department of surgery - queen's...

D E PA R T M E N T O F S U R G E R YA N N U A L R E P O R T 2 0 1 3

CONTENTS

2 Message from the Department Head

5 Undergraduate Surgical Education Program Update

6 Surgical Foundations Residency Program Update

7 General Surgery Residency Program Update

8 Orthopaedic Surgery Residency Program Update

9 Welcome to Two New Staff Members

10 Understanding Brain Functions and Dysfunction Using Electrophysiology

11 Improving Cancer Outcomes Through Collaborative Research BetweenSurgery and Oncology

12 In Memoriam– Dr. Michael Simurda

13 ASES European Exchange Fellowship Recipient – Dr. Ryan Bicknell

14 Human Mobility Research Centre Update

15 The Advent of Competency-Based Arthroscopic Curriculum

17 Transcatheter Aortic Valve Implantation (TAVI)

18 Resident Profile – Dr. Rosie Sendher

19 Resident Profile – Dr. Blair MacDonald

20 Charles Sorbie Faculty Research Day

21 The 31st Annual William Ersil Resident Research Day

22 Dr. Andrew Bruce and Margaret Bruce Endowment for Visiting Scholars in Surgical Innovation – Dr. Hans Ringertz, Visiting Scholar

22 Welcome to New PGY 1 Residents in Orthopaedic Surgery and General Surgery

23 John Provan Outstanding Canadian Surgical Educator Award 2013

24 Grants 2012-13

26 Publications 2012-13

28 By the Numbers

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MESSAGE F ROM THE DEPAR TMENT HEAD

We live in an economic environment that demandsthat hospitals, universities, and physicians work

efficiently and cost-effectively. There is almost aPavlovian response by those responsible for policy and funding decision making that in order to achieveeconomies of scale, bigger must be better.

Ever since the time of Adam Smith who describedalmost 250 years ago in his book The Wealth of Nationspeople have been enamored with the concept of theinvisible hand and economies of scale hoping to optimizeprofits and to minimize costs, the simple concept beingthat the factors that cause the average cost of producingsomething fall as your output increases. It may cost$3,000 to produce 100 copies of a magazine but only$4,000 to produce 1000 copies. Economies of scalehave driven corporate philosophy and governmentpolicy during the 20th century and into the 21st century.As a result, industries have merged to form largeconglomerates. In government, particularly for thedelivery of healthcare, there has been the formation of large health districts or regions and hospitalamalgamation and mergers. The intent has been totake advantage of economies of scale and reduce costand provide better healthcare delivery for patients.

There is a flipside to the equation – the so-calleddiseconomies of scale. The larger an organizationbecomes, the more complex it has to be to manage and run an organization of increasing size and scale.This complexity incurs costs and eventually the costsmay outweigh savings gained from greater scale,therefore bigger may not always be better. It’s findingthat sweet spot.

As a small academic Health Sciences Center in a lowerdensity population region in Ontario of approximately600,000 people, we are faced with considerableeconomic challenges, particularly as we are nestledquite closely to two large metropolitan centers. Theselarge centers are perhaps too big to fail and as a smallcenter, there is always the concern that we at Queen’smay not be big enough to survive.

But we are reminded that we may not be big, but weare fast. We can adapt, innovate, and compete. This is an advantage. Indeed, as many economists havepointed out, many conglomerates formed in the 90sand the early part of this century are now beingdisassembled and sold off as smaller units that aremore valuable and more productive. Smaller units canbe more easily governed. There is more transparency in how the organization functions and greater efficiencythrough improved communication with less duplicationof service and more cohesion. Decision-makers are notisolated from the decisions that they make. They livewith the consequences of either good or bad decisions.As a result, decisions can be made in a more timelyfashion, more efficiently, and more effectively.

That Queen’s is smaller is an advantage. We takeadvantage of closeness and proximity. The medicalschool, its Learning Center, its teaching, its researchand clinical activities are closely linked on the campus.Not only do we work closely, we are integrated witheach other in the organization as teachers in theuniversity and in the hospital. Administratively wework with the Southeastern Ontario MedicalOrganization (SEAMO). This organization helps toadminister person power requirements for both theUniversity to meet its academic needs and the clinicalneeds of our teaching hospitals. Department Headshold joint appointments in both the University and in the hospitals. Policymakers and decision-makers live with the results of their decisions. Closeness andproximity breeds a cooperative and collaborativeenvironment. This environment is necessary and essentialfor the translation of information to improve clinicaland academic outcomes in both education and research.

2 DEPAR TMENT OF SURGERY A n n u A l R e p o R t 2013

DEPAR TMENT OF SURGERY A n n u A l R e p o R t 2013 3

We have seen this happening every day for years in ourHuman Mobility Research Center where orthopaedicsurgeons work closely in the same workspace asbiomechanical engineers, tissue scientists, molecularbiologists, rehabilitation specialists, chemical engineers,computer scientists and epidemiologists. The result isone of the leading biomechanical research centers inNorth America and beyond. With the addition of twoclinician scientist neurosurgeons, under the leadershipof Dr. Chris Wallace, the Neurosciences ResearchCenter at Queen’s University is poised to take the nextsteps that will bear fruit by taking this exceptionalNeurosciences Research Center and leading it tointernational prominence. Already we have seen thefruits of their labor as they have been able to secure or$2 million in CFI funding in the last year. In 2014, ajoint venture between the Department of Surgery andthe Department of Medicine to establish a healthoutcomes research Center has been undertaken. Thisgroup of collaborators will work hand-in-hand to helpevaluate population health issues in medicine andsurgery utilizing ICES and other large databases.

The atmosphere of cooperation and innovation hasbeen inspired by our surgeons who endowed over $2.5 million to establish Chairs in research in theDepartment of Surgery at Queen’s. This is a phenomenalcontribution and recognizes the special nature andcommitment that surgeons have here at Queen’s. Themonies from these endowments will help fund twoendowed Chairs which will be used to support researchwithin the department.

This past year, through the generous donation of the A Britten Smith Foundation, a Chair in Surgery wasestablished. The Head of Surgery will hold the Chair,and the purpose of this Chair will be to provideacademic support and improve research in theDepartment of Surgery. Through the Foundation’sgenerosity, our Department now has a solid base offinancial resources on which to build an alreadyextremely successful research foundation. It is our goalin the next three years to double our productivity ofpapers, publications and grants. This increase will be

on top of the threefold increase we have had in grants,publications, and presentations over the last threeyears. It is our desire at Queen’s, despite our relativelysmall size, to provide excellence in clinical care,excellence in educating our undergraduate andpostgraduate learners, and excellence in research.

I am pleased with our progress so far and excited aboutour future endeavors. Each year our students highlyrate their surgical rotations which are in high demand.Resident satisfaction is high, and their researchparticipation has increased threefold over the lastseveral years.

We’ve had excellent additions to our staff as we recruitthe best and brightest to Queen’s to work in this trulyunique environment. We are looking forward torecruiting more surgeons in the near future as we lookto build on our success.

Congratulations to two of our surgeons who have beenrecognized internationally and nationally as excellentin their field. Ryan Bicknell in Orthopaedics waselected by the Shoulder and Elbow Society of NorthAmerica to be their European Travelling Fellow. And Paul Belliveau was recognized for his expertise,leadership, and for his outstanding contributions toCanadian undergraduate medical education by winningthe Canadian Undergraduate Surgical EducationCommittee Provan award.

So despite being small, we progress, we move quickly,efficiently and effectively while creating an environmentof excellence that attracts talented young people whowant to learn. Queen’s consistently is the most sought-after seat by medical school applicants across thecountry. We continue to do better and we look for newways to grow our research and improve our education.It has been my pleasure over the past five years to beHead of Surgery at Queen’s University. I am proud towork with such a dedicated and talented group ofsurgeons, students, and colleagues. The future is brightand the opportunities are endless.

j o h n R u d A n


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UNDERGRADUATE SURG I CAL EDUCAT ION P ROGRAM UPDATEp R e - c l e R k s h i p

With the evolution of our MD Program curriculum in the first two yearstowards a more competency-based education, our surgeons have

needed to be involved in a variety of innovative learning methods. Ourmembers have learned the instructional methods of Team Based Learning,Facilitated Group Learning, Self-Directed Study-Learning and more. It isimportant for students, even at the pre-clerkship level, to come into contactwith surgeons as they are at a stage of exploration of their future career.Clinical Skills courses are an integral part of our program, where studentslearn to appreciate the doctor-patient relationship and develop theirinterviewing and physical examination skills. Further involvement of oursurgical faculty comes at the time of the introduction/transition into Clerkship.With the help of the simulation lab personnel and other faculty, we exposethe keen students to a variety of situations and procedures they will no doubtcome across in their surgical and non-surgical rotations/blocks.

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Our Surgical Clerkship Programcontinues to support local and

distant learning sites. As ClerkshipDirector, I welcome the incomingclass of students for their six-weekexperience and explain the natureand expectations of the rotation.We advise them of the importanceof obtaining written evaluationsfrom both faculty supervisors andresidents. This is an essential com-ponent of the narrative feedbackon their performance. I then meetindividually with each student toreview their progress at the mid-point of the rotation and directthem to concentrate on certain aspects where there is room for improvement. I encourage them by highlighting their strong points according to the evaluations submitted. We monitor their studyplan to make sure their learning isin keeping with the objectives of

the surgery course. I suggest certaindomains to concentrate their reviewin preparing for the exam (the NBMEwritten MCQ after completing boththis course and the Peri-Op Block.)

The Curriculum Committee and theClerkship Program Director have recently introduced an expectationfrom the students to demonstratean experience where their advocacycompetency was expressed. This willbe discussed with the student duringthe mid/end rotation meetings. Thescholar competency will also be assessed with the report the studentpresents to the Course Director focusing on one aspect of the management of a clinical encounterwith a review of basic literature.The goal is to demonstrate the integration of the learning from the encounter in their overall problem-solving ability.

This fall the CUSEC 2013 Symposiumheld in Ottawa, and strongly supportedby the Surgical Chairs across Canada,was devoted to the Science of Learning. There were workshops on wellness for students and faculty, as well as fascinating discussionsabout the role of electronic learning methods and the impact of socialmedia on the student experience.

I believe our students will have thebenefit of additional exposure tocomplex situations during three newsegments of clerkship, namely CC1,CC2 and CC3.

I would welcome any comments youmay have on the surgical exposureour students are offered, as we alwaysstrive to improve the program.


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SURG I CAL FOUNDAT IONS R E S ID ENCY P ROGRAM UPDATE

The Surgical Foundations Programcontinues to provide the General

Surgery, Urology, and Orthopaedic,PGY 1s and 2s with an integratedcurriculum and training in multiplesurgical specialties.

The Royal College is planning ontranslating the innovative Queen’sSurgical Boot Camp and NightmaresCourse to all other programs in thecountry. The combined approach of surgical simulation and problem-based learning in these two sessionshelps new residents feel preparedfor their residency.

In addition, the Surgical FoundationsAcademic Curriculum has expanded

to include resident taught didacticsessions on all Royal College SurgicalFoundations Learning Objectives.Each Resident is expected to researchand present on a topic included inthe objectives, with the support of a Staff Facilitator. The referencematerial and presentations are beingcollated to create a learning libraryspecific to Surgical Foundations for future generations of SurgicalResidents.

Our plan is to continue the goodwork we are doing and prepare toexpand to incorporate Obstetrics andGynecology, as they will be officiallypart of the Surgical FoundationProgram in July of 2015.


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GENERAL SURGERY R E S ID ENCY P ROGRAM UPDATE

This past year has been one of ongoing challenges in the

Queen’s General Surgery ResidencyProgram. The program is striving to remain a strong, competitiveprogram that allows our trainees to enter practice or fellowshipprograms as confident, competentsurgeons.

Significant effort was put intoimproving resident research withinthe Division over the past year.Thanks to the hard work of thedivisional members, led by ResidentResearch Coordinator Dr. Nanji,many new projects were initiated.Five of these projects were presentedat the annual William Ersil ResidentResearch Day. We hope to build onthis success with every residentparticipating in this importantcomponent of residency training.

We are moving forward with our other post-accreditationrecommendations. The institutionof new and improved forms ofcurriculum delivery and evaluationneed to be meshed with the Royal

College rolling out its Competencyby Design initiative and CanMeds2017. Work hour restrictions arebeing looked at carefully with afocus on resident well being asopposed to further decrease inshift length.


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OR THOPAED IC SURGERY R E S ID ENCY P ROGRAM UPDATE

The academic program has hadcontinued success over the past

year with an increased number ofsurgical simulation sessions in thecurriculum to allow residents topractice specific surgical skills in alow stress, risk-free environmentwhile affording them the opportunityto gain familiarity with techniquesbefore they perform them onpatients in the OR. In addition, the residents participated in twocadaveric workshops focusing on arthroscopy and traumareconstruction which allowedthem to further develop acquisitionof new skills and knowledge.

Research continues to be a strongcomponent of the OrthopaedicResidency Program at Queens. Inlarge part this is due to the decision

to allow residents a dedicated half-day for research without clinicalresponsibilities, in order toparticipate in multi-disciplinaryresearch teams at the HumanMobility Research Centre. Thisprotected time has resulted inincreased resident researchproductivity as evidenced by the 23 resident projects that have beenpresented at the Queen’sWilliamErsil Resident Research Day inSurgery over the past two years.The quality of resident projects has been very high with 18 projectspresented at national or internationalconferences over the same period.During 2013, ten resident projectswere published in peer reviewedjournals.

As a small program, the interactionbetween the staff and the residentsis what makes this orthopaedicresidency program special. Queen’sorthopaedic residents spend asignificant amount of time witheach and every staff person overthe five years of surgical training.Dr. Daniel Hesse, a PGY 5 residentrecently reviewed his surgical caselog which has over 1050 cases asprimary surgeon. He stated that“the close interaction between staffand resident creates a relationshipthat allows for the development ofgraduated responsibility andfeedback that is specifically tailoredto your needs as you become moresenior. This guidance provides the foundation for your surgicaland clinical skills to mature at aremarkable pace to become afundamentally sound surgeon.”


DR. D. J. COOK JO IN S D I V I S ION OF N EUROSURGERY

The Department of Surgery extendsa warm welcome to Dr. D.J. Cook,

who joined the Division ofNeurosurgery as an AssistantProfessor in May 2013. He receivedhis undergraduate degree from theUniversity of Guelph and his MDfrom the University of Toronto. Heundertook residency training inneurosurgery at the University ofToronto. During his residency hetook time away from neurosurgeryto complete basic science researchin stroke neuroprotection towardshis PhD. Following this he undertooka fellowship in Cerebrovascular andSkull Base Surgery with Dr. GarySteinberg at Stanford University. Dr. Cook’s scientific reputation intranslational stroke research hasgrown at a rapid pace. He has

published his research in prestigiousjournals such as Nature, ScienceTranslational Medicine and Stroke. He has received multiple awards forresearch from a number of nationaland international societies includingthe Congress of NeurologicalSurgeons, the American Associationof Neurological Surgeons, and theCanadian Stroke Network. Hisclinical interests include cerebralrevascularization, minimallyinvasive approaches for skull baselesions and aneurysms and thetreatment of arteriovenousmalformations. Dr. Cook will have a double life while on staff atKingston General Hospital. Supportedby a Clinician Scientist Award fromSEAMO, half of his time will bedevoted to stroke research in the

Centre for Neuroscience Studies at Queen’s University. D.J. lives inHarrowsmith with his wife, Rebecca,and their 3 children, where theyhave established a family farmingoperation, Otter Creek Farm,focused on producing organic beef,chicken and seasonal vegetables.

DR. SCOT T MCCLURE JO IN S D I V I S ION OF CARD IAC SURGERY

The Department of Surgery wouldlike to welcome Dr. Scott McClure

to its Division of Cardiac Surgery.Dr. McClure comes to us aftercompleting his residency at theUniversity of Western Ontario.After this he completed fellowshipswith Dr. Lawrence Cohn (HarvardUniversity) in Advanced CardiacValve Surgery, and also with

Dr. Joseph Bavaria (University of Pennsylvania) in AdvancedThoracic Aortic Surgery. He alsoholds a Master of Science in ClinicalEpidemiology, from Harvard. With the addition of Dr. McClure,the Division rounds out its ability to provide comprehensive cardiacsurgical care for even the mostcomplex cases.

c R e At i o n o f t w o n e w c h A i R s i n d e p A R t m e n t o f s u R g e R y

We are excited to announce the creation of two new Chairs in the Department of Surgery, made possible by anexceptional donation from a private donor in the amount of $4.5 million, as well as a $2 million donation fromthe surgeons with the Department; both donations to be directed to further support the research initiatives ofthe Department of Surgery.


UNDERS TAND ING B RA IN FUNC T ION AND DYS FUNC T IONUS ING E L EC TROPHYS IO LOGY

Queen’sMedical School graduate, Dr. Ron Levy, joined the

Department of Surgery and theCentre for Neuroscience Studies as an Assistant Professor last Julyfrom Toronto Western Hospital,where he was a Clinical Fellow in Stereotactic and FunctionalNeurosurgery. A neurosurgeonwith a PhD in neuroscience, Dr. Levy was recently awarded a$320,000 grant from the CanadaFoundation for Innovation (CFI)pending additional funding fromthe Ministry of Research andInnovation (MRI), which will

enable him to research the use oftherapeutic neuromodulation totreat various neurological diseases.Two of these illnesses, Parkinson’sdisease and epilepsy, are verydebilitating to a person’s quality of life. He will study the changesthat occur in the brain duringdisease using electrophysiologicaltechniques. In the brain,electrophysiology is defined as the study of the electricalproperties of neurons and howthey communicate using actionpotentials. This is importantbecause normal communication

between neurons can break downand cause neurological illness.Neuromodulation therapy isdefined as a technique to enhanceor suppress brain activity by use of electrical, magnetic, chemical, or light energy. Dr. Levy will applytherapeutic neuromodulation inorder to stabilize or reverse brainactivity and improve the symptomsof disease. This research programwill lead to improved treatment ofpatients with Parkinson’s diseaseand epilepsy with neuromodulationtherapies.


IMPROV ING CANCER OUTCOMES THROUGH COL LABORAT I V ER E S EARCH B E T WEEN SURGERY AND ONCOLOGY

Dr. Sulaiman Nanji joined theDepartment of Surgery in 2010

as a surgeon-scientist after earningan MD and PhD, and fellowshiptraining in hepatobiliary andtransplant surgery. His researchinterests in oncology complementhis clinical practice in the surgicaltreatment of advanced hepatobiliaryand pancreatic malignancies.

He has established a basic sciencelaboratory that conducts translationalresearch in the epigenetics ofhuman liver cancer. The goal is tounderstand the correlation between

genetic changes and their clinicalimpact in order to develop a clinicaltool to risk stratify tumours to bettertreat patients with liver cancer.

He has also developed a strong collaboration with Dr. Chris Booth,clinician-scientist and AssociateProfessor in the Department of Oncology. Together they conductpopulation-based cancer outcomesresearch to study the role of surgeryand chemotherapy in improvingclinical outcomes. They have devel-oped databases for patients withliver metastases that are among the

largest in the world. These data sets incorporate surgical treatmentinformation, chemotherapy and radiation therapy records from allprovincial cancer centres, allowingfor population-level studies in canceroutcomes. Other specific aims are to evaluate the effectiveness of newtherapies in the general population,assess adherence to treatmentguidelines, and explore issues of access to, and quality of, cancer carein Ontario.


I N MEMOR IAM – DR. M I CHAE L S IMURDA

Professor Michael Simurda,founder and former Division

Chair of Orthopaedics at Queen’sUniversity, Hotel Dieu andKingston General Hospitals,peacefully passed away at home

on November 19th, 2013 at the age of 85.

In 1934, Mike and his mother arrived in Canada fromCzechoslovakia to rejoin his father who had immigratedto Canada in 1930 to shape a new life for his youngfamily. The family settled in Bradford, Ontario and established a vegetable farm in the newly opened Holland Marsh. His early farm-life experience wouldhelp shape his personal and professional values; inlater years Mike would mischievously evaluate hismany loyal disciples based on the core attributes of‘onion pickers’.

Mike attended medical school at the University ofToronto, graduating in 1953. There he was awardedthe Gold Key and nominated into the Alpha OmegaAlpha Honor Medical Society. Continuing in Toronto,he completed orthopaedic training in the Galliecourse of surgery. He was subsequently awarded aMcLaughlin Fellowship under the auspices of Queen’sUniversity for further specialized training at King’s College Hospital in London, England. Upon starting hispractice at Queen’sUniversity in Kingston, he opened a public clinic, which provided free orthopaedic consultation and surgery.

Mike had a vision for the future of orthopaedic surgery.In 1965, he applied to the Royal College of Physiciansand Surgeons of Canada and was granted approval toestablish a postgraduate orthopaedic training programat Queen’s. Mike, along with Charles Sorbie—the firstDivision Chair, John Hazlett, Derek Cooke, Tony Ashworth and Don Taylor (one of their first gradu-ates) formed the nucleus for the first generation of orthopaedic faculty at Queen’s. Quietly, Mike supportedthe careers of these colleagues, and those that followed.Over the years, many individuals have been able tocomplete their orthopaedic residency training at Queen’s.Many of our graduates play key roles on Queen’s faculty,and the faculties of prestigious orthopaedic programsacross Canada and in the United States. By the early ‘90s

we started a Clinical Fellowship Program. Initially, ourFellows were our own former residents, but in recentyears we have also attracted many Canadian and inter-national fellows who are now orthopaedic leaders inCanada, Australia, the Middle East, and South East Asia.

Mike was admired and respected by his residents.Above all he was a ‘cutter’s cutter’, renowned for hisoutstanding surgical skills and judgment. He couldguide any resident through even the most complexreconstruction—and each of us lost many nickels tohim. But whenever we had a tough challenge to tackle,we’d turn to Mike for help. He got tremendous pleasure from following the careers and staying intouch with those he inspired and mentored over the span of his long career.

Mike dedicated himself to teaching, clinical researchand surgery. He published and presented numerous academic papers. Widely recognized for his wisdomand leadership, he served as President of both the Ontario and Canadian Orthopaedic Associations. He was a member of the Dewar Orthopaedic Society, the Little Orthopaedic Club in the United States, andthe American Academy of Orthopaedic Surgeons.

In 1973, he, along with a small group of associates,purchased the Montreal Canadiens Major Junior Afranchise and brought Major Junior A hockey toKingston as the Kingston Canadians. He was a memberof the Cataraqui Golf and Country club for 50 yearsand he treasured his fairway buddies immensely. Although he rarely used a pager, the KGH switch-board operators could track him down to any hole onthe course! His wife Binka, who made a welcominghome for orthopaedic residents, enabled his life ofhard work. Orthopaedic residents have cherished herwarm heart, welcoming home, and delicious cabbagerolls for decades. He was a devoted father and grand-father; generous with advice and support that hasserved each of them so well.

Eventually, well into his seventies, he retired fromQueen’s University as Professor Emeritus. Age andarthritis forced him to choose an easier life-style – heenjoyed cottage life, reading and bridge. To those wholoved him and knew him best, he was a gentle giantwith a heart of gold.


THE A S E S EUROPEAN EXCHANGE F E L LOWSH I P R EC I P I ENT – DR. R YAN B I C KNE L L

left-to-right: Dr. Bob Tashjian, Dr. Alex Castagna,Dr. Raphael Garofalo, Dr. Ryan Bicknell

It is with great pleasure that we announce that Dr. Ryan Bicknell has been awardedthe 2013 ASES (American Shoulder and Elbow Surgeons) European ExchangeFellowship. This fellowship was established in 1993 as an exchange between theAmerican Shoulder and Elbow Surgeons (ASES) and the European Society for Surgeryof the Shoulder and Elbow (SECEC). The fellowship is awarded every two years to twoASES members/orthopaedic surgeons from the United States or Canada, who are inthe first seven years of practice with a special interest and experience in shoulder and elbow research and patient care. These fellows travel for four weeks throughoutEurope to visit eight prominent shoulder and elbow centres and attend the annualSECEC closed meeting and in corresponding years, two European fellows are selectedto visit North American centres. Fellowship recipients become correspondingmembers of SECEC, are also eligible for an ASES Research Grant and receive anexpense-paid trip to the ASES Closed Meeting the following year to present theirtravel experiences.


HUMAN MOB I L I T Y R E S EARCH C ENTRE

i n t e g R At e d R e s e A R c h t e A m s

Projects at the Human Mobility Research Centre (HMRC) areundertaken in Integrated Research Teams (IRTs). Senior basic

and clinical scientists mentor trainees in a structure that emphasisesclinical needs identification and research question developmentwhile providing skills in conducting and managing interdisciplinaryresearch.

Dr. Bicknell is the clinical lead of IRTs studying: Shoulder Reconstruction using Biomechanical Assessment and Optimized Image Guidance.

The long term objective of the work is to develop methods forshoulder reconstruction that are optimized for a specific patient.The team has designed and built a unique mechanical shouldersimulator and a surgical planning tool with an automatic opti-mization of the placement of the Reverse Shoulder Arthroplastyimplant. In addition, the group has developed novel computermodels to predict how the shoulder replacement will behave fora given patient’s musculature and anatomy.

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Last year we reported on the Grand Opening of the HMRC Motion Performance Lab.Since it’s opening, more than 400 subjects have participated in a variety of research

project, 9 of which focus on clinical research.

One such study is being conducted by Allison Tucker, Elizabeth Hassan, Dan Borschneckand Kevin Deluzio and is looking at Performance Outcomes Post-ACL Reconstruction in aPediatric Population.

The objective of this study is to examine if there are significant differences in kneestrength and function, dynamic stability and reoperation rate in a skeletally immaturepediatric cohort who receive conventional ACL repair compared to those who receivean ACL repair with the tightrope fixation technique.


THE ADVENT OF COMPE TENCY -BASED AR THROSCOP IC CURR ICULUM

The Division of Orthopaedic Surgery purchased the insightArthroVR®, a virtual arthroscopic simulator for the

training of orthopaedic residents in both competency andproficiency in complex arthroscopic tasks. This simulatorprovides a series of training modules of increasing difficulty so the trainee can learn the necessary psychomotorskills for arthroscopy. A number of residents have ravedabout the realistic depiction of an intra-operative scenariousing the simulator and the fact that the system allows foradditional arthroscopy time which may be limited in oper-ating room. Although it is currently used as an elective tool,the Orthopaedic Sports Medicine Team has immediateplans for incorporating this tool as a mandatory part of alljunior resident training. The team is currently in the midstof developing an arthroscopic competency-based curricu-lum which would require that all residents acquire baselinearthroscopic skills prior to entering the operating room.This surgical simulation tool has provided the residentswith the means of acquiring difficult hands-on skill wherevisibility is limited.

In addition, the arthroscopic simulator has proven to be an invaluable research tool. A research team lead by PGY2 resident Dr. Dan Banaszek has completed a pilot validationstudy for its use along with a global rating scale for theevaluation of resident performance of arthroscopic tasks.The team is in the process of performing a randomized controlled trial of surgical novices, i.e. medical students,comparing their arthroscopic skills using the simulator totraditional bench-top sawbone simulated arthroscopy. Bothmodalities of surgical simulation training will play a majorrole in the competency-based arthroscopic training curriculum.


Dr. Darrin Payne – TAVI Procedure


TRANSCATHE T ER AOR T I C VA LV E IMP LANTAT ION

In January 2013 Kingston General Hospital and Queen’s University began a new transcatheter aortic valve implantation (TAVI) program. TAVI is aminimally invasive procedure for patients with severe, symptomatic aorticstenosis who have been deemed very high risk for conventional aorticvalve replacement surgery. It involves introducing a prosthetic aortic valvein retrograde fashion through the aorta and implanting it in the patient’saortic annulus, thus avoiding the morbidity of a median sternotomy andcardiopulmonary bypass. Typically the valve is introduced through thefemoral artery, but if the femoral arteries are unsuitable it can also be deliv-ered via the subclavian artery or through direct aortic access using a mini-thoracotomy incision. When performed via the femoral artery the procedurecan be accomplished either entirely percutaneously or via a small 4-5 cmgroin incision. The native aortic valve is not surgically removed, but israther pushed out into the sinotubular junction with the expansion of thenew valve. The procedure is analogous to percutaneous coronary stenting,however instead of stenting the coronary artery we are stenting open thestenotic aortic valve with a bioprosthesis. The transcatheter valve is mountedon a self-expanding nitinol frame and compressed onto an 18 Frenchcatheter for delivery. TAVI is performed in our hybrid operating room whichhas the full capabilities of both an OR as well as a cardiac catheterizationlab. Dr. Darrin Payne from cardiac surgery and Dr. Paul Malik from inter-ventional cardiology, in conjunction with a newly comprised “Heart Team”consisting of a full complement of both operating room and interventionalcardiology staff performed the first case January 29th 2013. The team hassince successfully performed 13 cases. This new and innovative procedurehas brought the Divisions of Cardiac Surgery and Cardiology even closeras they now scrub in together and work side-by-side to treat patients with severe aortic stenosis. Most importantly, TAVI has allowed us to offer treat-ment to some of our sickest and most frail cardiac patients who otherwisewould have no efficacious treatment options available.


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DR. ROS I E S ENDHER

Arole model for future female orthopaedic surgeons, Dr. Rosie Sendher could never have predicted the path that would eventually lead her to where she is

today, a practicing hand surgeon at Precision Orthopaedics in Salinas, California.Having every intention of becoming a family medicine physician, Rosie completedher undergraduate medical schooling at the University of British Columbia andwas later accepted into their family medicine residency program. However, twomonths into the program, her passion for orthopaedics revealed itself and Rosierealized she wanted to pursue it as her lifework.

Her path into orthopaedics took her first to the completion of a Masters inHealthcare and Epidemiology degree, while still in her family medicine program.The next step took a real leap of faith. Moving across the country and leavingher family behind in B.C., Rosie accepted the position of Hospitalist at KingstonGeneral Hospital, before then being accepted as a second year resident in theOrthopaedic Surgery Residency Program at Queen’s University. An elective atStanford University led to an offer for a Fellowship in Hand and Upper Extremity.Following this Fellowship, she returned to Queen’s and completed a rewardingFellowship in Trauma Surgery under the supervision of Dr. Jeff Yach.

Rosie credits her success along the way to the outstanding support she has receivedfrom all the orthopaedic surgeons she has worked with, and emphasizes howimportant it is to have good female role models who showed her that orthopaedicsis not necessarily about brute force; that instead, devices and special techniquescan be employed to elicit the same results. Today, in her practice, Rosie is ableto offer this same hands-on training to the medical students and residents whotrain with her. Her tremendous talent and passion for her work, coupled withthe unconventional path she has followed in pursuit of her chosen career, affordher the unique opportunity to show others how anything is possible when youbelieve you can accomplish whatever you set out to do.


R e s i d e n t p R o f i l e

DR. B LA I R MACDONALD

While Blair MacDonald’s path tohis current position as Chief

Resident of the Queen’s GeneralSurgery Program is in many waysconventional, it all began in a bluecollar family in one of the coldest,darkest, and most remote places inCanada: The Yukon Territory. Hisfather’s work as a miner led themto move early on to Yarmouth,Nova Scotia, where Blair grew up.Of the formative locations in hislife, though, Deschappelles, Haiti,looms large, because that is wherehis love of serving others was born.Blair spent a summer in Haiti whenhe was fifteen years old workingwith his missionary aunt. The prag-matic, hands-on nature of thework, which garnered immediateresults, both good and bad, struck a chord with the pubescent Doctor,and sowed the seeds that woulddrive the rest of his education andprofessional development.

After graduating from HoughtonCollege and attending DalhousieUniversity for medicine, Blair cemented his aspirations for generalsurgery. He is currently pursuing aunique dual program which com-bines General Surgery and CriticalCare. Blair has found the programextremely rewarding, noting howsatisfying it is to care for those withcritical illness. While his operationsbegin in the OR, or “sometimes eventhe ICU, when the patients are tooill to be transported to the OR,”Blair’s treatment continues beyondthe last suture, diligently managingthe post-operative care of thesecomplex patients.

While Blair’s primary passion is hisholistic surgery practice, he has dis-covered a secondary passion duringhis time as a resident: teaching. Hewas awarded the CAGS “Excellence inTeaching” award for Queen’s GeneraSurgery at the Canadian SurgicalForum. Queen’s Surgery has fosteredhis love of surgery and providedstrong, individualized teaching whichhas enabled Blair to be an excellentsurgeon while learning to teach andmentor fellow residents. Not only is Blair an accomplished surgical resident, he is also a committed father and husband, whose first childwas born only four weeks before hestarted his residency. While home-life balance can be a struggle, Blair

gives all of the credit to his “lovely,talented, and brilliant wife”, who is,as he proudly notes, “an amazingmother.”

Blair hopes to spend his post-l

residency career pursuing a practicethat combines his passions: surgery,critical care, and humanitarian efforts. While he has no concretepost-residency plans, he does antici-pate returning to Haiti to participatein humanitarian work there, stating:“Humanitarian work is my greatestpassion, and I can imagine no greaterprivilege than returning to the country which has and continues to be a great source of inspiration.”

“The purpose of human life is to serve and toshow compassion and the will to help others” –Albert Schweitzer


CHARL E S SORB I E FACULT Y R E S EARCH DAY

On Friday April 12th, 2013, the Department of Surgery held its third annual Charles Sorbie Faculty Research Day, an all-day event attended

by faculty, residents and fellows which provides participants the opportunityto enhance surgical research by familiarizing themselves with the researchactivities of others within the Department. It also provides research mentorship for our surgical residents.

The guest speaker of this year’s event was Dr. Chris Booth, Cancer Care Ontario Chair in Health Services Research, Division of Medical Oncology, at the Cancer Centre of Southeastern Ontario. He presented his talk on “Do cancer treatments actually work in the real world? Insights from a program in population-based outcomes research.”

This annual event is made possible by the generous donation from Dr. Janet Sorbie in loving memory of her husband Dr. Charles Sorbie who was a very distinguished member of our Department as well as Head of the Department for ten years.

Our next Charles Sorbie Faculty Research Day will take place April 11, 2014


THE 3 1 S T ANNUAL W I L L I AM E R S I L R E S ID ENT R E S EARCH DAY

The Department of Surgery at Queen’s University held its 31st AnnualWilliam Ersil Resident Research Day on Monday November 19, 2012.

This annual event is designed specifically to enable residents from the Department of Surgery to present ongoing clinical and basic science research performed during the year under the supervision of attendingstaff. It was established in honour of Dr. William Ersil who received his medical degree from Queen’s in 1979 and entered the Orthopaedic SurgeryProgram at Queen’s. Sadly, he developed a malignant disease and died during his second year of residency training. He had an inquisitive mind,and he believed in the value of research.

This Annual Research Day, which is held in conjunction with the Office of Continuing Medical Education, has become one of the most importantevents in the Department of Surgery, when all surgical residents and attending staff gather for the opportunity to familiarize themselves withthe surgical research activities within the Department. It also provides aforum for surgeons from both within and outside the Queen’s community to renew or establish professional and personal liaisons.

Congratulations to the followingaward winners!

dAnny ARoRAThe William Ersil Award for Best Orthopaedic Surgery Paper

steve mAnnBest Clinical Paper

michel tAyloRBest Poster

dAniel bAnAszekBest Basic Science Paper


DR . ANDREW BRUCE AND MARGARE T B RUCE ENDOWMENT FOR V I S I T I NG SCHOLARS I N SURG I CAL I NNOVAT ION – DR . HANS R I NGER TZ, V I S I T I NG SCHOLAR

Thanks to the generous donation of Dr. Andrew Bruce and Margaret Bruce, the Departments of Surgery and Urology were proud to host their inaugural Visiting Scholars in Surgical Innovation event in October 2012 –

a special presentation by Dr. Hans Ringertz, MD, PhD, entitled “What does it take to win a Nobel Prize! MRI andMore Recent Nobel Prizes in Physiology and Medicine” The event was very well attended; with many standing to listen to Dr. Ringertz speak. Dr. Ringertz was the Chair of the Nobel Assembly at the Karolinska Institute in Stockholm 2003, as well as Professor and Chairman of the Department of Radiology. He now serves as visiting professor in the Department of Radiology at the Lucile Packard Children’s Hospital, Stanford University Hospital.We were also very honoured to have Dr. Bruce attend, where he was able to meet this year’s visiting scholar. The Dr. Andrew and Margaret Bruce endowment will continue to support the hosting of prominent scholars atQueen’s University with the goal that the visiting scholar will bring special expertise in the area of surgical scholarship, will introduce new research and ideas, will teach new methodologies to Queen’smedical scientistsand clinicians, and provide new concepts to our students.

WELCOME TO OUR NEW PGY 1 R E S ID ENTS

We would like to extend a warm welcome to our new general and orthopaedic surgical residents who commenced their programs July 1, 2013

g e n e R A l s u R g e R y

ninA he, University of British Columbia

gARy ko, Queen’s University

meRcedes pilkington, Queen’s University

igAl RAizmAn, Queen’s University

o R t h o p A e d i c s u R g e R y

dAvid AlcoloumbRe, McGill University

fAizAl kAssAm, Queen’s University

AndRew mARsh, Dalhousie UniversityDavid Alcoloumbre, Andrew Marsh, Faizal Kassam, Mercedes Pilkington, Gary Ko


Dr. Paul Belliveau (left)

l A s t n o v e m b e R i n o t tA w A, d u R i n g t h e b i A n n u A l c u s e c s y m p o s i u m,d R. pA u l b e l l i v e A u, c o l o R e c tA l s u R g e o n At Q u e e n ’ s w A s p R e s e n t e d t h e

20 1 3 JOHN P ROVAN OUTS TAND ING CANAD IAN SURG I CALEDUCATOR AWARD

This award is sponsored by the Canadian Association of Surgical Chairs (CASC). The award was first presented in 1993. The award is a wonderful large Inuit soap

stone carving which will remain in the custody of the winner’s Department of Surgeryfor a period of 2 years. It is presented at the meeting of the Canadian UndergraduateSurgical Education Committee, which this year was devoted to the Science of Learning.Dr. Belliveau will have his name permanently affixed to the award. A smaller awardsculpture of the same theme remains with him and is suitably engraved.

Dr. John Provan, a Vascular Surgeon from University of Toronto has been known for hisextraordinary impact on medical students, by demonstrating enthusiasm for surgicallearning through innovation and leadership.

The Award is designed to recognize outstanding contribution to undergraduate surgicaleducation in Canada. The achievements must have occurred in Canadian undergraduatesurgical education. Nominations may be made by any Canadian involved in undergrad-uate surgical education (e.g. teacher, trainee). Each nomination must have at least oneseconder who is an eligible nominator. Nominations were received from the SurgicalDepartment Heads across Canada and included reasons for nomination. Dr. Belliveauwas very pleased, but humbled by this prestigious honour.


G RANTS 20 1 2 - 20 1 3

Principal Investigator: Abolmaesumi, Purang, Electrical and Computer Engineering, UBCCo-Investigators: david pichora; Parvin Mousavi; David WilsonSponsor: Natural Sciences and Engineering ResearchCouncil of Canada (NSERC)Total Awarded: 418,700Project Title: Real Time Guidance Surgical NavigationSystem for Scaphoid Fracture Fixation

Principal Investigator: Aiken, Alice, B, RehabilitationTherapy, School ofCo-Investigators: mark harrison, john RudanSponsor: Queen’s Health SciencesTotal Awarded: 20,132Project Title: Obesity and Knee Replacement Surgery

Principal Investigator: Amsden, Brian, G, ChemicalEngineeringCo-Investigators: Stephen Waldman; Andrew Winterborn;davide bardanaSponsor: CIHR – New Operating GrantTotal Awarded: 100,000Project Title: Biomimetic Scaffold for Ligament Regeneratio

Principal Investigator: bardana davide, SurgeryCo-Investigators: Joan StevensonSponsor: Department of SurgeryTotal Awarded: 20,000Project Title: Implementation of objective biomechanicaland psychological measures for return to military activityfollowing primary ACL reconstruction

Principal Investigator: bardana davide, SurgerySponsor: Research Initiation GrantTotal Awarded: 18,180Project Title: Anterior Crucite Ligament Project

Principal Investigator: bicknell, Ryan, SurgerySponsor: Research Initiation GrantTotal Awarded: 18,772Project Title: Reverse Shoulder Arthroplasty

Principal Investigator: bicknell, Ryan, SurgerySponsor: Department of SurgeryTotal Awarded: 20,000Project Title: Development of Cadaveric ShoulderKinematic Simulator

Principal Investigator: bicknell, Ryan, SurgerySponsor: Zimmer Inc.Total Awarded: 42,250Project Title:Multicenter Trial of the Sidus? Stem-Free Shoulder Arthroplasty System

Principal Investigator: bicknell, Ryan, SurgeryCo-Investigators: Paul FentonSponsor: Physicians’ Services Inc. Foundation (PSIF)Total Awarded: 19,500Project Title: Treatment of Adhesive Capsulitis: ARandomized Placebo-Controlled Trial ComparingArthrographic Joint Distention with Steroid and LocalAnesthetic Versus Arthrographic Joint Distention withLocal Anesthetic Alone

Principal Investigator: Booth, Christopher M, OncologyCo-Investigators: sulaiman nanji, SurgerySponsor: Queen’s UniversityTotal Awarded: 40,000Project Title: CRC Mets Project – Oncology

n

Principal Investigator: borschneck,daniel p, SurgeryCo-Investigators: Ryan bicknell; Aaron campbell;davide bardana; lindsay davidson;mark harrison;david pichora; john Rudan;gavin wood; jeff yach;david yenSponsor: Depuy (Canada) Ltd.Total Awarded: $649,880Project Title: Orthopaedic Research – Human MobilityResearch Centre

Principal Investigator: borschneck,daniel p, SurgeryCo-Investigators: davide bardanaSponsor: SEAMO – Educational Innovation and Research FundTotal Awarded: 15,000Project Title: Virtual Reality Versus Benchtop Simulation in the Acquisition of Arthroscopic Skill

Principal Investigator: borschneck,daniel p, SurgerySponsor: Stryker CanadaTotal Awarded: 10,000Project Title: Queen’s University Orthopaedic ResidentResearch Projects

Principal Investigator: borschneck,daniel p, SurgerySponsor: Queen’s UniversityTotal Awarded: 20,000Project Title: Gait Analysis in the Pediatric Population

Principal Investigator: borschneck,daniel p, SurgeryCo-Investigators: Ryan bicknell; Aaron campbell;davide bardana; lindsay davidson;mark harrison;david pichora; john Rudan;gavin wood; jeff yach;david yenSponsor: Depuy (Canada) Ltd.Total Awarded: 100,000Project Title: Educational Grant in Excellence inOrthopaedic Surgery

Principal Investigator: Brander, Rosemary, School ofRehabilitation TherapyCo-Investigators:Margo Paterson, Richard ReznickSponsor: Ontario Ministry of Health and Long-Term CareTotal Awarded: 557,670Project Title: Canadian Interprofessional Health LeadershipCollaborative Project (CIHLC)

Principal Investigator: campbell, Aaron R, SurgerySponsor: Queen’s UniversityTotal Awarded: 30,000Project Title: The establishment of an infrastructure foranterior cruciate ligament reconstruction investigations

Principal Investigator: cook,douglas, james, SurgerySponsor: SEAMO – Clinician Scientist DevelopmentProgramTotal Awarded: 100,000Project Title: Translational Stroke Research Program

Principal Investigator: cook,douglas, james, SurgerySponsor: Queen’s UniversityTotal Awarded: 180,000Project Title: Translational Stroke Research Program

Principal Investigator: cook,douglas, james, SurgerySponsor: Canada Foundation for InnovationTotal Awarded: 480,000Project Title: Translational Stroke Research Program

Principal Investigator: davidson, lindsay, SurgeryCo-Investigators:Michelle Gibson; Sheila Pinchin; Richard Van WylickSponsor: SEAMO – Educational Innovation and Research FundTotal Awarded: 15,000Project Title: Case-based teaching in the UndergraduateMD program: an analysis of levels of learning anddevelopment of targeted faculty development process.

Principal Investigator: davidson, lindsay, SurgeryCo-Investigators: Renee Fitzpatrick; Sheila PinchinSponsor: Queen’s Centre for Teaching and LearningTotal Awarded: 2,000Project Title: Virtual video modules for distributedteaching of psychiatry

Principal Investigator: Fichtinger, Gabor, School ofComputingCo-Investigators: Richard Reznick; daniel borschneck;Melanie Jaeger; Robert McGrawSponsor: CIHR – Collaborative Health Research Projects(CHRP)Total Awarded: 336,940Project Title: Perk Tutor: Ultrasound-guided NeedlePlacement Training Platform

Principal Investigator: Flynn, Lauren, Chemical EngineeringCo-Investigators: Donald Maurice, Brian Amsden, Andrew g hamiltonSponsor: Heart & Stroke FoundationTotal Awarded: 70,000Project Title: Co-delivery of adipose-derived stem cells and SDF-1/HGF-1 in ligand grafted, in situ setting gels for the treatment of peripherial arterial disease

Principal Investigator: Flynn, Lauren, Chemical EngineeringCo-Investigators: Brian Amsden, Stephen Waldman, john frederick watkinsSponsor: Canadian Institutes of Health Research (CIHR)Total Awarded: 423,928Project Title: Engineering adipogenesis for soft tissueregeneration

Principal Investigator: Hanna, Timothy, Cancer Care andEpidemiologyCo-Investigators: Tara Baetz; Christopher Booth; Craig Earle; Elizabeth Ann Eisenhauer; doug mckay;Yingwei Paul Peng; Victor A TronSponsor: Ontario Institute for Cancer ResearchTotal Awarded: 25,086Project Title: A Population-Based Study of Adjuvant High-Dose Interferon Use for High-Risk Melanoma in Ontario:Toxicity

Principal Investigator: Henry, Richard A, AnesthesiologyCo-Investigators: gavin wood, John HopeSponsor: Southeastern Ontario Academic MedicalOrganization (SEAMO) AHSC-AFP Innovation FundTotal Awarded: 31,000Project Title: Prospective randomized controlled trialcomparing conservative therapies for the alleviation ofknee pain in knee osteoarthritis

Principal Investigator: Jaeger, Melanie T, AnaesthesiologyCo-Investigators: Parvin Mousavi; Gabor Fichtinger; Tamas Ungi; daniel borschneckSponsor: SEAMO – Educational Innovation and Research FundTotal Awarded: 14,161Project Title: Real-time needle and ultrasound trackingsystem for invasive procedure skill acquisition: a pilot study


Principal Investigator: lau, Rick, SurgeryCo-Investigators: jeff yachSponsor: Department of SurgeryTotal Awarded: 7,140Project Title: Topical application of tranexamic acid and postoperative blood loss in femoral neck fractures a randomized control trial

Principal Investigator: levy, Ron, SurgeryCo-Investigators: david yen; Randy Ellis; Ronald pokrupaSponsor: SEAMO – Clinician Scientist Development ProgramTotal Awarded: 100,000Project Title: Intra-operative reduction and alignment of cervical spine injuries using a novel dynamic halo ringadapter

Principal Investigator: levy, Ron, SurgerySponsor: Canada Foundation for Innovation (CFI)Total Awarded: 320,000Project Title:Models of movement disorders:Electrophysiology and neuromodulation therapies

Principal Investigator: levy, Ron, SurgerySponsor: Department of Surgery, Queen’s UniversityTotal Awarded: 6,227Project Title: Assessment of cognitive dysfunction in anon-human primate model of Parkinson’s disease usingCANTAB technology

Principal Investigator: levy, Ron, SurgeryCo-Investigators: Giovanna Pari; Stephen H ScottSponsor: Southeastern Ontario Academic MedicalOrganization (SEAMO)Total Awarded: 45,000Project Title: Precise evaluation of motor and non-motordysfunction in Parkinson’s disease and Parkinsonian modelusing KINARM

Principal Investigator: levy, Ron, SurgerySponsor: Department of Surgery, Queen’s UniversityTotal Awarded: 180,000Project Title: Department of Surgery – Start Up ResearchMonies

Principal Investigator: levy, Ron, SurgerySponsor: Parkinson Society CanadaTotal Awarded: 90,000Project Title: Role of abnormal neuronal synchronization in the pathophysiology of Parkinson’s disease

Principal Investigator:Muscedere, John, Department of MedicineCo-Investigators: david pichora; Denise Stockley; Karen Yeates; Timothy J Bryant, Ana JohnsonSponsor: Networks of Centres of ExcellenceTotal Awarded: 23,888,157Project Title: Technology Evaluation in the Elderly Network(TECH VALUE NET)

Principal Investigator: nanji, sulaiman, SurgeryCo-Investigators: Sean W Cleary; Harriet Feilotter; Michael Korenberg; Shyam RamchandaniSponsor: SEAMO Research (CTAQ) Endowment FundTotal Awarded: 20,000Project Title:Molecular profiling to improve outcomes in hepatocellular carcinoma

Principal Investigator: nanji, sulaiman, SurgeryCo-Investigator: diederick jalinkSponsor: Donations from Queen’s Faculty/DepartmentsTotal Awarded: 3,000Project Title: Improving outcomes in patients withhepatobiliary malignancies

Principal Investigator: nanji, sulaiman, SurgeryCo-Investigator: Harriet Feilotter; Shyam RamchandaniSponsor: Canadian Association of General SurgeonsTotal Awarded: 10,000Project Title: Identifying molecular markers forprognostication and treatment in patients withhepatocellular carcinoma

Principal Investigator: nanji, sulaiman, SurgeryCo-Investigator: Harriet Feilotter; Shyam RamchandaniSponsor: AHSC AFP Innovation FundTotal Awarded: 20,000Project Title:Molecular profiling to improve outcomes in patients with hepatocellular carcinoma

Principal Investigator: nanji, sulaiman, SurgeryCo-Investigator: Christopher BoothSponsor: Queen’s University, Health SciencesTotal Awarded: 60,000Project Title: CRC Mets Project – Surgery

Principal Investigator: pichora,david, SurgeryCo-Investigators: john Rudan; Randy Ellis; Ryan bicknellSponsor: AHSC AFP Innovation FundTotal Awarded: 80,358Project Title: Advanced 3D Imaging and Planning ofSurgical Shoulder Repair and Reconstruction

Principal Investigator: Saha, Tarit, AnaesthesiologyCo-Investigators: Brian Milne; Elizabeth VanDenKerkhof;Andrew hamilton; darrin payne; dimitri petsikasSponsor: SEAMO AHSC-AFP Innovation FundTotal Awarded: 66,000Project Title: Does the speed of sternal retraction duringcardiac surgery affect postoperative pain outcomes: Arandomized controlled trial

Principal Investigator:Waldman, Stephen, Daniel,Mechanical and Materials EngineeringCo-Investigators: James Stewart; Stephen Pang; Manuela Kunz; Andrew Winterborn; davide bardanaSponsor: CIHR – Collaborative Health Research Projects(CHRP)Total Awarded: 239,229Project Title: Patient-specific cartilage implants:development and surgical implantation

Principal Investigator:Waldman, Stephen, Daniel, Mechanical and Materials EngineeringCo-Investigators: James Stewart; Andrew Winterborn;Stephen Pang; Manuela Kunz; davide bardanaSponsor: NSERC – Collaborative Health Research ProjectsTotal Awarded: 61,843Project Title: Patient-specific cartilage implants:development and surgical implantation


PUB L I CAT IONS 20 1 2 - 1 3

Allan G, Smith EJ, MacLeod F, pichora dR,Ellis RE, A wrist stabilization device forinternal fixation of scaphoid fractures, 7-2012, Int J. Comput Assist Radiol Surg,Vol. 7, S150-S151

Almosnino S, bardana dd, Diaconescu ED,Dvir Z, Reproducibility of isokinetic kneeeccentric and concentric strength indicesin asymptomatic young adults, 11-2012,Physical Therapy in Sport, Vol. 13(3):156-62

Almosnino S, Stevenson JM, Day GA,bardana dd, Dvir Z, Discriminatingbetween Maximal and Feigned IsokineticKnee Musculature Performance usingWaveform Similarity Measures, 5-2012,Clinical Biomechanics, Vol. 27(4):377-383

Almosnino S, Stevenson JM, Day GA,bardana dd, Diaconescu ED, Dvir Z,Differentiating Between Types and Levelsof Isokinetic Knee Musculature Efforts, 12-2011, Journal of Electromyography and Kinesiology, Vol. 21(6):974-981

Arora D, Wali Z, yen d, Preoperativepredictive clinical and radiographic factorsinfluencing functional outcome afterlumbar discectomy, 6-2012, CanadianJournal of Surgery, Vol. 55, S49

Boileau P, Fourati E, bicknell R, Neermodification of open Bankart procedure:what are the rates of recurrent instability,functional outcome, and arthritis?, 9-2012,Clinical Orthopaedics and RelatedResearch, Vol. 470(9):2554-60

Booth C, Li G, Biagi JJ, Krzyzanoskwa MK,Mackillop WJ, nanji s, Surgical resectionand perioperative chemotherapy forcolorectal liver metastases in routineclinical practice: a population-basedoutcomes study, 5-2012, Journal of clinicaloncology, Vol. 30(S15):3632

Bow J, Rudan jf, Grant H, Mann S, Kunz M,Are Hip Resurfacing ArthroplastiesMeeting the Needs of Our Patients? AProspective Review, 6-2012, J. Arthroplasty,Vol. 27(6):984-9

Braga M, Wischmeyer PE, drover jw,Heyland DK, Clinical Evidence forPharmaconutrition in Major ElectiveSurgery, 8-2013, JPEN, Vol. 37, 66S-72S

Brenner JM, Kunz M., Tse MY, Winterborn A,bardana dd, Pang SC, and Waldman SD,Development of Engineered CartilageConstructs from a Small Population ofCells, 1-2013, Biotechnology Progress, Vol. 29(1):213-21

brown pm, dt zelt, J. E. Tramner, FactorsRelated to Walking Performance inClaudicants, 10-2012, Canadian Journal of Surgery, Vol. 55, 347

brown pm, dt zelt, J. E. Tramner, S. Sagar,Further Clinical Validation of the WalkingImpairment Questionnaire for Classificationof Walking Performance in Patients withPeripheral Artery Disease, 8-2012 (e-pub),International Journal of Vascular Medicine

Cadotte DW, Bosma R, Mikulis D, NugaevaN, Smith K, pokrupa R, Islam Om StromanP, Fehlings M, Plasticity of the injuredhuman spinal cord: Insights revealed byspinal cord functional MRI, 9-2012, PLoSOne, Vol. 7(9):e45560

Cao R, Tim St Amand, XinZin Li, Sung-HeeYoan, Carol P Wang, peter m brown,david t zelt, Colin D Funk, ProstaglandinReceptor EP4 in Abdominal AorticAneurysms, 3-2012, American Journal ofPathology, Vol. 181(1):313-21

Cawthorn TR, Phelan R, davidson js,Turner KE, Retrospective analysis ofperioperative ketorolac and postoperativebleeding in reduction mammoplasty, 5-2012, Canadian journal of Anaesthesia,Vol. 59(5):466-72

Cheung HK, Han TTY, Marecak DM,watkins jf, Amsden BG, Flynn LE.,Composite hydrogel scaffoldsincorporating decellularized adipose tissue for soft tissue engineering withadipose -derived stem cells, 12-2013,Biomaterials, Vol. 35(6):1914-1923

Clouthier AL, Hetzler MA, Fedorak G, BryantJT, Deluzio KJ, bicknell Rt, Factorsaffecting the stability of reverse shoulderarthroplasty: a biomechanical study, 4-2013, Journal of shoulder and elbowsurgery / American Shoulder and ElbowSurgeons ... [et al.], Vol. 22(4):439-44

Conde D, van Oosten EM, hamilton A,petsikas d, payne d, Redfearn DP,Hopman WM, Bayes de Luna A, BaranchukA., Prevalence of interatrial block inpatients undergoing coronary bypass graftsurgery, 12-2013, International Journal ofCardiology, 2014 Feb 15; 171(3):e98-9

cook dj, Mukerji N, Steinberg GK, Clipreconstruction of midbasilar aneurysms, 5-2013, World neurosurgery, 2013 May-Jun;79(5-6):675-7

davidson js, Demsey D, Atypicalfibroxanthoma: Clinicopathologicdeterminants for recurrence andimplications for surgical management,Pending Approval, Journal of SurgicalOncology, 2012 May;105(6):559-62

davidson l, Walz L, Virtual patient storiesas a facilitator of IPE: a pilot study, 10-2013,Medical Science Educator, Vol. 23(3S)

davidson l, Gibson M, Rahmani A, BoneHealing, 12-2013, MedEdPortal

davidson l, Adult Fractures, 12-2013,MedEdPortal

Dehdashti AR, Le Roux A, Bacigaluppi S,wallace mc, Long-term visual outcomeand aneurysm obliteration rate for verylarge and giant ophthalmic segmentaneurysms: assessment of surgicaltreatment, 1-2012, Acta neurochirurgica,Vol. 154(1):43-52

Devaud N, Kanji ZS, Dhani N, Grant RC,Shoushtari H, Serrano PE, nanji s, GreigPD, McGilvray I, Moulton CA, Wei A,Gallinger S, Cleary SP, Liver resection afterchemotherapy and tumour downsizing in patients with initially unresectablecolorectal cancer liver metastases, 8-2013,HPB, Vol. e-pub, e-pub

Diaconescu ED, Almosnino S, Tripp D,bardana dd, Stevenson JM, Robustness of Pain Catastrophizing Scores duringIsokinetic Testing of Anterior CruciateLigament Deficient Patients, 5-2012,Medicine and Science in Sports andExercise, Vol. 44:5, Supplement

Ellis AK, Saha T, Arellano R, Zajac A, paynedm, Successful Management of Cold-Induced Urticaria During HypothermicCirculatory Arrest, 11-2013, Ann ThoracicSurgery, Vol. 96, 1860-62

Giles AE, Corneman NA, Bhachu S, Rudanjf, Ellis RE, Grant H, Wood GC, Sharedmorphology of slipped capital femoralepiphysis and femoroacetabularimpingement in early-onset arthritis, 11-2013, Orthopedics, Vol. 36(11):e1365-70

Haslam S, yen d, Dvirnik N, Engen D,Cefazolin Use in Patients who Report aNon-IgE Mediated Penicillin Allergy: ARetrospective Look at Adverse Reactions in Arthroplasty, 6-2012, The IowaOrthopaedic Journal, Vol. 32, 100-103

Hefny MS, Dickinson AW, Giles AE, woodgc, Ellis RE, The aspherical human hip:implication for early osteoarthritis, 12-2013, Studies in health technology and informatics, Vol. 184, 195-201

Heyland DK, Dhaliwal R, Cahill NE, Carli F,Flum D, Ko C, Kozar R, drover jw, McClaveSA, Driving Perioperative Nutrition QualityImprovement Processes Forward, 9-2013,JPEN, Vol. 37, 83S-98S

Kandel R, N. Coakley, J. Werier, j. engel, S.Verma, CCO guideline #11-10 AppropriateSurgical Margins and Proper Handling ofSoft Tissue Sarcoma of the Extremities, 9-2012 (e-pub), CCO website

Kis, saunders f, ten Hove, Tator, etc., AMethod of Evaluating Helmet rotationalAcceleration Protection using the KingstonImpact Simulator, 11-2013, Clinical Journalof Sport Medicine, Vol. 23(6):470-477

Kunz M, Devlin S, Hurtig M, Waldman S,Rudan j, bardana d, Stewart J, Imageguided techniques improve short-termoutcome of autologous osteocondralcartilage repair surgeries – An animalmodel, 4-2013, Cartilage, Vol 4(2):153-164

Kunz M, Ma B, Rudan jf, Ellis RE, pichoradR, Image-guided distal radius osteotomyusing patient-specific instrument guides, 8-2013, The Journal of hand surgery, Vol. 38(8):1618-24

Kunz M, Rudan jf,wood g, Ellis RE, Hip resurfacing with individualized drilltemplates-comparison betweenanterolateral and posterior approach, 10-2012, Current Orthopaedic Practice, Vol. 23(5):473-475

Kunz M, Waldman SD, Rudan jf, bardanadd, Stewart AJ, Computer-assisted mosaicarthroplasty using patient-specificinstrument guides, 5-2012, Knee Surgery,Sports Traumatology, Arthroscopy: officialjournal of the ESSKA, Vol. 20(5):857-61

Ma B, Kunz M, Gammon B, Ellis RE, pichoradR, A laboratory comparison of computernavigation and individualized guides fordistal radius osteotomy, 12-2013,International journal of computer assistedradiology and surgery, Vol. 1

Mahaffey R, Wang L, hamilton A, Phelan R,Arellano R., A Retrospective Analysis ofBlood Loss With Combined Topical andIntravenous Tranexamic Acid AfterCoronary Artery Bypass Graft Surgery, 2-2013, Journal of Cardiothoracic andVascular Anesthesia, Vol. 27, 18-22

Mahaffey R, Wang L, hamilton A, Phelan R,Arellano R., A retrospective analysis ofblood loss with combined topical andintravenous tranexamic acid after coronaryartery bypass graft surgery, 2-2013, JCardiothorac Vasc Anesth, Vol. 27(2):18-22

McClave SA, Kozar R, Martindale RG,Heyland DK, Braga M, Carli F, drover jw,Flum D, Gramlich L, Herndon DN, Ko C,Kudsk KA, Lawson CM, Miller KR, Taylor B,Wishchmeyer PE, Summary Points andRecommedations from the North AmericanSurgical Nutrition Summit. Journal ofParenteral and Enteral Nutrition, 9-2013,JPEN, Vol. 37, 99S-105S

mcclure Rs, Athanasopoulos LV, McGurk S,Davidson MJ, Couper GS, Cohn LH, Onethousand minimally invasive mitral valveoperations: early outcomes, late outcomes,and echocardiographic follow-up, 5-2013,The Journal of thoracic and cardiovascularsurgery, Vol. 145(5):1199-206

McGuire A, Hoopman W, petsikas d, Reidk., Outcomes: Wedge Resection VersusLobectomy for Non-Small Cell Lung Cancerat the Cancer Centre of SoutheasternOntario, 1998-2009, 12-2013, Can JSurgery, Vol. 56(6):E165-170

mckay dR, Costs of regional and generalanesthesia: what the plastic surgeon needsto know, 10-2013, Clinics in plastic surgery,Vol. 40(4):529-35

mckay dR, Peters DA, Compensating aPlastic Surgeon: What is the best way toreward quality while optimizing efficiency?,12-2012, Canadian Journal of PlasticSurgery, Vol. 20(4):71-5

mckay dR, Peters DA,The Practical Benefitsof Planning. Can Journal of Plastic Surgery,7-2012, Canadian Journal of PlasticSurgery, Vol. 20(2):107-8

mckay dR, Peters DA, You want me towrite a business plan? Capital budgetingfundamentals for the plastic surgeon, 7-2013, Canadian Journal of PlasticSurgery, Vol. 21(2):107-9

mckay dR, Peters DA, Cost: It’s all in theeyes of the beholder, 12-2013, CanadianJournal of Plastic Surgery, Vol. 21(4):251-252


Melanie T, Theman Kirstin, mercer dale,Hopman Wilma, Hookey Lawrence, Patientperceptions of Natural Orifice TranslumenalSurgery, 1-2012, Minimally InvasiveSurgery, Vol. 2012, 1-7

Mukerji N, cook dj, Steinberg GK,Temporary Clipping for UnrupturedAneurysms, 8-2013, World neurosurgery,2013 Aug 4. Pii: S1878(13)00908-X

Mukerji N, cook dj, Steinberg GK,Temporary Artery Occlusion in RupturedAneurysms, 8-2013, World neurosurgery,2013 Aug 3. Pii: S1878-8750(13)00909-1

nanji s, Cleary S, Ryan P, Guindi M,Selvarajah S, Grieg P, McGilvary I, Taylor B,Wei A, Moulton CA, Gallinger S, Up-fronthepatic resection for metastatic colorectalcancer results in favorable long-termsurvival, 1-2013, Annals of surgicaloncology, Vol. 20(1):295-304

nanji s, Cleary S, Ryan P, Guindi M,Selvarajah S, Grieg P, McGilvary I, Taylor B,Wei A, Moulton CA, Gallinger S, Up-fronthepatic resection for metastatic colorectalcancer results in favorable long-termsurvival, 6-2012, HPB, Vol. 14(S15):57

nanji s, Li G, Mackillop W, Booth C,Surgical resection of colorectal livermetastases in routine clinical practice: apopulation-based outcomes study, 6-2012,HPB, Vol. 14(S2):414

Peters DA, mckay dR, Starting out orwinding down: How to value a Practice, 9-2012, Canadian Journal of PlasticSurgery, Vol. 20(3):201-3

Peters DA, mckay dR., Are you HoltRenfrew or Wal-Mart? Applied Economicsin Pricing Plastic Surgery, 5-2012, CanadianJournal of Plastic Surgery, Vol. 20(1):51-53

Peters DA, mckay dR, To CORP or not toCORP: strategic tax considerations forInvesting, 5-2013, Canadian Journal ofPlastic Surgery, Vol. 21(1):62-3

Peters DA,Vale AZ, mckay dR, Where do Iput my Money? Mutual Funds versusExchange Traded Funds, 9-2013, CanadianJournal of Plastic Surgery, Vol. 21(3):197-8

Rasquinha BJ, Sayani J, Rudan jf, woodgcA, Ellis RE, Articular surface remodelingof the hip after periacetabular osteotomy,3-2012, International Journal of ComputerAssisted Radiology and Surgery, Vol. 2(7):241-248

Sagar SP, pm brown,dt zelt, W Pickett, JE Tranmer, Validation of the walkingimpairment questionnaire for classificationof walking performance in patients withperipheral arterial disease, 3-2012, Int Journal of Vascular Medicine, Vol. 2012(2012):190641

Sandhu G, Garcha I, Sleeth J, Yeates K,walker gR, AIDER: A model for socialaccountability in medical education andpractice, 8-2013, Medical Teacher, Vol. 35,no.8, e1403-1408

Sandhu G, walker gR, Rich J, RoleModeling - Not to be mistaken forteaching, 10-2012 (e-pub), MedEd Publish

Sandhu G, walker gR, Rich J, New ways of talking about the C-word: Psst... it’s stillCanMEDS, 9-2013, MedEdWorld

Simpson AL, Ma B, Vasarhelyi EM,borschneck dp, Ellis RE, and Stewart AJ,,Computation and visualization of uncertaintyin surgical navigation, 7-2013, IJMRCAS

Smith EJ, Al-Sanawi HA, Gammon B, StJohn PJ, pichora dR, Ellis RE, Volumeslicing of cone-beam computedtomography images for navigation ofpercutaneous scaphoid fixation, 7-2012,International Journal of Computer AssistedRadiology and Surgery, Vol. 7(3):433-444

Smith EJ, Al-Sanawi H, Gammon B, pichoradR, Ellis RE, Volume rendering of three-dimensional fluoroscopic images forpercutaneous scaphoid fixation: an in vitro study, 4-2013, Proceedings of theInstitution of Mechanical Engineers. Part H, Journal of engineering in medicine,Vol. 227(4):384-92

Smith EJ, Anstey J, Kunz M, Rasquinha B,Rudan j, St. John PJ, wood g, and Ellis RE,Investigating the contribution of softtissues to impingements at the hip joint: A preliminary study, 6-2012, J Bone JointSurg Br., Vol. 94-B (SUPPL XLIV):73

Smith EJ, Allan G, Gammon B, Sellens RW,Ellis RE, pichora dR, Investigating theperformance of a wrist stabilization devicefor image-guided percutaneous scaphoidfixation, 4-2013, International journal ofcomputer assisted radiology and surgery,Vol. 1

Smith EJ, Ellis RE, pichora dR, Computer-assisted percutaneous scaphoid fixation:concepts and evolution 11-2013, Journal of wrist surgery, Vol. 2(4):299-305

Thines L, Dehdashti AR, da Costa L,Tymianski M, ter Brugge KG, Willinsky RA,Schwartz M, wallace mc, Challenges in themanagement of ruptured and unrupturedbrainstem arteriovenous malformations:outcome after conservative, single-modality, or multimodality treatments,1-2012, Neurosurgery, Vol. 70(1):155-61;discussion 161

Tokmaji G, mcclure Rs, Kaneko T, ArankiSF, Management Strategies in CardiacSurgery for Postoperative Atrial Fibrillation:Contemporary Prophylaxis and FuturisticAnticoagulant Possibilities, 12-2013,Cardiology research and practice, Vol. 2013,637482

Turner A, Yu C, Bianco J, watkins f, Flynn L,The Performance of Decellularized AdiposeTissue Microcarriers as an InductiveSubstrate for Human Adipose-DerivedStem Cells, 3-2012 (e-pub), Biomaterials

Ungi T, Abolmaesumi P, Jalal R, Welch M,Ayukawa I, Nagpal S, Lasso A, Jaeger M,borschneck dp, Fichtinger G, Mousavi P,Spinal needle navigation by trackedultrasound snapshots, 10-2012, IEEETransactions on Bio-medical Engineering,Vol. 59(10):2766-72

Ungi T, King F, Kempston M, Keri Z, Lasso A, Mousavi P, Rudan j, borschneck dp,Fichtinger G, Spinal CurvatureMeasurement by Tracked UltrasoundSnapshots, 11-2013, Ultrasound inmedicine & biology, Vol. 13, 1055-7

Vallabhajosyula P, mcclure Rs, Hanson CW3rd, Woo YJ, Dissected axillary arterycannulation in redo-total arch replacementsurgery, 6-2013, The Journal of thoracic andcardiovascular surgery, Vol. 145(6):e57-9

Witiw CD, Abou-Hamden A, Kulkarni AV,Silvaggio JA, Schneider C, wallace mc,Cerebral Cavernous Malformations andPregnancy: Hemorrhage Risk and Influenceon Obstetrical Management, 6-2012,Neurosurgery, 2012 Sep;71(3):626-30

wood gA, Henry R, Cahill CM, Hroch J,Wilson R, Cupido T, VanDenKerkhof E,Myofascial Pain in Patients Waitlisted forTotal Knee Arthroplasty, 9-2012, PainResearch and Management, Vol. 17(5):321-7

wood gA, Rudan jf, Rasquinha B and Ellis RE, Acetabular orientation in adultswith developmental dysplasia of the hip, 4-2012, J Bone Joint Surg Br., Vol. 94-B(SUPPL XXXI):61

wood gA, Rasquinha B, Sayani J, Rudan j,Ellis R, Articular Surface Remodeling of theHip After Periacetabular Osteotomy, 3-2012, International Journal of ComputerAssisted Radiology and Surgery, Vol.7(2):241-8

Zakani S, Venne G, Smith EJ, bicknell R,Ellis RE, Analyzing shoulder translationwith navigation technology, 11-2012,International Journal of Computer AssistedRadiology and Surgery, Vol. 7(6):853-60

zelt dt, brown pm, Analysis of 15 Years ofWait Time 1 and 2 data in Vascular Surgeryat Kingston General Hospital, 10-2012,Canadian Journal of Surgery, Vol. 55, 351

BY THE NUMBERS A c A d e m i c y e A R 2 0 1 2 / 1 3

Undergraduate Medical Students 102

Undergraduate Visiting Elective Students 17

Undergraduate Australian Exchange Students 4

Postgraduate Orthopaedic Surgery Residents 18

Postgraduate General Surgery Residents 20

Postgraduate Fellows 7

Active Clinical Faculty 38

Adjunct Faculty 34

Administrative Staff 5

28 D E PA R TM EN T O F S U R G E R Y A n n u A l R e p o R t 2 0 1 3

For more information about our department and staff, please visit our website at:

http://surgery.queensu.ca

department of surgeryKingston General Hospital, Victory 3-35076 Stuart StreetKingston, onk7l 2v7T 613.533.2660F [email protected] 13

-0611 Queen’sUniversity Marketing project coordination:Mara Kottis photos: Kari H

urst, Jeanine M

acRow

,Matthew

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