pseudopapillary Tumor
video

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
video

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

Totally Laparoscopic Total Proctocolectomy for Ulcerative Colitis
video

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

Hybrid Laparoscopic and Robotic Pancreaticoduodenectomy
video

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.

Robotic Sigmoid Resection and Intracorporeal Anastomosis
video

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
video

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

Minimally Invasive Repair of Pectus Carinatum
video

MINIMALLY INVASIVE REPAIR OF PECTUS CARINATUM Robert Kelly, MD1, Sherif Emil, MD, CM2. 1Children’s Hospital of the King’s Daughters; East Virginia Medical School, Norfolk, VA, USA, 2Montreal Children’s Hospital; McGill University Health Centre, Montreal, QC, Canada. Pectus carinatum is a chest wall anomaly amenable to correction by a number of surgical and non-surgical techniques. Minimally invasive repair of pectus carinatum, also unknown as the Abramson or reverse Nuss procedure, is an innovative technique that can achieve correction without major cartilage resection, large incisions, or prolonged bracing. Like other innovative techniques, the operation has gone through several technical problem-solving stages, and has yet to be adopted widely. We present a high fidelity video that illustrates the required equipment and surgical maneuvers necessary to optimize safety and outcome of this new technique. The results in two teen-age boys are demonstrated. DOI: https://doi.org/10.17797/fo5h3wx5hz

Ultrasound Guided Thoracoscopic Dental Extraction
video

Contributors: Rodrigo Ruiz and Adele Brudnicki We present a minimally invasive approach for removal of an aspirated tooth that was not extractable via rigid / flexible bronchoscopy. The multimodal technique results in a successful extraction via non-anatomic wedge resection of the affected portion of the lung and thereby obviates the need for a formal lobectomy.

Laparoscopic Heller Myotomy and Anterior Partial Fundoplication
video

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
video

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

Use of Mini-Laparoscopic Percutaneous Graspers During Laparoscopic Cholecystectomy
video

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.

Laparoscopic Common Bile Duct Exploration for Mirizzi Syndrome: Technical Tips
video

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

Lower eyelid ectropion repair with lateral tarsal strip and medial spindle procedure
video

One of the most common causes of lower lid ectropion is horizontal lid laxity, the incidence of which increases with age. This condition induces poor ocular surface tear film coverage which leads to irritation, tearing, and keratopathy. Lateral tarsal strip fixation is the technique which is widely used to repair involutional ectropion due to horizontal lid laxity. Medial spindle procedure is the well-known technique for puntal ectropion correction. Both surgeries are minimally invasive, simple and effective. Contributors Suzanne K. Freitag, MD, Ophthalmic Plastic Surgery Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School Thidarat Tanking, MD, Ophthalmic Plastic Surgery Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School

Difficult Dissection during a Low Anterior Resection
video

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 Management of Hemoperitoneum Occurring As A Complication of Sleeve Gastrectomy
video

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.

Fully Endoscopic Uniportal Interlaminar Microdiscectomy
video

The conventional approach to the lumbar discectomy requires significant tissue dissection to obtain a sufficient working space and is known to cause possible complications and injuries. The minimally invasive, fully endoscopic uniportal interlaminar discectomy provides numerous advantages to the typical open procedure. Some advantages include: good visualization of anatomical structures utilizing continuous lavage; lower rates of operative complications such as dural injury, bleeding, and infection; and shorter hospitalization, with increased post-operative rehabilitation. Surgical procedure utilizes guided fluoroscopy to gain access to the interlaminar window, with subsequent placement of the working channel endoscope. Microscopic debridement of herniated lumbar disc and decompression of nerve roots is conducted. This case highlights a patient with significant disc herniation at the L5-S1 level with concurrent mild to moderate cervicothoracic scoliosis. The patient elected for the minimally invasive, fully endoscopic interlaminar microdiscectomy. Authors: William Fuell, Eylem Ocal M.D., Salih Aydin M.D. Institutions: Emsey Hospital-Istanbul, Arkansas Children’s Hospital

Robotic Loop Ileostomy Closure
video

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).

Treatment of Chronic Atelectatic Middle Ear with Endoscopic Placement of Cartilage Shield T-tube
video

Chronic tympanic membrane (TM) atelectasis is a difficult condition with many management challenges and currently has no acceptable gold standard treatment. TM atelectasis is the loss of the normal elasticity of the TM as a result of chronic negative pressure in the middle ear and can be associated with retraction pockets. The under-ventilation of the middle ear and TM retraction can cause ossicular erosion, hearing loss, or cholesteatoma formation. Atelectasis can be halted or reversed with placement of pressure equalization tube (PET). Cartilage tympanoplasty with or without PET has been reported as the preferred material likely due to its higher mechanical stability under negative pressure changes within the middle ear, in addition to its resistance to resorption. This video demonstrates the feasibility of a minimally invasive endoscopic approach of cartilage shield T-tube tympanoplasty as a treatment of chronic TM atelectasis.

Trabectome
video

This is a trabectome procedure performed on a patient with moderate severity open angle glaucoma. Trabectome is a minimally invasive glaucoma surgery (MIGS) developed by Baerdveldt and Chuck where the trabecular meshwork is electrocauterized, irrigated, and aspirated under gonioscopy to improve the drainage of aqueous humor and reduce intraocular pressures. Procedure Topical TetraVisc is first administered to the eye. The patient’s head is rotated 30 degrees away from the surgeon and the microscope tilted 30 degrees toward the surgeon. The patient’s axial core can be rotated if turning the neck proves difficult. The gonioscope lens is used to visualize the trabecular meshwork, the pigmented line between Schwalbe’s line and the scleral spur. A 1.7 mm temporal clear corneal and uniplanar incision is made 2 mm anterior to the limbus. While applying continuous irrigation to deepen the angle, the Trabectome handpiece is introduced into the anterior chamber under gonioscopic visualization, and the end of the device was inserted into the inferonasal trabecular meshwork. When properly inserted, the trabecular meshwork should enter between the electrode tip and the footplate, causing the footplate to be obscured by the trabecular meshwork. The handpiece is used to ablate trabecular meshwork at a setting of flow 3 and 0.7 mW. It is rotated superiorly to create a 120 degree cleft, exposing the outer white wall of Schlemm’s canal. Care must be taken to prevent outward push on Schlemm’s canal by applying a slight inward pull during ablation. The handpiece may need to be readjusted as it is rotated in a counter-clockwise fashion. The handpiece is removed from the anterior chamber. The patient’s head is returned to a neutral position, and BSS was used to exchange viscoelastic from the anterior chamber through the temporal wound. BSS is to irrigate red blood cells from the Schlemm’s canal collector channels. The gonioscope is used to verify the cleft. At the conclusion of the case, the intraocular chamber is formed and pressure checked to be appropriate via digital palpation. Indications Trabectome is indicated for narrow-angle [1], open-angle, and secondary glaucoma with uncontrolled intraocular pressures and progressive nerve injury refractory to maximal or tolerable medication management [2]. As a MIGS, trabecome can be considered in initial stages of glaucoma due to its safety and quick routine recovery. Reduction of drops due to side effects, costs, or poor compliance are reasons to offer this procedure to patients [3]. Trabectome surgery can also be performed in conjunction with cataract surgery, in pseudophakic and phakic eyes, and after trauma, scleral buckle [4], laser trabeculoplasty [5], or failed trabeculectomy or tube shunt [6,7]. Contraindications Contraindications are few but the most common is pathology that limits gonioscopic view of the angle (active neovascular glaucoma, uveitis, corneal edema etc). Setup Patient’s head is rotated 30 degrees away from the surgeon and the microscope rotated 30 degrees toward the surgeon to provide optimal surgical approach. Preoperative Workup The patient’s glaucoma stage and type are identified. History taking should involve asking patients about trauma and prior eye surgeries. A complete ophthalmic examination is performed, including intraocular pressure and assessment of the angles under gonioscopy. Nerve OCTs and Humphrey visual fields are also obtained. No bloodwork, EKG, or imaging are required. Anesthesia questionnaire is completed prior to the procedure. Anatomy and Landmark Trabecular meshwork should be identified as the pigmented line between Schwalbe’s line and the scleral spur. Care must be taken to not ablate the ciliary body band. Blood reflux from Schelmm’s canal collector channels to confirm the ablation target can be induced by burping the main incision. After ablation, the cleft should be verified. The pigmented line from the trabecular meshwork should no longer be visible and only the outer wall of Schlemm’s canal seen. Advantages/Disadvantages Numerous studies have looked at the efficacy of trabectome surgery. Intraocular pressure drops to the mid-teens and decreasing the number of medications in most cases [8]. Unlike trabeculectomy or tube shunts, there is little scarring, the conjunctiva is preserved, the recovery is predictable, and there are less complications [3]. Patients with higher IOPs stand to benefit with greater reductions in IOPs than those with lower IOPs. There is limited data on the long-term success rate of trabectome surgeries. Studies following patients after surgery show that trabectome alone has a 70% success rate at 1 year but only 22% at 2 years [9,10,11]. Complications/Risks The most common complications are transient hyphema, peripheral anterior synechiae, corneal injury, and transient IOP spikes of 10 mmHg or higher. Surgical failure can be due to incomplete or improper removal of the trabecular meshwork as well as damage to the ciliary body band or surrounding tissues [12]. The rate of serious vision-threatening complications, such as hypotony, cyclodialysis cleft, choroidal hemorrhage, and endophthalmitis, is <1% [13].

Totally Robotic Sigmoidectomy with Trans-anal Specimen Extraction and Intra- corporeal, Single Stapler, End-to-End Anastomosis
video

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.

Endoscopic Repair of a Jugular Diverticulum
video

We present a case of a patient with a jugular diverticulum causing persistent pulsatile tinnitus which was successfully treated with a CO2 laser endoscopic procedure. To our knowledge this is the first instance of a dehiscent jugular diverticulum being successfully treated in this manner. We believe this procedure is advantageous when compared to other treatment modalities because it is 1) minimally invasive 2) there is decreased pain and recovery time compared to other surgical approaches and 3) the risk of serious post-op infection such as meningitis is theoretically much lower when compared to posterior auricular approaches that must expose the dura of the brain to reach the jugular diverticulum.

Treatment of mild eyelid ptosis with conjunctivo-mullerectomy
video

Mild eyelid ptosis with good elevator function can be treated with minimally invasive procedures. When Muller's muscle contraction corrects the deficiency (evaluated by phenilefrine test) conjunctivo-mullerectomy is the procedure of choice. This video presents the surgical steps to perform conjunctivo-mullerectomy. Contributors Dov Charles Goldenberg, MD Phd, Division of Plastic Surgery, Hospital das Clinicas, University of Sao Paulo Medical School Vania Kharmandayan, MD, Division of Plastic Surgery, Hospital das Clinicas, University of Sao Paulo Medical School

Robotic-Assisted Transanal Polyp Resection
video

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

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

leadership (12)

img
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.

img
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.

img
Adam Zanation, MD
leadership

University of North Carolina at Chapel Hill
  • Director, Head and Neck Robotic Surgery Program
  • Director of the Advanced Head and Neck Oncology, Skull Base, and Rhinology Fellowships
  • Associate Professor, Department of Otolaryngology – Head and Neck Surgery

Dr. Adam Mikial Zanation is a tenure tract Associate Professor within the Department of Otolaryngology – Head and Neck Surgery at the University of North Carolina at Chapel Hill. He is also the Director of the Head and Neck Robotic Surgery Program and the Director of the Advanced Head and Neck Oncology, Skull Base, and Rhinology Fellowships. He was born on July 11, 1976, in Concord, North Carolina and attended the University of North Carolina where he was a three-year graduate with honors and research commendation in 1997. He then matriculated to the University of North Carolina School of Medicine where he graduated 1of 4 students in his class with highest honors. Following residency, Dr. Zanation completed a Cranial Base Surgical Oncology Fellowship at the University of Pittsburgh Medical Center. Dr. Zanation’s clinical practices focus on cranial base surgery, specifically employing endoscopic and minimally invasive approaches to complex tumor locations. His clinical research focuses on quality of life, neurofunctional, and neurocognitive outcomes, as well as application of new surgical technology such as robotic surgery to reduce patient morbidity. Dr. Zanation’s translational basic research interests focuses on genomic analyses of head and neck tumors and thyroid cancers for diagnostic and prognostic purposes. Dr. Zanation currently has 70 PubMed Indexed publications and in the last five years has presented at over 60 national and international meetings. Dr. Zanation is married to Jennifer Stegall Zanation who is a Neonatal ICU Pharmacist at UNC Hospitals. They have two young children and enjoy a multitude of outdoor activities.

img
Ehab Hanna, MD, FACS
leadership

The University of Texas MD Anderson Cancer Center
  • Professor and Vice Chair
  • Department of Head and Neck Surgery

Ehab Hanna, M.D., FACS, is an internationally recognized head and neck surgeon and expert in the treatment of patients with skull base tumors and head and neck cancer. He is Professor and Vice Chair of the Department of Head and Neck Surgery at The University of Texas MD Anderson Cancer Center in Houston, Texas. After earning his medical degree, he completed a surgery internship at Vanderbilt University, and residency in Otolaryngology-Head and Neck Surgery at The Cleveland Clinic in Cleveland, Ohio. He received advanced fellowship training in skull base surgery and head and neck surgical oncology at the University of Pittsburgh Medical Center. He joined the MD Anderson faculty in 2004 with a joint appointment at Baylor College of Medicine. He is the medical director of the Multidisciplinary Head and Neck Center and co- director of the Skull Base Tumor program at MD Anderson. Dr. Hanna recently served as President of the North American Skull Base Society (NASBS) which was founded in 1989, and is a professional medical society that facilitates communication worldwide between individuals pursuing clinical and research excellence in skull base surgery. Dr. Hanna is leading the development of minimally invasive and robotic applications in skull base surgery. He has consistently been named one of America’s Top Doctors by the Castle Connolly Guide. In addition to patient care, Dr. Hanna is actively engaged in clinical and translational research with emphasis on skull base tumors. He is the Editor-in-Chief of the journal of Head & Neck, which is the official journal of the International Federation of Head and Neck Societies. He also co-edited a text book on “Comprehensive Management of Skull Base Tumors”.

img
Ram Eitan, MD, MPH
leadership

Sackler School of Medicine
  • Chief of the Gynecologic Oncology Division
  • Department of Obstetrics and Gynecology

Dr. Ram Eitan attended medical school at the Ben-Gurion University of the Negev Medical School in Beer Sheva, Israel. Dr. Eitan completed his Residency in Obstetrics and Gynecology at the Shaare Zedek Medical Center in Jerusalem, Israel and his Gynecologic Oncology Fellowship on the Gynecology Service, Department of Surgery at Memorial Sloan-Kettering Cancer Center in New York, NY, USA.

Dr. Eitan is now the Chief of the Gynecologic Oncology Division in the Department of Obstetrics and Gynecology at Rabin Medical Center in Petah Tikva, Israel and Assistant Professor at Sackler School of Medicine in Tel Aviv University, Israel. He is a member of the Society of Gynecologic Oncology, the Society of Memorial Gynecologic Oncologists and the Israel Society of Obstetrics & Gynecology.

Dr. Eitan’s expertise and research interests include minimally invasive surgery for the treatment of gynecological cancers, robotic- assisted surgery, pre-invasive cervical dysplasia – colposcopy diagnosis and management, and extensive cytoreductive surgery for advanced ovarian carcinoma.

img
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.

img
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.

img
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.

img
Joseph McCain, MD
leadership

  • OMFS - Director of TMJ and Minimally Invasive Endoscopic
  • Associate Professor of OMFS at the Harvard MEdical School and Harvard School of Dental Medicine
  • Attending Surgeon at MGH

Dr. Joseph McCain is a Board Certified Oral and Maxillofacial Surgeon and Fellow of the American College of Surgeon. He completed his undergraduate and Dental School education at the University of Pittsburgh. Residency training in OMFS was completed at the University of Miami, Jackson Memorial Hospital. Dr. McCain was the Founder of Miami Oral and Maxillofacial Surgery, a hybrid academic private practice that focused on patient care, graduate medical education, and clinical research.

He has previously served as Chief of OMFS of the Baptist Health System in Miami, OMFS Program Director at Nova Southeastern School of Dental Medicine, and professor and Chairman of the OMFS section of Florida International University School of Medicine. He currently serves as the President of the American Society of TMJ Surgeons.

Dr. McCain's specialty focused interest  include TMJ and OMFS Endoscopic Surgery. Dr. McCain has published, lectured, and operated both nationally and internationally regarding this field of specialized surgery. Dr. McCain joined the Harvard/MGH Family as a a full-time faculty in the Department of OMFS in 2018. Currently he is an Associate Professor of OMFS at the Harvard Medical School and Harvard School of Dental Medicine and Attending Surgeon at Massachusetts General Hospital.

img
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.

img
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.

img
Michael Blute, Sr, MD
leadership

Massachusetts General Hospital
  • Chief of Urology

Dr. Michael L. Blute received his BA Degree from the College of the Holy Cross in Worcester, and his MD Degree from Creighton University School of Medicine in 1982, graduating Magna Cum Laude. Subsequent to internship and residency in urology at the Mayo Clinic in Rochester, he remained on the staff and rose rapidly through the ranks to become the Anson L. Clark Professor and Chairman in the Department of Urology in 1999. He remained as Chairman of the Department of Urology and on the Executive Board of the Mayo Clinic until appointed Interim Chief of Urology and Director of the Cancer Center of Excellence at the University of Massachusetts Memorial Medical Center in 2010. In April 2012 Dr. Blute was appointed Chief of Urology at The Massachusetts General Hospital in Boston.

Dr. Blute has had a major interest in urologic oncology and is well-known in the field of academic urology. His major areas of interest include prostate cancer, nephron-sparing surgery for kidney masses, and the management of complex renal cell and bladder neoplasms. He has been involved in phase III trials of Finasteride, chemoprevention of prostatic intraepithelial neoplasia with anti-androgens, minimally invasive surgery for BPH, biomarkers in prostate cancer, and localization of tumor suppressor genes in prostate cancer. He serves as a reviewer on 13 editorial boards. He serves on the AUA Renal Mass Guideline Panel and served on the American Joint Committee on Cancer. He is the recipient of the 2010 AUA Career Contribution Award. He has been honored as Department of Urology Teacher of the Year at the Mayo Clinic on several occasions. His bibliography includes 387 peer-reviewed publications, one book, and 26 book chapters.

webinar (5)

img
Pediatric Cricotracheal Resection: A Step by Step Surgical Presentation
webinar

This talk will focus on the surgical principals of resective airway surgeries with a step by step discussion on the surgical technique of Pediatric Cricotracheal resection.


Sohit Paul Kanotra , MD

Director, Complex Pediatric Airway Program / Associate Professor of Otolaryngology Head and Neck Surgery & Pediatrics
University of Iowa Hospitals & Clinics

Dr. Sohit Kanotra is a Clinical Associate Professor in the Department of Otolaryngology – Head and Neck Surgery and the Department of Pediatrics at the Roy J. and Lucille A. Carver College of Medicine at University of Iowa and the Director of the Complex Pediatric Airway program at University of Iowa Hospitals & Clinics. He has clinical expertise in the management of children with complex airway disorders including open airway reconstructive surgeries. He also has clinical interest in the management of Head and Neck vascular anomalies, pediatric thyroid disorders, minimally invasive endoscopic ear surgery and robotic airway surgery. Dr. Kanotra joined University of Iowa in 2019 prior to which he was the Director of the Pediatric Aerodigestive Center and the surgical director of the vascular anomalies’ clinic at Children’s Hospital of New Orleans in Louisiana.

img
Advanced Salivary Endoscopy: Challenging Cases Diagnosis & Treatment
webinar

The advanced course will assume a basic understanding of the procedure. It will include complex interventions including endoscopic and combined open (transoral and external procedures), complications and management of complications, approach to revision surgery, in-office procedures, advanced radiology, and will include case studies.

Meet the Course Directors!

Rohan R. Walvekar, MD

Assistant Professor in Head Neck Surgery

University of Pittsburgh/VA Medical Center

Rohan R. Walvekar, MD, earned his doctoral degree from the University of Mumbai. After graduating in 1998, he completed a residency in Otolaryngology and Head Neck Surgery at the TN Medical College & BYL Nair Charitable Hospital, Mumbai, India, with triple honors. Subsequently, he completed two head neck surgery fellowships, and trained at at the Tata Memorial Hospital, Mumbai, which is India's most prestigious cancer institute. After completing an Advanced Head Neck Oncologic Surgery fellowship at the University of Pittsburgh, he became an Assistant Professor in Head Neck Surgery within the Department of Otolaryngology Head Neck Surgery at the University of Pittsburgh/VA Medical Center, prior to joining the LSU Health Sciences Center in July 2008. His clinical interests are head neck surgery and salivary endoscopy. His research interests include evaluating prognostic markers and clinical outcomes of head and neck cancer therapy and treatment of salivary gland disorders.


Barry M Schaitkin, MD

Professor of Otolaryngology

UPMC Pittsburgh

Dr. Schaitkin specializes in the treatment of inflammatory and neoplastic conditions of the salivary glands. He practices at UPMC in the Department of Otolaryngology and is affiliated with UPMC branches all across the city of Pittsburgh. He completed his medical degree and residency at Pennsylvania State University College of Medicine.


Meet the Presenters!


Jolie Chang, MD

Associate Professor, Chief of Sleep Surgery and General Otolaryngology

University of California, San Francisco

Dr. Chang specializes in sleep apnea surgery and minimally invasive approaches to the salivary duct with sialendoscopy. She has interest in studying patient reported outcomes after sialendoscopy procedures.


Mark Marzouk, MD

Clinical Associate Professor of Otolaryngology - Head and Neck Surgery

SUNY Upstate Medical University

Dr. Marzouk completed his residency training in 2010 from the UPMC Department of Otolaryngology. He is currently the Division Chief of Head and Neck Oncologic Surgery in Syracuse. He is also the Associate Program Director of Residency Programs.


David W. Eisele, MD. FACS

Andelot Professor and Director - Department of Otolaryngology-Head and Neck Surgery

Johns Hopkins University School of Medicine

Dr. Eisele is the Past-President of the American Board of Otolaryngology- Head and Neck Surgery and a member of the NCCN Head and Neck Cancer Panel. He has served as a member of the Residency Review Committee for Otolaryngology, as Chair of the Advisory Council for Otolaryngology - Head and Neck Surgery for the American College of Surgeons, President of the American Head and Neck Society, and as Vice-President of the Triological Society. He served as President of the Maryland Society of Otolaryngology and is a former Governor of the American College of Surgeons.


M. Boyd Gillespie, MD, MSc, FACS

Professor and Chair

UTHSC Otolaryngology-Head and Neck Surgery

M. Boyd Gillespie is Professor and Chair of Otolaryngology-Head & Neck Surgery at University of Tennessee Health Science Center. He is a graduate of the Johns Hopkins University School of Medicine where he a completed residency and fellowship in Otolaryngology-Head & Neck Surgery. Dr. Gillespie earned a Masters in Clinical Research at the Medical University of South Carolina, and is board certified in Otolaryngology-Head and Neck Surgery and Sleep Medicine. He has published over 150 academic papers and is editor of the textbook Gland-Preserving Salivary Surgery: A Problem-Based Approach. He is a former Director of the American Board of Otolaryngology-Head & Neck Surgery (ABOHNS) and current member of the otolaryngology section of the Accreditation Council for Graduate Medical Education (ACGME).


M. Allison Ogden, MD FACS

Professor & Vice-Chair of Clinical Operations - Department of Otolaryngology

Washington University School of Medicine

Dr. Ogden is a Professor and Vice-Chair of Clinical Operations in the Department of Otolaryngology at Washington University School of Medicine. She graduated from the Washington University School of Medicine in 2002 and went on to complete her residency there as well in Otolaryngology in 2007. Her clinical interests include sialendoscopy, nasal obstructions, and hearling loss. In 2015 Dr. Ogden was listed in "Best Doctors in America", an honor that continues to this day.


Arjun S. Joshi, MD

Professor of Surgery

The George Washington University School of Medicine & Health Sciences

Arjun Joshi, MD is board-certified in Otolaryngology and Head & Neck surgery by both the American Board of Otolaryngology – Head and Neck Surgery and the Royal College of Physicians and Surgeons of Canada. Dr. Joshi received his medical degree from the State University of New York at Syracuse and completed his residency at The George Washington University Medical Center. His areas of expertise include: Head and Neck Cancer, Head and Neck Masses, Head and Neck Reconstruction, Thyroid and Parathyroid Surgery, and Salivary Endoscopy.


Henry T. Hoffman, MD

Professor of Otolaryngology / Professor of Radiation Oncology

University of Iowa Healthcare

Dr. Henry T. Hoffman is an ENT-otolaryngologist in Iowa City, Iowa and is affiliated with University of Iowa Hospitals and Clinics. He received his medical degree from University of California San Diego School of Medicine and has been in practice for more than 20 years.


David M. Cognetti, MD, FACS

Professor and Chair of Department of Otolaryngology-Head & Neck Surgery

Thomas Jefferson University

Dr. Cognetti received his BS in Biology from Georgetown University and his MD from the University of Pittsburgh School of Medicine. He completed a residency in Otolaryngology – Head and Neck Surgery at Thomas Jefferson University before completing a fellowship in Advanced Head and Neck Oncologic Surgery at the University of Pittsburgh Medical Center.  Dr. Cognetti returned to Jefferson, his professional home, as faculty in 2008.


Christopher H. Rassekh, MD, FACS

Professor in Department of Otorhinolaryngology - Head & Neck Surgery / Director of Penn Medicine Sialendoscopy Program

University of Pennsylvania

Christopher H. Rassekh, MD is Professor of Clinical Otorhinolaryngology-Head and Neck Surgery at Penn Medicine. He is the Director of the Penn Medicine Sialendoscopy Program, which provides evaluation of and minimally invasive surgery for diseases that cause swelling of the salivary glands including obstructive diseases such as salivary stones, salivary duct strictures and tumors. Dr. Rassekh sees patients with head and neck tumors including cancers of the mouth, throat, voice box, salivary gland, thyroid and neck and also was a very early adopter of Transoral Robotic Surgery (TORS) for tumors and salivary gland diseases, and is an expert in cranial base surgery. He also is co-chair of the Airway Safety Committee at the Hospital of the University of Pennsylvania.


img
A Deep Dive into Congenital Cystic Lesions of the Head and Neck
webinar

Attendees will hear from an expert panel on the presentation, work-up, and management of congenital cystic lesions of the head and neck in the pediatric patient. Surgical techniques for excision of cystic lesions will be described in detail including anatomical landmarks, surgical pearls, and common pitfalls. We will also discuss novel surgical approaches, such as minimally invasive techniques.

img
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.

img
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 (4)

img
Meet our Presenters for Day 1!
news

The International Adult Airway Symposium is coming up on February 4th & 5th. For more information view the itinerary or register here!

Dr Gitta Madani, FRCR, MRCS, MBBS, FDSRCS, BDS

Consultant Radiologist and Honorary Senior Lecturer

Imperial College Healthcare NHS Trust and Imperial College London

Gitta Madani is a Consultant Radiologist with a specialist interest in all aspects of head and neck and skull base radiology and performs image-guided procedures in the head and neck. She is an Honorary Lecturer at Imperial College London and involved in research, training and teaching. She has authored several book chapters, various peer-reviewed articles and national imaging guidelines.


Ali Zul Jiwani, MD, MSc, DAABIP

Director of Interventional Pulmonology

Orlando Health Cancer Institute

Dr. Jiwani, is a board-certified interventional pulmonologist with the Rod Taylor Thoracic Care Center at Orlando Health Cancer Institute where he also leads the institute’s lung cancer screening program. As an interventional pulmonologist he specializes in minimally invasive diagnostic and therapeutic endoscopy and other procedures to treat malignant and benign conditions of the airway, lungs and thorax plus pleural diseases.


David E. Rosow, MD, FACS

Director, Division of Laryngology and Voice / Associate Professor, Dept. of Otolaryngology

University of Miami Miller School of Medicine

Dr. Rosow is Associate Professor of Otolaryngology at the University of Miami Miller School of Medicine, where he has led the Division of Laryngology and Voice for over 10 years. His research and clinical interests include laryngeal cancer, recurrent respiratory papillomatosis, vocal fold paralysis, laryngotracheal stenosis and airway reconstruction, and spasmodic dysphonia. In addition to scientific publications in these areas, he has also written and edited a textbook on evidence-based practice in Laryngology.


Professor Stephen R Durham MD FRCP

Professor of Allergy and Respiratory Medicinec

National Heart and Lung Institute, Imperial College London and Royal Brompton Hospital London

Professor Durham is Head of Allergy and Clinical Immunology at NHLI and has run a joint Nose Clinic with Professor Hesham Saleh for many years. His research interests include allergic rhinitis, asthma and translational studies in allergen immunotherapy. He is a member of the Steering Committee, Immune Tolerance Network, National Institutes of Allergy and Infectious Diseases, NIH, USA.


Professor Jane Setterfield

Professor of Oral & Dermatological Medicine

Guy's & St Thomas Hospital & King's College London

Jane Setterfield is Professor of Oral and Dermatological Medicine at King’s College London and Consultant in Dermatology at St John’s Institute of Dermatology, Guy’s & St Thomas Hospitals. She leads the Oral Dermatology Service both at St John’s Institute and the Department Oral Medicine Guy’s Dental Institute. Her areas of clinical interest include immunobullous diseases, lichenoid disorders vulval dermatoses and mucocutaneous diseases. Her research areas include diagnostic techniques, pathogenic mechanisms, clinical outcome measures and optimising therapeutic approaches for mucocutaneous diseases.


Laura Matrka, MD

Associate Professor

Ohio State University Wexner Medical Center Department of Otolaryngology - Head and Neck Surgery

Laura Matrka, MD, is an Associate Professor at the Ohio State University Wexner Medical Department of Otolaryngology – Head & Neck Surgery. She graduated magna cum laude from Dartmouth College with a BA in English and concentrations in Anthropology and Spanish, completed medical school at University of Cincinnati College of Medicine, completed her residency in Otolaryngology at The Ohio State University, and completed a Laryngology fellowship at the University of Texas Health Sciences Center, San Antonio. She is a full-time clinician who devotes significant additional time to clinical research, focusing on complicated airway management, tracheostomy complications, dysphagia after anterior cervical spine surgery, recurrent respiratory papillomatosis, gender-affirming health care, and opioid-related research, among other topics. She was inducted into the American Laryngologic Association in 2020, the Triological Society in 2019, and the American Bronchoesophageal Association in 2015.


Alexander Gelbard, MD

Co-Director

Vanderbilt Center for Complex Airway Reconstruction (AeroVU)

Dr. Gelbard is a board certified Otolaryngologist at Vanderbilt University in Nashville Tennessee specializing in adult laryngeal and tracheal disease. He completed his undergraduate education at Stanford University, medical school at Tulane School of Medicine, and internship and residency at the Baylor College of Medicine in Houston Texas. Dr. Gelbard completed a postdoctoral research fellowship in Immunology at the MD Anderson Cancer Center as well as a clinical fellowship in Laryngeal Surgery at Vanderbilt School of Medicine. He has authored numerous peer-reviewed articles and book chapters and lectures internationally on adult airway disease. He currently is Co-director of the Vanderbilt Center for Complex Airway Reconstruction (AeroVU). Additionally, he is a NIH-funded principle investigator studying the immunologic mechanisms underlying benign laryngeal and tracheal disease. He is also PI of an externally funded prospective multi-institutional study of idiopathic subglottic stenosis (iSGS) and managing director of the North American Airway Collaborative (NoAAC). NoAAC is a funded, multi-institutional consortium with 40 participating centers in the United States and Europe that works to exchange information concerning the treatment of adult airway disease. It is composed of outstanding collaborators who pursue a unique combination of genetic, molecular, and epidemiologic based approaches to investigate the critical factors underlying the pathogenesis and outcomes of laryngotracheal stenosis.


Taner Yilmaz, MD

Professor of Otolaryngology-Head & Neck Surgery

Hacettepe University Faculty of Medicine, Ankara, Turkey

Dr. Yilmaz has worked in laryngology since 2000. He is a member of ELS, ALA and IAP, publishing 94 international manuscripts which received 1100 citations. On top of those achieveiments, he also has two patents for a laryngoscope for arytenoidectomies and an epiglottis holding forceps for grasping a floppy epiglottis that folds inside the larynx during larygoscopy.


Edward J. Damrose, MD, FACS

Professor of Otolaryngology-Head & Neck Surgery

Stanford University School of Medicine

Dr. Damrose is Professor of Otolaryngology/Head and Neck Surgery and (by courtesy) of Anesthesiology, Perioperative & Pain Medicine in the Stanford University School of Medicine. He is the founding Chief of the Division of Laryngology and Program Director of the Stanford Fellowship in Laryngology & Laryngeal Surgery. He is member of the American Laryngological Association as well as the Triological Society, and has authored or coauthored more than 80 peer reviewed publications and 16 book chapters.


Kate Heathcote, MBBS, FRCS

Consultant Laryngologist

University Hospitals Dorset

Kate Heathcote established the Robert White Centre for Airway, Voice and Swallow to provide a comprehensive diagnostic and treatment service. She has lectured and trained surgeons nationally and internationally in cutting edge laryngology techniques.


Phillip Song, MD

Division Director in Laryngology

Imperial College LonMassachusetts Eye and Ear Infirmary

Dr Song is the Division Director of Laryngology at Massachusetts Eye and Ear Infirmary and Assistant Professor of Otolaryngology and Head and Neck Surgery at Harvard Medical School. He specializes in laryngology with a special interest in neurolaryngology and central airway disease.


Brianna Crawley, MD

Associate Professor, Co-Director

Loma Linda University Voice and Swallowing Center

Dr. Crawley is a board-certified otolaryngologist and member of the Academy of Otolaryngology- Head and Neck Surgery, the ABEA, and the post-grad ALA. Her interests include neurolaryngology, swallowing disorders, performing voice and the surgical airway. She continues to work in new fields of research focusing on presbylarynx and presbyphonia, neurolaryngology, and understanding the patient experience.


Ramon Franco Jr, MD

Medical Director, Voice and Speech Lab, Senior Laryngologist

Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston MA, USA

Dr. Ramon Franco is a board-certified laryngologist who specializes in voice, swallowing, and breathing disorders. His main areas of expertise are in the diagnosis and treatment of voice disorders, airway stenosis, laryngeal cancer, and neurological disorders affecting the voice box. He also has special interests in the medical and surgical care of the professional voice. He serves as an Executive Board Member for the Massachusetts Society of Otolaryngology and is a fellow for the Triological Society and the American Laryngological Association.


Clark A. Rosen, MD

Co-Director / Chief - Division of Laryngology

UCSF Voice and Swallowing Center

Clark Rosen, MD is a Co-Director of the UCSF Voice and Swallowing Center, Chief of the Division of Laryngology, Professor of Otolaryngology-Head and Neck Surgery and the F Lewis Morrison MD Endowed chair of Laryngology. Dr. Rosen inaugurated modern laryngology at the University of Pittsburgh beginning in 1995 creating a dedicated center of excellence in Laryngology: University of Pittsburgh Voice Center. Dr. Rosen originated the outstanding Fellowship in Laryngology and Care of the Professional Voice at the University of Pittsburgh in 2002 and trained over 15 fellows in Larynogology and numerous visiting Otolaryngologists until 2018. He is now the director of the Laryngology fellowship at the UCSF Voice and Swallowing Center. Dr. Rosen has been a sought after speaker internationally and has had major service to multiple publications and professional societies. He is a founding member of the Fall Voice Conference, was the Vice Chair of the Annual Meeting Program Committee for the American Academy of Otolaryngology-Head and Neck Surgery (AAOHNS), and was the Treasurer of the American Laryngological Association (ALA) and is now president of the ALA.


img
Meet our Presenters for Day 2!
news

The International Adult Airway Symposium is coming up this weekend! For more information view the itinerary or register here!

Dr. Vyvy Young

Associate Professor and the Associate Residency Program Director in the Department of Otolaryngology-Head and Neck Surgery

University of California – San Francisco

VyVy Young, MD, is an Associate Professor and the Associate Residency Program Director in the Department of Otolaryngology-Head and Neck Surgery at the University of California – San Francisco. Dr. Young received her undergraduate and medical degrees from the University of Louisville, in Louisville, Kentucky, where she also pursued her Otolaryngology training. She then completed a fellowship in Laryngology and Care of the Professional Voice at the University of Pittsburgh Voice Center. She currently serves the American Academy of Otolaryngology – Head and Neck Surgery as member of the Annual Meeting Program Committee and Executive Committee for ENThealth.org. She is immediate past-chair of the Voice Committee and the Women in Otolaryngology Communications Committee and was recently selected as chair of the Finance and Audit Committee of the American Broncho-Esophagological Association.


Justin Roe, PhD, FRCSLT

Clinical Service Lead - Speech and Language Therapy – National Centre for Airway Reconstruction

Imperial College Healthcare NHS Trust

Dr. Roe is a clinical-academic and service lead, specialising in dysphagia in benign and malignant head and neck disease. He leads the speech and language therapy service for the National Centre for Airway Reconstruction at Imperial College Healthcare NHS Trust and is a consultant and service lead at the Royal Marsden NHS Foundation Trust. He is an Honorary Clinical Senior Lecturer at Imperial College London and an investigator on a number of NIHR portfolio studies. He is currently on an NIHR Imperial Biomedical Research Centre/ Imperial Health Charity funded post-doctoral research fellowship. He is an elected council member for the British Laryngological Association and British Association of Head and Neck Oncologists.


Professor Anil Patel MBBS PhD FRCA

Clinical Anaesthetist / Chairman of Department of Anaesthesia

Royal National ENT & Eastman Dental Hospital

Professor Anil Patel graduated from University College London in 1991. He is a clinical anaesthetist and continues to develop and refine the largest experience of anaesthetising adult airway patients under general anaesthesia (> 6,000 procedures) in the UK, probably Europe and possibly the world. His research interests include all aspects of shared airway and difficult airway management. Professor Patel has been an invited speaker to over 300 national and international meetings in 38 countries. He has over 130+ peer reviewed publications, 25 book chapters, over 4,500 citations and an h-index of 25.


Robbi A. Kupfer, MD

Associate Professor, Department of Otolaryngology-Head & Neck Surgery

University of Michigan

Dr. Kupfer is an Associate Professor of Otolaryngology-Head & Neck Surgery at the University of Michigan who specializes in Laryngology and Bronchoesophagology. She is the Program Director for the Laryngology Fellowship as well as the Otolaryngology Residency at the University of Michigan.


Alexander T. Hillel, MD, FACS

Associate Professor

Johns Hopkins University School of Medicine

Dr. Alexander Hillel is a Laryngologist, Residency Program Director, and Vice Director of Education in the Johns Hopkins Department of Otolaryngology – Head & Neck Surgery. His clinical practice and research centers on the treatment, prevention, and causes of laryngotracheal stenosis (LTS).


Dale Ekbom, MD

Associate Professor of Otolaryngology / Director of Voice Disorders/Laryngology

Mayo Clinic

Residency in Otolaryngology/Head and Neck Surgery at the University of Michigan with a fellowship in Laryngology/Care of the Professional Voice at Vanderbilt University Medical Center. Clinically specializing in voice, especially management of vocal fold paralysis, Zenker’s diverticulum and Cricopharyngeal muscle dysfunction, early laryngeal cancer, and airway compromise due to laryngeal, subglottic, and tracheal stenosis. Research interests include idiopathic subglottic stenosis and GPA with surgical and medical management of the airway, vocal fold paralysis, new injectables using Jellyfish collagen.


Dr. Ricky Thakrar

Consultant Chest Physician

University College London Hospital

Dr. Ricky Thakrar qualified in Medicine from Imperial College London. He trained in Respiratory Medicine at the Royal Brompton Hospital and completed his training in Northwest London. He was appointed to a three-year academic fellowship at UCL where his PhD examined state of the art bronchoscopy techniques for managing cancers arising in central airways and lung. He is a Consultant in Thoracic Medicine and his main interests are in interventional bronchoscopy procedures (laser resection, airway stenting, cryotherapy, photodynamic therapy and brachytherapy) for pre-malignant and malignant disease of the tracheobronchial tree.


Dr. Michael Rutter

Director of the Aerodigestive Center

Cincinnati Children's Hospital

Dr. Rutter is an ENT surgeon specializing in pediatric otolaryngology with an emphasis on airway problems in children, adolescents and young adults. His interests include tracheal reconstruction and complex airway surgery. Always a problem-solver, he strives to involve the patient in their own care by having them help evaluate the issue and then craft a solution together. He was drawn to his career by the challenge and highly individualized nature of pediatric airway problems and management. Dr. Rutter enjoys working in a multidisciplinary team setting and focusing on coordinated care for complex childhood airway conditions. He was honored to receive the 2016 Gabriel Frederick Tucker Award from the American Laryngological Association, and the 2018 Sylvan Stool Teaching Award from the Society for Ear Nose and Throat Advancement in Children (SENTAC). These awards are for his contributions to the field of pediatric laryngology. In addition to caring for patients, he is also dedicated to his research trying to find improvements in airway management.


Christopher T. Wootten, MD, MMHC

Director, Pediatric Otolaryngology—Head and Neck Surgery

Vanderbilt University Medical Center

Dr. Wootten has a longstanding interest in surgical management of congenital and acquired airway disorders.  To better equip himself to lead the Pediatric ENT service through expansion, evolution of practice models, and differentiation into multidisciplinary care, Dr. Wootten obtained a Masters of Management in Health Care at Vanderbilt’s Owen School of Business in 2017.  Areas of his professional research emphasis include airway obstruction in children and adults and aerodigestive care. He innovates minimally invasive surgical techniques in the head and neck.  Dr. Wootten is actively investigating the role of eosinophil and mast cell-based inflammation in the pediatric larynx.


Karla O'Dell, M.D.

Assistant Professor / Co-director

USC Voice Center, Caruso Department of Otolaryngology Head and Neck Surgery @ University of Southern California / USC Center for Airway Intervention and Reconstruction

Karla O’Dell, MD, specializes in head and neck surgery and disorders of the voice, airway and swallowing. She is cofounder and codirector of the USC Airway Intervention & Reconstruction Center (USC Air Center).


Jeanne L. Hatcher, MD, FACS

Co-Director of the Emory Voice Center and Associate Professor of Otolaryngology

Emory University School of Medicine

Dr. Hatcher has been at Emory since 2014 after completing her laryngology fellowship with Dr. Blake Simpson; she specializes in open and endoscopic airway surgery as well as voice disorders. Dr. Hatcher is a member of the ABEA and post-graduate member of the ALA and also serves on the Ethics and Voice Committees for the American Academy of Otolaryngology Head and Neck Surgery.


Mr. Lee Aspland

Patient / Freelance Artist

Lee Aspland Photography

Lee Aspland is a photographer, author and mindful practitioner who creates photography that reflects his feelings about living in such a glorious world. He specializes in Mindful Photography, capturing a fleeting feeling or thought, a hope or fear, a frozen single moment in time.


Gemma Clunie, MSc, BA (Hon), MRCSLT

Clinical Specialist Speech-Language Pathologist (Airways/ENT) and HEE/NIHR Clinical Doctoral Research Fellow

Imperial College Healthcare NHS Trust/ Imperial College London, Department of Surgery & Cancer

Gemma is a Clinical Specialist Speech and Language Therapist with an interest in voice and swallowing disorders that is particularly focused on the benign ENT, head and neck, respiratory and critical care populations. Gemma is a current NIHR/HEE Clinical Doctoral Research Fellow at Imperial College London. Her PhD studies focus on the voice and swallowing difficulties of airway stenosis patients. She is based at Charing Cross Hospital in London where she has worked for the last six years as part of the National Centre for Airway Reconstruction, Europe’s largest centre for the management of airway disorders.


Niall C. Anderson, CPsychol, MSc, BSc

Lead Psychologist (formerly Respiratory Highly Specialist Health Psychologist)

Bart's Health NHS Trust (formerly Central & North West London NHS Foundation Trust)

Niall is a HCPC Registered & BPS Chartered Practitioner Health Psychologist, and BPS RAPPS Registered Supervisor. Niall has specialist experience of working within healthcare systems with people with long-term health conditions at all system levels to support physical, psychological and social wellbeing. Niall worked in the Airway Service at Charing Cross Hospital (London, UK) between January-December 2021 in order to develop and implement the Airway Psychology Service.


img
Introducing a Two-Part Sialendoscopy Series!
news

Brought to you by our partnership with Cook Medical, we are having a two-part series on Sialendoscopy. The sessions will feed into one another, the first covering basics like a review of instrumentation and set up, as well as some of the most basic interventions you will see.

The second session will assume a basic knowledge of the procedure and will deal with complex interventions including both endoscopic and combined open procedures, advanced radiology, and complication management for revision surgery and in-office procedures.

Meet the Course Directors!

Rohan R. Walvekar, MD

Assistant Professor in Head Neck Surgery

University of Pittsburgh/VA Medical Center

Rohan R. Walvekar, MD, earned his doctoral degree from the University of Mumbai. After graduating in 1998, he completed a residency in Otolaryngology and Head Neck Surgery at the TN Medical College & BYL Nair Charitable Hospital, Mumbai, India, with triple honors. Subsequently, he completed two head neck surgery fellowships, and trained at at the Tata Memorial Hospital, Mumbai, which is India's most prestigious cancer institute. After completing an Advanced Head Neck Oncologic Surgery fellowship at the University of Pittsburgh, he became an Assistant Professor in Head Neck Surgery within the Department of Otolaryngology Head Neck Surgery at the University of Pittsburgh/VA Medical Center, prior to joining the LSU Health Sciences Center in July 2008. His clinical interests are head neck surgery and salivary endoscopy. His research interests include evaluating prognostic markers and clinical outcomes of head and neck cancer therapy and treatment of salivary gland disorders.


Barry M Schaitkin, MD

Professor of Otolaryngology

UPMC Pittsburgh

Dr. Schaitkin specializes in the treatment of inflammatory and neoplastic conditions of the salivary glands. He practices at UPMC in the Department of Otolaryngology and is affiliated with UPMC branches all across the city of Pittsburgh. He completed his medical degree and residency at Pennsylvania State University College of Medicine.


Meet the Presenters!


Jolie Chang, MD

Associate Professor, Chief of Sleep Surgery and General Otolaryngology

University of California, San Francisco

Dr. Chang specializes in sleep apnea surgery and minimally invasive approaches to the salivary duct with sialendoscopy. She has interest in studying patient reported outcomes after sialendoscopy procedures.


Mark Marzouk, MD

Clinical Associate Professor of Otolaryngology - Head and Neck Surgery

SUNY Upstate Medical University

Dr. Marzouk completed his residency training in 2010 from the UPMC Department of Otolaryngology. He is currently the Division Chief of Head and Neck Oncologic Surgery in Syracuse. He is also the Associate Program Director of Residency Programs.


David W. Eisele, MD. FACS

Andelot Professor and Director - Department of Otolaryngology-Head and Neck Surgery

Johns Hopkins University School of Medicine

Dr. Eisele is the Past-President of the American Board of Otolaryngology- Head and Neck Surgery and a member of the NCCN Head and Neck Cancer Panel. He has served as a member of the Residency Review Committee for Otolaryngology, as Chair of the Advisory Council for Otolaryngology - Head and Neck Surgery for the American College of Surgeons, President of the American Head and Neck Society, and as Vice-President of the Triological Society. He served as President of the Maryland Society of Otolaryngology and is a former Governor of the American College of Surgeons.


M. Boyd Gillespie, MD, MSc, FACS

Professor and Chair

UTHSC Otolaryngology-Head and Neck Surgery

M. Boyd Gillespie is Professor and Chair of Otolaryngology-Head & Neck Surgery at University of Tennessee Health Science Center. He is a graduate of the Johns Hopkins University School of Medicine where he a completed residency and fellowship in Otolaryngology-Head & Neck Surgery. Dr. Gillespie earned a Masters in Clinical Research at the Medical University of South Carolina, and is board certified in Otolaryngology-Head and Neck Surgery and Sleep Medicine. He has published over 150 academic papers and is editor of the textbook Gland-Preserving Salivary Surgery: A Problem-Based Approach. He is a former Director of the American Board of Otolaryngology-Head & Neck Surgery (ABOHNS) and current member of the otolaryngology section of the Accreditation Council for Graduate Medical Education (ACGME).


M. Allison Ogden, MD FACS

Professor & Vice-Chair of Clinical Operations - Department of Otolaryngology

Washington University School of Medicine

Dr. Ogden is a Professor and Vice-Chair of Clinical Operations in the Department of Otolaryngology at Washington University School of Medicine. She graduated from the Washington University School of Medicine in 2002 and went on to complete her residency there as well in Otolaryngology in 2007. Her clinical interests include sialendoscopy, nasal obstructions, and hearling loss. In 2015 Dr. Ogden was listed in "Best Doctors in America", an honor that continues to this day.


Arjun S. Joshi, MD

Professor of Surgery

The George Washington University School of Medicine & Health Sciences

Arjun Joshi, MD is board-certified in Otolaryngology and Head & Neck surgery by both the American Board of Otolaryngology – Head and Neck Surgery and the Royal College of Physicians and Surgeons of Canada. Dr. Joshi received his medical degree from the State University of New York at Syracuse and completed his residency at The George Washington University Medical Center. His areas of expertise include: Head and Neck Cancer, Head and Neck Masses, Head and Neck Reconstruction, Thyroid and Parathyroid Surgery, and Salivary Endoscopy.


Henry T. Hoffman, MD

Professor of Otolaryngology / Professor of Radiation Oncology

University of Iowa Healthcare

Dr. Henry T. Hoffman is an ENT-otolaryngologist in Iowa City, Iowa and is affiliated with University of Iowa Hospitals and Clinics. He received his medical degree from University of California San Diego School of Medicine and has been in practice for more than 20 years.


David M. Cognetti, MD, FACS

Professor and Chair of Department of Otolaryngology-Head & Neck Surgery

Thomas Jefferson University

Dr. Cognetti received his BS in Biology from Georgetown University and his MD from the University of Pittsburgh School of Medicine. He completed a residency in Otolaryngology – Head and Neck Surgery at Thomas Jefferson University before completing a fellowship in Advanced Head and Neck Oncologic Surgery at the University of Pittsburgh Medical Center. Dr. Cognetti returned to Jefferson, his professional home, as faculty in 2008.


img
Physician perspectives: Sialendoscopy during COVID-19
news

COVID-19 has changed the way that physicians are thinking about patient care, forcing them to adapt to new technologies and protocols. It has also given physicians the opportunity to think about the future of medicine, including what it may look like after COVID-19. Through this blog series, we’re interviewing physicians to share their first-hand experiences on how they’re adapting their practices during the COVID-19 pandemic, as well as their thoughts on the future of patient care.

We interviewed Rohan R. Walvekar, MD, to get his perspective on patient care and what the future of sialendoscopy procedures may look like during the COVID-19 pandemic. Dr. Walvekar is the Director of Salivary Endoscopy Service and the Co-Director of ENT Service University Medical Center in the department of Otolaryngology Head & Neck surgery at the Louisiana State University Health Sciences Center in New Orleans, Louisiana.

Below are some highlights of the interview. For the full interview, download the PDF here.

The future of sialendoscopy procedures

How have sialendoscopy procedures changed to adapt to COVID-19 in your practice?

COVID-19 has definitely changed our practice patterns, especially for outpatient services. Many of the otolaryngology procedures, including sialendoscopy, are now considered high-risk since they are aerosol-generating procedures (AGPs). Patients who need an interventional procedure, whether it is a routine flexible endoscopy as a normal part of a head and neck examination during their visit or an interventional sialendoscopy procedure, are now required to have a COVID-19 test within 48 to 72 hours of their in-office procedure, since these are all considered to be AGPs. Some of our clinic spaces have been re-structured to provide negative pressure ventilation in the rooms. In-office AGPs are performed in these negative pressure rooms with proper PPE precautions. Many practices at some sites, including ours, have moved to the use of disposable scopes and equipment when possible for COVID-19-positive patients. Social distancing and its impact on triaging patients, the need for COVID-19 testing, and the need to use additional sterilization procedures to clean and turnover clinic rooms, e.g., UV light technology, has significantly reduced overall patient volumes in clinics. Some of these factors have also impacted surgical turnovers in the hospital setting, impacting surgical volumes. However, these precautions have been vital to help keep our patients, staff, and other healthcare professionals safe during this pandemic.

How will the procedural landscape for salivary gland treatment change?

The thought process for salivary intervention will be influenced by the COVID-19 status. For COVID-19-negative patients, the procedural landscape may remain the same. However, if the patient is COVID-19 positive, then the surgical intervention will be postponed until the patient is past the infective phase, i.e., after 14 days of quarantine and after demonstrating two successive COVID-19-negative tests. Or, if intervention is necessary, a gland excision route may be preferred for certain indications where intra-oral intervention may be complex and have a high risk of viral shedding—for example, an intermediate sized (5-6 mm) hilar stone in the submandibular gland that needs a combined approach procedure, laser fragmentation of hilar-intraglandular stones, or possibly an endoscopic management of high-grade diffuse stenosis. All of these conditions are surgical challenges.

It is more likely that procedures will move from in office to the operating room setting as the intervention is more controlled and measured. All healthcare professionals can take adequate PPE precautions, and once the patient is intubated, the risk of viral shedding decreases compared to an awake patient, who may cough, sneeze, or have a robust gag reflex.

Innovations will come in various ways to help the current situation. Innovations such as the ACE2-X solution could be helpful, if proven effective, to help reduce viral burden and make intervention safer. There are many new innovations, such as innovative techniques to perform examinations, negative pressure environments, and perforated face masks or helmets to allow ENT examinations.

Sialendoscopy products

Do you anticipate an increase in demand in Cook’s minimally invasive sialendoscopy products?

I do anticipate an increase in the demand for certain Cook products, especially the disposable access catheters and wire guides. There also may be an increase demand for the use of the SialoCath® Salivary Duct Catheter, which may be considered for irrigation and washout procedures for chronic sialadenitis, radioactive iodine induced sialadenitis, and Sjogren’s syndrome. Dilation followed by only irrigation with saline, or antibiotics or steroids, or a combination thereof may be a less-invasive alternative to endoscopy and pose a reduced risk of contamination to the salivary endoscope. For centers equipped with negative pressure clinics, the ability to perform these procedures may help reduce the demand for operating room time, which is already reduced due to the requirement for resource management and PPE conservation.

In the full interview, Dr. Walvekar also answers the following questions:

The future of sialendoscopy procedures

  • As otolaryngology procedures start back up, how quickly do you see sialendoscopy procedures returning?
  • How have patient consultations and physical examinations changed?
  • How have you implemented PPE into your practice?
  • How are the examination rooms set up?
  • How are you screening patients for COVID-19?
  • We have heard of some physicians changing from betadine to chlorhexidine for prep prior to salivary and sialendoscopy procedures. Do you have any thoughts on this and the impact on COVID-19?
  • How do you see hands-on educational courses adapting to further physician education?
  • Will there be a shift away from surgical procedures?

Sialendoscopy products

  • Do you anticipate an increased usage of the Advance® Salivary Duct Balloon Catheter by bringing more stricture patients into the office and using ultrasound?
  • Do you anticipate an increase in the preference of disposable sialendoscopy devices over reusable devices?

To learn more about Cook’s products for sialendoscopy, click here.

Dr. Walvekar is a paid consultant of Cook Medical.
The opinions expressed by Dr. Walvekar in this interview are his own, and not the opinions of Cook Medical, and represent his experience within his practice.

Source: Cook Medical

To hear more from Dr. Walvekar and his
colleagues, register for their webinars below:

Register today to continue watching

Sign up for our free membership to watch and submit videos today! If you are already a member please log in to access your account.

Sign Up Now

Already a member? Click here to log in

Register today to submit a video

Sign up for our free membership to watch and submit videos today! If you are already a member please log in to access your account.

Sign Up Now

Already a member? Click here to log in

Upgrade your membership to continue watching

Please upgrade to membership to continue watching more videos.

Upgrade Now

Renew your subscription to continue watching

Please renew your subscription to continue watching.

Renew Now

Create An Author

Create A User

Create A Term

A Global Presence
for Surgical Education
info@csurgeries.com

Little Rock, AR
(844) OPER8 CS
(844) 673.7827

Sign up for our newsletter

© 2022 CSurgeries.com