Description of Research Expertise

My most recent publications consist of book chapters (such as a recent updated chapter on Thoracic Emergencies for the textbook "Fleisher and Ludwig’s Textbook of Pediatric Emergency Medicine, 7th edition," and 5 recent chapters in 2011 for the ED textbook “5-minute Pediatric Emergency Consult.” In addition, I have been integrally involved in two recent clinical papers relating to the care of traumatic injuries in children, both of which have been submitted to peer-review journals.

I am also working on two proposals related to Intestinal Rehab Program and adolescent bariatric program research for the future. Such clinical studies are in design process and will be multidisciplinary in nature.

Description of Clinical Expertise

Most of my time is spent evaluating patients in both inpatient and outpatient settings, performing surgical procedures, and teaching medical students, residents and surgical fellows. I regularly see outpatients at CHOP's main campus and at the specialty care centers in Voorhees and Princeton, New Jersey (approximately 120-135 patient visits per month). I perform procedures at the CHOP main campus and at the Voorhees, NJ surgicenter, with an approximate average of 350 surgical cases per year. I am particularly passionate about the education of students and surgcial trainees, and spend most of my clinical patient care time working with these individuals and passing along my knowledge. In addition to this, I actively teach medical students, residents, surgical fellows, and assorted other hospital personnel in a variety of roles during multidisciplinary educational sessions and simulation sessions.

I am the surgical director of the multidisciplinary Intestinal Rehabilitation Program, and conduct several inpatient and outpatient consultations per month in conjunction with Dr. Christina Bales from GI medicine. I am working to develop and grow this program with Dr. Bales, through education here at CHOP and soon, more broadly in the community. In addition to our clinical program, we hold annual faculty seminars and patient/family education days in order to provide ongoing education to our staff, colleagues, and families.

I am also the Surgical Director of the newly-developed multidisciplinary Adolescent Bariatric Surgery program. This endeavor has been developed in partnership with the Healthy Weight Program here at CHOP and the surgical bariatric team at the Hospital of the University of Pennsylvania to create a robust program the provides the patients with the best care in all aspects. We are currently evaluating new patients and several are in the pre-surgical evaluation process. Our plan is to carefully study our patient outcomes in a variety of ways and to publish our findings widely. My goal is to make our program here at CHOP/HUP world-renowned from both clinical and research standpoints.

I am one of the “core” trauma surgeons at CHOP, and in that capacity I am responsible for covering all new trauma resuscitations and the inpatient trauma service during the weekdays and also when I am on call. I am available to consult with our trauma APNs on these patients, both in the inpatient and outpatient setting. I run two trauma clinics a month, and see trauma patients as needed in my general clinics, both at CHOP main and at the New Jersey satellites. I have specialized training in concussion evaluation and management, and have developed and direct the Trauma Simulation program here at CHOP (also a multidisciplinary endeavor). Additional trauma responsibilities include attendance at monthly trauma committee meetings, weekly quality improvement meetings, and bi-monthly trauma video review sessions, in which we review videos of our recent trauma activations and resuscitations.

I have particular experience and additional training in minimally invasive surgery, both in the pediatric patient and in the obese patient. I have completed a minimally invasive surgical fellowship with particular experience in laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy. Through this fellowship training, I also have a large experience in complex revisional bariatric procedures and minimally invasive foregut surgery. I have continued to gain experience in minimally invasive thoracic and abdominal procedures in neonates and children of all ages and sizes, and continue to perform a large number of laparoscopic foregut procedures each year. I am particularly passionate about teaching minimally invasive surgical techniques to our fellows, residents, and students.

In addition to my more straightforward clinical duties, I am actively involved in the quality improvement (QI) process as it impacts several facets of the care of our surgical patients. In this role, the majority of my time is spent participating in the ongoing trauma QI program, which involves weekly assessment of our trauma resuscitations and inpatient care, with active improvement of our program on a continual basis. Participation in the Clinical Pathways Steering Committee here at CHOP over the past 2-3 years has led to the development and implementation of our Appendicitis Pathway to standardize patient care and to work toward building a framework for measuring our outcomes in these patients. During the development of the pathway, standardization of antibiotic choice and duration of administration was achieved. Currently I am involved with data collection and analysis on an ongoing basis to assess the effectiveness of our pathway directives.