Annual Report

Thoracic Surgery | 2020 Annual Report

Three images of WashU Thoracic Surgery faculty (from left to right) Benjamin Kozower, MD, MPH, Varun Puri, MD, MSCI, with Bryan Meyers, MD, MPH, and Daniel Kreisel, MD, PhD, with text overlay that reads "Ahead of the Curve Thoracic Surgery."

Board-certified, internationally recognized general thoracic surgeons provide leading-edge respiratory medical and critical care, research and training. Treatments offered by Washington University general thoracic surgeons include airway surgery, procedures for benign esophageal disease, esophageal and lung cancer and lung transplantation. The lung transplant program at Barnes-Jewish Hospital is among the most active transplant centers in the world. These surgeons perform lung volume reduction surgery and, with Siteman Cancer Center, offer the latest advances in lung and esophageal cancer treatment.

Section of Thoracic Surgery | 2020 Annual Report

Tipping Point

Robotic surgery offers numerous advantages for thoracic surgeons, from smaller incisions to greater freedom of movement and precision during operations. This technical fine-tuning results in quicker healing and less pain than open surgery for most patients. The number of robotic cases in the Thoracic Surgery Section has continuously increased in recent years.

Thoracic surgeons at Christian Hospital were among the early adopters of robotic surgery. Professors of Surgery Nabil Munfakh, MD, and Varun Puri, MD, MSCI, have achieved years of clinical success with robotic utilization for lung care in North County. In 2012, they performed the first full lung lobectomy in the St. Louis region through the use of robotic technology.

“This technology gives us the ability to quickly diagnose lung cancer with minimal setback to the patient’s life and recovery,” Munfakh says.

Pulmonary resections, esophageal surgery and surgery for mediastinal tumors—growths that form in the middle of the chest, between the lungs—are all areas of robotic growth in thoracic surgery.

From its early success at Christian Hospital, Benjamin Kozower, MD, MPH, Professor of Surgery, has helped to establish a successful robotic practice at Barnes-Jewish Hospital. Thoracic surgeons Ruben Nava, MD, and Shuddhadeb Ray, MD, MPHS, joined the section in recent years, expanding the number of thoracic cases handled robotically. Nava sees patients at Barnes-Jewish Hospital, while Ray joins Munfakh and Puri at Christian Hospital. Both Nava and Ray completed fellowship training at Washington University School of Medicine in St. Louis, where they developed the robotic skills they now put into practice.

The addition of surgeons with a background in robotic surgery has been essential to the program’s growth. Thoracic Surgery Chief Bryan Meyers, MD, MPH, recognized the enthusiasm around this developing technology early, receiving the necessary training and certification for robotic surgery himself. Now, approximately half of the section’s pulmonary resections are performed robotically. Meyers, the Patrick and Joy Williamson Professor of Surgery, expects that number to grow.

“In the last few years, we have reached the tipping point in robotic thoracic surgery,” Meyers says. “We have the investment and expertise in place to offer these procedures for an ever-growing number of patients.”

2020 Highlights

Varun Puri, MD, MSCI
Daniel Kreisel, MD, PhD, left, and Andrew Gelman, PhD
Matt Henn, MD, MS, Spencer Melby, MD, Shuddhadeb Ray, MD, MPHS, and Jacob Miller, MD




Lung transplant surgeons at Washington University School of Medicine in St. Louis lead one of the most active transplant centers in the world, completing
over 1,800 transplants since the program’s beginning in 1988. This year, Daniel Kreisel, MD, PhD, becomes the inaugural section chief of Cardiothoracic Transplantation. “I can think of no one more suited to direct this new section than Dr. Kreisel,” says Division Chief Ralph Damiano, Jr., MD, Evarts A. Graham Professor of Surgery. Kreisel and Lung Transplant Program Associate Director Varun Puri, MD, MSCI, are stalwarts of the lung transplant program, handling some of the most challenging cases, including patients who may have been turned down at other centers.

Surgical Director of Lung Transplantation Daniel
Kreisel, MD, PhD, the G. Alexander Patterson, MD/Mid- America Transplant Endowed Distinguished Chair in Lung Transplantation, is principal investigator of two grants from the National Institutes of Health to study the prevention of organ rejection after transplantation. “Dr. Kreisel is very highly regarded for his surgical skills in organ transplantation and for his research involving immunological mechanisms of transplant rejections,” says David H. Perlmutter, MD, executive vice chancellor for medical affairs and the George and Carol Bauer Dean of the School of Medicine. “His determination to improve outcomes for patients drives his work and will continue to have profound impact for transplant patients.”

Thoracic Surgery Fellowship graduates Matthew Henn, MD, MS, Jacob Miller, MD, and Shuddhadeb Ray, MD, MPHS, started their general surgery residencies together at Washington University School of Medicine in St. Louis nearly a decade ago. Henn returns to his home state of Ohio to practice at the Ohio State University; Miller continues his training at the School of Medicine as the first fellow in the new Congenital Cardiac Fellowship; Ray joins the thoracic surgery faculty at Christian Hospital. “I’ve known Matt, Shuddie and Jacob for years, from their general surgery years, through all their cardiothoracic surgery training,” says Spencer Melby, MD, Thoracic Surgery Fellowship Program Director. “These surgeons are remarkable.”

In 2020, the cardiothoracic surgery training program at Washington University School of Medicine in St. Louis entered new territory. For the first time, more women than men are training in cardiothoracic surgery at Washington University and Barnes-Jewish Hospital. Six of the program’s 11 current trainees are women. This majority will be solidified in July 2021, when the program will graduate two men and a woman, replacing them with two incoming women and one man.

“The trend towards training women for cardiothoracic surgery is not a flash in the pan,” says Thoracic Surgery Section Chief Bryan Meyers, MD, MPH. “Word has gotten out that we offer exceptional training in an excellent environment. We have been able to attract very talented trainees in thoracic surgery.”

The example of past trainees demonstrates the excellence of the program. Christine Lau, MD, MBA, who completed cardiothoracic fellowship training at the School of Medicine in 2005, is now chair of surgery at University of Maryland School of Medicine. Cardiac surgeon Puja Kachroo, MD, was a thoracic surgery fellow prior to joining the cardiac surgery faculty in 2016.

“My mentors in thoracic surgery have been instrumental in my career development,” says Kachroo.

Meyers credits his mentor G. Alexander Patterson, MD, the Joseph Bancroft Professor of Surgery, for setting the tone for thoracic surgery training at the School of Medicine.

“He has always demonstrated exemplary ability to be a supportive mentor to trainees,” Meyers says. “It can be tough to transition from being a PGY-5 general surgery trainee to starting a fellowship at a new institution. Dr. Patterson saw that, and I can think of specific examples where he helped fellows get their feet under them and find the resources they needed. He sets the tone for personal interaction and dedication to training that permeates throughout all the faculty, making this an appealing place to train whether you are a man or a woman.”

Meyers anticipates that increased gender equity will lead to positive growth and advancements in cardiothoracic surgery training.

“We stand to maintain and improve the quality of our field, because we have the best surgical trainees as candidates,” Meyers says. “I think it is fantastic for the future of thoracic surgery.”