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Department of Surgery

Annual Report 2010 2011

Department of SurgeryUniversity of Ottawa

ContentJuly 1, 2010 to June 30, 2011

Wilbert J. Keon Chairman and Professor: Dr. Éric C. Poulin

Research: Dr. James Watters Director of Research

University of Ottawa Surgical Education: Dr. Farid Shamji Director Undergraduate Education Dr. Stuart Oake Director Surgical Education Program Dr. Tim Brandys CORE Program Director

University of Ottawa Surgical Division Chairs: Dr. Thierry Mesana Division of Cardiac Surgery Michael Pitfield Chair Dr. Kevin Butterfield Division of Oral & Maxiofacial Surgery Dr. Joseph Mamazza Division of General Surgery Dr. Richard Moulton Division of Neurosurgery Dr. Geoffrey Dervin Division of Orthopaedic Surgery Dr. Mario Jarmuske Division of Plastic Surgery Dr. Sudhir Sundaresan Division of Thoracic Surgery Dr. Ronald Gerridzen Division of Urology Dr. Andrew Hill Division of Vascular Surgery Dr. Baxter Willis Chief, Department of Surgery Children’s Hospital of Eastern Ontario

Department of Surgery Annual Report

Report from the ChairAcademic Year 2010 2011

Eric C. Poulin MD, MSc, FRCSC, FACS Wilbert J. Keon Professor and Chair, Department of Surgery, University of Ottawa Surgeon-in-Chief, The Ottawa Hospital

Well, another year gone! Our Health Care system is still stressed. I learned that Canadian hospitals have the highest occupancy average rate in all developed countries (90%). They forgot to ask us because TOH hovers around 102% and higher and has consistently done so for many months. Nevertheless everyone is working hard to make our teaching programs and our research better. The same can be said for improving the quality and safety of the patient encounter. Again this year the achievements have been many.

88% 86% 86% 84% 79% 79% 79%

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Acute Care Bed Occupancy 2009 - OECD (Organisation for Economic Co-operation and Development) Health Data.


Honors and AwardsDr. Luis Guerra, Division of Pediatric Urology received the 2009 Journal of Urology Best Reviewer award.Dr. Ken Kontio, Division of Pediatric Orthopedic Surgery was chosen for the Distinguished Teacher Program.Dr. Eve Tsai was appointed as a member on the Collaborative Health Research Projects Selection Panel for a three year term ending in June 2013 with the Natural Sciences and Engineering Research Council of Canada.

MilestonesThe past year will have been the first year we collected patient data for the NSQIP program.

We ran into some challenges with the Ontario Privacy legislation with regards to the ACS NSQIP contract. Finally the issues were settled, and the contract signed. Our nurse reviewers were able to submit over 2000 cases to the NSQIP database. We are going to get our first risk-adjusted results at the end of July at the NSQIP annualmeeting in Boston. The American College of Surgeons National Surgery Quality Improvement Program (ACS NSQIP) benchmarks quality parameters in over 300 American hospitals including most American Universities.

TOH is the only Canadian Hospital enrolled in the high-volume multi-specialty (10) NSQIP program. There are currently 2 other Canadian groups enrolled in the General and vascular surgery programs: The Jewish General in Montreal and Fraser Valley in B.C. There is no doubt that over time many other centres will join. This program is particularly well-aligned with the current TOH strategic initiative on quality and patient safety. The real work will start once we get our results.

As many of our readers will have seen this in the Media; TOH is deploying iPads 1 and 2 plus the iPhone 4 for all medical staff and residents. The IS/IT Department has created a number of in-house apps giving access to vOacis for patient data and imaging. Most who are using the platform consider it a “game-changer” for usefulness in daily patient care and access to timely scientific information. Many more applications are in the works, including direct order entry.

The following picture shows Drs. Jim Waterson, Brian Blew and the Urology team using an iPad for “rounding” on their patients in the surgeon’s lounge prior to entering the OR.


This year was the first year of activity in the new University of Ottawa Skills and Simulation Centre (uOSSC), an outstanding 22,000 sq. Feet facility. What a success story! Under the guidance of Dr. Vern Naik Medical Director, uOSSC and Stan Hamstra Research Director, uOSSC the Centre is somewhat victim of its own success because of the rapid growth of its activities, a good challenge to have. This year Collins Day, our annual Research Day was held in the Skills Centre with great success.

The Department is fortunate to have three of our surgical educators taking research, education and administrative responsibilities in this wonderful environment: Drs. Tim Brandys, Vascular Surgery; Wade Gofton, Orthopedic Surgery and Fady Bala, General Surgery.

The Centre has also hosted cadaver-model courses in laparoscopic colon surgery and knee arthroplasty with attendees coming from all Canadian Provinces, the US and Europe. Other than the usual skills models, we are fortunate that the Centre can host both cadaveric-model and large animal based courses in the same facility.

One other interesting development is the project that will see the first floor of the uOssc being developed as a consolidated Education Administrative Centre serving all learners. A similar satellite unit would also be developed at the General campus at a later date. Dr. Stuart Oake, Director of Post-graduate education for the Department of Surgery is leading this initiative for the Department.


End of MandateIn the coming year we will witness the end of the 10-year mandates for the Heads of the Vascular and Cardiac Surgery Divisions.

On July 1st, Dr. Farid Shamji stepped down as the Department of Surgery Director of Undergraduate Education after many years of dedicated services (28). Dr. Shamji took on this role when there was little interest in Undergraduate Education and was instrumental in fostering many developments including the introduction of webcasting for the various lectures and the participation of surgery residents in the annual CUSEC meeting. Dr. Shamji is the current President of CUSEC until November. The Department of Surgery is extremely grateful for his tenure. Dr. Buu-Kan Lam from the Division of Cardiac Surgery will succeed Dr. Shamji.

PromotionsTo Associate Professor:

Dr. Dennis Pitt, Division of General Surgery

Dr. Chris Morash, Division of Urology

Dr. Ilias Cagiannos, Division of Urology

Dr. Eugene Wai, Division of Orthopedic Surgery


Cross-AppointmentsDean Ferguson, Department of Medicine and Dr. Leanne Ward, Department of Paediatrics were cross-appointed to the Department of Surgery.

Dr. Eve Tsai, Division of Neurosurgery was cross-appointed to the Department of Cellular & Molecular Medicine.

Dr. Daniel Peters, MBA., Division of Plastic Surgery has been cross-appointed to the Telfer School of Management at the University of Ottawa.

Dr. Paul Beaulé, Division of Orthopaedic Surgery has been appointed to the Faculty of Graduate and Post Graduate Studies.

Dr. Marc Ruel, Division of Cardiac Surgery is cross-appointed to the Department of Cellular & Molecular Medicine.

RecruitmentDr. Ganesh Shanmugam, Pediatric Cardiovascular Surgery, CHEO

Dr. Shanmugam obtained his training in General Surgery in India. He pursued Cardiothoracic training in India, Australia and the UK. He did two fellowships, first in Halifax and then in Pediatric Cardiac Surgery in Edmonton. Dr. Shanmugam will be working at CHEO.

Dr. Angel Arnaout, General Surgery

Dr. Arnaout is a Surgical Oncologist with a special interest in Breast Cancer. She completed to Medical School at Dalhousie University and also obtained her General Surgery training in Halifax. She went on to pursue a Masters of Science degree in the Surgeon Scientist Program at the University of Toronto. She also did a Surgical Oncology Fellowship at Sunnybrook Hospital and the Toronto Sunnybrook Regional Cancer Centre. She has a specialinterest in Oncoplastic Breast Surgery.

Dr. Jacinthe Lampron, General Surgery

Dr. Lampron attended to Medical School at université Laval in Québec City where she also trained in General Surgery. She obtained Royal College certification in critical care in 2008 following a Critical Care Fellowship in Ottawa. She pursued further training in trauma at St. Michael’s Hospital in Toronto, Stellenbosh University in South Africa. She also performed as a trauma surgeon for the Canadian Forces in Kandahar Airfield, Afghanistan. Prior to coming to Ottawa she was a faculty member of the Northern Ontario School of Medicine (NOSM). She is currently pursuing a MSc. Public Health from the London School of Hygiene and Tropical Medicine.

Dr. Kyle Cowan, Pediatric General Surgery, CHEO

Dr. Cowan holds a PhD from the University of Toronto where he graduated from Medical School in 2004. He did his General Surgery residency at the University of Western Ontario including a post doctoral fellowship. He then pursued further training in Pediatric General Surgery at CHEO. Dr. Cowan has received many research-related awards including a Canadian Institute of Health Research (CIHR) and the Canadian Society for Clinical Investigation Joint Resident Research Award.


Departures and RetirementsDr. John Collins, former Head of the Division of Urology and Chair of the Department of Surgery Finance Committee.

Dr. Michael Bell, Division of Plastic Surgery

Dr. Rosalind Labow, Scientist at the Heart Institute

Dr. Brian Sweeny, Pediatric General Surgeon

Dr. Hugo St-Amand, Division of Plastic Surgery

Operations and Facilities

At TOH, construction of the a new Clinical and Research building between the General Campus cafeteria and the Medical School is scheduled to be finished November 2011. Over 200 staff and research offices will be relocated and the current clinic footprint will be enlarged.

At the same time, there will be a relocation/consolidation of the offices of both Chairs of the Departments of Surgery and Medicine in the current site of the Clinical Epidemiology unit next to the TOH Administrative suites.


Strategic DirectionsThe TOH long-term strategic initiative with emphasis on Quality of Care, Patient Safety and Service Excellence has focused this year on physician engagement. After much debate in all leadership venues (MAC, Department/Division Heads/CEO round table, etc) and many focus groups of rank and file physicians, a unique document was produced and co-signed by the CEO and each physician at the time of re-credentialing: The Ottawa Hospital Physician Engagement Agreement. The document is appended and speaks for itself. Based on the Hospital Core Values; it states the Hospital commitment to physicians and the physician’ commitment to the Hospital.


Postgraduate Education CommitteeReport

Department of Surgery Postgraduate Education Committee (Surgery PGEC)

The Department of Surgery Postgraduate Education Committee (PGEC) has had a productive and fruitful year. Throughout the year several departmental initiatives have been brought to the table for discussion and consideration by the Department of Surgery Post Graduate Education Committee. Membership of Postgraduate Education Committee

Surgery PGEC Chair Dr. Stuart Oake Department Chair Dr. Eric Poulin General Surgery Dr. Fady Balaa Orthopedic Surgery Dr. Joel Werier Urology Dr. Jim Watterson Cardiac Surgery Dr. Fraser Rubens Neurosurgery Dr. Richard Moulton Pediatric General Surgery Dr. Shirley Chow Thoracic Surgery Dr. Donna Maziak Vascular Surgery Dr. Tim Brandys Plastic Surgery Dr. Mary Jean Duncan Colorectal Surgery Dr. Martin Friedlich

Evaluation Procedure

The Royal College is advocating evaluation objectives: reflective of the rotation, level and surgical specialty. The PGEC continues to explore options that would facilitate the above and lead to departmental standardization of the evaluation process, particularly amongst departmental programs of like structure. The PGEC chair represents the Department of Surgery on the University of Ottawa’s Webeval Committee who’s for which the mandate is to establish a more valid process of evaluation. Rotation evaluations are sent directly to the most responsible preceptor of a rotation for an objective evaluation including comments: a two step rather than a three step process. Changes to the one45 software specific to the needs of the University are supported by the Webeval Committee. Changes will be implemented in the 2011 - 2012 academic year.

Training Policy

The University of Ottawa Senate has approved a bylaw change (December 15, 2010) allowing the draft Training Policy to be effective July 01, 2011. This Policy allows the Department of Surgery Postgraduate Education Committee to set policies and educational principles that are specific to surgical programs. “The Postgraduate Medical Education Committee shall be responsible for approving residency training requirements which exceed the minimum specialty training requirements defined by the Royal College of Physicians and Surgeons of Canada or the College of Family Physicians of Canada where the failure for a resident to achieve such enhanced requirements would result in a prolongation of training”.


Department of Surgery Educational Days

The Clin-Epi course was held December 16 & 17, 2010. The methods /evidence base research developments course has a PGY2 resident target base. The course is funded by the contract between The Department of Surgery and the OHRI Methods Center.

The PGEC held a CanMEDS discussion meeting early in the 2010/11 academic year with divisional CanMEDS presentations made by the divisions of: Neurosurgery, Orthopedic Surgery, Colorectal Surgery, Urology, Vascular Surgery and Cardiac Surgery, commonalities were noted. Strategic planning around CanMEDS teaching resulted in the following decisions:

• Research and development of new evaluation techniques need to be implemented• Date and format to be established• Policies and guidelines for Departmental CanMEDs teaching and evaluation incorporated into responsibilities of the evolving Department of Surgery Education Office (below)

Department of Surgery Education Office

Historically, divisions in the Department of Surgery have each maintained a divisional office for Postgraduate Education in some form. Three models have existed in the past:

• Full time program administration• Part time program administration• Shared administration between Postgraduate education and clinical responsibilities

The Department of Surgery is well into the planning and development of the newly formed Office of Education. The PGEC Chair has received full support from the committee and Departmental Chair to move forward with the implementation of the Department of Surgery Office of Education. As previously outlined, the office would facilitate the communication of information that relates to program setup, both from an educational and resources-sharing perspective. The shared space allows for a consolidation of man power hours and efficiency. A workflow template would be established: template timelines would assist all divisions and standardize the accreditation process. Corporate memory would be established; program director changes would be seamless.

The Office of Education will be located at the uOSSC Center, Loeb Building, at the Civic Campus. The planning outline: design, lay out, office complement, HR and financial planning are approaching the final stages. Stan Hamstra has met with the stakeholders to establish the complete Loeb Building Project.

The Department of Surgery office complement would include the following groups:

• Department of Surgery Core Program• Department of Surgery Undergraduate Education • All Departmental Post Graduate Surgical programs

Respectfully submitted,

Dr. J. Stuart OakeDepartment of Surgery, Postgraduate Education Director


The 2010 - 2011 academic year proved to be another successful one for the CORE program. Once again, 50 first and second year surgical residents from all surgical specialties participated. Objectives of the program continue to center on the attainment of the basic surgical knowledge, technical skills, and CANMEDS values required to provide a strong foundation for the senior residency years.

HighlightsThe program received full approval status and a very favorable review in 2010 by the Royal College of Physicians and Surgeons of Canada during their accreditation visit.

Without a doubt, the highlight of the year for the CORE program was the establishment of its new home base at the University of Ottawa Skills and Simulation Center. This new state of the art facility is the perfect venue for CORE program activities. With a large lecture room, even larger skills area and simulated operating rooms all of the educational activities are easily accommodated.

As always, the enthusiastic participation of the surgical faculty and dedicated work of the CORE program coordinator Kim Tardioli are essential for the program to run smoothly and their efforts need to be applauded.

The FutureWith the Skills and Simulation Center as our new home, we hope to further develop our abilities to teach and evaluate surgical skills for residents in the CORE program.

CORE Program


Skills and Simulation Center The University of Ottawa Skills and Simulation Centre had its official opening on October the 14th 2010. The opening was attended by the president of the University of Ottawa, the honorable Alan Rock, the Dean of Medicine Dr. Jacques Bradwejn and the CEO of the Ottawa Hospital Dr. Jack Kitts. The opening ceremonies set the tone for what was to be a very successful academic year at the center .The Skills and Simulation Centre with over 20,000 square feet of working space is the largest of its kind in Canada and one of the largest in North America.

HighlightsSurgery played a dominant role in the activities hosted at the center over the last year. For every level of learner from medical student to practicing surgeon, the surgical divisions put on a variety of skills based and didactic educational sessions.

Medical students: Rotating through surgery received hands on workshops in wound care and suturing.

Residents: The CORE surgery program ran its usual biweekly curriculum of surgical skills, knowledge acquisition and CANMEDS activities for first and second year residents from all surgical specialties. Divisions such as General Surgery, Plastics, Neurosurgery, Orthopaedic Surgery, Thoracic Surgery and Urology all ran high end technical training sessions for their residents.

Practicing Surgeons: CME events were run for practicing surgeons including the Canadian Network for International Surgery (CNIS) Instructors Course, Orthopeadic Knee Symposium and General Surgery Colorectal MIS courses.

Departmental Events: Collin’s Day was held at the center on May 13th 2011.

The Future The state of the art Skills and Simulation Centre in a short period of time has already proven itself to be an invalu-able component in the education of medical students, residents and practicing surgeons. Looking forward, the Department of Surgery looks to see surgical education and research opportunities grow exponentially at the centre. One such initiative beginning in the 2011 - 2012 academic year includes the Department of Surgery joining forces with the Academy for Innovation in Medical Education (AIME) and the Skills and Simulation Centre to create a Surgical Education Research Fellowship. Enrolled trainees will develop expertise in surgical education research and achieve Master’s Credentials in Education.

International Surgery Course Orthopedics Knee Course


Research ReportCollins Day

The 28th Collins Surgical Day was held Friday, May 14, 2010. This annual event began in 1979 and in 1984 was named in honor of Dr. W.E. Collins, Emeritus Professor of Surgery and the first Coordinator of the Surgical Training Programs (1976-1984).

Our honored guest this year was Dr. Andres Lozano, Professor and Dan Family Chair of Neurosurgery at the Uni-versity of Toronto, RR Tasker Chair in Functional Neurosurgery at Toronto Western Hospital, Senior Scientist at Toronto Western Research Institute, and Canada Research Chair in Neuroscience.

The scientific session was held for the first time in the University of Ottawa Skills and Simulation Centre. There were 14 podium and 27 poster presentations, selected competitively and reflecting a great diversity of high quality research. Dr. Lozano gave an excellent keynote address, entitled: “Towards restoring function in neurological and psychiatric disorders with neurological surgery.”

The scientific program was very well attended and highly successful. The latter reflects the skill, commitment and hard work of the residents and fellows in our training programs, but thanks are also very much due to their supervisors and mentors in the Department and elsewhere. Thanks are also due to the adjudicators for Collins Day, Drs. Luis Guerra, Mohamed Shamji, Eve Tsai, and Eugene Wai, and to Dr. Rebecca Auer for chairing the poster session.

The Collins Day Reception and Dinner were held at the Rideau Club, where the Main Dining Room was at full capacity with residents, staff, spouses and others. Mr. David Hill was again kind enough to be our host, although he was unable to attend in person this year. A key part of the evening were the presentations of the research prizes and teaching awards (see below), and recognition of the graduating residents and fellows.

Royal College CPD accreditation was obtained for this year’s scientific program for the first time.


W.E. Collins Award for Best Overall Paper

Dr. R. Seth (General Surgery)

Surgical stress promotes the development of cancer metastases by a coagulation-dependent mechanism in a murine model. Rashmi Seth, Lee-Hwa Tai, Agnieszka Kus, Theresa Falls, John Bell, Marc Carrier, Harold Atkins, Robin Boushey, Rebecca Auer.

Graeme Barber Award for Best Clinical Paper

Dr. T. Malas (Cardiac Surgery)

A randomized evaluation of simulation training on performance of vascular anastomosis on a high-fidelity in-vivo model: the role of deliberate practice. Tarek Malas, Joel Price, Viren Naik, Munir Boodhwani, Tim Brandys, Paul Hendry, Buu-Khanh Lam

John P. Collins Award for Best Basic Science Paper

Dr. Talal Al-Atassi (Cardiac Surgery)

Pre-clinical evaluation of biopolymer delivered endothelial progenitor cells in hibernating myocardium. Al-Atassi, Talal; Giordano, Céline; Thorn, Stephanie; Suuronen, Erik J; Boodhwani, Munir; Renaud, Jennifer; Zhang, Pingchuan; deKemp, Robert A; Beanlands, Rob SB ; Ruel, Marc.

Best Poster Presentation

Dr. Beverly Chan (General Surgery) Validation of electronically derived short term outcomes in colo-rectal surgery. Beverley P Chan, John BP Arm-strong, Robin P Boushey, Dean A Fergusson, Alan J Forster.

Award for Best Surgical Teacher (chosen and presented by the residents of the Department of Surgery)

Dr. Tim Brandys (Vascular Surgery)

Dr. Steven Papp (Orthopedic Surgery)

Dr. Sudhir Sundaresan (Thoracic Surgery)

Award for Best Resident Teacher (chosen by the medical students rotating in the Department of Surgery, presented by Dr. F. Shamji, Director, Undergraduate Education)

Dr. Malika Oberoi (General Surgery)

Dr. Michael Creech (Orthopedic Surgery)

Dr. Mathieu Carriere (Urology)


Department of Surgery Research Awards

The winners in the third competition for the one-time $25,000 awards were selected from amongst many excellent submissions and announced in September. The aim of the awards is to promote high quality research and the development of research capacity in the Department. Review of the progress reports from earlier awards supports the view that the program is successful, and a fourth competition will be held in 2011. Drs. Marc Ruel (Cardiac Surgery, Chair in Cardiac Surgery Research, and Assistant Dean, Clinical and Translational Research) and Tim Ramsay (Director, Clinical Epidemiology Program Methods Centre) have contributed greatly by their reviews of the proposals submitted.

The 2010 awardees (alphabetically) are:

Dr. Robin Boushey (General Surgery)Models of Peer Support for Colorectal Cancer Patients Dr. Wade Gofton (Orthopedics)The Ottawa Surgical Competency Operating Room Evaluation (O-SCORE) – Evaluation of A Tool to Assess Surgical Competence Across Specialties

Dr. Eve Tsai (Neurosurgery)Lumbar Spinal Tractography

Clinician Investigator Program

Through the Divisions, the Department has encouraged and on occasion provided support for appropriate surgical residents who elect to pursue a Master’s degree or PhD, or an equivalent program of research training. There are a number of options available, but the Department and its residents have been very active in the Faculty’s Royal College-accredited Clinician Investigator Program (CIP) (http://cipottawa.com/index.html). The primary goal of the CIP is to foster the development of clinician investigators in a formal educational pathway that integrates a minimum of two years of structured research training with the clinical specialty/subspecialty training requirements of the Royal College.

Methods Centre Agreement

The agreement between the Department of Surgery and the Clinical Epidemiology Program ‘Ottawa Methods Centre’ was renewed for a three-year period. Dr. Tim Ramsay, Director of the Methods Centre, presented to the Surgical Executive Committee and identified the importance of interactions with clinical departments from their perspective, and the value of straightforward access to expertise in study design, statistical analysis and grant preparation for both staff members and residents in the Department. With respect to how the Department might benefit further from the agreement, he suggested that projects and even simply ideas or questions be brought to them for advice at their formative stage. The Methods Centre provides study design and methodological support, data management services, statistical services, and education in a modified cost-recovery model that allows stable funding for the Methods Centre and significant research support without additional cost for projects developed by members of the Department.


Division of Cardiac SurgeryOverview

Dr. Thierry Mesana Division Chief, Deputy Chief Ottawa Heart Institute

Cardiac Surgeons

Research Scientists Involved with Cardiac Surgery Research Activities:

Dr . Munir Boodhwani

Dr. Paul Hendry Assistant Dean, Post Graduate Education

Dr. William Goldstein

Dr. Khanh Lam Undergraduate Program Director

Dr. Harry Lapierre

Dr. Roy Masters Deputy Chief

Dr. Gyani Maharajh Chief Pediatric Cardiac Surgery, CHEO

Dr . Fraser Rubens Post-Graduate Program Director

Dr. Marc Ruel Cardiac Surgery Research Director, Chair Transplant Committee

Dr. Laszlo Ressler

Dr. Simon Saito

Dr. Erik Suuronen PhD, Basic Science Molecular Biology

Dr. Rosalind Labow PhD, Director of Taichman Research Laboratory.


Surgical ServicesThe Division offers cardiac surgery to the Ottawa-Gatineau population and beyond. We continue to receive a significant number of patients from Western Quebec. The reputation of the center being constantly expanding we are receiving an increased number of referrals across other regions of Ontario and other parts of Canada, including the Maritime provinces and even British Columbia. This is in particular for procedures requiring specific expertise as valve repair, instead of replacement, transcatheter aortic valve implant (TAVI), minimally invasive coronary surgery (MVST), pulmonary thromboendarterectomy (PTE) and ventricular assist device (VAD) implantations. The surgical volumes have been quite stable at around 1500 major open heart surgery procedures, and with an increase in heart transplantation and VAD implantation. Our waiting list has remained stable at around 150 patients. We continue to have a significant number of patients coming for a second opinion after rejection from other Ontario centers.

Our mortality rate has hit an impressive bottom of 2.7% over a 12 month period which is similar to the Cleveland Clinic results. Our mortality in elective CABG is below 1%. Our mortality in elective mitral valve repair is very close to 0%. Our volume of valve surgery has considerably increased in the fiscal year 2010/11, up to 675 valve cases, with or without combined bypass surgery. This number is almost double the number of valve procedures done ten years ago at the Heart Institute. Similarly the number of octogenarians in our population has considerably increased. In particular, we have a higher number of older patients referred for aortic valve replacement. Since 2008, we have developed collaboratively with cardiology the procedure named TAVI. We started to use the Core valve device (Medtronic) transfemoral only. We now have added to the TAVI procedures the trans-apical implant from Edwards, which is done through a small thoracotomy. Dr. Ruel collaborating with Dr. Labinaz, started this innovative program which has now expanded. Dr. Lam and another cardiologist, Dr. Glover joined and have built a very strong TAVI team. This team includes a non-TAVI cardiologist, Dr. Burwash, who specializes in echocardiography and aortic valve stenosis, and another non-TAVI surgeon, Dr. Mesana as Chief of Cardiac Surgery participates in optimal patient selection. This team also includes a nurse coordinator. There is a weekly meeting to evaluate the referrals, indications and booking for this innovative and challenging procedure. It is expected that this program will expand considerably in the next few years, and possibly 50% of the future aortic valve replacements could be done as a TAVI procedure within five years from now. The main drawback at this point is more financial than clinical. The PARTNER trial has demonstrated that in high-risk patients TAVI could be as effective as conventional surgery. Conventional surgery has less stroke rates, but overall the risk of stroke in TAVI is still quite acceptable and widely compensated by the reduction in invasiveness of the procedure.

In the last 12 months, we have also seen considerable expansion of the aortic valve repair program with the adjunct of Dr. Boodhwani as new recruit. Dr. Boodhwani initiated his training in Ottawa on valve repair and has focused further his interest in valve surgery by completing a fellowship in Europe. He has acquired additional skills to expand surgical treatment of thoracic aorta aneurysm. Dr. Boodhwani and Dr. K. Chan (Cardiology) have started a thoracic aorta clinic. Adequate resources have been implemented for initial stages and it is already a very active clinic, specialized in detecting thoracic aorta disease and following patients under going surgery at the Heart Institute for thoracic aorta pathology, or referred from elsewhere for thoracic aorta disease management.

This clinic comes in addition to the Valve Clinic, which follows more than 7,000 patients operated for valve surgery at the Heart Institute. Additionally to these two clinics, Dr. Mesana has expanded his mitral valve repair database which is now beyond 1,000 patients treated at the Heart Institute by a single surgeon. An endowed Research Chair in Valve Surgery has been established by the UOHI in June 2011, with Dr. Mesana the recipient of this Chair. The Division of Cardiac Surgery retains two other endowed chairs, the M.Pittfield Chair held by theChief of Cardiac Surgery, currently held by Dr. Mesana and a Research Chair held by Dr. Ruel.

Finally, regarding clinical services, the VAD and transplant program have been quite active in the last fiscal year with excellent results. The result of the last ten-year transplants at the Heart Institute will be published at the next CCS meeting showing above 90% survival at one year, which is above the national benchmark average.


Of note, many of these patients now have transplantation after a period or bridging with the new Heartmate II artificial heart, which is a miniature artificial pump to support the failing the heart while waiting for transplantation.

Summary of Highlights

The Heart Institute cardiac surgeons continue to be heavily involved in the organization of national and international meetings such as Canadian Cardiovascular Society, American Heart Association Annual Meeting, American Association for Thoracic Surgery and Society of Thoracic Surgeons.

Dr. Ruel is very active with his peer to peer MVST procedures.

The Heart Institute has become a peer to peer program for TAVI procedure. Our members continue to be solicited for lectures in the national and international scene on subjects of expertise such as mitral valve repair, minimally invasive coronary surgery, minimally invasive valve surgery and minimally invasive atrial fibrillation surgery.

Our academic contribution is also very heavy in administration.

Dr. Paul Hendry has been doing tremendous efforts and achieving well recognized success in his position as Assistant Dean Postgraduate Medical Education.

Dr. Ruel has been appointed as Assistant Dean Translational Research; this is testament to his outstanding leadership and capacity in translating basic research to the clinical arena.

Dr. Lam is now Director of the Undergraduate Program for the Department of Surgery at the University of Ottawa.

Dr. Mesana has been awarded the UOHI academic award in clinical research and has been entitled to the Endowed Chair for Research in Valve Surgery ($2 million).

Dr. Mesana has been active and involved in the Heart Institute expansion project, which has been approved by the province of Ontario. An announcement was made in August 2011 for significant expansion at the Heart Institute with a new building, which will include new cardiac OR’s, new ICU’s, Cath labs and other cardiac imaging infrastructure. This will allow the Heart Institute to stay at the forefront of cardiovascular care as a world class center.

Education and Research

As a consequence to the development of intense academic activities, the Division of Cardiac Surgery has attracted in the last few years, high quality residents and fellows. Dr. Vincent Chan has finished his residency training with successful pass of his Royal College exam in June 2011. Along with his residency training, Dr. Chan has achieved an impressive number of presentations and publications at the international level. He has received many awards from the Department of Surgery, as well as from the Heart Institute for clinical research. Dr. Chan has been nominated as the Young Investigator Award for 2011 CCS to be received in Vancouver, October 2011, for his work on MV repair.

The division has continued to be active in publishing in the many clinical areas, and specifically in valve surgery, and at the same time, basic science publications have seen exponential growth.

In basic science research, Drs. Ruel and Suuronen have continued to expand the research in the field of regenerative myocardial therapy. Their lab is extraordinarily active with increasing number of students and fellows. Both Drs. Ruel and Suuronen have obtained numerous large grants to support their research. They exemplify the success of basic science in the field of surgery, in general and cardiac surgery in particular. Their lab was


proud to have its first PhD graduate, Dr. Mary Zhang who completed all of her research in Dr. Ruel/Suuronen laboratory on myocardial regeneration. Celine Giordano will write her Master’s thesis this fall, and other Masters and PhD students are working hard and progressing in the lab.

Dr. Labow has continued to serve as an outstanding mentor in the lab and still cooperates with several research projects in collaboration with Dr. Suuronen and Dr. Santerre from Toronto.

Finally, we had several visiting professors at the Heart Institute:

Dr. M. Yacoub gave the Keon Lecuture in June 2010. Dr. Yacoub is one of the three top cardiac surgeons in the overall history of cardiac surgery.

Dr. David Adams from New York gave the Foustanellas Lecture in March 2010 and is a world leader in valve surgery.

Dr. Alfieri from Italy, and President of the European Association for Cardiothoracic Surgery, presented the Foustanellas Lecture in March 2011. He is also a world leader in cardiac surgery.

These three cardiac surgeons are extremely prominent cardiac surgery leaders in the world and have been particularly impressed by the work done at the Heart Institute by the organization of cardiac surgery in our hospital.

Publications

Our team has presented one or several papers in each important meeting for Cardio Thoracic Surgeons (AATS, EACTS, AHA, CCS, STS).

We have been Section Editor for four Issues of Opinion in Cardiology in 2009-2010 (Dr Mesana, Valve Surgery and Coronary Surgery).

Our surgeons have been invited to present lectures nationally and internationally. (Dr. Ruel, Dr. Rubens, Dr. Lam, Dr. Mesana) Below is the non exhaustive list of publications as presented in Pubmed On line, where various members of our division have been involved in 2010-2011:

1. Dawson J, Schussler O, Al-Madhoun A, Menard C, Ruel M, Skerjanc IS. Collagen scaffolds with or without the addition of RGD peptides support cardiomyogenesis after aggregation of mouse embryonic stem cells. In Vitro Cell Dev Biol Anim. 2011 Sep 23.

2. Chan V, Malas T, Lapierre H, Boodhwani M, Lam BK, Rubens FD, Hendry PJ, Masters RG, Goldstein W, Mesana TG, Ruel M. Reoperation of left heart valve bioprostheses according to age at implantation. Circulation. 2011 Sep 13;124(11 Suppl):S75-80.

3. Kulik A, Ruel M. Lipid-lowering therapy and coronary artery bypass graft surgery: what are the benefits? Curr Opin Cardiol. 2011 Sep 19.

4. Kulik A, Ruel M. Clopidogrel after coronary artery bypass graft surgery insufficient evidence. J Am Coll Cardiol. 2011 Aug 58(10):1084-5.

5. Tran DT, Dupuis JY, Mesana T, Ruel M, Nathan HJ. Comparison of the EuroSCORE and Cardiac Anesthesia Risk Evaluation (CARE) score for risk-adjusted mortality analysis in cardiac surgery. Eur J Cardiothorac Surg. 2011 Jul 30.

6. Kuraitis D, Ruel M, Suuronen EJ. Mesenchymal stem cells for cardiovascular regeneration. Cardiovasc Drugs Ther. 2011 Aug;25(4):349-62.


7. Kuraitis D, Hou C, Zhang Y, Vulesevic B, Sofrenovic T, McKee D, Sharif Z, Ruel M, Suuronen EJ. Ex vivo generation of a highly potent population of circulating angiogenic cells using a collagen matrix. J Mol Cell Cardiol. 2011 Aug;51(2):187-97.

8. Lapierre H, Chan V, Sohmer B, Mesana TG, Ruel M. Minimally invasive coronary artery bypass grafting via a small thoracotomy versus off-pump: a case-matched study. Eur J Cardiothorac Surg. 2011Oct;40(4):804-10.

9. Kulik A, Le May MR, Voisine P, Tardif JC, Delarochelliere R, Naidoo S, Wells GA, Mesana TG, Ruel M. Aspirin plus clopidogrel versus aspirin alone aftercoronary artery bypass grafting: the clopidogrel after surgery for coronary artery disease (CASCADE) Trial. Circulation. 2010 Dec 21;122(25):2680-7.

10. Ruel M, Dickie S, Chow BJ, Labinaz M. Interventional valve surgery: building a team and working together. Semin Thorac Cardiovasc Surg. 2010 Summer;22(2):145-9.

11. Grisoli D, Chan V, Tran A, Ressler L, Nicholson D, Hynes M, Ruel M, Mesana TG. Frequency and surgical management of complex posterior leaflet prolapse of the mitral valve. J Heart Valve Dis. 2010 Sep;19(5):568-75.

12. Kuraitis D, Suuronen EJ, Sellke FW, Ruel M. The future of regenerating the myocardium. Curr Opin Cardiol. 2010 Nov;25(6):575-82. Review

13. Chan V, Kulik A, Tran A, Hendry P, Masters R, Mesana TG, Ruel M. Long-term clinical and hemodynamic performance of the Hancock II versus the Perimount aortic bioprostheses. Circulation. 2010 Sep 14;122(11 Suppl):S10-6.

14. Deng C, Zhang P, Vulesevic B, Kuraitis D, Li F, Yang AF, Griffith M, Ruel M, Suuronen EJ. A collagen–chitosan hydrogel for endothelial differentiation and angiogenesis. Tissue Eng Part A. 2010 Oct;16(10):3099-109.

15. Chan V, Jamieson WR, Lam BK, Ruel M, Ling H, Fradet G, Mesana TG. Influence of the On-X mechanical prosthesis on intermediate-term major thromboembolism and hemorrhage: a prospective multicenter study. J Thorac Cardiovasc Surg. 2010 Nov;140(5):1053-8.e2.

16. Chan V, Lau J, Rubens FD, Dennie C, Ruel M. Malignant invasion of sternotomy incision after cardiac operation. Ann Thorac Surg. 2010 Apr;89(4):1295-6.

17. Nairn TK, Giulivi A, Neurath D, Tokessy M, Sia YT, Ruel M, Wilkes PR. Urgent replacement of a mechanical mitral prosthesis in an anticoagulated patient with Bombay red blood cell phenotype. Can J Anaesth. 2010 Jun;57(6):583-7.

18. Schussler O, Chachques JC, Mesana TG, Suuronen EJ, Lecarpentier Y, Ruel M. 3-dimensional structures to enhance cell therapy and engineer contractile tissue. Asian Cardiovasc Thorac Ann. 2010 Feb;18(2):188-98.

19. Zhang Y, Wong S, Laflèche J, Crowe S, Mesana TG, Suuronen EJ, Ruel M. In vitro functional comparison of therapeutically relevant human vasculogenic progenitor cells used for cardiac cell therapy. J Thorac Cardiovasc Surg. 2010 Jul;140(1):216-24, 224.e1-4.

20. Suuronen EJ, Hazra S, Zhang P, Vincent R, Kumarathasan P, Zhang Y, Price J, Chan V, Sellke FW, Mesana TG, Veinot JP, Ruel M. Impairment of human cell-based vasculogenesis in rats by hypercholesterolemia-induced endothelial dysfunction and rescue with L-arginine supplementation. J Thorac Cardiovasc Surg. 2010 Jan;139(1):209-216.e2.

21. Ruel M, Labinaz M. Transcatheter aortic-valve replacement: a cardiac surgeon and cardiologist team perspective. Curr Opin Cardiol. 2010 Mar;25(2):107-13. 22. Chan V, Wang B, Veinot JP, Suh KN, Rose G, Desjardins M, Mesana TG. Tropheryma whipplei aortic valve endocarditis without systemic Whipple’s disease. Int J Infect Dis. 2011 Aug 29.

23. Chan V, Jamieson WR, Mesana TG. Reply to the editor. J Thorac Cardiovasc Surg. 2011 Sep;142(3):720.

24. Elmistekawy EM, Veinot JP, Dennie CJ, Rubens FD. Recurrent Cardiac Constriction After Complete Pericardiectomy. Heart Lung Circ. 2011 Jun 1.


25. Rubens FD. Thromboelastography to expand transfusion practice. Perfusion. 2011 May;26(3):173.

26. Carless PA, Rubens FD, Anthony DM, O’Connell D, Henry DA. Platelet-rich-plasmapheresis for minimising peri-operative allogeneic blood transfusion. Cochrane Database Syst Rev. 2011 Mar 16;(3):CD004172.

27. Forster AJ, Worthington JR, Hawken S, Bourke M, Rubens F, Shojania K, van Walraven C. Using prospective clinical surveillance to identify adverse events in hospital. BMJ Qual Saf. 2011 Sep;20(9):756-63.

28. Mehta S, Helmersen D, Provencher S, Hirani N, Rubens FD, De Perrot M, Blostein M, Boutet K, Chandy G, Dennie C, Granton J, Hernandez P, Hirsch AM, Laframboise K, Levy RD, Lien D, Martel S, Shoemaker G, Swiston J, Weinkauf J; for the Canadian Thoracic Society Pulmonary Vascular Disease - CTEPH CPG Development Committee; and the Canadian Thoracic Society Canadian Respiratory Guidelines Committee. Diagnostic evaluation and management of chronic thromboembolic pulmonary hypertension: A clinical practice guideline. Can Respir J. 2010 November/December;17(6):301-334.

29. Rodriguez RA, Rubens FD, Wozny D, Nathan HJ. Cerebral emboli detected by transcranial Doppler during cardiopulmonary bypass are not correlated with postoperative cognitive deficits. Stroke. 2010 Oct;41(10):2229-35.

30. Chan B, Huynh HP, Moonje V, Price J, Rubens FD. Cardiac tamponade caused by incarcerated small bowel in the pericardium after coronary bypass grafting using the right gastroepiploic artery. Ann Thorac Surg. 2010 Aug;90(2):641-2.

31. Boodhwani M, Hamilton A, de Varennes B, Mesana T, Williams K, Wells GA, Nathan H, Dupuis JY, Babaev A, Wells P, Rubens FD. A multicenter randomized controlled trial to assess the feasibility of testing modified ultrafiltration as a blood conservation technology in cardiac surgery. J Thorac Cardiovasc Surg. 2010 Mar;139(3):701-6

32. de Kerchove L, Boodhwani M, Glineur D, Noirhomme P, El Khoury G. A new simple and objective method for graft sizing in valve-sparing root replacement using the reimplantation technique. Ann Thorac Surg. 2011 Aug;92(2):749-51.

33. Price J, Naik V, Boodhwani M, Brandys T, Hendry P, Lam BK. A randomized evaluation of simulation training on performance of vascular anastomosis on a high-fidelity in vivo model: The role of deliberate practice. J Thorac Cardiovasc Surg. 2011 Sep;142(3):496-503.

34. Labrosse MR, Boodhwani M, Sohmer B, Beller CJ. Modeling leaflet correction techniques in aortic valve repair: A finite element study. J Biomech. 2011 Aug 11;44(12):2292-8. Epub 2011 Jun 16.

35. Belway D, Tee R, Nathan H, Rubens F, Boodhwani M. Temperature management and monitoring practices during adult cardiac surgery under cardiopulmonary bypass: results of a Canadian national survey. Perfusion. 2011 Sep;26(5):395-400.

36. El Oumeiri B, Glineur D, Price J, Boodhwani M, Etienne PY, Poncelet A, De Kerchove L, Papadatos S, Noirhomme P, El Khoury G. Recycling of internal thoracic arteries in reoperative coronary surgery: in-hospital and midterm results. Ann Thorac Surg. 2011 Apr;91(4):1165-8.

37. Boodhwani M, de Kerchove L, Watremez C, Glineur D, Vanoverschelde JL, Noirhomme P, El Khoury G. Assessment and repair of aortic valve cusp prolapse: implications for valve-sparing procedures. J Thorac Cardiovasc Surg. 2011 Apr;141(4):917-25.

38. Boodhwani M, de Kerchove L, Glineur D, Rubay J, Vanoverschelde JL, Van Dyck M, Noirhomme P, El Khoury G. Aortic valve repair with ascending aortic aneurysms: associated lesions and adjunctive techniques. Eur J Cardiothorac Surg. 2011 Aug;40(2):424-8.

39. Wykrzykowska JJ, Rosinberg A, Lee SU, Voisine P, Wu G, Appelbaum E, Boodhwani M, Sellke FW, Laham RJ. Autologous cardiomyotissue implantation promotes myocardial regeneration, decreases infarct size, and improves left ventricular function. Circulation. 2011 Jan 4;123(1):62-9. 40. Bradshaw SH, Hendry P, Boodhwani M, Dennie C, Veinot JP. Left ventricular mesenchymal hamartoma, a new hamartoma of the heart. Cardiovasc Pathol. 2011 Sep-Oct;20(5):307-14.


41. Robich MP, Osipov RM, Nezafat R, Feng J, Clements RT, Bianchi C, Boodhwani M, Coady MA, Laham RJ, Sellke FW. Resveratrol improves myocardial perfusion in a swine model of hypercholesterolemia and chronic myocardial ischemia. Circulation. 2010 Sep 14;122(11 Suppl):S142-9.

42. Mieno S, Boodhwani M, Robich MP, Clements RT, Sodha NR, Sellke FW. Effects of diabetes mellitus on VEGF-induced proliferation response in bone marrow derived endothelial progenitor cells. J Card Surg. 2010 Sep;25(5):618-25.

43. Van Dyck MJ, Watremez C, Boodhwani M, Vanoverschelde JL, El Khoury G. Transesophageal echocardiographic evaluation during aortic valve repair surgery. Anesth Analg. 2010 Jul;111(1):59-70.

44. Boodhwani M, de Kerchove L, Glineur D, Rubay J, Vanoverschelde JL, Noirhomme P, El Khoury G. Repair of regurgitant bicuspid aortic valves: a systematic approach. J Thorac Cardiovasc Surg. 2010 Aug;140(2):276-284.

45. de Kerchove L, Boodhwani M, Etienne PY, Poncelet A, Glineur D, Noirhomme P, Rubay J, El Khoury G. Preservation of the pulmonary autograft after failure of the Ross procedure. Eur J Cardiothorac Surg. 2010 Sep;38(3):326-32.

46. Sodha NR, Chu LM, Boodhwani M, Sellke FW. Pharmacotherapy for end-stage coronary artery disease. Expert Opin Pharmacother. 2010 Feb;11(2):207-13.

47. Kuraitis D, Zhang P, Zhang Y, Padavan DT, McEwan K, Sofrenovic T, McKee D, Zhang J, Griffith M, Cao X, Musaro A, Ruel M, Suuronen EJ. A stromal cell-derived factor-1 releasing matrix enhances the progenitor cell response and blood vessel growth in ischaemic skeletal muscle. Eur Cell Mater. 2011 Sep;22:109-123.

48. McDonald S, Matheson LA, McBane J, Kuraitis D, Suuronen EJ, Santerre JP, Labow RS. Characterization of a degradable polyurethane for use in vascular tissue engineering with a monocyte/ endothelial cell co-culture and a subcutaneous implant mouse model. J Cell Biochem. 2011 Aug 8.

49. Thackeray JT, Radziuk J, Harper ME, Suuronen EJ, Ascah KJ, Beanlands RSB, DaSilva JN. Sympathetic nervous dysregulation in the absence of left ventricular dysfunction in a rat model of insulin resistance with hyperglycemia. Cardiovasc Diabetol. 2011;10:75.

50. McEwan K, Padavan DT, Deng C, Vulesevic B, Kuraitis D, Korbutt GS, Suuronen EJ. Tunable collagen hydrogels are modified by the therapeutic agents they are designed to deliver. J Biomater Sci Polym Ed. 2011 Jul 18;[e-pub ahead of print].

ResearchGrants

Member and Role

Suuronen, Erik (PI)Milne, Ross (co-PI)

Title

Endothelial Progenitor Cell Function in Defec-tive Ischemia-induced Neovascularization in Diabetes

FundingType

Peer reviewed

Funding Source

CIHR

Total Amount

$97,616

End Date

2011

Start Date

2010


Member and Role

Stewart, Duncan (PI)Ruel, Marc Suuronen, Erik

Ruel, Marc (PI)Suuronen, Erik (co-PI)

Skerjanc, Ilona (PI)Ruel, Marc (co-PI)

Suuronen, Erik (PI)Ruel, Marc (co-investigator)

Ruel, Marc (PI)Suuronen, Erik (co-investigator)

Korbutt, Greg (PI)Suuronen, Erik (co-PI)

Stewart, Duncan (PI) Suuronen, Erik (co-investigator)

Santerre, Paul (PI)Suuronen, Erik (co-investigator)Ruel, Marc (co-investigator)

Davis, Darryl (PI)Suuronen, Erik (co-investigator)

Title

Translation of Innovation into Medical Excellence (TimEX)

Mechanisms of Progenitor Cell-based Angiogenic Therapy with Tissue-Engineered Biopolymer Delivery Matrices and Effects of Host Substrate Modification

The molecular basis of cardiac muscle development

Recruitment of endogenous circulat-ing progenitor cells for cardiac regenera-tion using enhanced tissue-engineered biomatrices

Evaluation of biopolymer delivered EPC’s for cardiac repair in a swine model of hibernating myocardium

Bioengineering a highly vascularized ectopic site for islet transplantation

Cardiovascular Repair using Enhanced Stem Cell Therapy (CREST)

Monocyte directed tissue regeneration of a blood vessel substitute using a pro-cellular degradable tubular scaffold

Second generation cardiac cell therapy: Combination and genetic tailoring of stem cells in ischemic heart disease

FundingType

Peer reviewed

Peer reviewed

Peer reviewed

Peer reviewed

Peer reviewed

Peer reviewed

Peer reviewed

Peer reviewed

Peer reviewed

Funding Source

CFI

CIHR

CIHR

Heart andStroke

FoundationCanada

Heart and Stroke

FoundationCanada

Juvenile Diabetes Research

Foundation

OntarioMinistry of Research & Innovation

CIHR

CIHR

Total Amount

$925,507

$599,241

$675,000

$375,696

$159,052

$792,000

$12,911,991

$379,080

$355,416

End Date

2013

2012

2012

2011

2012

2015

2014

2014

Start Date

2008

2008

2009

2009

2009

2010

2011

2011


Member and Role

Wright, Graham (PI)Ruel, Marc (co-investigator)Suuronen, Erik (co-investigator)

Beanlands, Rob (director)Suuronen, Erik (PI)Ruel, Marc (PI)

Title

Imaging for Cardiovascular Therapeutics

Metabolic and cellular function in cardiovascular disease

FundingType

Peer reviewed

Peer reviewed

Funding Source

OntarioMinistry of Research & Innovation

Heart & Stroke Found of Ontario

Total Amount

$14,490,484

$1,250,000

End Date

2013

2012

Start Date

2008

2007


Division of General SurgeryOverview

Dr. Joseph MamazzaAssociate Professor, University of Ottawa Chair, Division of General Surgery, University of OttawaHead, Division of General Surgery, The Ottawa Hospital Director, Minimally Invasive Surgery ProgramCo-Director, Bariatric Surgery Program

The Ottawa Hospital – Civic Campus CPC Building Room 121 Ottawa, ON K1Y 4E9 Tel: (613) 798-5555 13151 Fax: (613) 761-4124

Faculty MembersDr. Eric PoulinWilbert J. Keon Chair and ProfessorDepartment of Surgery, University of OttawaSurgeon-in-Chief, The Ottawa Hospital - General Campus Subspecialty: Minimal Invasive Surgery Tel: (613) 737-8899 ext. 71763Fax: (613) 739-6769

Dr. Rebecca AuerAssistant Professor, University of OttawaSurgeon, The Ottawa Hospital - General Campus Subspecialty: ColorectalTel: (613) 737-8899 ext 72791Fax: (613) 739-6646

Dr. Dennis PittAssistant Professor, University of OttawaSurgeon, The Ottawa Hospital - General Campus General Campus site ChiefSubspecialty: Laparoscopic SurgeryTel: (613) 738-0468Fax: (613) 738-7427

Dr. Vijay MoonjeLecturer, University of OttawaSurgeon, The Ottawa Hospital – General CampusSubspecialties: General, Laparoscopic SurgeryTel: (613) 521-4961Fax: (613) 521-5321

Dr. James WattersProfessor, University of Ottawa Director of Research, Department of SurgeryMedical Director, Women’s Breast Health CenterSurgeon, The Ottawa Hospital - Civic Campus Subspecialty: Breast Surgical Oncology Tel: (613) 798-5555 ext 14780Fax: (613) 761-5371

Dr. Robin BousheyAssistant Professor, University of OttawaResearch Director, General SurgerySurgeon, The Ottawa Hospital - General Campus Subspecialty: ColorectalTel: (613) 737-8899 ext 71724Fax: (613) 739-6646

Dr. Jean-Denis YelleAssociate Professor, University of OttawaDirector, Trauma Co-Director, Bariatric Surgery ProgramThe Ottawa Hospital - Civic Campus Subspecialties: Trauma, Critical Care and Laparoscopic SurgeryTel: (613) 798-5555 ext 19605Fax: (613) 761-4262

Dr. Martin FriedlichAssistant Professor, University of Ottawa Director, Colorectal ProgramDirector, Colorectal FellowshipSurgeon, The Ottawa Hospital - General Campus Subspecialty: Colorectal SurgeryTel: (613) 737-8899 ext 76650Fax: (613) 739-6646


Dr. Robin Fairfull-SmithAssistant Professor, University of OttawaSurgeon, The Ottawa Hospital - Civic Campus Subspecialty: Hepatobiliary-Pancreatico SurgeryTel: (613) 761-5015Fax: (613) 761-4029

Dr. Audley BodurthaProfessor, University of OttawaSurgeon, The Ottawa Hospital - General Campus Subspecialty: Breast SurgeryTel: (613) 737-8544 Fax: (613) 737-8371

Dr. Christopher ChadwickAssistant Professor, University of Ottawa Surgeon, The Ottawa Hospital - Civic Campus Subspecialty: Breast SurgeryTel: (613) 798-5555 ext 14068Fax: (613) 761-5371

Dr. John LorimerAssociate Professor, University of Ottawa Surgeon, The Ottawa Hospital - General Campus Subspecialties: Breast, Laparoscopic SurgeryTel: (613) 737-8899 ext 78428Fax: (613) 737-371

Dr. Fady BalaaDirector, General Surgery Postgraduate Education ProgramDirector, Surgical Oncology FellowshipDirector, HPB Program Assistant Professor, University of OttawaSurgeon, The Ottawa Hospital - Civic Campus Subspecialty: Hepatobiliary-Pancreatico SurgeryTel: (613) 761-5015Fax: (613) 761-4029

Dr. Richard MimeaultAssistant Professor, University of OttawaSurgeon, The Ottawa Hospital – Civic HospitalSubspecialty: Hepatobiliary-Pancreatico SurgeryTel: (613) 761-5015Fax: (613) 761-4029

Dr. Giuseppe PagliarelloAssistant Professor, University of OttawaSurgeon, The Ottawa Hospital - Civic CampusCivic Campus site ChiefSubspecialties: Critical Care, TraumaTel: (613) 798-5555 ext 15199Fax: (613) 761-5371

Dr. Alfred StedmanLecturer, University of OttawaSurgeon, The Ottawa Hospital - Civic Campus Riverside Campus site ChiefSubspecialty: General Surgery Tel: (613) 725-3721Fax: (613) 725-3073

Dr. Shaheer TadrosLecturer, University of OttawaSurgeon, The Ottawa Hospital - General Campus Subspecialties: General SurgeryTel: (613) 739-7165Fax: (613) 738-1019

Dr. Jacinthe LampronAssistant Professor, University of OttawaSurgeon, The Ottawa Hospital - Civic Campus Subspecialty: Trauma Tel: (613) 798-5555 x 19605Fax: (613) 761-4262

Dr. Juan Alejandro BassAssociate Professor, University of OttawaChief, Paediatric General SurgerySurgeon, Children’s Hospital of Eastern OntarioSubspecialty: Paediatric SurgeryTel: (613) 737-7600 ext 2060Fax: (613) 738-4840

Dr. Shirley ChouAssistant Professor, University of OttawaPostgraduate program directorSurgeon, Children’s Hospital of Eastern OntarioSubspecialty: Paediatric SurgeryTel: (613) 737-2060Fax: (613) 738-4840

Dr. Marcos Bettoli Assistant Professor, University of OttawaUndergraduate CoordinatorSurgeon, Children’s Hospital of Eastern OntarioSubspecialty: Paediatric SurgeryTel: (613) 737-7600 ext 2878Fax: (613) 738-4849

Dr. Kyle CowanAssistant Professor, University of OttawaResearch DirectorSurgeon, Children’s Hospital of Eastern OntarioSubspecialty: Paediatric SurgeryTel: (613) 737-7600 ext 2878Fax: (613) 738-4849

Paediatric Surgery


Summary of HighlightsWe have plans to recruit an additional MIS hepatobiliary surgeon and a MIS surgeon in the next five years. Dr. Jacinthe Lampron, a trauma surgeon has been recruited and will be joining our division as of July 2011. Dr. Angel Arnaout has been a consultant at the Women’s Breast Health Centre will join our division on a full time basis as a breast surgeon starting July 1st, 2011.

We currently have two of our residents enrolled in a Surgeon Scientist Program; Dr. Reilly Musselman and Dr. Stephanie Lapierre.

The Bariatric Surgery program will be welcoming a new surgeon, Dr. Isabelle Raiche as of July 1st, 2011. Dr. Raiche will be working part-time with the bariatric program for the next two years while completing her Masters in Education.

AwardsDr. Robin Boushey received one of the $25,000 research grants from the Department of Surgery.

Dr. Rebecca Auer received the Best Paper-Basic Science award from the Canadian Association of General Surgeons in September 2010.

A number of our division members received a Guardian Angel award during this academic year namely, Dr. Fady Balaa, Dr. Angel Arnaout, Dr. Rebecca Auer, Dr. Robin Boushey, Dr. Christopher Chadwick, Dr. Robin Fairfull-Smith, Dr. Vijay Moonje, Dr. Husein Moloo, Dr. Giuseppe Pagliarello, Dr. Eric Poulin, Dr. Shaheer Tadros and Dr. Jean-Denis Yelle.

This year, Dr. Richard Mimeault was the recipient of the “Audley Bodurtha Teaching Award”.

Dr. Robin Fairfull-Smith was honored with a bursary award named after him in tribute to all of his efforts over the years promoting international surgery, the “Robin Fairfull-Smith International Bursary Award”.

General Surgery Resident hard work this year was evident by the number of awards received;

Dr. Jean-Claude Gauthier, PGY4, received the “2011 Heringer Award” at our research day in April 2011

Dr. Rashmi Seth, PGY2, and Dr. Guillaume Martel, PG5, received the “Award of Excellence”.

At the Department of Surgery Collins Day, Dr. Malika Oberoi, PGY5 received the 2011 “Outstanding Resident Teaching – Best Resident Teacher” award. Dr. Beverley Chan, PGY3, received the “Best Poster Presentation” award and Dr. Rashmi Seth, PGY2, received the “Best Overall Paper” award.

Dr. Rashmi Seth, PGY2, was awarded the “Best Paper (Basic Science)” award at the Canadian Association of General Surgeons last September. She also received the 1st Prize at the BMI Seminar day in February 2011.

OtherOur General Surgery Research Day was held on April 27th, 2011. Dr. David Geller from Pittsburgh was our invited professor. He presented “Laparoscopic Liver Resection for Cancer: Outcomes and Benefits” at the Department of Surgery Grand Rounds.

Dr. R. Fairfull-Smith continues to volunteer his time and expertise in developing countries.


ResearchGrants

Member and Role

Poulin, EricCollaborator

Auer, Rebecca AnnCo-PrincipaleInvestigator

Boushey, Robin PaulCollaborator

Auer, Rebecca AnnPrincipal or Joint Investigator


Title

Virtual Reality Based Minimally Invasive Surgical Skills Program, University of Ottawa Educational Initiative in Residency Education Fund

Vascular progenitor cells and recovery after cancer surgery

The Use of Extended Peri-Operative Low Molecular Weight Heparin to Improve Cancer Specific Survival Following Surgical Resection of Colon Cancer: A Randomized Controlled Trial

The Use of Extended Perioperative Low Molecular Weight Heparin to Improve Cancer Specific Survival Following Surgical Resection of Colon Cancer: A Randomized Controlled Trial

The Use of Extended Perioperative Low Molecular Weight Heparin to Improve Cancer Specific Survival Following Surgical Resection of Colon Cancer: A Randomized Controlled Trial

Peer Reviewed

True

True

True

True

False

Funding Source

Ottawa Regional Cancer

Foundation

Ottawa Hospital Research Institute

Canadian Institute of Health Research

Leo Pharma Inc

Total Amount

204 044.00

End Date

present

2011/04

2014/06

2015/03

2015/03

Start Date

2006

2010/04

2010/06

2011/03

2011/03


Member and Role

Mamazza, JosephCollaborator


Balaa, FadyCo-principal Investigator

Boushey, Robin PaulPrincipal or Joint Investigator


Yelle, Jean-DenisInvestigator : Trauma care input


Pagliarello, GiuseppeCollaborator

Watters, JamesCollaborator

Title

The Use if Extended Peri-operative Low Molecular Weight Heparin to Improve Cancer Specific Survival Following Surgical Resection of ColonCancer: A Randomized Controlled Trial.

The Role of Tissue Factor Following Surgery in the Development of Postoperative Metastatic Disease

The general surgery rotation for family medicine residents: The impact, barriers, and lessons learned

The development and evaluation of a patient decision aid for patients with mid and distal rectal cancer.

The development and evaluation of a patient decision aid for patients with mid and distal rectal cancer

Resuscitation Outcomes Consortium

Regional Communities of Practise Meetings for Colorectal Cancer

Reducing Death due to Oxidative Stress: Glutamine and Antioxi-dant Supplementation

PROSE (Perioperative Ischemia Reduction): Remote ECG-ST Monitoring

Peer Reviewed

True

True

False

True

True

True

True

True

True

Funding Source

CIHR

Cancer Research Society

Physicians Services

Incorporated Foundation

(PSI)

Physician Services

Incorporated - Resident

Research Grant

PSI

ROC

Surgical Oncology

Group at the University of Ottawa

TOH Academic Medical

Organization Innovation

Fund

Total Amount

19 200.0040 800.00

End Date

2014/03

2012/09

present

2010/11

2010/11

present

present

present

2011/09

Start Date

2010/03

2010/09

2008

2009/11

2009/11

2006/12

2006/01

2006/01

2009/09


Member and Role

Pagliarello, GiuseppeCollaborator

Bodurtha, AudleyCollaborator

Boushey, Robin PaulCo-principal Investigator

Bodurtha, AudleySite co-investigator

Auer, Rebecca AnnResearch Supervisor


Balaa, FadyCollaborator


Tadros, ShaheerCo-principal Investigator

Mamazza, JosephPrincipal or Joint Investigator

Balaa, FadyPrincipal or Joint Investigator

Title

Prophylaxis for Thromboembolism in Critical Care Trial (PROTECT)

Preop MRI decreases local recurrence in breast cancer.

Phase III HDREBT Study

P-2 study of tamoxifen and Raloxifene for prevention of breast cancer.

Ontario Graduate Scholarship

Ontario Graduate Scholarship

Neoadjuvant JX-594 in Hepatic Metastases from Colorectal Cancer

Models of Peer Support for Colorectal Cancer Patients

Low molecular weight heparin perioperatively in colon cancer patients

Laparoscopic Colon Cancer Mentorship Program

Laparoscopic cholecystectomy skills training curriculum for junior general surgery residents

Peer Reviewed

True

False

False

True

True

True

False

False

True

True

False

Funding Source

CIHR

Canadian Institutes of Health Research

NSABP

Ontario Student

Assistance Program

Ontario Student

Assistance Program

Ontario Cancer Institute

Physicians Services

Incorporated

Cancer Care Ontario

Ottawa Regional

Cancer Centre Foundation

University of Ottawa

Total Amount

15 000.00

End Date

present

2010/08

2012

2010/07

2011/08

2010/08

present

present

2010/12

present

present

Start Date

2006/01

2009/08

2010

2008/01

2010/09

2009/09

2008

2010/06

2009/01

2007

2007


Member and Role


Chou, ShirleyPrincipal or Joint Investigator






Bass, JuanCo-principal Investigator

Bodurtha, AudleyPrincipal or Joint Investigator

Bass, JuanPrincipal or Joint Investigator

Title

Innovative Cancer Therapies Targeting the Perioperative Period: A Translational Research Project

Improving a non-invasive method for monitoring core temperatuve in infants.

Health-Related Quality of Life and Functional Status after Surgical Treatment for Rectal Cancer

FRSQ Postdoctoral Training Award (Basic Research)

Frederick Banting and Charles Best Canada Graduate Scholarship-Master’s Award

Evaluating Surgical Outcomes: Systematic Comparison of Evidence from Randomized Trials and Observational Studies in Laparoscopic Colorectal Surgery

Evaluating different approaches in monitor-ing surgeon specific complication rates in patients undergoing colorectal surgery

Centre for Computer-Assisted Intervention and Innovation (CCAII)

Cancer Care Ontario “PET PREDICT” Clinical Trial in Breast Cancer

Basic Abdominal Sign Simulator

Peer Reviewed

True

True

True

True

True

True

True

True

False

True

Funding Source

Canada Foundation for

Innovation

CHEO/FHS partnership

grant

Physicians Services


Fonds de la Research en Santé du

Québec


Canadian Society

of Colon and Rectal Surgeons

Physician Services

Incorporated - Resident

Research GrantFunding Source

ORF-RE Ontario

Research Fund Research

Excellence

Total Amount

45 000.0045 000.00

17 500.00

End Date

2011/12

2010/12

present

2013/06

2010/08

present

present

2012/07

present

present

Start Date

2011/06

2008/06

2009

2010/06

2009/09

2008

2010/06

2008/01

2006/01

2005/06


Member and Role

Mamazza, JosephPrincipal or Joint Investigator





Moloo, HuseinPrincipal or Joint Investigator

Boushey, Robin PaulCo-principal Investigator

Title

Bariatric Surgery Program

Assessment of Patient’s Intestinal, Bladder and Sexual Function Following Rectal Cancer Surgery.

Annual General Surgery Resident Research Day April 20-21, 2010.

An Innovation in Breast Cancer Care in Ottawa: The Evaluation and Validation of a Rapid Diagnostic and Support Clinic for Women Undergoing Assessment for Breast Cancer (RADS)

An Innovation in Breast Cancer Care in Ottawa: The Evaluation and Validation of a Rapid Diagnostic and Support Clinic for Women Undergoing Assessment for Breast Cancer (RADS)

A Randomized, Prospective, Multi-centered Study Comparing Clinical Outcomes of the Ligation of Intersphinc-teric Fistula Tract (LIFT) Procedure versus Use of an Anal Fistula Plug (AFP) in the Surgical Repair of Trans-sphinc-teric Anal Fistulae of Cryptoglandular origin

A team of clinical researchers and clinicians has been assembled from King Saud University, TOH, and St Michaels Hospital that will focus on gastrointestinal diseases.

Peer Reviewed

False

False

True

True

False

True

False

Funding Source

Covidien

Anonymous Private

Individuals (Canadians)

Sanofi Aventis

The Ottawa Hospital

Academic Medical

Organization Innovation

Fund

Hoffman-Laroche Limited

Department of Surgery,


King Saud University

Total Amount

64 792.00

Annual funding

approximately $100 000.

End Date

2014/01

2010/11

present

2012/12

2012/12

2011/09

present

Start Date

2010/01

2009/11

2010/04

2011/01

2010/12

2009/09

2009/02


Member and Role

Auer, Rebecca AnnCo-principal Investigator

Yelle, Jean-DenisPrincipal or Joint Investigator

Auer, Rebecca AnnCollaborator




Title

A Phase II Trial of neoadjuvant IXO Regimen (Capecitabine, Oxaliplatin, Irinotecan) Followed by Combined Modality Capecitabine and Radiation for Locally Resectable Advanced Rectal Cancer

A multi-center randomized, double-blind, parallel group, placebo controlld trial to evaluate the efficacy and safety of activated recombinant factor VII in the treatment of refractory bleeding in severely injured trauma patients

A multicenter randomized controlled trial of pre-operative high dose rate endorectal brachytherapy in preparation for sphincter preservation surgery for patients with advanced cancer of the lower rectum

“The Role of Platelet Activation/Aggregation Following Surgery and the Postoperative Development of Metastatic Disease”

“The Role of Platelet Activation/Aggregation Following Surgery and the Postoperative Development of Metastatic Disease”

“Pilot study of extended duration of pre-operative and post-operative low molecular weight heparin to improve survival in patients with resectable colorectal cancer”

Peer Reviewed

False

False

True

True

True

True

Funding Source

Hoffman-LaRocheIndustry,

NovoSeven/Niastase

$15 000 per patient entered


Ottawa Regional Cancer

Foundation

J.P. Bickell Foundation

Department of Medicine, University of

Ottawa

Total Amount

14 340.00

48 020.00

62 515.00

10 000.00

End Date

2012/09

present

present

2011/03

2011/03

2011/08

Start Date

2009/09

2007/02

2011/03

2010/03

2010/04

2009/08


Member and Role


Auer, Rebecca AnnCo-principal Investigator


Chadwick, ChristopherPrincipal or Joint Investigator

Title

“Pilot study of extended duration of pre-operative and postoperative low molecular weight heparin to improve survival in patients with resectable colorectal cancer”

“Novel strategies for enhancing oncolytic virus-mediated cancer therapy”

“Neoadjuvant intratumoral administrating of JX-594 for treatment of hepatic metastases from colorectal cancer”

Peer Reviewed

False

True

True

False

Funding Source

LEO Pharma Inc.

Ontario Research Fund

Ontario Institute for

Cancer Research

CBCF

Total Amount

10 000.00

85 000.00

End Date

2011/08

2013/03

2013/07

2012/04

Start Date

2009/08

2009/03

2009/07

2009/04

PublicationsJournal Article

1. Hameed SM, Schuurman N, Razek T, Boone D, Van Heest R, Taulu T, Lakha N, Evans DC, Brown DR, Kirkpatrick AW, Stelfox HT, Dyer D, van Wijngaarden-Stephens M, Logsetty S, Nathens AB, Charyk-Stewart T, Rizoli S, Tremblay LN, Brenneman F, Ahmed N, Galbraith E, Parry N, Girotti MJ, Pagliarello G, Tze N, Khwaja K, Yanchar N, Tallon JM, Trenholm JA, Tegart C, Amram O, Berube M, Hameed U, Simons RK. Access to trauma systems in Canada. J Trauma. 2010 Dec;69(6):1350-61.

2. Asano Tk, Soto C, Poulin EC, Mamazza J, Boushey RP. Assessing the impact of a 2-day laparoscopic intestinal workshop. Can J Surg 2011 Jun 1;54(3):epub ahead of print.

3. Lefort J, Moloo H. Benign Anorectal Pain: A common problem. Canadian Journal of Diagnosis Feb2011 28;2, 64-66.

4. Bass J, Halton J, Drouet Y, Ni A, Barrowman N. Central Line Database: An important issue in quality assurance. Journal of Pediatric Surgery (2011) 46, 942-945.

5. Yarom N, Marginean C, Moyana T, Gorn-Hondermann I, Birnboim HC, Marginean H, Auer RC, Vickers M, Asmis TR, Maroun J, Jonker D. EGFR expression variance in paired colorectal cancer primary and metastatic tumours. Cancer Biol Ther. 2010 Sep;10(5):416-21. Epub 2010 Sep 8.

6. Moloo H, Haggar F, Coyle D, Hutton B, Duhaime S, Mamazza J, Poulin EC, Boushey RP, Grimshaw J. Hand Assisted Laparoscopic Surgery Versus Conventional Laparoscopy for Colorectal Surgery. Cochrane Database Syst Review. 2010 Oct 6;10:CD006585.


7. Bettolli M, De Carli C, Cornejo-Palma D, Kheira J, Xuan-Yu W, Huizinga J, Krantis A, Rubin S, Staines W. Interstitial cells of Cajal (ICC) loss correlates with the degree of inflammation in the human appendix and reverses following inflammation. Neurogastroenterology and Motility Journal (in review).

8. Martel G, Bouchard A, Soto CM, Poulin EC, Mamazza J, Boushey RP. Laparoscopic Colectomy for Complex Diverticular Disease: a Justifiable Choice? Surg Endosc 2010;24 Sept:2273-2280.

9. Huynh H, Trottier DC, Soto CM, Moloo H, Poulin EC, Mamazza J, Boushey RP. Laparoscopic colostomy reversal after a Hartmann procedure: a prospective series, literature review and an argument against laparotomy as the primary approach. Can J Surg 2011 April ;54(2) 133-137

10. Bleier J, Moloo H. Management of Cryptoglandular Fistula in Ano. Seminars in Colon and Rectal Surg Mar2011 22;1 9-14

11. Drover JW, Cahill NE, Kutsogiannis J, Pagliarello G, Wischmeyer P, Wang M, Day AG, Heyland DK. Nutrition therapy for the critically ill surgical patient: we need to do better! JPEN J Parenter Enteral Nutr. 2010 Nov-Dec;34(6):644-52.

12. Hernadez-Alejandro R, Wall W, Jevnikar A, Luke P, Sharpe M, Russell D, Gangji A, Cole E, Kim SJ, Selzner M, Keshavjee S, Hebert D, Prasad GV, Baker A, Knoll G, Winterbottom R, Pagliarello G, Payne C, Zaltzman J. Organ donation after cardiac death: donor and recipient outcomes after the first three years of the Ontario experience. Can J Anaesth. 2011 Jul;58(7):599-605. Epub 2011 May 3.

13. Fayad A, Yang HY, Ruddy TD, Watters JM, Wells GA. Perioperative Myocardial Ischemia and Isolated Systolic Hypertension (ISH) in Non-Cardiac Surgery. Canadian Journal of Anesthesia 2011; 58: 428-435.

14. Chan B, Huynh HP, Moonje V, Price J, Ruben F. Cardiac Tampinade caused by Incarcerated Small Bowel in Pericardium. Ann Thorac Surg 2010;90:641-642

Book Chapter/Article Review1. Chou S, Bettolli M. Malrotation and Midgut Volvulus. Pediatric Review Series: Multiple Choice Questions in Pedatirc Surgery & Extended Matching Questions in Pedatric Surgery. Radcliffe Publications Ltd Submitted June 2010.

Published Abstracts1. Williams LJ, Zolfaghari S, Boushey RP. Complications of Enterocutaneous Fistulas and Their Management. Clinics in Colon and Rectal Surgery 2010 Vol. 23(3).209-220.

2. Williams LJ, Boushey RP. Management of Anastomotic Complications of Colorectal Surgery (including fistulas). Up To Date, Basow DS (Ed), UpToDate Waltham, MA USA 2011. 3. Williams LJ, Boushey RP. Management of Intra-Abdominal, pelvic, and genitourinary complications of colorectalsurgery. Up To Date, Basow DS (Ed), UpToDate Waltham, MA USA 2011. 4. Williams LJ, Boushey RP. Management of perineal complications following abdominal perieal resections. Up To Date, Basow DS (Ed), UpToDate Waltham, MA USA 2011.


5. Nadav Slijper, William Staines, Anthony Krantis, Marcos Bettolli. Expression of neuropeptides in the appendix vermiform during and after inflammation. EUPSA Meeting June 2010.

6. Moloo H, Haggar F, Coyle D, Hutton B, Duhaime S, Mamazza J, Poulin EC, Boushey RP, Grimshaw J. Hand assisted laparoscopic surgery versus conventional laparoscopy for colorectal surgery. Cochrane Database Syst Rev. 2010 Oct 6;10.

7. Carrier M, Boushey RP, Asmis T, Wells P, Jonker D, Auer R.. The Use of Extended Perioperative Low Molecular Weight Heparin to Improve Disease-Free Survival Following Surgical resection of Colon Cancer: a Pilot Randomized Controlled Trial. Thrombosis Research 2010;125(2): S184.

8. Lapierre S., Mohammad W., Balaa F., Akil M., Mimeault R. , Fairfull Smith R. Acute care surgery services: Does it affect the managment of acute cholecystitis? Can. J. Surg Vol 53, Suppl August 2010.

9. Mohammad W, Trottier D, Nadolny K, Poulin Ec, Mamazza J, Balaa F. Application of global operative assessment of laparoscopic skills in a trainer box setting. Can J Surg 2010;53 (4) August:S28.

10. Mohamed W., Trottier D., Nadolny J., Labrosse M., Tardioli K., Poulin EC, Mamazza J, Fairfull Smith R, Mimeault R, Moloo H, Balaa F. Application of Global Operative Assessment of Laparoscopic Skills in A Trainer Box Setting. HPB 12 (suppl. 1) p410 # P-743.

11. Musselman R, Chan B, Gomes T, Moloo H, Auer R, Mamazza J, Poulin E, Mamdani M, Boushey R, AlObaid O. Changing trends in laparoscopic surgery for rectal cancer in the province of Ontario. Dis Colon Rectum. 2011 May;54-(5):e251.

12. Kus A, Mackenzie L, Lemay C, Parato K, Atkins H, Bell J, Auer R. Developing a neoadjuvant murine surgical model of cancer using Vesicular Stomatitis Virus. J ImmunoTher. 2010 Oct;33(8):898.

13. Marginean EC, Asmis T, Auer R, Soulierres D, Simmonds L, Verma S. Development of a comprehensive registry of gastrointestinal stromal tumor (GIST) patients in Eastern Ontario. Ann Oncol. 2010 Oct; 21(suppl 8): viii232.

14. Marginean EC, Asmis T, Auer R, Soulierres D, Simmonds L, Verma S. Development of a comprehensive registry of gastrointestinal stromal tumor (GIST) patients in Eastern Ontario. Proceedings of the 16th Annual CTOS Meet-ing. 2010 Nov; 894167.

15. Moloo H, Haggar F, Coyle D, Hutton B, Duhaime S, Mamazza J, Poulin EC, Boushey RP, Grimshaw J. Hand assisted laparoscopic surgery versus conventional laparoscopy for colorectal surgery. Cochrane Database Syst. Rev.2010 Oct 6;10.

16. Moloo H, Haggar F, Hutton B, Duhaime S, Mamazza J, Poulin EC, Coyle D, Boushey RP, Grimshaw J. Hand Assisted vs Conventional Laparoscopic Colorectal Resections: A systematic Review. EAES book of abstracts.

17. Moloo H, Haggar F, Duhaime S, Hutton B, Grimshaw J, Coyle D, Poulin EC, Mamazza J, Boushey RP. Hand-as-sisted versus conventional laparoscopic colorectal resections: a systematic review and meta-analysis. Can J Surg 2010;53 (4) August:S50.

18. Williams L, Crawford A, McLaughlin K, Mackey M, Moloo H, Mamazza J, Poulin E, Friedlich M, Boushey R, Auer R. Implementation of a regional colorectal cancer communities of practice (CoP) leads to improved quality of care for rectal cancer patients. Dis Colon Rectum. 2011 May;54-(5):e270.

19. Barnes A, Liang S, Auer R, Moloo H, Mamazza J, Poulin EC, Boushey RP. Outcomes of laparoscopic surgery for colorectal cancer: Does sex matter? Can J Surg 2010;53 (4) August:S54.

20. Scheer AS , McSparron JI, Schulman AR, Tuorto S, Gonen M, Gonsalves J, Fong Y, Auer RC. Postoperative venous thromboembolism independently predicts disease-specific survival in cancer patients. Can J Surg. 2010 Aug;53(4):e116.


21. Mohammad W, Mimeault R, Fairfull-Smith R, Auer R, Balaa F Resectability of colorectal liver metastases: an imaging based survey of concordance between hepatic surgeons in Canada. Can J Surg. 2010 Aug;53(4):e96.

22. Marginean EC, Auer R, Asmis T, Verma S. STEP (Stromal Tumor Evaluation for Pathologists) Program: A contemporary diagnostic method of educating pathologists and standardized reporting of gastrointestinal stromal tumours (GIST). Proceedings of the 16th Annual CTOS Meeting. 2010 Nov; 894192.

23. Williams LJ, Morash R, Shin S, Smylie J, Moloo H, Auer R, Poulin EC, Mamazza J, Watters J, Fung-Kee-Fung M, Boushey RP. Successful implementation of a novel communities of practice (CoP) model to facilitate quality improvement initiatives in colorectal cancer surgery. Can J Surg. 2010 Aug;53(4):e143.

24. Davenport E, Haggar F, Trottier D, Huyn H, Soto C, Shamjii FM, Seely A, Sundaresan S, Pagliarello G, Tadros S, Yelle JD, Maziak D, Moloo H, Poulin EC, Mamazza J. Surgical approach and outcomes following paraesophageal hernia repair. Can J Surg 2010;53 (4) August:S14.

25. Zolfaghari S, Auer R, Moloo H, Mamazza M, Friedlich M, Poulin EC, Stern HS, Boushey RP. Surgical outcome of mid- and distal T4 rectal cancer in the neoadjuvant era. Can J Surg. 2010 Aug;53(4):e149.

26. Seth R, MacKenzie L, Kus A, Bell J, Carrier M, Atkins H, Boushey R, Auer R. Surgical stress promotes the development of cancer metastases by a coagulation-dependent mechanism. Can J Surg. 2010 Aug;53(4):e7

Manuscript1. Haggar F, Grimshaw J, Mayhew A, Lybanon V, Poulin EC, Runnels R, Moe, J, Mamazza J, Boushey RP. Education strategies to improve surgical technical skills in operative procedures. Cochrane Database of Systematic Reviews, Issue 12, 2010.

2. Moloo H, Haggar F, Coyle D, Hutton B, Duhaime S, Mamazza J, Poulin EC, Boushey RP, Grimshaw J. Hand assisted laparoscopic surgery versus conventional laparoscopy for colorectal surgery. Cochrane Database of Systematic Reviews, Issue 11, 2010.

3. Haggar F, Mamazza J, Moloo M. Mesh reinforcement versus primary repair in laparoscopic paraoesophageal hernia repairs of the hiatus. Cochrane Database of Systematic Reviews, Issue 11, 2010.

4. Auer RA, Scheer AS, McSparron JI, Schulman AR, Tuorto S, Gonen M, Gonsalves J, Fong Y. Postoperative venous thromboembolism independently predicts disease specific survival in cancer patients. Annals of Surgery (manuscript accepted April 2011).


Division of NeurosurgeryOverview

FacultyThe Ottawa Hospital Dr. Charles Agbi Dr. Brien BenoitDr. Vasco DaSilvaDr. Amin KassamDr. Howard LesiukDr. Michael RichardDr. John Sinclair Dr. Eve Tsai CHEODr. Munyao NzauDr. Enrique Ventureyra - Chief Pediatric Neurosurgery DivisionDr. Michael Vassilyadi

FellowsDr. Sarmand Al-Kawari - Pediatric Neurosurgery Fellowship - CHEO - December 31 2011Dr. Ikhlass Altweijri - Pediatric Neurosurgery Fellowship - CHEO - June 30 2011Dr. Fahad Alkherayf - Peripheral Nerve / Complex Spine Fellowship - TOH - June 30 2011

Dr. Richard Moulton Division Chief and Program Director


Academic EventsThe Division of Neurosurgery hosted the Brien Benoit Visiting Professorship May 2011 Special guest: Dr. Charles Tator, University of Toronto.

Highlights and AwardsJune 5, 2011 Dr. M. Vassilyadi Received Proclamation from the Mayor of Ottawa for injury prevention in Ottawa

March 5, 2011 With the support of a Gala Chairman, Ottawa’s first “Children’s Gala” took place at the Museum of Civilization. $30,000 raised was presented to Ottawa ThinkFirst for head injury prevention initiatives (www.ottawachildrensgala.com). Hosted by Max Keeping and Lianne Laing. Televised on CTV News on March 6th and Rogers T.V. on March 27th. (Dr. Vassilyadi)

October 3, 2010 With the support of the Hellenic Community of Ottawa, raised $40,000 in the “Hike for CHEO” (on October 3rd) and the Hellenic Community of Ottawa first Golf Tournament (on June 29th) for the purchase of a bedside portable ultrasound for the CHEO Emergency Department. Televised on Rogers T.V. on October 24th, October 30th and November 2nd. (Dr. Vassilyadi)

2011 - 2012 Ontario Graduate Scholarship Program, Ontario Ministry of Training, Colleges and Universities and University of Ottawa, Student: Ushananthini Shanmugalingam Project: Biomaterials and Drugs for Endogenous Neural Stem/Progenitor Cell Proliferation and Differentiation, Eve Tsai, Co-Supervisor with Xudong Cao, Ottawa, Ontario, Canada

2011 - 2012 Ontario Graduate Scholarship Program, Ontario Ministry of Training, Colleges and Universities and University of Ottawa, Student: Matthew Cooke Project: Targeting connexins and the extracellular matrix to promote functional spinal cord repair, Eve Tsai, Co-Supervisor with Xudong Cao and Steffany Bennett, Primary Supervisor, Ottawa, Ontario, Canada

2011 First Place, Poster Award Feb 9 2011, University of Ottawa Engineering Research Poster Day 2011, Student: Ushananthini Shanmugalingam Poster: Ushananthini Shanmugalingam, Matt Coyle, Xudong Cao, and Eve C. Tsai, Biocompatibility of Novel Biomaterials for Adult Neural Progenitor Cell Proliferation and Differentiation, Eve Tsai, Supervisor, Xudong Cao, Co-supervisor, Ottawa, Ontario, Canada

2011 Undergraduate Student Research Award, National Science and Engineering Research Council (NSERC), Student: Eric HuangProject: Development of Multifunctional Nanoparticles for Neuronal Labelling, Eve Tsai, Supervisor, Ottawa, Ontario, Canada

2011 Undergraduate Student Research Award, National Science and Engineering Research Council (NSERC), Student: Taryn LloydProject: Biomaterial regulation of endogenous neural stem cell microRNAs, Eve Tsai, Supervisor, Ottawa, Ontario, Canada


2010 - 2020 Endowed Chair in Spinal Cord Research, The Ottawa Hospital, 10 year Salary Support for Eve Tsai, Recipient, Ottawa, Ontario, Canada

2010 - 2011 Ontario Graduate Scholarship Program, Ontario Ministry of Training, Colleges and Universitieis and University of Ottawa, Student: Matthew CoyleProject: Endogenous Neural Stem/Progenitor Cell Proliferation and Differentiation with a Novel Biomaterial, Eve Tsai, Co-Supervisor with Dr. Xudong Cao, Ottawa, Ontario, Canada

PublicationsJournal articles

1. Marin SC, Skinner CR, Da Silva VF. Posterior Fossa Arachnoid Cyst Associated with Chiari I and Syringomyelia.Can J of Neurol Sc. 37 (2):273-275, Sep 2010.

2. Muftah S, Xu Z, El Gaddafi W, Moulton R, Burns B, Woulfe J. Synchronous intravascular large B-cell lymphoma within meningioma. Neuropathology. 1440-1789, 2011.

3. Shamji MF, Purgina B, Flood T, Michaud J, Ventureyra EC. Classification of Symptomatic Chiari I malformation to guide surgical strategy. Can J Neurol Sd, 2010 Jul:37(4);482-7. No abstract available. Feb 13, 2011.

4. Hutchison JS, Fmdova H, Lo TY, Guerguerian AM, Hypothermia Pediatric Head Injury Trial Investigators; Canadian Critical Care Trials Group. Impact of hypotension and low cerebral perfusion pressure on outcomes in children treated with hypothermia therapy following severe traumatic brain injury: a post hoc analysis of the Hypothermia Pediatric Head Injury Trial. Dev Neurosci: 2010,32(5-6);406-12. Epub 2011 Jan 21.

5. Kulkami AV, Warf BC, Drake JM, Mallucci CL, Sgouros, S, Constantini S; Canadian Pediatric Neurosurgery Study Group. Surgery for hydrocephalus in sub-Saharan Africa versus developed nations: a risk-adjusted comparison of outcome. Childs Nerv Syst. 2010 Dec:26(12);1711-7.Epub 2010 Jun 16.

6. Kulkami AV,Warf BC, Drake JM, Mallucci CL, Sgouros S, Caonstantini S; Canadian Pediatric Neurosurgery Study Group. Endoscopic third ventriculostomy vs. cerebrospinal fluid shunt in the treatment of hydrocephalus inchildren; a propensity score-adjusted analysis. Neurosurgery, 2010 Sep;67(3);588-93.

7. McMillan HJ, Sell E, Nzau M, Ventureyra EC. Chiari 1 malformation and holocord syringgomyelia presenting as abrupt onset foot drop. Child’s Nerv Syst 2011 Jan 27(1);183-6, Epub 2010 Sep 2.

8. Shamji MF ,Purgina B , Flood T ,Michaud J, Ventureyra ECG . Pediatic Malignant Peripheral Nerve Sheath Tumour of the Radial Nerve. Can J Neurol Sci, 2010; 37: 524-527.

9. Shamji MF, Purgina B, Flood T, Michaud J, Ventureyra EC. Pediatric malignant peripheral nere sheath tumour of the radial nerve. Can J. Neurol Sci, 2010 Jul;37(4),482-7.

10. Shamji MF, Vassilyadi M. Role of urodynamics in the management of children with tethered cord. Journal of Spinal Surgery 3: July, 2011


11. Shaikh F, Johnston D, Michaud J, Hurteau J, Vassilyadi M, Keene D: Extensive central nervous system involvement in optic pathway gliomas in neurofibromatosis type 1. Pediatr Blood Cancer. Epub: April 4, 2011Vassilyadi M, Tataryn ZL, Alkherayf F, Udjus K, Ventureyra ECG : The necessity of shunt series. J Neurosurg Pediatrics 6:468-473, 2010

12. Trigylidas T, Yuh SJ, Vassilyadi M, Matzinger MA, Mikrogianakis A: Spinal cord injuries without radiographic abnormality at two pediatric trauma centres in Ontario. Pediatr Neurosurg 46:283-289, 2010

Published Abstracts1. Tsai, EC. Biocompatibility of a Novel Biomaterial for Adult Neural Progenitor Cell Proliferation and Differentiation. Congress of Neurological Surgeons, 2011 Secion on Neurotrauma and Critical Care Neruosurgical Forum annual Meeting, October 1-6, Washington, DC, USA, 3:00-4:30pm Monday Oct 3rd. Interactive oral poster, presentation to Section President, senior leadership and attendees. (Award to be given to Best presentation in each section. Abstract no. 116. In Press.

Book Chapters Published1. Shamji, M.F.; Seth, R; Tsai, E. Procedure: Cervical Laminoforaminotomy. Shamji MF, Tsai EC: Cervical Laminoforaminotomy in Fehlings MG (ed): Neurosurgery: Tricks of the Trade, by Dr. Remi Nader, Dr. Scott Berta and Dr. Michael Levy. New York: Thieme 2011, Chpt 176.

2. Vassilyadi M. Dorsal root rhizotomy for the treatment of spasticity. In Panteliadis CP, Strassburg H-M (eds): Cerebral Palsy: Principals and Management, 2nd edition, Thieme, pages 245-250, 2011

3. Vassilyadi M. Intrathecal baclofen therapy for the control of spacticity. In Panteliadis CP, Strassburg H-M (eds): Cerebral Palsy: Principals and Management, 2nd edition, Thieme, pages 237-243, 2011

ResearchGrants

Member and Role

Dr. E Tsai Co-investigator

Dr. E. TsaiCo-Investigator

Title Peer Reviewed

Yes

Funding Source

National / International

Research Alliances Program,

Queensland, Australia

CIHR (Canadian Institute

for Health Research)

Total Amount

$933,460.00

$438,186.00

End Date

2013

2013

Start Date

2010

2010


Member and Role

Dr. E. Tsai Principal Investigator


Dr. E. Tsai Co-Investigator


Dr. V. Vassilyadi Principal Investigator

Dr. V. Vassilyadi Principal Investigator

Dr. V. Vassilyadi Co-Investigator

Dr. V. Vassilyadi Collaborator

Dr. V. Vassilyadi Supervisor

Title Peer Reviewed

Yes

Yes

Funding Source

Rick Hansen Spinal Cord

Injury Registry

Canadian Foundation

for Innovation

CIHR

Lumbar Spinal TractographyDepartment of SurgeryResearch Awards

Ottawa ThinkFirst

CHEO RI

AHSC AFP Innovation

Fund

CIHR

CHEO Surgery Research and Development

Fund

Total Amount

$120 000.00

$177 000.00

$415 947.00

$25.000

$6 000.00

$50 234.50

$52 812.00

$263 965.00

$1 000.00

End Date

2011

2010

2011

2011

2012

2012

2013

2014

Start Date

2009

2008

2008

2010

2011

2011

2011

2010

2010


Division of Orthopaedic Surgery Overview

FacultyGeneral Campus

Dr. Paul Beaulé Adult Reconstruction Dr. Jacques Brunet Foot and AnkleDr. Geoff Dervin Knee reconstruction Dr. Jean Pierre Desjardins General OrthopaedicsDr. Robert Feibel Adult Reconstruction Dr. Alan Giachino Hand and Wrist, Adult Reconstruction Dr. Paul Kim Adult Reconstruction Dr. Karl-Andre Lalonde Foot and Ankle Dr. Peter Lapner Shoulder Dr. J Pollock Shoulder, ElbowDr. Peter Thurston Adult Reconstruction Dr. Joel Werier Orthopaedic Oncology, Upper Extremity

Civic CampusDr. Donald Chow Spine Dr. Kathleen Gartke Foot and AnkleDr. Wade Gofton Trauma, Adult Reconstruction Dr. Donald Johnson Sports Medicine Dr. Garth Johnson Spine Dr. Stephen Kingwell Spine Dr. Allan Liew Trauma, Sports Medicine Dr. Joseph O’Neil Spine, Adult Reconstruction Dr. Steven Papp Trauma, Upper extremity Dr. Oliver Portner Sports Medicine Dr. Eugene Wai Spine Dr. Ross Wilkinson Sports Medicine

CHEODr. James Jarvis Pediatric Orthopaedics Dr. Ken Kontio Pediatric Orthopaedics Dr. Louis Lawton Pediatric Orthopaedics Dr. Paul Moroz Pediatric Orthopaedics Dr. Baxter Willis Pediatric Orthopaedics

Dr. Geoff Dervin Chair


Message from the Chair

The Division of Orthopaedic Surgery is once again happy to highlight many of the remarkable achievements in the academic year July 1, 2010 until June 30, 2011.

As the year concluded, a large of faculty and residents were preparing to travel to St. Johns, Newfoundland for the annual Canadian Orthopaedic Association Meeting where once again the Division found excellent representation in original scientific articles, posters, symposia and instructional course lectures. The exposure of the Division is now higher than it has ever been nationally and this is a testament to the excellent work being carried out by the staff, both clinically and in research areas. This same excellence is gaining notice through undergraduate, postgraduate, orthopaedic residents and fellows who are seeking to come to participate in the experience in Ottawa.

While there were no formal additions to the attending orthopaedic staff during this past year, we do thank and recognize the excellent contribution by Dr. Oliver Portner who is moving to more full-time duty within the military orthopaedics at the Montfort Hospital. Dr. Portner enthusiastically jumped into his role within the academic centre as part of the merger with the Riverside Hospital over 10 years ago and was a strong participant in Rounds, clinical education and ultimately research with a publication in the Journal of Bone & Joint Surgery this past year.

The Residency Training Program continues to be held in high esteem and is powered by Dr. Joel Werier, a tireless promoter of postgraduate issues and his strong Residency Training Committee populated by a number of surgeons with master’s degrees in education and with excellent resident representation as well. These open lines of communication and communal work continue to address issues that ultimately will enhance the learning at the resident level. The formal opening of The Ottawa Hospital and University of Ottawa Skills Simulation Centre at the Civic Campus has provided a state-of-the-art facility for small group teaching, both simulator and cadaveric training with facilities that are second to none in Canada. It is with thanks to the subspecialties leaders that we are able to provide the world-class care that The Ottawa Hospital strives for while maintaining the highest academic research and education standard consistent with our Mission to the University of Ottawa.

Dr. Don Chow was seriously injured in a motorcycle accident, but has thankfully Dr. Chow exceeded the most optimistic expectations as he continuous to make an excellent recovery. The Division owes a debt of gratitude to the members at the Civic Campus and in particular the other members of the Spinal Unit for their help in taking on the additional case load as a result.

The tertiary and quaternary orthopaedic care provided within The Ottawa Hospital lends itself to better be described along the subspecialty lines that follow these comments.

Geoffrey F Dervin, MD, FRCSCHead and Chairman , Division Orthopaedic Surgery

The Ottawa Hospital and the University of Ottawa


Adult ReconstructionSubmitted by Dr. Paul Beaulé

This year was again a very productive year for the Adult Reconstruction Service with over 15 presentations at the Canadian Orthopaedic Association as well as participation from our faculty at various Symposium and instructional course lectures. In the fall we had our Annual visiting Professor, Dr. Wayne Paprosky from Rush University in Chicago who gave several lectures on complex hip revision surgery as well as case discussions with our residents and fellows which was lively and extremely well received.

At the American Academy of Orthopaedic Surgeons, Dr. Paul E. Beaulé organized a combined symposium with the Orthopaedic Research Society entitled New Frontiers in Cartilage Imaging of the Hip discussing most current diagnosis imaging methods of early degenerative disease of the hip using high resolution cartilage mapping techniques. This was highlighted in the AAOS headlines and will be published in the Instructional Course Lectures in 2012. Again this year we held the 9th edition of the Joint Preserving and Minimally Invasive Surgeries Symposium in collaboration with Hospital for Special Surgery in New York which was a great success with over 100 attendees and 35 Faculty members (Figure 1). In addition, for the first time the proceedings of the Symposium were published in the Journal of Bone and Joint Surgery with a selection of over 26 articles from the 2009 Ottawa meeting. Some of the research showcased Dr. Paul Kim’s work metal ions with the Conserve Plus® hip resurfacing system as well as scientific papers by Drs Catelas, Lamontagne and Rakhra.

In May of this year, Dr. Dervin and Johnson held the first Comprehensive Knee Symposium in Ottawa which took place at the new surgical simulation laboratory with over 60 attendees from all over the country as well as an international faculty from Europe. Dr. Kim was again chairman for an industry sponsored meeting looking at primary and revision hip surgery.

Our clinical research unit has continued to be extremely active. This year we welcomed Mr. Kyle Kemp as our new research manager for our research team which includes: Mrs. Heather Belanger, Kimberly Bell, Sarah Plamondon and Miss Gillian Parker. After several months of effort, we now have online patient data entry at our clinics using the ORTECH system. Dr. Dervin initiated a collaboration with Dr. Lamontagne in looking at knee kinetics and kinematics pre and post knee replacement surgery and collaborating this with function outcome. Dr. Feibel has continued his research on the impact of diabetes on surgical morbidity with hip and knee replacement surgery in close collaboration with Dr. Kelly from the Endocrinology department. As noted above, one of our main focus is the development of multi-disciplinary collaborations with Faculty Health Sciences (Drs. Lamontagne and Poitras), Mechanical Engineering (Drs. Catelas and Ngnabe) and Department of Radiology (Drs. Schweitzer and Rakhra). This year saw two Master’s student complete their thesis in Mechanical Engineering as a result of the generousity from the Hans Uhthoff Fellowship Fund.

Foot and AnkleSubmitted by Dr. Karl André Lalonde

The Foot and Ankle group continue to provide excellent clinical care while developing the research program and maintaining their educational mission.

On the clinical front, the group provides a comprehensive tertiary level program for Foot and Ankle pathologies ranging from forefoot deformities to neuropathic ankle fractures. The ankle arthroplasty program is growing and attracting patients from all across Ontario. The role of ankle arthroscopy has also been evolving and our group continues to offer this expertise to our community. The demand for our services in the Eastern Ontario region is sustained and timely care of Foot and Ankle patients continues to be a challenge, both locally and nationally.


On the research front, Dr. Gartke is investigating the role of popliteal fossa blocks in the day surgery setting. Dr. Brunet has been involved in wound care education at a regional level. Dr. Lalonde continues to collaborate with the Canadian Orthopaedic Foot and Ankle Surgeons (COFAS) in prospectively studying patients undergoing ankle arthroplasty and ankle fusion as part of a national database. Studies are also ongoing comparing various bone graft substitutes alternatives to autologous bone graft for hindfoot and ankle fusions.

The group has been represented as invited speakers at various educational meetings across Canada. This year, Dr. Lalonde also represented the University of Ottawa and our Division as the 2010 Canadian-French-Belgian-Swiss Travelling Fellow.

Resident education continues to be a focus for the group. Bi-weekly Foot and Ankle conferences are held at the General Campus. The group also contributes to the half-day academic sessions and runs a successful journal club with the residents. On the national stage, Dr. Lalonde continues his involvement as a Royal College Examination Co-Chair and Dr Brunet participated as faculty at the Canadian Orthopaedic Research Forum in Calgary. Dr. Lalonde continues to pursue post-graduate studies in medical education and is also involved in a study examining the quality of newly introduced online in-training evaluations. Overall, the group has noted an increasing interest in foot and ankle surgery amongst the resident group, with many graduating residents seeking fellowship opportunities in this area.

Musculoskeletal oncologySubmitted by Dr. Joel Werier

The Musculoskeletal Oncology Unit at the University of Ottawa provides comprehensive tertiary care for patients with sarcoma and related musculoskeletal tumours from Ottawa and Eastern Ontario, including the paediatric population at the Children’s Hospital of Eastern Ontario. The program is involved with teaching at the graduate and undergraduate level and has fostered academic research collaborations with other Canadian oncology centers as well as the Departments of Diagnostic Imaging and Medical Oncology at the Ottawa Hospital.

An active collaborative basic science research program continues with the Ottawa Hospital Research Institute and the lab of Dr. John Bell investigating the role of oncolytic virus for the treatment of musculoskeletal neoplasm.

Our continued collaboration with the Department of Radiology with Drs. Mark Schweitzer, Greg Cron, Gina DiPrimio, Adnan Sheikh and Ian Cameron evaluating dynamic contrast enhanced MRI and its role as a prognostic tool for musculoskeletal neoplasia.

The Musculoskeletal Oncology Program continues to maintain a prospective database of functional and oncological outcomes on all sarcoma patients. A dedicated sarcoma tumour-banking program maintains tumour samples on all sarcoma patients to complement the database.

From an educational perspective there are weekly teleconferenced sarcoma teaching rounds as well as bi-weekly multidisciplinary sarcoma conferences and bi-weekly paediatric tumour review boards. There is an annual MSK oncology journal club for orthopaedic residents as well as multidisciplinary journal clubs. Residents are exposed to multidisciplinary clinics at the Ottawa Hospital Cancer Centre and the Children’s Hospital of Easter Ontario.

An orthopaedic oncology fellowship program has been a very positive addition to the unit and to the experience of the residents. Dr. Hesham Abdelbary and Dr. Sabig Edrees were musculoskeletal oncology fellows in 2010-2011.

The musculoskeletal oncology program welcomes the addition Dr. Garth Nicholas (medical oncology). We note the retirement on Susan Commons (Pathology) and recognize her many years of dedicated service and teaching.


Dr. Werier is Chair of the University of Ottawa Musculoskeletal Oncology Unit (Sarcoma site Group), Co-PI of the Ottawa Hospital tumour banking program, secretary of the Canadian Orthopaedic Oncology Society (CANOOS), a member of Cancer Care Ontario’s sarcoma clinical guidelines group and sits on Cancer Care Ontario’s expert panel for provincial sarcoma care delivery

Pediatric Orthopaedics (CHEO)Submitted by Dr. Jay Jarvis

InternationalAll members are involved in International Outreach Programs in developing countries including both teaching and operating. Baxter Willis, as past President of the Pediatric Orthopaedic Society of North America, has toured the globe representing the world’s leading Pediatric Orthopaedic Society. Most recently, this took him to Iran where he participated in the Annual Meeting of the Iranian Orthopaedic Association. Paul Moroz has returned to both Bhutan and Tanzania where he is involved in teaching and surgery. Ken Kontio has visited Antarctica as part of a medical team while Jay Jarvis and Lou Lawton have returned to Quito, Ecuador with the Canadian Association of Medical Teams Abroad.

ProgramsKen. Kontio has initiated a dedicated Clubfoot Clinic with its concomitant opportunities for resident teaching and research. The VEPTR program, under Paul Moroz has expanded and provides care for the young children with asphyxiating thoracic dystrophy obviating transfer to other centers. Lou Lawton has initiated a Pediatric Shoulder program which provides shoulder arthroscopy for the skeletally immature.

TeachingAll five members of the Division remain dedicated to resident and student teaching with three members on the Resident Training Committee. Ken Kontio has been awarded the Masters of Education (University of Ottawa) and is also in the inaugural class of the Distinguished Teacher Program (University of Ottawa). Paul Moroz was nominated at the spring convocation for the Medicine Excellence in Mentorship Award.

Research and PublicationsThe Pediatric Orthopaedic Division remains active in research with recent publications on foot deformities, children’s scaphoid injuries, teaching and surgical skills, effects of alternative payment plans on surgical practice, and anaesthetic aspects of paediatric surgery. The Division is also active with a number of multi-centre studies and grants including the use of E-Health for scoliosis pre-op teaching, the prevalence of femoral acetabular impingement in paediatric population, and provision of safer surgery in communities in Africa.

SpineSubmitted by Dr. Eugene Wai

As the only children’s spinal unit in Eastern Ontario, it provides the whole range of spinal surgical care including trauma, deformity, degenerative and tumour in the Champlain LHIN as well as a quaternary referral centre for northern Ontario and Nunavut. The spine unit is involved in daily clinical education of fellows, residents and medical students as well as organizing and presenting weekly multidisciplinary teaching rounds under the supervision of Dr. Stephen Kingwell. The combined adult orthopaedic and neurosurgical spine program at the University of Ottawa continues to progress towards being recognized as one of the top programs in the country. Dr. Garth Johnson has returned from a humanitarian sabbatical this past year in Sri Lanka providing orthopaedic and spinal care for Medecins Sans Frontieres. Dr. Eugene Wai has been promoted to the rank of Associate Professor this year and has been


appointed director of research for the Canadian Spine Society. His research program continues with the development of tools to better manage the flow of patients referred for assessment and is investigating the role of physical activity as a cause and a treatment in the chronic low back pain. As well, the Spine Unit has recently received funding to research and develop improved triage methods to identify surgical candidates and reduce wait lists. Provincial support has been obtained to hire a Physician Assistant to further integrate the multidisciplinary nature of spinal care. Minimally invasive spinal surgery continues to grow with the addition and development of techniques using computer assisted 3D navigation and percutaneous fixation.

Sports MedicineSubmitted by Dr. Geoff Dervin

Historically, Sport Medicine has encompassed soft tissue and arthroscopic reconstruction of most joints in addition to the conservative treatment of soft tissue injuries, many in the pursuit of athletic endeavours. As the complexity of reconstructive procedures has advanced, it has become difficult for a single individual to be expert in the global arena of Sport Medicine and the overlap with joint reconstruction is evolving. Our philosophy has been to promote and encourage the development of joint specific surgeons who retain an expertise in all manners of soft tissue and ultimately prosthetic reconstruction of joints in addition to being facile with soft tissue reconstructions. Soft tissue sports reconstruction remains the focus for both Drs. Don Johnson (past president of the Arthroscopy Association of North America) and Ross Wilkinson for the treatment of local high level athletes. Several others in the Division combine arthroscopic treatment with more complex bony reconstructions to complement this soft tissue work.

The highlight of the Sport Medicine year was the visit by Dr. Thomas DeBerardino from Connecticut, who served as the Sport Medicine Visiting Professor in February, 2011. The visit opened with a Wednesday night informal dinner with discussion of various topics and pertinent ones related to resident training and job prospects. Thursday provided a forum for presentation of interesting cases and a didactic presentation by Dr. DeBerardino followed by a demonstration of a novel tibial osteotomy technique and practice with saw bone models in the Skills Lab.

Finally Drs. Johnson and Dervin co-chaired a national Knee Symposium which took place in May, 2011 which was the inaugural meeting at the Skills Centre which was very well received and provided an excellent forum for hands-on cadaveric training in all aspects of knee reconstruction and that was highlighted by broad based national attendance from every province across the country.

TraumaSubmitted by Dr. Allan Liew

The Orthopaedic Trauma Service comprised of Drs. Gofton, Liew, and Papp and the most recent addition to the team Jodi Pachal, the first graduate year of the Ministry of Health’s physician assistant program. They upheld its mandate as a centre of excellence in the treatment of traumatic musculoskeletal injuries with multiple areas of activity in over 1000 operative cases at the Civic Campus alone.

In trauma research, the second phase of the study on VAC treatment of fasciotomy wounds in compartment syndrome in a porcine model was completed. The group was also involved in several randomized clinical trials in conjunction with the Canadian Orthopaedic Trauma Society (COTS) , including operative vs non-operative treatment of AC joint injuries, intramedullary vs extramedullary treatment of intertrochanteric hip fractures, DHS vs cannulated screws for femoral neck fractures, the FLOW study for open fractures, comparison of 3 fixation methods for distal radius fractures, ulnar nerve transposition for distal humerus fractures, operative vs nonoperative treatment for ulnar shaft fractures, and operative vs non-operative treatment of humerus fractures. Research


assistant Julia Foxall has kept these studies on track, and she has managed the trauma database well. Hani Zamil successfully completed his trauma fellowship, and has continued with a subsequent fellowship in knee surgery with Dr. Dervin at the General campus.

The staff members have been actively involved as teaching faculty at national and international courses, as well as presenting symposiums at trauma society meetings.

The “Walking Wounded” program has continued to expand at all 3 campuses, providing ambulatory fracture treatment for an increasing number of patients, simultaneously improving patient satisfaction with their care while improving hospital patient flow through. The team has continued to exceed the provincial average for the mandate of expedient treatment of hip fractures.

Upper Extremity ServiceSubmitted by Dr. Peter Lapner

The Upper Extremity Service provides a multispecialty approach to the care of patients. In 2010, members of the Upper Extremity Service had approximately 5500 patient visits and performed more than 650 surgical procedures. In addition, members of our service treated a significant number of patients with complex upper extremity trauma as referred to our Service within the Champlain LHIN. With this volume of cases, we have been able to acquire a significant volume of information on the functional and quality of life outcomes of surgical procedures; information that is being used to improve techniques. This effort is being further advanced as data is now being collected prospectively on procedures related to the rotator cuff, instability surgery, shoulder arthroplasty as well as acromio-clavicular joint procedures and shoulder fractures.

The service has recently completed three large-scale randomized controlled trials. Two such trials involved repair of the rotator cuff and the third investigated two different surgical approaches in shoulder replacement surgery.

Basic science research is carried out in the Orthopedics Biomechanics Laboratory. Among other studies, the optimal surgical exposure for open elbow procedures is currently being investigated. The anatomy of the biceps tendon is currently under investigation, as it applies to repair of distal biceps ruptures. A simulator for the shoulder has been created, and has now been modified to work as an elbow simulator as well, for the assessment of kinematics of the shoulder and elbow. The optimal method of rehabilitation following shoulder arthroplasty, given the limitations of a fresh tendon repair, is also currently under investigation. As well, investigations are also underway to determine the relationship between Smith’s distal radial fractures, and carpal instability.

From an educational perspective, the service continues to train residents and fellows with a comprehensive schedule that includes weekly specialty-specific teaching rounds in addition to other regular clinical activities.


Postgraduate Orthopaedic EducationProgram Director: Dr. Joel Werier

The Post Graduate Residency Program is the life blood of the academic environment for the Division of Orthopaedic Surgery. We currently have 31 residents and mark the graduation from the program of Drs. Michael Lapner, Sulaiman Almousa, Will McCormick, Maurice Tom-Pack, Salah Elfatori, and Othman Ramadan. A special thanks to Dr. Michael Lapner for his leadership in the role of Chief Resident.

The Division continues to attract both Canadian and International fellows to various subspecialties. The 2010-2011 academic years saw nine fellows distributed among the subspecialties of arthroplasty, upper extremity, trauma, oncology, paediatrics, sports medicine and arthroscopy.

A vibrant academic program continues under the guidance of a dedicated postgraduate education committee. In addition to the academic half day program there are daily teaching rounds at both the Civic and General Campuses covering all subspecialty areas, as well as an ongoing teaching program at CHEO. In addition we hold monthly journal clubs and four visiting professorships a year. Drs. Wade Gofton, Karl Lalonde, and Ken Kontio have all pursued advanced degrees in surgical education and their expertise enhances our ability to deliver innovative educational initiatives. In particular we have implemented a series of innovative surgical skills labs at the new skills centre which has been a welcome addition to the academic program.

We are indebted to Dr. Eugene Wai who completed a very successful seven year tenure as director of research. Dr. Peter Lapner will take on the role of Director of Research for the 2011 – 2012 academic year. The culmination of our academic year was the presentation of the resident research papers at H.K. Uhthoff day in April. Dr. Pierre Guy from British Columbia was the visiting professor and moderator for the event. Many of the research presentations were accepted to national and international meetings, and are en route to peer reviewed publication, testifying to the quality of the research.

Our residents continue to secure prestigious fellowships and have taken leadership roles at both academic and community practices around the continent. A program is defined by its human resources, and we are fortunate to have attracted top quality individuals who are engaged learners and teachers, who enhance our educational and academic programs at every level.

Director of Research Dr. Eugene Wai Visting professors Academic year 2010-2011

November 3, 2010 Arthroplasty Visiting Professor Wayne G. Paprosky, MD, FACS Professor Rush University Medical Center Chicago, Illinois 60612 November 24. 2010 Research Visiting Professor Dr. Kellie Leitch Orthopaedic Pediatric Surgeon at Hospital for Sick Children in Toronto Associate Professor at University of Toronto Chair of the Ivey Centre for Health Innovation and Leadership


Director of Health Sector MBA Program at Richard Ivey School Business, University of Western Ontario

March 24, 2011 Sports Medicine Visiting Professor Dr. Thomas Deberardino Associate Professor, Dept. of Orthopaedic Surgery University of Connecticut Health Center Farmington, Ct 06030 April 28, 2011 H.K. Uhthoff Visiting Professor Dr. Pierre Guy Associate Professor and Clinical Scientist Department of Orthopaedic Surgery UBC Vancouver, British Columbia

H.K. Uhthoff Annual Research Day Thursday, April 28, 2011 The Ottawa Hospital – General Campus Main Auditorium

Visiting Professor Dr. Pierre Guy Vancouver, B.C.

Dr. Guy is an orthopaedic surgeon sub-specialized in orthopaedic trauma, practicing at Vancouver General Hospital, which is a level one Trauma centre in British Columbia. He originates from Montreal where he completed his medical school training and residency at McGill University. He then pursued Orthopaedic Trauma Fellowship training in Germany and in Vancouver as an R.S. McLaughlin Fellow. He additionally holds a Masters degree (MBA) from Concordia University’s Molson School of Business.

He is an Associate Professor with the UBC Department of Orthopedics where he teaches and carries out his research work. He is a research leader at the UBC Centre for Hip Health and Mobility a CFI-funded facility, where he is in charge of the Hip

Fracture Treatment and Prevention Program. He is Associate Director of Graduate Education for the Centre. His research work spans many domains related to hip fractures including: Epidemiological and Health Services Research using Administrative Data Bases and Lab-based work in Mechanical and Materials Engineering. He finally pursues clinical research work on proximal humerus fractures and other general orthopaedic trauma topics.

A former Royal College Chief examiner in Orthopedics in 2007, he has extensive experience in the medical education of orthopaedic trauma at local, provincial, national, and international levels. He teaches at the Faculty of Medicine at UBC and in Engineering at the Faculty of Applied Sciences. He teaches residents, fellows and colleague orthopods on trauma related topics and has a specific interest in teaching family practitioners and emergency physicians about the primary care of musculoskeletal injuries.


Funded StudiesCivic Campus1) Fluid Irrigation Techniques in Patients with Open Fracture Wounds: A Multi-Center Blinded Randomized Controlled Trial (FLOW)

Principal Investigator: Dr. Steven Papp; Division of Orthopaedic Surgery, Department of Surgery

Co- Investigators: Dr. Gofton, Dr. Liew, Dr. Wai; Division of Orthopaedic Surgery, Department of Surgery

Funding Agency: Physician Services Incorporated Foundation (PSI) Orthopaedic Trauma Association (OTA) Canadian Orthopaedic Foundation (COF) CIHR Amount: 1 756 616

Dates: December 2006 – present

Summary: Patients with open fractures are at risk for developing an infection, with up to 50% infection rates if their open fracture is severe or becomes grossly contaminated due to the mechanism of their injury. Surgeons can decrease the risk of infection with their initial surgical wound care techniques, with a thorough irrigation and debridement of the open wound as the most important initial step to preventing infection in open fractures. There is currently no clinical evidence on the optimal pressure of irrigation or irrigation additives. Objective: To conduct a pilot study for a blinded (patients and outcome assessors), 2 x 2 factorial design randomized trial to investigate whether irrigation solution (soap vs. saline solution), or irrigation pressure (high vs. low) will decrease the rate of infection among patients with open fracture wounds. We hypothesize that soap solution may be more effective for reducing risk of infection among patients with open fractures compared to saline solution, and that low-pressure irrigation will result in fewer complications than high-pressure irrigation.

2) A Multi-Centre-Randomized Control Trial Comparing a Novel Intramedullary Device (InterTAN) Versus Conventional Treatment (Sliding Hip Screw) of Geriatric Hip Fractures


Co-Investigators: Dr. Gofton, Dr. Liew, Dr. Wai; Division of Orthopaedic Surgery, Department of Surgery

Funding Agency: OTA

Dates: December 2008 – present

Summary: Newer implants to repair hip fractures are typically intramedullary nail designs (IMN), in which a metal nail is placed within the canal of the femur and a large-diameter screw is placed in the centre of the femoral head. The theoretical advantage of newer designs is based upon, first, an improved stability of the implant, allowing earlier and more aggressive mobilization; and second, a less invasive surgical procedure to minimize blood loss. The InterTAN device (IT) has been designed to improve stability after fixation of intertrochanteric fractures. This device has a double proximal hip screw, to achieve rotational control; improved implant geometry, to improve immediate stability; and immediate compression to achieve stability while avoiding uncontrolled leg length changes. The IT device retains the percutaneous insertion technique of other IMN devices and simplifies insertion with redesigned instrumentation. The InterTAN device is the first device designed specifically to provide enhanced stability to intertrochanteric fractures and seems to offer significant promise compared to other IM designs. The InterTAN device has not, as of yet, been compared to conventional surgical techniques. According to the Cochrane Database Reviews, “Any new design should be evaluated in a randomised comparison


with the sliding hip screw.” We wish to determine whether the theoretical advantages offered by the InterTAN device will translate into improved function and mortality for elderly patients with hip fractures, compared to treatment with conventional treatment using a sliding hip screw.

3) A Prospective Randomized Trial Comparing Open Reduction and Internal Fixation, Non-Spanning External Fixation, and Closed Reduction with Percutaneous in Displaced Distal Radius Fractures with Joint Congruity


Co-Investigators: Dr. Johnson, Dr. Gofton, Dr. Wai; Division of Orthopaedic Surgery, Department of Surgery

Funding Agency: Orthopaedic Trauma Association (OTA)

Dates: November 2007 – present

Summary: Distal radius fractures, the majority of which are displaced, are one of the most common orthopaedic injuries and are the most common fracture in adults, particularly among mature Caucasian women. An estimated 800,000 distal radius fractures occur in the US each year. Osteoporosis is the primary risk factor for this fracture with white women over the age of 50 years having a 15 percent lifetime risk of distal radius fracture as compared to 2 percent lifetime risk in men of the same age and geographic origin. The population in North America is ageing, with an expected doubling of the number of individuals over 65 years of age between now and 2050. As a consequence, the incidence of this injury will continue to increase, as will its impact on health care systems. In 1995, the care of distal radius fractures alone accounted for $385 million USD in the United States. Primary research question: Is open reduction and internal fixation with modern plate-screw constructs more efficacious than percutaneous pinning or external fixation in restoring function of the hand and wrist following displaced distal radius fractures with joint congruity? Secondary research questions: Does open reduction and internal fixation (ORIF) provide more rapid functional recovery? Does ORIF improve objective measures of physical function? Does ORIF restore radiographic anatomy more accurately?

4) A Multicenter Randomized Clinical Trial of Non-operative versus Operative Treatment of Acute Acromioclavicular Joint Dislocation


Co-Investigators: Dr. Gofton, Dr. Liew; Division of Orthopaedic Surgery, Department of Surgery

Funding Agency: Orthopaedic Trauma Association (OTA), Osteosynthesis and Trauma Care Foundation (OTC)

Dates: May 2008 – present

Summary: Acromioclavicular (AC) joint dislocation is one of the most common shoulder injuries seen in the general orthopaedic practice2. Classification of this injury is necessary to determine what type of care an individual receives to treat the dislocated joint. A Type I AC joint separation involves damage to the ligaments that form the joint without complete rupture, while Type II AC separation involves complete tearing of the acromioclavicular ligament as well as a partial tear of the coracoclavicular ligaments. Rockwood et al. classified the complete tearing of the acromioclavicular and the coracoclavicular ligaments with 100% dislocation of the joint as a Type III AC joint injury3. Type IV includes an avulsion of the coracoclavicular ligament from the clavicle and distal clavicle impalement posteriorly into trapezial fascia, while Type V includes severe vertical displacement of the clavicle into, or through, the delto-trapezial fascia.

The literature on the treatment approaches for a complete dislocation of the joint (Type III, IV and V) reveals a conflicting assortment of treatment methods. Both non-operative and operative management reveals imperfect success rates and potential associated complications7. The results of operative treatment, however satisfactory, are nearly the same as those obtained when non-operative treatment is employed, and thus, the routine


operative treatment of these acute high-grade AC joint dislocations is not supported.

The literature suggests that there is a trend towards non-operative treatment for initial care of Type III AC joint dislocations; however, the issue still remains as to what patient characteristics and identifiers are specific to, and benefit from, which treatment outcomes7. Occupational and sporting activities that require overhead work and/or repetitive motion may be interrupted due to pain and mechanical symptoms (i.e. instability) following the disruption of the synchronous scapuloclavicular rotation that normally occurs with an intact AC joint1. This finding has prompted some surgeons to recommend operative treatment for the stabilization of the AC joint in specific patients8,9. Also, when operative treatment is considered, Weinstein et al. found a trend towards better results with the ligament reconstruction was performed within three weeks of injury9. These points need to be evaluated and clarified. With respect to high-grade acute Type IV and V injuries of the AC joint, it is generally thought that operative treatment is required due to the morbidity associated with the severe soft tissue disruption and a persistently dislocated joint2. Yet, there are no comparative or prospective randomized studies to support this view.

5) BioSET - A multi-center, prospective, parallel group, randomized, pilot study evaluating safety and preliminary effectiveness of Prefix compared to iliac crest bone in participants with degenerative disc disease undergoing transforaminal lumbar interbody fusion (TLIF): PFX-101.

Principal Investigator: Dr. Eugene Wai; Division of Orthopaedic Surgery, Department of Surgery

Co-Investigators: Dr. Kingwell, Dr. Johnson; Division of Orthopaedic Surgery, Department of Surgery and Dr. Tsai; Division of Neurosurgery, Department of Surgery

Funding Agency: BioSET Inc.

Funding: Total Provided: $29,333.86 CAD

Dates: January 2009 - ongoing

Summary: Lumbar spinal fusion (transforaminal lumbar interbody fusion: TLIF) remains the treatment method of choice for serious degenerative disc disease (DDD) and the sole option for the end stage of the treatment continuum. The current standard of care for spine fusion requires the use of internal fixation complemented with a biological component, autograft, which is harvested from the iliac crest of the patient and requires a second surgical procedure during the same anaesthetic. Autograft is effective in achieving fusion in 60%-90% of procedures; however it comes at a high patient cost in terms of additional pain, blood loss, recovery time and possible infection at the bone donor site, as well as a significant financial cost due the operative time and staff utilization required for the second surgical procedure. Hence, there is a desire to develop alternative techniques as effective as iliac crest autograft but without the associated morbidity and cost. BioSET’s product ‘Prefix’ is the combination of a synthetic peptide coating (B2A: composed of 45 synthetic amino acids that enhance the osteoinductive signal required to start the bone repair process) and ceramic granules [bone void filler (BVF)]. Together, the B2A synthetic peptide and BVF of Prefix provides an osteoconductive matrix for cells to move into and guide their bone growth. The primary objectives are as follows: 1) assess feasibility and parameters for larger definitive study; 2) evaluate the safety and preliminary effectiveness of two coating concentrations of Prefix B2A™ Peptide Enhanced Ceramic Granules in combination with locally-derived autograft in adults with degenerative disc disease who are undergoing transforaminal lumbar interbody fusion (TLIF); 3) assess the preliminary effectiveness of Prefix compared to autologous iliac crest bone graft control at 6 months and 12 months after surgery.

6) FAITH: Transfusion Trigger Trial for Outcomes in Cardiovascular Patients Undergoing Surgical Hip Fracture Repair



Co- Investigators: Dr. Papp, Dr. Gofton, Dr O’Neil, Dr. Liew, Dr. Kingwell; Division of Orthopaedic Surgery, Department of Surgery

Funding Agency: Canadian Institutes for Health Research (CIHR)

Funding: Total Provided: $500.00 CAD

Dates: April 2009 – ongoing

Summary: The primary objective of this study is to assess the impact of sliding hip screws versus cancellous screw fixation on rates of revision surgery at 2 years in individuals with femoral neck fractures. The secondary objective is to determine the impact on health-related quality of life (Short Form-12, SF-12), functional outcomes (Western Ontario McMaster Osteoarthritis Index, WOMAC), and health outcome (EuroQol-5D, EQ-5D).

7) RECORD 4 Study – Part 2: Retrospective Chart Review to Abstract any Unreported AE/SAE Data that will Facili-tate the Completion of the New US FDA NDA Evaluation


Funding Agency: Bayer Healthcare Inc.


Dates: March 2010 – April 2011

Summary: In order to facilitate the United States Food and Drug Administration in completing the new drug ap-plication (NDA) evaluation relating to rivaroxaban (Xarelto®), Bayer HealthCare and their partner Ortho-McNeil-Jansen Pharmaceuticals, Inc. and its affiliate Johnson & Johnson Pharmaceuticals Research and Development, L.L.C. requested that any data relating to unreported adverse events (AE) or serious adverse events (SAE) from the study period and the ~2 years since study completion be collected from the RECORD 4 Study (Protocol #: 2006820-01H) sites.

8) Does a Simple 3-Item Questionnaire Reduce Wait Times for Consultations for Patients Who Would Benefit from Lumbar Surgery? A Pilot Prospective Randomized Controlled Trial


Co-Investigators: Dr. Kingwell; Division of Orthopaedic Surgery, Department of Surgery and Dr. Tsai; Division of Neurosurgery, Department of Surgery

Funding Agency: TOHAMO


Dates: March 2011 – ongoing

Summary: Requests for spinal surgery consultation are currently prioritized according to the information in the referral letter from the family physician and the MRI or CT radiology report. Surgeons review this information and patients are prioritized into an approximate time frame in which they should be seen (i.e., “urgent”, “routine”, or “non-urgent”). However, previous research has demonstrated extremely poor correlation between information in the referral letter and the patients’ presenting clinical assessment. Given the risk of chronic LBP becomes much higher as patients languish on wait lists, often without adequate evidence-based primary non-operative treatment, and the direct and indirect costs of chronic pain for a single patient add up to hundreds of thousands of dollars, even modest improvements in the timely identification of appropriate surgical candidates will have a dramatic


impact not only on patient outcomes but also health-care utilization costs. The primary objective of this study is to use a self-administered 3-item questionnaire, developed by our group, to improve identification of appropriate surgical candidates for elective lumbar surgery and reduce their pre-surgical consultation wait times. The secondary objectives of this study are to: compare post-surgical follow-up outcomes assessments between the treatment arms; explore other factors that may aide in identification of surgical candidates; document course of lumbar pain and disability while waiting for surgical consultation; assess health care utilization amongst patients on surgical consultation waiting list. 9)The Ottawa Surgical Competency Operating Room Evaluation (O-SCORE) – Evaluation of a Tool to Assess Surgical Competence Across Specialties

Principal Investigator: Dr. Wade Gofton, Division of Orthopaedic Surgery, Department of Surgery

Co-investigators: NL Dudek MD MEd FRCPC, TJ Wood PhD, F Balaa MD MEd FRCSC, SJ Hamstra PhD

Start Date and Duration: July 2010 (9 month duration)

Funding Agency: Physician Services Incorporporated

Funding: $23,850 (July 2010-July 2011)

Summary: The present study is a follow-up to a pilot of a novel surgical assessment tool anchored on competency for independent practice in an orthopaedic surgery program. The tool demonstrated a significant effect of post-graduate year (PGY) level with higher scores for increases in training level except for PGY 4 and 5 regardless of procedure type. Qualitative analysis indicated that the staff surgeons found the easy to use and trainees found it improved feedback. Analysis of the original scale has allowed for refinement to a nine question tool which we have named the Ottawa Surgical Competency Operating Room Evaluation (O-SCORE) and which plan to assess across specialties.

The objectives of this study are:1) To assess the reliability and validity of the O-SCORE for the assessment of surgical competence in the post-graduate surgical trainee.

2) To assess for generalizability of this competency based surgical assessment tool across surgical procedures and specialties.

We anticipate that the O-SCORE will reliably discriminate between junior and senior surgical residents, and ideally between specific years. We also anticipate that the O-SCORE will be feasible and reliable across specialties and procedure type.

We have included an arthroscopic and laparoscopic procedure in this assessment. While we anticipate that the O-SCORE will remain valid for these procedures, as it does not utilize specific technical skills, we recognize the potential that it will not given the definite differences between open and laparoscopic surgical techniques. Regardless, the analysis of the quantitative and qualitative data regarding the applicability of the O-SCORE for laparoscopic procedures will be useful as surgical educators work towards finding reliable assessments of competence for these surgeries. These results will be used to inform further development of the scale if necessary.

10)The Ottawa Surgical Competency Operating Room Evaluation (O-SCORE) – Development of an Electronic Competency Based Surgical Evaluation

Principal Investigator: WT Gofton MD MEd FRCSC, Division of Orthopaedic Surgery, Department of Surgery

Co-Investigators: NL Dudek MD MEd FRCPC, Steve R Papp MD Med FRCSC, TJ Wood PhD, SJHamstra PhD

Funding Agency: AIME


Funding: $25,000 (June 2011-July 2012)

Surgical training programs are responsible for ensuring the competency of their graduates. This includes their ability to perform the various surgical procedures safely and successfully. In most training programs, a resident’s ability to do these procedures is evaluated by general observations documented under the single item of “technical skills” on an In-training Evaluation Report (ITER). We have developed and novel competency based surgical evaluation tool (O-SCORE) that demonstrated a significant effect of post-graduate year (PGY) level with higher scores for increases in training level except for PGY 4 and 5 regardless of procedure type. Qualitative analysis indicated that the staff surgeons found it easy to use and trainees found it improved feedback. In this study the O-SCORE will be converted to an electronic format and assessed for continued validity and feasibility. Thirty volunteer surgical trainees from the Division of Orthopaedic Surgery at the University of Ottawa will collect electronic O-SCORE evaluations when any of six pre-selected procedures are performed during a 4-month period. The psychometric characteristics of the electronic scale will be examined to determine reliability and validity. Following the quantitative data collection period, two focus groups will be conducted to gather information on the utility of the scale, and to provide valuable input, which can be used as part of the ongoing effort to improve content validity. The feasibility of using the O-SCORE to develop a ‘competency based’ procedure log will also be evaluated.

12)The Development of an Electronic Competency Based Procedure Log – linking the Ottawa Surgical Competency Operating Room Evaluation (O-SCORE) with a Procedure Log

Principal Investigator: Wade Gofton MD MEd FRCSC, Division of Orthopaedic Surgery, Department of Surgery Co-Investigators: Nancy Dudek MD MEd FRCSC, Steve R Papp MD MEd FRCSC, TJ Wood PhD, Stan J Hamstra PhD, Kent Hadden, Jodi Pachal

Funding Agency: TOHAMO

Funding: $103,250 (June 2011- June 2013)

Summary: Surgical training programs are responsible for ensuring the competency of their graduates. This includes their ability to perform the various surgical procedures safely and successfully. In most training programs, a resident’s ability to do these procedures is evaluated by general observations documented under the single item of “technical skills” on an In-training Evaluation Report (ITER). While trainees are increasingly required to maintain procedure logs, unfortunately the result is often a log of procedural performance lacking content validity rather than a reflection of trainee’s operative ability.

We have developed and novel succinct competency based surgical evaluation tool (O-SCORE) that provides both summative and formative feedback. Using multiple assessors and by rating the trainee with respect to readiness for independent performance of the particular procedure (as opposed to comparing them to peer group i.e. ability to do this procedure relative to other PGY2) the O-SCORE proved to be one of the first technical performance assessment tools to differentiate between year of training.

In this study the O-SCORE will be converted to an electronic format and linked to an electronic procedure log to develop an innovative ‘competency based’ procedure log. This would be a powerful tool in proving surgical competency for index procedures within a surgical specialty. This information would allow a program to objectively demonstrate trainee competence or quickly identify a trainee in need of extra assistance. Programs could utilize this information to improve efficiency in training, allowing residents to progress based on competence rather than time on service. Finally a large electronic database would have the potential to determine the average number of procedures required to achieve competence in each index procedure. An electronic ‘competency-based’ procedure log would be an invaluable tool in demonstrating competency in Ontario’s future surgeons, and an important tool in ensuring a continued high standard of patient safety and quality of care.


General CampusMember and Role: Beaulé, Paul; PITitle: Femoroacetabular Impingement: Correlating Hip Morphology to Changes in Cartilage and Subchondral BonePeer reviewed: YesFunding Source: CIHRTotal Amount: $581,782 over 5 yearsStart Date: October 2009End Date: September 2014

Member and Role: Beaulé, Paul; Co-ITitle: Detection and Simulation of Femoroacetabular ImpingementPeer reviewed: YesFunding Source: CIHR/NSERC/IMHATotal Amount: $507,300 over 3 yearsStart Date: April 2011End Date: March 2014

Grants CHEOMember and Role

Paul Moroz, principal investigator, S. Carson, P. Beaule, H.Dunlap, L. Ward, B. Willis,

Co-applicants: R. Lett, Lorne Braune, T Razek, K Mbolekwa, D Wallis, A Howard, P Moroz, G Hollar, J Christilaw, S Logsetty, G Leifsa, F Couturier.

Jarvis, JamesPrinicpal InvestigatorWright,JamesCo-investigator

Title

A Pilot Study to Assess the Prevalence of CAM-type Femoroacetabular Impingement in an Asymptomatic Pediatric Population.

Safer Surgery, Obstetrics and Communities in Africa (grant proposalfor funding of Canadian Network for International Surgery programs in 9 African countries).

Improving Education and coping of scoliosis patients undergoing surgery and their families using e-health

Peer Reviewed

No

Yes

Funding Source

The Ottawa Hospital RI;

CHEO RI; CHEO Surgical

Associates Fund

Canadian International Development

Agency (CIDA),

Government of Canada,

grant # S064830-001


Grant MOP 79485

Total Amount

$25,000.00

$2.18 million

$5704.00

End Date

September 2011

2013

March2012

Start Date

September 2010

September 2010

Novembre 2008


Member and Role: Beaulé, Paul; PITitle: A Randomized Clinical Trial of a Modular Cementless Acetabular Metal on Poly Component versus a Monoblock Cementless Titanium Shell with Ceramic on Ceramic Bearing and CORAIL Stem: A Bone Mineral Density StudyPeer reviewed: YesFunding Source: Johnson and Johnson Medical ProductsTotal Amount: $311,064Start Date: April 2011End Date: Ongoing

Member and Role: Beaulé, Paul; Co-PITitle: Mobility Assessment of a Dual Mobility Hip Arthroplasty for Osteoarthritic Hip: Feasibility for a Prospective Randomized Controlled TrialPeer reviewed: NoFunding Source: Medacta International SA, Strada ReginaTotal Amount: $96,687 Start Date: January 2010End Date: Ongoing

Member and Role: Beaulé, Paul; PITitle: Do MRI Findings Correlate with Hip Pain and Radiographic Findings: Development of a Better Diagnostic Tool for Surgical InterventionPeer reviewed: YesFunding Source: Department of SurgeryTotal Amount: $25,000Start Date: September 2009End Date: Ongoing

Member and Role: Beaulé, Paul; Co-PITitle: Pregabalin in the Prevention of Post-Operative Delirium and PainPeer reviewed: YesFunding Source: Physician Services Incorporated Foundation (PSI)Total Amount: $159,000Start Date: September 2009End Date: August 2011

Member and Role: Beaulé, Paul; PITitle: Randomized Clinical Trial of a Cemented Versus Cementless Femoral Component for Metal Hip Resurfacing Assessing Bone Mineral DensityPeer reviewed: NoFunding Source: Corin LtdTotal Amount: $7,600 quarterlyStart Date: May 2009End Date: Ongoing

Member and Role: Beaulé, Paul; PITitle: A Prospective Randomized Clinical Trial Comparing Ion Levels and Clinical Outcomes of the CONSERVE® A-Class Total Hip System with BFH Technology to Metal on Polyethylene Total Hip Replacement


Peer reviewed: NoFunding Source: Wright Medical TechnologyTotal Amount: $800/ppStart Date: June 2007End Date: Ongoing

Member and Role: Dervin, Geoff; PITitle: Feasability of Outpatient Total Knee ArthroplastyPeer reviewed: YesFunding Source: The Ottawa Hospital Academic Medical Organization (TOHAMO)Total Amount: $89,500Start Date: June 2010End Date: Ongoing

Member and Role: Lalonde, Karl-André; PITitle: A Multi-Center, Randomized, Pilot Study Evaluating Amplex Compared To Autograft Bone In Foot and Ankle Fusion SurgeryPeer reviewed: NoFunding Source: BioSETTotal Amount: $6,700 US/ppStart Date: Feb 2011End Date: Ongoing (recruitment closed; follow-ups ongoing)

Member and Role: Lalonde, Karl-André; PITitle: Prospective, Randomized, Multi-Center Clinical Evaluation of the Open Wedge Osteotomy and Low Profile Plate & Screw (LPS) System Compared to the Proximal Chevron Osteotomy for the Treatment of Hallux Valgus with an Increased Intermetatarsal AnglePeer reviewed: NoFunding Source: Arthrex IncTotal Amount: $3,000.00 start up and $380.00 per patientStart Date: December 2008End Date: Ongoing

Member and Role: Lalonde, Karl-André; PITitle: A Prospective, Randomized, Controlled, Multi-Center, Pivotal Human Clinical Trial to Evaluate the Safety and Effectiveness of Augment™ Injectable Bone Graft Compared to Autologous Bone Graft as a Bone Regeneration Device in Foot and Ankle FusionsPeer reviewed: NoFunding Source: BioMimetics TherapeuticsTotal Amount: $7,501 US/ppStart Date: August 2009End Date: May 2011 (recruitment closed; follow-ups completed)

Member and Role: Lapner, Peter; PITitle: Comparison of Two Methods of Fixation of Subscapularis During Shoulder Arthroplasty Peer reviewed: YesFunding Source: Physicians Services Incorporated (PSI) Total Amount: $97,000


Start Date: March 2008End Date: May 2011 (recruitment closed, follow-ups completed)

Member and Role: Lapner, Peter; Co-ITitle: Autologous Bone Marrow-Derived Cellular Augmentation in Rotator Cuff RepairPeer reviewed: YesFunding Source: CIHRTotal Amount: $866,864 over 5 yearsStart Date: October 2010End Date: September 2015

Member and Role: Pollock, J; PITitle: A Single Blinded, Multi-center, Randomized, Controlled, Pilot Study to Evaluate the Safety and Performance of Augment™ Rotator Cuff for Primary Surgical Treatment of Full Thickness Rotator Cuff Tears Peer reviewed: NoFunding Source: BioMimetics TherapeuticsTotal Amount: $6,636 US/ppStart Date: October 2010End Date: July 2011 (recruitment closed; follow-ups completed)

Orthopaedic Biomechanics Laboratory1) CT assessment of a third generation shoulder implant: Replicating native shoulder anatomy

Principal Investigator: Dr. Peter Lapner; Department of SurgeryCo- Investigators: N/AFunding Agency: N/AFunding: N/ADates: May 2011 - present Summary: Total shoulder arthroplasty is a common procedure in the treatment of degenerative shoulder disease, with demonstrated efficacy in pain relief and improved range of motion. Despite its success, relatively high complication rates have remained a significant problem. Implant loosening has been particularly problematic in first and second generation devices, accounting for up to 30% of all reported complications. Inaccurate replication of native anatomy has been implicated as the primary cause, leading to altered joint motion, contact kinematics, centre of rotation, and rotator cuff tensioning. Current, third generation, total shoulder arthroplasty systems offer a much greater range of component sizing and offset options than earlier implants. This modularity is thought to allow for more accurate reconstruction of native joint anatomy, alleviating some of the problems found in previous designs. The purpose of this project is to assess the accuracy of a third generation shoulder implant through pre and post operative CT morphometric analysis.

2) Development and validation of an unconstrained in vitro knee joint simulator

Principal Investigator: Dr. Daniel Benoit; University of OttawaCo- Investigators: Dr. Geoffrey Dervin; Department of Surgery


Funding Agency: CFIFunding: $30,000Dates: March 2010 - present Summary: The objective of this project is to develop a physiologically accurate static knee simulator. As a research tool, the simulator allows for controlled in vitro exploration of various physiological and kinematic parameters of the human knee joint. The knee simulator’s main advantage is the ability to reproduce physiological loads without any artificial external constraints. It simulates six individual muscle groups which can be adjusted to reproduce various joint loading strategies. The simulator, combined with the Tekscan system, can be used to measure changes to tibio-femoral contact pressure distribution under accurate physiological loading conditions. Furthermore, developing this simulator will allow for the experimental validation and verification of several computer simulation models currently employed in biomechanical research. The completion of the static simulator, will allow for future modifications in the form of dynamic muscle load and control. This will provide an even wider array of possible investigations into the biomechanics of the knee joint.

3) Autologous stem cell augmentation in rotator cuff repair

Principal Investigator: Dr. Guy Trudel; Bone and Joint LaboratoryCo- Investigators: Hans K. Uhthoff; Bone and Joint Laboratory, Dr. Peter Lapner; Department of Surgery, Dr. J Pollock; Department of Surgery, Dr. Donald Russell; Carleton University Funding Agency: CIHRFunding: N/ADates: January 2010 – present Summary: The rotator cuff tendon of the shoulder is the most commonly injured tendon in human. Surgical repair of the tear is a most common procedure. Unfortunately the failure rate of this procedure is unacceptable high and long-standing continuity between tendon and bone is achieved in only one out of two patients. Not repairing or failed repairs cause pain, muscle wasting and retraction, fat accumulation which is irreversible, weakness, lack of range of motion and decreased upper limb function for patients. Historically, surgical repair consisted of opening the skin and muscles, creating a bony through while bony sutures temporarily held the tendon until healing. Recently, arthroscopic rotator cuff surgery replaced the open surgery. Now the current arthroscopic procedure excludes bone marrow-derived mesenchymal stem cells (MSC) from participating in the repair. Many believe MSC are essential contributors to healing the tendon and their timely recruitment in large numbers could improve the success of tendon attachment surgery. We aim to test this concept in both an animal model and a human trial. The distinguishing feature of this research is the unique timing for recruiting bone marrow cells to initiate the healing. Our hypothesis is that the bone marrow cells will not only accelerate the healing but also increase the success of the surgery and the patient’s shoulder function.

4) Biomechanical Evaluation of the Long and Short Heads of the Distal Biceps Contribution to Elbow Flexion Strength and Forearm Supination Strength Principal Investigator: Dr. Steven Papp; Department of SurgeryCo- Investigators: Dr. J Pollock; Department of SurgeryFunding Agency: PSIFunding: Pending Dates: September 2009 – present Summary: Distal biceps tendon (DBT) ruptures are often treated by surgical repair. Non-operative treatment results in weakness in both flexion and supination. The goal of surgery is to restore normal strength to the elbow. The treatment of partial biceps tendon ruptures is more controversial. Patient outcomes are acceptable with non-operative treatment. However, delayed surgery is not uncommon. Treatment guidelines for partial biceps tendon ruptures have not been established. Some authors have recommended non-operative treatment


for tears involving less then 50% of the tendon and surgical repair for tears exceeding 50%. Surgery consists of completion of the partial tendon rupture followed by tendon to bone fixation using various methods. However, this approach may be over simplifying the complex anatomy of the distal biceps tendon. This project will look at defining the contribution of the distal short head (SH) and long head (LH) of the biceps to arm function in flexion and supination. It will also look at the effect of the location of the insertion site on the radius for the repair of DBT ruptures.

5) Oxford unicompartmental knee arthroplasty: Effect of procedural deficiencies on lateral compartment contact pressure and knee alignment Principal Investigator: Dr. Geoffrey Dervin; Department of SurgeryCo- Investigators: N/AFunding Agency: BiometFunding: $30,000Dates: September 2009 – present Summary: Unicompartmental knee replacement is an established procedure for the treatment of medial compartment osteoarthritis. Registry outcome data consistently shows early revision rates of close to 5% in the first 3 years, which is significantly higher than with total knee replacement. One concern is the frequency with which technical error can lead to this early failure. The goal of the study is to help define the possible procedural errors with a mobile bearing UKR using surgical navigation and a Tekscan pressure system in a cadaver model. 6) Cartilage Degeneration in Femoro-Acetabular Impingment

Principal Investigator: Dr. Paul Beaulé; Department of SurgeryCo- Investigators: Dr. Schweitzer, Department of Radiology; Dr. Frei, Carleton University; Dr. Lamontagne, University of OttawaFunding Agency: CIHRFunding: $551,782Dates: October 2009 – September 2013 Summary: Femoro-acetabular impingement (FAI) is a deformity of the hip joint and has been recently identified as a potential major cause of hip osteoarthritis (OA). However, some people have been identified who have a characteristic sign of FAI deformity but do not exhibit OA symptoms. The goal of this study is to morphologically characterize the deformity in live patients and to investigate the stresses in the cartilage and bone that may explain degenerative changes in the tissues. This will give a better understanding of cartilage degeneration as well as a better assessment of who is at risk of developing OA. This is a multi-centre project that makes use of novel medical imaging techniques, motion analysis, mechanical testing, histological analysis and computer simulation to investigate arthritic changes in the joint. 7) Objective Comparison of Lateral Surgical Approaches to Radial Head and Capitellum Fractures Principal Investigator: Dr. J Pollock; Department of SurgeryCo- Investigators: N/AFunding Agency: N/AFunding: N/ADates: Preliminary work Summary: Various approaches are currently available for the open reduction and internal fixation (ORIF) of capitellum and radial head fractures. To achieve this, the elbow can be exposed from the posterior, lateral and anterior aspect, and many approaches for each have been described. The optimal technique and positioning of


the patient for ORIF of these fractures is determined pre-operatively depending on the fracture pattern and pathology. However, there is a lack of literature comparing articular surface visible and accessible within the surgical approach options. The purpose of this study is to compare the visualization of the articular surface of the elbow joint using four different lateral approaches. Determining the approach that allows optimal exposure for specific articular surfaces of the elbow can assist in preoperative planning and ultimately facilitate internal fixation of capitellum and radial head fractures. 8) Development of a Pizoelectric Transducer to Measure Intramuscular Pressures Principal Investigator: Dr. Hanspeter Frei; Department of Mechanical Engineering (Carlton U) Co- Investigators: Dr. Peter Lapner; Department of Surgery, Dr. Marcias Martinez: Institute for Aerospace Research (NRC)Funding Agency: NRCFunding: $5000Dates: Preliminary work Summary: The objective of this study is to validate a computer model and develop a miniature prototype piezoelectric transducer (PZT) as proof of concept. The PZT will allow for the direct measurement of intramuscular and intratendinous pressures in order to better approximate muscle forces across various joints. The individual muscle force data will be invaluable in future biomechanical analyses and will allow for improved rehabilitation protocols as more is understood about the contributions of individual muscles. 9) Spine Helix Principal Investigator: Dr. Hanspeter Frei; Department of Mechanical Engineering (Carlton U)Co- Investigators: Dr. Wai, Department of SurgeryFunding Agency: NSERCFunding: $112,043Dates: Ended December 2010. Summary: Osteoporosis related fractures are among the most common causes of disability and are a major contributor to medical care cost in many parts of the world. The surgical treatment of osteoporotic fractures usually requires the fixation of bone fragments with screws, which remains a significant clinical challenge. A novel medical device has been designed for the enhanced fixation of bone screws in osteoporotic bone. The new device is an expandable nut in the form of a helix which can be inserted and radially expanded into trabecular bone through a pre-drilled hole. This novel device is expected to significantly increase the fixation strength of bone screws in osteoporotic bone, which would avoid the disadvantages of other techniques used for this purpose such as supplementary cement fixation. The new device will also decrease the time of surgery. The goal of this study is to determine the fixation strength and stability of pedicle screws inserted with and without the new device. 10) Recession of the Patellar Tendon Insertion for Surgical Exposure During Knee Surgery: A Biomechanical Study Principal Investigator: Dr. Geoffrey Dervin; Department of SurgeryCo- Investigators: N/AFunding Agency: N/AFunding: N/ADates: Feb 2007 - present Summary: Satisfactory surgical exposure during total knee arthroplasty (TKA) requires sufficient translation of the patella, sometimes requiring partial soft tissue release, such as at the insertion site of the patellar tendon.


Subsequent rupture of the tendon disrupts the extensor mechanism of knee, a devastating complication of TKA. There are currently no guidelines on an acceptable extent of patellar tendon release to avoid rupture that are based on a biomechanical evaluation of the surgical technique. The objective of this study is to determine the decrease in tendon insertion strength due to a partial release of the insertion site; a secondary objective is to determine the increase in lateral translation of the patella afforded by the release. Following a standard anteromedial approach and partial insertion release, patellar translation will be measured with an optoelectronic motion tracking system with a static force applied. The contralateral knee, without tendon release, will serve as a control. The patellar tendon will subsequently be tested under cyclic force followed by a load to failure to evaluate the strength of the insertion against avulsion. This study will provide surgeons with guidelines on acceptable tendon release and the effect on exposure of the knee joint during TKA.

Publications1. Sink EL, Beaulé PE, Sucato D, Kim YJ, Millis MB, Dayton M, Trousdale RT, Sierra RJ, Zaltz I, Schoenecker P, Monreal A, Clohisy J. Multicenter Study of Complications Following Surgical Dislocation of the Hip. J Bone Joint Surg Am. 2011 May 13. [Epub ahead of print]

2. Canadian Hip Resurfacing Study Group. A survey on the prevalence of pseudotumors with metal-on-metal hip resurfacing in Canadian academic centers. J Bone Joint Surg Am. 2011 May;93 Suppl 2:118-21.

3. Kim PR, Beaulé PE, Dunbar M, Lee JK, Birkett N, Turner MC, Yenugadhati N, Armstrong V, Krewski D. Cobalt and chromium levels in blood and urine following hip resurfacing arthroplasty with the Conserve Plus implant. J Bone Joint Surg Am. 2011 May;93 Suppl 2:107-17.

4. Almoussa S, Barton C, Speirs AD, Gofton W, Beaulé PE. Computer-assisted correction of cam-type femoroac-etabular impingement: a Sawbones study. J Bone Joint Surg Am. 2011 May;93 Suppl 2:70-5.

5. Lamontagne M, Brisson N, Kennedy MJ, Beaulé PE. Preoperative and postoperative lower-extremity joint and pelvic kinematics during maximal squatting of patients with cam femoro-acetabular impingement. J Bone Joint Surg Am. 2011 May;93 Suppl 2:40-5.

6. Rhee PC, Woodcock JA, Clohisy JC, Millis M, Sucato DJ, Beaulé PE, Trousdale RT, Sierra RJ; Academic Network for Conservational Hip Outcomes Research Group. The Shenton line in the diagnosis of acetabular dysplasia in the skeletally mature patient. J Bone Joint Surg Am. 2011 May;93 Suppl 2:35-9.

7. Lamontagne M, Varin D, Beaulé PE. Does the anterior approach for total hip arthroplasty better restore stair climbing gait mechanics?J Orthop Res. 2011 Sep;29(9):1412-7. doi: 10.1002/jor.21392. Epub 2011 Mar 15.

8. Beaulé PE, Kim PR, Hamdi A, Fazekas A. A prospective metal ion study of large-head metal-on-metal bearing: a matched-pair analysis of hip resurfacing versus total hip replacement. Orthop Clin North Am. 2011 Apr;42(2):251-7, ix.

9. Nganbe M, Khan U, Louati H, Speirs A, Beaulé PE. In vitro assessment of strength, fatigue durability, and disassembly of Ti6Al4V and CoCrMo necks in modular total hip replacements. J Biomed Mater Res B Appl Biomater. 2011 Apr;97(1):132-8. doi: 10.1002/jbm.b.31794. Epub 2011 Feb 2.

10. Beaulé PE, Salineros M, Rakhra K. Acetabular labral limbus as a cause of hip pain: a report of five cases. J Bone Joint Surg Am. 2011 Jan 5;93(1):91-6. No abstract available.

11. Hack K, Di Primio G, Rakhra K, Beaulé PE. Prevalence of cam-type femoroacetabular impingement morphology in asymptomatic volunteers.J Bone Joint Surg Am. 2010 Oct 20;92(14):2436-44.


12. Barton C, Salineros MJ, Rakhra KS, Beaulé PE. Validity of the alpha angle measurement on plain radiographs in the evaluation of cam-type femoroacetabular impingement.Clin Orthop Relat Res. 2011 Feb;469(2):464-9.

13. Lamontagne M, Beaulieu ML, Beaulé PE. Comparison of joint mechanics of both lower limbs of THA patients with healthy participants during stair ascent and descent.J Orthop Res. 2011 Mar;29(3):305-11. doi: 10.1002/jor.21248. Epub 2010 Sep 30.

14. Nganbe M, Louati H, Khan U, Speirs A, Beaulé PE. Retrieval analysis and in vitro assessment of strength, durability, and distraction of a modular total hip replacement. J Biomed Mater Res A. 2010 Dec 1;95(3):819-27.

15. Beaulieu ML, Lamontagne M, Beaulé PE. Gait Posture. Lower limb biomechanics during gait do not return to normal following total hip arthroplasty. 2010 Jun;32(2):269-73. Epub 2010 Jun 11.

16. Goulding K, Beaulé PE, Kim PR, Fazekas A. Incidence of lateral femoral cutaneous nerve neuropraxia after anterior approach hip arthroplasty.Clin Orthop Relat Res. 2010 Sep;468(9):2397-404.

17. Sepucha KR, Stacey D, Clay CF, Chang Y, Cosenza C, Dervin G, Dorrwachter J, Feibelmann S, Katz JN, Kearing SA, Malchau H, Taljaard M, Tomek I, Tugwell P, Levin CA. Decision quality instrument for treatment of hip and knee osteoarthritis: a psychometric evaluation.BMC Musculoskelet Disord. 2011 Jul 5;12:149.

18. Khatri PJ, O’Connor AM, Dervin GF. Decision Support Needs of Patients Choosing Between Unicompartmental and Total Knee Arthroplasty for Advanced Medial Compartment Osteoarthritis of the Knee.J Arthroplasty. 2011 Mar 10. [Epub ahead of print]

19. Daneshvar P, Forster AJ, Dervin GF. Accuracy of administrative coding in identifying hip and knee primary replacements and revisions.J Eval Clin Pract. 2011 Jan 11. doi: 10.1111/j.1365-2753.2010.01622.x. [Epub ahead of print]

20. Dervin GF, Carruthers C, Feibel RJ, Giachino AA, Kim PR, Thurston PR. Initial experience with the oxford unicompartmental knee arthroplasty.J Arthroplasty. 2011 Feb;26(2):192-7. Epub 2010 Jul 29.

21. Pollock J, Giachino AA, Rakhra K, DiPrimio G, Hrushowy H, Conway AF, Andreyechen M. SLAC wrist in the absence of recognised trauma and CPPD.Hand Surg. 2010;15(3):193-201.

22. Simon DA, Taylor TL, Bayley G, Lalonde KA. Four-limb compartment syndrome associated with the systemic capillary leak syndrome. J Bone Joint Surg Br. 2010 Dec;92(12):1700-2.

23. Lapner PL, Lapner MA, Uhthoff HK. The anatomy of the superior labrum and biceps origin in the fetal shoulder.Clin Anat. 2010 Jul 6. [Epub ahead of print]

24. Lapner PC, Su Y, Simon D, El-Fatori S, Lopez-Vidriero E. Does the upward migration index predict function and quality of life in arthroscopic rotator cuff repair? Clin Orthop Relat Res. 2010 Nov;468(11):3063-9. Epub 2010 Jul 7.

25. Gortzak Y, Kandel R, Deheshi B, Werier J, Turcotte RE, Ferguson PC, Wunder JS. The efficacy of chemical adjuvants on giant-cell tumour of bone. An in vitro study. J Bone Joint Surg Br. 2010 Oct;92(10):1475-9.

26. Gropper A, Gartke K, MacLaren M. Work-life policies for Canadian medical faculty.J Womens Health (Larchmt). 2010 Sep;19(9):1683-703.

27. Lopez-Vidriero E, Simon DA, Johnson DH. Initial evaluation of posterior cruciate ligament injuries: history, physical examination, imaging studies, surgical and nonsurgical indications.Sports Med Arthrosc. 2010 Dec;18(4):230-7. Review.


28. Kingwell SP, Noonan VK, Fisher CG, Graeb DA, Keynan O, Zhang H, Dvorak MF. Relationship of neural axis level of injury to motor recovery and health-related quality of life in patients with a thoracolumbar spinal injury.J Bone Joint Surg Am. 2010 Jul 7;92(7):1591-9.

29. Portner O, Pakzad H. The evaluation of patellar height: a simple method.J Bone Joint Surg Am. 2011 Jan 5;93(1):73-80.

30. Roffey DM, Ashdown LC, Dornan HD, Creech MJ, Dagenais S, Dent RM, Wai EK. Pilot evaluation of a multidisciplinary, medically supervised, nonsurgical weight loss program on the severity of low back pain in obese adults.Spine J. 2011 Mar;11(3):197-204.

31. Alkherayf F, Wai EK, Tsai EC, Agbi C. Daily smoking and lower back pain in adult Canadians: the Canadian Community Health Survey. J Pain Res. 2010 Aug 26;3:155-60.

32. Roffey DM, Wai EK, Bishop P, Kwon BK, Dagenais S. Causal assessment of workplace manual handling or assisting patients and low back pain: results of a systematic review.Spine J. 2010 Jul;10(7):639-51. Epub 2010 May 26. Review.

33. Masquijo JJ, Willis BR, Kontio K, Dobbs MB. Symptomatic bunionette deformity in adolescents: surgical treatment with metatarsal sliding osteotomy.J Pediatr Orthop. 2010 Dec;30(8):904-9.

34. Firth GB, Roy A, Moroz PJ. Foreign body migration along a tendon sheath in the lower extremity: a case report and literature review. J Bone Joint Surg Am. 2011 Apr 20;93(8):e38. Review. No abstract available.

35. Wright JG, Menaker RJ; Waiting for children’s surgery in Canada: the Canadian Paediatric Surgical Wait Times project. Canadian Paediatric Surgical Wait Times Study Group. CMAJ. 2011 Jun 14;183(9):E559-64. Epub 2011 May 2.

36. Wright JG, Li K, Seguin C, Booth M, Fitzgerald P, Jones S, Leitch KK, Willis B. Development of paediatric wait time access targets.Can J Surg. 2011 Apr;54(2):107-10.

37. Bass J, Guerra L, Willis B. Effects of an alternate payment plan on paediatric surgical practice in an academic setting: the role of corporate indicators.Healthc Q. 2010;13(1):101-4.

38. Masquijo JJ, Willis B. Dysplasia epiphysealis hemimelica (Trevor’s disease).Arch Argent Pediatr. 2010 Feb;108(1):e20-3. Review. Spanish.

39. Martin H, McCarthy J, Baxter WR, Pizzutillo P. Top 10 paediatric orthopaedic surgical emergencies: a case-based approach for the surgeon on call. In: AAOS Instructional Course Lectures. 2011;60:373-95. American Academy of Orthopaedic Surgeons: Rosemont, IL.

40. Masquijo JJ, Jarvis J. Associated talocalcaneal and calcaneonavicular coalitions in the same foot.J Pediatr Orthop B. 2010 Nov;19(6):507-10.

41. Neira VM, Gardin L, Ryan G, Jarvis J, Roy D, Splinter W. A transesophageal echocardiography examination clarifies the cause of cardiovascular collapse during scoliosis surgery in a child.Can J Anaesth. 2011 May;58(5):451-5.

42. Jarvis J, Uhthoff H. Normal knee embryology and development. In: Surgery of the knee, 5th edition. Scott WN, ed. Churchill Livingstone Elsevier, Philadelphia, PA, 2011.

43. Moroz PJ, Malima AK. Common paediatric orthopaedic diseases: reducing the burden of orthopaedic surgi-cal disease in African children using an evidence based, public health approach: selected topics. In: Pediatric surgery: a comprehensive textbook for Africa. GLOBAL-HELP Books, Seattle, WA, 2011.


44. Moroz PJ. Orthopaedic emergencies and traumatology, essential surgical skills course manual, providers manual, third edition. Canadian Network for International Surgery, Vancouver, BC, 2010.

45. Kim C, Vassilyadi M, Moroz PJ. Traumatic spinal injuries in children. Can J Neurol Sci 2010;37(3, Suppl 1):S68.

46. Moroz PJ, Kingwell S. The epidemiology and clinical features of multiple, non-contiguous spine injuries in children. Inj Prev 2010;16(Suppl 1):A193.


Division of Plastic SurgeryOverview

FacultyDr. Mary Jean Duncan CHEO division head, program director

Dr. Danny Peters Course Co-Chairmen for Canadian National Resident Review Course, post graduate resident coordi-nator (civic)

Dr. Yvonne Ying, Course Co-Chairmen for Canadian National Resident Review Course

Dr. Paul Benoit

Dr. Stan Labow Dr. Murray AllenUndergraduate Program Coordinator

Dr. Nicolas Guay Director of Breast Cancer Reconstruction and Micro surgery fellowship

Dr. Gloria RockwellPost graduate resident coordinator (General Campus)

Dr. Lloyd van Wyck

Fellow

Perry Gdalevitch, Breast Reconstruction and Micro Surgery fellowship

Visiting Professor

Dr. Susan McKinnon

Dr. Mario Jarmuske Assistant Professor and Chair


Summary of HighlightsResidency Program

Dr. Mary Jean Duncan is in her fourth year as program director. Dr. Duncan is active chairing meetings from all campuses of the Ottawa Hospital as well as CHEO. On July 10th, Dr. M J Duncan and her husband Mike hosted the residents, their partners, and the Division staff for the 2nd Annual Summer Welcome Party at their cottage. Dr. Howard Silverman from the Queensway Carleton will be our new community representative, while Dr. Ignatiuk and Dr. Klok serve as resident members. We have developed a comprehensive curriculum, including weekly Hands Rounds in tandem with Orthopedic Surgery. Monthly journal clubs have been integrated into the National Capital Society meetings-allowing our residents to meet with community surgeons on a regular basis. Morbidity & Mortality rounds are also held monthly as a quality assurance measure.In picture L-R, Reid Chambers, Justyn Lufty, Ian Maxwell, Ashley Ignetiuk, and Jennifer Klok.

This year we were pleased to have Dr. Reid Chambers matched as a PGY1. Dr. Chambers is from the University of British Columbia faculty of medicine. Additionally, we welcome Dr. Ian Maxwell, transferring from the University of Calgary Cardiac program; joining us as a PGY3. These members will be joining Jennifer Klok (PGY2), Justyn Lufty (PGY2) and Ashley Ignatiuk (PGY4).

In an effort to keep residents optimally organized at all sites, we have maintained two Post-Graduate positions: Dr. Gloria Rockwell coordinating the General Campus, and Dr. Danny Peters functioning as the coordinator at the Civic Campus.

Rapid Access Clinic

As a Division we have been progressing with our conversion from community to hospital-based staff. Presently, the majority of our members are based on-site, with the expectation of all new recruits becoming GFTs. The Civic site is promoting an integrated facility, with the merger of offices, clinics and procedure rooms. Included is the medical, nursing, and therapy staff. Upon completion of the new office building at the General Campus, we anticipate a similar integration process.

Fellowship

Dr. Nicolas Guay is in his forth year as the Plastic Surgery Fellowship Director. The fellowship program was fortunate to have received the Johnson & Johnson Corporation $75,000.00 grant which was used to support fellowship bursaries, continuing education, and research. This past year, Dr. Guay welcomed Dr. Perry Gdalevitch as a full year Fellow. Dr. Gdalevitch will be followed this coming year by Dr. Genevieve Gaudreau, a graduate from the University of Montreal.

Membership Development

As a Division we are pleased to announce Dr. Kirsty Boyd as our next active member. Dr. Boyd graduated from the Plastic Surgery program in her home town of London Ontario in 2009. Under the direction of Dr. Guay, Kirsty completed a six month Breast Reconstruction/Micro-Surgery Fellowship, followed by an additional six month Breast Reconstruction fellowship in Toronto. During this past year, Kirsty completed a one year Peripheral Nerve/Micro-Surgery Fellowship in St-Louis, under the guidance of Dr. Susan MacKinnon. Over the past two years, Dr. Boyd has been proactively involved in our Annual Senior Resident preparatory course. Kirsty will be based out of the Civic Campus, with a dual focus on Breast Reconstruction and Upper Limb/Peripheral Nerve surgery. We eagerly anticipate her arrival!


Unfortunately, after 18 months as an active member, Dr. Hugo St-Amand has resigned from our division, citing personal reasons as his motivation. In order to meet our clinic needs, replacing Dr. St-Amand, we opened a locum position at the General Campus. We are pleased to offer the position to Dr. Ronald Borsuk. Ronny graduated from the McGill Plastic Surgery program in 2010, and will be joining us in September, 2011 for a period of one year. All members warmly welcome Dr. Borsuk.

Our former Chief, Dr. Stan Labow is enjoying an office-based practice, while maintaining a relationship with the University as Assistant Professor. This academic partnership allows Stan to continue his missionary work in Nicaragua, and maintain involvement with our local medical students, including active participation in OSCE examinations.

Dr. Paul Benoit is winding down his practice, with intentions to fully retire from TOH at the end of 2011. Paul maintains a private office, with hospital activities at the Riverside Campus as divisional site head. At the end of June 2011, Dr. Benoit retired from his pediatric appointment at CHEO.

Canadian Plastic Surgery Chief Resident Review Course

Dr. Yvonne Ying and Dr. Danny Peters continue as Co-Chairs of the Canadian National Chief Resident Review Course. The Allergan Corporation supported our third annual event with an unrestricted education grant. The course included; a Royal College caliber written exam, two sets of mock oral exams (available in both official languages), and a comprehensive series of lectures. Local staff was very supportive, with many volunteers giving lectures and/or examinations. In addition, active members joined the Ottawa based event from Canadian coast to coast. It was an honor to have Dr. Susan McKinnon as a special guest speaker; we enjoyed two outstanding lectures related to peripheral nerve injuries and nerve transfers. Left: Yvonne Ying, center: Susan McKinnon, right: Danny Peters.

Membership Activity

Mary Jean DuncanDr. M J Duncan continues her role as the CHEO Chief of Pediatric Plastic Surgery. Additionally, Dr. Duncan is Associate Professor with the University of Ottawa, and our dedicated Program Director. Also, Dr. Duncan continues to work alongside Dr. Peters refining the program curriculum towards excellence in quality and efficacy. All this and M J still makes time to be involved in the Canadian Residency Review Course, hosted in Ottawa.

Mary Jean, as always, has a particular interest in cleft lip/palate deformities, including the chairing of monthly multidisciplinary meetings. Dr. Duncan’s administration responsibilities include; CHEO Dept. Surgery Committee, CHEO OR Committee, Pediatric Surgical Wait Times, and Ambulatory Care Partnership Council.

As the residency program matured, M J handed over her Kemptville satellite Plastic Surgery clinic to Dr. Sachen Chitte. This clinic, which is well attended, focuses on outpatient hand and skin cancer cases. Mary Jean has been invited to review abstracts for the Canadian section of the American Burn Association Meeting as well as the Canadian Society of Plastic Surgery Annual meeting. Dr. Duncan has also recently taken on the role as a Royal College examiner.

Mary Jean continues to participate in the Mentor Program through the University of Ottawa Undergraduate Medical School.


Danny PetersDr. Danny Peters has had a significant impact at CHEO, working in tandem with our Neurosurgery colleges performing complex craniofacial cases, which in years past would have been referred on to Toronto. This past year he accepted a partial GFT position at CHEO.

Yvonne YingDr. Yvonne Ying is well into her third year at CHEO, and is maintaining a broad and busy practice. Dr. Ying has a particular interest in upper limb surgery, including brachial plexus injury cases. This year Yvonne witnessed her first patient with a brachial plexus repair returning upper limb function – a monumental moment in CHEO’s history!

Dr. Ying, completed her Masters in Education (Health Professionals Education) this past year.

Dr. Ying has a broad spectrum interest in teaching; this past year she began mentoring 10 medical students from the University of Ottawa, with six group meetings and activities. Additionally, Dr. Ying supervised a medical student, Alexander Sebaldt, with the creation of a CHEO cleft lip and palate database. Along with Dr. D Peters, Yvonne has developed the Canadian Senior Resident Prep Course including a critical analysis producing a paper titled “Teaching to Learn or Teaching to Pass”- which was recently presented at an international meeting. Locally, she has helped modified the U of O Post-Graduate Resident-as-teacher Curriculum. Yvonne has also become involved with the Principles of Surgery curriculum. Internationally, Yvonne has made a number of contributions: assistance with a plastic surgery training program for senior general surgery trainees in Georgetown Guyana; supervision of a Guyanese resident with rotations both in Ottawa and Toronto, and travelled to China, Uganda and Tanzania teaching different surgical techniques to local surgeons and allied staff.

Murray AllenDr. Murray Allen is a GFT, based out of the Civic Campus. Dr. Allen is the Undergraduate Coordinator for our Division, a member of our Divisional Program Committee and the Division’s AFP representative and treasurer. This past year Murray has also taken on the role of chair for our monthly Morbidity & Mortality rounds.

Murray continues his collaboration with the ENT service at the General Campus, with complex Onco-Plastic Head and Neck Surgeries.

Dr. Allen maintains his ties with the Dermatology program, based out of the Civic Campus. He runs an integrated clinic with Dermatology at the Parkdale clinic on Monday mornings. This coincides with the Mohs clinics at the same campus, offering reconstruction services as needed.

Paul BenoitDr. Paul Benoit is now winding down his practice. Paul has ceased his on-call service since October 2009, with clinics and outpatient ORs based out of the Riverside Campus. Since shifting to the Riverside, he has taken over as Divisional site lead. Paul remains an active member of our Division, engaged in undergraduate and postgraduate teaching. Dr. Benoit continues to give formal lectures at the undergraduate (including PBL) and postgraduate levels (upper extremity orthopedic and skills lab). He also has been a lecturer and examiner for the Senior Resident Prep Course these past two years. He plans to retire from practice at the end of 2011.

Nicolas GuayDr. Nicolas Guay is the Division Site lead for the Civic Campus continuing his focus on Breast Reconstruction. Since 2006, he has been organizing the Breast Cancer and Microsurgery Fellowship, sponsored first by the Mentor Corporation, then Johnson & Johnson. The Fellowship is now international in scale and reputation.

Nicolas has pioneered the concept of “Single Stage” breast reconstruction surgery, whereby patients require only one trip to the main OR. Any other addendum procedures are done in the outpatient setting. This is a progressive approach, which has caught the attention of most in the field. In tandem with this, he has worked hard optimizing efficiency in the OR. This has evolved to the point of formal analysis, using a “four-component training scheme”. He has been invited to speak on these topics across the country. An indication that his


approaches are trend setting is the development of the “Centre of Excellence in Single Stage Breast Reconstruction” in Ottawa. Canadian Plastic Surgeons have been visiting the Ottawa Hospital for an educational session followed by a day of live surgery. These events are held as often as every second week. This past year he has hosted 18 Canadian plastic surgeons, from 13 different cities, and 8 provinces. These concepts were recently presented at an international meeting and have been accepted for publication.

Patient education has also been important to Dr. Guay. Early in his practice he founded the Breast Reconstruction Support Team. It offers quarterly educational seminars in public settings, during which Dr. Guaywill give a presentation on Breast Reconstruction. Also present are breast cancer survivors, who address the audience from a first person perspective. Dr. Guay has morphed this group information session into an Internet webinar, to be accessible to breast cancer survivors.

Dr. Guay was the recipient of a TOHAMO Innovation Grant for “Standardizing Breast Reconstruction Patient Information to Create an Internet-based Information Delivery System”. This was the first TOHAMO grant for a surgical proposal. Nicolas plans for the grant funds ($25,000.00) being forwarded towards the creation of the website. The anticipated launch date is October 19, 2011 – to coordinate with “Breast Cancer Awareness Day”. The development of the website has included input from Plastic Surgeons, Oncologists, patient groups and Family Physicians, and has been reviewed by a statistician.

Dr. Guay has numerous service and administrative responsibilities. In addition to Directing the Breast Reconstruction and microsurgery Fellowship, he is a member of the Canadian Society of Plastic surgery Nominating Committee, member of the Wait Time Strategy for Plastic and Reconstructive surgery, member of both the General and Plastic Surgery Resident Training Committees, Civic OR Committee and a member of the RCPSC Principles of Surgery test committee. He was also a reviewer for the Canadian Journal of Surgery.

Nicolas has mentored a number of students who have gone on to enter Plastic surgery Residency training program in different centers. He has maintained his ties with a number of them, resulting in podium presentations and publications. Locally he has been involved with the CARMS process, as well as the Canadian Senior Plastic Surgery Preparatory Course – both as a lecturer and as an examiner. Mario JarmuskeDr. Mario Jarmuske is in his fourth year as Division Chief working out of the General Campus. As Division Head, Dr. Jarmuske chairs the monthly business meetings, as well as Divisional finance meetings. Over the past three years, Mario has focused on recruitment aiming to create a strong integrated and comprehensive service. Dr. Jarmuske has added doctors Yvonne Ying, Danny Peters and most recently - Kirsty Boyd and Ronny Borsuk to the division. Parallel to Dr. Jarmuske’s effort to recruit new members, he has also worked towards the creation of a hospital-based team in hopes that it will enable greater visibility and accessibility for the division.

Dr. Jarmuske strongly felt that as an academic health center, the need for Plastic Surgery training program was an essential part of the hospital profile. The program has been a success and is also effective in creating cross-service benefits. For example, plastic surgery now has integrated upper limb rounds with orthopedics, greater connectivity with Neurosurgery (both at CHEO and TOH), and we anticipate further integration with General Surgery, ENT, and Dermatology.

Mario has been very engaged with the new teaching program, as an active member of the Program Committee, including CARMS application reviews, interviews and selection processes. Mario greatly enjoys welcoming new residents to the program, and is an active participant with the educational lectures and teaching sessions. In addition he has attended the Senior Resident Preparatory courses these first three years. He is also the University Supervisor for the Breast Reconstruction Fellowship.

As Division Head, Mario is involved with OR, Perioperative, Surgical Executive and Departmental Finance Committee meetings.

Mario has always had an interest in post-bariatric surgery. Now that we have a formal Bariatric Program in


Ottawa, there should be an enhancement in interdivisional ties. Dr. Jarmuske also continues his role as an examiner for the MCCQE part II exams.

Danny PetersDr. Daniel Peters joined our staff in October of 2009 as an Assistant Professor, with active privileges both at CHEO and the Ottawa Hospital. In June of 2010 he also acquired a cross appointment with the Telfer School of Management (University of Ottawa). He is an Assistant Professor, with a Clinician-Teacher tract.

Danny joined the Plastic Surgery Program Committee shortly after his arrival and developed a novel approach for residency selection. He first devised a methodology for reviewing and ranking the CARMS applicants, and then adapted a corporate human resources interview technique for the residency selection process. Two streams of interviews were developed, and applied to all candidates. A national survey on residency selection was present-ed at an international conference and accepted for publication.

Danny has been Dr. Duncan’s right hand man - helping to develop the Plastic Surgery Curriculum for our new program. He is also the Post-graduate Education coordinator for the Civic campus. Along with Dr. Ying, Danny has co-chaired the national review course in plastic surgery. This is the first of its kind in our field and forms a cornerstone for fellowship exam preparation in plastic surgery. Dr. Peters has developed a curriculum of exam preparation, which will be published quarterly in the Canadian Journal of Plastic surgery. He has also developed a curriculum of business development, economics and strategy, also to be published quarterly in the Canadian Journal of Plastic Surgery.

Since acquiring an office at the Civic Campus this January, Danny immediately began to develop strategies for the development of an integrated “rapid access” clinic. Many of the Divisional members have helped to broaden the scope of this initiative. With minor adjustments to the old cancer clinic, including the creation of minor procedure rooms (which can accommodate a mini c-arm), and a centralization of staff to one site. This will allow emergency patients needing Plastic Surgery care to have rapid access to a new treatment facility. With a capacity to shift surgery away from the main OR we will be able to assess the impact on wait times, cost and quality of care. Renovations begin this fall, with hopes of completion in January 2012.

Dr. Peters has been invited as a Plastic Surgery Representative to the Nucleus Committee for the Royal Collage Principles of Surgery examination. He was also invited as a panel moderator for a Craniofacial Surgery segment of the last IPRAS meeting. At the business portion of our last Canadian Society of Plastic Surgeons it was announced that Dr. Peters was invited as an Associate Editor for the Canadian Journal of Plastic Surgery. Well done Danny!

Gloria RockwellDr. Gloria Rockwell has been on staff at the Ottawa Hospital for seven years now. During the first three years, she coupled a full clinical practice with Masters of Science program, based in Hamilton. She now has a Masters of Science degree in Health Research and Methodology from McMaster University. She has supervised a series of medical students through research projects (often via university and personal-supported “summer studentships”). Upon the start of our Plastic Surgery Training Program, Gloria has taken on the new task of Research Coordinator. Each resident in our program will produce at least one paper/year. While president of the National Society of Plastic Surgeons, Gloria organized monthly journal clubs – presented by our three residents. The caliber of presentations was uniformly superb under Gloria’s guidance!

Dr. Rockwell’s practice is heavily focused on breast surgery, with approximately half dedicated to reconstruction. She is involved at all campuses, including surgeries at the General and Civic, with outpatient clinics at both the General and Riverside. While Gloria is currently a VPT, she looks forward to becoming a GFT once office space becomes available at the General Campus.

Gloria has a number of other administrative and service responsibilities. At a Divisional level, she is an active member with our Program Committee, is the General site Post-Grad Coordinator and is an AFP trustee. She is also a CPSP Committee member (Surgical Cosmetic Procedures Working Group). She has just completed a suc-


cessful year as President of the National Capital Society of Plastic Surgeons.

Dr. Rockwell has published a variety of papers again this past year, and has acquired another Grant through the Faculty of Medicine for $4,000.00.

LLyod Van Wyck Dr. Lloyd Van Wyck is a senior Divisional member, now based at the Riverside Campus. Dr. Van Wyck will be the next Riverside Division site lead (following Dr. Benoit’s retirement). He still maintains an outpatient clinic at the Civic, and shares in the Divisional call schedule. Dr. Van Wyck has been very engaged with our new teaching program. With a strong interest in aesthetic surgery, Lloyd will have a central role in this part of the curriculum - which is a core component of all Plastic Surgery training programs.

Grants & Bursaries1. Name: Breast Reconstruction and Microsurgery Fellowship Award Value: $75,000.00 Source: Johnson & Johnson Canada Award Date: July 2009 Renewable: Yes

Comment: Support for fellow bursary, continuing medical education and research

2. Title: Canadian Chief Resident Review Course Source: Allergan Inc. Principal Applicant: Dr. Yvonne Ying /Dr. Danny Peters Total Amount: $75,000.00 Grant Type: Education Teaching - Education Research Role: Principal or Joint Investigator Involvement: Course Chairman Renewable: Yes

Comment: Supporting the Canadian Plastic Surgery Senior Resident Preparatory Course – hosted in Ottawa

3. Title: National Research Grant Source: Johnson & Johnson Canada (Personal award) Total Amount: $50,000.00 Principal Applicant: Nicolas A. Guay M.D. Award Date: 2010 Mar Grant Type: Group/Program (Research) Role: Principal Investigator Renewable: Yes

Comment: Support for research coordinator and statistician to create research database of Dr. Guay’s Single Stage Breast Reconstruction practice (longest series in the world)

4. Title: Standardizing Breast Reconstruction Patient Information to Create an Internet Based Information Delivery System Source: TOHAMO (Peer reviewed) Principal Applicant: Nicolas A. Guay BSC M.D. FRCS Total Amount: $25,000.00 Grant Type: Education Teaching - Education Research (Education/Teaching) Involvement: Principal Investigator

Comment: Breast reconstruction is an important part of breast cancer care. Those who seek reconstruction often receive information during the first consultation with a specialist after a significant waiting period. In order to expedite and improve accessibility to information, we propose to create breast reconstruction patient information system using information verified by national specialists. The objective of this project is to deliver high quality,


standardized information to all breast cancer survivors in Canada through an Internet seminar

5. Title: Plastic Surgery Resident Fund Source: Johnson & Johnson Canada Total Amount: $20,000.00 Principal Applicant: Mary Jean Duncan M.D. Grant Type: Group/Program (Research) Role: Principal or Joint Investigator Involvement: Director of Plastic Surgery Program Renewable: Yes. 6. Title: Development of a Cleft lip and Palate Database Source: CHEO Research Institute Total Amount: $5,000.00 Principal Applicant: Yvonne Ying From: 2011 Apr - 2011 Jul Grant Type: Group/Program (Research) Role: Co-principal Investigator Involvement: Co-Supervisor (with Dr M J Duncan) Trainee Name: Alexander Sebaldt

7. Title: Center of Excellence Source: Johnson & Johnson Canada (Personal award) Principal Applicant: Nicolas A. Guay M.D. Renewable: Yes Grant Type: Group/Program (Research) Role: Principal Investigator.

8. Program Type: * Summer Research Project - Bursary From: 2008 Apr To: present Research Project Title: Early active motion versus intermittent wrist immobilization following open carpal tunnel release surgery. Trainee Name: Blake Murphy Supervisory Role: Primary Supervisor – Dr G Rockwell

Comments: $4000.00 Grant obtained from the University of Ottawa for Summer Student Research Project IPRAS 2011 Podium Session Scientific Podium Presentation: A decision tree for treatment of enchondromas of the metacarpals and phalanges CSPS 63rd Annual Meeting June 2009, Kelowna BC

9. Program Type: * Summer Research Project - Bursary From: 2009 To: present Research Project Title: Evaluation of a global abstract rating scale to increase liability and validity of abstract ranking as compared to the current abstract review form used for the CSPS annual scientific program. Trainee Name: Matthew Murphy Program Type: * Summer Research Project – Bursary Supervisory Role: Primary Supervisor – Dr G Rockwell

Comments: Grant - $4000 - University of Ottawa Student Summership Award $1000 - Dr. G.M. Rockwell


Publications1. Bonaparte JP, Corsten MJ, Allen M. Healing time of radial forearm free flap donor sites after preoperative tissue expansion: randomized controlled trial. J Otolaryngol Head Neck Surg. 2011 Feb;40 Suppl 1:S20-7.

2. Bonaparte JP, Corsten M, Allen M. Cost-effectiveness of a topically applied pre-operative tissue expan-sion device for radial forearm free flaps: a cohort study. J Otolaryngol Head Neck Surg. 2011 Feb;40 Suppl 1:S20-7.

3. Donald Lalonde, MD; Marty LeBlanc ,MD; Mike Bell, MD; Jan Lalonde, RN; Achilleas Thoma, MD;Neil Wells, MD; Murray Allen, MD; Peter Chang, MD; Daniel McKee, BSC; 1504 Consecu-tive Cases of Minor Procedure Field Sterility in Carpal Tunnel Surgery: Is Main Operating Room Sterility Necessary? Vol. 126, No. 4 Supplement to Plastic and Reconstructive Surgery. Published: 2010 Oct.

4. MJ Murphy DA Peters. Primary Intraosseous Hemangioma of the Calvarium: A treatment Algorithm. Canadian Journal of Plastic Surgery Volume 19 Supplement A Summer 2011 p. 9A.

5. A Ignatiuk, M Hale, DA Peters. A Novel Evidence Based Approach to Residency Selection in Plastic Surgery: A National Survey. Canadian Journal of Plastic Surgery Volume 19 Supplement A Summer 2011 p 133A.

6. MJ Murphy, GM Rockwell. A rare case of tendon rupture in a patient with stenosing tenosynovitis who had steroid injection within 7 weeks of surgical release. Can J Plast Surg Vol 19 Suppl A Summer 2011.


Division of Thoracic SurgeryOverview

FacultyDr. Farid ShamjiProfessor, Director of Undergraduate Surgery Education, Director of Esophageal Function Laboratory

Dr. Donna MaziakProfessor, Thoracic Surgery Residency Training Program Director

Dr. Andrew SeelyAssociate Professor, Director of Clinical Research

Dr. Sebastien GilbertAssociate Professor, Director of Section of Foregut Surgery

Residents/Fellows

Dr. James Villeneuve

Dr. Saleh Abu Daff

Dr. Sudhir SundaresanProfessor and ChairSite chief of Surgery, General Campus/Chair, OR Committee General Campus


Summary of HighlightsThe Division of Thoracic Surgery continues as a clinically busy and productive thoracic surgery program, with heavy emphasis in thoracic oncology, and equally heavy emphasis on multidisciplinary and interdisciplinary approaches to patient care. The Cancer Assessment Clinic (CAC) at the General Campus provides the backbone for intake and assessment of thoracic oncology referrals. The Thoracic CAC receives 1200 referrals each year and currently accommodates about 2300 patient visits per year, with approximately 800 new lung cancer patients assessed per year. The heavy emphasis on cancer care has occurred at the expense of caring for patients with benign disorders, largely benign esophageal disease. Mechanisms for improving the timeliness of care for these patients with benign disorders remains an ongoing challenge in the thoracic division.

The esophageal function laboratory, directed by Dr. Shamji, continues to provide superb diagnostic assessment for patients with swallowing disorders. The lab has grown in size and patient volume, with a second nurse now trained to conduct esophageal manometric assessment. There has also been considerable growth in complexity, with generous funding from The Ottawa Hospital for acquisition of state-of-the-art impedance manometry equipment.

The clinical activity of the thoracic surgery division has been notable for a progressive rise in the proportion of minimally invasive operations for lung and esophageal disease, such that currently, slightly more than 50% of these procedures are done by MIS approaches. This has been correlated with noticeable reduction in length of hospital stay (compared to the corresponding open procedures), and a significant reduction in inpatient bed utilization (which is now typically at or under 50%).

An important academic contribution from the Division of Thoracic Surgery was the “TM&M” (Thoracic Mortality and Morbidity). This novel method of reporting postoperative adverse events by quantifying their severity was created three years ago and implemented in the division since then. A rigorous analysis of its applicability was conducted, and the ensuing study was presented by Dr. Seely at the annual meeting of the Society of Thoracic Surgeons in 2010. This report, along with additional subsequent studies aimed at validating its effectiveness has now been published. This has attracted considerable interest from other thoracic surgical programs in Canada and the United States, as a valuable tool for surgical quality improvement. The TM&M has also spurred the development of TSQMS (Thoracic Surgery Quality Monitoring System) a web-based clinical database using a tablet platform for immediate data entry, which can be integrated with TM&M for continuous quality assessment. TSQMS is now going through several iterations, and we hope to expand this to other clinical programs within The Ottawa Hospital, and to other thoracic surgery programs throughout North America.

The Division of Thoracic Surgery was honored to have Dr. Tom Gilbert as Visiting Professor at the PneumoClub on May 2, 2011. Dr. Gilbert is a former collaborator with Dr. Sebastien Gilbert at the University of Pittsburg, and gave a very stimulating lecture on Extracellular Matrix Scaffolds and Airway Regeneration.

The members of the Division of Thoracic Surgery continued to play active roles at the national level in our specialty. These include the following: Dr. Maziak, President of CATS (Canadian Association of Thoracic Surgeons); Dr. Shamji, President of CUSEC (Canadian Undergraduate Surgery Education Committee); Dr. Seely, Director of Research, CATS; Dr. Sundaresan, completing five-year term as vice chair, Thoracic Surgery Exam Board, Royal College of Physicians and Surgeons of Canada.

Dr. James Villeneuve successfully completed his thoracic training on June 30, 2011 and will be undertaking a fellowship in Thoracic Oncology Surgery in Leuven Belgium; with a plan for recruitment back to the division of thoracic surgery in late 2012.


Division of UrologyOverview

Dr. Ronald G. Gerridzen Division Chair & Chief, The Ottawa Hospital

FacultyCivic CampusDr. Anthony J. Bella Dr. Ilias Cagiannos - Director, Resident ResearchDr. Filemon DeJesusDr. Christopher G. L. Morash - Director, Urologic Oncology & TOH Prostate CACDr. Matthew T. RobertsDr. M. Eric SaltelDr. Fadi Kamal - Fellow, Urologic OncologyDr. Rany Shamloul - Fellow, Men’s Health

General Campus:Dr. Brian D. M. Blew Dr. Rodney H. BreauDr. John E. Mahoney Dr. J. Stuart Oake - Site-chief, General & Riverside CampusesDr. Jeffrey WarrenDr. James D. Watterson - Program Director CHEO:Dr. Luis A. Guerra - ChiefDr. Michael P. Leonard - part-timeDr. Antonio Baltazar - Fellow, Pediatric Urology


Honors, Awards and Special RecognitionFour residents finished their training in June 2011. Dr. Abdussalam Abuhjar will practice general urology in Regina Saskatchewan; Dr. Yasser Jamalalail will be a Fellow in Paediatric Urology at CHEO; Dr. Robert Payne travels to Stanford University in California for a two year Fellowship in Paediatric Urology; and Dr. Mark Preston will do a combined Fellowship in Urologic Oncology at The Massachusetts General Hospital in Boston, and a Masters degree in Public Health (MPH) at Harvard University. At Collins Day in May 2011, Dr. Mathieu Carriere (PGY3) was recipient of a Department of Surgery Resident Teacher of the Year Award.

On August 30, 2010, the Division of Urology officially became the benefactor of an endowed, named Research Chair. The Greta and John Hansen Chair in Men’s Health Research support protected time for research in men’s health issues. This is only the fourth Research Chair of its kind internationally and the first in Canada, bringing prestige to the Division and its holder as well as a family legacy for its namesake, Greta and John Hansen. The Division of Urology is grateful to The Ottawa Hospital senior management, The Ottawa Hospital Foundation and all its great staff, Dr. Eric Poulin and the Department of Surgery, Ron and Gayle Zambonini for co-chairing the campaign and last but by no means least Greta and John Hansen, major contributors to the Chair for their tremendous support and graciously allowing us to name the Chair in their honor.

The University of Ottawa Urology Residency Program was nominated for a PAIRO Program Excellence Awardin 2011. While not the final awarded, this was a tremendous honor and both current and previous Program Directors (Drs. James Watterson & Stuart Oake, respectively) and all members of the Division should be very proud of this honor.

Dr. Anthony Bella is the chair holder of the newly-created Greta and John Hansen Chair in Men’s Health Research. He was nominated by the Sexual Medicine Society of North America to represent them at the American Urological Association’s Rising Stars in Research symposium held in Washington DC in May 2011. Dr. Bella was selected to be a Travelling Scholar by the Canadian Urological Association and the European Association of Urology. This involved travelling to European countries (UK, Italy and Spain) over a two week period in March 2011 to observe, teach and operate in a number of European centers. As a result of basic research, Dr. Bella was successful in a US Patent Application No. 12/904,891 for the use of Neuregulin to Treat Peripheral Nerve Injury in November 2010 (Drs. Caggiannos, Bella and Iaci)

Dr. Bella was recipient of the Basic Science Research Prize at the Annual Meeting of the Sexual Medicine Society of North America in Miami, and third prize for a poster presentation by the medical and nursing staff of the TOH Men’s Health clinic, at the American Academy of Ambulatory Care Nurses 36th Annual Conference in San Antonio.

Dr. Brian Blew was awarded the John P. Collins Award as Divisional Teacher of the Year in June 2011. Last year’s recipient was Dr. Christopher Morash. This award is given annually by all residents in the Urology Training Program in recognition of one staff member’s exceptional teaching abilities. Congratulations to Brian for this well-deserved achievement.

Dr. Rodney Breau joined the Division in August 2010 as a urologic oncologist and Associate Scientist at OHRI. Rodney did a two year Fellowship in Urologic Oncology at The Mayo Clinic and obtained a Master’s Degree in Clinical Research while at Mayo. He will be a valuable clinical and research addition to the Division. Rod was recipient of a Canadian Urological Association Scholarship Foundation Award in June 2011. He has already in his first year racked up an impressive list of publications and collaborative international research efforts.

Dr. Ilias Cagiannos was principal investigator on a successful CIHR grant application for a randomized controlled trial of renal hypothermia during partial nephrectomy. This is a first for the Division and a great achievement for Dr. Cagiannos.


Dr. Luis Guerra was presented with a Certificate of Honor by the residents for dedication to teaching, clinical excellence, research and administrative leadership while under difficult conditions as sole full-time pediatric urologist at CHEO. Dr. Guerra was founder and coordinator of the “Canadian Working Group for Urologists in Clinical Epidemiology”. This is an independent national endeavor in collaboration with the Department of Epidemiology and Community Medicine at the University of Ottawa and the Office of Education of the Canadian Urological Association (CUA).

Dr. John Mahoney continues his administrative work as President of the Medical Staff of The Ottawa Hospital. John is completing his OMA Medical Leadership and Development program at York University, and is involved in Physician Engagement at TOH. Congratulations to Dr. Mahoney on his promotion to Associate Professor, Department of Surgery.

Dr. Christopher Morash is Director of Urologic Oncology and the TOH Prostate Cancer Assessment Centre as well as the Division’s Robotics initiative. Chris continues his work as leader of the Prostate Communities of Practice, striving to standardize prostate cancer care across the Champlain LHIN. For the first time surgeons have become aware of their own surgical margin status and transfusion rates, which is leading to alterations in individual practice and mentoring experiences benefitting patients. With the assistance of Dr. Cagiannos, an evidence-based template for active surveillance of prostate cancer is being formulated for the region. Congratulations to Chris on this important endeavor.

Dr. Stuart Oake was accepted into the MBA program at uOttawa Telfer School of Business. Dr. Oake is Director of the Department of Surgery’s new Office of Education, and last summer became Vice-Chair of the Royal College of Physicians & Surgeons of Canada Examination Board in Urology. In June 2011 Dr. Oake completed a five year term as Treasurer of the Canadian Urological Association (CUA) and was instrumental in its administrative reorganization, including financial arrangements for an Office of Education and new administrative offices for the CUA in Montreal. Congratulations to Stuart on a job well done!

Dr. Matthew Roberts joined the Division in July 2010 following a two year Fellowship in Reproductive Medicine & Surgery at the University of Toronto. Matt also completed a Master’s degree in Education. Matt has created a multidisciplinary male fertility clinic at the Ottawa Fertility Centre, involving the Reproductive Endocrinology Fellow. Matt chairs the Division’s resident education sub-committee.

Dr. Eric Saltel continues to offer males with urinary incontinence a surgical alternative in the use of the male sling. Eric will be involved in developing a strategy for a Botox program for overactive bladder in Ottawa.

Dr. Jeffrey Warren has developed an algorithm for consideration of borderline extended criteria donor kidneys for dual en-bloc transplantation, supported the national live donor paired exchange program, and along with Dr. Brian Blew travelled by air to Kingston to procure donor kidneys, a new initiative for the Ottawa renal transplant program. To help Dr. Guerra with his workload at CHEO, Dr. Warren has been running pediatric urology clinics a few times monthly.

Dr. James Watterson completed his first full year as the Division’s Program Director. He has created a sub-committee on Resident Education chaired by Dr. Matthew Roberts. Dr. Watterson was nominated for a COMPASS award in 2011.Drs. Watterson and Roberts are working together on developing new and innovative methods of resident evaluation (including technical skills)

The Division underwent a two-day external review chaired by Dr. Hassan Razvi from the University of Western Ontario. The report was very favorable and the Faculty of Medicine and Ottawa Hospital leadership confirmed Dr. Gerridzen’s position as Division Chair for a second term.

One of the Division’s key activities this past year was leading the fund-raising for a Da Vinci robot. Led byDr. Christopher Morash, many Division members have freely given of their time to public speaking engagements, golf tournaments, breakfast meetings, etc. and with the generosity of grateful patients and the Ottawa business community, robotic surgery at TOH should become a reality by the end of 2011. A consortium led by Ottawa


business leaders will help finish off the Ottawa Hospital campaign, which aspires to realize 6M to fund the robot’s acquisition and deployment. Thanks as well to the enthusiastic and determined staff of The Ottawa Hospital Foundation, and also TOH senior management and Dr. Michael Fung-Kee-Fung for their collaboration in this endeavor.

November 2010 will be remembered as “Movember”, during which time most staff and residents grew moustaches in support of Prostate Cancer Research. Clandestine photographs of the best (and worst) moustaches appeared in a slide show at the final Divisional Journal Club and are likely now circulating on social media sites.

Finally, special mention is necessary for the tremendous collaborative effort of all TOH urologists for pitching in and covering CHEO for on-call duty at night, and especially those from the General Campus for covering busy daytime periods, often at the expense of their own activities at their adult hospital, when Dr. Guerra is out of town. Thanks as well to Drs. Roberts and Warren for helping out in the clinics to reduce wait-times and Dr. Guerra’s clinical workload. It is hoped that the Division can recruit one, if not two, academic paediatric urologists by 2013.

Visiting ProfessorsDr. Bradley Leibovitch, attending urologist and Program Director, Department of Urology at The Mayo Clinic, Rochester MN, was guest professor at the annual GU Oncology Update course in November 2010, organized by Dr. Chris Morash. Dr. Igor Frank, attending urologist and Director of Robotics at The Mayo Clinic, Rochester MN, was the Division’s Visiting Professor at the annual Resident Research Day in April 2011. Dr. Frank gave an excellent address on the organization and institution of a robotic surgical program.

ResearchGrants

Member and Role

Bella AJ (PI)

Bella AJ (PI)

Bella AJ (PI)

Title

Effect of targeted hypothermia on the recovery of erectile function after cavernous nerve crush injury in the rat

Molecular mechanisms for cavernous nerve neuroprotection and regeneration following injury due to prostate cancer treatment in men

Eli Lilly Research Fellowship Award

Peer Reviewed

Yes

Yes

Yes

Funding Source

Sexual Medicine Society of

North America

Sexual Medicine Society of

North America

Eli Lilly

Total Amount

$2,000

$4,500

$130,000

End Date

2011

2011

2013

Start Date

2010

2010

2011


Member and Role

Bella AJ (Co-PI)

Bella AJ (PI)

Blew BDM (PI)

Cagiannos I (PI)Morash CGL (CI) Breau RH (CI)

Breau RH (PI)

Cagiannos I (Coll.)Morash CGL (Coll.)

Cagiannos I (Co-PI)

Morash CGL (Co-PI)

Morash CGL (Co-PI)

Guerra LA (Coll)

Title

Prospective Registry of Outcomes with Penile Prothesis for Erectile Restoration (PROPER)

Effect of targeted hypothermia on the recovery of erectile function after cavernous nerve injury in the rat

Division of Urology Lap Labs

Randomized Controlled Trial of Renal Hypothermia during Partial Nephrectomy

The diagnostic performance of MRI for evaluation of extraprostatic tumours

Prostate morbidity through prostate proteome profile (PMProt)

Radiological Radiation and Secondary Tumors after Testicular Cancer

Understanding testicular cancer epidemiology and etiology (UTEE)

A Phase II study of PET-CT scanning with C-11 acetate in patients with intermediate and high risk prostate cancer undergoing radical prostatectomy

The addition of clonidine to 0.2 % ropivacaine for wound instillation after minor lower abdominal surgery in children (prospective double -blinded, age stratified RCT)

Peer Reviewed

No

Yes

No

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Funding Source

American Medical Systems

Pfizer – Canadian

Male Sexual Health Council

Baxter Canada

CIHR

Canadian Urological

Association Scholarship Foundation

CIHR

CIHR

Public Health Agency of

Canada

The Ottawa Regional Cancer

Foundation


Department of Anesthesia

Chairman’s Fund

Total Amount

$250,000

$50,000

$1,200

$450,000

$40,000

$350,000

$42,363.00

$20,000

$8,000

End Date

2012

2012

2012

Start Date

2011

2010

2011

2010

2011

2009

2010

2010

2010


Member and Role

Guerra LA (Coll.)

Roberts MT (PI)

Roberts MT (PI)

Title

Voiding urosonography with ultrasound contrast agent, a radiation-free technique for monitoring of vesico-ureteral reflux children

Intra-operative assessment of technical skill using economy of hand motion: Establishing learning curves of surgical competence

Intra-operative assessment of technical skill using economy of hand motion: Establishing learning curves of surgical competence

Peer Reviewed

Yes

Yes

Yes

Funding Source

AHSC-AFP, Ministry of

Health Innovation

Fund

Royal College of Physicians

and Surgeons Medical

Education Research

Grant

Physicians Services


Total Amount

$35,753

$49,900

$76,400

End DateStart Date

2010

2010

2010

Publications Journal Articles

1. Preston M, Carrière M, Raju G, Morash CG, Doucette S, Gerridzen RG, Bella AJ, Eastham JA, Scardino PT and Cagiannos I. The Prognostic Significance of Capsular Incision Into Tumor During Radical Prostatectomy. Eur Urol. 59(4):613-8, Apr 2011.

2. Shamloul R, Bella AJ. Impact of cannabis use on male sexual health. J Sex Med. 8:971–975, 201.

3. Morales A, Bella AJ, Chun S, Lee J, Assimakopoulos P, Bebb R, Gottesman I, Alarie P, Dugré H, Elliott S. A practical guide to diagnosis, management and treatment of testosterone deficiency for Canadian physicians. Can Urol Assoc J. 4(4):269-75, Aug 2010.

4. Wiesenthal JD, Fazio LM, Perks AE, Blew BD, Mazer D, Hare G, D’A Honey RJ, Pace KT. Effect of pneumoperitoneum on renal tissue oxygenation and blood flow in a rat model. Urology 77(6):1508.e9-1508.e15, Jun 2011.

5. Lavallee LT, Fergusson D, Breau RH. The role of randomized controlled trials in evidence-based urology. World J Urol. 29(3):257-63, Jun 2011.

6. Breau RH, Crispen PL, Jenkins SM, Blute ML, Leibovich BC. Treatment of patients with small renal masses: a survey of the American Urological Association. J Urol. 185(2):407-13, Feb 2011.


7. Breau RH, Clark AT, Morash CG, Fergusson D, Cagiannos I. Associations between radiographic characteristics and change in renal function following partial nephrectomy using 24-hour creatinine clearance. Can Urol Assoc J.5(1):45-8, Feb 2011.

8. Crispen PL, Breau RH, Allmer C, Lohse CM, Cheville JC, Leibovich BC, Blute ML. Lymph node dissection at the time of radical nephrectomy for high-risk clear cell renal cell carcinoma: Indications and recommendations for surgicaltemplates. Eur Urol. 59(1):18-23, Jan 2011.

9. Crispen PL, Tabidian MR, Allmer C, Lohse CM, Breau RH, Blute ML, Cheville JC, Leibovich BC. Unclassified renal cell carcinoma: impact on survival following nephrectomy. Urology, 76(3):580-6, Sep 2010.

10. Breau RH, Karnes RJ, Jacobson DJ, McGree ME, Jacobsen SJ, Nehra A, Lieber MM, St. Sauver JL. The association between statin use and the diagnosis of prostate cancer. J. Urol. 184(2): 494-9, 2010.

11. Kim B, Breau RH, Fergusson D, Cagiannos I, Morash C. Diagnostic accuracy of surface coil magnetic resonance imaging at 1.5T for local staging of elevated risk prostate cancer. Can Urol Assoc J. 4(4):257-62, Aug 2010 van Walraven C, Fergusson D, Earle C, Baxter N, Alibhai S, Macdonald B, Forster AJ, Cagiannos I. Association of Diagnostic Radiation Exposure and Second Abdominal-Pelvic Malignancies after Testicular cancer. J Clin Oncol.ePub ahead of print, June 20, 2011.

12. Chalasani V, Kassouf W, Chin JL, Fradet Y, Aprikian AG, Fairey AS, Estey E, Lacombe L, Rendon R, Bell D, Cagiannos I, Lattouf JB, Izawa JI. Radical cystectomy for the treatment of T1 bladder cancer: the Canadian Bladder Cancer Network experience. Can Urol Assoc J. 5(2):83-7. Apr. 2011.

13. Yafi FA, Aprikian AG, Chin JL, Fradet Y, Izawa J, Estey E, Fairey A, Rendon R, Cagiannos I, Lacombe L, Lattouf JB, Bell D, Drachenberg D, Kassouf W. Contemporary outcomes of 2287 patients with bladder cancer who were treated with radical cystectomy: a Canadian multicenter experience. BJU Unt. ePub ahead of print. Dec. 2010.

14. Andrea Lantz, Mark E Saltel, Ilias Cagiannos. Renal and functional outcomes following cystectomy and neobladder reconstruction. Can Urol Assoc J. 4(5):328-31, Oct. 2010.

15. Desantis DJ, Leonard MP, Preston M, Barrowman N and Guerra LA. Effectiveness of Biofeedback for Dysfunctional Elimination Syndrome in Pediatrics: A Systematic Review. J Pediatr Urol. 7(3):342-8. June 2011.

16. Al-Ghadir M, Masquijo J, Guerra LA and Willis RB. Combined Femoral and Pelvic Osteotomies Versus Femoral Osteotomy Alone in the Treatment of Hip Dysplasia in Children with Cerebral Palsy. J Pediatr Orthop. 29(7):779-83. Oct. 2010.

17. Melnyk M, Ni A, Guerra L, Leonard MP. Teaching of the male urogenital exam in medical school: are our students appropriately prepared for practice? CUAJ 4(3Suppl1): S86, 2010.

18. Guerra LA. Editorial comment to Lee KS, Han DH, Jeong JY, Lee YS, Ko JW. Efficacy of endoscopic subureteral injection for vesicoureteral reflux in adults with decreased bladder compliance.Int J Urol. 2010 Jul;17(7):650-4. Int J Urol.;17(7):655, Jul 2010.

19. Jewett MA, Mattar K, Basiuk J, Morash CGL, Pautler SE, Siemens DR, Tanguay S, Rendon RA, Gleave ME, Drachenberg DE, Chow R, Chung H, Chin JL, Fleshner NE, Evans AJ, Gallie BL, Haider MA, Kachura JR, KurbanG, Fernandes K, Finelli A. Active Surveillance of Small Renal Masses: Progression Patterns of Early Stage Kidney Cancer. Eur Urol. Jul; 60(1):39-44. Apr. 2011.

20. Erdeljan P, Caumartin Y, Warren J, Nguan C, Nott L, Luke PPW, Pautler SE. Robot-assisted Pyeloplasty: Follow-Up of First Canadian Experience with Comparison of Outcomes Between Experienced and Trainee Surgeons.Journal of Endourology; 24(9): 1447-50. Sept. 2010.


21. Touma N, Warren J, Sener A, Caumartin Y, Kwan K, Luke PW. Extra capsular versus intra-capsular allograft nephrectomy: impact on allosensitization and surgical outcomes. Canadian Urological Association Journal, 5(1): 49-52. Feb 2011.

Book Chapters/Invited Editorials1. Bella AJ, Shamloul R. Functional Anatomy of Male Sexual Organs. In: Cancer and Sexual Health, Mulhall JP (ed), Humana Press (Springer Science) NY, Chapter 1 pg 3-12, 2011.

2. Breau RH, Blute ML. Surgery for renal cell carcinoma metastases. Curr Opin Urol. 20(5):375-81. Sep 2010.

3. Lavallee L, Dahm P, Breau RH. Evidence based urology in practice: composite endpoints. BJU Int.;106(5):610-2, Sep 2010.

4. Karnes RJ, Breau RH, Lightner DJ. Surgery for urethral cancer. Urol Clin North Am.;37(3):445-457, Aug. 2010.

5. Morash CG. Prostate cancer follow-up care: expert perspectives. Oncology Exchange 9(3):13-14. Aug. 2010.

Abstracts1. Greenspan MB, Shamloul R, Bella AJ. Initial Surgical Series for 11 Men Reporting Technical, Safety and Satisfaction Considerations for the New American Medical Systems Spectra Malleable Penile Implant. JMH 7(3), 329, 2010.

2. Christine BS, Bella AJ. Prospective Analysis of Post-Radical Prostatectomy Climacturia Resolution With Treatment of Persistent Incontinence Using the Advance Male Sling. JMH 7(3), 333, 2010.

3. Zappavigna C, Shamloul R, Gerridzen R, Cagiannos I, Bella AJ. Development of Needs Assessment and Pilot Education Program for Delivery of Men’s Health Care via Nurse Practitioners. JMH 7(3), 329, 2010.

4. Christine BS, Bella AJ. Optimizing Patient Outcomes Using Controlled Length Expansion Cylinders and a Defined Post-Operative Inflation Protocol. JMH 7(3), 334, 2010.

5. Bella AJ, D Nienow, R Shamloul, Nehra A. Is there a change for International Prostate Symptom Scores (IPPS) following 3-piece penile prosthesis insertion? Results from a prospective series. JMH 7(3), 329, 2010.

6. Zappavigna C, Shamloul R, Gerridzen R, Cagiannos I, Bella AJ. Prospective follow-up of 11 patients for efficacy of intranasal oxytocin administered during coitus for treatment-resistant male anorgasmia. JMH 7(3), 334, 2010.

7. Hickling DH, Brock GB, Greenspan MB, Cagiannos I, Morash C, Gerridzen RG, Bella AJ. Analysis of Canadian Physician Practice Patterns Identifies Need for Continued Innovation in Men’s Health Care Delivery Strategies. JMH, 7(3), 334, 2010.

8. Bella AJ, Henry G. Outcome Analysis for Same-Day Discharge Three-Piece Penile Prosthesis Surgery. JMH 7(3), 328, 2010.

9. Preston M, Lantz A, Breau R, Morash C, Gerridzen RG, Bella A. Doucette S, Eastham J, Scardino P, Cagiannos I. The Impact of Nerve-Sparing on Capsular Incision into Tumor during Radical Prostatectomy. CUAJ 5 (3Suppl1): S38 (abstract MP-01.06), 2011.

10. Shamloul R, Bella A. The Use of a Wide Bore 18-Gauge Needle for Intralesional Treatment of Peyronie’s Disease Is Safe and Practical. CUAJ 5 (3Suppl1): S40 (abstract MP-03.07), 2011.


11. Nehra A, Milam D, Christine B, Bella A. Retrospective, Multi-Center Length and Erectile Function Outcomes after Implantation of Inflatable Penile Prostheses with Limited Length and Girth Expansion Cylinders. CUAJ 5(3Suppl1): S40 (abstract MP-03.08), 2011.

12. Harvey D, Saltel E, Gerridzen R, Bella A. Advance Male Urethral Sling as Day Procedure: Safe and Cost Effective. CUAJ 5 (3Suppl1): S41 (abstract MP 03.11), 2011.

13. Lantz A, Preston M, Morash, CG, Breau R, Bella A, Gerridzen RG, Eastham J, Scardino P, Cagiannos I. Cancer Specific and Overall Survival Following Capsular Incision into Tumor During Radical Prostatectomy. CUAJ 5 (3Suppl1) S52 (abstract MP-05.14), 2011.

14. Morash CG, Breau R, Shamloul R, Saltel E, Cagiannos I, Roberts M, Kamal F, Gerridzen RG, Bella A. Integrating a Cancer Survivorship Components to Established Urologic Oncology Fellowships. CUAJ 5 (3Suppl1) S62 (abstract MP-07.10), 2011.

15. Christine B, Bella A. Reservoir through the Inguinal Ring: Safety Considerations dor Men Post-Robot Assisted Radical Prostatectomy . CUAJ 5 (3Suppl1) S96 (abstract UP-063), 2011.

16. DaSilva V, Henry G, Shamloul R, Christine B, Bella A. Evolution of the ‘Mummy Wrap’ Concept to Separable Component Dressing Facilitates Same Day Inflatable Penile Prosthesis Discharge, At-Home Scrotal Compression for 72 Hours, and Earlier Normalized Voiding and Device Activation. CUAJ 5 (3Suppl1) S97 (abstract UP-066), 2011.

17. DaSilva V, Roberts M, Shamloul R, Zappavigna C, Gerridzen R, Cagiannos I, Saltel M , Morash C, Bella A. Prospective Determination of Pharmaceutical Sample Use in a Tertiary Care Comprehensive Urology Practice for 184 Consecutive Visits for Patients with Erectile Function Compromise. CUAJ 5 (3Suppl1) S97 (abstract UP-067), 2011.

18. Shamloul R, Bella A. Noctural Penile Tumescence Recording Is Useful to Identify Erectile Dysfunction Etiology for Young Men. CUAJ 5 (3Suppl1) S101 (abstract UP-80), 2011.

19. Christine B, Bella A. Post-Radical Prostatectomy Climacturia Resolution with Treatment of Persistent Incontinence Using the Advance Male Sling. J Urology 185 (4supp): e722-723 (abstract 1799), 2011.

20. Bella AJ, Iaci JF, Coderre E, Renaud LP, Caggiano AO. Remote from injury site delivery of glial growth factor 2 (ggf2) facilitates recovery of erectile dysfunction following bilateral cavernous nerve injury in the rat with directevidence of cavernous nerve preservation. J Urol 185 (4supp): e301 (abstract748), 2011.

21. Bella AJ, Christine BSm Henry G, Kramer AC, Rhee E, Khera M, Brant WO, Bennett NE, Karpman E, Jones LA, Carrion R. Review of 1103 Inflatable penile prosthetic surgeries performed in 2009 demonstrates almost complete variability for irrigation and antibiotic practice amongst eleven high-volume reconstructive surgeons. J Urol 185 (4supp): e725-726 (abstract 1807), 2011.

22. Fandel TM, Albersen M, Xuefeng Q, Lin G, Bella AJ, Lin C-S, Lue TF. Comparison of cultured adipose tissue-derived stem cells (ADSC) and freshly isolated uncultured ADSC in erectile function recovery after cavernous nervecrush injury in aged rats. J Urol 185 (4supp): e451-452 (abstract 1123), 2011.

23. Henry G, Carson C, Delk J, McKim S, Cleves M, Simmons C, Bella A, Donatucci C. Positive culture growths from infection retardant-coated penile prosthesis at the time of revision/salvage surgery: a multicenter study. J Urol185 (4supp): e723 (abstract 1801), 2011.

24. Shamloul R, Bella AJ, Adams M. Contemporary role of nocturnal penile tumescence recording to identify erectile dysfunction etiology for select cases in young men. J Urol 185 (4supp): e729 (abstract 1818), 2011.


25. Bella AJ, Payne R, Plunet W, Carson JJ, Shamloul R, Cagiannos I, Tetzlaff W, Renaud LP. The Neurobiological Response to Bilateral Cavernous Nerve Crush Injury is Modified by Intermittent Caloric Restriction and Facilitatesrecovery of Erectile Function in the Aged Rat. J Sex Med 8(Suppl 1):4 (abstract 1), 2011.

26. Bella AJ, Nehra A. Prospective Evaluation of Urinary Symptoms Using the AUA Prostate Symptom Score Following 3-Piece Penile Prosthesis Insertion. J Sex Med 8(Suppl 1):23 (abstract 56), 2011.

27. Christine B, Bella A. Placement of an Inflatable Penile Prosthesis Reservoir Through The Inguinal Ring: safety Con-sideration for Men Post-Robot Assisted Radical Prostatectomy. J Sex Med 8(Suppl 1):28 (abstract NM11), 2011.

28. Greenspan MB, Shamloul R, Bella AJ. Technical, Safety and Satisfaction Considerations for the New American Medical Systems Spectra Malleable Penile Implant. J Sex Med 8(Suppl 1):34 (abstract 78), 2011.

29. Christine B, Bella A. Controlled Length Expansion Cylinders: A Defined Post Operative Inflation Protocol Yields Measurable Length Gain. J Sex Med 8(Suppl 1):35 (abstract 80), 2011.

30. Christine B, Bella A. Post-Radical Prostatectomy Climacturia Resolution with Treatment of Persistent Incontinence Using the Advance Male Sling. J Sex Med 8(Suppl 1):37 (abstract 87), 2011.

31. Henry G, Bella A. Safety Data and Technical Considerations for Same-Day Discharge Three-Piece Penile Prosthesis Surgery with 3 to 6 Years Follow Up. J Sex Med 8(Suppl 1):44 (abstract NM20), 2011.

32. Zappavigna C, Shamloul R, Gerridzen RG, Cagiannos I, Morash C, Bella AJ. Is Intranasal Oxytocin Administered During Coitus Efficacious for Treatment Resistant Male Anorgasmia. J Sex Med 7(suppl 4): 175 (abstract 73), 2010.

33. Christine B, Bella A. Safety Consideration for Placement of an Inflatable Penile Prosthesis Reservoir for Men Post-Robot Assisted Radical Prostatectomy. JMH 7(3), 334, 2010.

34. Saltel ME, Gerridzen RG, Bella AJ. Impact of Advance Male Sling on Post Radical Prostatectomy Climacturia: Robust Prospective Cohort Results at One-Year Follow-Up. J Sex Med 7(suppl 4): 179 (abstract 84), 2010.

35. Christine B, Wilson S, Shamloul R, Bella AJ. Simultaneous Placement of an Inflatable Penile Prosthesis and Advance Male Sling for Erectile Dysfunction and Incontinence: Robust Efficacy and Safety Data at 3 Years Follow-Up. J Sex Med 7(suppl 4): 180 (abstract 86), 2010.

36. Greenspan MB, Shamloul R, Bella AJ. Initial Experience with the New American Medical Systems SpectraMalleable Penile Implant. J Sex Med 7(suppl 4): 181 (abstract 89), 2010.

37. Bella AJ, Zappavigna C, Gerridzen RG, Cagiannos I, Morash C, Shamloul R. Primary Care Delivery of Men’s Health Care in Ontario Canada: Nurse Practitioner Needs Assessment and Pilot Targeted Education for ErectileDysfunction, Peyronie’s Disease, and Low Testosterone/Hypogonadism. J Sex Med 7(suppl 4): 185 (abstract 110), 2010.

38. Shamloul R, Bella A. Single Center Results for 400 Consecutive Men Evaluated for Peyronie’s Disease (2008-2009) Does Not Support Incident Traumatic Event As Underlying Etiology. J Sex Med 7(suppl 4): 232 (abstract 266), 2010.

39. Bella AJ, Payne R, Plunet W, Carson J, Tetzlaff W, Renaud LP. Intermittent Calorie Restriction Promotes Functional Erectile Recovery After Bilateral Cavernous Nerve Crush Injury in the Rat. J Sex Med 7(suppl 4): 154 (abstract11), 2010.

40. Rowe N, Blew B, Mahoney J, Warren J. Anastomotic Techniques in Renal Transplant Surgery: A Survey of Canadian Transplant Surgeons. CUAJ, Vol 5(3Suppl1) S69, June 2011.


41. Fairey A, Kassouf W, Estey E, Tanguay S, Rendon R, Bell D, Izawa J, Chin J, Kapoor A, Matsumoto E, Black P, So A, Lattouf J-B, Saad F, Drachenberg D, Cagiannos I, Lacoumbe L, Fradet Y, Jacobson N-E. Comparison of oncologicoutomes for open and laparoscopic radical nephroureterectomy: results from the Canadian upper tract collabo-ration. Can Urol Assoc J. 5(3Suppl1):S34. Jun 2011

42. Yafi F, Tanguay S, Rendon R, Jacobsen N, Fairey A,Izawa J, Kapoor A, Black P, Lacombe L, Chin J, So A, Lattouf J-B, Bell D, Fradet Y, Saad F, Matsumoto E, Drachenberg D, Cagiannos I, Kassouf W. Adjuvant Chemotherapy for upper tract urothelial carcinoma treated with nephroureterectomy: assessment of adequate renal function and impact on outcome. Can Urol Assoc J.;5(3Suppl1):S36. June 2011

43. Ross M, Kassouf W, Bell D, Lacombe L, Kapoor A, Jacobsen N, Fairey A, Izawa J, Black P, Tanguay S, Chin J, So A, Lattouf J-B, Saad F, Matsumoto E, Drachenberg D, Cagiannos I, Fradet Y, Rendon R. The role of lymph nodedissection during nephroureterectomy in the management of upper tract urothelial carcinoma: The Canadian Experience. Can Urol Assoc J, 5(3Suppl1):S48. June 2011

44. Lacombe L, Kassouf W, Rendon R, Jacobsen N, Fairey A, Izawa J, Kapoor A, Black P, Tanguay S, Chin J, So A, Lattouf J-B, Bell D, Saad F, Matsumoto E, Drachenberg D, Cagiannos I, Fradet Y. Risk factors for bladder cancerrecurrence after nephroureterectomies for upper tract TCC. Can Urol Assoc J. 5(3Suppl1):S89. June 2011

45. Preston MA, Breau RH, Morash R, Fung Kee Fung M, Fergusson DA, Cagiannos I, Morash C. Successful implementation of a Communities of Practice (CoP) model to facilitate quality improvement initiatives in prostate cancer surgery. Can Urol Assoc J. 5(3Suppl1):S91. Jun 2011

46. Rowe N, Leonard M, de Nanassy J and Guerra LA. Pathological Analysis of Testicular remnants in non-palpable undescended testis. Can Urol Assoc J, (5)Sup 3:54. June 2011

47. Harvey D, Yousif I, Leonard M and Guerra LA. Acute scrotum in boys less than 5 years old: 10 year experience at a single tertiary care centre. Can Urol Assoc J, (5)Sup 3:58. June 2011

48. Rowe N, Leonard M, de Nanassy J and Guerra LA. Pathological Analysis of Testicular remnants in non-palpable undescended testis. European Society of Paediatric Urology Proceedings- Annual Meeting, Copenhagen,Denmark. 2011

49. Melnyk MM, Ni A, Guerra L, Leonard MP. Teaching of the male urogenital exam in medical school: are our students appropriately prepared for practice? Proceedings of the Western Section American UrologicalAssociation Meeting, Hawaii Oct. 2010

50. Melnyk MM, Ni A, Guerra L, Leonard MP. Teaching of the male urogenital exam in medical school: are our students appropriately prepared for practice? CUAJ 4(3Suppl1): S86, 2010, June 2011.

51. Croke J, Malone S, Avruch L, Belanger E, Roustan Delatour N, Morash C, Kayser C, Underhill K, Spaans J. Post-operative radiotherapy in prostate cancer: Hit or miss? Radiotherapy & Oncology, Journal of the EuropeanSociety for Therapeutic Radiology & Oncology, 96, Suppl. 2, Abstract # 147, S48. Sep 21, 2010.

52. Croke J, Malone S, Avruch L, Belanger E, Roustan Delatour N, Morash C, Kayser C, Underhill K, Spaans J. Post-operative radiotherapy in prostate cancer: the case of the missing target. Int. J. Rad. Oncol. Biol. Phys., 78 (3),Supplement, Abstract # 64, S30. Oct 31, 2010.

53. Splinter KL, Watterson JD, Singh SS. Laparoscopic Management of Bilateral Ureteric Obstruction due to Endometriosis. Journal of Obstetrics and Gynecology of Canada; Volume 33, Number 6, Suppl 1, June 2011.


Division of Vascular SurgeryOverview

Andrew B Hill, MDCM Division Head / Research Coordinator

FacultyAndrew B Hill MDCM Division Head / Research Coordinator

Tim Brandys MD Program Director

George Hajjar MD Practice Plan Manager

Sudhir Nagpal MD Director of Vascular Diagnostic Laboratory

Prasad Jetty MD Research Coordinator

Ken Harris MD Adjunct Professor

The Division of Vascular and Endovascular Surgery consists of five full time surgeons located at the Civic Campus of The Ottawa Hospital.


Clinical ActivityClinically, the Division of Vascular & Endovascular Surgery has had a busy year. The practice of Vascular Surgery continues to evolve with the increasing role of endovascular therapies for the treatment of both peripheral vascular and aortic pathology. The Ottawa Hospital is one of the leading Canadian Centers in advanced endovascular technology such as the provision of branched and fenestrated endovascular stent grafts for the repair of complex aortic arch, thoracic, abdominal and thoracoabdominal aortic aneurysms. Division members act as proctors for other Centers that are introducing endovascular technologies and frequently host surgeons who are upgrading their training and endovascular skills.

The Ottawa Hospital has approved the building of four new operating theaters at the Civic Campus. Two of the theaters are to be devoted to Vascular Surgery. One of these theaters is being designed as a hybrid operating room with fixed floor mounted fluoroscopy.

The Divisional organization of care to patients who require vascular access for hemodialysis has also been recognized around the province and around the country. Dr. Andrew Hill and Janet Graham (Vascular Access Coordinator) have been invited to sit on provincial panels evaluating the provision of vascular access in Ontario with the Ottawa Hospital often cited as an ideal model of care delivery.

Educational ActivityThe Division of Vascular & Endovascular Surgery continues to have one of the most sought after vascular training programs in the country. Each year multiple candidates compete for limited training positions despite the presence of a number of training programs in Canada that go unmatched. This past June the Division was proud to witness the graduation of Dr Khalid Alomar and Dr Dalibor Kubelik from the training program.

The training model for vascular surgery is a continuing evolution. Division members have been working hard to submit a new five year direct entry program to the Royal College of Physicians and Surgeons of Canada. The anticipated date of the new direct entry primary subspecialty program is July 2012. For at least the next few years, it is anticipated that the five plus two model of training (with entry to Vascular Surgery from General Surgery or Cardiac Surgery) will continue in parallel with the new five year direct entry program.

The Division has developed endovascular training courses for practicing surgeons consisting of didactic teaching, operating room exposure and on-site proctoring for surgeons who wish to upgrade their endovascular skills. Plans are also being considered to train surgeons for more complicated procedures such as branched and fenestrated endovascular stent grafts.

Dr. Andrew Hill continues to co-direct a Winter CME Program in Vascular Surgery for active and in-training Vascular Surgeons. Dr Tim Brandys, Dr Prasad Jetty and Dr. Andrew Hill have also been invited speakers and moderators at the Winnipeg Vascular and Endovascular Symposium – an annual CME event for Vascular Surgeons and other interventional specialists.

Dr. Hill also helped to coordinate and presented at the Department of Radiology’s Annual Vascular Access CME program in May, 2011.

Dr. Prasad Jetty sits on the Canadian Society for Vascular Surgery Education Committee and is actively involved with their website construction and design.

Dr. Tim Brandys is an examiner for the Royal College of Physicians & Surgeons of Canada for Vascular Surgery.


Dr Brandys also won the “Excellence in Teaching” Award from the University of Ottawa Department of Surgery. He was presented the award at Collin’s Day on May 13th, 2011.

Dr. Brandys continues to function as the CORE Program Director for the Department of Surgery and he is the clinical lead for the Department of Surgery at the University of Ottawa Skills and Simulation Center.

Research ActivityCurrent Studies

Curcumin to prevent acute kidney injury from elective abdominal aortic aneurysm repair, Vanguard Phase I – multicentered randomized controlled trial. Andrew B Hill MDCM: co-investigator CIHR funded

Vascutek Anaconda™ Stent Graft System – Phase II IDE Study Sudhir Nagpal MD: site investigator Industry funded

Fibrin Sealant Grifols Study: a prospective, single-blind, randomized, Phase II/III Study Andrew B Hill MD: site investigator Industry funded

Contrast Ultrasound in the Surveillance of Endovascular Abdominal Aortic Aneurysm Repair Sudhir Nagpal MD: principle investigator Industry funded

Improving the Assessment of Hypothalamic Pituitary Adrenal Function in Acute Stress: CRAAS Study. Andrew B Hill MDCM: co-investigator CIHR funded Development and Validation of a Web-Based Tool to Facilitate Stent Graft Sizing for Endovascular Aneurysm Repair (2008-2011) Prasad Jetty MDCM: principle investigator Department of Surgery Research Award Funding

The fate of very large abdominal aortic aneurysms, in prohibitively non-operable patients George Hajjar MD: principle investigator Divisional funding

Does preoperative A1c predict in-hospital glucose control and adverse events following vascular surgery. Andrew B Hill MDCM: principle invesigator Divisional funding


Publications1. van Walraven C, Wong J, Morant K, Jennings A, Austin PC, Jetty P, Forster AJ. Radiographic monitoring of incidental abdominal aortic aneurysms: a retrospective population-based cohort study. Open Medicine, Vol 5, No 2 (2011).

2. van Walraven C, Wong J,Morant K, Jennings A, Jetty P, Forster A: Incidence, follow-up, and outcomes of incidental abdominal aortic aneurysms. J Vasc Surg 2010.

3. Jetty P, Walraven C: Coding Accuracy of Abdominal Aortic Aneurysm Repair Procedures in Administrative Databases - A Note of Caution. J Eval Clin Pract. 2011 Feb;17(1):91-6.

4. Jetty P, Hebert P, van Walraven C: Long-term Outcomes and Resource Utilization of Endovascular versus Open Repair of Abdominal Aortic Aneurysms in Ontario. J Vasc Surg 2010;51:577-83.

5. Moore R, Hill AB: Open versus endovascular repair of popliteal artery aneurysms. J Vasc Surg 2010 51(1) 271-276.

6. Price J, Naik V, Boodhwani M, Brandys T, Hendry P, Lam BK: A randomized evaluation of simulation training on performance of vascular anastomosis on a high-fidelity in vivo model: The role of deliberate practice. J Thorac Cardiovasc Surg 2011 142 496-503.

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