2020 Annual Report

The Department of Surgery has continued to flourish this past year.In fact, in spite of the many challenges COVID-19 presented in academic medicine, we continued to provide surgical care using best-practices to protect the health of our patients and care teams.The clinical care team transitioned to telehealth visits when possible.

Our faculty members with extensive expertise in public and global health assisted leadership with disaster management, infectious disease policies, and operationalizing the many aspects of the new COVID-19 world in the operating rooms, ICU, and clinics.Despite the many challenges the past few months have presented, members of the department have never wavered in their resolution to provide the best, most innovative care.

• Some particularly noteworthy departmental highlights from this past year include:•Clinical growth prior to COVID-19 was up significantly. Once elective surgeries resumed after being halted for one month, the department quickly rebounded to meet the needs of South Carolinians as you will see in the pages that follow.
• The research division had one of our most impressive years with all of our basic science investigators receiving extramural funding. Our investigators are nationally recognized in studying the causes and consequences of healthcare disparities in vulnerable patient populations with the goal of reducing the impact of race and socioeconomic status on health outcomes.The clean cell facility experienced significant growth. It has established strong extramural funding from the NIH and VA. In addition to sustaining the Islet Cell Transplant program, it has now started supporting the Blood and Marrow Transplant Program.
• We completed funding for five new endowed chairs - our philanthropic donors and colleagues coming together to invest in the recruitment and retention of the best surgical leaders in the nation.
• Our match was extremely successful. For general surgery, we matched 5 of 6 candidates within our top 10. All the integrated programs performed equally as well, matching their top number 1 or 2 candidate.
• A resident wellness program was established with significant improvement in addressing burnout.

During these unprecedented times, I am in awe of what we have achieved and extend my deepest appreciation to the dedicated faculty, fellows, residents, and staff who have contributed to our success.

Prabhakar Baliga, M.D. 

Professor and Chair
Department of Surgery
Medical University of South Carolina

The Department of Surgery has continued to flourish this past year.In fact, in spite of the many challenges COVID-19 presented in academic medicine, we continued to provide surgical care using best-practices to protect the health of our patients and care teams.

Expansive Growth

The division of Cardiothoracic Surgery experienced record growth this year, performing more cardiothoracic and thoracic surgeries than had ever been done before at MUSC. This year, prior to March 23 when Governor McMaster placed a COVID-19 moratorium on elective surgery, adult cardiac cases were up 32%, thoracic cases were up 12%. And, by the end of the fiscal year, the number of adult heart transplants nearly doubled from last year.

Nationally-renowned surgeon and a pioneer in minimally invasive and robotic heart surgery, Marc R. Katz, M.D.,MPH, joined the division nearly four years ago with the goal to expand the program by providing new, innovative,and collaborative procedures at MUSC. Within a year, the clinical staff grew to include three more cardiothoracic surgeons and the breadth of the program expanded to include an array of options:medical therapy, traditional open heart surgery, robotic surgery and transcatheter procedures.

He credits the strong foundation of the program, built by Dr. Fred Crawford, for creating the infrastructure that allowed for rapid progress in a short period of time. But it’s more than being an innovator and leader – it’s also being a collaborator with other leaders in the field. At MUSC, he’s teamed up with Dr. Daniel Steinberg,a renowned interventional cardiologist, and Dr. Ravi Veeraswamy, a national leader in vascular surgery. Together they are developing hybrid approaches at MUSC.

With growth comes new opportunities and two new adult cardiothoracic surgeons and one pediatric cardiac surgeon have been hired with two more leadership positions currently in the recruitment phase.The Pediatric Cardiac Surgery team, led by Scott Bradley, M.D., achieves excellent outcomes year after year. The latest U.S. News and World Report ranked the MUSC Children's Heart Network of South Carolina among the top 10 children’s heart programs in the country and the MUSC Children’s Heart Center has once again earned a distinguished three-star rating from The Society of Thoracic Surgeons (STS) for its patient care and outcomes in congenital heart surgery.

Outward Bound: New Outreach Clinics Established

Vascular surgery started a new outreach clinic with coverage at Beaufort Memorial Hospital, in addition to outreach at Murrells Inlet.Transplant surgery recruited an Outreach Director (Dr. Carlos Zayas) and placed APPs in Columbia, Florence and Greenville for the kidney transplant program. In addition, the liver transplant program started an outreach clinic this year at Columbia and Murrells Inlet.Thoracic surgery continues their outreach clinics in Beaufort and Murrells Inlet.Pediatric Surgery started an outreach clinic and performing ambulatory surgery at Beaufort Memorial Hospital.

Concierge Center for Hernia and Gallbladder Surgery & Abdominal Wall Reconstruction Center

New concierge services are offered for hernia and gallbladder surgery and for abdominal wall reconstruction with an assurance that patients will be seen within 48 hours. In addition, an ER to OR program has been established for patients presenting to the ER with an emergent situation.

Nationally-Accredited Adolescent Bariatric Surgery

Severe obesity affects 4.4 million children and adolescents in the U.S., yet surgery is underutilized with only about 2000 having surgery annually. According to Aaron Lesher, M.D. a pediatric surgeon leading MUSC’s adolescent bariatric program, adolescents can achieve significant weight loss - approximately a 30percent decrease in BMI – and experience tremendous improvements in health and quality of life. MUSC is the only adolescent bariatric surgery program in the Lowcountry and one of a few in the Southeastern U.S.,meeting the highest standards for patient safety and quality of care.

New Colorectal Division Reflects Expertise

The Colorectal Surgery Division, led by Virgilio George, M.D., was created to reflect its expert capacity to provide comprehensive care for benign and malignant diseases of the lower gastrointestinal tract. The division is nationally and internationally recognized for their pioneering efforts and extensive experience in minimally invasive surgery and state-of-the-art laparoscopic technologies for colorectal cancer, Crohn's Disease and other inflammatory bowel diseases. The surgeons specialize in robotic, laparoscopic, and transanal minimally invasive surgical techniques offering benefits including decreased post-operative pain, shorter post-operative recovery time, and less noticeable scarring.

New Interventions for Rib Fractures

Trauma surgeon Evert Eriksson, M.D. is utilizing anew rib fixation technology that enables rib stabilization in patients with flail chest, leading to better respiration and lower rates of ventilator usage. “We’re changing how we manage rib fractures,” says Eriksson. “We can now putin specially designed plates to fix the ribs and get these patients out of the hospital faster, decrease their pain and get them back to their lives sooner. Their ICU length of stay and their risk of pneumonia go down.”

New MUSC Burn Center Offers Comprehensive Treatment

Steven A. Kahn, M.D. joined the MUSC Department of Surgery as the Director of the Burn Program and Chief of Burn Surgery on July 1, 2019. As the newly appointed Burn Director, Kahn was charged with establishing the MUSC Burn Center to provide comprehensive care for adults and children in both the inpatient and outpatient settings, with the vision of establishing an American Burn Association (ABA) certified burn center.Prior to opening, most adults in South Carolina would have to travel to Georgia for burn care.The Burn Center recently hired an expert specialty team that includes Katie Hollowed, a leader in burn nursing care. Theburn team focuses on more than just survival after burn injury,striving for complete functional recovery and reintegration back into society.Patients treated at the Burn Center have access to more than 50 specialists and programs. Since it opened in May, the Burn Center has met the projections established for the 3 - 5 yearmark. It recently performed the first reported successful minimally invasive skin graft in the U.S.

Pediatric ECMO Program Ranks Among the Best in the U.S.

The Pediatric ECMO Program at the MUSC Shawn Jenkins Children’s Hospital received the platinum-level Award for Excellence in Life Support from the Extracorporeal Life Support Organization (ELSO), an international consortium of centers offering ECMO (extracorporeal membrane oxygenation) for support of failing organ systems in infants, children and adults. This award is the highest attainable level of achievement an ELSO Center of Excellence can receive and recognizes select programs worldwide that have demonstrated the highest level of performance, innovation and quality in the delivery of extracorporeal life support. 

Human Centered Design

The Department of Surgery created a Human Centered Design (HCD) Program to focus on utilizing design thinking principles to create innovative solutions to unmet medical needs at MUSC and beyond. HCD is a user centered approach to design where the process begins and ends with the impacted users at the center of the work.The HCD program currently consists of Joshua Kim, M.S., senior designer and three surgical residents who are leading medical innovation and entrepreneurship projects in a collaborative setting. The residents are innovators who are trained to identify unmet medical needs and then generate solutions to solve those needs.

Fostering Innovation Through Research

The Department of Surgery had a very productive year in both clinical and basic science research. The Faculty Mentoring Program is operational with established teams or “research pods.”Each division has clear visions for health services research and translational science or innovation arms and inter-institutional resources have been identified in many cases to help support these pods.

Message from  the Vice Chair of Research

Our research mission is to create a bedside to bench and back again culture of discovery and innovation at MUSC.

As I look back over the year, I am humbled at the way everyone in the department has taken this mission on as their own and created a palpable shift in our culture toward academic productivity and innovation while maintaining high clinical productivity and excellent patient care.

The research roadmap that the research council rolled out in 2018 highlighted several areas of growth opportunities in clinical research, human centered design and basic science collaborations.

Here is the impact since the roadmap's inception:

• Dave Taber, Pharm.D. and Heather Evans,M.D., MS have expanded clinical research within the department.
• The Human Centered Design program launched with an immediate impact: responding to the N-95 mask shortage with a 3D mask and cartridge system with printing plans. The mask and cartridge system received national and international attention, won the MUSC Innovator Award, and is currently on display in the South Carolina State Museum.
• Every Department of Surgery Ph.D. researcher is extramurally funded at the national level.
• Jean Marie Ruddy, M.D. has transformed resident research into a high-functioning enterprise creating a meaningful and productive experience for each resident in the program.

I invite you to read through the highlights in this report and know that this is just a few high points in a program that has a deep commitment in translating the latest developments, understanding and technology into improved surgical patient care.

Michael J. Yost, Ph.D., FAIMBE, FNAI

Professor of Surgery and Bioengineering
Vice Chair, Research
Department of Surgery

Improving Surgical Outcomes Through Disparities Research

Investigators within the Department of Surgery are nationally recognized in studying the causes and consequences of healthcare disparities in vulnerable patient populations; most notably African Americans.

Our researchers are conducting pioneering interventional studies with the goal of reducing the impact of race and socioeconomic status on health outcomes.

Within our clinical trials, we have a strong track record of enrolling patients that are underrepresented in research. Often these patient populations are missing in clinical trials and inclusion is of paramount importance to providing best clinical outcomes to all populations.We strive to include a highly diverse patient population in all of our clinical trials in transplantation. Many of our other clinical trials, including oncology, cardiac surgery and acute care surgery clinical trials, have similarly diverse populations.

Vascular Surgery Active in Clinical Trials

Vascular Surgery had an active FY20.

• Assessment of the GORE® EXCLUDER®Conformable AAA Endoprosthesis (CEXC Device) in theTreatment of Abdominal Aortic Aneurysms

Sponsor: Gore

• Aneurysm Treatment Using the Heli-FX™EndoAnchor System Global Registry (ANCHOR)

Sponsor: Medtronic

• A Randomized Double Blind Placebo Controlled Clinical Study to Assess Blood-Derived Autologous Angiogenic Cell Precursor Therapy in Patients with Critical Limb Ischemia

Sponsor: Hemostemix

• A Prospective, observational, global, multicenter,post-market registry of the Valiant Navion™Thoracic Stent Graft System (DISSECT-N)

Sponsor: Medtronic

Innovation and Entrepreneurship

The MUSC Department of Surgery is a leader in innovation and discovery that allows us to transform technology into improved surgical patient care. Our teams of physicians, scientists and engineers have developed new technologies and devices to advance surgical science.

International Partnerships

 

Pandorum Technologies, Pvt. Ltd. and the Transplant Research and ImmunoBiology Institute (TRII) along with the Center for Cellular Therapy (CCT) have partnered to push forward bioengineered tissues and cellular therapies in the treatment of diseases spanning corneal wound healing and COVID-related lung disease. These translational activities have utilized the strengths of MUSC's Department of Surgery bench-to-bedside culture.

The TRII along with the CCT at MUSC have been a ‘one stop shop’ for an aspiring start-up like Pandorum Technologies, operating in the field of tissue engineering and regenerative medicine, in the journey to clinical translation of its novel therapies developed to serve patients with unmet clinical needs.The team and the infrastructure at MUSC have been critical for the formulation optimization, cGMP grade material production, clinician study design, execution,and guidance through clinical regulatory approval maintaining global standards with ‘patients first’ in mind- driven by precise decision making and fast execution atan affordable cost.

We are looking forward to an exciting journey ahead.

Tuhin Bhowmick, Ph.D.
Co-founder, CEO
Pandorum Technologies Pvt. Ltd.

Research Funding

FY20 was an outstanding year for research with our portfolio reaching nearly $6 million in extramural funding, a 49% increase from the previous year.

Research Pods Create Energy and Synergy

SORIN

The Surgical Outcomes Research and Innovation Nucleus (SORIN) was formalized in 2019 and serves to foster the development, testing and implementation of innovative therapeutic and health services interventions aimed at improving outcomes in patients undergoing surgery at MUSC.

• SORIN has a diverse and active portfolio of clinical research endeavors, including nearly 50ongoing clinical trials across all surgical disciplines housed within the Department of Surgery. We actively follow nearly 600 patients enrolled in our trials. We are currently testing new drug therapies,devices and cellular-based interventions designed to improve and extend the lives of South Carolinians seeking surgical care within our institution.
• Embedded within SORIN and an arm of the Transplant Research and ImmunoBiology Institute(TRII) is the Transplant Clinical Research Core (TCRC). The main function of the TCRC is to facilitate the benchtop-to-bedside concept within organ transplantation by streamlining the process of innovative therapies moving from the laboratory to clinical trials and use within usual care.
• The TCRC currently oversees 15 clinical trials, of which nine are actively enrolling and six are in the follow-up phase. Within these 15 trials, we actively follow 262 transplant recipients.
• These clinical trials are testing novel therapies and innovations designed to improve outcomes in transplantation.

“We are assessing new antiviral therapies, new methods and therapies to diagnose, prevent and treat rejection and innovative methods to care for our patients using mobile health, remote monitoring and telehealth services,” said Dave Taber, Pharm.D.,who leads the surgical outcomes nucleus.

“This is particularly salient given the current COVID 19pandemic; allowing our patients to receive optimal care while safely residing in their homes and local communities. Our ultimate goal is to be at the forefront of the science of transplantation and improve the lives of transplant recipients.”

TRII

The Transplant Research and ImmunoBiology Institute(TRII) was formalized in 2019 and encompasses both clinical research in the Transplant Clinical Research Core(TCRC) and basic/translational research in both the LeePatterson Allen Transplant ImmunoBiology Laboratory(TIBL) and the ImmunoEngineering Core.

Additionally, the TRII is a comprehensive federally and privately funded institute that also engages the Center for Cellular Therapy and the Foundation for Research and Development for all aspects of transition of therapeutics to patient care.

The Patterson Barclay Memorial Foundation was instrumental in the development of the TIBL and formalization of the entire institute. Dr. Satish Nadig serves as the institute scientific director and Drs. David Taber, Carl Atkinson, and Michael Yost serve as directors to the TCRC, TIBL and the ImmunoEngineering Cores respectively. The TRII has partnered with various industries (both domestic and international) to move transplant-related therapeutics closer to the bedside.Recently, these industry ties have led to the TRII focusing on COVID-related therapeutics as well.

In 2019, the Patterson Allen Family members gifted $1.5M through the Patterson Barclay Memorial Foundation to the Transplant Research and ImmunoBiology Institute Fundwith the desire for community partners and patients to match their gift to reach the needed $3M goal. 

Lipo-ImmunoTech Receives STTR Grant

 

Lipo-ImmunoTech, LLC, a startup based in Charleston, South Carolina,recently received a Phase I Small Business Technology Transfer (STTR) grant of justover $224,000 to continue to develop its novel adoptive cell therapy technology for cancer. The startup is a joint venture involving Shikhar Mehrotra, Ph.D., an immunologist, and Besim Ogretmen,Ph.D., a sphingolipid expert.Lipo-ImmunoTech also executed an option agreement with the MUSC Foundation for Research Development, which gives it the rights to evaluate the technology further with an eye toward eventually licensing it for commercialization./

Wang Laboratory Active in Clinical Trials

 

The Wang Lab, led by Hongjun Wang, Ph.D. has had an active FY20.

• Type 1 diabetes (T1D) NIH R01 clinical trial: With the joint efforts from the Wang Laboratory, the clinical team led by Dr. Charlie Strange, the Center for Cellular Therapy, the OB/GYN Department, andthe strong support from the Department of Surgery, the multidisciplinary team has met their Year 1 patient enrollment goal in this trial.
• Chronic pancreatitis trial: They have enrolled 46 of the 48 chronic pancreatitis patients for their AAT trial and are now transitioning to the data analysis phase.
• Novel cell and gene therapy for the treatment of diabetes and chronic pancreatitis: Their first paper on this topic was accepted for publication in the journalStem Cell Translational Medicine (IF: 6.4).

Center for Cellular Therapy Expands Scope

The Center for Cellular Therapy (CCT) is an FDA registered cGMP level facility that meets the most rigorous standards in the aspect of processing of cells. FY20 saw a significant increase in the scope of work the CCT performs:

• In addition to sustaining the Islet Cell Transplant program, the CCT now supports the MUSC Blood and Marrow Transplant Program.
• A new clinical research infrastructure has now been established with clinical trial coordinators, IRBand analytic support.
• As part of MUSC's response to COVID, the CCT rapidly developed an in-house seroassayand facilitated the establishment of the COVID-19 antibody testing, with the capacity to perform thousands of tests a day.
• Additionally, this year the CCT has established strong extramural funding from the NIH and VA.

South Carolina Surgical Quality Collaborative

The South Carolina Surgical Quality Collaborative (SCSQC) is comprised of a group of hospital systems dedicated to improving the quality and value of general surgical care in South Carolina. SCSQC is led by a leadership team representing the South Carolina Hospital Association, Health Sciences South Carolina, MUSC, and Blue Cross Blue Shield of SC.Mark Lockett, M.D., vice chair of Veterans Affairs and chief of Surgery at the Ralph H. Johnson VA Hospital, serves as the Surgeon Lead for the Collaborative.

The initial study, published in the June 2018 American Surgeon, was a retrospective observational analysis that showed outcome rates for select general surgery procedures across a group of hospitals involved in the SCSQC. The study found SCSQC member facilities improved outcomes in 15 of 16 quality measures over the two-year period of the initiative.

“SCSQC provides a mechanism by which we can obtain better outcomes by providing actionable and believable data and facilitating collaboration between surgical leaders across the state,” said Dr. Lockett.

Spotlight On: Sharee Wright, M.D. COM Class of 2007; Surgical Residency Class of 2013

After completing a surgical residency at MUSC in2013 and a fellowship in Vascular and Endovascular Surgery in June 2015 at Temple University, Sharee Wright, M.D. is now a vascular surgeon with Surgical Associates of Richmond. Her path to a career in vascular surgery was a long - and often challenging - journey. Growing up in a single parent household in the quiet community of Bonneau, SC, surrounded by the Francis Marion Forest, her life was a good country life.

By her junior year in high school, her horizon expanded when she was accepted to The SC Governor's School, a two-year, in-residence program for academically advanced students in science and mathematics. There she met students from different backgrounds and cultures and developed a well rounded perspective that provided the foundation for her future in academic medicine. When the high school curriculum required a research project, she chose to research spinal cord injury at MUSC, and became interested in neurosurgery, which eventually led her down a path to vascular surgery.

Dr. Wright attended North Carolina State University. After graduating, she did not gain admission to medical school; instead she was offered a spot in the MUSC Post-Baccalaureate Reapplication Education Program (PREP), a program that engages promising underrepresented minorities (URM), rural and disadvantaged students in post-baccalaureate courses to prepare them for medical school.

After completing PREP, she was admitted to the MUSC College of Medicine. As a black student, she felt that she frequently needed to prove herself. She found her way to Dr. Myra Singleton, Associate Dean for Student Affairs in the College of Medicine. Dr. Singleton bonded with Wright and other URM students, inspiring them continue to work harder and be stronger. She embraced Singleton's advice and matched into MUSC's surgical residency.

New hurdles appeared.

When Dr. Wright entered her surgical training, there were only a handful of URM students and she was the only black woman. Residency is a time during which trainees develop an understanding of how they fit into their work environment and solidify plans for their career. This concept is even more significant for URM and women trainees.

“There were many times I questioned if the faculty thought I deserved to be in the program,” she said. “You need people who believe in you, who lift you up.”

She found those people when she rotated on vascular surgery and developed a special bond with vascular surgeons Jay Robison, M.D., Bruce Elliott, M.D. and Thomas Brothers, M.D.

Dr. Robison became her mentor. “He believed in me even when I didn’t believe in myself, and made me a stronger, more confident surgeon,” she said. “Even now, when I have a particularly challenging case, I call him and we talk about it.”

“Sharee had to be smart, strong, determined, dedicated and hard working to fulfill her historic accomplishment of being the first black woman to finish MUSC’s surgery residency program and go on to complete a 2-year fellowship in vascular surgery,” said Dr. Robison. “As administrative chief resident, she was respected and acknowledged by students as a very good teacher, with high - but fair - expectations.”

“I couldn’t be more proud of all she has accomplished,” he added.

She admires Dr. Brothers for his surgical skills. “He is the most technically-gifted surgeon I ever met,” Wright recalls. “I aspire to be like him, plus we have the same dry sense of humor.”

The feeling is mutual.

“Dr. Wright is one of my most favorite people in the whole world,” said Dr.Brothers. “Not only do I have enormous respect for her accomplishments, her personal drive, and her exemplary humanity, we share the same quirky, extremely dry sense of humor that very few people seem to fully appreciate in its nuanced hilarity.”

She faced financial barriers as well.

When Dr. Wright found out all residents needed to purchase loupes in PGY-2, she didn't know how she could ask her mother for the money. “She was a single mom and money was tight,” she said. The struggle stayed with her and during her final year, she and her fellow graduates asked that their graduation gift to be gifted towards loupes for the incoming PGY-2 class. Since then, the Curtis P. Artz MUSC Surgical Society has provided loupes to all second-year residents as away to ease the financial burden.

Wright continues to give back to improve resident education. She hopes her gifts to the MUSC Surgical Resident Research and Education Fund will make the next generation of surgical trainees’ journey a little easier.

“If it buys a new couch, or some extra food, or in any way makes for a better, more enjoyable training environment, then I’ve achieved my goal.”

She gives back to the College of Medicine and the Elliott - Robison Endowed Chair in Vascular Surgery as a way to thank both the institution and the people who propelled her to a successful career in vascular surgery.

“It's quite simple - MUSC made me the successful surgeon I am today,” she said. “And I’m very grateful.”

Patient education and advocacy are important in her career choice of vascular surgery. “African Americans have more severe vascular disease by the time they seek care,” she explained. “And, black patients are more likely to have chronic diseases, like diabetes, hypertension, congestive heart failure and end-stage renal disease. Yet, vascular surgery is comprised of only 10% black vascular surgeons, a disparity that creates a barrier to care for the African American population.” Research shows that patients’ comfort level is better if there is racial concordance with their doctor. African American patients feel more comfortable discussing health-related concerns and are more open to advice if the physician looks like them.

“By educating and advocating for my URM patients, I know I can improve their outcomes,” she said. “It is rewarding to know I am making a difference.”

Pictured with Dr. Sharee Wright, during her administrative chief year are (left to right)  Jeb Hallett, M.D., Jay Robison, M.D.,Tahlia Weis, M.D., the first woman integrated vascular surgery resident to graduate, Nitin Garg, M.D., visiting lecturer Joe Mills, M.D., and Tom Brothers, M.D.

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Many of our alumni, like Dr. Wright, value their MUSC education and want to give back to the institution and program that made them the successful surgeons they are today. There are many philanthropic opportunities and each gift makes an impact on our residents' daily lives. We hope that you will partner with us to advance education and help pave the path for the next generation of surgical leaders.

Please contact Vera Ford, Director of Development,at 843-792-1840 or fordva@musc.edu or visit musc.edu/surgery/give.

Education Mission and Message from the Chair

The mission of the Division of Education is to inspire, promote, and encourage current and future generations of surgeons with thoughtful professional development, tools for life-long learning,and skills for success as a surgical leader.

This past year's challenges that COVID-19 presented were met with innovation and commitment to continue our mission for surgical education. We celebrate our 2019 successes and look forward to this year’s new innovative programs.

Cynthia Talley, M.D., FACS, vice chair of Education

2019 - 2020 Successes

• Virtual curriculum during COVID
• Backyard graduations
• Virtual intern orientation
• Hybrid ATLS course taught to all interns
• Vascular complement increase
• Education research team established
• Increased resident involvement in orientation and student teaching

New & Upcoming Initiatives

• Simulation: Robotics Trainer arrived! Laparoscopic Trainers coming. New space at Ashely River Tower
• Student Program: New lockers, 3+3 clerkship(general/specialty) created, honors scoring relaxed
• Virtual Interviews and Grand Rounds
• Virtual Vascular Surgery Visiting Student Rotation
• Tidelands General Surgery Rotation
• Student/Resident Lounge at Main Hospital

Enhancing Student Success

Resident Wellness Adds Resiliency

 

The Department of Surgery is committed to improving the wellness of residents and faculty. Over the last year an initiative was started to evaluate the current level of burnout among residents and faculty and then determine what improvements can be made.

A survey of residents indicated improving personal time and food would contribute to making residency a little less stressful.In response, the residents received two personal days to use throughout the year, improvements to the medical student and resident work space, and a monthly lottery for a $100 food card.

Along with paying for a state medical license, purchasing loupes during the second PG year, and quarterly social gatherings, the department, with the support of philanthropic donors, is making strides to foster a culture of wellness.

The Next Era of Surgical Leaders

Our graduates from our residency and fellowship programs are well prepared to enter the next level of their surgical journey, with 100% of our general surgery graduates entering the fellowship program at the academic medical center of their choice.

Virtual Learning

The use of technology in surgical education is rapidly evolving and the education team is leading the way with virtual simulation training and learning opportunities that could prove to be a model for training programs.

Virtual Simulation: Vascular surgeon Mathew Wooster,M.D. developed a virtual simulator training for the vascular surgery integrated residents with the help of his colleague, Elizabeth Genovese, M.D., MS who joined the effort by formalizing the survey and investigating potential research publication opportunities. According to Wooster, this is a pilot trial of virtual endovascular simulation training utilizing a benchtop simulation model and one-on-one mentoring with a Zoom interface.“Using a telephone camera to display the benchtop model as “live virtual fluoroscopy” and the laptop camera to watch the trainee’s hands on the catheter, we can give real time feedback and instruction from an appropriate social distance,” said Wooster. The team will then compare metrics including subjective analysis of the usability of the model, the benefit of virtual mentoring, perceived improvement in skills and importance to training, number of catheter exchanges required and time to successful cannulation.

Virtual Rotation: Visiting Student Learning Opportunities(VSLO) programs were canceled this year due to travel restrictions. In an effort to preserve some of the benefits of the visiting rotations (exposure to different practice patterns and patient populations, introduction to varied patient care,networking with a wider audience of residents and faculty), Dr. Wooster and the Division of Vascular Surgery have developed a virtual visiting student elective.Leveraging videoconferencing technology already inplace, visiting students will be able to round daily with the resident team (including writing notes/orders on patients), livestream operations from the new state of the art hybrid operating room, evaluate patients in telehealth clinic, and present during the weekly education conference just as they would if they could visit MUSC in person. While several other programs around the country have created virtual visiting rotations, MUSC will be the first and only to have traversed the legal hurdles to allow integration into direct patient care.

Kredel-Springs Lecture

 

The department held a successful Virtual Kredel-Springs Lecture. Invited lecturer, Karl Y. Bilimoria, M.D., MS, John B. Murphy Professor of Surgery, Northwestern University Feinberg School of Medicine, gave an enlightening presentation entitled Fanning the Burnout Fire: How Our Misconceptions and Good Intentions Could Fail Tomorrow’s Surgeons.Dr. Bilimoria is a lead author of the first and second trial that evaluates work hours and wellness impacts on patient safety.

Resident Research Continues to Grow

 

During Surgery Research Recognition Day, visiting professor Gerard Doherty, M.D., Crowley Family Distinguished Chair in the Department of Surgery at Brigham and Women’s Hospital, gave a well received Eric R. Frykberg, M.D. Lecture entitled Surgery and also served as guest judge. Steven Kahn, M.D., chief of Burn Surgery and Shikhar Mehrotra, Ph.D., Cecilia and Vincent Peng Endowed Chair in Melanoma and Cutaneous Oncology, served as MUSC judges.

This year, Surgery Research Recognition Day had a record number of abstract submissions (26).

Congratulations to our winners (pictured from left to right with Jean Marie Ruddy, M.D. associate program director for Resident Research): Kunal Patel, M.D., Ph.D. achieved first place in Basic Science Podium and Poster Competitions. Ryan King M.D. won the Clinical Science Podium Competition and Shelby Allen M.D. won the Clinical Science Poster Competition.

Our commitment to provide the highest level of compassionate patient care, best–in–class training for the next generation of surgical leaders, and cutting-edge clinical, basic science and translational research are Changing What's Possible for our patients.

Here are some quick facts about the department: 

FY2020 Clinical Activity: 

• 14,639 New Patients
• 10, 237 Surgical Cases
• 57,729 Outpatient Encounters

FY2020 Research Activity:

• 38 New Awards
• $6 Million Extramural Funding
• 50 Clinical Trials, 39 Federal Awards, 34 Funded Faculty

FY2020 Faculty, Staff,and Trainees:

• 77 Faculty
• 64 Residents, 8 Fellows,15 Post Docs
• 30 Research Staff, 47 Management and Support Staff, 31 APPs

FY2020  Philanthropic Gifts:

• $160,000 Philanthropic contributions in support of Surgical Resident Education and Research
• $2.1 Million Gifts and Pledges
• 5 New Endowed Chairs Created

Honoring John M. Kraz, M.D. 

The Department of Surgery recognized Dr. John Kratz' many contributions to MUSC, the Department of Surgery and the field of Cardiothoracic Surgery with the naming of an endowed chair in his honor: The John M. Kratz, M.D. Endowed Chair in Cardiac Surgery and Research.

Awards and Distinctions

• Andrea Abbott, M.D., MSCR named State Chair to the Commission on Cancer Liaison Program for the American College of Surgeons; named the MUSC Faculty Council Chair-Elect for 2020/2021.
• Milton Armstrong, M.D. appointed Director to the American Board of Plastic Surgery.
• Scott Bradley, M.D. named Robert M. Sade M.D. Endowed Chair in Pediatric Cardiac Surgery.
• T. Karl Byrne, M.D. named to MUSC chapter of the National Academy of Inventors.
• E. Ramsay Camp, M.D., MSCR elected a Fellow in the American Surgical Association.

• Denise Carneiro-Pla, M.D. nominated by the American College of Radiology (ACR) Committee on Appropriateness Criteria (AC) to represent the American Thyroid Association as an expert member to participate on the ACR AC Parathyroid Adenoma Committee.

• Chadrick Denlinger, M.D. named the Flora McLeod Edwards Distinguished Endowed Chair in Cancer Research.
• Nancy DeMore, M.D. appointed to the Society of Surgical Oncology Program Committee, received the HCC Senior Clinical Scholars Award, elected to the Board of Directors of the Make-A-Wish Foundation, SC Chapter, and elected to serve as a Senator for the 2019-2021 term on the MUSC Faculty Senate.
• Heather Evans, M.D., MS invited to join the Annals of Surgery Editorial Board; appointed to serve as a member of the Surviving Sepsis Campaign Steering Committee for the Society of Critical Care Medicine.
• Evert Eriksson, M.D. awarded the 2020 MUSC Foundation Outstanding Clinician Award; named Chair of the Lowcountry Regional Trauma Advisory Council.n Elizabeth Genovese, M.D., MS appointed as the Arterial Research Advisory Committee Chair of the Carolinas Vascular Quality Group.
• Stephen Fann, M.D. President of the South Carolina Chapter of the American College of Surgeons. 
• Ashley Hink, M.D., MPH accepted to the 2020 EAST INVEST-C Research Hackathon workshop.
• Steve Kahn, M.D. named Co-Chair of the Lowcountry Regional Trauma Advisory Council.
• Marc R. Katz, M.D., MPH named the Fred A. Crawford Jr. MD Endowed Chair in Cardiothoracic Surgery.n Laura Hollinger, M.D. elected to serve as Senator for the 2019-2021 term on the MUSC Faculty Senate.
• Aaron Lesher, M.D. MSCR named IDeA Fellow Idea Fellow, Pediatric Critical Care and Trauma Scientist Development Program (PCCTSDP), Eunice Kennedy Shriver National Institute of Child Health and Human Development.
• Mark Lockett, M.D. received the 2019 Outstanding Federal Manager of the Year Award from the Federal Executive Association of the Greater Charleston Area.
• Lucian Lozonschi, M.D. named the John M. Kratz, M.D. Endowed Chair in Cardiac Surgery and Research.
• Shikhar Mehrotra, Ph.D. named Co-Leader of Hollings Cancer Center; appointed to the Cecilia and Vincent Peng Endowed Chair in Melanoma and Cutaneous Oncology.
• Katherine Morgan, M.D. confirmed by the American College of Surgeons as the SESC Representative to the ACS Advisory Council for General Surgery.
• Satish Nadig M.D., Ph.D. named to MUSC chapter of the National Academy of Inventors; named the P.K. Baliga, M.D. Endowed Chair in Solid Organ Transplantation.
• E. Douglas Norcross, M.D. awarded the 2020 MUSC Foundation Distinguished Faculty Service Award.
• Mark Rubinstein, Ph.D. named to MUSC chapter of the National Academy of Inventors.
• Jean Marie Ruddy, M.D. selected to participate in the inaugural cohort of the Leadership Development Program, a collaborative effort between the Society for Vascular Surgery, Society for Clinical Vascular Surgery, and the Vascular and Endovascular Surgery Society.
• Robert M. Sade, M.D. recognized as an Expert Institute World Expert in Professional Ethics.
• Christian Streck, M.D. appointed to the national ACS Committee on Trauma; named as the APSA Trauma Committee Vice Chair and member of the Southern Surgical Association.
• David Taber, Pharm.D., MS, BCPS awarded the 2020 ACCP Clinical Practice Award by the Board of Regents and members of the American College of Clinical Pharmacy.
• Cynthia Talley, M.D. selected to the ACS Certificate in Applied Surgical Education Leadership program; named to the Board of Directors for the Eastern Association for the Surgery of Trauma; appointed Chair of the Member Service Committee of the Young Fellows Association of the ACS.

Journey of a Lifetime Leads to $1M Planned Gift

Vinny Martucci and Arlene Petty have traveled around the world – seven continents and 48 states, to be exact – experiencing the wonder, discoveries, and challenges touring the world offers. Of all their travels, perhaps their longest, most challenging – and most rewarding – was Vinny’s journey through kidney transplantation.

Professionally, Vinny was a communications engineer and Arlene owned her own professional liability insurance business. When not working, the couple spent time traveling, golfing, and kayaking. It was in 2001 when Vinny was 58, that he learned he had polycystic kidney disease (PKD), an inherited disorder in which clusters of cysts develop primarily within the kidneys, causing them to enlarge and lose function over time. The couple soon learned that eventually Vinny would need a kidney transplant or face dialysis, but at the time, he was in excellent health.

While enjoying retirement at their homes in Mahwah, NJ, Bluffton, SC and Lake Placid, NY, they realized by 2014 Vinny’s PKD was taking its toll and it was time to address having a transplant. It was pre-planned for that to be at St. Barnabas Hospital, Livingston New Jersey using Vinny’s sister’s ‘perfect match’ kidney. During the medical review, it was discovered Vinny had aggressive and invasive prostate cancer. While radiation was the recommended treatment, they knew radiation could compromise abdominal surgery which Vinny would need for the now elusive transplantation and so they sought surgical options. They were referred to MUSC Health in Charleston where Vinny had a perineal prostatectomy to avoid an incision in the abdominal wall. The surgery was a success.

Vinny was now 72 and a cancer survivor. But his kidneys were failing. His creatine levels were climbing, he was losing strength and it was becoming obvious he would soon need a transplant or go on dialysis.

He had some hurdles to get through since once a person has cancer and is reaching an advanced age, transplantation is not always considered an option. Most transplant centers require at least a two-year waiting period after a cancer diagnosis, and by then Vinny would have been 74 and less likely to be considered for transplantation due to age. In fact, things were looking grim and they decided to have a fistula put in just in case he needed to go on dialysis. 

Based on Vinny’s overall good health and active lifestyle, Dr. Thomas Keane, his urologic oncologist, advocated for Vinny to be considered for transplantation with the MUSC transplant team, a national leader in solid organ transplantation. The transplant team agreed Vinny was indeed a good candidate.

Still the couple didn’t get their hopes up – they learned that in light of Vinny’s cancer, his sister’s kidney would no longer be considered for Vinny’s transplant because she, too, had a prior cancer diagnosis. They needed a living donor. Many family and friends offered to be a donor, but for a variety of health-related reasons, no one was able to donate. “It was like being on a roller coaster,” said Arlene. “We didn’t know what to do so I put out an email to all of our friends.”

She wrote: I never thought I would have to ask, but I can’t give Vinny a kidney, because I’m a breast cancer survivor. I can’t help him, but I can ask for you to consider helping him. We have run out of options.

“Is anyone willing to give Vinny a kidney?” she asked.

Within fifteen minutes from hitting “send,” Chris Bidelspach, an acquaintance in Lake Placid, responded that he would donate his kidney.

“Chris is a remarkable person,” said Vinny. “We couldn’t believe he was willing to give me his kidney – he was literally willing to give me the gift of life.” Vinny and Arlene had known Chris and his wife, Becky, for about two years, but more as casual friends.

“They are very special people, taking emotionally challenging foster children into their homes,” explained Vinny.  “Plus, he gives me a kidney. I mean, it's just amazing that there could be people in the world that are that unselfish. People who just give away their life for you, even though they don't know you that well.”

As Chris explains it, it never crossed his mind that he wouldn’t do it. “I think for me I never saw it as a big deal. It always felt to me like when I donate blood. It's something I can do and doesn't take anything away from my quality of life. It doesn't hurt me, doesn't cost me anything. But I can help somebody.”

Becky recalls the day she read the email as a regular day in their home. They had just received a request to take in a new child in need of foster care.  Chris was putting together a bed for the child upstairs when Becky called up to him. “Chris, you know Vinny and Arlene, who we’ve met a few times?” She asked. “Well, Arlene just sent an email saying Vinny needs a kidney.”

“Tell them I’ll donate,” Chris said.

“No honey, he doesn’t need blood, he needs a kidney,” she said. To which he replied, “I’ll still do it.”

Chris and Becky equate the decision to similar decisions when asked to take in a child. Take Sarah, for instance. “She is medically fragile and was dropped off to us at 10 o'clock at night. And we had never dealt with special needs before so it was kind of a challenge in that we weren't sure that we could do it, but it's one of those things like Vinny -- You know, we just jumped and said ‘yes.’ And it worked out.” Five years later, the family is planning on adopting Sarah as she is ready to age out of the foster care system and cannot care for herself. One of the basic tenets the family lives by is taking care of their community and the people who live in their community.

And, so within fifteen minutes, the email was sent back to Vinny that Chris would be a donor.

Overjoyed, Arlene and Vinny set about making plans for Chris to be evaluated at MUSC, covering all expenses. Arlene and Chris flew up and down from Lake Placid to Charleston a couple of times that spring and summer for testing.

The good news was Chris was a match…but there was a catch.

Chris had high blood pressure. After a few months on blood pressure medicine, his health improved and the surgery was scheduled in October of 2015. Nine months from his prostate surgery, Vinny was going to get his new kidney!

Vinny and Arlene made the arrangements for Chris and his family to travel to Charleston. They covered the cost for Becky and one of their sons to be in Charleston for the surgery, paid for a week’s overnight care for their foster children, covered Chris’s wages at work through his eight weeks of disability, and took care of hotels, meals, and every incidental. They gladly did their best to make it as comfortable for the family as possible.

After the successful transplant, Vinny was back on the road to good health.

“Vinny represents one of our highest risk patients and the success is dependent on an entire team," said Vinny's transplant surgeon Prabhakar Baliga, M.D. "I am grateful and proud that we have such a great team that enabled us to facilitate a successful transplant outcome for the Martucci family.”

With all great journeys, new discoveries are made.

Vinny and Arlene realized how fortunate they were to be able to provide these resources to Chris and how others might not have the same opportunities. After Vinny recuperated, the couple started volunteering with the non-profit Staying Connected near their home in Bluffton, providing rides to medical appointments and grocery stores to those in need. It was there that they met a woman waiting for a transplant and on dialysis. They watched her decline and saw the financial barriers she faced to getting well. Vinny and Arlene realized again how lucky they were and that they needed to give back in some meaningful way.

The couple learned that South Carolinians suffer a higher rate of end-stage renal disease than in other areas of the country, which disproportionately affects the African American population. Sixty-six percent of MUSC’s kidney transplant recipients are African American, with nearly two-thirds of the transplant recipients having a household income of less than $30,000 per year. They wondered how patients with low incomes could possibly manage all the expenses they had easily managed.

“Having considerable financial challenges for both patient and donor only makes an already stressful situation extraordinarily more difficult,” said Arlene. “We realized we could help remove these financial barriers to transplantation by providing annual contributions to the MUSC Living Donor Institute (LDI) Patient Support Fund.”  Through their contributions, along with other grateful patients and donors, the LDI Patient Support Fund is able to cover lodging, lost wages, airfare, travel and cover household bills for qualifying living donors.

This year, Vinny and Arlene made a bequest of $1M from their estate to the MUSC Living Donor Institute. The gift will serve as a match to the Allen Family’s $1.5M Patterson Barclay Memorial Foundation gift in memory of their brother, Fred Allen, who also suffered with PKD. “It seemed the perfect way to give back in a personal way, to ease some of the burden,” said Arlene.

Vinny and Arlene are back in Lake Placid. Their bond with Chris and Becky has grown so strong they think of themselves as one family. Most recently they got together during their annual golf outing on Labor Day weekend.

Vinny and Arlene’s bond with MUSC continues, as well.

This spring, when Vinny's prostate cancer recurred five years after his prostatectomy, the couple, who mostly reside in Lake Placid, chose the University of Vermont (UVM) for his treatment. “There is medication and radiation in front of us, but it is a very exacting and successful protocol,” explained Arlene. “We are very hopeful.”

When Baliga heard Vinny was at UVM for treatment, he called the hospital to make sure the care team knew to protect his kidney during treatments. “Dr. Baliga really cares personally about Vinny,” said Arlene. “That means the world to us.”

"Getting to know the family has been a blessing," said Baliga. "They are a family that believes in paying it forward and supporting the advancement of the field so others may share the benefits of transplant. They belong to the category of those who give selflessly and have my highest respect!"

Changing What's Possible for Transplantation through Living Donation

Living donation is a profound way to help a loved one—or even a stranger—in need. That said, someone who wants to give the gift of life often has financial obstacles. Perhaps they can’t afford to be out of work for weeks without pay, or they can’t cover childcare expenses during the recovery process.

The Living Donor Institute Patient Support Fund provides patients and donors then needed resources and staff support. With contributions from generous donors and grateful patients like Vinny and Arlene, we are changing what's possible for many patients and donors who otherwise would not have been able to have their transplant due to financial obstacles.

Learn more about supporting the Living Donor Institute by visiting giving.musc.edu/living-donor-institute. 

Including the MUSC Department of Surgery in your estate plans, as the Martucci/Petty family has, is an incredible way to leave a legacy. To learn more or to let us know if you've already included us in your future plans, please contact Vera Ford at fordva@musc.edu or 843-792-1840, or visit muscgiving.org for more information.