Current Research & Innovations

General Surgery

• Comparison of the Insorb dermal stapler to standard techniques for closure of the dermal layer in incisional wounds. —We are comparing the results of wound closure with an absorbable dermal stapler to the results obtained with more traditional suture techniques. (Jeffrey Ascherman, MD)
• Diabetes Surgery Study (Global Randomized Prospective Study of Intensive Medical Management of Type 2 Diabetes, with and without Gastric Bypass Surgery) —Recently, some small studies have suggested that gastric bypass surgery may be useful in the treatment of diabetes and may be better than standard medical therapy (oral medications, insulin injections, etc) in the treatment of diabetes.
  
  The purpose of this study is to assess the short term effects of Roux-en-Y gastric bypass on type 2 diabetes and to determine whether intensive medical therapy or surgical therapy combined with intensive medical therapy is better in the treatment of patients with type 2 diabetes and moderate obesity. All study participants will receive comprehensive medical management of their diabetes including nutritional education for two years at no cost. If randomized to the surgical arm, costs also will be covered for the surgical procedure. (Judith Korner, MD)
• Robotic Scrub Technician Clinical Validation — (Spencer Amory, MD)
• Transvaginal Intraperitoneal Endoscopic Surgery —Surgery on abdominal organs is currently performed using incisions through the layers of the abdominal wall. Laparoscopic approaches, while decreasing the size of these incisions has not eliminated them. The abdominal wall incisions are the main source of pain and delayed recovery after abdominal surgery as abdominal organs have little if any pain sensation.
  
  Flexible scopes are currently used routinely for procedures such as examination of the inside of the esophagus, stomach, bowel and colon. These scopes have been increasingly used in a therapeutic manner to remove diseased tissue. Two physicians in India have reported on a group of seven patients in whom they used a flexible endoscope to perform appendectomy. They passed a standard flexible endoscope through the mouth, into and then through the wall of the stomach and after inflating the abdominal cavity used flexible instruments placed through the endoscope to operate upon and remove the appendix withdrawing it through the mouth. These procedures required no abdominal incisions and the patients were reported to have fared well. The major concern with the procedure described is that the hole made in the wall of the stomach may leak and cause a serious abdominal infection as the stomach contains acid and is not sterile.
  
  We propose to avoid the potential risk of the need to traverse the stomach wall by introducing a flexible endoscope through a small incision deep in the vagina behind the uterus. Trans-vaginal access to the abdominal cavity is not a new concept and has been practiced by gynecologic surgeons for decades. Trans-vaginal removal of the uterus is a commonly performed procedure. Operations that we propose to perform using the trans-vaginal approach include diagnostic procedures that require examination and biopsy of the peritoneal cavity, appendectomy and cholecystectomy (removal of the gallbladder).
  
  The purpose of this study is to evaluate the safety of performing the procedure through the transvaginal route. (Marc Bessler, MD)