Advances | Tampa General Hospital | West Coast Fall 2023

ADVANCES

THE ACADEMIC & RESEARCH DIFFERENCE

THE FUTURE OF SURGERY

TGH ACHIEVES 10,000 ROBOTIC PROCEDURES

CONTENTS

Departments FORWARD

08 A-PLUS CARE AND MORE Q&A with John Couris, president and CEO of Tampa General Hospital

10 GAME THEORY

Dr. Charles Lockwood, dean of the USF Health Morsani College of Medicine, discusses the benefits of academic medicine

12 FLYING FAST

TGH’s Aeromed Regional Transport Program can bring emergency services to the remotest locations

14 THANKS FOR SHARING

Patients can contribute to the advancement of medical knowledge by donating specimens to the new TGH-USF Health Precision Medicine Biorepository

16 READY AND WILLING

The story behind the 3D-printed swab that helped millions during the pandemic

18 MEDICAL MILESTONES

As it approaches 50 years of service, the TGH Transplant Institute celebrates an important achievement

WELL-BEING

59 BUILDING A HEALTHY PLATE

Expert insight into top sources of protein, fat, and carbohydrates

64 STATE OF TECHNOLOGY

Revolutionize day-to-day care with six tools from Florida companies

Features

20 THE FUTURE OF SURGERY

TGH surgeons hit 10,000 robotassisted surgeries and reflect upon how these machines have changed the landscape

26 THE PROMISE OF TOMORROW

The latest news from the Tampa Medical and Research District

30 TURNING THE TIDES

The Bone Marrow Transplant and Cell Therapies Unit is transforming treatment for those with hematologic cancers

34 PRIME THE PUMP

Why cardiothoracic surgeons are embracing the new Impella 5.5 device to save lives

38 ADVANCING INNOVATION IN WOMEN’S HEALTH

TGH is penning a new chapter for those suffering from endometriosis

42 SHARPENING PRECISION

How 3D printing is improving the outcomes of complex cases

46 CONSTRUCTING A NEW LIFE

The miracles of facial and plastic reconstructive surgery

50 NEXT-GENERATION PROSTATE TREATMENT

The Barrigel injectable medical device is reducing risks associated with radiation therapy for prostate cancer

54 TGH GIVES BACK

A look at the important work of the TGH Foundation

MEET OUR LEADERSHIP

To learn more about our institutes, visit TGH.org

Ambulatory Services

Daron Diecidue, MD

Chief of TGH Ambulatory Services

Cancer Institute

Eduardo Sotomayor, MD

Director of the TGH Cancer Institute

Abe Schwarzberg, MD

Chief of the TGH Cancer Institute

Richard Tuli, MD

Director of Radiation Oncology

Digestive Diseases Institute

Christopher DuCoin, MD, MPH, FACS

Chief of the TGH Digestive Diseases Institute, Surgery

Ear, Nose, & Throat Institute

Tapan Padhya, MD

Chief of the TGH Ear, Nose & Throat Institute

Enterprise Imaging

Krishna Nallamshetty, MD

Chief of TGH Imaging, Diagnostic Radiology

Bruce Zwiebel, MD

Chief of TGH Imaging, Interventional Radiology

TGH-USF Health Office of Clinical Research

Clifton Gooch, MD

Co-VP of Clinical & Translational Research

Abe Schwarzberg, MD

Co-VP of Clinical & Translational Research

Global Emerging Diseases Institute

John Sinnott, MD

Chief of the TGH Global Emerging Diseases Institute

Heart & Vascular Institute

Guilherme Oliveira, MD, MBA

VP & Chief of the TGH Heart & Vascular Institute

Neuroscience Institute

Clifton Gooch, MD

Chief of the TGH Neuroscience Institute, Neurology

Harry van Loveren, MD

Chief of the TGH Neuroscience Institute, Neurosurgery

Orthopaedic Institute

Roy Sanders, MD

Chief of the TGH Orthopaedic Institute

Transplant Institute

Kiran Dhanireddy, MD, FACS

VP & Chief of the TGH Transplant Institute

Urology Institute

Raviender Bukkapatnam, MD

Chief of the TGH Urology Institute

Rafael Carrion, MD

Chief of the TGH Urology Institute

Women’s Institute

Judette Louis, MD, MPH

Chief of the TGH Women’s Institute

Children’s Hospital

Patricia Emmanuel, MD

Chief of the TGH Children’s Hospital

Phillip S. Dingle, Chairman of the Board

Marylou Y. Bailey

Jeffrey W. Bak

Thomas L. Bernasek, M.D.

1 Tampa General Circle Tampa, FL 33606

813.844.7000 • TGH.org

BOARD OF DIRECTORS

Kimberly A. Bruce

Raviender Bukkapatnam, M.D.

Kenneth A. Burdick

Blake J. Casper

Gregory J. Celestan

Drew A. Graham

Oscar J. Horton

Patricia Jurinski

Les Muma

T. Corey Neil

EXECUTIVE LEADERSHIP TEAM

Scott Arnold, Executive Vice President & Chief Information Officer

Murray L. Shames, M.D., Chief of Staff

John T. Touchton, Jr., Immediate Past Chairman

Bruce Zwiebel, M.D.

Stacey Brandt, Executive Vice President & Chief Strategy and Marketing Officer

Peter Chang, M.D., Vice President, Healthcare Design

Kelly Cullen, Executive Vice President & Chief Operating Officer

Jennifer Crabtree, Chief of Staff, Office of President & CEO

Robin DeLaVergne, Senior Vice President, External Affairs

Peggy Duggan, M.D., Executive Vice President & Chief Medical Officer

Rachel Feinman, Vice President of Innovation & Managing Director, TGH Innoventures

Qualenta Kivett, Executive Vice President, Chief People & Talent Officer

Jim Kennedy, General Counsel

Frann M. Leppla, Senior Vice President & Chief Philanthropy Officer, TGH Foundation

Mark Moseley, M.D., MHA, CPE, President, USF Tampa General Physicians

Mark Runyon, Executive Vice President & Chief Financial Officer

Abraham Schwarzberg, M.D., Executive Vice President, Network Development; Chief of TGH Cancer Institute; Vice President of Clinical & Translational Research, TGH-USF Health Office of Clinical Research

Steve Short, Senior Vice President, Tampa General Provider Network Operations

Adam Smith, Executive Vice President & Chief Ambulatory Care Officer

SHARED PURPOSE

We heal. We teach. We innovate. Care for everyone. Every day.

VISION

We will become the safest and most innovative academic health system in America.

John Couris, President and CEO, Tampa General Hospital

MORE BREAKTHROUGHS, BETTER OUTCOMES FUELED BY ACADEMIC MEDICINE

TAMPA GENERAL HOSPITAL AND USF HEALTH MORSANI COLLEGE OF MEDICINE DRIVE INNOVATION. EVERY DAY.

For more than 50 years, our team of world-renowned researchers, doctors and pioneers in the medical field has partnered to deliver game-changing medicine. Through our focus on research, innovative treatments and clinical trials, we provide patients with lifesaving medical breakthroughs and groundbreaking care. That’s how we define medicine.

Florida’s Leading Academic Health System For Over 50 Years

THE ACADEMIC DIFFERENCE

Publisher Terry Duffy

Director of Sales Deidre Wade

Associate Publisher Dina Turner

Editorial Director Daphne Nikolopoulos

Editor Mary Murray

Creative Director Olga M. Gustine

Senior Art Director Ashley Meyer

CONTRIBUTING EDITORS

Stacey Brandt, Jennifer McVan, Laurie Slater, Tom Zebold

CONTRIBUTING WRITERS

Chris Curtland, Judy DiEdwardo, Karen Feldman, Sandra Gurvis, Yvette C. Hammett, Kelley Marcellus, K.S. Meyer, Michele Meyer, Dave Scheiber, Liza Grant Smith, Karina Wensjoe

CONTRIBUTING PHOTOGRAPHERS

Cara DeHart Lewis, Emily Panakos, Jerry Rabinowitz, Daniel Wallace

ADVERTISING

Publisher, Naples Meegan Wyatt

Account Managers Kathleen Beuttel, Kathy Breen, Tanya Lorigan

Advertising Services Coordinator Elizabeth Hackney

Marketing Manager Rebecca Desir

PRODUCTION

Production Director Selene M. Ceballo

Production Manager Lourdes Linares

Digital Pre-Press Specialist George Davis

Advertising Design Coordinators Anaely J. Perez Vargas, Jeffrey Rey

Production Coordinator Ileana Caban

Digital Marketing Manager Tyler Sansone

OPER ATIONS

Chief Operating Officer Todd Schmidt

Office Manager Tanya Gomez

Accounts Receivable Specialist Ana Coronel

Distribution Manager Judy Heflin

Logistics Manager Omar Morales

Circulation Manager Marjorie Leiva

Circulation Assistant Britney Stinson

Circulation Promotions Manager David Supple

IT Manager Keith Gonzalez

In Memoriam Ronald J. Woods (1935-2013)

HOUR

CEO Stefan Wanczyk

President John Balardo

AA-PLUS CARE AND MORE

TGH’s president and CEO discusses the importance of academic medicine

BY MARY MURRAY

Tampa General Hospital has been affiliated with the University of South Florida’s College of Medicine since the school’s inception in the early 1970s. Today TGH and USF Health are the leading academic health system on Florida’s West Coast. Together they are leading the way in patient care, education, and research with the collective goal to heal, teach, and innovate. Here, John Couris, president and CEO of TGH, shares insight into this partnership and important news from the TGH Cancer Institute.

How has Tampa General Hospital’s longtime partnership with the University of South Florida’s College of Medicine shaped the overall culture of innovation at TGH?

For nearly half a century, Tampa General and USF have experienced a dynamic affiliation, beginning with the College of Medicine up to today, as partners in one of the state’s largest and most accomplished academic health systems, the USF Tampa General Physicians medical group, and the joint TGH-USF Health Office of Research. Over the years, the partnership has continued to evolve, allowing both organizations to advance more quickly on a variety of strategic goals.

A hallmark of this partnership is its role in strengthening our path to discovery and innovation. Through our relationship with USF, we have been able to provide our patients with access to new therapies and treatments. It has allowed us to infuse the hospital with cutting-edge technologies and procedures, and we have been able to collaborate on joint clinical trials and translational studies that take discoveries from the laboratory bench to the patient bedside. All of this means that together we can bring the latest and best world-class care to the residents of this community and beyond.

The USF Tampa General Physicians organization officially launched in January 2022. Can you describe this organization and how it

has enhanced the relationship between TGH and USF?

As one of the largest academic medical groups in the state of Florida, USF Tampa General Physicians represents the best medical care available in Tampa and beyond, providing access to high-quality, world-class, academic medical care.

USF Tampa General Physicians is a jointly created academic medical group between USF Health and Tampa General Hospital; it represents a comprehensive and sustainable affiliation that formally joins shared clinical, research, and teaching efforts from both organizations. Specifically, the 1,400plus clinical personnel of USF Tampa General Physicians provide practice infrastructure, clinical management, and related operational and administrative support services to physicians employed by Tampa General Medical Group and USF Health and offer purchased services and management services to private practice physicians on staff at Tampa General Hospital.

USF Tampa General Physicians represents an elevation in Tampa General and USF Health’s already established and dynamic alliance and furthers our collaboration on key priorities that allow us to share greater resources. In addition, the medical group elevates the reputation of both organizations as the collective force behind the region’s preeminent academic health system, attracting both additional research dollars and academic physicians from across the country to the Tampa Medical and Research District.

If a patient has a choice of where to seek medical care, why should they prioritize an institution with an academic affiliation, as TGH has with USF?

Patients in our community certainly have choices on where to obtain care. However, academic health systems like Tampa General, in partnership with USF, provide cutting-edge, specialized care for the most complex and challenging illnesses

and conditions, as well as offer patients access to innovative research and clinical trials and train the next generation of health care professionals.

Here at Tampa General, with physicians, nurses, researchers, and medical educators working together, education, research, and clinical care are combined. It is the best possible clinical care that uses cutting-edge technologies, resources, and therapies and provides access to medical breakthroughs other community hospitals may not have available.

The TGH Cancer Institute was established in 2021 and last year received accreditation from the Commission on Cancer. What should this accreditation signal to patients?

TGH Cancer Institute is among the top 10 percent of hospitals in the nation for cancer care. With this accreditation, TGH’s Cancer Institute is recognized for meeting 34 quality care standards. It signals to patients that we take a multidisciplinary approach to deliver high-quality, patient-centered cancer care, and demonstrate a commitment to improving patient outcomes and quality of life for all cancer patients. Less than a quarter of hospitals nationwide meet the Commission on Cancer Accreditation (CoC) standards.

The CoC Accreditation is also a testament to the unparalleled expertise and quality of care we offer our patients and community across the continuum of cancer care services. TGH Cancer Institute is home to world-renowned cancer surgeons who have decades of surgical experience and are active in cutting-edge clinical trials. This gives our patients access to state-of-the-art diagnostic tools and therapies not available at other cancer hospitals.

The Cancer Institute aims to personalize care plans to treat the whole person and not just the condition. Can you describe this approach and how the patient navigation

program supports it?

The TGH Cancer Institute partners with patients to manage all aspects of their cancer care journey, from diagnosis to survivorship. This collaborative approach to cancer care ensures patients feel supported through what can often be an overwhelming process and offers comfort in knowing that there is continuity in their care at every step.

We are proud of the personalized care plans we provide for patients through our patient navigation program, which has helped us establish relationships with local oncologists, radiologists, and other physicians in the community to manage our patients’ care together. We also continue to invest in growing our services, as well as our physical footprint, to better support and reach more patients.

WE CAN BRING THE LATEST AND BEST WORLD-CLASS CARE TO THE RESIDENTS OF THIS COMMUNITY AND BEYOND.”

AGAME THEORY

USF Health and TGH’s symbiotic relationship is a net win for both institutions

BY MARY MURRAY

When Dr. Charles Lockwood chose to leave his post as dean at The Ohio State University College of Medicine to take the helm at the USF Health Morsani College of Medicine at the University of South Florida, Tampa Bay’s warm climate definitely played a factor in his decision. He’ll be the first to admit that. What appealed even more to the seasoned academic health leader and highrisk obstetrician, however, was the opportunity to join an institution that had an existing relationship with a top-tier hospital and foster it in such a way as to uplift the standing of both organizations.

Since 2014—when Lockwood joined USF Health as its senior vice president (now executive vice president) and dean of the Morsani College of Medicine, and Tampa General Hospital as its executive vice president and chief academic officer—the USF Health Morsani College of Medicine has risen in U.S. News & World Report rankings for research from 80 out of 124 medical schools to 46 out of 155. In that same time, USF Health has gone from about $138 million in annual research funding to more than $214 million, and TGH has grown from having three programs ranked by USN&WR in the top 50 nationally to seven. These achievements reflect Lockwood’s three-pronged focus on education, research, and cutting-edge patient care.

Here, he offers more insight into the nature of academic medicine and how it benefits both students and practitioners.

How have you seen the relationship between the USF Health Morsani College of Medicine and Tampa General Hospital evolve since you’ve been dean?

There was always incredible pride among our faculty working at Tampa General. They loved both their medical school and their hospital, but they did not see them as one seamless academic health system. Over the course of the last eight-and-a-half years, we have integrated so fully that you can’t think of one institution without thinking of the other. With that, Tampa General Hospital has fully embraced those three missions as well. It would now be unthinkable for Tampa General not to be focused like a laser beam on medical student teaching, resident training, fellowship training, clinical trials, and world-class clinical programs. So, in that way, the integration of the medical school and hospital is a great example of game theory. If you remember the movie A Beautiful Mind , a Nash Equilibrium is achieved when the outcomes for both players are optimized by working together. That is exactly what we’ve achieved. Both institutions have risen rapidly in national rankings because of that partnership. We’re also working together to elevate Tampa Bay as a national health hub with the ongoing development of downtown Tampa’s Medical and Research District.

WE ARE TRAINING THE NAVY SEALS OF MEDICAL STUDENTS. THEY ARE

What do you feel students gain from learning from the practicing physicians at TGH and being able to interact with the hospital’s patient population?

There is nothing like seeing a patient. Almost 90 percent of my clinical skills were derived at the bedside, on Labor and Delivery, and in the operating room. Seeing a complex patient condition, reading about it, studying it, thinking about it, asking deep questions also informed my research career. I have produced 315 research papers, and almost all of them were generated by questions that started at the bedside, and I think that’s true of most academic physicians. So having access to this huge facility that has such an incredibly varied patient population is truly remarkable.

I am a high-risk obstetrician, and the first time I took a call at Tampa General, we had three patients who had been transferred mostly from rural areas in heart failure and were in the intensive care unit with mechanical heart assistance devices after their deliveries. Fortunately, they all did great and went home. I was talking to the residents, and I said, “Wow, I have worked at NYU, Yale, and Ohio State, but I’ve never seen acuity like this.” And they looked at me and said, “Really, Dr. Lockwood?” I mean, for them it was just another day.

We are training the Navy SEALS of medical students. They are incredibly well-prepared and well-trained at graduation. We receive their residency program directors’ evaluations, and our students are always near the top of their peers because they’re so well-trained.

What do you feel physicians gain from being able to interact with students daily?

Rewards for our faculty are even greater. They feed off their students’ energy, their enthusiasm, to a certain extent, their virtuousness. And they must remain at the top of their game, having to answer their students’ really tough questions. These are super smart kids, as bright as any medical school in the country based on their MCAT scores and college GPAs. The key to great medicine is lifelong learning, and having the grit, the determination to constantly improve your craft and constantly keep up with the accretion of medical knowledge. Having bright, inquisitive students, residents, and fellows forces you to do that, and teaching is one of the great joys of life.

What would be your No. 1 piece of advice to medical students who have just begun to train in a hospital setting?

Seize the day. Carpe diem. Every single patient is an opportunity, not just to learn medicine, but to learn compassion and empathy. To both learn about their condition and feel what they are feeling, and to make sure that you help navigate them through a very difficult moment, whatever it might be. It could be a high-risk pregnancy or a kidney transplant, but strive to understand what they’re going through so that you can be a better doctor. And every day, you should seek to be a better doctor. We also talk a lot about grit with our medical students and about lifelong learning. Medical knowledge is doubling so quickly, you must commit yourself to a lifetime of learning.

INCREDIBLY WELL-PREPARED AND WELL-TRAINED AT GRADUATION.”

FLYING FAST

BY KAREN FELDMAN

Critical injuries and illnesses can strike anywhere, including locations far from hospitals and health care professionals. That’s when aeromedical helicopters can make the difference between life and death.

Tampa General Hospital is a Level I trauma center and operates five such helicopters as part of its Aeromed Regional Transport Program, each outfitted with advanced lifesupport equipment and specially trained medical teams. Based in Polk, Charlotte, Highlands, and Hillsborough counties, these helicopters transport patients from a vast region encompassing 23 surrounding counties.

Michele Moran, TGH’s senior director of emergency services, said in 2022 alone, they completed 1,916 transports. That included more than 800 adult trauma and 140 pediatric trauma patients, as well as people who suf-

fered burns, heart attacks, strokes, and other emergencies.

For the health care providers onboard, these emergency flights challenge their skill sets in the best way. “I love my job,” said Jimmy Holt, a veteran flight nurse and a TGH chief flight nurse of seven years. “You get up in the morning and you never know what you’re going to do beyond the basic checking out of the aircraft. You don’t know if you’ll be 40 miles away or in the middle of nowhere on a twolane highway at an accident giving blood while transporting someone to a surgeon. You have to be prepared for everything, every day.”

Holt recalled a Mother’s Day when his helicopter crew was called to help a 20-year-old man with a stab wound to the chest. A ground ambulance team was the first responder and providing basic life support. The ground

ambulance crew requested Aeromed with blood, breathing equipment, and advanced medications. Holt provided critical care while transporting the patient to the nearest trauma center, where a cardiothoracic surgeon successfully was able to stop the bleed, saving this patient’s life. He was discharged a week later, thanks to close integration of the ground ambulance, the Aeromed crew, and the everready trauma center.

“Every shift, there’s something like that,” Holt said. “That’s the fulfilling part, getting to affect somebody else’s life and that of their families as well.”

As Tampa Bay’s only Level I trauma and comprehensive burn center, “it is imperative that our air transport medical services function at this high level,” said Kelly Cullen, TGH’s executive vice president and chief operating officer.

TGH’S AEROMED FLIGHTS TAKE TO THE SKIES TO SAVE LIVES

The medical teams on the Aeromed flights must have advanced critical care training and experience and be able to treat patients of all ages, including infants. Neonatal intensive care unit (NICU) patients are among those transported, often to TGH, for advanced care.

Aeromed teams are also qualified to transport patients requiring a form of artificial life support, extracorporeal membrane oxygenation (ECMO). ECMO machines keep blood pumping and oxygenated when the heart and

lungs aren’t functioning properly. This type of advanced treatment is not typically available in on-ground ambulances or other air medical programs, and focuses on stabilizing patients and getting them to advanced cardiac centers, like TGH, as quickly as possible.

“I have great respect for all our ground partners,” Holt said. “We serve different purposes. We are a tiny emergency department out in the field. We do a lot of what emergency room doctors do to alleviate problems that would cause

someone to perish.”

TGH’s Aeromed program has earned full three-year accreditation from the Commission on Accreditation of Medical Transport Systems (CAMTS) four times. This recognition is considered the gold standard for patient care in the transport setting.

Operating a service like this is costly but vital, Moran noted. “John Couris, our president and CEO, is a big believer in taking care of everyone, every day, no matter the circumstance,” she said. “A lot of communities really rely on us because of our training, expertise, and compassionate care. If it were someone who I loved out in an area that doesn’t have a large medical center but needed care, I’d want a team of experts like this to bring it to them.”

SEASON SPONSOR

Michele Moran

PMBIOR STATS AS OF APRIL 2023

Enrolled: 1,627

Specimen Types Collected: 6,242

Number of Collaborators: 18

TOTAL SPECIMENS SENT

USF Collaborators: 210

Other Collaborators: 251

Partnerships: 352

Internal Studies: 903

Thanks for SHARING

cific treatments impact the broad ethnic, racial, and social demographic of a community.

BY SANDRA GURVIS

You don’t have to donate your body or an organ to science to contribute to the advancement of medical knowledge. Sometimes a tissue sample, vial of bodily fluid, or another small specimen will do. Such is the purpose of biorepositories, including the new TGH-USF Health Precision Medicine Biorepository (PMBioR).

A secure facility that collects, catalogs, and stores samples of biological material, “a biorepository is designed to facilitate clinical and translational research across a broad number of medical specialties,” explained Dr. Matthew L. Anderson, a professor in the Department of Obstetrics and Gynecology at the USF Health Morsani College of Medicine at the University of South Florida and medical director of the Office of Clinical Research at Tampa General Hospital.

Cancer researchers, for example, can use specimens shared by a biorepository for investigational work in DNA sequencing, learning the exact order of building blocks that make up a tumor’s genomics and result in its formation. In turn, this work helps scientists to develop new therapies and better understand how spe-

At the new TGH-USF Health Precision Medicine Biorepository, specimens, which may include blood, urine, tissues, and cells, are donated by patients receiving care at TGH or USF Health after they give informed consent to use medical samples for health research purposes. Because researchers, physicians, and scientists from various disciplines across the country can access donated samples and share data, they can more readily evaluate what works and what does not, Anderson noted. For example, “clinicians are finding that treatments may be more effective for cancers that carry a specific type of genetic mutation,” he continued. “Leveraging this type of insight using specimens from the biorepository can help investigators discover new uses for old medications and overcome resistance to standard chemotherapy by combining them with new types of targeted therapy.”

The repository is a source of data for precision medicine, information specific to a patient’s genes or proteins that can be used to prevent, diagnose, or treat cancer, as well as Alzheimer’s, cardiac diseases, neurological conditions, and more. After donors give consent and sign paperwork, the materials are collected, processed, and preserved. Samples can be stored in the ultra-

cold cryogenic repository for either a brief period or up to several years. Specimens are coded so that they can be linked to clinical and demographic data via a de-identified database and are only shared with other secure systems.

“The biorepository is a key facet of the infrastructure that powers major academic health systems like Tampa General and USF Health,” said Dr. Eduardo M. Sotomayor, director of the TGH Cancer Institute.

The biorepository further cements TGH and USF Health as cornerstones of Tampa’s budding Medical and Research District, which is poised to not only attract top-level researchers and businesses but greatly add to the community’s health equity. “We now have a unique, state-of-the-art resource that will help take us to the next level,” Anderson concluded.

“The TGH-USF Health Precision Medicine Biorepository will not only enable researchers and clinicians to bring home the promise of personalized medical care by studying patients’ own cells and tailoring treatment specifically to them but will also advance our understanding of cancers and other diseases across the spectrum, accelerating progress toward cures,” said Dr. Clifton L. Gooch, vice president of clinical and translational research at the TGH-USF Health Joint Office of Clinical Research, professor and chair of the Department of Neurology, and associate dean of Clinical Research in the USF Health Morsani College of Medicine.

WITH A LITTLE HELP FROM PATIENTS, THE NEW TGH-USF HEALTH PRECISION MEDICINE BIOREPOSITORY ADVANCES THE GREATER GOOD

Dr. Matthew L. Anderson

TOP 10% IN THE NATION FOR

CARDIOLOGY & HEART SURGERY

TAMPA GENERAL HOSPITAL DELIVERS

COMPLEX HEART CARE FUELED BY ACADEMIC MEDICINE.

As Florida’s leading academic health system for over 50 years, Tampa General Hospital and USF Health Morsani College of Medicine deliver unparalleled innovation, access and superior care to patients throughout Florida. Our award-winning cardiology care has been named top 10% in the nation by U.S. News & World Report, with award-winning treatments for heart attack and heart failure. And our heart transplant program is one of the nation’s busiest and best.

Florida’s Leading Academic Health System For Over 50 Years

READY AND WILLING

BY DAVE SCHEIBER

Dr. Summer Decker will never forget the moment. It was only several days into the coronavirus pandemic U.S. shutdown in March 2020, and she and her 3D clinical applications team were preparing to head home. Instead, an idea that would have a profound impact on the battle against COVID-19 was born.

“It was March 17, and the university had sent everybody home, and the hospitals were scaling back to prepare for this,” recalled Decker, professor and director of the Division of 3D Clinical Applications in the Department of Radiology in the USF Health Morsani College of Medicine at the University of South Florida. “We thought, ‘We are the 3D team and when they cancel elective cases or postpone them, we’re going to leave.’ But while we were packing up our things at the hospital, we got a new trauma case.”

It was a motor vehicle accident, so Decker and her team, including technical director Dr. Jonathan Ford, remained to help, creating a 3D print to assist in the surgery at Tampa General Hospital. While they were there, an email arrived from Dr. Charles Lockwood, executive

vice president for USF Health and dean of the USF Health Morsani College of Medicine, as well as vice president and chief academic officer at TGH. The email underscored that the hospital was short on personal protective equipment and COVID-19 test kits, including swabs. Decker, however, had a solution.

“Here we were standing in the OR using surgical-grade material. I looked to Dr. Ford and said, ‘I’ve got an idea: What if we use that same FDA-approved material to make a 3D swab?’”

Decker and Ford found a way to do just that, including replicating the fuzzy swab tip that could collect tissue samples. Joining forces with Dr. Michael Teng, associate professor in the USF Health Division of Allergy and Immunology, Decker and Ford subjected the swabs to testing and re-testing over the next three days—even trying it on themselves. Decker and Ford filed for a patent through USF on March 20, 2020, and

started a multisite, national clinical trial. Teams from USF Health, TGH, Northwell Health (New York’s largest health care provider), and Formlabs (a Massachusetts-based 3D printing company) collaborated to create the swab over the next week.

Today, more than 100 million 3D-printed nasopharyngeal swabs have been produced around the world, all utilizing the USF-patented design. This past February, Decker, Ford, other USF/TGH team members, Northwell Health, and Formlabs were honored with the U.S. Patent and Trademark Office’s prestigious Patents for Humanity Award for playing a critical role in the diagnostic testing of COVID-19 early in the pandemic.

“I am so proud of how our USF Health team stepped forward to combine their expertise and innovation with the teams from Tampa General Hospital, Formlabs, and Northwell Health to help save lives around the world,” Lockwood said. “This recognition by the U.S. Patent and Trademark Office validates both the tremendous power of academic medicine, especially during a crisis, and the values and commitment these teams have for contributing to the greater good.”

AT THE OUTSET OF THE COVID-19 PANDEMIC, INNOVATORS AT USF HEALTH DEVELOPED A 3D-PRINTED SWAB THAT HAS HELPED MILLIONS AND RECENTLY WON THE PATENTS FOR HUMANITY AWARD

Left: The 3D-printed swabs developed by radiologists at USF Health. Below: Dr. Summer Decker is pictured with (from left) Dr. Krishna Nallamshetty, Dr. John Sinnott, and Dr. Jonathan Ford.

CONVENIENT EMERGENCY CARE FROM TAMPA BAY’S #1 HOSPITAL

NEW, EASY ACCESS, 24/7 EMERGENCY CENTER IN SOUTH TAMPA.

Tampa General Hospital has expanded our trusted emergency care with the opening of a convenient, new location at the corner of Kennedy and Willow. The TGH Kennedy Emergency Center brings together board-certified emergency medicine physicians and a world-class team to care for adult and pediatric patients in a cutting-edge 15,000-square-foot facility — 24/7, 365 days a year — with shorter wait times and easy access.

For more information, visit TGH.org

OUR EMERGENCY LOCATIONS:

TGH Emergency & Trauma Center (Davis Islands Main TGH Campus)

TGH Brandon Emergency Center (Freestanding at TGH Brandon Healthplex)

NEW: TGH Kennedy Emergency Center (Freestanding on Kennedy Boulevard in South Tampa)

Florida’s Leading Academic Health System For Over 50 Years

A

MEDICAL MILESTONE

BY JUDY ALEXANDRA DIEDWARDO

Delivering groundbreaking advancements and shorter wait times for patients in need of a kidney, liver, lung, or heart transplant, the Tampa General Hospital Transplant Institute is leading the nation in meeting the growing demand for these lifesaving surgeries. TGH is the third-largest kidney transplant program in the country, the top living-donor kidney transplant program in Florida for the past three years, and the top pediatric kidney transplant program in the state. The TGH liver transplant program is the seventh largest in the country.

Since its inception nearly 50 years ago, the TGH Transplant Institute has performed more than 12,000 transplant surgeries. In 2022, TGH had a record-breaking 682 transplants and ranked sixth in the nation. That total included 404 kidney transplants, 167 liver transplants, and more than 100 heart and lung transplants. Kidney transplant is the most common trans-

plant, with 85 percent of the national waitlist comprised of patients waiting for a kidney transplant. TGH’s first kidney transplant was in 1974, and in December 2022, it performed its 7,500th.

“The TGH Transplant Institute is dedicated to providing equitable access to all patients with advanced kidney disease in Florida,” said Dr. Kiran Dhanireddy, vice president and chief of the TGH Transplant Institute. “Because of our success, we have made a concerted effort to care for patients on the East Coast who have relatively poor access to organ transplantation and advanced organ disease care. Our partnership network with East Coast physicians now allows the full complement of TGH’s advanced therapies to be funneled to those patients who otherwise may not have received adequate care.”

In an effort to ensure equitable access

for patients, TGH started a Hispanic Kidney Transplant Program in 2022. The goal of that program is to help create a clear, compassionate, personalized, and culturally competent process for Spanish-speaking patients and their families. The TGH Transplant Institute has assembled a bilingual team comprised of surgeons, physicians, social workers, financial coordinators, and support staff.

In addition to proficiency and quantity, integrity and innovation are pillars of the Transplant Institute’s mission. “We’re working hard to create equitable access for all patients in our community regardless of where that patient lives, their race, ethnicity, level of education, or medical savvy,” Dhanireddy said. “We’ve also gone back to our roots of innovation. We’ve been early adopters of new technologies, like machine perfusion of organs, that allow us to use more marginal organs, to transport them farther, and, therefore, provide more access to transplantation with shorter wait times. Our team is committed on a daily basis to provide greater and greater access to transplantation.”

Dr. Kiran Dhanireddy

TGH’s Transplant Institute performs its 7,500th kidney transplant—and it’s only getting started

ONE OF THE NATION’S TOP 10 TRANSPLANT INSTITUTES

TAMPA GENERAL HOSPITAL’S TRANSPLANT INSTITUTE HAS PERFORMED OVER 12,000 LIFESAVING TRANSPLANTS.

Tampa General’s Transplant Institute has been a national leader in advanced organ disease treatment and transplant surgery for almost 50 years. More procedures mean more expertise — and better outcomes. We handle all five solid organ transplants for adults, and we’re a premier destination for multi-organ transplants and complex cases. We have Florida’s largest living donor kidney transplant program and the largest pediatric kidney transplant program in the state. And we’re the only living donor liver transplant program on Florida’s West Coast. Best of all, our multidisciplinary team combines this expertise with a commitment to advocating for patients and families, so you’re informed and supported every step of the way.

THE FUTURE OF SURGERY

TGH SURPASSES 10,000 ROBOT-ASSISTED SURGERIES, AS THE TECHNOLOGY CONTINUES TO TRANSFORM THE OPERATING ROOM LANDSCAPE

By Dave Scheiber

It is a milestone measured in enhanced precision and heightened visualization for surgeons, reduced pain and shorter hospital stays for patients—a high-tech landmark that embodies a world-class commitment to care and improved outcomes.

On the road ahead as one of the nation’s leading academic health systems, Tampa General Hospital recently reached a milestone worth celebrating. In late 2022, TGH performed its 10,000th robot-assisted surgery. It also received accreditation as a Center of Excellence in Robot-Assisted Surgery from the Surgical Review Corporation (SRC), an internationally recognized patient safety organization.

“Our demonstrated success in the area of robot-assisted surgery, our ability to lead in this space through collaboration and innovation, along with the recognition as a Center of Excellence, speaks to the quality and breadth of care we provide in the region, state, and beyond,” said John Couris, TGH’s president and CEO.

For this landmark robot-assisted surgery, TGH physicians utilized the da Vinci Surgical System by Intuitive Surgical, which has enabled top surgeons from an array of specialties to perform complex operations with smaller incisions and

greater exactitude, mobility, and viewpoint. Key benefits for patients include less pain, lower risk of infection, significantly curtailed time in the hospital, and quicker recovery.

“The credentialing agency didn’t just look at our 10,000 robot-assisted surgeries,” said Dr. Christopher DuCoin, the co-director of robotic surgery at TGH and associate professor and director of the Division of GI Surgery in the Department of Surgery in the USF Health Morsani College of Medicine at the University of South Florida.

“They looked at the patient pathway—the experience the robot-assisted patients have from the time they enter the hospital until they leave.”

The platform, DuCoin stressed, has been a game changer in minimally invasive surgery:

“In standard laparoscopy [minimally invasive surgery], it’s two-dimensional; with robotic surgeries, it’s three-dimensional, so you can visualize it better. And there’s better articulation; the robotic hands move on a smaller scale, much like a surgeon’s hands.”

The da Vinci Surgical System multi-port robots (TGH has six) are used for urologic, gynecologic, thoracic, cardiac, and general surgeries, as well

Dr. Christopher DuCoin

Dr. K. Eric Sommers of TGH’s Lung Cancer Center of Excellence utilizes robotic lobectomies for the treatment of lung cancer. His techique is being utilized as a teaching tool for other thoracic surgeons.

Dr. Salvatore Docimo

Dr. Ashley MooneyDr. Raviender Bukkapatnam

Dr. K. Eric Sommers

Dr. Jorge Marcet

as surgical oncology. Then there’s the da Vinci single-port system, which is used for certain urological and ear, nose, and throat procedures. (Single-port requires a lone incision as opposed to several with multi-port.) In 2021, TGH surgeons performed 1,619 robot-assisted procedures. In 2022, they exceeded 2,300.

DuCoin has completed more than 1,000 robot-assisted surgeries and was recognized as a Surgeon of Excellence as part of the assessment. He underscored the value robotic surgeries provide in terms of “case control.”

“Multiple surgeries are dictated as twosurgeon operations [because] you literally can’t do them by yourself,” he explained. “But with the robotic platform, you’re in complete control. You can get through the surgery from skin incision to closure all by yourself. When we talk about innovation, this is just the be-

ginning. It’s like the first generation of Nintendo. There’s so much more to come.”

To Dr. Salvatore Docimo—associate professor in the Department of Surgery in the USF Health Morsani College of Medicine and a bariatric surgeon who serves as director of the TGH + USF Health Abdominal Core Health and Hernia Center and specializes in weightloss surgeries and hernia repairs—achieving the 10,000 robot-assisted surgery distinction along with the accreditation speaks volumes.

“Essentially what it means is that we as an organization are completely committed to robotic surgery,” Docimo said. “It is a tool that helps us complete the cases, and this accreditation says we have performed a significant number of surgeries and are efficient at what we do. Most importantly, we have excellent outcomes for our patients. It’s a stamp of ap-

proval that says, ‘We are the place to be if you’re interested in having robotic surgery.’”

Health care facilities such as TGH undergo an extensive assessment and inspection process to receive accreditation and to ensure they meet SRC’s proven standards and requirements. These include surgical volumes, facility equipment, clinical pathways, and standardized operating procedures, as well as an emphasis on patient education and continuous quality assessment.

“Some patients might have a concern with the robotic platform that we’re going to wheel them in a room and push a button, and then we’ll walk out and the robot’s going to take over,” said Docimo. “Obviously that’s not true. It’s simply a new tool, but it’s a more advanced tool.

“It’s still important to understand that

WHEN WE MERGE THE HUMAN COMPONENT OF TRAINING AND EXPERIENCE WITH THIS NEW, ADVANCED TECHNOLOGY, IT SIMPLY LEADS TO EXCELLENT OUTCOMES.” — DR. SALVATORE DOCIMO

there is a human being behind the robot— an individual who has undergone years of training. And they have to combine these new technologies with their basic underlying clinical acumen. When we merge the human component of training and experience with this new, advanced technology, it simply leads to excellent outcomes.”

Dr. Ashley Mooney, assistant professor in the Department of Surgery in the USF Health Morsani College of Medicine and a bariatric and general surgeon at TGH and USF Health, had the honor of performing the 10,000th robot-assisted surgery and has completed more than 800 robotic surgeries.

“We all knew the 10,000th was coming up and that somebody was going to hit it that week,” Mooney recalled. “I was just handling my cases. When I was finished, Dr. DuCoin texted me, ‘Congratulations on the 9,999th surgery!’

“It was my last case of the day and I thought, ‘Hey, I guess I’m runner-up.’ But it turned out they had not captured the case that was

finished the night before. So, my case ended up being the 10,000th. It was really no big deal, because that number is truly about the whole multitude of robotic surgeons at the hospital and what this entire group has achieved. This is a collective celebration.”

One aspect to celebrate, Mooney emphasized, is TGH’s stature in the robot-assist surgery field. The TGH + USF Health Bariatric Center had already earned accreditation in October 2022 as a Comprehensive Center under the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, which sets national standards for bariatric surgery centers. Now, benefiting from the framework Mooney created for the bariatric center, TGH as an institution is not only a Center of Excellence but will serve as a national model as well.

“The actual accrediting firm said we were one of the model programs that they are going to use for accrediting and handing out Centers of Excellence certificates and titles in the future,” said Mooney.

All this bodes well for TGH and patient care

as a whole, she added. “It’s where we want to go. The future of medicine is quality-based health care and really safe outcomes. And for us to have already built that sort of structure, which can be replicated among different surgical and procedure-based specialties, is significant. It’s a very reproducible framework.”

Urology is another specialty that utilizes robots. The very first case performed using the da Vinci single-port system at TGH dates back to 2008. That’s when Dr. Raviender Bukkapatnam, chief of the TGH Urology Institute, said, “When we’re taking care of patients who already are dealing with a difficult diagnosis, it’s critical to offer them any technology that could provide any kind of improvement or more rapid recovery. Bringing this kind of advanced technology to Florida and to our patients is what Tampa General is all about.”

TGH is providing robotic surgery in many specialties across the organization. Lung cancers are being removed robotically, and TGH is one of the few centers in the region utilizing da Vinci–assisted thoracic surgeries. The Lung

Dr. Docimo is pictured here with the da Vinci Xi multi-port robot.

As described on the Intuitive Surgical website, this system can translate the surgeon’s hand movements at the console in real time, moving much like a human hand but with a greater range of motion.

Cancer Center of Excellence within the TGH Cancer Institute is nationally recognized. Dr. K. Eric Sommers, a thoracic surgeon and medical director of the Lung Cancer Center of Excellence at the TGH Cancer Institute, has helped prove the safety and effectiveness of robotic lobectomies for the treatment of lung cancer.

“I’ve had the opportunity to perform more than 8,000 thoracic surgeries, including more than 4,000 for lung cancer,” Sommers said. “We offer minimally invasive and open surgical techniques to treat complicated lung cancer cases. These patients and families choose TGH for our team approach, worldclass care, and successful outcomes.”

By using the robotic da Vinci Surgical System, TGH Cancer Institute surgeons can reach difficult-to-access locations with techniques that can deliver less morbidity, 3D optics, better precision, and mobility with EndoWrist instruments, a stable camera platform with better ergonomics for surgeons.

“Lung cancer patients should ask their doctor if they are using robotic techniques, and if not, look for one who does,” Sommers said.

Whether single- or multi-port, robot-assisted surgery is the way of the future, and TGH continues to prove that it is at the cutting edge of innovative, multidisciplinary care.

Another high-volume service that offers patients the most up-to-date and technically advanced medical treatments available is the Colorectal Cancer Center at TGH’s Cancer Institute. “Surgeons at the TGH Cancer Institute have been at the forefront of developing a variety of modern surgical techniques that result in shorter hospital stays, less pain, and quicker recovery, all with an eye on improved outcomes for our patients,” said Dr. Jorge Marcet, director of colon and rectal surgery at TGH and professor and director of the Division of Colorectal Surgery in the Department of Surgery in the USF Health Morsani College of Medicine.

An early adopter of the robotic technology, Marcet was the first in the region to employ robotic surgery for the precise removal of the cancerous organ with a reconstruction of the colon and was a leader in national clinical trials that established the safety and improved outcomes of robotic surgery for patients with

rectal cancer. With some of the most extensive experience in the country in the use of this platform for the treatment of colorectal cancer, Marcet has assisted Intuitive Surgical with the development of new technologies for future applications of the robotic techniques.

Another unique procedure offered at TGH is transanal minimally invasive surgery (TAMIS), which offers incisionless surgical approaches for rectal tumors, often resulting in same-day discharge from the hospital.

“At TGH, we offer treatments that are not available at most other hospitals,” said Marcet. “It’s all about ensuring our patients are given the best possible treatment options for improving and maintaining their quality of life.”

The surgeons of the Gastrointestinal Tumor Group of the TGH Cancer Institute routinely apply robotic techniques in the treatment of cancerous intestinal organs, including surgery of the colon and rectum, liver, pancreas, and stomach. As a Center of Excellence in the management of intestinal malignancies, TGH and its doctors offer a modern, precise, and personalized multidisciplinary approach in

SURGEONS AT THE

MEET THE ROBOTS

LEARN MORE ABOUT TWO OF THE ROBOTIC SURGEONS REVOLUTIONIZING MINIMALLY INVASIVE PROCEDURES AT TGH

1THE DA VINCI XI MULTI-PORT ROBOT

This system is known for its versatility, flexibility, and efficiency in the operating room. It provides multi-quadrant access—giving surgeons total control of the wristed instrument on each of the four arms—and is used for a variety of complex procedures. The vision cart includes a large, high-definition display that shows a live feed of the procedure that is visible to everyone in the OR. “In the same way it helps with the upper portion of the abdomen, which is a very small space, it works extremely well for urology and gynecology, because in the pelvis there’s a small, fixed space,” said Dr. Christopher DuCoin. “In these tight areas, it can be extremely tough to operate and perform meticulous work. That’s where the robotic platform excels.”

THE DA VINCI SINGLE-PORT ROBOT

the care of the patient.

As robot-assisted surgery continues to transform the operating room (OR) landscape, TGH hopes to mark many more significant achievements and save many more lives in the future. As innovation and technology drive many health care systems, TGH welcomes the robotic technology.

“You can actually look at robotics as another member of our multidisciplinary team,” DuCoin concluded. “It’s one part of a big process that puts TGH at the forefront.”

This system is designed with instruments optimized for single-port surgery—with one incision—and advanced vision that allows surgeons to perform highly complex procedures. It also makes possible a greater natural range of motion than the human hand is capable of and is designed with an elbow and a wrist. Dr. Salvatore Docimo said, “In some situations where you’re working deeper in the pelvis, where the areas are a little bit smaller, the singleport may be a really solid option.”

TGH CANCER INSTITUTE HAVE BEEN AT THE FOREFRONT OF DEVELOPING A VARIETY OF MODERN SURGICAL TECHNIQUES THAT RESULT IN SHORTER HOSPITAL STAYS, LESS PAIN, AND QUICKER RECOVERY.”

DR. JORGE MARCET

A

THE PROMISE OF

TOMORROW

THE TAMPA MEDICAL AND RESEARCH DISTRICT IS COMING TO FRUITION AND POISED TO YIELD BENEFITS THAT WILL EXTEND FAR BEYOND TAMPA BAY

BY MARY MURRAY WITH MICHELE MEYER

Tampa General Hospital occupies a 3-million-square-foot campus on Davis Islands, but that is just a fraction of the 1,500 acres that comprise the Tampa Medical and Research District.

The Tampa Medical and Research District is a dream many years in the making. John Couris, president and CEO of Tampa General Hospital, has long expressed his intent to create a medical district in downtown Tampa with the help of TGH’s academic partner, the USF Health Morsani College of Medicine at the University of South Florida. Such a district would not only strengthen the partnership between the two organizations—which dates back 50 years—and facilitate a more seamless experience for patients, but it would also attract global leaders in medicine, research, biotech, pharma, and more.

Now, with the support of the Tampa Bay Economic Development Council (EDC), planning and action for the district is in hyperdrive.

“This city is uniquely well-positioned to fuel a world-class medical and research district, and we are excited to partner with the Tampa Bay Economic Development Council to expand this further and amplify its impact,” Couris said.

The Tampa Bay Economic Development Council will support the burgeoning district in many ways, including surveying land within the existing boundaries of TGH to evaluate potential development and redevelopment sites for medical, research, and health care business use. Over the course of five years, the council will also provide planning, strategic partnership creation, talent attraction, and research and

life science business recruitment, as well as workforce housing project identification and marketing services. In its partnership with TGH, the council will also hire a new director of health care and life sciences.

Tampa General Hospital was established as Tampa Municipal Hospital in 1926, when it opened on Davis Islands with 186 beds. Today, TGH boasts 1,040 beds, is ranked among the top 100 hospitals in the country, and is the bedrock of the emerging Tampa Medical and Research District.

“While the Tampa Medical and Research District is anchored by TGH and the USF Health Morsani College of Medicine, it is also an open ecosystem driven by medical innovation and an array of partnerships,” said Jennifer Crabtree, TGH’s chief of staff for the Office of the President and CEO. “The work we are doing with the Tampa Bay EDC will help further this.”

Craig J. Richard, president and CEO of the Tampa Bay Economic Development Council, said that his organization is “proud to partner with Tampa General Hospital to realize its vision for a globally renowned medical and research district. This partnership aligns perfectly with the EDC’s own strategic plan goals for business recruitment, placemaking, and talent attraction and development—allowing our team to exercise its diverse strengths in the creation and promotion of this innovative new district that will shape the economic future of our region.”

Covering more than 1,500 acres in and around downtown Tampa, the district has evolved organically in recent years, anchored by TGH’s 3-million-square-foot campus on Davis Islands. TGH alone has expanded from 17 locations in 2017 to more than 130 today, including primary health care offices, imaging centers, and subspecialty clinics. The hospital is investing more than $550 million in its Master Facility Plan to modernize infrastructure, build a new physical plant, and expand capacity. Within the main boundaries of the district, TGH has already opened an 80-bed acute rehabilitation hospital, the Global Emerging Diseases Institute (GEDI), a 96-bed behavioral health facility (with room to grow to 120 beds), and a freestanding emergency department. A new surgical tower is also being built on campus.

In 2019, as part of its USF Health Downtown Initiative, USF Health relocated its Morsani College of Medicine and Heart Institute to a new campus at Water Street Tampa, a $3.5 billion development sponsored by Bill Gates and former hedge fund manager Jeffrey Vinik. (Vinik is also the owner of the Tampa Bay Lightning, which is a partner of Tampa General Hospital.) This move only enhanced the district’s educational capital, as it was already home to the University of Tampa (which operates a top-rated nursing school) and the USF Health South Tampa Center for Advanced Healthcare. Downtown Tampa is also home to the

USF Health Center for Advanced Medical Learning and Simulation (CAMLS), which is exclusively dedicated to training health care professionals.

Further enhancing the relationship between the district’s two bedrocks is USF Tampa General Physicians, a new physician management service organization that launched in January 2022 and aims to unify the clinical, research, and teaching efforts between TGH and USF Health. Research, in particular, will play a key role in how the Tampa Medical and Research District develops and the type of talent it is able to attract, noted Dr. Charles Lockwood, executive vice president of USF Health, dean of the USF Health Morsani College of Medicine, and TGH’s executive vice president and chief academic officer.

TGH didn’t undertake its first major expansion until 1959, when it grew to 514 beds. The hospital’s current Master Facility Plan includes the addition of the Center for Excellence Pavilion, an acute rehabilitation hospital, and a freestanding emergency department.

“One of my philosophies when I first arrived here was that medical knowledge is increasing at a rate far beyond our brain’s ability to keep up with it,” Lockwood said. “When we were building the new medical school building, I said to everyone, ‘By the time this building is open, medical knowledge will double every 71 days.’ Now it’s probably more like every 30 days.”

Lockwood added that USF Health’s research output has grown by $76 million in annual funding since he began his tenure in 2014—and their only current limitation is space. He hopes that a new research building will eventually join the ranks of the impressive facilities that have taken shape in the district.

In addition to research, academics, and clinical care, the Tampa Medical and Research District will also act as a breeding ground for the best in biotechnology and innovations in health care. TGH has already forged strategic partnerships with such industry leaders as GE Healthcare, Medtronic, and Philips to implement the kinds of system-wide equipment and infrastructures that will not only enhance the patient experience of today but future-proof the hospital for decades to come.

Outside of their day-to-day business of treating patients, TGH and USF Health have developed venture capital programs to support health care start-ups, and leadership at both organizations believe that the district and its competitive cluster of industry innovators will be uniquely positioned to attract federal, state, and philanthropic funding as well as venture capital and private equity. While the resultant breakthroughs could potentially impact the global health landscape, the presence alone of such funding and capital could ripple across Tampa’s economy

and the state’s economy as a whole.

“Every dollar of NIH [National Institutes of Health] funding generates a minimum of $2.21 in local economic activity,” said Lockwood. “Some estimates are as high as $2.60. But that doesn’t include the companies that you create from your faculty’s discoveries and the companies that are recruited in because of the intellectual firepower that they are able to access.

“As Tampa Bay’s economy has evolved—and this is true of Florida in general—we’ve begun to diversify beyond tourism and agriculture. Tampa is now being recognized as an epicenter for medical innovation, biotech, and life sciences.”

Crabtree added that it “makes sense to put business in Tampa,” where the health care industry is the fastest-growing employment sector, accounting for more than 17,000 new jobs since 2018. But it won’t stop there: A recent study by the Washington Economics Group found that the district, once completed, is expected to generate more than $8.3 billion in annual economic impact to the state of Florida, and it will support more than 57,900 jobs.

As the Tampa Medical and Research District grows, so too does its footprint as an economic driver, a hotbed of innovation, and a model for how collaborative health care can lead to a brighter tomorrow.

Every dollar of NIH [National Institutes of Health] funding generates a minimum of $2.21 in local economic activity.”

DR. CHARLES LOCKWOOD

TURNING THE TIDES

THE TGH CANCER INSTITUTE’S NEW BONE MARROW TRANSPLANT AND CELL THERAPIES UNIT BRINGS LABORATORY RESEARCH TO THE FRONT LINES OF PATIENT CARE

By Kelley Marcellus

Thanks to ever-advancing research that is crossing the threshold from laboratories to the clinical setting, greater promise is dawning for patients diagnosed with multiple myeloma and other hematologic cancers. Tampa General Hospital is at the forefront of these advancements while delivering cutting-edge treatments that provide patients with a seamless continuum of care, beginning with the opening of its Bone Marrow Transplant and Cell Therapies Unit in Spring 2022.

Late last year, Dr. Ivan Borrello—a leading expert in multiple myeloma and a top researcher of bone marrow transplants and immunotherapy treatments for blood cancers—took the helm of the unit, which is part of the TGH Cancer Institute. Now TGH’s director of myeloma, bone marrow transplants (BMT), and cell therapies, Borrello came from Johns Hopkins University, where he led its myeloma program, directed its Cellular Therapies Core, and was a member of its cancer immunology and immunotherapy program for more than two decades.

Borrello’s goal, he said, is to quickly advance the successful treatment of patients at TGH. “Academic medicine faces significant hurdles, but a place like Tampa General is more of a start-up company,” he explained. “There is a big desire to make quick change, and the idea of building these programs is something I find very exciting.”

The Bone Marrow Transplant and Cell Therapies Unit offers TGH patients access to cuttingedge treatments that are leading to improved

outcomes and increased survival rates—greatly reducing the need for patients with complex cases to transfer to other facilities.

“Our program can provide improved continuity of care for our TGH Cancer Institute patients,” said Dr. Abraham Schwarzberg, TGH’s chief of the Cancer Institute, executive vice president of network development, and vice president of clinical and translational research. “They can stay here at Tampa General with their physicians and caregivers.”

THE REALITY: WHEN CANCER STRIKES

When Mauricio Perez immigrated to the United States from El Salvador in 1975, he envisioned a better life for himself and his family. That vision turned into a reality. When he wasn’t playing soccer with his three children, he was building his company, Perez Moving & Storage, from the ground up. One thing Mauricio didn’t count on, however, was cancer.

He fought his first battle with B-cell lymphoma in 2012. A decade later, in 2022, it returned with a vengeance.

“It started off with his back hurting,” recalled his daughter, TiTi. “Every night, I would go over [to his house] and massage his back. He was like, ‘You’re not getting the pain. You’re not getting it.’”

Mauricio didn’t have an appetite. He was losing weight. He was fatigued all the time. And his family was frightened.

A resident of West Palm Beach, Mauricio sought medical consultation on the East Coast

Dr. Eduardo Sotomayor, Director of the TGH Cancer Institute

Dr. Abraham Schwarzberg

Dr. Ivan Borrello

Tracy Stegeman, Oncology Practice Manager with the TGH Cancer Institute

In 2022, Mauricio Perez received lifesaving care from TGH’s new Bone Marrow Transplant and Cell Therapies Unit. His only chance at survival, the transplant allowed Mauricio to pass the business he built down to his children— who were with him every step of the way.

and was swiftly referred to the TGH Cancer Institute. Within hours, he and his son, Carlos, were en route to Tampa. Mauricio’s treatment began with three rounds of RICE (rituximab, ifosfamide, carboplatin, etoposide) chemotherapy. He then received a bone marrow transplant at the new Bone Marrow Transplant and Cell Therapies Unit.

Carlos noted that the new unit felt like coming to a second home, and Mauricio praised the nurses who helped him. “I was thinking, ‘Am I the only patient at the hospital?’” Mauricio said of the level of personal care he received. “They know what they are doing.”

THE JOURNEY: STEM CELL AND BONE MARROW TRANSPLANTS

Patients, such as Mauricio Perez, with cancer in blood-forming tissues, or hematologic cancer, have specific requirements that the new Bone Marrow Transplant and Cell Therapies Unit can uniquely accommodate. Early in treatment, many patients will receive an initial regimen of chemotherapy to ensure that they positively respond to it.

“We want at least a 50 percent reduction in their disease burden,” Borrello said. “Once a patient has demonstrated this reduction, they’ve proven they have chemosensitivity— they’re able to respond [to chemotherapy]— then we can talk to them about autologous transplants.”

In an autologous transplant, the patient is the donor; their own stem cells are extracted from either their bone marrow or blood and

given back to them. Stem cells also can come from a donor, called an allogeneic transplant. Before the transplant procedures start, however, the patient receives thorough medical examinations that include a lung and cardiac function evaluation, bone marrow biopsy, and ruling out serious viral infections like hepatitis and HIV. This process can take about 10 days, Borrello noted. Once cleared, treatment for the transplant can begin.

When circulating stem cells reach the required levels, they are collected in a procedure called pheresis, in which two catheter lines are inserted near the collarbone. One removes blood to allow stem cells to be harvested and one returns the filtered blood to the body.

“It’s a very painless procedure that takes place at the bedside over the course of about six hours,” Borrello explained. “The patient can read a book or take a nap—there is no surgery involved.”

Bone marrow transplants and cell therapies require a larger infrastructure than the treatment of solid tumors found in other types of

cancers, Borrello said. “Care of hematological malignancies need to be in, or closely associated with, a hospital, whereas a lot of standard chemotherapy given for solid tumors can be done as an outpatient.”

Following the retrieval of stem cells, multiple myeloma and other blood cancer patients undergo more chemotherapy, which essentially kills off the diseased bone marrow—along with the immune system’s ability to fight infection. That’s why the self-contained Bone Marrow Transplant and Cell Therapies Unit features HEPA (high-efficiency particulate absorbing) filtration, air exchanges, and water filtration to mitigate risks.

Previously retrieved stem cells that had been frozen are taken out of storage, thawed, and readministered to the patient via intravenous infusion through a catheter installed at the collarbone. Again, no surgery—this is a bedside procedure.

“The cells go in and find their way to the bone marrow,” Borrello explained. “It takes roughly two weeks for the bone marrow to reconstitute itself and allow patients to be discharged safely.”

Patients regain about 30 percent of their pre-treatment energy level by the time of discharge, Borrello said, and 50 percent at the one-month mark. By two months, most are feeling about 80 to 90 percent of their pretreatment energy levels and are ready to return to work and their usual routines. Their care team will continue to monitor them.

OUR PROGRAM CAN PROVIDE IMPROVED CONTINUITY OF CARE FOR OUR TGH CANCER INSTITUTE PATIENTS. THEY CAN STAY HERE AT TAMPA GENERAL WITH THEIR PHYSICIANS AND CAREGIVERS.”

—DR. ABRAHAM SCHWARZBERG

“The disease is either cured or goes into remission for a very long period of time, depending on the type of disease,” Borrello added. “With some blood cancers, like myeloma, we know that we cannot cure patients with a transplant, but what we can do is significantly delay the time it takes for the disease to come back.”

REVOLUTIONIZING TREATMENT WITH OUTPATIENT CLINIC

The management of many types of cancer is rapidly evolving. Since the 1990s, immunotherapy has taken off, offering hope to cancer patients whose diseases were previously difficult to treat. When Borrello entered the field, “we went from having three drugs to treat myeloma

and now we have eight or nine,” he noted.

Borrello has pioneered research that has led to the development of certain T-cell therapies that improve outcomes for patients who have undergone bone marrow and stem cell transplant procedures. A vaccine for these kinds of cancers remains on the horizon.

“There are several FDA-approved products that have shown quite dramatic and impressive results that are quickly becoming a mainstay in the treatment of multiple myeloma,” Borrello said. “I think we are going to have more of them, and the ones we already have are going to get better.”

This year, the TGH Cancer Institute plans to open an outpatient bone marrow transplant

and cell therapies clinic that could help reduce lengthy hospital stays. The clinic will allow more patients to be treated and could prove to be more comfortable and better support patients’ overall health and well-being.

“Our patients will be getting exercise, coming to and from their homes every day,” Borrello said. “They will eat their own food and not get woken up in the middle of the night and all the things that come with a hospital stay. I think it’s going to revolutionize the way we treat our patients.”

Schwarzberg agreed that the new unit and future clinic, as well as the addition of experts like Borrello, are huge assets to Florida’s cancer patients. “Bone marrow transplant and cell therapies can significantly increase the chance of recovery from blood cancers,” he said, “and hopefully soon, of patients with solid malignancies.”

TGH’s dedicated Bone Marrow Transplant and Cell Therapies Unit boasts HEPA filtration, air exchanges, and water filtration to mitigate risks for patients with weakened immune systems.

PRIME THE PUMP

BY YVETTE C. HAMMETT

Dr. Swaroop Bommareddi of the Tampa General Hospital Heart & Vascular Institute recently implanted the 8,000th Impella 5.5 heart pump in the nation.

The world’s smallest heart pump, the Impella 5.5 is used to provide patients with temporary mechanical cardiac support while the heart team determines the ability for the heart to recover or the need for cardiac replacement therapy such as a transplant or a ventricular assist device. It is just one example of the cutting-edge technology offered at TGH, which U.S. News & World Report ranked in the top 10 percent among U.S. hospitals for cardiology and heart surgery and one of the best hospitals for heart failure and heart attack care for 2022-23.

Bommareddi—assistant professor in the Department of Surgery in the USF Health Morsani College of Medicine at the University of South Florida and a cardiothoracic surgeon who completed a fellowship in thoracic transplantation and mechanical circulatory support devices at the University of Wisconsin School of Medicine and Public Health in 2021—said his patients are having “tremendous success” with the newest iteration of the Impella heart pump. It has enabled TGH to successfully treat and recover patients who are “on death’s door,” who might not previously have had the opportunity to survive, Bommareddi said.

“Oftentimes, these patients are in cardiogenic shock; they may also have multisystem failure and need additional cardiac support,”

The Impella 5.5 heart pump is revolutionizing cardiac intervention for high-risk and critically ill patients

Below and left: Dr. Swaroop Bommareddi was an early advocate of the Impella 5.5 with SmartAssist. (Illustration image courtesy of Abiomed.) Below center: Dr. Debbie Rinde-Hoffman. Below right: TGH cardiothoracic surgeons utilize the Impella 5.5 to provide temporary mechanical cardiac support while determining next steps.

We have been using the very early iterations of this device at TGH for more than 20 years and have been very early adopters of this newest iteration. When Dr. Bommareddi joined us, he became a significant advocate for this pump.”

—Dr. Debbie rinDe-Hoffman

Bommareddi noted. He went on to describe the Impella 5.5 heart pump, which is FDAapproved and minimally invasive, as a bridge to recovery: It is a temporary fix that allows the patient to recover from heart failure and undergo rehabilitation while the cardiovascular team determines whether the heart will rebound and what steps need to come next.

To implant the pump, a surgeon makes an incision under the collarbone and places a graft on the axillary artery. The device is guided into the left ventricle, the heart’s main pumping chamber. It then pulls blood from the ventricle, pushing it out into the aorta to deliver oxygen-rich blood to the rest of the body. Following the implantation of the pump, patients are admitted into the intensive care unit (ICU), where they may remain

for days or weeks while a long-term fix is determined. Once patients recover from the initial surgical procedure, they are able to walk around in the ICU to regain strength, and the pump allows for recovery of other previously oxygen-starved organs.

For some patients, that fix may be a transplant, a durable ventricular assist device, or conventional open-heart surgery. For others, it may simply be recovery in heart function or a percutaneous coronary intervention (PCI), which are minimally invasive procedures that open blocked coronary arteries using stents or balloons. While many patients do not require support from a heart pump during these procedures, the Impella can play a critical role in maintaining blood flow during high-risk PCIs, effectively opening this intervention to

a new class of patients.

“This is the workhorse of short-term devices for patients who have left-sided issues when the left side of the heart is affected and weak,” added Dr. Debbie Rinde-Hoffman, vice-chief of Business Development & Physician Network with the TGH Heart & Vascular Institute and a cardiologist with TGH’s Cardiac Transplant Program, which provides consults for patient cases. “We have been using the very early iterations of this device at TGH for more than 20 years and have been very early adopters of this newest iteration. When Dr. Bommareddi joined us, he became a significant advocate for this pump.”

Patients are coming to TGH from across the state to take advantage of this cutting-edge technology.

“For smaller hospitals that need help, it is our duty to help those hospitals and support our community,” Bommareddi said. “That is a big mission of this institution.”

A product by the Abiomed medical technology company, the Impella 5.5 has become an integral part of TGH’s approach to caring for patients in cardiogenic shock. The definition of success for these patients, however, varies significantly from person to person.

“Success is defined as either liberation from any pump, or it can be defined as the patient leaving the hospital having had conventional surgery and with a durable, implanted ventricular assist device or a heart transplant,” said Rinde-Hoffman. “These machines are paramount to that success.”

Collaboration leads to superior outcomes for TGH’s heart valve program

When doctors meet with patients hours or days apart, a lot can be lost in translation. At Tampa General Hospital, 100 percent of patients being considered for heart valve replacement meet with the entire team at once. This type of collaboration leads to an unbiased approach to care and greater success, noted Dr. Hiram Bezerra, medical director of TGH’s Interventional Cardiology Center of Excellence and a professor in the Division of Cardiovascular Sciences in the USF Health Morsani College of Medicine at the University of South Florida.

“One of the highlights of our program is that all patients go through a specialty clinic, the valve clinic, and are seen in conjunction between the cardiothoracic surgeon and the interventional cardiologist,” Bezerra said. “When you sit down with a patient in a multidisciplinary approach, it becomes patient-centric, and all options are on the table. We prioritize patient care and outcomes using this multidisciplinary approach.”

Bezerra and his team perform minimally invasive transcatheter heart valve

replacements (TAVR), with the aortic valve being the most common. As Bezerra explained, the procedure is offered at TGH in a streamlined fashion, with the patient under conscious sedation.

A MATTERS OF THE HEART

“You are replacing a valve in the heart and the patient is still talking to you,” he said. “This is not universal. Most places do this under general anesthesia.”

The rationale behind using conscious sedation is that the recovery time is much faster, and the patient can be walking in a matter of hours. The patient pool for such a procedure is also a factor. “These are frail patients who tend to be elderly and with other issues, so we prefer to avoid general anesthesia,” Bezerra said.

The valve program performs between 300 and 350 valve replacements annually. Most patients experience symptom relief almost immediately, including improved energy and breathing.

When you sit down with a patient in a multidisciplinary approach, it becomes patient-centric, and all options are on the table. We prioritize patient care and outcomes using this multidisciplinary approach.” —DR. HIRAM BEZERRA

Dr. Hiram Bezerra

Dr. Hiram Bezerra, medical director of TGH’s Interventional Cardiology Center of Excellence, notes that all patients being considered for heart valve replacement procedures—including TAVR and TricValve (pictured above left)—begin with a multidisciplinary consultation at the hospital’s valve clinic.

in

Women’s Health

TGH pioneers multidisciplinary and minimally invasive techniques to help those suffering from endometriosis, a debilitating—and too often dismissed—condition

BY K.S. MEYER

Imagine having an illness that causes you significant pain. Sometimes this pain is moderate, a “five or six out of 10.” Perhaps, it comes and goes. But then, at unpredictable times, it is constant and debilitating. Imagine the adjustments you’d have to make to manage this pain as it stretches out over many months, years, or even decades. Imagine the toll it would take not only on you and your

mental health, but also on your loved ones, work, hobbies, social engagements—practically every aspect of life as you know it.

Now imagine you’ve been to half a dozen doctors over the years only to be told, essentially, “We don’t know what’s wrong with you. You’ll just have to learn to live with it.”

While this dystopian vignette may seem like something out of the very early twentieth

AADVANCING INNOVATION

century, it is somehow still a stark reality for far too many women.

Endometriosis has a reputation for being insidious. A condition in which tissue similar to that which lines the uterus grows on other parts of the body, its most common symptoms (acute abdominal and menstrual pain, painful bowel movements, uncomfortable intercourse, and infertility) are easily

mistaken as “red flags” for other conditions such as cancers of the ovaries, uterus, or bowel. Because such other diagnoses tend to carry relatively grim prognoses unless caught early, and because endometriosis itself is not fatal, physicians may be prone to push it aside once they’ve ruled out the more serious differentials.

“The main problem with endometriosis is that patients suffer for a long time before getting diagnosed,” said Dr. Emad Mikhail, a minimally invasive gynecologic surgeon at Tampa General Hospital and an associate professor and director of the Division of Gynecology at the USF Health Morsani College of Medicine at the University of South Florida. “Sometimes they get dismissed, by their family members, by their spouses, by their doctors, [who say,] ‘We cannot see anything. You’re fine. This is normal.’ And this is, of course, not normal.”

If this were a matter of a few outlier cases fooling a few doctors here and there, it might be understandable. But “endometriosis affects about 10 to 15 percent of reproductive-age females,” Mikhail noted. “Actually, a rough estimate is it is affecting maybe 200 million people in the world.”

How is it that, in an age when heart attacks can be reversed through a catheter in the leg and malignant tumors can be obliterated the

day they’re detected with pinpoint radiation therapy, so many women still go undiagnosed and untreated with such a painful, lifealtering illness?

“It invades adjacent organs, similar to cancer,” explained Dr. Robert Bennett, a colorectal surgeon, assistant professor in the Department of Surgery in the USF Health Morsani College of Medicine, and director of colorectal surgery research at USF/TGH. “It causes pain just like cancer can. When it involves the intestines it can cause obstruction, just like GYN malignancies can, so the manifestation is often very similar to cancer, although it in and of itself is not a malignant process.”

In most cases—depending on the severity of symptoms, a patient’s age, and how the condition impacts her fertility—treatment options seek to manage pain rather than identify, target, and rectify the underlying issue.

“Traditionally, people have used hormone therapy, birth control pills, other types of hormones that actually do not cure the disease,” said Mikhail. “The vast majority of the problem is the fibrosis, and hormones will not get rid of the fibrosis. [It] will only be treated if we remove it surgically. This is so difficult because it can affect different organs in a very tight space. And this is where the nature of a multidisciplinary team becomes the most effective and safe way to treat the patient.”

Dr. Emad Mikhail

The main problem with endometriosis is that patients suffer for a long time before getting diagnosed. Sometimes they get dismissed by their family members, by their spouses, by their doctors, [who say,] ‘We cannot see anything. You’re fine. This is normal.’ And this is, of course, not normal.”

—Dr. EmaD mikhail

Deep infiltrating endometriosis is the most severe form of the disease and the most difficult to treat because it invades other organs. Advances in robotassisted surgery and various imaging modalities have enabled surgeons and specialists at TGH to target fibrosis and eliminate it without disturbing other surrounding structures.

In the same way, multidisciplinary teams have been used in recent years to diagnose and determine courses of treatment for cancer patients, TGH has assembled such a team of experts to identify and treat this widespread condition that can involve multiple organ systems.

“Just like any other medical condition, the history and the physical exam should guide the diagnostic workup,” said Bennett. “I think there’s maybe no [disease that] illustrates that better than endometriosis, because the problem is that symptoms quite often mimic a lot of other disease processes, and unless the clinician is considering endometriosis … they don’t get the proper diagnostic tests done. [Patients] suffer for a long period of time before they finally get to the right team of people—and you do need a whole team of people: You need a specialized radiologist, a specialized sonographer, a specialized GYN surgeon, quite often a colorectal surgeon, a urologist. They all need to be in tune with this

and understand the disease process to really work it up and treat it properly.”

“There are subtypes of endometriosis,” Mikhail added. “There is a superficial type, an endometrioma type, but the subtype we are focusing on is the deep infiltrating subtype. And this is the most difficult [because] it invades different organs. It can invade the rectum, the sigmoid colon, other parts of the colon, other parts of the small intestine, the urinary bladder, the ureters. It can be devastating. We have seen patients with almost total occlusion of their bowel. I have seen multiple patients who’ve lost kidneys because of the occlusion of the ureters, and the kidney becomes nonfunctional over a period of time.”

Diagnosis is only the first step, and after so many months or years shuttling from doctor to doctor, newly diagnosed endometriosis patients might assume their treatment will be similarly protracted.

At TGH, however, this process is expedited, thanks to the involvement of so many

experts who are trained to recognize and fix endometriosis specifically. Within only a few days, patients can be properly assessed, treated through minimally invasive techniques, and sent home for a relatively swift recovery.

“With minimally invasive surgery (MIS), you have magnification, you have visualization that cannot be matched in open surgery,” Mikhail explained. “You can actually see the disease and differentiate disease from normal tissue in an effort to preserve normal tissue, not to cause complication or harm to structures that can be saved.”

While laparoscopy is still the most conventional approach for the treatment of endometriosis, robot-assisted surgery is now an important tool in treating this disease. Not only do these advanced robotic surgical tools provide 3D visualization and superior instrument articulation, but they also enable surgeons to work in very tight spaces within the human body.

In concert with robot-assisted surgery, Bennett stressed the importance of using various imaging modalities to identify (and ultimately preserve) other critical structures, like the ureters, that might be obscured due to fibrosis.

One development pioneered by Mikhail and Bennett at TGH is intraoperative ultrasound–integrated robotic identification of deep infiltrating endometriosis (or DIE, the most severe of the condition’s three subtypes). This added depth of imaging builds on the 3D visualization offered by robotic surgery, providing an even sharper delineation of the boundaries of endometriosis lesions. They detailed this novel procedure in a paper published in the September 2022 issue of the American Journal of Obstetrics & Gynecology

“Internally, the ultrasound probe is held by the robotic instrument during surgery to excise properly,” explained Mikhail.

Therefore, if there were any chance a lesion might be mistaken for normal tissue during visual inspection through laparoscopic or robotic cameras, the ultrasound “double checks” the field, significantly increasing the likelihood of sparing surrounding tissues. This will mean increased recovery rates and fewer side effects or complications for patients undergoing deep infiltrating endometriosis surgery.

With the aid of these and other techniques at the forefront of medical research and development, physicians involved in these multidisciplinary groups are transforming what used to be a lingering, devastating, relatively unknown condition into something that can be both identified with certainty and treated definitively within days or weeks—not years. There is a great deal still to learn about endometriosis, but the days of it haunting women throughout the rest of their lives seem as though they may be soon behind us.

AN ALTERNATIVE TO HYSTERECTOMY

For women suffering from symptomatic fibroids (muscular tumors on the wall of the uterus), TGH offers a minimally invasive alternative to hysterectomy that can have them in and out of the hospital on the same day. Introduced at TGH in May 2021 , the Acessa procedure involves three small incisions and utilizes laparoscopic radiofrequency ablation to shrink fibroids and spare the uterus, explained Dr. Emad Mikhail. Women can typically return to their normal activities in four to five days and, depending on the severity of their original symptoms, most will see relief in around three months. Best of all: This procedure doesn’t come with any of the negative side effects typically associated with a hysterectomy.

[Patients] suffer for a long period of time before they fi nally get to the right team of people—and you do need a whole team of people: You need a specialized radiologist, a specialized sonographer, a specialized GYN surgeon, quite often a colorectal surgeon, a urologist. They all need to be in tune with this and understand the disease process to really work it up and treat it properly.”

—DR. ROBERT BENNETT

Dr. Robert Bennett

Dr. Judette Louis, Chief, TGH Women’s Institute

SharpeningPRECISION

THREE-DIMENSIONAL PRINTING COMBINED WITH RADIOLOGY IMAGING PUTS

COMPLEX CASES IN PHYSICIANS’ HANDS BEFORE THEY EVEN PICK UP A SCALPEL

By Dave Scheiber

The situation was life-threatening, one that would leave surgeons in Tampa General Hospital’s maternal-fetal medicine program no room for error or lost time. Internal imagery showed that a fetus had a gap in its airway—and every second counted. Once born, it might only take a minute for the baby to suf-

fer brain damage without sufficient oxygen. Several more minutes could prove fatal.

Enter the USF Health Radiology Division of 3D Clinical Applications, which has made a critical impact in improving fetal and pediatric medicine at Tampa General Hospital. One of the most advanced point-of-care

printing labs in the United States moved swiftly into action.

“What we were able to do was take the fetal imaging they gave us and actually create a model, and then print out a 3D copy of the baby—flexible just like [a newborn] would be,” explained Dr. Summer Decker, professor

and director of the Division of 3D Clinical Applications in the Department of Radiology in the USF Health Morsani College of Medicine at the University of South Florida. “And the colors showed exactly where the airway gap was and how they could repair it.”

This state-of-the art innovation allowed doctors to practice the specific surgery for this case in advance to ensure they had the timing—and every move—just right.

In general, this technology can also go a long way in alleviating parents’ anxiety by providing them with a full understanding of the situation at hand.

“As you can imagine, this can be such a serious and tense time for parents,” Decker said. “This innovative technology removes a great deal of stress from the parents and shows them clearly what is going on with their baby or child and how we are going to work together to fix it.”

“We’ve found that it really helps,” continued Dr. Jonathan Ford, technical director of the Department of Radiology for USF Health.

THIS INNOVATIVE TECHNOLOGY REMOVES A GREAT DEAL OF STRESS FROM THE PARENTS AND SHOWS THEM CLEARLY WHAT IS GOING ON WITH THEIR BABY OR CHILD AND HOW WE ARE GOING TO WORK TOGETHER TO FIX IT.”

—DR.

SUMMER DECKER

Dr. Summer Decker (below) and her colleagues in the USF Health Radiology Division of 3D Clinical Applications create 3D-printed models that can help physicians and surgeons treat complex cases. These models run the gamut from a shoulder (pictured) to a baby with a birth defect.

“With an ultrasound, you can point to a darker or lighter gray area. With an MRI, you might point out a slightly whitish or mid-tone spot. But when you have the actual physical object and can show, for instance, where the trachea is connecting to the mouth, the understanding is almost instantaneous.”

The team’s work has a long and distinguished history dating back to 2011, when TGH and the USF Health Morsani College of Medicine established one of the first clinical laboratories in Florida, specifically to print replicas of human hearts to aid in complex surgical procedures. Today, the radiology team can create 3D models that are precise to within one one-hundredth of an inch. And the division now serves as an international test site where this technology can be ap-

WITH AN ULTRASOUND, YOU CAN POINT TO A DARKER OR LIGHTER GRAY AREA. WITH AN MRI, YOU MIGHT POINT OUT A SLIGHTLY WHITISH OR MID-TONE SPOT. BUT WHEN YOU HAVE THE ACTUAL PHYSICAL OBJECT AND CAN SHOW, FOR INSTANCE, WHERE THE TRACHEA IS CONNECTING TO THE MOUTH, THE UNDERSTANDING IS ALMOST INSTANTANEOUS.”

—DR.

JONATHAN FORD

plied to not only maternal-fetal medicine and pediatric surgery, but in other areas, such as cardiology, orthopedics, and gynecology.

“We’re a really small team but we work very hard with our clinical partners here at the hospital,” Decker said. “And knowing that they have a team like us here allows them to be more creative and determine areas where we can collaborate.”

Decker said she is fueled by passion when a clinical group “comes in, saying, ‘We have this really advanced case and we think your team might be able to help.’ Some of my favorite photos that we have are of us all sitting together, looking over a model. This is truly interdisciplinary collaboration.”

Dr. Sarah Obican, associate professor and director of the Division of Maternal-Fetal

Medicine in the USF Health Morsani College of Medicine and co-director of the USF Health + TGH Fetal Care Center, couldn’t be more appreciative of their efforts and the full range of multidisciplinary collaboration.

“One of the best aspects of my job is working in a multidisciplinary team taking care of difficult clinical cases,” Obican said. “We pride ourselves on being able to take on challenging cases. Having the breadth of experiences from different medical teams brings the best outcome to our patients and their families.”

Not surprisingly, the 3D efforts have drawn the attention of physicians around the world who want to learn from the experts in the USF Health radiology department. “We’re really honored by that,” Decker said. “It underscores that we have this technology and want to find

novel ways to help our patients safely.”

TGH surgeons utilize the technology developed by the USF Health team to prepare for highly complicated, high-risk surgeries that will need to take place immediately upon delivery to correct issues that present in utero, such as EXIT (short for ex-utero intrapartum treatment). In this procedure—which is necessary when fetuses are found to be suffering a compression of their airways in the womb due to an obstruction—the baby’s head and shoulders are delivered through a Cesarean incision. The baby is quickly intubated while still connected to the placenta in order to receive cardiopulmonary support, and then the delivery can be completed.

TGH has been performing the procedure since 2009 and is one of the only hospitals in Florida with surgeons who have the requisite expertise. Coupled with the introduction of 3D printing, TGH surgeons can plan and execute the operation with greater confidence and less time in the operating room, significantly improving outcomes for the mother and baby.

“We get the hospital’s most complex cases or cases in which there’s something very tricky or difficult and our surgeons need some help,” Decker said. “Being radiologists, we use medical imaging and have a consultation with the physicians. Many times, we’ve worked with them before and know exactly what they’re looking for and how to help.”

Decker said her team addresses an array of custom requests. For instance, a physician may desire a computer model “so they can simply put it on an iPad and rotate it around as an educational piece. Or they might come to our lab and say, ‘I really want it to look or feel like this.’ We have all those options available to them. We can be creative in how we are able to approach a given case. We might take something that worked in another case and combine it. And because we can take multiple different types of imaging, like MRI or ultrasound, this gives us a lot more freedom to answer a tough question they may have.”

For pediatric surgeons treating cranial facial deformities, 3D printing of the baby’s skull im-

proves procedural planning and practice. As a result, surgeons spend less time performing surgeries, patients require less anesthesia, and the subsequently associated risks decrease.

Decker and her team also teach in the USF Health Morsani College of Medicine and perform research in this area, benefiting doctors around the country.

“A lot of what we do and have done with our clinical partners is the first time anyone has done it,” Decker said. “We turn that around and put it out there for the rest of the world to see and benefit from this innovative technology.”

Radiologists at USF Health can also create 3D-printed models using a biomimetic material that mimics human tissue. This is especially useful when making models of complex organs such as the heart.

Dr. Sarah Običan

CONSTRUCTING A NEW LIFE

FACIAL PLASTIC AND RECONSTRUCTIVE SURGERY SKILLS PLUS ENT EXPERTISE EQUALS EXTRAORDINARY RESULTS FOR PATIENTS

BY KAREN FELDMAN

Considering the sort of work Dr. Julia Toman does, one might expect to find her in a private plastic surgery practice. Instead, she’s helping patients put their best face forward as a subspecialized ear, nose, and throat surgeon, or otolaryngologist, at USF Health and the Tampa General Hospital Ear, Nose & Throat Institute, which is led by Dr. Tapan Padhya, who serves as chief of the institute and professor and chair of the Department of Otolaryngology Head & Neck Surgery in the USF Health Morsani College of Medicine at the University of South Florida.

Toman specializes in facial and plastic reconstructive surgery. Her training started with ENT surgical training, following which she completed additional fellowship training in facial plastic and reconstructive surgery. Given her extensive knowledge of the ear, nose, and throat, as well as training involving the head and neck, she has an in-depth understanding of the anatomy and function of these structures—making her uniquely suited to help patients of all ages in great need of such surgical services, whether for functional or aesthetic reasons.

“I do anything aesthetic or reconstructive from the collarbone up,” said Toman, who is also an assistant professor in the Department of Otolaryngology Head & Neck Surgery in the USF Health Morsani College of Medicine. “Facial plastics is a specific sub-specialty within ENT providing specialized skills to restore form and function in the head and neck region.”

Padhya is chief of the TGH Ear, Nose & Throat Institute, which is ranked in the top 20 hospitals nationally for ear, nose & throat by U.S. News & World Report. Surgeons at the institute, such as Padhya and Toman, have decades of experience leading complex surgical procedures.

Dr. Julia Toman

Dr. Tapan Padhya

For someone like Colleen Johnson, who endured the devastating effects of granulomatosis with polyangiitis (formerly called Wegener’s granulomatosis), Toman’s skills proved to be life-changing.

A rare autoimmune disorder, granulomatosis with polyangiitis is a vasculitis that can present in various organ manifestations, though ear, nose, and throat symptoms occur in most cases. Johnson struggled with the autoimmune disorder for 15 years. It caused her nose to collapse, forcing her to breathe through her

mouth, limiting airflow, and severely hampering even basic activities.

“[Johnson] came to me to address structural and functional elements of her nose,” Toman said. “We were able to use cartilage from other parts of the body to rebuild the nasal structure so that instead of her nose being collapsed in on itself, she had a normal structure that projected the nose from her face, allowing for restoration of normal breathing airways.”

The surgery included a multidisciplinary approach, combining the nasal reconstruction

along with management of her chronic sinusitis by Toman’s colleague, Dr. Mark Tabor, associate professor and chief of the Division of Rhinology/Endoscopic Skull Base Surgery in the Department of Otolaryngology Head & Neck Surgery in the USF Health Morsani College of Medicine.

“When I got the procedure done, I’d had a collapsed nose for at least 10 years,” Johnson said. “I thought that would be my life forever. But afterward, I had more energy. I was able to go outside again. I was able to do just about anything.”

Johnson is one of many patients whom Toman has helped. Allen Parent of Brooksville, Florida, found a lump on the left side of his neck that turned out to be squamous cell mouth cancer. The surgery required to remove it left noticeable disfigurement. “It’s emotional because it’s your looks,” Parent said.

Again, a multidisciplinary approach was

I’D HAD A COLLAPSED NOSE FOR AT LEAST 10 YEARS. ... BUT AFTERWARD, I HAD MORE ENERGY. I WAS ABLE TO GO OUTSIDE AGAIN. I WAS ABLE TO DO JUST ABOUT ANYTHING.”

—COLLEEN JOHNSON

required, and Parent underwent management of his cancer and initial reconstruction with Dr. Matthew Mifsud, a head and neck oncology surgeon at USF and an assistant professor in the Department of Otolaryngology Head & Neck Surgery in the USF Health Morsani College of Medicine. Following this, Parent underwent surgery for the neck deformity that had resulted from his cancer therapy with Toman.

Today, Parent said he does not notice the area once in need of surgery and neither do other people. “I’m really grateful,” he said. “I’m appreciative of everyone who was involved. The results are just amazing.”

Toman also handles trauma management, such as severe cuts, disfiguring dog bites, gunshot wounds, and injuries to the facial skeleton from motor vehicle accidents. “These injuries

can be devastating to patients, and surgery provides a true opportunity to improve patient quality of life,” she said. Additionally, patients plagued by scars or keloids can be a true challenge, and she works with patients to minimize these scars and restore their appearance.

Along similar lines of appearance improvement, Toman has a specific interest in facial rejuvenation. This includes both nonsurgical injectables and surgical procedures to reshape the nose or lift the face or eyelids. She focuses specifically on providing a natural and refreshed appearance for patients. “To allow people to be seen on the outside the same way they feel on the inside really affirms people’s quality of life,” Toman said.

In addition to her surgical practice, in her role as an assistant professor, Toman is training the next generation of doctors at the USF

Health Morsani College of Medicine. And while she is teaching them the technical aspects that they will need to be successful surgeons, she is also exposing them to global health outreach.

She currently maintains partnerships in South Africa and Malawi (a landlocked country in southeastern Africa), where there is a great need for improved access to care, education, and research infrastructure development. These projects include travel of trainees from both sides of the Atlantic and joint research endeavors. “While many are familiar with the Maimonides proverb about teaching a man to fish, the next step in the future of global health outreach is fishing together and learning from each other,” said Toman.

Above: Toman reconstructed patient Allen Parent’s neck after his bout with squamous cell mouth cancer. Opposite page: Toman and Dr. Mark Tabor worked collaboratively to help patient Colleen Johnson, who had a collapsed nose due to granulomatosis with polyangiitis.

I’M REALLY GRATEFUL. I’M APPRECIATIVE OF EVERYONE WHO WAS INVOLVED. THE RESULTS ARE JUST AMAZING.” —ALLEN PARENT

NEXT-GENERATION

PROSTATE

TREATMENT

BY EMBRACING

AN

INNOVATIVE, NEW PROTECTION

DURING RADIATION

THERAPY, TGH PAVES THE PATH TOWARD

“THE NEXT BIG STEP IN CANCER CARE”

BY SANDRA GURVIS

ncologists and researchers have made major progress in the prevention and cure of prostate cancer. However, it remains the second most common cancer among men in the United States. In fact, the American Cancer Society estimates that in 2023 there will be around 288,300 new cases of prostate cancer and about 34,700 deaths.

The majority survive due to proven treatments, such as radiation therapy. While most patients tolerate treatment with few side effects, there are potential risks, “which can sometimes also be associated with longterm or after-the-fact changes,” said Dr. Alexander Engelman, director of radiation oncology at Florida Urology Partners and a

Oradiation oncologist at the Tampa General Hospital Cancer Institute.

Although the high-energy radiation beams destroy and stop the spread of cancer cells, they “can also harm healthy tissue surrounding the prostate, causing damage to the rectum,” explained Dr. John David, assistant professor and director of brachytherapy services and radiopharmaceuticals at the USF Health Morsani College of Medicine at the University of South Florida and a radiation oncologist at TGH.

Enter Barrigel, which can offer protection to the estimated 268,000 men in the United States receiving radiation treatment for prostate cancer. Approved in June 2022 by the Food and Drug Administration (FDA), the Barrigel injectable, malleable, and biodegradable medical device provides a barrier between the prostate and the rectum, protect-

ing healthy tissue during therapy. Consisting of nonanimal stabilized hyaluronic acid (NASHA), a substance that naturally occurs in and is absorbed by the body, Barrigel moves with the body yet maintains its shape and efficacy, “making it the ideal material to create a custom-made interface for each patient to protect their anatomy during treatment,” said Dr. Raviender Bukkapatnam, chief of TGH’s Urology Institute.

Although the basic material itself has been around for a long time and has been used for plastic surgery and in urological applications, TGH and Florida Urology Partners were the first in the nation to treat patients with Barrigel, with Engelman performing the initial procedure. As Tampa’s only site principal investigator for the Barrigel national clinical trials, Engelman will also be advising adopters in other states and

Dr. Raviender Bukkapatnam

Dr. John David

Dr. Alexander Engelman

[Barrigel is] the ideal material to create a custom-made interface for each patient to protect their anatomy during treatment.”

—Dr. Raviender Bukkapatnam

Europe. David and other physicians at TGH and Florida Urology Partners will be performing the Barrigel procedure as well.

“Because we manage prostate cancer patients at all stages and see a large number of them, we are able to recruit [physicians] who bring a great breadth of experience to our community,” said Bukkapatnam.

“I feel very honored by patients’ trust during these clinical trials,” Engelman said. “It was especially rewarding to see a 78 percent reduction in gastrointestinal side effects, a protection which continued to manifest itself months after treatment was concluded. These benefits are also anticipated to further improve as time goes on.”

According to an FDA clinical study published in JAMA Oncology in February 2023, 98.5 percent of Barrigel patients experienced a significant reduction in radiation in the rectum. Six-month followup results showed that Barrigel also significantly reduced long-term, negative side effects.

“Along with minimizing the side effects of radiation therapy, it allows for improved recovery

The Barrigel procedure is offered at Florida Urology Partners at the TGH Cancer Institute on an outpatient basis and can be completed in less than 30 minutes.

and better healing,” David noted. “Patients can quickly return to their current day-to-day activities.”

So how does it work? After the patient is put under anesthesia, urologists position fiducial markers—tiny metal objects about the size of a grain of rice—in the prostate. Per the Barrigel website, these markers help treatment teams line up the radiation beams to ensure the “radiation therapy is delivered the same way each time,” thereby targeting the tumor with greater accuracy and delivering “the maximum radiation dose to the tumor while avoiding the healthy tissue surrounding the cancer.”

Typically, Barrigel is placed at the same time as the fiducial markers, which are harmless but permanent. The Barrigel, on the other hand, will dissipate after the radiation treat-

ment is completed. The Barrigel placement “is minimally invasive and can be done safely in an office setting,” Engelman said. The procedure is covered by most insurance plans and completed at TGH on an outpatient basis in less than 30 minutes. Barrigel is also the only gel spacer that can be viewed clearly on a transrectal ultrasound, the imaging machine used to guide its placement. “This added visibility provides even greater control and precision,” David explained.

The collaboration between TGH, Florida Urology Partners, and others to get Barrigel quickly and safely in use for patients points to a wider trend in translational or bench-tobedside medicine.

“This is an excellent example of how different stakeholders can work together to use

cutting-edge research to benefit community care,” Engelman observed. “Our partnership with TGH allows us to offer innovative procedures, treatments, and clinical trials—previously only available in one central location— to patients in their own backyards.”

Furthermore, products such as Barrigel can be adapted to protect patients who receive radiation therapy for other types of cancer as well. Even better: Such innovations are becoming the norm rather than the stuff of science fiction.

“As a next-generation technology, it can help prostate cancer patients achieve a better quality of life,” said Engelman.

“This is a game changer,” concluded Bukkapatnam. “It’s the next big step in cancer care.’’

The initial Barrigel placement begins with the surgical positioning of fiducial markers in the prostate.

Our partnership with TGH allows us to offer innovative procedures, treatments, and clinical trials—previously only available in one central location—to patients in their own backyards.”

—Dr. Alexander Engelman

TGH gives AAA

BACK

THE HEALTH SYSTEM SUPPORTS

THE COMMUNITY AND, IN RETURN, IS SUPPORTED BY THE COMMUNITY

By Chris Curtland

OUR ABILITY TO CARE FOR THIS COMMUNITY, DRIVE INNOVATION AND MEDICAL BREAKTHROUGHS, AND SUPPORT OUR TEAM IS A DIRECT RESULT OF THE FOUNDATION’S EXCEPTIONAL WORK.”

JOHN COURIS

As the region’s leading safety net hospital, Tampa General Hospital won’t turn away people who can’t pay for the care they need—even if it’s rare, complex care. Operating as a not-for-profit academic health system, TGH not only provides compassionate care to patients at its 1,040-bed facility but also at more than 130 locations throughout the state of Florida.

That work to support the Tampa Bay area and beyond is support-

ed largely by the Tampa General Hospital Foundation.

The Tampa General Hospital Foundation is a philanthropic organization, acting as a crucial source of funding for the hospital’s mission to heal, teach, innovate, and care for everyone, every day. The Foundation’s vision is to help TGH achieve its vision of becoming the safest and most innovative academic health system in America.

“By inspiring philanthropic in-

John Couris

vestment from generous donors each year, the Foundation can provide Tampa General with resources to significantly strengthen our impact on the lives of our patients and their families, our team members, and our community,” said John Couris, president and CEO of TGH. “Our ability to care for this community, drive innovation and medical breakthroughs, and support our team is a direct result of the Foundation’s exceptional work.”

Over the last five years, fueled by the strategic vision of TGH leadership, the Foundation has grown enormously, currently raising an average of 463 percent more annual dollars than it has historically. It has accomplished this through a variety of endeavors, includ-

ing hosting professional networking events, sponsoring initiatives that help the community, and supporting like-minded organizations. Dollars raised by the Foundation directly support the hospital’s mission and are distributed across several interests:

Brick and mortar: As Tampa General Hospital continues to grow and its Master Facility Plan is developed, there is a near-constant need for renovation and new construction. Announced in September 2021, Tampa General’s comprehensive Master Facility Plan is the largest in the hospital’s history and is the strategic cornerstone to the academic health system’s commitment to developing Tampa Bay’s first Medical and Research District to serve the re-

gion’s increasing health care needs.

Equipment and technology: Through TGH’s affiliation with the USF Health Morsani College of Medicine at the University of South Florida, patients have access to a wider variety of clinical trials, research studies and breakthroughs, options for advanced immunotherapy procedures, enhanced personal treatment plans, and a convenient path to complex surgeries. Funds raised by the TGH Foundation have helped the hospital acquire important equipment and offer groundbreaking treatments.

Programming initiatives: These include community offerings such as wellness workshops, screening and prevention events, and

TGH President and CEO John Couris along with Tampa Mayor Jane Castor (both center) officially launch TampaWell Activated by Tampa General Hospital at the TGH Family Care Center Healthpark in May 2022. This revolutionary health and wellness initiative has the goal of making Tampa the ultimate wellness destination in the United States.

THERE ARE SO MANY EXCITING OPPORTUNITIES FOR PHILANTHROPISTS TO REALLY MOVE THE NEEDLE ON THE QUALITY OF HEALTH CARE IN FLORIDA. WITH TGH’S EXPLOSIVE GROWTH, INNOVATIVE PRACTICES, AND COMPASSIONATE PATIENT CARE, IT’S EASY FOR OUR FOUNDATION TEAM TO ALIGN STAKEHOLDERS WITH MEANINGFUL GIVING OPPORTUNITIES THROUGHOUT THE STATE.”

FRANN LEPPLA

OneTGH Employer Solutions, which takes a proactive and customized approach to helping businesses manage employee health, team member engagement, and rising health care costs; TGH Innoventures, a venture capital fund dedicated to driving a culture of innovation through the support of early-stage startups and direct investments; and the Home Base Warrior Program, a collaboration with the Red Sox Foundation and Massachusetts General Hospital, which offers a no-cost health and fitness program to veterans.

“We are incredibly grateful for the donors who choose to invest in our world-class

health system,” said Frann Leppla, senior vice president and chief philanthropy officer with the Tampa General Hospital Foundation. “There are so many exciting opportunities for philanthropists to really move the needle on the quality of health care in Florida. With TGH’s explosive growth, innovative practices, and compassionate patient care, it’s easy for our Foundation team to align stakeholders with meaningful giving opportunities throughout the state.”

Tampa General Hospital operates in a unique way. It supports the community and is in turn supported by the community, and the TGH Foundation helps to make that

happen. If a new piece of equipment or wing of the hospital can help improve patient outcomes or shorten patient stays, then that allows the hospital to serve more and more patients. There is a direct, cumulative benefit to the public.

“At the end of the day, what TGH and the Foundation are accomplishing is a spectacular investment,” Leppla added. “Highperforming hospitals are vital to the safety and well-being of local communities. When Floridians and their families find themselves needing rare, complex, and specialized care, they come to TGH. It’s an incredible benefit to have this option right here in the state.”

Frann Leppla

WORLD-CLASS CANCER CARE POWERED BY ACADEMIC MEDICINE

TAMPA GENERAL HOSPITAL’S CANCER INSTITUTE IS IN THE NATION’S TOP 10% FOR CANCER CARE.

The Cancer Institute at Tampa General Hospital hand selected the country’s top cancer specialists, surgeons and research scientists to expertly handle complex cases and cancers of all kinds. Our groundbreaking discoveries and innovative therapies deliver game-changing outcomes and our personalized treatment plans use genetics and artificial intelligence for truly custom care. Most importantly, your personal journey is compassionately guided by a health ambassador who is dedicated to keeping you supported and informed.

Florida’s Leading Academic Health System For Over 50 Years

Building a HEALTHY PLATE

A healthy eating routine is an essential part of daily life and overall well-being. In general, your plate should include three components: a protein, a fat, and a carbohydrate. Choosing the right ones for optimum nutritional impact, however, is where it gets tricky. In the following pages, Madison LaPorte, a clinical nutritionist and dietitian at Tampa General Hospital, offers up her best recommendations for sources of lean proteins, heart-healthy fats, and complex carbohydrates like fruit, vegetables, and whole grains.

BY KARINA WENSJOE

Protein:

CHICKEN BREAST

Boneless, skinless chicken breast is much lower in unhealthy fat than red meat, and its nutrients are very bioavailable, which refers to how much of a nutrient the body can absorb and utilize. Chicken contains essential nutrients such as vitamin B3, which aids in metabolic performance and nervous system function; vitamin B6, which supports the immune system; and phosphorus, which helps to maintain bone and tooth health.

“Protein is broken down into amino acids, which are the building blocks for muscle maintenance and muscle gain,” LaPorte said. “It also helps promote satiety (the satisfied feeling of being full after eating). Protein and fats take some time to break down, as opposed to carbohydrates, which start breaking down immediately once food reaches the mouth. That’s why we like to include all the different macronutrients [carbs, fat, and protein] in a meal.”

LaPorte recommends lean protein servings of three to four ounces, which is about the size of a deck of cards. A four-ounce serving of cooked chicken contains around 35 grams of protein. Grilling or oven baking are the two healthiest ways to cook chicken breast.

Vegetable: BELL PEPPERS

Seasonality plays a huge part in selecting the right vegetables for your plate. When in season, bell peppers make for a delicious—and healthy—addition to your grilled or baked chicken breast. High in vitamins A and C, this colorful vegetable contains antioxidants and fiber to help regulate bowel movements (combating issues such as constipation and bloating), maintain a healthy gut, and improve cholesterol levels.

WE USUALLY ENCOURAGE EATING A VARIETY OF DIFFERENT COLORS TO MAKE SURE YOU ARE GETTING ALL THOSE DIFFERENT VITAMINS AND MINERAL COMPONENTS.”

When selecting vegetables, variety and color are key. “Generally, the different colors mean different vitamin contents,” LaPorte explained. “For example, orange vegetables like carrots or sweet potatoes are high in vitamin A. Dark, leafy greens have vitamin K. We usually encourage eating a variety of different colors to make sure you are getting all those different vitamins and mineral components.”

OLIVE OIL Fat:

Whether you’re cooking with it or drizzling it on as a final touch, this Mediterranean ingredient is rich in polyphenols and omegas, meaning it packs a nutritious punch while also adding depth of flavor. Olive oil is also a quality source of monounsaturated fat.

“Mono and polyunsaturated fats are better for heart health than things like saturated fats and trans fats,” LaPorte said.

There is a reason why Homer referred to olive oil as “liquid gold.” According to a 2020 study published in the Journal of the American College of Cardiology, individuals who consumed more than half a tablespoon of olive oil daily had lower rates of premature death from cardiovascular disease and Alzheimer’s disease, among other causes.

For this plate, LaPorte suggests mixing a tablespoon of olive oil with your favorite spices and brushing it on your chicken breast. For another application, consider drizzling the oliveoil-herb mixture on sweet potatoes before roasting.

Grain: BROWN RICE

Whole grains keep you, well, whole. A great source of fiber, brown rice is the final component to add to this healthy plate. In contrast with white rice, brown rice is minimally processed, rich in vitamins and minerals, and high in fiber, which aids in digestion and regulation of blood sugar and cholesterol levels.

According to the American Institute for Cancer Research, there is probable evidence that consuming whole grains (such as brown rice) reduces one’s risk of developing colorectal cancer. Furthermore, brown rice has a relatively lower

glycemic index (GI) of 50 and is a healthier alternative to white rice, which boasts a GI of 70. When choosing a carbohydrate, it is important to opt for those with lower GI values because they will be broken down slowly—resulting in more sustained energy—and they won’t spike your blood sugar.

LaPorte recommends combining brown rice with chicken, bell peppers, and olive oil to make a stir-fry—a composed meal that will retain the nutritional value of each individual ingredient.

LAPORTE RECOMMENDS COMBINING BROWN RICE WITH CHICKEN, BELL PEPPERS, AND OLIVE OIL TO MAKE A STIR-FRY—A COMPOSED

MEAL THAT WILL RETAIN THE NUTRITIONAL VALUE OF EACH INDIVIDUAL INGREDIENT.

State of Technology

Discover

Discover SIX INNOVATIVE DEVICES with roots in Florida

BY LIZA GRANT SMITH

Miami-based mother-daughter duo Debbie and Markea Dickinson are the women behind the new Thermaband Zone ($300), which helps those suffering from hot flashes, cold flashes, or night sweats. When the AI-enabled wearable detects variations in body temperature, its batterypowered thermoelectric pump jumps into action to either cool down or warm up the wearer. (thermaband.com)

Just Keep Swimming

Four former University of Florida swimmers are making waves with the Phlex Edge swim assistant ($300). The sensor attaches to swim goggles and holds constant contact with skin, collecting data on helpful fitness information such as distance per stroke and lap time, as well as providing analytics on heart rate and calories burned. (phlexswim.com)

Trip the Light Fantastic

Splurge on your skin

care routine with the Rayo ($8,960) from Lumia out of Orlando, Florida. This lightweight and portable LED device utilizes phototherapy to rejuvenate skin on both the face and body. Its seven treatment protocols last 30 minutes each and incorporate blue, red, and nearinfrared LED light to boost collagen production and reverse signs of aging. (thelumia.com)

Care Package

Sleeping Beauty

The Bongo Rx from Air Avant Medical, based out of Deerfield Beach, Florida, is innovative in its simplicity. Designed for those with mild to moderate obstructive sleep apnea, the Bongo Rx (price varies) is an EPAP (expiratory positive airway pressure) device, meaning it only creates pressure on exhalation. During inhalation, small valves open to allow normal breathing; during exhalation, the valves close and direct air through specifically designed vent holes to generate EPAP and keep the airway open until the next inhale. (airavant.com)

A Leg Up

Based in Germany and operating a U.S. headquarters in Hollywood, Florida, Beurer has been creating health and wellness products for more than 100 years. Its Vital Legs circulation booster ($200) uses electrical muscle stimulation (EMS) to increase blood flow to the feet and legs, relieving aches and pain and promoting improved strength and endurance. (beurer.com)

To combat the overreliance on human observation in senior care, Satish Movva of Plantation, Florida, created CarePredict, which utilizes machine observation to cue justin-time intervention. The central component of his At-Home Kit ($450 for kit; $70 per month for subscription) is the Tempo Series 3, a smart wearable for seniors that tracks daily habits and uses that information to predict potential risks and alert caregivers. (carepredict.com)