Advancing Cultural Competency and Equity in Surgical Specialties (ACCESS): A Model for a Combined Resident and Faculty DEI Initiative.

Background: Committees dedicated to diversity, equity, and inclusion (DEI) are not commonplace within departments of surgery. Even rarer are joint initiatives for residents and faculty. We aim to describe the creation of a collaborative committee within a department of surgery to better foster and advance the ideals of DEI.

Robotic-Assisted Pleurectomy Is a Safe and Effective Surgical Treatment for Spontaneous Pneumothorax.

Introduction: Spontaneous pneumothorax is a common thoracic surgical problem. To prevent recurrence, surgical options include blebectomy, mechanical or chemical pleurodesis, pleurectomy, or a combination of these operations. Pleurectomy is associated with lower recurrence rates but may be technically challenging via video-assisted thoracoscopic surgery.

Robot-Assisted Left Lower Sleeve Lobectomy for Mucoepidermoid Carcinoma.

Surgical resection with lung preservation is the treatment of choice for low-grade mucoepidermoid carcinoma of the tracheobronchial tree. This report describes a case of minimally invasive robot-assisted sleeve resection for tracheobronchial mucoepidermoid carcinoma and provides detailed instruction, with video demonstration, of the operative technique.

Robot-Assisted Laparoscopic Reduction of Gastroesophageal Intussusception With Gastropexy.

We report the rare case of a 71-year-old man with a medical history including dysphagia, gastroesophageal reflux disease, and achalasia with remote open transthoracic Heller myotomy who presented acutely with symptoms of esophageal obstruction. Sustained gastroesophageal intussusception was diagnosed with esophagogastroduodenoscopy and computed tomography. The patient underwent urgent robot-assisted laparoscopic reduction with gastropexy.

Sustained Supratherapeutic Paclitaxel Delivery Enhances Irreversible Sarcoma Cell Death.

Risk of locoregional recurrence after sarcoma resection is high, increasing both morbidity and mortality. Intraoperative implantation of paclitaxel (PTX)-eluting polymer films locally delivers sustained, supratherapeutic PTX concentrations to the tumor bed that are not clinically feasible with systemic therapy, thereby reducing recurrence and improving survival in a murine model of recurrent sarcoma. However, the biology underlying increased efficacy of PTX-eluting films is unknown and provides the impetus for this work.

Obese Patients Undergoing Tracheobronchoplasty Have Excellent Outcomes.

Background: Tracheobronchoplasty (TBP) is the gold-standard treatment for severe symptomatic excessive central airway collapse; however outcomes among obese patients are unknown.

Methods: A retrospective, single-center analysis was conducted on consecutive patients undergoing TBP for severe symptomatic excessive central airway collapse from 2003 to 2020. Demographics, comorbidities, functional status, and perioperative complications were collected.

Finding the "True" N0 Cohort: Technical Aspects of Near-infrared Sentinel Lymph Node Mapping in Non-small Cell Lung Cancer.

Objective: To examine technical-, patient-, tumor-, and treatment-related factors associated with NIR guided SLN identification.

Background: Missed nodal disease correlates with recurrence in early stage NSCLC. NIR-guided SLN mapping may improve staging and outcomes through identification of occult nodal disease.

Long-term outcomes after near-infrared sentinel lymph node mapping in non-small cell lung cancer.

Objective: To report the first analysis of long-term outcomes using near-infrared (NIR) image-guided sentinel lymph node (SLN) mapping in non-small cell lung cancer (NSCLC).

Methods: Retrospective analysis of patients with NSCLC enrolled in 2 prospective phase 1 NIR-guided SLN mapping trials, including an indocyanine green (ICG) dose-escalation trial, was performed. All patients underwent NIR imaging for SLN identification followed by multistation mediastinal lymph node sampling (MLNS) and pathologic assessment.

A novel technique for tumor localization and targeted lymphatic mapping in early-stage lung cancer.

Objective: To investigate safety and feasibility of navigational bronchoscopy (NB)-guided near-infrared (NIR) localization of small, ill-defined lung lesions and sentinel lymph nodes (SLN) for accurate staging in patients with non-small cell lung cancer (NSCLC).

Methods: Patients with known or suspected stage I NSCLC were enrolled in a prospective pilot trial for lesion localization and SLN mapping via NB-guided NIR marking. Successful localization, SLN detection rates, histopathologic status of SLN versus overall nodes, and concordance to initial clinical stage were measured.

Management of Sarcoma Metastases to the Lung.

For decades, surgical resection of pulmonary metastases has been performed; despite limited randomized data, surgery is increasingly accepted as an integral part in the management of metastatic disease. Long-term results indicate resection is potentially curative with significantly improved survival following complete resection. Recurrence, however, is not uncommon with many patients undergoing repeat resection.

From Diagnosis to Treatment: Clinical Applications of Nanotechnology in Thoracic Surgery.

Nanotechnology is an emerging field with potential as an adjunct to cancer therapy, particularly thoracic surgery. Therapy can be delivered to tumors in a more targeted fashion, with less systemic toxicity. Nanoparticles may aid in diagnosis, preoperative characterization, and intraoperative localization of thoracic tumors and their lymphatics.

Expanding the indications for laparoscopic retroperitoneal adrenalectomy: experience with 81 resections.

Background: Laparoscopic retroperitoneal (RP) adrenalectomy has gained popularity as the preferred approach over transabdominal (TA) method; however, surgeons have been reluctant to offer this operation to obese patients because of the concerns over inadequate working space and overall perceived higher rate of complications. The aim of the present study was to evaluate the feasibility and safety of RP adrenalectomy compared with TA adrenalectomy, specifically in morbidly obese patients.

Methods: All laparoscopic adrenalectomies performed at our institution between 2004 and 2012 were reviewed retrospectively.

Live en face imaging of aortic valve leaflets under mechanical stress.

Soft tissues, such as tendons, skin, arteries, or lung, are constantly subject to mechanical stresses in vivo. None more so than the aortic heart valve that experiences an array of forces including shear stress, cyclic pressure, strain, and flexion. Anisotropic biaxial cyclic stretch maintains valve homeostasis; however, abnormal forces are implicated in disease progression.