University of Florida Department of Surgery : The Stitch

University of Florida Department of Surgery P.O. Box 100286 Gainesville, FL 32610

DESIGN JS Design Studio

CONTRIBUTORS Jesse S. Jones

EDITORS Katrina McAfee, Laura Mize 352.265.0646 TheStitch@surgery.ufl.edu

surgery.med.ufl.edu

THE STITCH

Check out exclusive articles at surgery.ufl.edu/stitch.

Advances in lung transplantation/ XVIVO Lung Perfusion

INSIDE THIS ISSUE:

Patient thriving after robotic colorectal surgery

Side effects of hemodialysis: steal syndrome

...and more

• Acute Care Surgery Frederick Moore, M.D., Chief • Gastrointestinal Surgery Steven Hughes, M.D., Chief • Surgical Oncology Steven Hughes, M.D., Interim Chief

GENERAL SURGERY Steven Hughes, M.D., Chief

UF DEPARTMENT OF SURGERY Kevin Behrns, M.D., Chairman Administrative Offices: 352.265.0646 Patient Appointments/Referrals: 352.265.0535 Research Office: 352.265.0494

TRANSPLANTATION SURGERY Jeffrey Fair, M.D., Chief VASCULAR SURGERY AND ENDOVASCULAR THERAPY Thomas Huber, M.D., Ph.D., Chief RESEARCH LABORATORIES Lyle Moldawer, Ph.D., Vice Chairman

PEDIATRIC SURGERY David Kays, M.D., Chief PLASTIC AND RECONSTRUCTIVE SURGERY Bruce Mast, M.D., Chief THORACIC AND CARDIOVASCULAR SURGERY Thomas Beaver, M.D., M.P.H., Chief

Rehabilitating

Donated Lungs

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he UF Health Shands Transplant Center is testing a new approach that could improve the viability of many donated lungs, allowing more to be used and shortening the time patients have to wait for transplantation.

The center is one of 15 nationwide participating in a study to continue evaluating the XVIVO Lung Perfusion System. This system allows donor lungs — about 80 percent of which are found unacceptable for transplant under the very high standards required for the organs — to essentially be kept alive and potentially improved to become eligible for transplant. Some lungs may have potentially reversible problems, such as pulmonary edema or impaired gas exchange. If these conditions are addressed, the lungs may be excellent candidates for successful transplantation.

The machine, called XPS, which the U.S. FDA approved under the humanitarian device exemption in 2014, pumps a special preservation solution and oxygen into the lungs to maintain and possibly improve their health outside the body. The lungs actually contract and expand inside the XPS for hours, allowing transplant surgeons to assess them over time. The FDA’s approval of the device last year came with a requirement that the manufacturer continue studies involving the devices to collect additional information on their use.

“The function of most of these lungs can now be improved by use of the XVIVO Lung Perfusion technique,” said Tiago Noguchi Machuca, M.D., Ph.D., an assistant professor in the division of transplantation surgery and a lung transplant surgeon who leads UF Health’s lung perfusion program. “This technique will help to expand the pool of acceptable donor lungs, hopefully shortening the waiting period for donor lungs and, more importantly, preventing deaths of those whose health condition cannot afford the wait time.”

Thomas Beaver, M.D., M.P.H., a professor and chief of the division of thoracic and cardiovascular surgery, established UF Health’s work in lung perfusion with a research program several years ago.

“We have been working since 2010 in the laboratory with our own system and have been looking forward to finally seeing the clinical application of the FDA-approved system in the United States,” Beaver said. “We are excited to be one of the few centers that will be utilizing this technology with Dr. Machuca, who used it extensively both clinically and in research while training at the leading institution for XVIVO. And, we are in a better position than most because we will

be rehabilitating our own lungs on-site rather than having to fly them to a perfusion center. This is a major advance in the field of lung transplantation.”

Machuca recently completed a thoracic surgery fellowship at the University of Toronto, where out-of-body lung perfusion technology was pioneered.

Physicians at UF Health have been seeking new options to increase the availability of acceptable donor organs.

Traditionally, lungs considered for transplant are evaluated once by a surgeon at the medical center offering the lungs, while the organs remain inside the donor. Such assessments may not provide all the information the transplanting surgeon may desire, and conclusions about the organs’ viability can be difficult to reach.

“We are excited to Absent convincing proof of excellent be one of the lung health, the organs are few centers that will be sometimes rejected utilizing this technology because doubt remains about their with Dr. Machuca.” condition. With the – Thomas Beaver, M.D., M.P.H. XVIVO Lung Perfusion system, lungs that fail initial screenings may be improved enough for transplantation.

UF Health lung transplant surgeons will bring lungs identified for perfusion back to Gainesville and attach them to the XVIVO machine, XPS, which keeps them “alive” and functioning under normal body temperature. Studies have shown that lungs treated in the XVIVO system and rated acceptable for transplant through numerous careful assessments are safe for transplant.

UF Health transplant providers became certified to begin using the new XVIVO technology in April 2015 after a training process of several weeks. Now, the lung transplant team is ready to help extend the lives of more patients.

“Dr. Machuca’s expertise will allow us to consider an expanded pool of donor lungs to be able to increase our patients’ chances of receiving new lungs,” said Juan Salgado, M.D., medical director for the UF Health Lung Transplant Program and an assistant professor in the department of pulmonary, critical care and sleep medicine.

The Stitch || Summer 2015 1

Robotic Surgery Helps Georgia Man Become Cancer-Free

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eorgia retiree James New had delayed his follow-up colonoscopy by a year.

Instead of going three years between exams, he’d gone four.

And the news he received after he completed his February 2014 colonoscopy was something no one wants to hear: The doctor was quite certain New had colorectal cancer.

New’s cancer was stage III, meaning it had spread to some of his lymph nodes but not yet made its way to other parts of his body.

His local oncologist, who had completed her fellowship at UF’s College of Medicine, recommended UF Health Shands Hospital and the UF Department of Surgery.

New, who was quite anxious about his diagnosis, was relieved to see Atif Iqbal, M.D., an assistant professor and a colorectal surgeon at UF Health, within three days of his referral. Iqbal and a team of other UF Health oncology experts created a multidisciplinary plan for treating New, which included radiation and chemotherapy before surgery. They helped arrange for these to take place in Valdosta, where the patient and his wife, Diane New, live.

New was glad to learn that despite having a low-rectal cancer close to the anus, he would likely not need a colostomy, which would require giving him a permanent bag. New also appreciated that robotic surgery would be an option for him at UF Health, which is much less invasive.

Iqbal discussed with New the benefits of robotic surgery, including smaller incisions, less pain, less bleeding, quicker recovery, quicker return to diet and reduced risk of infection and hernia compared to open surgery, which requires larger incisions.

“I’m 70. I just wanted to keep it (surgery) as minimal as possible,” New explained. “I was told that Dr. Iqbal specialized in robotic surgery, and he came highly recommended.”

Iqbal also sees advantages in robotic surgery over laparoscopic surgery, “which also has smaller incisions but lacks the 3-D vision, full-motion dexterity and higher degree of freedom offered by the robotic arms,” he said.

To conduct robotic surgery, the surgeon maneuvers hand controls at a special console in the operating room. His hand movements control the robotic arms carrying out the operation, which can mimic all degrees of hand movement.

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The University of Florida Department of Surgery

Standard laparoscopic instruments, in contrast, can only open and close.

The robot has a tiny camera attached to it that sends threedimensional images back to a screen at the console for the surgeon as he conducts the operation, as opposed to twodimensional images seen in standard laparoscopy.

After training in general surgery at the University of Missouri, Iqbal completed a fellowship in colorectal surgery at Washington University/Barnes Jewish Hospital in St. Louis.

There, he learned to perform robotic surgery.

UF Health is a high-volume center for robotic colorectal surgery, a notable designation considering the low percentage of U.S. surgeons performing this procedure who have completed a high volume of the operation.

After undergoing chemotherapy and radiation in the spring of 2014, New was ready in June 2014 for the first of two surgeries to address his colon cancer. Iqbal removed the diseased part of New’s colon and rectum robotically, and connected the ends back together. Because the connection was so close to the end of the rectum, a temporary bag (ileostomy) was made to allow for healing of the hook-up (anastomosis) site. Not long after this operation, New and Iqbal got some very good news.

“Dr. Iqbal had mentioned that I was the second patient he’d had during the three years or so he had been at Shands that, after surgery, the pathology report came back with absolutely no sign of any cancer cells,” New recalled. “So, that made me feel good.”

Robotic Surgery continued from page 2

From the Chairman

New also responded very well to chemoradiation, which in turn bodes well for his long-term outcome, Iqbal noted.

In a second surgery, a few months after the first, Iqbal reconnected the two ends of New’s colon back together and removed the ileostomy, since the colon had now healed.

This allowed New to start getting back to his original routine. He continues his recovery and, a little more than a year after his diagnosis, said he is getting back to his old self.

The soreness — normal after the surgeries he had — has subsided and New has been excited about getting back to the gym to exercise. He is more active in daily life than he was during his course of cancer treatment, he said, and he looks forward to getting out more with his wife and traveling throughout Georgia and to Tennessee to see their grown kids and grandchildren.

he delivery of high-quality, state-of-the-art care requires outstanding facilities that house sophisticated equipment that is used by highly trained surgeons. At UF Health, we are committed to offering our patients the best care, which necessitates an outstanding physical plant.

Recently, we have made two substantial commitments to upgrade our facilities that will provide outstanding care venues for our surgical patients.

First, in January, we broke ground on the UF Health Heart & Vascular Hospital and UF Health Neuromedicine Hospital. This new tower will have 216 private patient beds, 20 operating rooms, 120 intensive care unit beds and 78 clinic exam procedure rooms that permit multidisciplinary outpatient clinics. These onsite clinics will be the first clinics to be integrated with the hospital units at UF Health. This proximity of the clinic and inpatient beds should offer our patients ease of access and enhanced convenience. In addition, many of the operating rooms will be “hybrid” suites that will permit both open and/or endovascular surgery. The facility will be home to the department’s divisions of thoracic and cardiovascular surgery and vascular surgery and is scheduled to open in early 2018.

A second project that began in April 2015 is the addition of the UF Health Children’s Surgical Center to the existing UF Health Florida Surgical Center. A dedicated outpatient surgery center with four operating rooms and an environment designed to be children-centric will create an outstanding new facility that will provide convenient access for children and parents. The UF Health Children’s Surgical Center will continue to be staffed by fellowshiptrained pediatric surgeons, as well as anesthesiologists and nurses. Construction should be completed in spring 2016.

The construction of these two facilities will further upgrade our already spectacular facilities, including the UF Health Shands Cancer Hospital, which opened in November 2009. These new patient care venues provide vibrant and leading-edge environments that are welcoming to the patients and energizing to the staff.

Please come by and see our new facilities in the not too distant future. We would be happy to provide you with a tour.

UF Plastic Surgeon Speaks to International Gathering About Use of

Fat Stem Cells

Adam Katz, M.D., an associate professor in the UF department of surgery’s division of plastic and reconstructive surgery, spoke at the World Stem Cell Summit in December 2014. He was the keynote speaker for the track on “regenerative services and restorative medicine.”

Katz’s presentation, titled “Tissue Repair and Regeneration Using Adipose Tissue as a Biological Resource: Past, Present and Future,” gave attendees an overview of the use of stem cells from fat tissue in medical research.

Scientists around the world are exploring ways to use these stem cells to fight a wide variety of diseases, including heart disease, Crohn’s disease, osteoarthritis and multiple sclerosis, he said in an interview after the summit.

Stem cells from fat are “a very practical and attractive alternative” to embryonic stem cells and induced pluripotent stem cells, Katz also noted.

As part of the Armed Forces Institute on Regenerative Medicine II, Katz leads a clinical trial that involves taking fat from a patient through small incisions during surgery, washing and preparing the tissue, then reinjecting it under a scar or skin graft elsewhere on the patient’s body.

“The goal is to determine if this fat transplantation procedure can improve the appearance and/or quality of existing scar tissue,” he explained.

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Kevin E. Behrns, M.D. Chairman The Stitch || Summer 2015 3

UF Liver Researcher Selected from Thousands of Applicants to Speak at Scientific Meeting Jae-Sung Kim, Ph.D., an associate professor in the UF College of Medicine’s department of surgery and head of the Cell Death and Mitochondrial Biology Laboratory, was one of six presenters at the plenary session on basic science at the American Association for the Study of Liver Diseases (AASLD) meeting in Boston in the fall of 2014.

The association is the most prominent organization dedicated to liver study in the world.

Kim was selected out of more than 4,000 applicants to present during the session, he said. He spoke about his research team’s work to understand the causes and effects of impaired liver cell autophagy following surgery. Autophagy, the cell’s cleanup process, allows it to discard or repair abnormal or old components.

Behrns Accepts New Roles with ACS, National Surgical Journal Kevin E. Behrns, M.D., chairman of the department of surgery and the Edward R. Woodward professor of surgery, has accepted roles as co-editor-in-chief of the journal Surgery and as a member of the executive committee of the American College of Surgeons’ board of governors.

Behrns said he wants to help the journal establish a dynamic social media presence, enhance its electronic edition and mobile accessibility, and find engaging new ways of communicating with young surgeons.

He and other leaders from Surgery, which is published by Elsevier, also will continue working to enrich the journal’s content on basic science, clinical, health policy and surgical-education topics. Currently, the journal is best known for its robust basic science content.

Behrns has served on the editorial board of Surgery for more than 10 years. His co-editor is Michael G. Sarr, M.D., a professor of surgery at the Mayo Clinic in Rochester, Minnesota.

In his new role on the ACS board of governors executive committee, Behrns will chair the college’s membership services pillar.

This group manages humanitarian medical efforts and coordinates awards from the college’s industry partners to surgeons who have contributed significantly to global health efforts. A third role of the group is to oversee the college’s chapters throughout the world.

As a member of the executive committee, Behrns also will provide input on college matters related to quality, education, health policy and finance.

“The major goal is to see how we can strengthen the domestic and international chapters so that they can remain strong and undertake grassroots efforts for health policy and finance, for local education, for all those kind of things,” he said.

Exciting Developments are in the Works at UF Health!

To read about the UF Health Heart & Vascular Hospital and the UF Health Neuromedicine Hospital, visit http://bit.ly/15DWHpB. For the latest on the new UF Health Shands Children’s Surgical Center, go to http://bit.ly/1Osnoyl.

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The University of Florida Department of Surgery

This Just In...

Machuca

Friedman

Smith

Tiago N. Machuca, M.D., PhD

Assistant professor of thoracic and cardiovascular surgery Medical school: Federal University of Parana, Brazil Residency (general surgery): University of Sao Paulo, Brazil Residency (thoracic surgery): Santa Casa de Misericordia Hospital, Brazil Fellowship (thoracic surgery and lung transplantation): University of Toronto, Canada Clinical interests: thoracic surgical oncology, minimally invasive thoracic surgery, robotic surgery, tracheal surgery, lung transplantation, extracorporeal life support

Jeffrey Friedman, M.D., FACS

Assistant professor of general surgery and bariatric surgery Medical school: University of Mississippi Residency (general surgery): Carraway Methodist Medical Center, Birmingham, AL Fellowship (surgery research): Mary Imogene Bassett Research Institute, NY Fellowship (minimally invasive surgery/ bariatric surgery): Sacred Heart Health System, Pensacola, FL Clinical interests: bariatric surgery, revisional bariatric surgery, metabolic surgery, advanced endoscopy, minimally invasive surgery and foregut surgery

R. Stephen Smith, M.D., RDMS, FACS

Professor of acute care surgery Medical school: University of Arkansas, Fayetteville, AK Residency (general surgery): University of Kansas School of Medicine, Wichita, KS Fellowship (trauma/surgical critical care): Shock Trauma Associates of California and St. Mary’s Medical Center in Long Beach, CA Fellowship (minimally invasive surgery/ bariatric surgery): Sacred Heart Health System, Pensacola, FL Clinical interests: emergency general surgery, trauma and surgical critical care

Lee

Johnson

Teng C. Lee, M.D.

Assistant professor of thoracic and cardiovascular surgery Medical school: Washington University, Saint Louis, MO Residency (general surgery): Case Western Reserve University, Cleveland, OH Fellowship (endovascular and interventional radiology): Malmo University Hospital, Sweden Fellowship (thoracic surgery residency; fellowship in aortic surgery and cardiopulmonary transplant/mechanical circulatory support): Duke University Medical Center, Raleigh, NC Clinical interests: cardiac surgery, hybrid arch debranching, minimally invasive cardiac surgery and surgery of the thoracic aorta

Khanna

Meyers

grafting (TECAB), robotic thoracic and cardiac surgery and ascending aortic aneurysm repair

Cary Meyers, M.D., FACC, FACS

Assistant professor of thoracic and cardiovascular surgery Medical school: University of Chicago Pritzker School of Medicine, Chicago Residency (general surgery): Duke University Medical Center, Raleigh, NC Fellowship (cardiothoracic surgery): Duke University Medical Center, Raleigh, NC Clinical interests: endovenous laser treatment procedures, heart valve procedures and thoracic aortic aneurysm repair.

Mark W. Johnson, M.D., FACS

Professor of transplantation surgery Medical school: Tufts University School of Medicine, Boston Residency (general surgery): New England Medical Center, Boston Fellowship (transplantation surgery, clinical and research): Harvard Medical School, Boston Fellowship (clinical teaching): Tufts University School of Medicine, Boston Clinical interests: liver transplantation, renal transplantation, pancreas transplantation and management of biliary complications after liver transplantation

Sohit Khanna, M.D.

Assistant professor of thoracic and cardiovascular surgery Medical school: The Ohio State University College of Medicine, Columbus, OH Residency (general surgery): Henry Ford Hospital, Detroit, MI Fellowship (cardiopulmonary transplant surgery): Henry Ford Hospital, Detroit, MI Fellowship (cardiothoracic surgery): Medical College of Georgia, Augusta, GA Clinical interests: off-pump CABG with endoscopic vein harvesting, totally endoscopic coronary artery bypass

The UF department of surgery is excited that several months of planning and work have come to fruition as we officially embark on a new partnership with Halifax Health in Daytona Beach. We will staff the thoracic and cardiovascular surgery needs of Halifax Health with two UF faculty surgeons, Sohit Khanna, M.D., and Cary Meyers, M.D., FACC, FACS. Both physicians began seeing patients on July 7 at our new practice location in Daytona: UF Health Heart and Vascular Surgery – Halifax Health.

We are also currently recruiting two vascular surgeons for the practice.

The Stitch || Summer 2015 5

STEAL SYNDROME: More Than a Blood-Flow Problem?

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emodialysis is a lifesaving procedure, but it has its own share of difficult complications and side effects. One is steal syndrome, a poorly understood phenomenon associated with the creation of a fistula for hemodialysis access.

Hemodialysis access-related hand ischemia or ‘steal syndrome’ causes problems such as hand numbness, pain, coldness and weakness, as well as significantly reduced blood flow/pressure to affected tissues. In extreme cases, it can cause tissue death (gangrene), which may lead to the loss of fingers.

Salvatore Scali, M.D., FACS, an assistant professor in the division of vascular surgery and endovascular therapy, holds a K23 award from the National Institutes of Health for his work investigating steal syndrome. Under the mentorship of Scott Berceli, M.D., PhD, a professor in the same division, Dr. Scali has launched a clinical study to evaluate dialysis patient hand function, circulation and neuromuscular physiology before and after fistula creation.

He hypothesizes that the long-accepted explanation of this condition’s cause — that the fistula “steals” blood from the hand and/or forearm — is only part of the story.

“That is oversimplified dogma,” Scali said, “however, because nobody’s really investigated this question from an alternative perspective. (That) is where we come in.”

Scali hopes the study, which has 33 people enrolled so far, will shed light on any pre-existing problems that may set the stage for ‘steal syndrome’.

“While it’s most likely modulated by the changes in blood flow that occur after fistula placement, these patients frequently have a baseline level of neuromuscular dysfunction that is influenced by comorbidities such as renal failure and diabetes.”

Coupled with reduced blood flow to the area, the pre-existent neuromuscular dysfunction “may lead to a maladaptive postoperative response,” Scali hypothesizes.

He calls the condition “access-related hand dysfunction,” and said UF Health is a major referral center for patients with this and other complications related to hemodialysis access.

“We do a lot of remedial operations for the patients. We are able to achieve reasonable results in a majority of patients. However, there is a certain subset of patients that no matter how much you correct the circulation, they don’t get return of their hand function,” Scali said. “We believe that’s one of the things that bolsters the hypothesis that ischemia’s not the only explanation. It’s an important modulator of the process, but it doesn’t give you the entire picture of what’s going on with these patients.”

This pair of images shows the typical angiographic appearance of a patient with an arteriovenous fistula (top) and how different patients have variable degrees of distal forearm and hand arterial occlusive disease (bottom).

This can impact how patients adapt to the hemodynamic challenge of an arteriovenous fistula leading to variable phenotypes of hand dysfunction.

2015 Research Day The department of surgery held its 11th annual Research Day on April 15.

Dr. Richard H. Turnage, executive associate dean for clinical sciences and professor and chairman for the department of surgery at University of Arkansas Medical Sciences, was the Lester R. Dragstedt Visiting Professor for this event.

Check out this year’s winners at surgery.ufl.edu/stitch

Visit surgery.med.ufl.edu/about-us/news-archive/ for news about department research initiatives.

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The University of Florida Department of Surgery

Woodward Society Meeting Unites UF Surgery Grads for Education, Fellowship

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he Edward R. Woodward Surgical Society held its sixth annual meeting in February. Makesha Miggins, M.D. (2014), recipient of the 2014 Hugh Walters Award Humanitarian Award and a breast surgical oncology fellow at the University of Texas MD Anderson Cancer Center, led attendees in surgery grand rounds to start the day.

Participants then enjoyed a breakfast before moving on to the rest of the agenda. Mark Kelley, M.D. (1995), a professor and chief of the division of surgical oncology and endocrine surgery at Vanderbilt-Ingram Cancer Center, provided welcoming remarks. Beau Toskich, M.D. (2013), affiliate assistant professor of soft tissue surgery and surgical oncology at UF’s College of Veterinary Medicine, presented “Radioembolization”; Elizabeth Beierle-Chen, M.D. (1996), also a professor of pediatric surgery, discussed “Novel Therapeutics for the Treatment of Neuroblastoma”; Frederick Ryckman, M.D. (1982), a professor of surgery at the University of Cincinnati and senior vice president of medical operations at Cincinnati Children’s Hospital, presented “Building a Hospitalwide System for Safety and Efficiency”; Kirby Bland, M.D. (1976), Fay Fletcher Kerner professor and chairman of the department of surgery at the University of Alabama at Birmingham, presented the event’s keynote address “History and Evolution of Breast Cancer Therapy”; Ramsay Camp, M.D. (2002), an associate professor in the division of Oncologic and Endocrine Surgery at the Medical University of South Carolina talked about “Conservative Management Following Neoadjuvant Therapy for Rectal Cancer”; Mike Chen, M.D. (1993), a professor of pediatric surgery at the University of Alabama at Birmingham, presented “Global Surgery Delivery: Lessons from Medical Missions to Vietnam”; Randy Jenkins, Esq., president of Healthcare Education Insurance Company and a clinical associate professor in UF’s College of Public Health and Health Professions, presented “Best Practices for Disclosing Adverse Events and for Avoiding Medical Malpractice Lawsuits”; Caren Gaines-Wilkie, M.D. (1989), a general surgeon at Halifax Health in Daytona Beach, presented “Rural Surgery among the Navajo”; Kevin Behrns, M.D., chair of the UF department of surgery and the Edward R. Woodward Professor of Surgery, ended the meeting with a state of the department address. The day concluded with dinner at Mark’s Prime Steakhouse in downtown Gainesville.

Kevin Steadland, M.D. (1993), traveled from Mercy General Surgery Clinic in Andover, Minnesota, to attend this year’s meeting. “I had a great time,” said Steadland. “I enjoyed the wide range of presentations from basic science research being done. I’m really glad I made the trip and highly encourage all former residents to come next year.”

View photos of this year’s event, as well as past years’, at surgery.ufl.edu/wsphotos.

New Acute Care Surgery Fellowship Ready to Launch The department’s acute care surgery fellowship began July 1, 2015 and is an intensive, two-year experience that fits closely with the existing one-year surgical critical care fellowship.

After completing the surgical critical care fellowship, trainees start in the acute care surgery fellowship. This program emphasizes surgical treatment of traumatic and non-traumatic emergencies, alongside fundamental general surgery training. Fellows train in abdominal and endocrine surgery, head and neck surgery, thoracic surgery, vascular surgery and “damage-control” surgical training in orthopedics and neurosurgery.

The idea is to give trainees a broad, well-rounded education in surgical procedures and care, allowing them to work confidently and competently with patients suffering from any type of traumatic injury. They also will operate on the acute care service, with a backup attending acute care surgeon to offer guidance and support as needed.

Alicia Mohr, M.D., an associate professor and director of the surgical critical care training program, will serve as director of the new fellowship.

The Stitch || Summer 2015 7

THE STITCH surgery.med.ufl.edu

EDITORS Katrina McAfee, Laura Mize 352.265.0646 TheStitch@surgery.ufl.edu

UF DEPARTMENT OF SURGERY Kevin Behrns, M.D., Chairman Administrative Offices: 352.265.0646 Patient Appointments/Referrals: 352.265.0535 Research Office: 352.265.0494 GENERAL SURGERY Steven Hughes, M.D., Chief • Acute Care Surgery Frederick Moore, M.D., Chief • Gastrointestinal Surgery Steven Hughes, M.D., Chief • Surgical Oncology Steven Hughes, M.D., Interim Chief

CONTRIBUTORS Jesse S. Jones DESIGN JS Design Studio

University of Florida Department of Surgery P.O. Box 100286 Gainesville, FL 32610

PEDIATRIC SURGERY David Kays, M.D., Chief

TRANSPLANTATION SURGERY Jeffrey Fair, M.D., Chief

PLASTIC AND RECONSTRUCTIVE SURGERY Bruce Mast, M.D., Chief

VASCULAR SURGERY AND ENDOVASCULAR THERAPY Thomas Huber, M.D., Ph.D., Chief

THORACIC AND CARDIOVASCULAR SURGERY Thomas Beaver, M.D., M.P.H., Chief

RESEARCH LABORATORIES Lyle Moldawer, Ph.D., Vice Chairman

Check out exclusive articles at surgery.ufl.edu/stitch.

INSIDE THIS ISSUE:

Advances in lung transplantation/ XVIVO Lung Perfusion

Patient thriving after robotic colorectal surgery

Side effects of hemodialysis: steal syndrome

...and more