Surgery

Host: Shira Johnson, MD

Guest: Joseph M. Serletti MD

Reconstructive microsurgery, where specialized operating microscopes and precision instrumentation are utilized to perform intricate operations in very small fields, is a rapidly evolving specialty. Dr. Joseph Serletti, Chief of the Division of Plastic Surgery at the University of Pennsylvania Perelman School of Medicine, oversees the largest reconstructive microsurgery program by volume in the country, performing over 700 free tissue transfers for breast, head & neck, and extremity reconstructions. Dr. Serletti joins host Dr. Ashira Johnson discusses the nuances of these complex procedures, as well as updates on the next horizons in reconstructive microsurgery such as facial and hand tranplants and replants.

Host: Shira Johnson, MD

Guest: Sunil Singhal, MD

The clinical ramifications for adding special fluorescent features to tumors at various stages of malignancy and penetration are enormous. But how do surgical, oncologic, and radiological specialists create these glowing tumors, what impacts do such markers have on clinical care, and which patient populations benefit most from this approach? Host Dr. Ashira Johnson welcomes Dr. Sunil Singhal, Director of the Thoracic Surgery Research Laboratory and Assistant Professor of Surgery at the University of Pennsylvania. Dr. Singhal reviews the use of fluorescence in tumors, articulating how new and emerging applications for this technology will advance the field of oncologic surgery.

Host: Jennifer Caudle, DO

Guest: G. Russell Huffman, MD, MPH

Host Dr. Jennifer Caudle welcomes Dr. G. Russell Huffman, Associate Professor and Director of the Shoulder and Elbow Fellowship at the University of Pennsylvania. Dr. Huffman provides an overview of the various types of elbow injuries, treatment options for athletes at all levels, and special considerations for those who require surgery. Dr. Huffman focuses in particular on updated techniques in ulnar collateral ligament reconstruction, otherwise known as the Tommy John surgery.

Host: Jennifer Caudle, DO

Guest: James L. Carey, MD, MPH

What happens when articular cartilage is damaged? And what are the differences between focal cartilage defects and arthritis? Joining Dr. Jennifer Caudle to discuss current mechanistic understandings of articular cartilage is Dr. James Carey, Director of the Penn Center for Cartilage Repair and Osteochodritis Dissecans Treatment; and, Assistant Professor of Orthopaedic Surgery at Penn Medicine

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Emphysema is a serious lung disease that results in severe shortness of breath and impaired quality of life. Management of emphysema is challenging since there is no cure and current therapies, including lung reduction surgery, can be risky. A new study examined a minimally invasive procedure to see if it could improve shortness of breath and also be a safe and cost effective way to treat emphysema.

Researchers from Hôpital Universitaire de Reims, France studied a new procedure that permanently places several coils into the lung. The study included one hundred patients from ten centers across France. Fifty patients had coils placed in their lungs and the other fifty received standard medical treatment. Both groups were followed closely and assessed at six and twelve months. They participated in a six minute walk test to see if their breathing had improved, allowing them to walk farther.

Results showed that thirty-six percent of patients who received the coil treatment had improvement in the six minute walk test, compared to only eighteen percent in the control group. There was also a significant improvement in quality of life at six and twelve months for patients who received coil treatment.

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Host: Jennifer Caudle, DO

Guest: Scott O. Trerotola, MD, FACR, FSIR

Is there a way to predict complex removal of inferior vena cava filters, and if so, what is the success rate? Dr. Scott Trerotola adresses these and other questions in details. Dr. Trerotola is Stanley Baum Professor at the Hospital of the University of Pennsylvania, Chief of Vascular and Interventional Radiology and Vice Chair for Quality of the Department of Radiology at the University Of Pennsylvania Medical Center.

Host: Jennifer Caudle, DO

Guest: Pavan Atluri, MD

What are the latest advances in minimally invasive & robotic operations? And, which patients are candidates for robotic procedures? Host Dr. Jennifer Caudle welcomes Dr. Pavan Atluri, Assistant Professor of Surgery; Director of the Cardiac Transplantation and Mechanical Circulatory Assist Program; and, Director of the Minimally Invasive and Robotic Cardiac Surgery Program in the Division of Cardiovascular Surgery at the University of Pennsylvania. Dr. Atluri will discuss the latest advancements at Penn Medicine where he and his colleagues have been working for several years to perfect the robotic, minimally invasive, mitral valve repair procedure.

And, don't forget to view some of the additional content below.

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Successful treatment of stage II or stage III rectal cancer relies on surgical removal of the tumor. However, researchers from Baylor University Medical Center wanted to know if a "minimally invasive" procedure called a laparoscopy, would be as effective as a standard or "open" operation for patients with rectal cancer.

Researchers assigned 486 patients to receive either a standard open operation or the less invasive laparoscopic approach. All procedures were done by forty-six highly trained surgeons. Specimens from each procedure were examined to see whether all the tumor was removed ("complete resection").

Results found that 90 percent of the patients who underwent the open operation had a complete resection, where patients who underwent the laparoscopy only had an 81 percent success rate. The researchers concluded that these findings do not support laparoscopic removal of rectal cancer.

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JAMA Report videos provided pursuant to license. ©2015 American Medical Association, publisher of JAMA® and The JAMA Network® journals.

Host: Jennifer Caudle, DO

Guest: Renée Simone Yolanda Allen, MD, MHSc., FACOG

In the past 20 years, rates of bariatric surgery have risen more than 800%. Of the number of bariatric procedures performed every year, women of reproductive age account for the vast majority of patients. What are the obstetric and gynecological effects of these various surgical procedures on female patients, and how can potential complications be prevented? Host Dr. Jennifer Caudle welcomes Dr. Renee S. Allen, Board certified OB/GYN and hospitalist, Fellow of ACOG, and Masters of Health Sciences from Atlanta, Georgia, to discuss OB/GYN counseling strategies for women who have undergone or intend to undergo bariatric surgery.

Host: Prathima Setty, MD

Disorders of sex development (DSDs) occur more frequently than most people realize, and yet there are numerous misconceptions persisting in the clinical arena as to how these disorders are best approached. For example, whereas older prevailing sentiments on presentations of ambiguous genitalia called for immediate sex assignments at birth followed by surgical alignments of those decisions, more modern philosophies advocate for direct patient involvement in these decisions a little later in life.

Joining Dr. Prathima Setty to focus on this important topic is Dr. Earl Cheng, Professor of Urology, Division Head of Urology and Co-Head of Reconstructive Pediatric Urology at Northwestern University Feinberg School of Medicine. Dr. Cheng directs the Gender and Sex Development Program at Ann & Robert H. Lurie Children's Hospital of Chicago.