In 1915, the Atlanta Medical College aligned itself with Emory University to create the Emory University School of Medicine. Over the next 15 years, the University standardized the medical education curriculum, rationalized the training standards for physicians, and built Emory University Hospital (EUH).
While the Department of Surgery had existed as a primarily clinical operation at EUH since 1925, it wasn't until the appointment of Dr. Daniel C. Elkin as the first official chairman of the Department in 1930 that the process began of shaping the Department into a top-tier academic medical institution. During his tenure, Dr. Elkin elevated teaching to equal footing with clinical activities and added a year to the surgical residency.
In 1939, J.B. Whitehead, Jr., the son of Coca Cola magnate J.B. Whitehead, Sr., established a substantial endowment at Emory that allowed Dr. Elkin to be named the first Joseph Brown Whitehead Professor of Surgery. Numerous Whitehead family funds were instrumental in stabilizing the original infrastructure of the Department, including the creation of research labs, the expansion of various divisions, and the construction of the Whitehead Surgical Pavilion in EUH.
Through his innovative contributions to the developing fields of vascular and trauma surgery, Dr. Elkin solidified the Department's position in the vanguard of surgical practice and research. He was a prolific author throughout the thirties, forties, and early fifties, and his lasting contributions include his description of pericadiocentesis for cardiac tamponade and his popularization of those surgical exposures used to access the proximal subclavian artery, the peroneal artery, and the intraosseous portion of the vertebral body.
After years of negotiation, The Emory Clinic (TEC) was established in 1953 as a source of revenue for both faculty and the School of Medicine. In addition to quickly becoming the foremost medical center in Atlanta, TEC received national attention for the quality of its cardiac services. Various Department faculty were founding members of TEC, including the late Dr. William McGarity, whose trenchant studies of hyperparathyroid cases contributed to a greater understanding of multiglandular parathyroid disease, and Dr. Charles Hatcher, who performed Georgia's first "blue baby" open heart procedure in 1962; the state's first single, double, and triple aortic valve replacements in 1963 and 1964; and the state's first successful coronary bypass surgery in 1970.
Following Dr. Elkin's tenure, Dr. John D. Martin was appointed chairman in 1957. Dr. Martin successfully integrated the separate residency programs at Grady, Piedmont, Emory, and the VA hospitals, streamlining and creating an even more effective curriculum. During Dr. Martin's term, significant advances in surgical treatment were achieved by Emory faculty, including the performance of Georgia's first successful renal transplant in 1966 by Dr. Garland Perdue.
The Department continued to make dramatic progress in the clinical arena. Emory cardiac surgeons performed Georgia's first successful coronary bypass in 1970; the musculocutaneous flap procedure, the foundation for techniques that are now the standard for reconstructive breast surgery, was developed by Emory plastic surgeons in 1975; the Department's heart transplant program was established in 1985; Georgia's first liver transplant was performed in 1987; and Georgia's first kidney-pancreas transplant was done in 1989.
The Department was chaired from 1971 to 1989 by Dr. W. Dean Warren, a leading investigator of portal hypertension for three decades and the co-originator of the distal splenorenal shunt. Leading by example, Dr. Warren instilled his own commitment to academic research in both the Department and the residency, and his legacy remains in the vitality and pervasiveness of the Department's research endeavors. Following Dr. Warren's death from cancer in May of 1989, Dr. Robert Smith, chief of the division of vascular surgery from 1984-1988, served as acting chair until 1991.
In 1991 Dr. William C. Wood was appointed chairman, coming to Emory after serving as medical director of the Cancer Center and chief of surgical oncology at Massachusetts General Hospital. Dr. Wood has come to be recognized nationally and internationally for his outstanding contributions to cancer therapy and for his influence on the design and meta-analysis of conceptually driven clinical trials.
Shortly after arriving at Emory, Dr. Wood recruited Dr. David Feliciano, appointed chief of surgery at Grady Memorial Hospital in 1992, and Dr. Grace Rozycki, appointed chief of Grady's section of trauma/surgical critical care in 1994. Dr. Feliciano's extensive research in vascular and abdominal trauma and Dr. Rozycki's development of surgeon-performed ultrasound helped redefine how trauma surgery is practiced in this country. Dr. Feliciano left the department in 2012, at which point Dr. Sheryl Gabram was appointed chief of surgery at Grady.
The Department synchronized with the accelerated pace of change in surgical technique in the nineties. In 1991 the late Dr. John Bostwick published the 1st edition of his landmark, two-volume atlas Plastic and Reconstructive Breast Surgery, a touchstone in the field, and Dr. Chris Larsen and Dr. Tom Pearson initiated the Transplant Immunology Lab, one of the foremost programs of its type in the world; in 1993 Emory plastic surgeons adapted endoscopes for certain plastic surgery procedures, Georgia's only lung transplant program began, and Dr. Elliot Chaikof established the Department's first program for the endovascular repair of abdominal and thoracic aortic aneurysms; in 1996 Dr. Joseph Craver performed Georgia's first minimally invasive direct coronary artery bypass surgery; in 1997 Dr. John Puskas did the world's first minimally invasive triple off-pump bypass surgery using Mini-CABG instrumentation and Dr. Thomas Heffron performed Georgia's first living-related liver transplant; and in 1999 the FDA approved the implantation of the endovascular stent graft in tandem with a minimally invasive procedure, a method refined by our vascular surgery group, and Dr. David Vega implanted the first ventricular assist device (VAD) in Georgia to be used as a bridge to transplant.
When Dr. Wood became chair in 1991 the Department had no NIH funded grants, but by the early 2000s it began a steady climb in the rankings. The Department was ranked the 8th leading academic department of surgery in NIH funding nationwide in fiscal year 2005, later rising to the 5th in FY2008 and maintaining that ranking through FY2012. According to the Blue Ridge Institute for Medical Research, which publishes ranking tables online of annual NIH funding, the Department was sixth in funding for FY2013. While indicative of the effect of massive NIH budget cuts, the 2013 ranking also confirms the diversification of our faculty researchers' funding streams, with significant grants from such entities as the Agency for Healthcare Research and Quality, the FDA, Department of Defense, and foundational and corporate sponsors.
Significant investigations included Dr. Lily Yang's nanotechnology studies, Dr. Collin Weber's diabetes research, and various projects in the divisions of transplantation and vascular surgery. Transplantation's NIH research dollars nearly tripled between 2004-2010, funding such areas as immunology research and liver transplantation when crossing blood groups. Dr. Elliot Chaikof, whose Emory-based research involved the development of artificial organs and strategies for improving the clinical performance characteristics of implanted medical devices, helmed a basic science research program in vascular surgery that was particularly well funded by the NIH, NSF, and JDRF during his 1992-2010 tenure in the division of vascular surgery.
Other milestones during this period included Dr. Thomas Vassiliades' establishment of one of the only cardiac surgery centers in the world to offer endoscopic atraumatic coronary artery bypass in 2003, Dr. Larsen and Dr. Thomas Pearson's performance of Georgia's first islet transplant that same year, Dr. David Vega and his surgical team's implantation of Georgia's first ventricular assist device (VAD) as a means of providing permanent therapy for heart failure rather than as a bridge to transplant in 2006, and Dr. Kirk Kanter's performance of Georgia's first pediatric Berlin Heart surgery and Dr. Juan Sarmiento's pioneering development of three-to-four small incision, laparoscopic-assisted full right hepatectomies in 2008.
In February 2009, Dr. Larsen—who was associate vice president and executive director of the Emory Transplant Center at the time—succeeded Dr. Wood as department chair. In 2010 Dr. Larsen and Dr. Pearson published the positive results of two international phase III clinical trials comparing belatacept to standard immunosuppressive drugs in the March issue of American Journal of Transplantation, and in June 2011 the FDA approved belatacept in the form of the drug Nulojix for the prevention of graft rejection after kidney transplants.
Additional faculty achievements in 2010 included the conclusion of our vascular surgery group's participation in a nine-year, landmark multi-center study comparing carotid endarterectomy to carotid artery stenting; Dr. Kenneth Newell and his research team identifying a gene pattern in kidney transplant recipients who had successfully stopped taking anti-rejection drugs; Dr. Seth Force performing Emory's 300th lung transplant; and Dr. Lily Yang being co-principal investigator of a study of theranostic nanoparticles for targeted treatment of pancreatic cancer that received a five year grant from the NIH/NCI Alliance for Nanotechnology in Cancer.
In January 2013, Dr. Larsen left his positions as chair of the Department of Surgery and executive director of the Emory Transplant Center to become dean of the Emory University School of Medicine. Dr. John Sweeney then became interim chair of the Department.