Our team currently performs the world’s smallest incisions for mitral valve repair surgery using an endoscopic robotic approach with all percutaneous cannulation. Largest incision in the entire body is the 8mm working port (approx. the diameter of a pen)
This a patient one week after robotic assisted TECAB (totally endoscopic coronary artery bypass)
@TJUHospital
@JEFFsurgery
by my truly great robotic OR team. Discharged the day after surgery. Not easy for surgeons to evolve but evolve we must to meet the needs of our patients!
Amazing case
@TJUHospital
- robotic endoscopic removal of prior Mitraclip X 2 followed by Mitral valve repair with neochords and band, cryo MAZE, tricuspid valve repair, PFO and LAA closures. 8 mm working port and all percutaneous cannulation, extubation in the OR.
@JEFFsurgery
Robotic mitral valve repair patient done yesterday discharged home today! Likely the first postoperative day 1 discharge after surgical mitral repair in the southern US and in Georgia!
@GaHeart_NGHS
@myNGHS
@ACC_Georgia
@GeorgiaAHA
John Pryor from
@pennsurgery
killed in Mosul, Iraq at FOB Diamondback. I was trained by him in trauma & replaced him in Mosul. Will never forget seeing the hole made by the mortar that first night - it was my 3rd tour but war was not real until that moment. RIP.
At Philadelphia airport doing medical triage of the first Afghanis arriving. Extremely happy to see this happening having been there years ago and given all that is happening there today.
@PHLAirport
@TJUHospital
@JEFFsurgery
This is the spot where Dr. John Pryor lost his life when a mortar round in Mosul, Iraq struck. Shortly after, I replaced Dr. Pryor, my friend who had trained me. I felt guilt that his family would never step foot on this hallowed ground. Remember the fallen this Memorial Day.
Totally endoscopic robotic mitral valve repair with all percutaneous cannulation and 8 mm Airseal working port for endocarditis with A2/A3 anterior leaflet involvement. Pericardial patch repair with neochords and ring placed with v-lock sutures.
@JEFFsurgery
@TJUHospital
@SpeakerPelosi
Speaker Pelosi I remember meeting you in San Francisco. I know your heart is in the right place. But we really need you and leaders on both sides of the aisle to stop blaming each other and playing politics and fix problems.
Sad to hear of passing of Dr. William “Bill” Norwood, mentor & pioneer in congenital heart surgery made famous for the the “Norwood Procedure” for hypoplastic left ventricle. He taught me so much. A genius who was under-appreciated as so many pioneers are. I miss him greatly.
On this Memorial Day I want to thank my friend and colleague from
@pennsurgery
and
@ArmyMedicine
for his and his family making the ultimate sacrifice for our country. He died at FOB Diamondback in Mosul Iraq. He is not forgotten. Replacing him was the greatest honor of my life.
Happy to announce that I have accepted a position at the Georgia Heart Institute in Gainesville! Have greatly enjoyed working with many excellent colleagues at
@TJUHospital
and
@JEFFsurgery
and looking forward to this new chapter!
@habib_samady
@myNGHS
Our incredible team
@TJUHospital
@JEFFsurgery
did a robotic mitral valve repair with 8mm AirSeal® port
@CONMEDCorp
& percutaneous cannulation. Largest incision in body 8mm (24 F). By far the smallest incision heart surgery ever performed in the world. Patient extubated in the OR.
Important to not discount the pressure placed on surgeons by referrings to operate. Unfortunately those applying the pressure often the same ones to judge when outcomes predictably not so good. And there is no specialty under greater public scrutiny!
It’s time for noncompetes to be eliminated. They are totally anti-free market and remove the only real power physicians have left - to leave without having to move. “The 'exploitative practice' of noncompetes: 5 key statistics”
This wonderful man underwent one of our country’s first totally endoscopic robotic aortic valve replacement and complex mitral valve repair by my team
@TJUHospital
! 3 cm incision and all percutaneous cannulation! He is the real pioneer who bravely followed me to a new frontier!
The
@TJUHospital
robotic cardiac surgery team had a great performance this week: 3 robotic endoscopic mitral repairs all discharged home on postoperative day
#1
(day after surgery)!
@JEFFsurgery
#roboticcardiac
Happy to announce the launch of our robotic mitral valve program at the Georgia Heart Institute at the Northeast Georgia Medical Center! 1st patient discharged 2 days after surgery, seen here in clinic 6 days after surgery. With patient permission.
@myNGHS
@GaHeart_NGHS
Our robotic team
@TJUHospital
and this wonderful patient recorded his endoscopic robotic mitral repair today for the
@AATSHQ
meeting Master Class with
@EdwardsLifesci
: 8 mm working port, percutaneous cannulation, endoballoon, extubated in the OR! Posted with patient permission.
“…study suggests that patients operated as second cases are exposed to an increased morbidity and mortality probably due to fatigue, loss of attention and hurriedness in the operating room, and decreased human resources in the intensive care unit.”
I’m so proud of my son who is headed to
@Bucknell_FB
on scholarship. And now being recognized as one of the top athletes in New Jersey. And he has had incredible academic performance with a >4.0 GPA while taking AP and honor classes
@DBP_Football
Another dream come true. With over 35 robotic cardiac surgeons worldwide we put together the most comprehensive online learning curriculum on the subject ever made. Fully available now including discussion sessions
@STS_CTsurgery
. Sign up and learn at
“Open-heart surgery was a postwar American invention, as miraculous as space travel and as bloody as the Battle of the Bulge.”
Blue Babies, Big Egos, and the Wild World of Early Open Heart Surgery | Literary Hub
Totally endoscopic robotic mitral repair, all percutaneous cannulation, 12mm working port and four 8mm robotic ports. Another happy patient who came from Pittsburgh to
@TJUHospital
@JEFFsurgery
Posted with permission of patient.
The world of cardiac surgery is changing! This is our endoscopic robotic mitral valve repair patient we did live for the
@GaHeart_NGHS
CV symposium. He was discharged on day 1 and now day 3 for a checkup in clinic prior to heading home to NC!
Was truly wonderful to spend time with Virginia Campbell, my high school English teacher. In 9th grade every teacher except her told me I was not going to college. Would be nothing if she had not believed in me!
Really interesting article diving into the true financial value of house staff. On one neurosurgery service when the residency was closed 3 APP’s replaced each resident with each APP at over double the salary of each resident.
Excellent talk by Dr. Michael Acker from
@pennsurgery
on the evolution of cardiothoracic surgery training. Arguably one of our finest educators if not the best in our specialty, great to hear his thoughts
@ECTSS_CTsurg
#ECTSS2023
These are the ports for my “no working port” robotic mitral valve repairs. The least invasive method of surgical repair ever performed. Still not sure if leaving out the 8 mm working port valuable or not but incredible we have been able to do this.
T2 I don’t think that graduating medical students early is such a great idea. Very few medical students are able to provide independent medical care upon graduation .
#TSSMN
#COVID19
Let me assure the public - if complications, especially unavoidable, become criminalized in the US, you will find yourself on your own when you get sick! Would definitely be the last straw. “Doctors avoiding risky operations due to prosecution threat”
I am very proud of my son
@_Jake_Guy
a freshman at
@Bucknell_FB
. He earned a scholarship and then a starting position at center. Despite a tough year for the Bison they learned much and a great future lies ahead for this young player and team!
Important for hospital administrators everywhere to read this & understand how physicians feel about the way we are spoken to and treated. It is time for administrators to get some coaching and start truly respecting us for doing what most of them could never handle.
I did 22 pump cases in the last two weeks, but it is the stern email that my presence attestation statement in one of my op notes was delinquent and had to be done ASAP that really threw me off. Hard work is NOT the reason why physicians are burning out at alarming rates.
Robotic Cardiac Surgery Team 2023 at the Georgia Heart Institute! The era of the “rock star 🎸surgeon” is over and that of the “rock star team” is here!
@GaHeart_NGHS
@myNGHS
Back in Philly and shaking things up again! Routinely doing all mitral valve repairs with a totally endoscopic robotic technique including a 12 mm (yes, mm!) working port as largest incision and all percutaneous cannulation using ultrasound, TEE, and fluoroscopy for safety!
@DavidLBrownMD
By slowing repolarization, diltiazen slows the HR through the AV node. Do trainees still learn this classification system? It is quite helpful in understanding the differences in anti-arrhythmia drugs.
The uphill, hard-fought effort to grow endoscopic robotic cardiac surgery in the US has definitely been the road less traveled, but well worth it for countless patients who avoided large incisions for their surgery.
Last official day employed by Jefferson is today. Will miss my team and many great friends and patients! On to the next exciting chapter in Georgia starting tomorrow!
Very excited for this years
@STS_CTsurgery
Robotic Cardiac Surgery Workshop
@IntuitiveSurg
training facility in Atlanta. Amazing speakers and hands on lab for all including mitral valve repair and coronary artery bypass!
Incredible advance in robotic cardiac OR teamwork
@TJUHospital
@JEFFsurgery
with use of
@quaildigital
professional wireless headset system for the whole team. Creates a calm quiet environment and clear communication. We are just like Seal Team 6 now! Thank you
@drbypass
@drjeffk
Insightful - Interesting to speculate where the profession of cardiovascular surgery is. My opinion: The reason we slid left in recent times has been a relative lack of innovation. Advances in TAVR, TMVR, TEVAR, MCS, & robotics pushing us back to the middle!
@AlanLumsdenMD
Amazing case where we removed a recurrent left ventricular myxoma after prior sternotomy and atrial myxoma resection and partial resection of the LV myxoma! All percutaneous cannulation, 8 mm ports only. Discharged day 3 and driving Memphis day 6!
Cardiac surgery requires a multidisciplinary team. The idea that only the surgeon impacts clinical outcomes is absurd, particularly today when the surgeon has little to no formal authority over team members. It's time for team outcome assessment & accountability!
#Cardiology
Our
@JEFFsurgery
team first in world to use newly released
@EdwardsLifesci
IntraClude after voluntary Class I recall a year ago. It worked perfectly and we are thrilled to have this important and improved tool for robotic mitral valve surgery back for our patients!
@TJUHospital
Here are the ports that I currently use for robotic mitral valve repair. All 8 mm ports only. All percutaneous cannulation. It’s the smallest incision open heart surgery being done in the world today.
Early in my career, I witnessed a female pregnant surgeon colleague threatened with termination weeks after she announced. I stood up for her and was immediately attacked myself. I hope such stories become a thing of the past.
What a wonderful gift today from an amazing patient - endoscopic robotic mitral valve repair, 8 mm working port, all percutaneous cannulation, discharged the day after open heart surgery from
@TJUHospital
@JEFFsurgery
. This is what keeps me going!
The tradition continues - medical student
@mikcy326
@TJUHospital
learning about heart transplantation just as I learned many years ago from Dr
@bfrist
!
Stanford Type A aortic dissection. Successfully repaired with percutaneous femoral artery cannulation (proglides x 2) and antegrade cerebral perfusion via 14F cannula in innominate artery with separate circuit with circulatory arrest. Head cooled to 21 C and body to 30 C.
Pleased to announce the first ever
@STS_CTsurgery
Robotic Cardiac Surgery Online Course! Don’t miss this opportunity to learn about how to build a program!
“TAVI was associated with a 2.5-fold increased risk of death at 5 years when compared with surgery” TAVI, SAVR Almost Equally Performed in California Patients Under 60 |
One of the biggest problems in hospitals today is that physicians are held increasingly accountable yet have decreasing (if any) ability to hold any other members of the team accountable. The public needs to know.
COVID-19 will be tipping point for Telehealth. Time to fix ridiculous state laws that restrict telemedicine across state lines. You can phone a patient but no video in many states if no license in that state - how archaic!
@JuddHollander
This wonderful man successfully underwent one of the country’s first totally endoscopic robotic aortic valve replacements plus complex mitral valve repair by my team
@TJUHospital
! All percutaneous cannulation, 3 cm incision.
@JEFFsurgery
Posted with patient permission.
Not sure why this is not getting more attention - “The researchers found that taking selective serotonin reuptake inhibitors (SSRIs) … associated with severe mitral regurgitation,” due to valve thickening.
So many hospital administrators these days. It’s an administrative “arms race”. I wonder what the ratio of bedside clinicians versus administrators is these days? 🧐
Great work by our team reporting the least invasive surgical mitral valve repair ever performed! “A New Frontier: No Working Port for Robotic Mitral Valve Repair”
@Innovationsjour
Interested in adding robotic cardiac surgery to your practice? Consider applying for the Thoracic Surgery Foundation Advanced Robotic Cardiac Surgery Fellowship! https:// roboticcardiacfellowship
@STS_CTsurgery
@ThoracicSurgFnd
“It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena,...”
Hard to believe the ACC/AHA 2020 valvular disease management guidelines gave a class 3 recommendation to LAA closure during valve surgery in the absence of afib based on this one paper.
@georgetolisjr
It’s actually worse than that. If you look broadly at our profession and perhaps our society now, style is far more valued than substance. So many “big shots” are known to not be good surgeons but instead great talkers.
Was looking through my photos from my tours in Afghanistan today and ran across this picture of this amazing Afghan girl I operated on for scrapnel injuries. I wonder where she is today. I hope she is ok. I worry so much about all my patients.
To add to this historic case, the patient was the first ever patient discharged from
@TJUHospital
on post-operative day
#1
after open heart surgery! Zero pain in part due to
@AtriCure
cryoablation technique we have been using.
Had the opportunity to meet Paula Miller, who was operated on by Dr. C. Walt Lillehei in 1961 for Tetralogy of Fallot at the South Atlantic Cardiovascular Society & Adult Congenital Heart Association meeting! Amazing to hear her perspectives.
@ACHA_Heart
@sacsconference