January 2015 Emory Surgery newsletter Department of Surgery of the Emory University School of Medicine

 

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Dr. John Sweeney appointed Chair of Emory Surgery

  Dr. John Sweeney
  John Sweeney

After serving as interim chair since January 2013, Dr. John Sweeney has been appointed Joseph Brown Whitehead Professor and Chair, Department of Surgery, Emory University School of Medicine; Chief of Surgery, Emory Healthcare; Director of Surgical Services, Emory Healthcare; and Surgeon-in-Chief of Emory Healthcare.

"John is an individual of personal integrity, professional energy and commitment to quality leadership who is extremely effective in building teams through professional development and recruitment of top talent to complement his own leadership skills," says Dr. Christian Larsen, dean of Emory's School of Medicine and Physician Group President for Emory Healthcare. "In addition, John brings an exceptional background of surgical innovation and commitment to excellence, quality, and the highest level of patient care."

Coming from the Baylor College of Medicine, where he directed the division of general surgery, the bariatric surgery program, and the Michael E. DeBakey Minimally Invasive Surgery Center of Excellence, Dr. Sweeney joined the Emory Department of Surgery in 2007 as chief of the division of general and gastrointestinal surgery. After being appointed chief quality officer in 2008, he implemented various strategies and initiatives that greatly enhanced the Department's quality and safety culture, including participation in the University HealthSystem Consortium Quality and Accountability Program and the Surgical Care Improvement Project.

Dr. Sweeney's current research includes two studies he is conducting with James C. Cox, PhD, director of the Experimental Economics Center (ExCEN) of the Andrew Young School of Policy Studies at Georgia State University, that are concerned with reducing costs and hospital readmissions by increasing physicians' effectiveness in identifying the optimal time to discharge patients. One study is being funded by the National Institute on Aging of the NIH, the other by the Georgia Research Alliance.

"I am extremely pleased to be named chair of the Department of Surgery," says Dr. Sweeney. "Since joining the Emory faculty I have been fortunate to work with excellent colleagues who are committed to achieving the very highest levels of quality and positive health outcomes. Together we will continue to strive for excellence by all measures in order to save and improve the lives of our patients."

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CSAT receives ACS Education Accreditation

CSAT medical illustrator Andy Matlock creates complex medical visualization by combining his skills in 3D animation with his knowledge of human anatomy.
CSAT medical illustrator Andy Matlock creates complex medical visualization by combining his skills in 3D animation with his knowledge of human anatomy.

The Carlos and Davis Center for Surgical Anatomy and Technique (CSAT) of Emory University has been awarded accreditation for three years as a Comprehensive Education Institute (CEI) of the American College of Surgeons Accredited Education Institutes (ACS-AEI) program. ACS-AEI promotes patient safety by advocating the use of simulation to cultivate skills in academic surgical programs; supports the development of new education methods, emerging technologies, and best practices; and facilitates research and collaboration among its member centers. CSAT's accreditation follows a successful site visit in September 2014.

CSAT's adept use of 21st century media technology exemplifies the ACS requirement that CEIs demonstrate innovation by developing and refining original curricula directed at multiple audiences. CSAT's "Surgical Anatomy of the Liver" iPad app—now available in the Apple iTunes App Store—publicly initiated CSAT's new focus on using electronic methods to distribute the message that knowledge of surgical anatomy is critical to minimizing complications in the OR. Intended for trainees, medical students, instructors, and anyone that needs a quick way to learn or teach liver anatomy, the interactive 3D app allows users to mentally map the anatomy of the liver in ways that were never before possible with print illustrations or imaging studies. Additional CSAT apps currently in development include a pelvic anatomy app, a common surgical procedures app or "video atlas" that will contain step-by-step video presentations shot in the OR, and a 2.0 version of the liver app that will feature a CT scan function.

CSAT's role in vetting the teaching and training systems housed in the 24-hour simulation lab of the Emory Office of Surgical Education illustrates its commitment to the CEI principle that state-of-the-art simulations, simulators, and progressive technologies should be available to trainees. In addition to leading training sessions in the lab, chief residents and faculty of the Department of Surgery also participate in CSAT's surgical anatomy, embryology, and operative techniques course for 4th year medical students. The course's traditional workshop setting features didactic lectures and demonstrations, human cadaveric dissection labs, animal surgery sessions, simulation and robotics labs, and laparoscopic training, and can lead to the types of beneficial mentoring relationships that CEIs should nurture.

"This accreditation has many levels of significance," says Dr. Keith Delman, Carlos Professor of Surgical Anatomy and Technique and director of CSAT. "It validates our educational programs and efforts to this point, it gives us access to the network of ACS-AEIs which will further enhance our opportunities for the exchange of ideas, and it will serve as another platform to grow our educational offerings, particularly in the area of CME and formalized skills sessions."

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Dr. Muralidhar Padala
Muralidhar Padala
Dr. Vinod Thourani
Vinod Thourani
Dr. Eric Sarin
Eric Sarin
Dr. Robert Guyton
Robert Guyton

From the patient and back: Structural Heart Research Lab translates science to practice full circle

Surgical techniques to correct functional mitral regurgitation (FMR) in patients with ischemic heart disease have had minimal success. Undersized mitral annuloplasty (UMA) is the traditional first option, but a substantial number of patients experience recurrent regurgitation within a year after surgery, as evidenced by a recent National Heart, Lung, and Blood Institute-funded, multi-center clinical trial that found that 36% of the patients had recurring MR after ring annuoplasty. Emory cardiothoracic surgeon Dr. Vinod Thourani was the Emory-based PI for that study.

Sensing an opportunity for discovery within the data amassed for the NHLBI trial, Dr. Muralidhar Padala, who heads Emory's structural heart research lab, analyzed cardiac MRI images of the patient enrollees. Working with his then-research fellow Dr. Kanika Kalra (now an Emory PGY1 surgical resident), he found that UMA focused on a component of the valve which appeared to have little affect on the development of regurgitation. Instead, ventricular contraction in the vicinity of the mitral valve and the extent of scarring seemed to impact the valve through the loss of lateral shortening of the papillary muscles.

Using these observations, senior research associate Dr. Weiwei Shi and then-research fellow Dr. Bryant McIver (now a PGY4 surgical resident), both members of Dr. Padala's research team, developed a porcine model of FMR. Their work confirmed the validity of Dr. Padala's hypothesis when they found that the swine with a loss of lateral papillary muscle shortening developed MR, while those with preservation of the shortening did not. This result was tested further in an anatomically accurate MR computer model designed by Dr. Wei Sun of the Mechanical Engineering Department of the Georgia Technological Institute and his graduate student assistant Qian Wang. The results of this work were published as "Temporal Changes in Interpapillary Muscle Dynamics as an Active Indicator of Mitral Valve and Left Ventricular Interaction in Ischemic Mitral Regurgitation" in the Journal of the American College of Cardiology.

"With the hope of translating these findings for use in the patient, I began working with Dr. Eric Sarin, a very skilled Emory cardiothoracic surgeon with a strong interest and commitment to laboratory research, to develop a surgical technique that could help restore this shortening and repair the valve leak," says Dr. Padala.

The team devised a new mitral repair technique called intra-ventricular papillary muscle banding (PMB), which reduced the lateral distance between the two papillary muscles. Using a chronic IMR porcine model, they tested UMA against PMB alone and PMB with UMA, and demonstrated that PMB was effective in repairing IMR and had better mechanics compared to UMA. The work was reported as "Intra-ventricular Papillary Muscle Banding vs. Undersized Mitral Annuloplasty to Treat Ischemic Mitral Regurgitation in a Chronic Swine Model" at the 2014 Scientific Sessions of the American Heart Association.

"Dr. Robert Guyton is very supportive of translating this technique to humans, but he knows that we have to continue testing its safety first," says Dr. Padala. "With assistance from Emory cardiac anesthesiologist Dr. Michael Duggan, we are currently simulating the technique on virtual models of patients' hearts created from cardiac MRI and 3D echo imaging. It's going well, and we're getting closer to use in humans. It took a variety of skill sets and interests to get this far, and I'm convinced that such collaboration is key to translational science."

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GO-TRAVEL Award funds Dr. Tim Love's return to Ethiopia

Dr. Love at Soddo Hospital with Dr. Tewodros Tamiru, a graduate of Soddo's PAACS residency.
Dr. Love at Soddo Hospital with Dr. Tewodros Tamiru, a graduate of Soddo's PAACS residency.

PGY4 Dr. Timothy Love was the inaugural recipient of the GO-TRAVEL (Global Outreach Traveling Resident Award to Visit, Experience and Learn) award, which allowed him to spend six weeks in Ethiopia completing a clinical rotation in surgery. He divided his time between Soddo Christian Hospital—located in its namesake city in the densely populated Wolaitta region of the country—and Myungsung Christian Medical Center in Addis Ababa, Ethiopia's capital.

During his stay Dr. Love also traveled to Bahir Dar in north-western Ethiopia for the annual meeting of the Surgical Society of Ethiopia, where he presented research involving a trauma registry that he and Dr. Jonathan Pollock, director of the Emory Global Surgery Program at Soddo Hospital, had established at the facility. The Global Surgery Program features a rotation for Emory general surgery residents, who train alongside Ethiopian surgical residents enrolled in the hospital's Pan African Academy of Christian Surgeons (PAACS)-sponsored surgical residency.

GO-TRAVEL was conceived and funded by the Emory University School of Medicine Alumni Board to support resident education and to provide unique international training experience where fellows will get the chance "to experience disease processes you simply do not see in the United States," according to Dr. Farzad R. Nahai, president of the board.

Dr. Love is already familiar with Ethiopia and its multiple healthcare crises, from widespread poverty and disease to a dire shortage of trained doctors. He first visited the country more than ten years ago while working on an HIV/AIDS research project as an undergraduate, and has returned several times, most recently in 2013 as an NIH Fogarty Global Health Fellow doing a feasibility study of the establishment of cancer epidemiology and registration in low-resource settings. He hopes to live and practice in Ethiopia full time when his training is completed.

With part of his modest GO-TRAVEL award, Dr. Love purchased and provided surgical textbooks to the Ethiopian residents with whom he worked at Soddo Hospital. "Every Ethiopian medical library I've been in has been filled with textbooks from the 1980s and 1990s. Hard copies of up-to-date textbooks are almost impossible to come by, and they devoured them," he said.

Upon his return, Dr. Love presented his findings to the Alumni Board in order to inform the application and selection process for 2015.

A call for applications for the 2015 GO-TRAVEL award will be sent through all clinical and basic science departments this spring. The Alumni Board will select the recipient. For more information, contact the SOM Alumni Office at 404.727.0462 or email medicalalumni@emory.edu.

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Awards and appointments

Dr. Luke Brewster  
Luke Brewster  

Dr. Luke Brewster has been inducted into Emory's 1% Club, which recognizes faculty whose NIH proposals have been ranked in the top 1% or more in the last six years by NIH reviewers. This award recognizes Dr. Brewster's NIH K08 "Molecular Mechanism of Disturbed Flow in Arterial Stiffening," which he received in April 2014. This award was later matched by a grant from The Society for Vascular Surgery Foundation and the American College of Surgeons.

Dr. Brian Kogon  
Brian Kogon  

Dr. Brian Kogon received a 2014 Dean's Teaching Award. Recipients of the award are nominated by colleagues and students and chosen by the Teaching Awards Committee for their dedication to teaching and their many contributions as course directors and mentors. The benefactors of Dr. Kogon's versatile teaching style include cardiology and cardiothoracic surgery fellows, nurses, nurse practitioners, PAs, respiratory therapists, residents, medical students, perfusionists, and international physicians.

Dr. David Kooby  
David Kooby  
Dr. Nicole Turgeon  
Nicole Turgeon  

Dr. David Kooby and Dr. Nicole Turgeon have been named to the 2015 Woodruff Leadership Committee. The selection process for this intensive, five-month leadership program is rigorous, and those selected as WLA Fellows represent some of the most promising leaders within the Woodruff Health Sciences Center. WLA develops managerial and technical expertise, as well as the interpersonal, communications, and presentation skills necessary to meet the challenges of the rapidly changing landscape in research, education, and health care.

Dr. Kooby is considered an international leader in minimally invasive pancreatic surgery, and has collaborated regularly with investigators at both Emory and around the country. Dr. Turgeon is surgical director of the living donor kidney transplant and the pancreas transplant programs, and has been a prime mover in expanding Emory's paired donor exchange program.

Dr. Ravi Rajani  
Ravi Rajani  

Dr. Ravi Rajani, director of vascular and endovascular surgery at Grady Memorial Hospital, has been named the Emory Department of Surgery's institutional representative to the Association for Academic Surgery. His responsibilities will include distributing AAS communications among departmental faculty, medical students, and residents; encouraging abstract submission and meeting registration and participation; and submitting two reports per year to the AAS that describe Emory Surgery's activities, needs, and member suggestions. AAS created the Institutional Representative Program (IRP) to strengthen its relationship with its member institutions.

Susan Ratliff  
Susan Ratliff  

Susan Ratliff, program business manager for the general surgery residency, has been selected to serve on the Executive Committee of the Association of Residency Coordinators in Surgery (ARCS) for a four-year term. As a member of the committee, she will participate in the planning of the annual ARCS meeting, bring relevant topics to the national meeting to educate coordinators for success, and assist new coordinators in their positions. Working closely with Dr. Keith Delman, program director of the residency, Ms. Ratliff manages the day-to-day operations of the surgical residency program, including but not limited to accreditation, credentialing, recruitment, orientation, evaluations, and scheduling.

Dr. Rachael Williams  
Rachael Williams  

Burn fellow Dr. Rachael Williams won the Fellow/Resident Oral Presentation Award of the 27th Annual Southern Region Burn Conference for her abstract, "Investigating the Referral Patterns of Burn Patients to a Level I Trauma Center: Coherent or Chaotic?" Dr. Williams will also present the abstract at the American Burn Association's 47th Annual Meeting in April in Chicago. Dr. Williams began her burn fellowship after completing her general surgery residency at Eastern Virginia Medical School.

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Med students meet potential guides at 3rd Annual Emory SNMA Surgical Mentorship Dinner

SNMA dinner
The mentorship dinner is one of many ways the SNMA works towards insuring the diversification of the field of surgery in the U.S.

The Student National Medical Association (SNMA) is committed to supporting current and future underrepresented minority medical students, addressing the needs of underserved communities, and increasing the number of clinically excellent, culturally competent, and socially conscious physicians. It is the oldest and largest student-governed organization of its type.

The surgical mentorship dinner is an annual tradition of the Emory chapter of the SNMA, and provides an opportunity for minority medical students interested in a surgical career to mingle with surgery residents and faculty and to begin establishing mentoring relationships. The 2014 dinner was hosted by Emory cardiothoracic surgeon Dr. Allan Pickens and his wife at their home. Dr. Pickens directs minimally invasive thoracic surgery for Emory Healthcare and thoracic oncology at Emory University Hospital.

The Emory general surgery residents in attendance included PGY1s Nnaemeka Ndubisi, Adekemi Egunsola, Alexandra Lopez-Aguiar, and Matthew Perez; PGY2 Annie Bailey; and PGY5 Denis Foretia.

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Dr. William Wood
William Wood

Save the dates: Annual Research Symposium & Faculty Boot Camp

The Annual Department of Surgery Research Day, scheduled this year for April 30th, has been renamed the Annual William C. Wood Research Symposium. As chair of the Emory Department of Surgery from 1991-2009, Dr. Wood guided the department to its current stature as one of the nation's leading institutions for surgical research and innovation. He also gained national and international recognition for his outstanding contributions to cancer therapy and the design and meta-analysis of conceptually driven clinical trials.

For this 14th installment of the symposium, oral presentations will begin shortly after the 8:00 AM completion of Dr. John Alverdy's lecture for Surgical Grand Rounds in the EUH Auditorium. Dr. Alverdy is the Sara and Harold Lincoln Thompson Professor of Surgery and director of surgical treatment of obesity, University of Chicago. It is hoped that a full-house of the Department's faculty, house officers, and staff will gather to support the accomplishments of its students, postdocs, residents, and fellows as they present their research. The day's events will conclude by 11:00 AM.

The first Faculty Boot Camp of the 2015 Faculty Development Seminar Series will be held on Monday, February 16 in the classroom of the Office of Surgical Education, 1st floor H-Wing, Emory University Hospital. Hors d'oeuvres will be served.

This overview session of the series will feature descriptions of the essentials of faculty life—promotions, research, quality, etc.—presented by such speakers as department chair Dr. John Sweeney, research vice chair Dr. Craig Coopersmith, and clinical administrators Lisa Fisher and Chris Rayburn. Download the full agenda here as well as the agendas of future seminars, which will concentrate on single components of successful career-building for academic surgeons.

The 2015 development series is open to all faculty, and those who are relatively new to the department are particularly encouraged to attend. Please RSVP to surgery.facultydevelopment@emory.edu.

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Upcoming events

EVENT DATE/TIME LOCATION
SURGICAL GRAND ROUNDS
Liver Transplantation for HCC: Looking Beyond Size and Number
Presented by Karim J. Halazun, MD
– Assistant Professor of Surgery, Division of Transplantation, Department of Surgery, Emory University School of Medicine
7:00 a.m.–8:00 a.m., Feb. 5, 2015 EUH auditorium
SURGICAL GRAND ROUNDS
Joseph B. Whitehead Lectureship
New Paradigms in the Management of the Regional Nodes in Breast Cancer

Presented by Kelly K. Hunt, MD
– Professor, Department of Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center
– Chief, Breast Surgical Oncology Section, Department of Surgical Oncology, MD Anderson Cancer Center
– Hamill Foundation Distinguished Professor in Honor of Dr. Richard G. Martin, Sr., Department of Surgical Oncology, MD Anderson Cancer Center
7:00 a.m.–8:00 a.m., Feb. 12, 2015 EUH auditorium
SURGICAL GRAND ROUNDS
Advances in Extracorporeal Liver Support
Presented by Ram Subramanian, MD
– Associate Professor, Digestive Diseases, Department of Medicine, Emory University School of Medicine
7:00 a.m.–8:00 a.m., Feb. 19, 2015 EUH auditorium
SURGICAL GRAND ROUNDS
“Minimizing Surgery” for Rectal Cancer
Presented by Benjamin Martin, MD
– Chief Resident, Department of Surgery, Emory University School of Medicine
7:00 a.m.–8:00 a.m., Feb. 26, 2015 EUH auditorium
"When the Emory Unit Went to War" exhibit
Read more.
Through March 2015 Woodruff Health Sciences Center Library
Advancement in Child Health: A Celebration of the First 10 Years as Chair; Honoring Barbara J. Stoll, M.D. 8:00 a.m.–5:30 p.m., Mar. 20, 2015 HSRB, Rollins Auditorium
     
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