This section is dedicated to furthering innovations and utilizing the technological and research advancements on outcomes, techniques and biomaterials. Washington University minimally invasive surgeons specialize in laparoscopic and open treatment of upper gastrointestinal conditions, abdominal wall hernias and bariatric surgery. Their goal is to increase patient benefit by decreasing the size of surgical incisions, resulting in less pain and faster recovery. This section is active on the frontiers of clinical research as well as surgical education, and offers a one-year fellowship.
Our Year In Numbers
2,400
operating room cases
12,785
visits
9
faculty
252
office procedures
49
clinical research studies
$30,450
research funding
Section of Minimally Invasive Surgery | 2022 Annual Report
A hernia occurs when the intestines bulge through a weak spot in the abdominal wall. For a person with a hernia, hernia repair typically provides a long-lasting solution. Successful surgery can be life changing. The Washington University Hernia Center provides patients with comprehensive hernia care, from diagnosis and prehabilitation to decision making, treatment and postoperative recovery. Washington University hernia surgeons Jeffrey Blatnik, MD, Arnab Majumder, MD, and Sara Holden, MD, specialize in all forms of hernia repair, including traditional open surgery, minimally invasive and robotic procedures, and complex abdominal wall reconstruction.
A Commitment to Surgical Excellence
The Section of Minimally Invasive Surgery has a long-standing history of leadership and excellence in surgical training. This legacy began in 1993 with the establishment of the Washington University Institute for Minimally Invasive Surgery (WUIMIS) and grew once again one decade later with the creation of the Washington University Fellowship in Minimally Invasive Surgery. Bringing minimally invasive techniques to the learners in WUIMIS was critical to the development of their educational programming, says Minimally Invasive Surgery Section Chief Michael Brunt, MD.
Highlights
CLINICAL
Patients undergoing bariatric surgery, hernia repair and other operations offered by Washington University surgeons now have a dedicated team to help them achieve their preoperative weight loss goals. A new medical weight management program, led by Shaina Eckhouse, MD, and advanced nurse practitioner Michelle Cusumano, NP-C, assesses patients who may need to lose weight and helps them meet any mandated weight loss requirements prior to their surgery. The first of its kind within the Department of Surgery, this program helps make medical weight management accessible to a broad demographic of patients and benefits those who may require weight loss support prior to their procedures.
RESEARCH
The Geriatric Assessment and Medical Preoperative Screening (GrAMPS) Program, which studies age-associated risk factors in older patients undergoing hernia surgery, is working towards individualized patient care and shared decision-making in geriatric hernia surgery. Older patients are disproportionately affected by age-related risk factors, which are often under-recognized and can adversely affect surgical outcomes. Focused on frailty and prehabilitation before hernia surgery, GrAMPS intends to prepare older patients who are less mobile and active for complex abdominal wall reconstruction. The program is led by Sara Holden, MD in collaboration with Timothy Holden, MD, a geriatric primary care physician also at Washington University.
EDUCATION
With new knowledge comes new techniques for teaching and learning. Washington University’s Gateway Curriculum was developed to adjust to such innovation, renewing the way that physicians are educated in medicine. Bethany Sacks, MD, MEd, aided in developing the Gateway Curriculum, which entered Phase II in January 2022. “The medical school is focusing on the integration of knowledge into surgical practice,” Sacks says of the updated curriculum. This curriculum is enriched by a culture that supports diversity, inclusion, critical thinking and creativity. Through the training program, students learn to become more than physicians – they also learn to be scientists, educators and advocates who will reimagine the medical field towards advancing high quality healthcare.
Comprehensive Hernia Care
A hernia occurs when the intestines bulge through a weak spot in the abdominal wall. For a person with a hernia, hernia repair typically provides a long-lasting solution. Successful surgery can be life changing. The Washington University Hernia Center provides patients with comprehensive hernia care, from diagnosis and prehabilitation to decision making, treatment and postoperative recovery.
Washington University hernia surgeons Jeffrey Blatnik, MD, Arnab Majumder, MD, and Sara Holden, MD, specialize in all forms of hernia repair, including traditional open surgery, minimally invasive and robotic procedures, and complex abdominal wall reconstruction.
“At the Hernia Center, our focus is on providing the best repair for each individual patient,” says Blatnik, who leads the center. “We engage our patients in important conversations about their health, their treatment options and their goals for after surgery.”
For patients like Vojin Bozovich, who struggled with recurrent hernias for decades before coming to the Hernia Center, finding a durable solution is life-changing. Previous surgeries had provided temporary relief, but Bozovich’s hernias inevitably recurred. Using a minimally invasive approach and surgical mesh, Blatnik was able to provide Bozovich with lasting relief.
The Hernia Center aims to make it easier for patients with challenging hernias to find the care they need. Blatnik, Majumder and Holden are leading initiatives to inform patients about their options, address common surgical concerns and implement a patient-centered scheduling platform.
“One key aspect of the Washington University Hernia Center is that every surgeon on our team has completed advanced fellowship training in the latest techniques, giving us a large toolkit to address different types of hernias,” says Majumder, an assistant professor of surgery.
This toolkit includes techniques like transversus abdominis release, which the hernia team reviewed in a retrospective case study published in the journal Surgery. The study examined the charts of more than 130 patients who underwent recurrent ventral hernia repair using the technique at Washington University, finding that the procedure tends to provide durable and long-lasting results.
“With these various techniques, we offer personalized hernia care,” says Holden, an assistant professor of surgery. “Not every hernia that we see is treated the same in all patients. From the preoperative care to postoperative follow-up, we see our patients as individuals. We know that they may have different goals for surgery. We help them prepare for surgery, discuss different surgical techniques and carefully manage their postoperative course to ensure the smoothest recovery with the best results.”
A Commitment to Surgical Excellence
The Section of Minimally Invasive Surgery has a long-standing history of leadership and excellence in surgical training. This legacy began in 1993 with the establishment of the Washington University Institute for Minimally Invasive Surgery (WUIMIS) and grew once again one decade later with the creation of the Washington University Fellowship in Minimally Invasive Surgery.
Bringing minimally invasive techniques to the learners in WUIMIS was critical to the development of their educational programming, says Minimally Invasive Surgery Section Chief Michael Brunt, MD.
“The first skills labs that came into being were around laparoscopic surgery,” says Brunt. “It was such a change in surgical technique, and our trainees really needed to gain baseline skills outside the operating room before the practices were brought into patient care.”
The work and training within WUMIS laid the groundwork for the development of the Washington University Institute for Surgical Education (WISE). This formal skills lab, now led by Michael Awad, MD, PhD, was founded by Mary Klingensmith, MD, an emeritus member of the section who now serves as the Accreditation Council for Graduate Medical Education’s senior vice president of accreditation.
Awad was named Clinical Teacher of the Year by the 2022 graduating class of medical students. He also directs the ACS-AEI Education Fellowship program at Washington University, which has now trained four fellows: Eileen Smith, MD, Britta Han, MD, MSEd, Julie Clanahan, MD, and most recently Tiffany Brocke, MD.
Shaina Eckhouse, MD, has also been recognized for her outstanding mentorship by the 2022 class of general surgery residents. She received the 2022 Jeffrey F. Moley Mentorship Award, which has previously been awarded to MIS faculty including J. Chris Eagon, MD, and Jeffrey Blatnik, MD.
The Department of Surgery fosters an environment that allows its faculty to grow into outstanding leaders in the institution and wider surgical education community. Brunt serves as the current president of the Fellowship Council, which oversees 183 advanced gastrointestinal surgical training programs across the country. In addition to being president-elect of the Association for Surgical Education, Awad is also a member of the American College of Surgeons Academy of Master Surgeon Educators. Eckhouse leads a peer advocate program for health care workers and initiatives to develop a culture of patient safety in surgery. Additionally, she partners with residents including Smith to publish research such as a recent chapter in the SAGES Manual of Quality, Outcomes, and Patient Safety.
“Our group of surgeons are very committed to education and training across the board and are willing to invest the time to do it well,” says Brunt.