Surgery news
DEPARTMENT OF
Fall 2016
Message from the Chairman
I
In This Issue
News. . . . . . . . . . 3
New Faculty . . . 7
Promotions. . . . 8
C-STARS
Prepares
Providers
for Wartime
Medicine . . . . . 10
Artificial Blood
Vessel Trial . . . 11
Division
Spotlight:
Pediatric Surgery
. . . . . . . . . . . . . . .12
Education
Updates:
MPHS Celebrates
Five Years. . . . . 14
Interprofessional
Education . . . . 15
Incoming and
Outgoing
Residents,
Fellows. . . . . . . 16
AndersonNewton Lecture
. . . . . . . . . . . . . . .18
t has been an eventful year thus
far! Since our last newsletter
was published in March,
we said goodbye to our beloved,
pioneering surgeon Jessie Ternberg;
at the same time, we welcomed 15
new faculty members and more
than 40 recruits to our postgraduate
programs. Bill Hawkins, MD,
received a $10.4 million SPORE
grant to translate research findings
into more effective treatments
for pancreas cancer, one of the
deadliest cancers. And faculty
members Mary Klingensmith,
MD, and Bruce Hall, MD, PhD,
MBA, were appointed to high-level
leadership positions at the medical
school and BJC, respectively.
Our faculty members continue
working to improve conditions and
treatment for patients, with Aimee
James, PhD, MPH, obtaining a
grant to help low-income patients
cope with high medical costs
and low financial resources, and
Surendra Shenoy, MD, PhD, serving
as a PI at Barnes-Jewish Hospital for
a trial testing artifical blood vessels
in hemodialysis treatment.
Outwardly focused, two of our
surgeons, Sean Glasgow, MD, and
Gerry Fortuna, MD, have prepared
Air Force personnel to treat
wounded soldiers in the battlefield.
Dr. Glasgow started Washington
University’s involvement in the
Air Force’s C-STARS (Center
for Sustainment of Trauma and
Readiness Skills) program and
conducted training courses for
SPORE grant PI Bill Hawkins, MD, and research
fellow Linda Jin, MD, in the lab
three years. Dr. Fortuna is the new
director of St. Louis C-STARS, which
is based at Saint Louis University.
Over the summer, Stephanie
Chang, MD, became the
first resident to complete an
international two-month rotation
at Mzuzu Central Hospital in
Mzuzu, Malawi. Among other
accomplishments in education,
the Master of Population Health
Sciences Program celebrated its fifth
anniversary and graduated its 48th
student, and the surgery clerkship
offered medical students training to
achieve better teamwork with other
professions. This is a concept we
have stressed with our own faculty
through guest speakers in patient
safety/quality improvement (PS/QI).
Looking ahead, we will continue
implementing the Department of
Surgery Vision for 2020, which
reaffirms the department’s tripartite
mission (research, patient care and
education) and our commitment
to activities that support it. We will
also see many physical changes to
the campus, with improved facilities
for us and our hospital partners. Stay
tuned to watch our progress!
Timothy J. Eberlein, MD
William K. Bixby Professor of Surgery
Chairman, Department of Surgery
Director, Alvin J. Siteman Cancer Center
Washington University
School of Medicine
In Memoriam:
Jessie L. Ternberg,
professor emerita of
surgery
In 1954, when
Jessie L. Ternberg,
PhD, MD, became
the first female
surgical resident
at what was then
Barnes Hospital
in St. Louis, the
Jessie Ternberg, PhD,
young physicianMD
scientist was not
given a warm welcome by her new, male colleagues.
Undaunted, Dr. Ternberg’s pioneering step became the first of several,
as she eventually was embraced
not only as an extremely talented
surgeon but an excellent leader, role
model and mentor. She served on
the Washington University School
of Medicine faculty for 37 years, first
as a general surgeon and later as
the director of pediatric surgery at
St. Louis Children’s Hospital.
A professor emerita of surgery and
surgery in pediatrics, Dr. Ternberg
died July 9, 2016, of natural causes
while on vacation in Zermatt,
Switzerland, one of her favorite
places, according to her longtime
friend and travel companion, Mabel
Purkerson, MD, also a School of
Medicine professor emerita. Dr.
Ternberg, of Creve Coeur, was 92.
Dr. Ternberg paved the way for many
women in medicine. During her
internship at Boston City Hospital,
Dr. Ternberg — a 1953 graduate of
Washington University School of
Medicine — decided she wanted to
be a surgeon. When she couldn’t find
a surgical residency program that
would consider an application from
a woman, she wrote to Carl Moyer,
Story continued on page 2
Page 2
Department of Surgery News
of professional organizations, including serving as president of the St. Louis
Children’s Hospital Society and president
of the St. Louis Surgical Society. She was
a member of the American College of
Surgeons and the American Pediatric
Surgical Association.
Jessie Ternberg
Continued from previous page
MD, the head of surgery at Washington
University. “I told him I thought it was a
bum rap they wouldn’t take women,” Dr.
Ternberg recalled in a 2002 interview published in Washington magazine. “He agreed
— and he accepted me.”
Raised in Fairmont, Minn., she earned her
bachelor’s degree from Grinnell College
in 1946. She went on to earn a doctorate
in biochemistry from the University of
Texas at Austin in 1950. There, she and
Robert Eakin, PhD, reported their discovery of the mechanism by which Vitamin
B-12 is absorbed in the intestine, helping
to establish a cure for pernicious anemia.
There were still many obstacles to overcome, though, from where she would
live — residents lived at the hospital, and
no one had ever had to make room for a
woman before — to how and where she
would prepare for surgery.
“She had to be twice as good and twice as
smart as everybody else to survive, and she
was,” said Timothy J. Eberlein, MD, head
of the Department of Surgery, director of
Siteman Cancer Center and a longtime
friend of Ternberg. “She had a fierce determination, and that’s probably how she overcame all those obstacles over the years. She
was like that to the end.”
In 1958, she became the first female chief
resident at Barnes, and in 1959, she became
an instructor in surgery at the School of
Medicine. Promoted to professor of surgery
in 1971, she was instrumental in establishing the Division of Pediatric Surgery and
was named its director in 1972. The next
year, she became the first woman to be
elected head of the School of Medicine’s
faculty council.
“She had a wonderful life, and it was a life
she made for herself – nobody gave it to
her,” said Chancellor Emeritus William H.
Danforth, MD. “She had enormous determination and focus and courage, and she was
unflappable and put up with things that
other people didn’t have to. She never gave
up, she never slowed down. She just kept
going and was an absolutely wonderful surgeon and a wonderful physician who was
greatly admired by everybody. I was very
lucky to know her.”
During Dr. Ternberg’s tenure at the School
of Medicine and St. Louis Children’s
Hospital, she routinely performed more
than 500 operations a year. In addition,
she led a surgical team in successfully
separating two sets of conjoined twins,
connected at the pelvis, a very rare condi-
Jessie L. Ternberg, PhD, MD, (right) in surgery.
(Photo: Washington University)
tion. Colleagues described her surgeries as
“works of art.”
“Jessie was the go-to person,” said Dr.
Eberlein, who is also the Bixby Professor of
Surgery. “If you had a child with a tough
problem — and it didn’t necessarily have to
be a surgical problem — Jessie was the person you consulted. Everybody regarded her
with a kind of awe. She was a remarkable
individual.”
In 1993, former pediatric surgical residents
and colleagues established the Jessie L.
Ternberg Award, to be given annually to a
female medical graduate who best exemplifies Dr. Ternberg’s “indomitable spirit of
determination, perseverance and dedication
to her patients.”
In 2000, she was named a fellow of the
American Association for the Advancement
of Science for her contributions to the practice and teaching of pediatric surgery and
for her role in mentoring students.
She was the author of more than 100 papers
and 10 book chapters. She also wrote A
Handbook for Pediatric Surgery, which
became known as the bible of pediatric
surgery and made her name familiar to a
generation of pediatric surgeons.
Dr. Ternberg was involved with a variety
Among her numerous honors, she
received honorary doctor of science
degrees from Grinnell, the University
of Missouri-St. Louis and Washington
University; several Washington University
Alumni Awards; a Washington University
Second Century Award; and membership in Alpha Omega Alpha Honor
Medical Society. She also was named the
honorary grand marshal at Washington
University’s 2006 commencement, and
was a life trustee at Grinnell. Other honors included the Trustees’ Award from
the Academy of Science of St. Louis; the
St. Louis Globe-Democrat Woman of
Achievement Award; a U.S. Department
of Health, Education and Welfare’s
International Women’s Year Award;
and membership in the Horatio Alger
Association of Distinguished Americans.
In 2009, more than 50 of Dr. Ternberg’s
friends and admirers funded a professorship in her name, the Jessie L. Ternberg,
MD, PhD, Distinguished Professorship
in Pediatric Surgery. The professorship
is held by the director of the Division of
Pediatric Surgery and surgeon-in-chief at
St. Louis Children’s Hospital.
Following Dr. Ternberg’s retirement
in 1996, she remained involved with a
national pediatric oncology group.
A memorial service was held Sept. 25 at
the Missouri Botanical Garden in St. Louis.
Originally published by the School of
Medicine
Department of Surgery News
News
Mary Klingensmith
named interim senior
associate dean
Mary
Klingensmith, MD,
has been
named as
interim
senior
associate
dean for
educaMary
Klingensmith, MD
tion at
Washington
University School of Medicine,
effective Sept. 2. She is stepping in for Alison Whelan, MD,
who left the school to become
chief medical education officer
for the Association of American
Medical Colleges.
Dr. Klingensmith is the Mary
Culver Distinguished Professor
of Surgery and vice chair for
education in the Department
of Surgery. As vice chair for
education in Surgery since
2011, she has overseen all
aspects of education in the
department. She also serves
on the department’s Surgical
Executive Council. For 11 years,
Dr. Klingensmith directed the
General Surgery Residency
program and has continued
to have a significant teaching
commitment in the medical
student clerkship and other
arenas.
Dr. Klingensmith also has
a leadership role in the
Surgical Council on Resident
Education (SCORE) and serves
as a director to the American
Board of Surgery (ABS). The
vice chair-elect for ABS, she
will chair the board in 2017-18.
She chairs the General Surgery
Advisory Council of the ABS;
is a former director on the
American Board of Thoracic
Surgery; and is immediate past
president of the Association for
Surgical Education.
University of Cincinnati faculty member
Charles Park, MD, and Washington
University general surgery chief resident
Stephanie Chang, MD, at Mzuzu Central
Hospital.
General Surgery Residency
establishes international
rotation in Malawi
The Washington University
General Surgery Residency
established an international
two-month rotation this
summer at Mzuzu Central
Hospital in Mzuzu, Malawi.
Chief resident Stephanie
Chang, MD, was the first to
rotate at the clinic, under
the guidance of University
of Cincinnati faculty. Mzuzu
Central Hospital is a district
hospital and referral center
in northern Malawi serving
a region of approximately
2.5 million people. Residents
have expressed heightened
interest in global education,
hoping to make a positive
impact on people through
surgical care, education and
research. Ultimately, they hope
to improve the health of the
Mzuzu community.
Graham Colditz named as
advisor to National Cancer
Moonshot Initiative
Graham Colditz, MD, DrPH, the
Niess-Gain Professor of Surgery
and chief of the Division of
Public Health Sciences, was
named as an adviser to the
National Cancer Moonshot
Initiative. The effort is intended
to maximize
federal,
industry
and philanthropic
investments in
cancer
Graham Colditz,
research
MD, DrPH
and to
advance cancer care.
The Moonshot initiative,
led by Vice President Joe
Biden, will rely in part on the
recommendations of seven
working groups comprised of
leading cancer experts. The
groups will consider input
from cancer researchers and
the public and ultimately will
recommend how federal cancer
research grants should be
awarded next summer.
Robert Schreiber, PhD, the
Alumni Endowed Professor of
Pathology and Immunology,
was also named as an advisor.
Ross Brownson receives
APHA Award for Excellence
Ross
Brownson,
PhD, the
Bernard
Becker
Professor
at the
George
Warren
Ross Brownson, PhD
Brown
School
of Social
Work and professor of
surgery in the Division of
Public Health Sciences, has
received the American Public
Health Association Award for
Excellence for his work as a
scholar, leader and publichealth practitioner.
Dr. Brownson is also director of
the Prevention Research Center.
Timothy Eberlein
elected chairman of
NCCN board
Timothy
Eberlein,
MD,
director
of
Siteman
Cancer
Center at
BarnesJewish
Timothy Eberlein,
MD
Hospital
and
chairman of the Department
of Surgery, has been elected
chairman of the National
Comprehensive Cancer
Network (NCCN) board of
directors.
The NCCN is a not-for-profit
alliance of 27 leading U.S.
cancer centers devoted
to patient care, research
and education. Siteman is
the only NCCN member
institution in Missouri.
Dr. Eberlein had served as
the NCCN vice chairman
since 2013. He was elected
chairman during the NCCN’s
21st Annual Conference,
March 31-April 2 in
Hollywood, Fla. He succeeds
Samuel Silver, MD, PhD, of
the University of Michigan
Comprehensive Cancer
Center.
Dr. Eberlein has held
leadership roles on
a number of NCCN
committees, including the
Executive Committee; the
Governance Committee,
for which he served as
chairman; and the NCCN
Guidelines Steering
Committee. In addition,
he has held numerous
positions in the fields of
cancer and surgery and is
a member of the National
Academy of Medicine.
Excerpt from medical school press
release
Page 3
Page 4
Department of Surgery News
News
Timothy Eberlein named
honorary fellow of Society
of Black Academic Surgeons
Timothy Eberlein, MD, the Bixby
Professor of Surgery and head
of the Department of Surgery at
Washington University School of
Medicine in St. Louis, has been
named an honorary fellow of
the Society of Black Academic
Surgeons.
The society’s goal is to advance
academic excellence among
its more than 200 members by
providing a forum of scholarship
in collaboration with leading
academic departments of
surgery in the U.S.
“Dr. Eberlein’s contributions
to the careers of many of this
organization’s members and
his contributions to American
surgery at large have been both
substantial and appreciated,”
said Orlando Kirton, MD, the
society’s president.
Dr. Eberlein was recognized
during the Annual Society
of Black Academic Surgeons
Honorary Fellows Luncheon,
which coincided with the
American Surgical Association’s
annual meeting in Chicago in
April 2016.
“The society’s work is important
NOV.
Calendar
Fundamentals of
Hyperbaric Oxygen
Therapy
November 12-16, 2016
Surgical and Wound Care Clinic
Center for Outpatient Health
4901 Forest Park Ave.
Floor 3, Suite 340
For more information, call
(314) 747-4185
HBOTcourse.wustl.edu
for so many reasons, especially
developing talented black
surgeons and helping them
become leaders of academic
medicine in America,” Dr.
Eberlein said.
Excerpt from medical school press release
Bruce Hall named VP & CQO
for BJC Healthcare
Bruce
Hall, MD,
PhD, MBA,
professor of
surgery and
professor of
healthcare
management, has
been named
Bruce Hall,
MD, PhD, MBA
chief quality
officer (CQO)
for BJC HealthCare. Dr. Hall has
served as BJC vice president
for patient-centered outcomes
for the past three years, and
now assumes the expanded
responsibilities of the CQO
position.
As the CQO, Dr. Hall will lead
initiatives to systematically
improve the quality, safety and
sustainability of care through
evidence-based interventions,
informed by the expertise of BJCaffiliated physicians, nurses and
other clinicians and operational
experts.
Dr. Hall joined the Washington
University School of Medicine
Department of Surgery in 2000
as a member of the burn/trauma/
critical care section and later the
endocrine and oncologic surgery
section, of which he remains a
member. He was promoted to
professor of surgery in 2009.
Aimee James wins grant
from National Institute on
Minority Health
Aimee
James,
PhD, MPH,
associate
professor
of surgery,
received a
3-year, $1.14
million
Aimee James,
grant from
PhD, MPH
the National
Institute on
Minority Health and Health
Disparities that will focus
on reducing cost-related
nonadherence to medical
treatment plans.
Specifically, Dr. James will work
with patients and providers to
learn how patients cope with
the high cost of medications
and medical procedures; this will
lead to a pilot intervention to
reduce nonadherence related to
cost. The overall goal is to help
improve health outcomes and
reduce health disparities.
The grant is titled: “Understanding and addressing cost-related
nonadherence to medication:
A mixed method multi-phase
study.” Dr. James will work with
co-investigators Jean Hunleth,
PhD, MPH; Su-Hsin Chang, PhD;
Cynthia Herrick, MD; and Amy
McQueen, PhD, on the project.
Donald Buck receives
British Book Award
The newest
book of
assistant
professor
of surgery
Donald Buck,
MD, Review
of Plastic
Surgery,
Donald Buck, MD
was one
of only five
books within the entire surgical
textbook spectrum to receive a
commendation from the British
Medical Association for 2016.
This book, along with his first
book, Core Procedures in Plastic
Surgery, are both set to be
translated into Portuguese.
Mohamed Zayed awarded
ASA Foundation Research
Fellowship
Mohamed
Zayed, MD,
PhD, an
assistant
professor in
the Section
of Vascular
Surgery,
recently was
Mohamed Zayed,
awarded
MD, PhD
the American
Surgical
Association Foundation Research
Fellowship Award. The twoyear award, which will begin
July 1, 2017, supports Dr.
Zayed’s research on diabetes
and peripheral arterial disease,
specifically what makes diabetic
individuals more prone to
developing atherosclerotic
blockages in the peripheral
arterial system.
Persons who have this condition
are more likely to develop
significant disability and
potential limb loss. Through
ongoing research, Dr. Zayed aims
to target specific molecules that
may decrease the risk of disease
progression and improve patient
quality of life.
Department of Surgery News
Tracey Guthrie wins
magazine’s Excellence in
Nursing Award
St. Louis
Magazine
named
Tracey
Guthrie, RN,
the winner
of a 2016
Excellence
in Nursing
Tracey Guthrie, RN
Award in
Research.
Tracey, director of clinical trials
for the Department of Surgery,
was honored at an awards
presentation in April at The
Chase Park Plaza.
Ms. Guthrie is also director
of patient safety/clinical
effectiveness for the department.
In this role, she shares in setting
the departmental priorities
and goals for patient safety
and clinical effectiveness;
assumes responsibility for the
development of the safety
and outcomes dashboard; and
oversees the daily operations of
staff providing support to patient
safety and clinical effectiveness
efforts in the Department of
Surgery.
Wound clinic develops
center of excellence for
dressings
The Surgical and Wound Care
Clinic is developing a center of
excellence for negative pressure
dressings and other wound care
therapies, offering advanced
techniques and training other
physicians in the application of
the dressings.
When applying a negative
pressure dressing, clinicians
can place a variety of foams or
gauzes in a wound cavity and
each have different therapeutic
properties;
they apply
suction
forces to
help close
the wound;
they
manage
the wound
John Kirby, MD
with fewer
dressing
changes and keep the wound
clean. Newer techniques can be
combined with mechanisms to
irrigate contaminated wounds
or assist with tissue grafts.
Candidates for negative pressure
dressings include patients with
massive abdominal trauma,
necrotizing fasciitis, and other
large soft tissue wounds; and
those recovering from complex
abdominal wall hernia repairs.
Director of Wound Healing
Programs John Kirby, MD, says
plans are under development
for a one- or two-day course
including instruction in the
outpatient clinic and the
operating room, and a lab for
participants to practice methods.
Kamlesh Patel wins postgrad student clinical award
Kamlesh
Patel, MD,
assistant
professor
of plastic
surgery,
won the
2016 Postdoctoral
Kamlesh Patel, MD
Mentored
Training
Program in Clinical Investigation
(MTPCI) Outstanding Citizenship
Award. Dr. Patel is a student
in the MTPCI program. This
award is given each year to top
Clinical Training Research Center
scholars who are identified as the
most engaged, respectful and
willing to provide support and
constructive feedback to peers.
Page 5
$10.4 million awarded for pancreatic cancer research
The National Cancer Institute
(NCI) has awarded a $10.4 million, five-year grant to Washington University researchers and
physicians at Siteman Cancer
Center to lead a national group
of experts in collaborative pancreatic cancer research.
The award, a prestigious Specialized Program of Research
Excellence (SPORE) grant, will
help scientists pursue new treatments for the deadliest form of
the disease, pancreatic ductal
adenocarcinoma, including
development of more effective
chemotherapies and a vaccine.
Partner institutions are the
University of Rochester, the
University of North Carolina at
Chapel Hill and Johns Hopkins
University.
“This grant addresses a huge
need to improve therapies for
pancreatic cancer patients,” said
William Hawkins, MD, a Washington University professor of surgery and principal investigator
of the grant. “With it, we are able
to build on our already extensive
knowledge of the disease and to
further pursue a multipronged
approach aimed at extending
lives.”
The SPORE grant supports four
new projects that involve:
• Altering the environment
around the tumor to make it
more susceptible to immunotherapy, which harnesses a
patient’s own immune system
to fight cancer. This research is
led by David DeNardo, PhD, a
Washington University assistant
professor of medicine, who will
work with David Linehan, MD, of
the University of Rochester;
• Developing a more effective
chemotherapy aimed at targeting pancreatic cancer and inducing tumor cell death. This work
William Hawkins, MD, right —
shown with surgery research fellows
Linda Jin, MD, and Darren Cullinan,
MD — is among several faculty performing pancreatic cancer research
funded by a SPORE grant.
is led by Dr. Hawkins, who also
sees patients at Barnes-Jewish
Hospital and is the Neidorff
Family and Robert C. Packman
Professor;
• Evaluating for future clinical testing another potential
chemotherapy that overcomes
tumor resistance. This area of
study is led by Andrea WangGillam, MD, PhD, a Washington
University associate professor
of medicine, who will work
with Channing Der, PhD, of the
University of North Carolina at
Chapel Hill;
• Conducting preclinical studies
of a personalized pancreatic
cancer vaccine. This work is led
by William Gillanders, MD, a
Washington University professor of surgery, who will work
with Robert Schreiber, PhD, the
Alumni Endowed Professor of
Pathology and Immunology
at Washington University, and
Elizabeth Jaffee, MD, of Johns
Hopkins University.
Three other Washington University faculty members are key
partners: Ryan Fields, MD, an
assistant professor of surgery;
Graham Colditz, MD, DrPH, the
Niess-Gain Professor of Surgery;
and Albert Lockhart, MD, a professor of medicine.
From medical school press release
Page 6
Department of Surgery News
Resident Leisha Elmore
represents Society of
University Surgeons
Leisha
Elmore, MD,
a general
surgery
resident
at BarnesJewish
Hospital and
Washington
University
Leisha Elmore, MD
School
of Medicine, was selected
to represent the Society of
University Surgeons at the
Society of Academic & Research
Surgery’s annual meeting in
January 2017 at the Royal
College of Surgeons in Ireland.
Her selection was awarded
based upon research presented
in the education plenary at
the 2016 Academic Surgical
Congress, co-hosted by the
Society of University Surgeons
and the Association for Academic
Surgery. Elmore’s abstract was
based on a national survey that
evaluated gender differences in
burnout during surgical training.
Elmore, who graduated from
the School of Medicine in 2013,
also presented an overview of
the research at the American
College of Surgeons conference
in September 2015.
Elmore’s principal investigator
for the research was Isaiah
Turnbull, MD, an assistant
professor of surgery.
From medical school press release
Eleanor Drew named
clerkship associate director
Eleanor Drew, MD, assistant
professor in the Section of
Acute and Critical Care Surgery,
has been appointed associate
director of the Surgery Clerkship
for third-year medical students.
The clerkship, directed by John
Kirby, MD, associate professor
of surgery,
provides
in-depth
experience
in surgical
care in a
clinical
setting.
Dr. Drew,
Eleanor Drew, MD
who joined the
faculty in 2015, specializes in the
surgical management of trauma
and burns, as well as trauma and
burn critical care.
BJH ranked among
nation’s best by U.S. News
24th straight year
For the 24th straight year,
Barnes-Jewish Hospital and
Washington University School
of Medicine are ranked among
the nation’s best by U.S. News
& World Report, including a
place on the Honor Roll in the
2017 Best Hospitals edition. The
hospital was ranked 11th on the
Honor Roll and ranked nationally
in all 12 data-driven specialties. It
was also number one in Missouri
for all of the specialties.
Department of Surgery faculty
were involved in patient care in
the following seven specialties:
Cancer –15
Cardiology & Heart Surgery – 14
Diabetes & Endocrinology – 29
Gastroenterology/GI Surgery – 29
Nephrology – 8
Pulmonology – 10
Urology –14
BJH sets monthly record in
trauma admissions
Barnes-Jewish Hospital, which
has the busiest trauma center in
the region, set a new monthly
record in July 2016 with 390
trauma admissions. The highest
number of admissions previously
was 355 in July 2015. The trauma
center treats about 13,000
trauma patients annually with a
99 percent survival rate.
‘TEAMING’ AT WORK: Congratulations to plastic surgery CAM Surgery Center team members Shalonda Tyus, RN, ASN, center, a former surgical tech who completed her ASN degree
and nursing certification, and to Tammy Adams, second from left, a surgical tech who is
working on her nursing degree. Pictured with them are family members and other members of the surgical team: (from l-r) Marissa Tenenbaum, MD, Tammy’s daughter Tamera,
Terence Myckatyn, MD, Plastic Resource Nurse Ronald Kemp, RN, and his grandson Adrian.
The surgical team has offered great support and encouragement, including carpooling
by Dr. Tenenbaum and Dr. Terence Myckatyn, and their families, to get Tammy’s daughter Tamera to school. Ron and Plastic Surgery Chief Susan Mackinnon, MD, encouraged
Shalonda to go to nursing school, which she completed in 2015. Tammy received encouragement from Ron, Shalonda and Pod 4 Assistant Nurse Manager Bobbie Dorsey-Lauberg,
RN, BSN, MSN. CAM leadership has also worked with Tammy and Shalonda to accommodate their school schedules.
Colonoscopy study observes increase in adequate prep
The Strategies to Improve
Colonoscopy study was led by
Rebecca Lobb, ScD, MPH, at
six BJC HealthCare hospitals,
in collaboration with gastroenterologist Jean Wang, MD,
and the BJC Center for Clinical
Excellence.
The study examined a staff
intervention to improve
patient education for bowel
preparation and adenoma
detection for outpatient colonoscopy. Endoscopy staff in
the intervention group were
trained and equipped to use
evidence-based practices for
patient education (e.g. splitdosing and low-literacy materials).
The study observed a 2.31 percent increase in the number of
adequately prepped patients
in the intervention group but
(From left) Public health sciences
researcher Rebecca Lobb, ScD, MPH,
gastroenterologist Jean Wang, MD,
and research coordinator Julia Maki,
PhD, review results of the Strategies to
Improve Colonscopy study.
no change in the comparison
group. With 16,285 colonoscopies performed annually at the
hospitals involved, the potential benefit is 376 fewer cancelled procedures or missed
adenomas.
Department of Surgery News
Page 6
Page 7
Faculty Appointments & Promotions
Appointments
Sean English, MD
Assistant Professor
Section of Vascular Surgery
Sean Glasgow, MD
Assistant Professor
Section of Colon and Rectal
Surgery
Training and experience: Medical degree,
Washington University; general surgery internship,
University of California, San Francisco; urology residency, Washington University; urologist, Belleville,
Illinois
Training and experience: Medical degree,
University of Pennsylvania; general surgery residency, University of Michigan, Ann Arbor; vascular
surgery clinical and research fellowship, Harvard
University
Clinical interests: Men’s health, benign prostatic
hyperplasia, general urology (Barnes-Jewish West
County Hospital)
Clinical interests: General vascular surgery, aortic
disease
Training and experience: Medical degree, Duke
University; general surgery residency, Washington
University; colon and rectal surgery fellowship,
University of Minnesota; U.S. Air Force C-STARS
instructor; staff surgeon/assistant professor, San
Antonio Military Medical Center, Fort Sam Houston,
Texas; adjunct assistant professor, Washington
University
Christopher Arett, MD
Assistant Professor
Division of Urology
Diego Casali, MD
Assistant Professor
Division of Cardiothoracic
Surgery, Department of
Anesthesiology
Training and experience: Medical degree,
University of Brescia, Italy; cardiothoracic critical
care medicine fellowship, Harvard Medical School;
critical care medicine fellowship, Washington
University; emergency medicine residency, State
University of New York at Stony Brook
Clinical interests: Intensivist in the cardiothoracic
and surgical intensive care units; extracorporeal life
support, mechanical circulatory support and perioperative echocardiography
Shaina Eckhouse, MD
Assistant Professor
Section of Minimally
Invasive Surgery
Training and experience: Medical degree, University
of Texas Health Science Center, San Antonio; general surgery residency, Medical University of South
Carolina, Charleston; minimally invasive/bariatric
surgery fellowship, Duke University
Clinical interests: Advanced laparoscopic techniques in the treatment of morbid obesity
Research interests: Outcomes after weight-loss
surgery, how obesity surgery impacts chronic disease progression across multiple fields in medicine
Research interest: Pathophysiology of AAA disease
and its associated rupture
John Felder, MD
Assistant Professor
Division of Plastic Surgery
Training and experience: Medical degree, Baylor
College of Medicine; plastic surgery residency,
Georgetown University; hand surgery fellowship,
Washington University
Clinical interests: Hand surgery, peripheral
nerve surgery, full range of plastic surgery (Alton
Memorial Hospital)
Gerald Fortuna, MD, Col,
USAF, SFS, MC
Assistant Professor, Sections
of Acute and Critical Care
Surgery and Vascular
Surgery; Director of the U.S.
Air Force C-STARS
(Center for Sustainment of
Trauma and Readiness Skills)
program, St. Louis
Training and experience: Medical degree,
University of South Carolina; general surgery
residency and trauma/critical care fellowship,
University of Cincinnati; vascular/endovascular surgery fellowship, University of Texas, Houston
Clinical interests: Trauma/critical care and
vascular surgery
Clinical interests: Colon and rectal cancer, carcinomatosis, inflammatory bowel disease, benign
anorectal diseases
Katherine Glover-Collins,
MD, PhD
Assistant Professor
Section of Endocrine and
Oncologic Surgery
Training and experience: Medical and doctoral
degrees, Meharry Medical College, Nashville; general surgery residency, University of Arkansas;
breast surgical oncology fellowship, Washington
University
Clinical interests: Breast oncology, breast surgery,
breast health
Puja Kachroo, MD
Instructor
Section of Cardiac Surgery
Training and experience: Master’s degree, biomedical engineering, Columbia University; medical
degree, Ross University, Dominica, West Indies; general surgery residency, Rutgers; research thoracic
surgery fellowship, UCLA; cardiothoracic surgery
fellowship, Washington University
Clinical interests: Coronary artery bypass grafting,
valve replacement incorporating transcatheterbased intervention, aortic disease surgery
Page 8
Department of Surgery News
Faculty Appointments & Promotions
Benjamin Kozower, MD,
MPH
Professor of Surgery
Section of Thoracic Surgery
Orlando Petrucci, MD, PhD
Assistant Professor
Section of Pediatric
Cardiothoracic Surgery
Training and experience: Medical degree,
University of Rochester; master of public health,
University of Virginia; general surgery residency,
University of Connecticut, Farmington; cardiothoracic surgery residency, Barnes-Jewish Hospital
and Washington University; professor of surgery
and public health sciences, University of Virginia,
Charlottesville
Training and experience: Medical and doctoral
degrees, general surgery and cardiac surgery residencies, faculty, University of Campinas, Sao Paul,
Brazil
Clinical interests: Surgical oncology, robotic surgery, benign foregut surgery, lung transplantation
Arghavan Salles, MD, PhD
Assistant Professor
Section of Minimally
Invasive Surgery
Constance Wye Leng Lee,
MD
Instructor
Division of Pediatric
Surgery
Training and experience: Medical degree,
University of Virginia, Charlottesville; general surgery residency, surgical critical care fellowship,
pediatric surgery fellowship, University of Florida,
Gainesville
Clinical interests: pediatric general surgery
(Washington University and University of Missouri
Women’s and Children’s Hospital, Columbia, Mo.)
Other interests: Instructional support, pediatric
residency, University of Missouri
Nadia Obeid, MD
Instructor
Section of Acute and
Critical Care Surgery
Training and experience: Medical degree, Wayne
State University; general surgery residency, Henry
Ford Hospital; fellowship, surgical critical care,
Washington University
Clinical interests: Trauma and non-trauma emergency care; selective elective surgical care, geriatric
trauma, surgery/burn/trauma intensive care
Clinical interests: Pediatric cardiothoracic surgery,
heart failure, heart transplant; adult congenital
heart disease
Training and experience: Medical and doctoral
degree (education), general surgery residency,
Stanford University; minimally invasive surgery fellowship, Washington University
Clinical interests: Bariatric and foregut surgery
(including anti-reflux procedures and treatment of
achalasia), cholecystectomy, inguinal hernia repair
Jason Snyder, MD
Assistant Professor
Section of Acute and Critical
Care Surgery
Training and experience: Medical degree, Marshall
University; general surgery residency, University of
Maryland; surgical critical care/trauma fellowship,
University of Tennessee, Memphis
Clinical interests: Trauma, emergency general surgery, critical care services
Promotions
Michael Awad, MD, PhD,
was promoted to associate professor of surgery.
Dr. Awad, who joined the
department in 2009, is a
minimally invasive surgeon who also serves as
associate dean for medical student education at
Washington University School of Medicine and
director of the Washington University Institute
for Surgical Education. He was the Washington
University General Surgery Residency program
director from 2012-2014. Dr. Awad earned medical and doctoral degrees from Brown University
School of Medicine and completed a general
surgery residency at Johns Hopkins Hospital.
He was a visiting registrar at Oxford University’s
John Radcliffe Hospital and completed a
minimally invasive surgery fellowship at Legacy
Health Systems in Portland, Oregon.
Ida Fox, MD, was promoted to associate professor of surgery. Dr. Fox is a
plastic, reconstructive and
hand surgeon whose primary clinical and research
interest is developing the
use of nerve transfers in
patients with cervical spinal cord injury. Dr. Fox joined the department in
2007 after completing a hand and microsurgery
fellowship at Washington University. She came
to Washington University from the University
of Rochester, where she received her medical
degree and completed a combined residency
in plastic surgery. While at the University of
Rochester, she also completed a research fellowship in the Peripheral Nerve Lab of Plastic and
Reconstructive Surgery Chief Susan Mackinnon,
MD, at Washington University.
Promotions continued on next page
Department of Surgery News
Page 9
Promotions
Continued from previous page
Andrew Gelman, PhD,
was recently promoted to
professor of surgery. Dr.
Gelman joined the faculty
in the Section of Thoracic
Surgery in 2006 after
completing a doctoral
degree in molecular and
cellular immunology at
the University of Pennsylvania. He studies the
immune response to lung injury and infection.
Dr. Gelman is part of the Department of Surgery
research team that was awarded a $7.3 million
Program Project grant to investigate the immunological basis of lung transplant rejection, with
the aim of improving the long-term outlook
for transplant patients. As part of the grant, he
will help define the role of infection-fighting
immune cells, called neutrophils, in building tolerance or acceptance of the transplanted organ.
Matthew Mutch, MD,
chief of the Section of
Colon and Rectal Surgery,
was promoted to professor of surgery. Dr. Mutch
joined the department in
2002 and has developed a
national reputation in the
laparoscopic treatment
of colorectal cancer and training of surgeons
in laparoscopic colorectal surgery. He was program director of the Colon and Rectal Surgery
Fellowship from 2007-2016 and has served as
section chief since 2015. He received his medical
degree and completed a general surgery residency at Washington University. He completed
a colon and rectal surgery fellowship at Lahey
Clinic in Burlington, Massachusetts.
Terence Myckatyn,
MD, was promoted to
professor of surgery.
Dr. Myckatyn is director
of Cosmetic and Breast
Plastic Surgery for the
Division of Plastic and
Reconstructive Surgery.
He specializes in facial
and breast cosmetic surgery, body contouring,
breast reconstruction, and general reconstructive surgery at West County Plastic Surgeons, a
practice that he and Marissa Tenenbaum, MD,
serve as the primary partners. Dr. Myckatyn
earned his medical degree at the University
of British Columbia. He completed his plastic
surgery residency and fellowship training at
Washington University School of Medicine in St.
Louis.
Douglas Schuerer,
MD, was promoted to
professor of surgery. Dr.
Schuerer is director of
trauma for Barnes-Jewish
Hospital and director of
the Surgical Critical Care
Fellowship. His focus is the
care of traumatized and
critically injured patients, with an emphasis on
patient safety and improved patient outcomes.
Dr. Schuerer received his medical degree at the
University of Pittsburgh. He completed a general surgery residency at Henry Ford Hospital in
Detroit, Michigan, and a fellowship in surgical
critical care at the University of Michigan in Ann
Arbor.
Seth Strope, MD, MPH,
was promoted to associate professor of surgery.
Dr. Strope’s urology
practice focuses on urinary tract cancer in men
and women, including
kidney cancer, prostate
cancer, bladder cancer,
laparoscopic surgery, robotic surgery and testes
cancer. His research is on comparative effectiveness of therapies for benign and malignant urologic disease and the use of follow-up care after
definitive therapy for urologic malignancies. Dr.
Strope received his medical degree from Albany
Medical College in Albany, New York, and completed general surgery and urology residencies
at Mount Sinai Medical Center in New York City.
He completed a health services research fellowship and clinical fellowships in urologic oncology
and endo urology at the University of Michigan
in Ann Arbor.
Minimally invasive surgeons offer
enhanced laparoscopy course
Jeffrey Blatnik, MD, left, instructs resident Jared
McAllister, MD, on laparoscopic inguinal hernia
repair in the surgery training lab.
For colleagues nationwide, Washington
University minimally invasive surgeons
are offering an enhanced version of their
existing training in laparoscopic inguinal
hernia repair. Rather than a one- or twoday class, the post-graduate course takes
place over several months and includes
mentoring over time. Participants start in
the surgery training lab, observe complex
surgeries and then return to the lab for
more practice.
L. Michael Brunt, MD, chief of the Section
of Minimally Invasive Surgery, and minimally invasive surgeon Jeffrey Blatnik,
MD, later travel to the surgeons’ hospitals,
spend a day watching trainees perform
the surgery and provide a critique.
Instructors also make themselves available
for later consultation.
The new approach may encourage more
widespread adoption of laparoscopic
techniques.
Page 10
Department of Surgery News
Washington University Surgeons prep Air Force personnel for wartime medicine
F
or the past three years, Washington
University colorectal surgeon Sean
Glasgow, MD, has played an active role
in training U.S. Air Force physicians, nurses
and medics to take care of traumatic injuries to
soldiers under the St. Louis C-STARS (Center
for Sustainment of Trauma and Readiness
Skills) program. The Washington University
Department of Surgery will continue to support
the program as Dr. Glasgow passes the baton
to Gerald Fortuna Jr., MD, a newly appointed
trauma and vascular surgeon.
Since 2002, the St. Louis C-STARS program has been based at Saint Louis University
(SLU) School of Medicine. In 2013, Dr.
Glasgow brought Washington University into
the program when he joined the Section of
Colon and Rectal Surgery after serving as a surgeon at San Antonio Military Medical Center
at Fort Sam Houston, Texas. Dr. Glasgow split
his time between his colorectal surgery practice
at Washington University and training courses
at SLU, also taking a 24-hour trauma rotation at
SLU once a month.
“The military views any military surgeon
as a combat surgeon,” he says. “The majority of
the overseas deployments are manned by general surgeons, not by trauma-trained surgeons.
They place a high premium on any of their surgeons being able to do combat-related trauma
surgery.”
The St. Louis C-STARS program – one of
three C-STARS programs in the country – offers
16 to 18 courses a year. Dr. Glasgow provided
surgical and trauma instruction to visiting
surgeons and other medical personnel from
around the globe in both the active and reserve
components of the Air Force. Training included
classroom instruction and time in the operating
room, ICU and emergency department, as well
as advanced simulator training.
In teaching, Dr. Glasgow drew on his own
combat deployments totalling 15 months in
Afghanistan and the Philippines.
“I was in Afghanistan, in a place called
Ghazni, in 2010,” he says. “It was right at the
time of the U.S. surge. There were a lot of
amputations from ground level IEDs: soldiers
with their legs or arms blown off; penetrating
abdominal and pelvic trauma; and some chest
trauma. We also took a lot of indirect fire in
Sean Glasgow, MD, standing second from left,
at a field hospital in Afghanistan.
our own camp. In fact, I operated on a few of
my colleagues.”
Dr. Glasgow, who trained as a general surgery resident at Washington University before
completing a colorectal surgery fellowship at
the University of Minnesota, left the C-STARS
program in spring 2016 to become a full-time
faculty member in the Washington University
Department of Surgery. He is board certified
in surgery and colorectal surgery. A Lieutenant
Colonel, Dr. Glasgow continues to serve in the
U.S. Air Force Reserves as a surgeon for an airtransportable theater hospital based at Scott Air
Force Base, Illinois.
New directions for
C-STARS program
Dr. Fortuna, an Air Force Colonel, will
play a key role in expanding the training platform of St. Louis C-STARS. He will also be
director of St. Louis C-STARS and a faculty
member at both Washington University and
Saint Louis University.
Dr. Fortuna joined both the acute and
critical care surgery section and the vascular
surgery section after completing a vascular fellowship at the University of Texas at Houston.
His background will be pivotal in developing
courses on new vascular techniques for controlling bleeding, such as resuscitated endovascular
balloon occlusion of the aorta – replacing traditional resuscitative thoracotomy – and placing
covered stent grafts to treat injuries at the junction of the trunk and groin. These advanced
hemorrhage control techniques could significantly improve survival of wounded soldiers.
“The military’s Joint Theater Trauma
System found that 20 to 25 percent of our prehospital casualties resulted from lack of hemor-
rhage control,” says Dr. Fortuna. “These are
potentially preventable.
“Early administration of tranexamic acid
(TXA) has helped control soldiers’ bleeding
from gunshots and other trauma, but the challenge is what to do with this junctional bleeding. One of the potential visions of advancing
the platform in St. Louis will be to develop
an advanced hemorrhage control model, and
that marries up very nicely to the work Grant
Bochicchio (chief of Acute and Critical Care
Surgery) is doing on agents that stop hemorrhaging.”
St. Louis C-STARS may also train team
members of a new type of tactical critical care
team that administers lifesaving techniques and
blood products on the battlefield.
“We are trying to capture all the lessons
that we have learned from this last 14-15 years
of conflict,” says Dr. Fortuna. “How do we train
new surgeons who have only had the opportunity to read about some of these things? With
C-STARS, we will be able to give them real life,
hands-on experience.”
Dr. Fortuna completed a general surgery
residency and trauma/critical care fellowship at
the University of Cincinnati. He is board certified
in general surgery and surgical critical care.
Gerald Fortuna, MD, center, trains U.S. Air Force
medical personnel to provide trauma care during
wartime.
Department of Surgery News
Clinical trial at BJH, Washington University tests
artifical blood vessels in hemodialysis treatment
The first-ever bioengineered blood
vessel created entirely out of human
tissue was implanted in a patient needing vascular access for hemodialysis at
the Washington University School of
Medicine and Barnes-Jewish Hospital as
part of a multicenter clinical trial.
Surendra Shenoy, MD, PhD, a
Washington University transplant surgeon, is the site principal investigator
of the HUMANITY® AV Access Trial,
which is investigating the use of a graft
made from a completely human acellular vessel (HAV) bioengineered using
human cells from the aorta of deceased
donors.
Hemodialysis is used to replace
kidney function in patients with irreversible kidney failure. During hemodialysis,
Human acellular vessels
provide a biological scaffold,
which the body can repopulate
with its own cells to reproduce
and function like a blood
vessel.
a pump within a machine drives the
patient’s blood through a special filter
to remove waste that previously was
removed by the kidney. Vascular access
is the method used to deliver this blood
from the patient’s body to be circulated
through the machine for cleansing.
Surgeons perform technically challenging
outpatient surgical procedures to create
areas of blood circulation in the arms
of kidney failure patients, which can be
used for hemodialysis.
The ideal method to create a vascular access for hemodialysis in patients
with end-stage renal disease is to use a
patient’s existing veins in appropriate
anatomic locations and create an AV
(arteriovenous) fistula, or connection of
an artery to a vein.
While a fistula is
considered the best
option, some patients
do not have available veins for this
procedure. In these
situations, surgeons
Surendra Shenoy,
MD, PhD
insert a prosthetic tube
to connect an artery to
a vein to create an AV graft.
“An AV fistula using your own vein
is the ideal kind,” says Dr. Shenoy. “With
the artificial graft, there is a higher risk
of infection, and the graft predictably
fails over a period of time, with multiple
procedures needed to keep the patient
going.”
A well-functioning vascular access
provides successful dialysis, which is a
major parameter that makes a big difference in the quality of life and longevity
of the patient on hemodialysis. HAV is
a tube made from human collagen types
I and III and other extracellular matrix
proteins produced by human cells and
does not elicit an immune response. It
provides a biological scaffold, which the
body can repopulate with its own cells
to reproduce and function like a blood
vessel.
“You will see these tubes get lined
with endothelium, just like normal
vascular endothelium lining the vessel.
In a short time, you will also see some
smooth muscle cells in the walls” says
Dr. Shenoy. The HAVs are being tested
for safety, durability and their infection
rate compared to AV grafts.
More than 400,000 patients in
United States are on hemodialysis, and
around 40,000 patients are on peritoneal
dialysis (another modality of replacing
kidney function).
Page 11
Transplant program a national
leader using organ procurement
facility to harvest organs
M.B. Majella Doyle, MD, and Transplant Surgery
Chief William Chapman, MD, at Mid-America
Transplant organ producement facility
Washington University transplant surgeons at Barnes-Jewish Hospital are leaders in the movement toward using organ
procurement organization (OPO)-based
facilities to recover donor organs. They
have published groundbreaking research
on the benefits of OPO facilities and also
use a facility at Mid-America Transplant
Services (MTS) to recover about 90 percent of donor organs – the highest of
any transplant group in the country. M.B.
Majella Doyle, MD, MBA. and Transplant
Surgery Chief William Chapman, MD, led
a study published in the April 2016 issue
of the Journal of the American College
of Surgeons that found OPO facilities
reduced donor recovery costs by 54 percent over hospitals and increased organ
yield.
The Department of Surgery News at
Washington University School of Medicine
is published twice a year for faculty
members and staff.
Submit news items to Jeffrey Jim at jimj@
wudosis.wustl.edu
Editorial Advisory Board
Timothy J. Eberlein, MD
Jeffrey Jim, MD
Jamie Sauerburger
Editor: Jeffrey Jim, MD
Copy Editor and Writer:
Greg Barnett
Page 12
Department of Surgery News
SPOTLIGHT
Division of Pediatric
Surgery
Historic program leads trends in
academic pediatric surgery
P
ediatric surgery evolved later than
most surgical specialties in the 20th
Century, growing out of the recognition that children have surgical needs
distinct from those of adults.
One of the biggest proponents of
this concept was the late Jessie Ternberg,
PhD, MD, the first chief of pediatric surgery at Washington University and St.
Louis Children’s Hospital. The division
was established in 1972, and in ensuing
years, Dr. Ternberg performed up to 500
operations annually and published notable
reports on her research. She also was a
teacher with exacting standards, passing along both her rigor and pension for
warmth in caring for patients to surgical
residents.
Today, under the leadership of chief
Brad Warner, MD, the division has the
same mission — providing leading-edge
clinical care, discovering and imparting knowledge — but on a much greater
scale. In FY 2016, the division’s surgeons
performed more than 3,800 surgeries; the
scope of its research encompasses basic
science, clinical investigations and outcomes research; and its two-year pediatric
surgery fellowship offers a comprehensive
approach to training.
During the tenure of Dr. Warner, the
Jessie L. Ternberg, MD PhD Distinguished
Professor of Pediatric Surgery, Dr.
Ternberg was an invited guest at the annual lectureship named in her honor before
passing away in July 2016 (see obituary
on front page). Both the beginnings and
progress of the division tell the story of a
leading program that has shaped academic
pediatric surgery.
Jacqueline Saito, MD, MSCI, finishes a followup visit with patient Carrah McDaniel.
Clinical Care
The division’s pediatric surgeons
provide compassionate care and advanced
treatments in a child-friendly environment.
Among the conditions treated by surgeons
are congenital anomalies and diseases of
the head and neck, chest, abdomen and
gastrointestinal tract. In addition, expert
care is provided for children with cancer,
trauma and burns. There is also expertise in advanced gastrointestinal surgery
including intestinal lengthening procedures
for children with short-bowel syndrome.
Complementing their clinical skills,
pediatric surgeons often look for new ways
to improve care for challenging conditions.
Babies born with congenital diaphagmatic
hernia (CDH) — a condition in which a
hole in the diaphragm allows abdominal
organs to move into the chest — face
surgery and a survival rate of about 50
percent. Dr. Warner and other pediatric
surgeons work closely with patient families
on educational programs and fundraising for research, and contribute data to
Columbia University’s Diaphragmatic
Hernia Research & Exploration, Advancing
Molecular Science (DHREAMS) study,
which examines the molecular genetic basis
of CDH.
The division, which oversees the
hospital’s extracorporeal membrane oxygenation (ECMO) program, also has
developed new protocols to help children
who need ECMO to support their heart
and lung function. With the new protocols, major bleeding — the most common
complication of ECMO — decreased from
about 45 percent to 20 percent in the 18
months after implementation.
Even in treatment of appendicitis,
a more common operation, pediatric
surgeons are looking at possible ways to
improve outcomes. Jacqueline Saito, MD,
MSCI, was lead author in a study that
found ultrasound — a diagnostic test for
appendicitis that avoids radiation — was
more likely than CT scan to be performed
at Children’s Hospital (where scans are
evaluated by pediatric specialists) than at
general hospitals. The division also participated in a clinical trial examining the use
of antibiotics alone in treating appendicitis.
Story continued on next page...
Department of Surgery News
Pediatric Surgery, contnued from page 12
Trauma Care
In recent years, under trauma medical director Martin Keller, MD, the St.
Louis Children’s Hospital Trauma Center
— the only American College of Surgeons
(ACS)-verified Level 1 Pediatric Trauma
Center in Missouri and Illinois — has
played an increased role in oversight of the
trauma field regionally. Dr. Keller has been
active in development of the Time Critical
Diagnosis System in Missouri and sits
on trauma oversight committees in both
states.
Dr. Keller also works closely with
neurosurgeons, intensivists and emergency
physicians on aggressive protocols for the
treatment of intracranial pressure following brain injury. The protocols — which
include drugs to improve blood perfusion
and sedation to put the brain at rest —
were found to improve outcomes in a study
published in The Lancet Neurology
Improving Outcomes
Dr. Saito, who earned a master of
science in clinical investigation (MSCI)
degree at Washington University, has
played a key role in measuring outcomes
and improving quality at Children’s
Hospital, BJC and nationally. She is an
Clinical Highlights FY 2015-16
6,254 outpatient visits
3,842 total procedures
outcomes and quality physician at the
BJC Center for Clinical Excellence, and a
leader in the American College of Surgeons
National Surgical Quality Improvement
Program® (ACS NSQIP®) Pediatric, both
at the national level and at Children’s
Hospital.
ACS NSQIP® was established to
provide hospitals with high-quality surgical outcomes data and methods to help
improve care. More recently, the ACS
Intestinal Adaptation Lab principals Chris
Erwin, PhD, Brad Warner, MD, and Jun Guo,
PhD, continue to break ground in the study of
short-bowel syndrome.
has launched the Children’s Surgery
Verification Program, similar to the ACS
trauma verification. Dr. Saito serves as vice
chair of the Data Committee and member
of the Steering Committee for the national
organization.
Intestinal Adapation, Other Research
Under the direction of Dr. Warner,
researchers in the Intestinal Adaptation
Laboratory conduct collaborative basic
science research to solve a long-standing
clinical problem: the complications and
poor prognosis often associated with shortbowel syndrome.
In older children and adults, shortbowel syndrome most often results from
surgery undergone to treat intestinal diseases, injuries or congenital defects; these
procedures can require removal of half or
more of the small intestine. In infants, the
most common cause is necrotizing enterocolitis, which occurs with premature birth
and leads to death of bowel tissue.
Researchers recently have investigated
what happens to the gut microbiome — the
collection of gut microorganisms and their
genes — in response to removing the intestine; their long-term goal is to manipulate
Page 13
the microbiome to allow greater nutrient
absorption and prevent bacterial infections.
In the area of clinical effectiveness research, pediatric surgeons have
also formed the Program for Optimal
Outcomes in Pediatric Surgery (POOPS).
Dr. Saito leads the group, which works
with other centers in clinical trials and the
study of severe birth defects.
The group participates in the Midwest
Pediatric Surgery Consortium (MWPSC), a
research partnership of pediatric surgeons
at 11 children’s hospitals. With surgeons at
the other MWPSC centers, they have conducted trials on the use of needle aspiration
alone instead of a chest tube to treat pneumothorax, use of antibiotics alone to treat
appendicitis, and other areas.
Fellowship/Resident Research Training
The Division of Pediatric Surgery
offers a two-year, ACGME*-approved fellowship in surgery for infants and children.
Under the direction of Patrick Dillon, MD,
fellows are trained in open and minimally
invasive surgery for congenital conditions
of the chest, lungs, abdomen and gastrointestinal tract as well as treatment for pediatric cancer, burns and trauma.
General surgery residents may spend
their research years in the Intestinal
Adaptation Laboratory. Three Washington
University residents gave presentations on
short-gut syndrome at the 11th Annual
Academic Surgery Congress earlier this year:
Lauren Muckleroy-Barron, MD, reported
that giving an antibiotic in an animal model
prevented development of liver injury
associated with intestinal resection; Bola
Aladegbami, MD, presented the lab’s finding
that genes regulated by hypoxia, or oxygen
deficiency, affect blood flow and adaptation responses in the remnant intestine; and
Raphael Sun, MD, described ways in which
the protein mTOR may be involved in the
gut’s response after resection.
* Accreditation Council for Graduate Medical
Education
Page 14
Department of Surgery News
Education Updates
MPHS Program
celebrates five years
By Katy Henke
Media and Marketing Administrator
Division of Public Health Sciences
T
he Master of Population Health
Sciences (MPHS) program officially reached a five-year milestone
with its spring 2016 graduation. In honor
of the program’s first five years, its leaders shared some of their highlights with
faculty, staff, alumni and Washington
University community members on the
MPHS website.
MPHS Program five-year milestones
• Forty-eight graduates to date (34
MDs, 14 medical students, one
PhD)
• Twenty-four students enrolled for
fall 2017, the largest class size yet
• Twenty-six MPHS faculty members
• Three program concentrations
allow MPHS students to specialize in a particular research field.
• To meet growing demands,
MPHS courses have been
increased from nine to 23.
• Enrollment in the MPHS courses
climbed from 42 in 2010-11 to
262 in 2014-15.
• The number of courses taken by
students outside the MPHS program grew from 23 in 2010-11 to
80 in 2014-15.
• MPHS alumni represent seven
different departments on
Washington University School
of Medicine’s campus including:
Surgery (general, plastic, pediatric
and urology); Internal Medicine
(cardiovascular, hematology,
oncology and infectious disease);
Otolaryngology; Neurology;
Neurosurgery; Pediatrics and
Psychiatry
2016 MPHS graduates with Program Director Graham Colditz, MD, DrPH: from l-r, Scott Douglas
(medical student); Jesse Keller, MD; Natalia Brito Rivera (medical student); Dr. Colditz; David Brauer,
MD; Charlene Ong, MD; and Shawgi Silver (medical student)
•
•
Thirteen MPHS graduates have
been honored with awards; nine
in 2015-2016 academic year
There have been 191 total peerreviewed MPHS alumni publications
What’s new
Beginning in fall 2015, the MPHS
program began offering the joint MD/
MPHS degree. This unique degree provides
medical students with an opportunity to
add clinical research methods training to
their medical school experience. Medical
students in the program work on a research
project and use that project to complete
MPHS coursework in 10 months, creating
the ideal combination of didactic training
and hands-on experience. For spring 2016
graduation, four students earned this dual
degree. In fall 2016, the program welcomed
eight medical students into the MPHS program, the highest number yet.
In fall 2015, Melody Goodman,
MS, PhD, spearheaded the educational
Sastravangza workshop for Washington
University faculty, staff and students.
This workshop was the first to be held
on the Washington University School of
Medicine (WUSM) campus and was open
to MPHS students and faculty members.
The goal of the workshop was to help
increase Statistical Analysis System (SAS)
knowledge and learn about other SAS
research at WUSM.
In spring 2017, a new biostatistics
course will be offered. Yan Yan, MD,
PhD, will begin teaching Multilevel and
Longitudinal Data Analyses for Clinical
and Public Health Research after multiple
requests for an advanced biostatistics
course. The course is designed for medical
students, clinicians and health researchers
and course topics include basic statistical
concepts and methods for various types of
clinical data (continuous, categorical, count
and time-to-event outcome data) in multilevel and longitudinal settings.
Department of Surgery News
Page 15
Interprofessional training part of medical school, clerkship curriculum
A
ll first-year Washington
University medical students
now participate in a six-hour
program designed to hone their ability
to work as part of an interprofessional
team. The sessions are offered by the
Center for Interprofessional Practice
and Education (CIPE), a collaboration
between Goldfarb School of Nursing
at Barnes-Jewish College, St. Louis
College of Pharmacy and Washington
University School of Medicine. Other
students in the sessions include those
from audiology, deaf education, nursing, occupational therapy, pharmacy
and physical therapy.
Students identify and discuss their
strengths with members of a team to
which they are assigned; watch a video
showing a breakdown in infection
control in a patient care setting; discuss
what team member they identify with
in the video; work as a team to investigate a patient safety problem; and
make a presentation on how well they
worked as a team to solve the problem.
Heather Hageman, MBA, director
of the CIPE, explains these sessions are
Modern surgeons work better as a
team with experienced nurses, physical
and occupational therapists, and
pharmacists, especially as patients get
older and more complex.
– John Kirby, MD
the start of a longitudinal, integrated
IPE curriculum across the health professions that will focus primarily on
teamwork and leadership needed for
interprofessional practice.
“Leadership within an interprofessional team requires a unique and
critical skillset that includes followership, advocacy and collaboration.
While some content can be learned in
individual professions, the competencies for interprofessional teamwork
and leadership can only be achieved in
meaningful IPE experiences,” she says.
Session leader Amy Tiemeier leads a session on interprofessional education while medical,
nursing, audiology, deaf education, occupational therapy, pharmacy and physical therapy
students listen and take notes. Facilitator Thomas Ciesielski stands at right.
Medical student education overall is
implementing IPE activities through the
medical school’s collaboration in the CIPE.
The first step in CIPE’s developing longitudinal IPE curriculum are the first-year sessions
in which faculty from all three collaborating
schools facilitate, including surgery educators. Surgery educators have embraced IPE,
and as such, are engaging students on their
Surgery Clerkship rotation in an interprofessional simulation (which is connected to the
CIPE) as well as running other IPE activities
within the clerkship.
Mary Klingensmith, MD, vice chair for
education and interim senior associate dean
for education at WUSM, says that surgery
was included early in the CIPE experience
for medical student education as the first
clerkship to include interprofessional training as part of a pilot study some years ago.
“Our learners received tremendous benefit and helped to guide the subsequent
development of other CIPE programs for
students,” she says.
John Kirby, MD, director of the Surgery
Clerkship and team facilitator in the FirstYear Sessions, says the sessions teach
students who go on to be surgeons they
may not reliably achieve the best for their
patients if they work in isolation of the
teams of professionals around them.
“Modern surgeons work better as a
team with experienced nurses, with physical
and occupational therapists for better reha-
bilitation outcomes, with the pharmacists
for better medication management,
especially as patients get older and more
complex,” says Dr. Kirby. “This is where
the culture at our joined campuses can
really lead in surgery, especially when
team functioning is important, such as in
trauma surgery.”
Applications in trauma training
Department of Surgery educators have also provided insight into the
interprofessional teams needed to care
for severely injured trauma and critically
ill patients by establishing regular rotations in the surgical intensive care unit
and other ICUs for third- and fourth-year
medical students. And medical students
– in their fourth-year Capstone Course –
participate in the Trauma Evaluation and
Management® (TEAM®) course offered by
the American College of Surgeons.
Through TEAM®, medical students
in their clinical years are introduced to
the concepts of trauma assessment and
management, which most will take later
in their training as part of the American
College of Surgeons (ACS) Advanced
Trauma Life Support (ATLS) course. The
content of both these courses is developed by the ACS Committee on Trauma,
and each drives home how the execution
of better interprofessional patient care
can make a difference in trauma care
outcomes.
Page 16
Department of Surgery News
Page 15
Postgrads: Incoming & Outgoing
Medical Schools of
Incoming Residents:
Bryan Pham, MD
Baylor College of Medicine, Houston,
Texas
General Surgery Residency
Maung Htein (James) Thu, MD
Meharry Medical College, Nashville,
Tenn.
Erin Andrade, MD, Tulane University,
New Orleans, La.
Saeed Arefanian, MD, Tehran
University, Tehran, Iran
Katharine Caldwell, MD, University of
New Mexico, Albuquerque
Jad Chamieh, MD, American
University of Beirut, Beirut, Lebanon
Matthew Grant, MD, Baylor College of
Medicine, Houston, Texas
Rahul Handa, MD, University of
Cincinnati
Charles (Alston) James, III, MD, Wake
Forest University, Winston-Salem, N.C.
Meghan Kelly, MD, University of
Missouri-Columbia
Vascular Surgery Residency
Brandon Downing, MD, Indiana
University School of Medicine,
Indianapolis, Ind.
Where incoming
fellows came from:
Breast Disease
Jennifer Hawasli, MD, General Surgery
Residency: Saint Louis University
Cardiothoracic Surgery
Ruben Nava, MD, General Surgery
Residency: Washington University
Kelly Koch, MD, University of
Michigan, Ann Arbor
Lindsey Saint, MD, General Surgery
Residency: Washington University
Robert MacGregor, MD, Eastern
Virginia Medical School, Norfolk, Va.
Stephen Waterford, MD, General
Surgery Residency: Massachusetts
General Hospital, Boston, Mass.
Shellee Ogawa, MD, University of
California-Los Angeles (Urology intern)
Olubode (Bode) Olufajo, MD –
University of Ibadan, Ibadan, Nigeria
Ricardo Ramirez, MD, Universidad
Latina de Costa Rica
Jonathan Weese, MD, Washington
University School of Medicine
(Urology intern)
Affan Zafar, MD, Baylor College of
Medicine, Houston, Texas (Urology
intern)
Plastic Surgery Residency
Austin Ha, MD, Brown University,
Providence, R.I.
Amelia Van Handel, MD, Mayo Medical
School, Rochester, Minn.
Colorectal Surgery
John Berry, MD, General Surgery
Residency: San Antonio Military
Medical Center
Haniee Chung, MD, General Surgery
Residency: Washington University
Cristina Geltzeiler, MD, General
Surgery Residency: Oregon Health and
Science University, Portland, Ore.
HPB Surgery
J. Bart Rose, MD, General Surgery
Residency: Virgina Mason Medical
School, Seattle, Wash.
Minimally Invasive Surgery
Ema Zubovic, MD, Washington
University
Laura Grimmer, MD, General Surgery
Residency: Rush University, Chicago,
Ill.
Urology Residency
Pediatric Surgery
Michael Chevinsky, MD
Rutgers University, Robert Wood
Johnson Medical School, New
Brunswick, N.J.
Alice King, MD, General Surgery
Residency: University of Cincinnati
Plastic Surgery
Leahthan Domeshek, MD, Hand
Fellow, Plastic Surgery Residency:
Washington University
Aaron Morgan, MD, Hand Fellow,
General and Plastic Surgery
Residency: University of Oklahoma,
Norman, Okla.
Surgical Critical Care
Chun-Cheng (Richard) Chen, MD,
PhD, General Surgery Residency:
Washington University
Christian Dennis, MD, General Surgery
Residency: Virgina Mason Medical
School, Seattle, Wash.
Sina Khoshbin, MD, General Surgery
Residency: Inova Fairfax Hospital,
Falls Church, Va.
Kelly Vallar, MD, General Surgery
Residency: Saint Louis University
Transplant Surgery
Leigh Anne Dageforde, MD
General Surgery Residency: Vanderbilt
University, Nashville, Tenn.
Urology
Justin Benabdallah, MD, MSI Fellow;
Residency: Medical College of
Wisconsin, Milwaukee Wis.
Kefu Du, MD, MSI Fellow; Residency:
University of Utah, Salt Lake City, Utah
Kyle Rove, MD, Pediatric Urology
Fellow; Residency: University of
Colorado, Aurora, Colo.
Vascular Surgery
John Maijub, MD, General Surgery
Residency: University of Louisville,
Louisville, Ky.
Adrian Vlada, MD, General Surgery
Residency: University of Florida,
Gainesville, Fla.
Where MPHS students
came from:
Ziad Alhumayyd, MD, Fellow,
Neurology
Jyotirmoy Das, medical student
Rafael Garcia-Cortes, MD, Fellow,
Internal Medicine, Cardiology
Department of Surgery News
Incoming MPHS students, from page 13
Taleef Kahn, MD, medical student
Nickolas Karlow, medical student
Alyssa Kronen, medical student
Angela Lin, medical student
Karly Lorbeer, medical student
Roheena Panni, MD, Resident, General
Surgery, Hepatobiliary
Aalok Patel, medical student
Aref Qureini, MD, doing year off before
residency
David Raymer, MD, Fellow, Medicine,
Cardiology
Tara Semenkovich, MD, Resident,
General Surgery, Cardiothoracic
Christopher Sparrow, MD, Fellow,
Medicine, Cardiology
Wen Hui Tan, MD, Resident, General
Surgery, Critical Care
Theodore Thomas, MD, Fellow, Medicine,
Hematology/Oncology
Lulu Yu, medical student
Where graduating
residents have gone:
General Surgery:
R. (Richard) Chun-Cheng Chen, MD, PhD
Surgical Critical Care Fellowship,
Washington University
Haniee Chung, MD
Colorectal Surgery Fellowship,
Washington University
Ruben Nava, MD
Cardiothoracic Surgery Fellowship,
Washington University
Jason Robertson, MD, MS
Pediatric Surgery Fellowship, All
Children’s Hospital, Tampa, Fla.
Plastic Surgery Residency
Pediatric Surgery
Justin Cohen, MD, Microsurgery
Fellowship, Harvard Medical School/Beth
Israel Deaconess Hospital
Derek Wakeman, MD, academic practice,
University of Rochester, Rochester, N.Y.
Leahthan Domeshek, MD, Hand and
Microsurgery Fellowship, Washington
University
Urology Residency:
Grecori Anderson, MD, private practice,
Atlanta, Ga.
Adam Rensing, MD, Pediatric Urology
Fellowship, Indiana University,
Indianapolis, Ind.
Jennifer Robles, MD, Masters in Public
Health/VA Quality Scholars Fellowship,
Vanderbilt University, Nashville, Tenn.
Fellows:
Breast Disease
Katherine Glover-Collins, MD, academic
practice, Washington University
Cardiothoracic Surgery
Thomas Percival, MD, San Antonio
Military Medical Center, San Antonio,
Texas
Chirag Patel, MD, St. Joseph’s Hospital
and Medical Center, Phoenix, Ariz.
Puja Kachroo, MD, academic practice,
Washington Univerity
Colorectal Surgery
Alexander Hawkins, MD, academic practice, Vanderbilt University, Nashville,
Tenn.
Devi Mukkai Krishnamurty, MD,
academic practice, Creighton University,
Omaha, Neb.
Katerina Wells, MD, academic practice,
Baylor Medical Center, Dallas, Texas
Kathryn Rowland, MD, MPHS
Pediatric Surgery Fellowship, Oregon
Health & Science University, Portland,
Ore.
HPB
Lindsey Saint, MD
Cardiothoracic Surgery Fellowship,
Washington University
Minimally Invasive Surgery
Lauren Steward, MD, MHSA, MPHS
Fellowship, University of Colorado
Hospital/Denver Health
Page 17
Ismael Dominguez, MD, academic
practice, Nutrición Hospital, Mexico City
Arghavan Salles, MD, academic practice, Washington University School of
Medicine
Plastic Surgery Fellows
Hand fellow, John Felder, MD, academic
practice, Washington University
Hand fellow, Emily Krauss, MD, Plastic
Surgery Division, Victoria, British
Columbia
Surgical Critical Care
Bhani Chawla, MD, unknown
Nadia Obeid, MD, academic practice,
Washington University
LeRone Simpson, MD, unknown
Brandt Whitehurst, MD, academic practice, Southern Illinois University School
of Medicine, Springfield, Ill.
Transplant Surgery
Jacqueline Garonzik-Wang, MD, PhD,
academic practice, Johns Hopkins
University, Baltimore, Md.
Urology Fellows
Erik Grossgold, MD, U.S. Navy, Virginia
Beach, Va.
Joel F. Koenig, MD, Children’s Mercy
Hospital, Kansas City, Mo., academic
practice, University of Missouri and
University of Kansas
Alyssa Park, MD, private practice,
Geisinger Medical Center, Danville Pa.
Aaron Potretzke, MD, academic practice,
Mayo Clinic, Rochester, Minn.
Vascular Surgery
Joseph Karam, MD, private practice, Abbott Northwestern Hospital,
Minneapolis, Minn.
Jaime Benarroch, MD, academic practice,
Emory University Hospital, Atlanta, Ga.
MPHS students
Anchal Bansal, MPHS
Medical Student, Washington University
School of Medicine
Page 18
Department of Surgery News
where MPHS students are going, from page 17
David Brauer, MD, MPHS
General Surgery Resident, Washington
University School of Medicine
Natalia Brito Rivera, MPHS
Medical Student, Washington
University School of Medicine
Scott Douglas, MPHS
Medical Student, Washington
University School of Medicine
Daniel Scott Feng, MD, MPHS
Medical Student, Washington
University School of Medicine —
Residency, Internal Medicine, Oregon
Health and Science University
Clinical Fellow in Internal Medicine,
Washington University of Medicine
Sophia Mengting Li, MD, MPHS
Medical Student, Washington
University School of Medicine--Residency, Internal Medicine, Oregon
Health and Science University
Timothy Nywening, MD, MPHS
General Surgery Resident, Washington
University School of Medicine
Charlene Ong, MD, MPHS--Neurocritical Care Fellowship at
Massachusetts General/Brigham and
Women’s/Harvard Medical School
Neurology Resident, Washington
University School of Medicine
Jesse Keller, MD, MPHS
Rajiv Parikh, MD, MPHS
Plastic Surgery Resident, Washington
University School of Medicine
Carlos Santos, MD, MPHS
Assistant Professor of Medicine, Rush
University Medical CenterShawgi Silver, MPHS
Medical Student, Washington
University School of Medicine
Emily Walling, MD, MPHS
Clinical Fellow in Pediatrics,
Washington University School of
Medicine — Assistant Professor at
University of Michigan, Pediatric
Hematology & Oncology. Quality
Improvement Division Lead, Cancer
Survivorship
Second Annual Patient
Safety and Clinical
Effectiveness Poster Session
Ninth Annual Anderson-Newton Transplant Lecturer Carlos Esquivel, MD, (second from left) joins
members of the Washington University transplant team: (l-r) William Chapman, MD, abdominal
transplant chief; Yumirle Turmelle, MD; Surendra Shenoy, MD, PhD, and Jason Yellen, MD, MBA.
Transplant surgeons host 9th Anderson-Newton Lecture
Carlos Esquivel, MD, PhD, the
Arnold and Barbara Silverman Professor
of Surgery and chief of the Division
of Abdominal Transplantation at
Stanford University School of Medicine,
delivered the 9th Annual AndersonNewton Lecture Sept. 13 in the Farrell
Learning & Teaching Center. He spoke
on “Improving Longevity of Transplant
Organs in Children” and also delivered
a lecture at the National Studies in
Pediatric Liver Transplantation (SPLIT)
Conference at St. Louis Children’s
Hospital.
The endowed lectureship honors
two pioneers in transplant surgery:
Charles B. Anderson, MD, and the late
William T. Newton, MD., who, among
other accomplishments, worked together to establish the pediatric kidney transplant program at St. Louis Children’s
Hospital in the 1970s.
The distinguished speakers chosen
for the lectureship further the knowledge of fellows and residents and provide faculty members an opportunity to
collaborate with international leaders in
transplantation.
Gerald Andriole, MD, right, vice chair
for patient safety, presents Marc
Moon, MD, chief of cardiac surgery,
the first place award for the poster
“Multidisciplinary Team Approach to
Improving Quality Ratings for Coronary
Artery Bypass Grafting.” The award
was for the Second Annual Patient
Safety and Clinical Effectiveness Poster
Session.
Dr. Moon and team members Jacob
Miller, MD, and Melita Ware, MSN,
ANP-BC, display the winning poster.