sutures newsletter

PRODUCED BY AND FOR MEMBERS OF THE DEPARTMENT OF SURGERY July 2014 | Archived Issues

Vascular Surgeons Adapt to Changes in Field

By Bruce Gewertz, MD

The vascular surgical services at Cedars-Sinai have evolved considerably over the past decade. In specific, the nature of the clinical work has been significantly affected by the sea change in vascular interventions, moving from predominantly open surgery to minimally invasive endovascular approaches.

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New Award Named for Adashek

A cash award of $25,000 in honor of Kenneth Adashek, MD, (right) will be given annually to a surgeon on the staff of Cedars-Sinai. The award will provide recognition of Adashek's significant accomplishments, while highlighting Cedars-Sinai's emphasis on compassionate care for each patient.

 

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Recognition for Gordon, Khoynezhad

Physician News

Leo A. Gordon, MD, spoke at the Naval Medical Center in San Diego; and Ali Khoynezhad, MD, PhD, has won a scholarship from the Thoracic Surgery Foundation for Research and Education.

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Circle of Friends Honorees for June

The Circle of Friends program honored 197 people in June. Circle of Friends allows grateful patients to make a donation in honor of the physicians, nurses, caregivers and others who have made a difference during their time at Cedars-Sinai.

» Read more

FDA Warns Against Viscous Lidocaine for Teething Pain

Pharmacy Focus

The U.S. Food and Drug Administration has issued a warning that prescription oral viscous lidocaine 2 percent solution should not be used to treat infants and children with teething pain.

» Read more

Vascular Surgeons Adapt to Changes in Field

By Bruce Gewertz, MD
Surgeon-in-Chief
Chair, Department of Surgery

The vascular surgical services at Cedars-Sinai have evolved considerably over the past decade. In specific, the nature of the clinical work has been significantly affected by the sea change in vascular interventions, moving from predominantly open surgery to minimally invasive endovascular approaches.

In addition to lowering the morbidity from vascular procedures, this shift has markedly reduced the length of stay of vascular patients. While vascular surgeons from our department continue to collaborate closely with Interventional Radiology and Cardiology, it is noteworthy that the education of vascular surgeons has been retooled and the modern vascular surgeon is highly capable of utilizing both open and endovascular techniques.

The most obvious shift has been seen in the treatment of abdominal aortic aneurysms. At the current time, nearly 90 percent of aneurysms are successfully treated by endovascular means, while 10 percent with unfavorable anatomy continue to require open procedures. Even eight years ago, the mix was much closer to 50-50. The advent of new devices, delivery systems and exciting techniques such as fenestrated prosthetic grafts may virtually eliminate open aortic surgery in the coming years.

With the recruitment of Ali Khoynezhad, MD, PhD, and the enthusiastic participation of Raj Rao, MD, Suhail Dohad, MD, and Aamir Shah, MD, Cedars-Sinai now has one of the largest thoracic aortic programs in the country. The number of thoracic endografts has increased dramatically in the past few years with annual volumes of 44 cases per year. Coupled with our historical strengths in abdominal and arch aneurysms, we are now the market leader in expert care of the full range of aortic pathologies from the aortic valve to the bifurcation.

In cerebrovascular disease, Cedars-Sinai continues to perform more carotid procedures than any University HealthSystem Consortium (UHC) hospital in California. We offer the options of both open endarterectomy and carotid stenting. The latter is used for particularly high-risk patients or those with recurrent disease. Across the country, the balance between these approaches has stabilized at 70-30; our local experience parallels this. Our cerebrovascular services are strongly supported by our colleagues in stroke neurology (Patrick Lyden, MD, and crew) and by Michael Alexander, MD, and Marcel Maya, MD, in neuroendovascular services. The neurologic morbidity from these procedures at our hospital is among the lowest in the country.

In sum, vascular surgery at Cedars-Sinai is remarkably healthy. As the treatment of vascular disease has changed, our attending and faculty surgeons have adapted and now offer the full range of endovascular treatments. Cedars-Sinai vascular surgeons continue to publish and present at virtually every major regional and national meeting in the field. A number of our residents have gone on to prestigious vascular fellowships and academic careers. Given these trends, the next few years should be even more exciting.

New Award Named for Adashek

Kenneth Adashek, MD

A cash award of $25,000 in honor of Kenneth Adashek, MD, will be given annually to a surgeon on the staff of Cedars-Sinai.

The Dr. Kenneth Adashek Surgical Excellence Award is made possible by the generosity of Toni and Emmet Stephenson. It is intended to provide vital resources to surgeons, within 10 years of fellowship completion, who exemplify and promulgate the outstanding personal and professional qualities of Adashek, including surgical excellence, dedication to the field of surgery, exceptional interpersonal skills and complete integrity. The award will provide recognition of Adashek's significant accomplishments, while highlighting Cedars-Sinai's emphasis on compassionate care for each patient.

A committee of three, co-chaired by Bruce Gewertz, MD, surgeon-in-chief and chair of the Department of Surgery, and Adashek, will select a finalist from a group of nominees. Adashek and Gewertz will name a third committee member to help select a finalist.

Nominees for this award will be selected from those excellent surgeons who best exhibit professionalism and compassionate, patient-centered care. The prize funds may be applied to educational or academic activity.

Nominations may be sent to johnny.thomas@cshs.org.

The recipient of the first Adashek award will be announced on Dec. 1 and presented at the annual departmental holiday party.

Recognition for Gordon, Khoynezhad

Physician News

Rear Adm. Donald Sturtz (left) and Leo A. Gordon, MD

Gordon Speaks at Naval Medical Center in San Diego

Leo A. Gordon, MD, delivered the Sixth Annual Sturtz Oration to the Department of Surgery at the Naval Medical Center in San Diego on June 20.

The symposium is named in honor of Rear Adm. Donald Sturtz, former commander of the National Naval Medical Center, now known as Walter Reed National Military Medical Center. Sturtz, a legendary surgical educator, was in attendance.

Gordon participated in and critiqued the department's morbidity and mortality conference before delivering the oration.

His address — "The M+M Matrix: Channeling Dr. Ernest Codman" — reviewed the origins of the surgical morbidity and mortality conference. He then outlined a plan to convert this isolated conference into an ongoing renewable patient safety curriculum.

A round-table discussion of ongoing research and interesting case reports within the department followed the oration. Gordon met with the resident staff following the morning's presentations.


Khoynezhad Wins Scholarship to Leadership Program

Ali Khoynezhad, MD, PhD, director of Thoracic Aortic Surgery and professor of Cardiovascular Surgery at the Cedars-Sinai Heart Institute, has been awarded an Alley-Sheridan Scholarship from the Thoracic Surgery Foundation for Research and Education.

The scholarship will help Khoynezhad attend the Leadership Program in Health Policy and Management at the Heller School of Public Policy and Management at Brandeis University in Waltham, Mass.

The weeklong program equips health leaders with the knowledge and skills to improve the delivery of healthcare services, and to participate in healthcare policy and reform.

Circle of Friends Honorees for June

The Circle of Friends program honored 197 people in June.

Circle of Friends allows grateful patients to make a donation in honor of the physicians, nurses, caregivers and others who have made a difference during their time at Cedars-Sinai. When a gift is made, the person being honored receives a custom lapel pin and a letter of acknowledgement.

Click here for more information about the program and for a list of past honorees.

  • Kristine Acorda (Baker), MSN, RN, ANP-BC, CCTC
  • Kaelian L. Aldrich
  • Michael J. Alexander, MD
  • Ehsan Ali, MD
  • Daniel C. Allison, MD
  • Farin Amersi, MD
  • Paula J. Anastasia Davis, MN, RN, AOCN
  • John B. Andrews, MD
  • Francisco A. Arabia, MD
  • Arash Asher, MD
  • Regina Astilla, BSN, RN
  • Babak Azarbal, MD
  • C. Noel Bairey Merz, MD
  • Eli Baron, MD
  • Vanessa M. Batiste
  • George Berci, MD
  • Samuel A. Berkman, MD
  • Keith L. Black, MD
  • William W. Brien, MD
  • Barry J. Brock, MD
  • Philip G. Brooks, MD
  • Barbara A. Bryndle, RN
  • Mathew H. Bui, MD
  • Christiane Michele J. Burnison, MD
  • Jeffrey F. Caren, MD
  • Ilana Cass, MD
  • Kirk Y. Chang, MD
  • Sumeet S. Chugh, MD
  • Jason S. Cohen, MD
  • Scott W. Cohen, MD
  • Stephen R. Corday, MD
  • Michelle Cornejo
  • Alice C. Cruz, MD
  • Lawrence S. Czer, MD
  • Shaun S. Daneshrad, MD
  • Catherine M. Dang, MD
  • Hal C. Danzer, MD
  • Robert M. Davidson, MD
  • Robert W. Decker, MD
  • Rick B. Delamarter, MD
  • Ryan DellaMaggiora, MD
  • Virginia E. Doscher, RN
  • Noam Z. Drazin, MD
  • J. Kevin Drury, MD
  • Cheryl L. Dunnett, MD
  • Karyn Eilber, MD
  • Shahrooz Eshaghian, MD
  • Shervin Eshaghian, MD
  • Richard Essner, MD
  • Mardel Evans
  • Francis Y. Fah, RN
  • Azita Far, MD
  • Eugene L. Fishman, MD
  • Charles A. Forscher, MD
  • Stuart Friedman, MD
  • Gerhard J. Fuchs, MD
  • Steven S. Galen, MD
  • Monica Gallegos, MBA
  • Donna Gallik, MD
  • Avrom Gart, MD
  • Armando E. Giuliano, MD
  • Judy R. Glover, RN
  • Eskedar F. Gobeze, BSN, RN
  • Crystal F. Gonzalez, RN
  • Jeffrey R. Gramer, MD
  • Paul B. Hackmeyer, MD
  • Antoine Hage, MD
  • Behrooz Hakimian, MD
  • Michele A. Hamilton, MD
  • John G. Harold, MD
  • Miracle Hart, RN
  • David D. Hopp, MD
  • Henry A. Horton, MD
  • Jethro L. Hu, MD
  • Gabriel E. Hunt Jr., MD
  • Leonel A. Hunt, MD
  • Andrew F. Ippoliti, MD
  • Mariko L. Ishimori, MD
  • Griselda Islas, RN
  • Theresa E. Javier
  • J. Patrick Johnson, MD
  • David Y. Josephson, MD
  • Debra R. Judelson, MD
  • Valerie J. Juge, RN
  • Saibal Kar, MD
  • Sheila Kar, MD
  • Beth Y. Karlan, MD
  • Ronald P. Karlsberg, MD
  • Adam D. Karns, MD
  • David Kawashiri, MD
  • Ilan Kedan, MD, MPH
  • Juanita Keith, PSR
  • Mehran J. Khorsandi, MD
  • Janet L. Kimble, RN
  • Keith J. Kimble, MD
  • Michelle M. Kittleson, MD, PhD
  • Robert Klapper, MD
  • Jon A. Kobashigawa, MD
  • Megan S. Laib
  • Armida Leister
  • Ronald S. Leuchter, MD
  • Andrew J. Li, MD
  • Howard L. Liu, MD
  • Kathleen K. Lo
  • Simon K. Lo, MD
  • Rajendra Makkar, MD
  • Adam N. Mamelak, MD
  • Cindy Margolis, RN
  • Philomena McAndrew, MD
  • Michael Casey McGuire
  • Robert J. McKenna Jr., MD
  • Jessica McLane, RN
  • Sharron L. Mee, MD
  • Rachona Meza
  • Kiarash Michel, MD
  • Stewart Middler, MD, PhD
  • Amin Joseph Mirhadi, MD
  • Avinash Mondkar, MD
  • Charles N. Moon, MD
  • Jaime D. Moriguchi, MD
  • Yosef Y. Nasseri, MD
  • Ronald B. Natale, MD
  • Ricardo Navas, MD
  • Christopher S. Ng, MD
  • David G. Ng, MD
  • Nicholas N. Nissen, MD
  • Raena S. Olsen, DO
  • Dorothy J. Park, MD
  • Chirag G. Patil, MD
  • Brad Penenberg, MD
  • Alice Peng, MD
  • Brian Perri, DO
  • Glenn B. Pfeffer, MD
  • Edward H. Phillips Jr., MD
  • Mark Pimentel, MD
  • Edwin M. Posadas, MD
  • Jerry J. Pryde, MD, MPH
  • Richard M. Ress, MD
  • Luz M. Reyes
  • Jaime E. Richardson, BSN, RN, OCN, CCRP
  • Russell Robinson, RN
  • Amina S. Rodriguez
  • Rafael Rodriguez
  • Barry E. Rosenbloom, MD
  • Jeremy D. Rudnick, MD
  • Vivian L. Salle, RN
  • Marikit V. Santiago, BSN, RN
  • Gregory P. Sarna, MD
  • Jay N. Schapira, MD
  • Wouter I. Schievink, MD
  • Scott Serden, MD
  • Amar J. Shah, MD
  • Bahman Shamloo, MD
  • Eyvoughn C. Shane
  • Dinesh Sharma, MD
  • Randolph Sherman, MD
  • Toshie I. Shono
  • Khawar M. Siddique, MD
  • Robert J. Siegel, MD
  • Thomas P. Sokol, MD
  • Karyn Morse Solky, MD
  • Marilyn A. Solsky, MD
  • Bolivar G. Sotelo, LVN    
  • Harmik J. Soukiasian, MD
  • Jasminka Stegic, MS, ANP-BC, CCRN
  • Herbert Stein, MD
  • Jay J. Stein, MD
  • Colin Stokol, MD
  • Daniel J. Stone, MD, MPH, MBA
  • Eric R. Sue, MD
  • Ronald Sue, MD
  • Michele Tagliati, MD
  • Esperanza Tercero
  • David B. Thordarson, MD
  • Tram T. Tran, MD
  • Alfredo Trento, MD
  • Richard Tuli, MD, PhD
  • Mark K. Urman, MD
  • Michael B. Van Scoy-Mosher, MD
  • Eric Vasiliauskas, MD
  • Marina Vaysburd, MD
  • Angela Velleca, BSN, RN, CCTC
  • Swamy R. Venuturupalli, MD
  • Robert A. Vescio, MD
  • Olga Voroshilovsky, MD
  • Andrew S. Wachtel, MD
  • Emma Marlene Wainford, RN
  • Christine S. Walsh, MD
  • Ariel E. Weber, BSN, RN, CCRN
  • Alan Weinberger, MD
  • Tammi B. Weinstein Wise
  • Rosalyn L. White
  • John Williams III, MD
  • Donald A. Wiss, MD
  • Edward M. Wolin, MD  
  • Clement C. Yang, MD
  • Millard H. Zisser, MD

FDA Warns Against Viscous Lidocaine for Teething Pain

Pharmacy Focus

The U.S. Food and Drug Administration has notified health professionals and caregivers for infants that prescription oral viscous lidocaine 2 percent solution should not be used to treat infants and children with teething pain.

The FDA is requiring a boxed warning to be added to the prescribing information to highlight this information. Oral viscous lidocaine solution is not approved to treat teething pain, and use in infants and young children can cause serious harm, including death.

Topical pain relievers and medications that are rubbed on the gums are not necessary or even useful because they wash out of the baby's mouth within minutes, according to the FDA. When too much viscous lidocaine is given to infants and young children or they accidentally swallow too much, it can result in seizures, severe brain injury and problems with the heart.

The FDA recommends that parents and caregivers follow the American Academy of Pediatrics' recommendations for treating teething pain:

  • Use a teething ring chilled in the refrigerator (not frozen).
  • Gently rub or massage the child's gums with your finger to relieve the symptoms.

For more information, click here.