Annual Report 2017

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Annual Report Department of Surgery The Medical Center, Navicent Health

2017

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Message from the Chair The past year has proven to be yet another strong year for the Department of Surgery. Each division within the department has experienced many accomplishments and growth both clinically and academically. A major milestone was reached as our trauma center had a successful site visit from the American College of Surgeons (ACS) Committee on Trauma and was recognized as a nationally verified Level I trauma center. All trauma centers in the state are designated by the Department of Public Health, and the Medical Center has been designated as a Level I trauma center through this agency since 1998. At the time of this report, the trauma center at Navicent Health is the only ACS verified Level I trauma center in Georgia. In February 2017, Governor Nathan Deal visited the Medical Center and was the key note speaker at our press conference commemorating this achievement. The trauma center serves not only Macon but treated trauma patients from 79 of Georgia’s 159 counties last year.

Dennis W. Ashley, MD, FACS Milford B. Hatcher Professor Chair Department of Surgery Mercer Univ School of Medicine Director of Trauma and Critical Care Medical Center, Navicent Health

Our residency program continues to grow as the Accreditation Council for Graduate Medical Education granted an increase in our resident compliment from 4 to 5 residents per year. This July we will welcome 5 residents in the PGY 1 and 2 levels eventually graduating 5 chief residents per year. The department has been well represented with multiple presentations at the local, state, and national level. Faculty presented at the American College of Surgeons Trauma Quality Improvement Program and the Leadership and Advocacy Summit. It was a very strong year for resident scholarly activity. Residents presented at multiple meetings and had a particularly strong presence at the Southeastern Surgical Congress with 14 presentations. These included both poster and podium presentations one of which was a Gold Medal presentation. After many years of planning, the vision of having a truly dedicated children’s hospital is coming to fruition. Our President and CEO of Navicent Health, Dr. Ninfa Saunders, has been instrumental in developing and supporting this project. Construction has started, and the Navicent Health Foundation is in the middle of a major fundraising campaign. The Department of Surgery continues to play an important role in the quality initiative of Navicent Health. As the hospital has reorganized the quality infrastructure, our surgical faculty is represented as Chair or Co-Chairs of multiple committees taking on the charge of surgeon leaders. Finally, the future is bright as we have had a strong recruiting year for both our general surgery residency and surgical critical care fellowship programs. About the cover: Artwork done by Dr. Brett Howard

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Department of Surgery

Left to right: Milford B. Hatcher, Will C. Sealy, Martin L. Dalton, Don K. Nakayama, Dennis W. Ashley The Residency in Surgery had its start under its founding Chair, Milford B. Hatcher, M.D., in 1958. Internationally famous for arrhythmia surgery, Will C. Sealy, M.D. succeeded him in 1984. In 1991, Martin L. Dalton, M.D. followed Dr. Sealy as Professor and Chair. The academic growth of the department continued with important clinical programs in trauma and critical care and surgical research. The Residency grew from two to four chief resident positions. Don K. Nakayama, M.D., a pediatric surgeon, was named the Milford B. Hatcher Professor and Chair of the Department of Surgery in 2007. Dr. Dennis W. Ashley was named the Milford B. Hatcher Professor and Chair of the Department of Surgery July 1, 2014. The program is fully accredited by the Residency Review Committee in Surgery of the Accreditation Council for Graduate Medical Education. Residents regularly finish with more than 1,200 operations during the five year training program with extensive experience in all areas of general surgery. Residents enter fellowships in all major surgical specialties. The Surgery Department also has a third year medical student clerkship providing a broad experience in trauma, vascular, general and pediatric surgery.

Mercer University School of Medicine The School of Medicine was organized in 1982, part of a thirteen-year effort by city and community groups, the Bibb County Medical Society, and the Georgia State Legislature to educate physicians and other health professionals to meet the primary and ancillary healthcare needs of rural and medically underserved areas of Georgia. Currently there are 60 students per year. Programs have been offered by Mercer University School of Medicine in collaboration with The Medical Center, Navicent Health since 1984. A second four-year school was opened in 2008 in Savannah, and another clinical training site in Columbus,

The Medical Center, Navicent Health The Medical Center, Navicent Health (MCNH) has a 100-year history of serving the central and south Georgia regions. At 603 beds, it is the second largest hospital in the state, the largest in a region of a 1.2 million population bounded by Atlanta, Augusta, Jacksonville, and Birmingham. MCNH has been named one of the top one hundred hospitals in the nation with top programs in cardiac services, orthopaedics, and neurosurgery. The hospital has 28 operating rooms with the full range of advanced surgical technology, including robotics, neuroimaging, and endovascular and minimally invasive surgery. It is certified by the Georgia Division of Public Health and the Office of Trauma as a Level 1 Trauma Center, with more than 2400 trauma admissions. MCNH supports residency training programs in family practice, general surgery, internal medicine, obstetrics and gynecology and pediatrics. Specialty fellowships in surgical critical care and geriatrics are also available. MCNH’s graduate medical education programs have more than 100 trainees.

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Dennis W. Ashley, M.D., F.A.C.S.

Milford B. Hatcher Professor & Chair Director of Trauma and Critical Care Program Director, Surgical Critical Care Residency: The Medical Center, Navicent Health Fellowships: Trauma Surgery, Grady Hospital, Atlanta; Surgical Critical Care, University of Pittsburgh

Hany Atalah, M.D. Assistant Professor Robotic Surgery Director of Robotic Surgery Residency: University of Alexandria, Egypt Fellowship: General & Pediatric Surgery, University of Alexandria, Egypt

Macram M. Ayoub, M.D., F.A.C.S. Professor and Vice-Chair Residencies: Medical College of Ohio; The Medical Center, Navicent Health

Andrew P. Bozeman, M.D. Assistant Professor Residency: The Medical Center, Navicent Health Fellowships: Pediatric Surgery Research, Arkansas Children’s Hospital; Pediatric Surgery, Arkansas Children’s Hospital

Daniel S. Chan, M.D. Assistant Professor Associate Chair, Georgia Orthopaedic Trauma Institute Residency: University of Texas Southwestern Fellowships: AO International Fellowship, Tubingen, Germany; Orthopaedic Trauma, Florida Orthopaedic Institute

Jason Chapman, M.D. Assistant Professor Residency: The Medical Center, Navicent Health Fellowship: University of Tennessee, Medical Center in Knoxville, Tennessee

Amy B. Christie, M.D.

Assistant Professor Residency: The Medical Center, Navicent Health Fellowship: Surgical Critical Care, The Medical Center, Navicent Health

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D. Benjamin Christie, III, M.D., F.A.C.S. Assistant Professor Program Director, General Surgery Residency Residency: The Medical Center, Navicent Health Fellowship: Surgical Critical Care, The Medical Center, Navicent Health

Paul S. Dale, M.D., F.A.C.S. Professor Chief of Surgical Oncology Vice Dean of Translational Research Residency: The Medical Center, Navicent Health Fellowship: Surgical Oncology, John Wayne Cancer Institute

Martin L. Dalton, M.D., F.A.C.S. Professor, Chair and Dean Emeritus, MUSM Residency: University of Mississippi Medical Center Fellowship: Thoracic and Cardiovascular Surgery, University of Mississippi

Joshua Glenn, M.D., F.A.C.S. Assistant Professor Chief, Pediatric Surgery Residency: Medical University of South Carolina Fellowship: Pediatric Surgery, Vanderbilt University

Michael D. Honaker, M.D. Assistant Professor Residency: Carolinas Medical Center Fellowship: Colorectal Surgery, William Beaumont Hospital

Michael L. Klyachkin, M.D., F.A.C.S. Clinical Associate Professor Residency: University of Kentucky Medical Center, Lexington Fellowship: University of Stony Brook Medical Center

Eric Lincoln, D.O.

Clinical Assistant Professor Residency: Georgia Regents University Fellowship: Pediatric Orthopaedics, Brown Alpert Medical School, Providence R.I.

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Eric Long, M.D. Assistant Professor Residency: The Medical Center, Navicent Health Fellowships: NIH Research, Vanderbilt University Medical Center; Surgical Critical Care, The Medical Center Navicent Health

J. William (Billy) Mix, M.D., F.A.C.S. Assistant Professor Residency: The Medical Center, Navicent Health Fellowship: Vascular Surgery, University of Tennessee, Knoxville

Robert J. Parel, II, M.D., F.A.C.S. Assistant Professor Residency: Ochsner Clinic

Joe Sam Robinson, Jr., M.D., F.A.C.S. Professor Chief, Neurosurgery Residencies: Emory University and Northwestern University

William B. Schroder, M.D. Associate Professor Residency: New York University School of Medicine Fellowship: University of Medicine and Dentistry of New Jersey

Issam J. Shaker, M.D., F.A.C.S., F.A.A.P. Professor Residency: Vanderbilt University Affiliated Hospitals Fellowship: The Johns Hopkins Hospital

William (Kim) Thompson, M.D., F.A.C.S. Associate Professor Associate Chair, Clinical Education Residency: University of Texas Southwestern Medical Center

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Joseph M. Van De Water, M.D., F.A.C.S.

Professor (Emeritus); Assistant Dean for Research, MUSM Residency: UCLA Fellowships: Critical Care/Surgical Research, Harvard Medical School; Cardiac Surgery, Children’s Hospital of Los Angeles

Danny M. Vaughn, M.D. Assistant Professor Medical Director, Bariatric & Metabolic Institute Residency: The Medical Center, Navicent Health Fellowship: St Luke’s Hospital, Kansas City, Mo.

William N. Veale, Jr. , M.D. Vascular Institute, Navicent Health Residency: The Medical Center, Navicent Health Fellowship: Eastern Virginia Medical School

Zhongbiao Wang, M.D., Ph.D. Associate Professor Director Surgical Laboratories Residency: Fujian Provincial People’s Hospital, China Fellowships: Huashan Hospital Shanghai Medical University, Cardiology Ph.D.: Shanghai Medical University, Chinese Academy of Sciences

Lawrence X. Webb, M.D. Professor (Orthopaedics) Chair, Georgia Orthopaedic Trauma Institute Residency: North Carolina Baptist Hospital Fellowship: Science of Polytrauma, Harborview Hospital

Clinical faculty and Chiefs of Services General, Cardiothoracic, Vascular, and Pediatric Surgery Arnold Conforti, M.D. Asst Prof & Chief, Surg Vincent Culpepper, M.D. Asst Professor Douglas Brewer, M.D. Prof & Chief, Colorectal Surg Brown N. Ekeledo, M.D. Asst Professor Ellis Evans, M.D. Professor Lisa Farmer, M.D. Asst Professor James L. Foster, Jr., M.D. Asst Prof Robert Holl-Allen, M.D. Professor Bruce Innes, M.D. Professor (emeritus)

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John Williams, IV, M.D. Asst Professor Thomas Woodyard, M.D. Asst Professor Piedmont Transplant Institute, Atlanta Mark Johnson, M.D. Prof & Chief, Transplantation Marty Sellers, M.D. Asst Prof Miguel Tan, M.D. Asst Prof Harrison Pollinger, M.D. Asst Prof Clinical Chiefs of Services Amos M. Anderson, M.D. Asst Prof, Urology Howard Perofsky, M.D. Asst Prof, Plastics Waldo Floyd, III, M.D. Prof, Hand Surgery Matthew Jerles, M.D. Asst Prof, Otolaryngology Christopher Hendry, M.D. Chief Medical Officer

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The HAUNS in Africa On a hot and humid afternoon in northern Ghana, I was finishing my last clinic note when a nurse rushed in exclaiming "There's been a moto accident and a man's bowels are coming out!" I ran to the OR where the patient had just arrived. Despite his small bowel being eviscerated from a laceration on his left flank just caudal to the rib cage, he was talking and normotensive. His riding companion, however, was not doing as well. He was diaphoretic, hypotensive and minimally responsive. The two large bore IV's were passed, and we began squeezing two liters of ringers lactate into him. This patient also had a laceration on his left flank, but it was about two inches more cephalad than his friend's wound, at about the tenth intercostal space. A spleen injury was very likely so we moved him into the OR and moved his friend out. We asked his family to find him a compatible blood donor. At exploration, I found a shattered spleen, a large laceration of the diaphragm and a kidney laceration. I removed the spleen, repaired the diaphragm, and placed a chest tube. I applied gelfoam to the kidney laceration, and it became hemostatic so I left it in situ. After the case, I rode my bicycle home, ate dinner, nursed my one-year-old baby and put her to bed. Then I hopped back on the bike and returned to the hospital for the second laparotomy. The second patient had an almost identical kidney laceration and an eviscerated bowel. A few hours later, with both patients in stable condition, I headed back to the house to join my now sleeping family. Not every day is as exciting as that one and not every case has a positive outcome, but that's true whether you live and work in Nalerigu, Ghana or Macon, Georgia. My family's long-term commitment to the people of Northern Ghana is a marathon of sorts. I have learned to pace myself and to set boundaries so that I do not burn out. For the first six months, I hardly even set foot in the hospital except for emergencies. The International Mission Board (IMB) emphasizes the importance of language and cultural acquisition so our first task was to learn the local language of Mampruli. To do that, we immersed ourselves in the community and began to acquire a deeper understanding of Mamprusi culture. On many days, I felt like a toddler trying to communicate and failing miserably, but that only strengthened my bond with my Ghanaian friends as I turned to them for help. One huge milestone in my acceptance into the community came when I realized I was pregnant and decided to stay here to deliver. After her birth, locals proudly claimed my daughter as a Mamprupɔ'a (Mamprusi girl) and 200 people showed up for the traditional naming ceremony at our home. Now that I have been in Nalerigu for two years, I can communicate directly with many of my patients, though I still often use translators to confirm comprehension. I walk through the hospital greeting workers, nurses and patients alike in Mampruli. The smiles on their faces to hear me speaking their language is incredible. The time I took to learn their culture and worldview also breaks down many communication barriers as I work alongside the Ghanaian hospital staff.

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Each week, I schedule a few elective surgical cases and then take care of emergencies as they come. Electively, I repair hernias – inguinal, incisional and sometimes umbilical. Umbilical hernias are very common in West Africa and are seen as a normal variant so I have only repaired ones that have problems. I opened one large umbilical hernia to find an incarcerated floppy cecum completely full of bush-grape seeds -- a favorite snack among local children. I also see lipomas and cysts of all sizes, breast lumps and hydroceles with relative frequency. In the past few months, I have dealt with multiple anal fistulas that have required cutting setons. After researching possible seton materials, I came across a paper out of India which described the use of a cable tie or zip tie. I used this DIY method on a patient and saw excellent results.

Urgent cases at BMC vary from abscesses to occasional emergent traumas. One common issue is that patients' wounds progress to severe infections before they seek medical attention. Patients sometimes present with necrotizing fasciitis requiring wide debridement. Many skin grafts are subsequently needed. I perform many more amputations than I'd like, and again, patients delaying in seeking treatment is often the cause. Indications for amputation range from diabetic foot necrosis, peripheral vascular disease, large tumors and trauma. The saddest cases develop after a child's arm or leg fracture is mismanaged by a local bone setter which compromises blood flow. The children are finally brought to the hospital once gangrene has done its damage and amputation is the only option. Multiple disease processes lead to "acute abdomens." Typhoid ileal perforations create a filthy peritoneal cavity, second only to that of gastric perforations. Bowel obstructions present from postoperative or post-infectious adhesions, congenital bands, chronic strictures and even advanced cancer. Appendicitis is fairly common, and as we have no laparoscopic equipment I am thankful for the few open appendectomies I did during my training in Macon. Many of these patients come only after an abscess has already formed, and I have learned to do ultrasound-guided percutaneous drains. I'm extremely grateful to my colleagues and mentors from my MCCG residency who are always happy to advise me via email or phone when I run across particularly challenging or puzzling cases. One such case was a patient who had presented with jaundice and RUQ pain. On ultrasound, my colleague and I were able to detect a massively dilated common bile duct and shadowing in the head of the pancreas. Here biliary disease is rare enough but rarer still is a common bile duct stone lodged at the ampulla of Vater! Wanting to avoid a duodenotomy, I called my mentor Dr. Ayoub in Macon for advice. At his suggestion, I was able to remove the gallbladder and successfully extract the large stone through the dilated duct. Preparing patients for surgery in Nalerigu is very different than it is in the US. Our lab is limited to tests such as hematocrit, blood film, and urinalysis. Plain x-rays and ultrasound are the only imaging modalities available. The only way that we can assess adequate IV resuscitation and kidney function is by monitoring urine output. In the absense of post-operative ventilators, we use spinal anesthesia and ketamine sedation for as many operations as possible. The day after that motorcycle accident's double laparotomies, my family had an audience with the Nayiri, Paramount Chief of the Mamprusis (the majority ethnic group where we live). The palace had heard about the accident and the king expressed his sadness that the two had died. "No! They're alive!" my husband excitedly reassured him. "My wife operated on them both and they are recovering well." Amazed at the good news, he observed that the rumors of their death had spread because in years past it would have been impossible for them to be saved. He sent us home with a gift of yams and two guinea fowls, a royal gesture of appreciation and respect. -This article was used by permission from William and Heidi Haun and the Bibb County Medical Society ANNUAL

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Bibb County Medical Society Physician of the Year Dr. Macram Ayoub Dr. Ayoub’s medical career started a long way from Macon, Georgia, as he was born in Egypt and completed medical school at Cairo University. This was followed by surgical training in the United Kingdom where he ultimately became a Fellow of the Royal College of Surgeons in Edinburgh and England. He moved to the United States and completed additional surgery training at the Medical College of Ohio in Toledo and the Medical Center of Central Georgia in Macon now known as The Medical Center, Navicent Health. He completed additional training in the United States, so that he could practice general surgery and be fully board certified by the American Board of Surgery. If you want to talk about being intimating, can you imagine being a Chief Resident and taking your intern through an appendectomy when the intern is already board certified by the Royal College of Surgeons. As you would expect, he was at the top of his resident class, and after completion of his surgery training, he joined the faculty of the Surgery Department at the Medical Center. He is double boarded with a certificate in general surgery and added qualification in surgical critical care from the American Board of Surgery. Dr. Macram Ayoub has served as faculty of the Department of Surgery at The Medical Center, Navicent Health for the past 36 years and is a Professor of Surgery at the Mercer University School of Medicine. He has affected countless lives of his students, residents, patients and peers. He has had a profound effect on surgical education as he has trained over 90 surgical residents and hundreds of medical students. In addition to training multiple residents that practice in Georgia, his impact extends across the United States as his residents are practicing in Texas, Wisconsin, Tennessee, California, Mississippi, Louisiana, Kansas, Alabama, Florida, Missouri, North Carolina, Pennsylvania, Minnesota, New York, South Dakota, and Virginia. He even has one resident, Dr. Heidi Haun, who is practicing as a missionary surgeon in a Baptist Hospital in Ghana. Actually, Dr. Haun was featured in the Bibb County Medical Society Newsletter this week. Dr. Ayoub is an avid teacher winning the Attending Teacher of the Year Award over 10 times. As a matter of fact, he won it so many years that we just named the award after him so someone else could win it. He has many other honors but two worth noting are the Humanism in Medicine Award from Mercer and, most recently, the Superhero Physician Award from Navicent Health. He was also honored in 2013 by Mercer University and Navicent Health with a festschrift in celebration of his educational leadership. As a matter of fact, it was in this very room where faculty and former residents gathered to honor this great educator. Dr. Ayoub is well known for his teaching rounds as many times he has seen the patient and checked the surgical pathology report before the resident. It is always a competition with the residents to try and “scoop” Dr. Ayoub, but they rarely win. Dr. Andrea Long, a former resident, alluded to this in her reflections of Dr. Ayoub. “I still feel giddy on the few occasions when I can tell you the path results before you can find them out yourself. . . and I love the little smile on your face when I do so.” There is an acronym that is known by all the surgery residents WWAD. What would Ayoub do? Dr. Craig Wengler, a former resident now practicing in Florida, notes that there is not a day that goes by I don’t ask myself “What would Dr. Ayoub do?” “Whether I am in the OR, at a patient’s bedside, in clinic, or working with medical students, I am constantly trying to assess situations through your eyes.” Dr. Ayoub does like to have fun with the residents. He has led them to believe that he can diagnose a bilirubin level just by looking at the patient. One day on rounds with students and residents gathered around him he examined a patient, paused, and then said, “I believe the bilirubin is 3.2”. As the residents looked in amazement when they read the lab value of 3.2, they had little idea that he had already looked at the labs before he walked in the room. Dr. Ayoub has earned the respect of all that have ever been trained by him as well as his colleagues. He is the epitome of what a surgeon ought to be. ANNUAL

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Message from the General Surgery Residency Program Director The 2016-2017 academic year for the Department of Surgery will be remembered for its productivity and growth, an increase in scale of which I am certain has never been achieved in the history of the Department of Surgery. The Program exceeded expectations in the realms of academic and scholastic contributions, medical technology application and resident performances in nonclinical leadership roles. The Department of Surgery grew in both number and stature thanks to the sacrifice and dedication of each member of our department. Led by the graduating PGY5 residents, the education curriculum was overhauled and tailored to their specifications, resulting in an overall improvement in the Programs mean score on the American Board of Surgery in Training Examination. The residency continued to build on its scholarly activities, recording more presentations, scientific exhibits and publications than any year in recent memory. Of special note, the residents proudly represented our institution at this year’s Southeastern Surgical Congress and were formally recognized by the Congresses Dudley Benjamin Christie, III, MD leadership as we accounted for near 10% of the meetings educational content, more than any Assistant Professor of Surgery other participating institution in the entire country. The residents presented original work at Mercer University School of Medicine meetings around the United States over the course of the year, propagating the Department of Medical Center Navicent Health Surgery’s sound reputation on a national scale. Department of Surgery Trauma and Critical Care

Under the guidance of Dr. Hany Atalah, the 2016-2017 academic year will mark the first year that the graduating chief residents will receive certificate equivalents for their robotic surgery training experience facilitating their credentialing at future institutions for the use of robotic surgical techniques, an advantage that few training programs in the country can provide. In 2016-2017, the residents were increasingly recruited to, and integrate within, hospital quality and process improvement committees of our institution, roles that have been traditionally filled by non-resident hospital staff, reflecting the institutions recognition of the programs strength and pervasive hospital influence. The residents are now directly part of the strategy and development of improving quality care delivery processes on a system wide scale, driving our hospital’s efforts at achieving excellence in patient care. The Department of Surgery continues to be on the leading edge of championing the application of new technology for health care delivery. In years past, the Program has been recognized as being 1 of 40 departments in the country at one point in time to use transesophageal echocardiography in the ICU, one of the leading institutions in the country for the management and study of chest wall reconstruction with rib plating after traumatic chest wall injury, and this year, became the 57 th institution in the country to institute a REBOA program for the trauma patient in shock. This academic year, the Department of Surgery has grown as we was welcomed Brandon Bradley, PA as an anchor in our clinical office and look forward to the addition of NP Brandi Sheppard and PA Jana Comer who will augment the trauma and critical care service lines. Also, after a thorough review by the ACGME, the residency was granted an increase in our resident compliment to 5 residents per year, based on a comprehensive review of the Program’s educational and training merit. The compliment increase will begin on July1 as we will welcome 5 residents in the PGY2 and PGY1 levels. As we reflect on the state of the Program, we do so with mixed emotions. As much as we relish the Department of Surgery’s achievements over the last year and discuss them with pride, we are also reminded that we are losing a part of us. We are graduating four outstanding surgeon leaders with bright futures. They are a truly special group. Over the course of their five-year career with us, their impact can be seen in, not just the aforementioned accomplishments, but in the countless patients they have care for, the medical students and junior residents that have influenced and mentored, the friends they have made in Macon, Georgia, and those of us that consider them family. We wish the graduating chiefs the best of all possibilities and could not be more proud.

Dr. Benjie Christie Elected as New GMEC Chair Dr. D. Benjamin Christie was unanimously elected as the new Chair of the Graduate Medical Education Committee (GMEC). He will start a 3 year term on July 1, 2017. The GMEC convenes under the leadership of the elected Chair and the Designated Institutional Official. The elected GMEC Chair is responsible for planning, preparing, and leading the meeting. Duties include, but are not limited to, assigning subcommittees as required to carry out portions of the GMEC’s responsibilities, keeping the committee on task, and follow-up on agenda items from previous meetings. ANNUAL

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Residents in Surgery

2016-2017

PGY 5’s Mike Fitzgerald

Brett Howard

Joey Jarrard

Heather Nolan

PGY 4’s Akeel Allen

Trine Engebretsen

Alicia Register

Phillip Rideout

PGY 3’s Crystal Fancher

Madison Griffin

Christopher Jean-Louis

Justin Vaughn

PGY 2’s Andrew Drahos

Matthew Johnson

Alex Sapp

Tony Scott

PGY 1’s Matthew Barnes ANNUAL

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Timothy Nowack

James Parker

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2017 Graduating Chief Residents Michael T. Fitzgerald, M.D., was born in Pickerington, Ohio. He attended Clemson University where he majored in Biology and played rugby. He then attended medical school at the Medical University of South Carolina in Charleston, South Carolina. Upon completion of residency, Michael and his fiancé Katie will move to Memphis, Tennessee, where he will begin a Trauma/Critical Care fellowship at UT-Memphis. Brett M. Howard, M.D., was born in South Florida and grew up in Weston, Florida. He completed his undergraduate education at Florida State University in Tallahassee, Florida. He also earned his medical degree from Florida State University. Upon completion of residency, Brett will join Surgical Associates of Tallahassee at Tallahassee Memorial Hospital in North Florida. Brett, his wife Emily, and their three sons Bennett, age 5, Walter Rhodes, age 3 and Max, age 1 are looking forward to cheering on the Seminoles at Doak Campbell Stadium. Go Noles! Joey A. Jarrard, M.D., was born in Alma, Georgia. He double-majored in Biology and Chemistry from Valdosta State University and graduated with honors. He completed medical school at the Medical College of Georgia. Upon completion of residency, he will begin a 1 year fellowship in Bariatrics and Minimally Invasive Surgery at Saint Luke's Hospital in Kansas City, Missouri. Joey and his wife Laurie have three children: Claire, age 4, Walter, age 2, and Henry, age 8 months. Heather R. Nolan, M.D., was born in Dayton, Ohio. She doublemajored in English and Mass Communications at Carson-Newman College and graduated Summa Cum Laude with a Bachelor of Arts with Honors. She earned her medical degree from the University of Kentucky College of Medicine. Upon completion of residency, she will begin a fellowship in Fetal Surgery at Cincinnati Children’s Hospital. Heather and her husband, Matthew, have been married for 13 years and have one dog, Riley, age 4. ANNUAL

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R E S I D E N C Y I N G E N E R A L S U R G E RY WELCOMES NEW PGY 1’S AND PGY 2 Mallory “Blake” Bowden will graduate from the Medical College of

Georgia at Augusta University in May. A native of Columbus, Georgia, she attended the University of Georgia where she received her Bachelor of Science degree in Biology and Psychology and graduated Magna Cum Laude. As one of triplets, with twin brothers, Blake learned to be a team member yet compete in a positive way early on in her life. She volunteered at Cervico Cusco at a free women’s health clinic in Peru where she helped set up clinics in underserved communities, educated local residents about tropical diseases, performed physical exams, and assisted in the treatment of the local population under her attending physician’s supervision.

Eric Donald Forney will graduate from the University of Nebraska College of Medicine in May. A native of Lincoln, Nebraska, he attended Creighton University where he received his Bachelor of Science degree in Biology and a minor in Health Administration and Policies where he graduated Cum Laude.

As an undergraduate, he did volunteer work in Haiti working as an assistant to a surgeon. This experience convinced him that he wanted to pursue a surgical career. He is described as hardworking, dedicated, and conscientious. His integrity is impeccable, and he is a well-liked member of the team.

Casey Chinn Hawes will graduate from the University of Mississippi School

of Medicine. Born in Jackson, Mississippi, she attended the University of Mississippi in Oxford where she received her Bachelor of Arts degree in Biology and graduated Summa Cum Laude. During the summer after her first year of medical school, she traveled to Nicaragua with a group of her classmates and other volunteers for a week long medical mission trip. Once in Nicaragua, she spent the week traveling to different locations in delivering medical and dental care to patients without accessible health care.

Carmen Elizabeth Lee will graduate from Mercer University School of

Medicine. Born in Augusta and raised in Columbus she attended Georgia Institute of Technology in Atlanta where she received her Bachelor of Science degree in Biology. Carmen is a legacy in Columbus as her father is a beloved ENT surgeon. Because of this, Carmen was exposed in her childhood to the rigors of night call and ER exposure for acute surgical care. Carmen is well aware of the lifestyle limitations for the private practice surgeon and is fully prepared to accept this role. ANNUAL

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R E S I D E N C Y I N G E N E R A L S U R G E RY W E L C O M E S NEW PGY 1’S AND PGY 2 William “Bill” Wallace will graduate from the University of Oklahoma

College of Medicine. Born in Oklahoma City, he attended the University of Central Oklahoma where he received his Bachelor of Science degree in Nursing. Bill has been an active volunteer at various free clinics and community outreach projects. He enjoys playing intramural sports throughout medical school and continued to work part-time as a Registered Nurse during his first two years of medical school. With his accomplished background in health care prior to entering medical school, he will be a great asset to our general surgery program.

Raviteja “Ravi” Devalla, M.D., has accepted a PGY-2 position with

our department. He completed his undergraduate training at both the University of Vermont and the University of Rhode Island attaining his degree in Biology with a minor in Chemistry. He graduated from the Trinity School of Medicine in Saint Vincent and the Grenadines and spent a year at the University of Maryland in Baltimore, Maryland, as a preliminary resident in general surgery. An attending surgeon at Baltimore VA Medical Center notes that “Ravi was very well liked by all the surgeons and staff, as he has a very pleasant demeanor and very willing to undertake any task in the interest of patient care. He is very dependable and a very good team worker.” Ravi is very interested in overseas volunteer work and has been collaborating with the House of Hope Orphanage in Port Au Prince, Haiti, to provide physicals and health care advice for locals. His goal is to pursue a Cardiothoracic

2017-2018 Surgical Critical Care Fellow Steven Lyons, D.O., will be joining us as the 2017-2018 Surgical Critical Care Fellow. He will be graduating from the General Surgery Residency Program at the Northeast Regional Medical Center (NRMC) located in Kirksville, Missouri. His experience includes general surgery at NRMC; rural clinic and hospital experience in multiple nearby communities; pediatric surgery and trauma experience in Dayton, Ohio; and acute care surgery, surgical intensive care, and trauma at Swedish Medical Center in Denver, Colorado. “His medical and surgical knowledge is extensive, well integrated, and very impressive. In surgical specialty knowledge (i.e. cardiovascular thoracic surgery), Steve is definitely ahead of his peers.” -Kent J. Blanke, D.O., F.A.C.O.S., Clinical Professor of Surgery, A.T. Still University, Director of Medical Education, Northeast Regional Medical Center.

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TRAUMA Georgia Governor Nathan Deal Visits State’s Only NationallyVerified Level I Trauma Center

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The Medical Center, Navicent Health Provides Nationally Recognized Trauma Care

The Honorable Nathan Deal, Governor of the State of Georgia, visited The Medical Center, Navicent Health (MCNH) on February 22, 2017, to tour the hospital’s nationally-verified Level I Trauma Center. MCNH boasts the only Level I Trauma Center in the state nationally verified by the American College of Surgeons. In November 2016, MCNH achieved verification as an American College of Surgeons (ACS) verified Level I trauma center. MCNH has been designated a Level I Trauma Center by the State of Georgia since 1998, and is now the only Level I trauma center in the state and only one of 17 hospitals in the Southeast to achieve this additional, national recognition. Gov. Deal, a strong supporter of Georgia’s Trauma Care Network, visited MCNH’s Trauma Center. The trauma team voluntarily sought verification from the American College of Surgeons, for the benefit of our patients and their loved ones. We have gone beyond the standard requirements for Level I trauma centers to meet the highest standards set forth by this national organization. “As a nationally-recognized ACS Level I trauma center, our patients can trust that we are exceeding the standards in order to provide the highest levels of care. Our team truly is setting the standard for trauma care in this state,” said Ninfa M. Saunders, DHA, President and CEO of Navicent Health. Of the185 hospitals in Georgia, only 30 are trauma centers. The state of Georgia classifies trauma centers on a scale of Levels I-IV, dependent on the level of care provided. Only six hospitals in the state – including MCNH – are classified at the most comprehensive level, Level I. MCNH’s Level I trauma team, comprised of numerous surgeons in various specialties as well as highly-trained and specialized clinicians, is available 24 hours per day and able to provide the most sophisticated level of care for trauma patients. In addition, as a Level I trauma center, MCNH leads the field in research and provides training for future surgeons through residency and fellowship programs. “Across the nation, Level I trauma centers are typically in large, metropolitan areas. The availability of care provided at The Medical Center, Navicent Health is very rare in smaller communities like Macon. Patients in central and south Georgia are incredibly fortunate to have access to the Level I trauma services, now nationally verified by the American College of Surgeons, so close at hand when accidents and injuries occur,” said Chris Hendry, MD, Chief Medical Officer for MCNH.

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Trauma Awareness Day at the Gold Dome - A Success! Georgia’s General Assembly invited trauma physicians and clinicians to the state capitol on Tuesday, February 7. Representatives of The Medical Center, Navicent Health were pleased to join trauma professionals from around the state to launch Georgia’s "Stop the Bleed" Campaign.

Over 200 physicians, nurses, and paramedics spent the day talking to legislators about the trauma system and then trained several hundred lawmakers, legislative staff and Capitol visitors on how to “Stop the Bleed”. The trauma professionals from across the state presented their plan to distribute training and equipment to law enforcement, school systems and lay citizens. The trauma advocates asked legislators to appropriate an additional $1million to the Georgia Trauma Commission (GTC) to be used to provide training and place small bleeding control kits in all of Georgia’s public schools. “Our goal is to provide life-saving education and equip our school classrooms, law enforcement vehicles and public venues including airports, stadiums and churches with bleeding control kits. These kits will accompany education and training to fully equip individuals with the necessary skills to save a life,” said Dr. Ashley. Both the Georgia House of Representatives and the Georgia Senate passed special resolutions declaring February 7, 2017 to be Trauma Awareness Day in Georgia. Georgia Society of the American College of Surgeons President-elect and Georgia Trauma Commission Chairman, Dr. Dennis Ashley, accompanied by Drs. Fred Mullins, Robert Cowles, John Bleacher, Colville Ferdinand and trauma survivor Ashley Power accepted the Trauma Day resolution on the floor of the Senate and addressed the senators. This special event was made possible by a grant from the American College of Surgeons and the collaboration of the Georgia Trauma Foundation, the Georgia Trauma Commission and the Georgia Committee on Trauma.

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Stop the Bleed - A Call to Action UNCONTROLLED BLEEDING IS THE NUMBER ONE CAUSE OF PREVENTABLE DEATH FROM TRAUMA. Regardless of the cause of injury, uncontrolled bleeding is the number one cause of preventable death from trauma. Severe bleeding may claim a life within minutes, potentially before trained responders arrive on scene. "Stop the Bleed" is a new nationwide initiative to empower individuals to act quickly and save lives. Motivated by the 2012 tragedy in Sandy Hook and multiple tragedies that have occurred in the ensuing years, the Joint Committee to Increase Survival from Active Shooter and Intentional Mass Casualty Events was convened by the American College of Surgeons to bring together leaders from law enforcement, the federal government, and the medical community to determine how to increase survival from such incidents. They concluded that injuries from these events generally present with severe bleeding which, if left unattended, can result in death. Collectively, their recommendations are known as the Hartford Consensus. The overarching principle of their findings is that no one should die from uncontrolled bleeding. The Hartford Consensus recommendations and the “Stop the Bleed” campaign represent a call to action for every person to learn the basics about how to respond to uncontrolled bleeding and to put those lessons into use when placed in a position to help. “Research has shown that bystanders with little or no medical training can heroically save a life if equipped with the right knowledge. This is seen in incidents where bystanders use CPR training or automatic defibrillators until help arrives. We firmly believe this program has the ability to help people save lives in the event of an emergency situation.” said Dr. Dennis Ashley. Representatives from The Medical Center, Navicent Health are joining the national effort to champion the “Stop the Bleed’ in our community and beyond. In addition to presenting the program to lawmakers during Trauma Awareness Day, Trauma Services personnel working with regional partners has trained over 1,500 central Georgian’s having presented the program to local civic organizations, emergency responders, churches, and schools. Kristal Smith, Injury Prevention and Outreach Coordinator is currently working with the Region 5 Regional Trauma Advisory Committee and the Region F Healthcare Preparedness Coalition to coordinate two “Stop the Bleed” pilot initiatives for area schools and law enforcement personnel. ANNUAL

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Education and Outreach Trauma care knowledge and skills need to be continuously updated, refined, and expanded through targeted trauma care training. —Region 5 EMS Regional Trauma Advisory Committee, August 2011

Trauma Services at the Medical Center Navicent Health is committed to expanding access and improving outcomes for all patients experiencing trauma. In addition to providing patient care services, Trauma Services, a source of information, expertise, and leadership in the treatment of major injury, working hand in hand with our partners to periodically assess the training needs of trauma care providers in the region in order to deliver robust trauma training programs.

Advanced Trauma Life Support

Advanced Trauma Life Support (ATLS) courses are provided by the faculty and staff of the Department of Trauma Services to improve patient care during the golden hour of the victim's experience. These courses are offered both at our facility and in smaller courses at the referral hospitals based on physician need. To further support the national trauma training system, Trauma Services also offers ATLS instructor courses for physicians throughout the country.

Rural Trauma Team Development

Rural Trauma Team Development (RTTDC) courses are conducted at for partnering hospitals in rural locations. Developed by the Rural Trauma Committee of the American College of Surgeons Committee on Trauma, RTTDC emphasizes a team approach to the initial assessment, resuscitation and transfer of the trauma patient in a systemized, concise manner.

Additional Courses

The Medical Center Navicent Health offers Trauma Nursing Core Course (TNCC), Emergency Nursing Pediatric Course (ENPC), and Advanced Trauma Care for Nurses (ATCN), class for clinicians throughout the region to better prepare nurses caring for trauma victims. Recognizing patient care does not end when the patient is transferred from the trauma theater MCNH began offering TCAR courses to nurses and other non-physician clinicians working in the ICU and post ICU settings. Additionally, Trauma Services has a strong, long-standing relationship with area prehospital clinicians and has been extremely active in the provision of education which addresses the needs of first responders, emergency medical technicians, and paramedics. Examples of these efforts include Prehospital Trauma Life Support Courses, field simulations and exercises, and in-service training offerings designed to address needs identified through our performance improvement process or regional peer review.

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School Response Program Emergencies such as tornadoes, fires, floods or acts of violence can -and dohappen in any school, at any time. No one wants to think about such disasters, but being prepared for an emergency can help. When a disaster hits a community or a region, the entire health care and emergency preparedness system will be impacted and will have to respond. In some cases, this will mean that traditional response from EMS, fire, and law enforcement personnel may be delayed. In an early effort to implement the recommendations of the Hartford Consensus within area schools, the School Response Program was designed to equip and enable “non-traditional” responders (teachers, coaches, and school administrators) to render immediate, potentially life-saving medical aid to injured students or co-workers while they await the arrival of professional responders. Participating schools were each provided a School Response Bag capable of treating multiple victims and up to 15 Individual Response Kits. The program was piloted in 84 Schools in 27 counties. Since January 2015, more than 1,000 school staff members have participated in two-hour training on bleeding control and basic airway support during a crisis. Training was provided using a train-the-trainer structure with local paramedics, firefighters, school nurses and hospital personnel serving as the trainers. Funding for all program materials was received initially from the Georgia Department of Public Health Healthcare Preparedness Program and carried on with funding from the Georgia Trauma Care Network Commission. The State of Georgia has provided the Trauma Commission with over one million dollars in Super Speeder funds to provide training and individual bleeding control kits more than 2,000 Georgia schools in the coming school year.

Law Enforcement Mutual Aid Trauma Program When a patient is severely injured, time is considered the key determinant in the patient’s outcome especially when the patient is bleeding heavily. The Law Enforcement Mutual Aid Trauma Program was developed to decrease the time from injury to provision of care by enabling those who might bridge the gap between the injurious moment and the traditional health system response. The program is jointly administered by Georgia’s Region 5 EMS Advisory Council and the Regional Trauma Advisory Committee. Georgia Trauma Care Network Commission Regional Trauma System Improvement Grant funding allowed for the purchase of 600 Mutual Aid Trauma (MAT) Kits designed for distribution to law enforcement professionals. Containing only essential components, the kits were built to be placed on vehicle headrest offering high visibility and rapid access. In order to receive program materials, participants must first complete a three-hour bleeding control training program consistent with Tactical Emergency Care Casualty Care Guidelines. While the program is ongoing, in just three months since implementation, over 300 law enforcement personnel representing 34 central Georgia agencies have been issued MAT kits. ANNUAL

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Injury Prevention

Trauma is the leading cause of death for Americans 1-44 years old. —Centers for Disease Control, September 2016

Despite decades of progress in the development of trauma centers and trauma systems, injury remains the leading cause of years of potential lives lost and leaves millions chronically disabled every year. Injuries are a significant health concern in Georgia affecting everyone regardless of age, gender, race, or economic status. Approximately 5,200 Georgians die from injuries annually. Injuries present a significant burden to Georgians, measured not only in deaths, but also in immediate costs incurred during Emergency Department (ED) visits and hospitalizations; and long term costs associated with in to extended therapies, disabilities, and lost productivity. Each year, more than 41,000 Georgians are hospitalized and 730,000 are treated solely in the ED. Navicent Health community outreach and injury prevention initiatives include a wide range of activities aimed at reducing risks or threats to health. Our trauma program has an organized and effective approach to injury prevention and prioritizes our efforts based on local trauma registry and epidemiologic data. The multi-faceted approach to injury prevention utilized by Trauma Services is designed to reduce the occurrence of injuries as well to as reduce the morbidity and mortality of injuries once they occur. We conduct educational activities on a widerange of injury prevention topics like child passenger safety, distracted driving, helmet use, fall prevention, and violence prevention to name a few. Here we will describe just a few of the initiates the Navicent Health is currently engaged in.

Motor Vehicle Related Injuries Motor vehicle-related injuries are the leading cause of injury death in Georgia. Trauma Services works in collaboration with its community partners to educate the community to drive safety through educational programs and initiatives on child passenger safety, teen driving, and senior driving. Trauma Services proudly participates in the following safe driving programs.      

Car Fit Drive Safe, Drive Smart EndDD - Distracted Driving Campaign Georgia P.R.I.D.E. Kiwanis Teen Driving Roadeo Teens in the Driver's Seat

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Did You Know? In 2015, 36 percent of the Medical Center Navicent Health patients entered into the trauma registry were injured in a motor vehicle crash.

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Rainbow over new construction site.

SINCE 1987 Children's Hospital, Navicent Health has been the only designated Children's Hospital between Atlanta, Georgia and Gainesville, Florida.

Navicent Health is moving ahead with plans for a new children’s hospital. The original building was built in 1962 and initially served as an adult health care facility. It has served as the Children’s Hospital since 1987. The new facility will be designed specifically for children and their families and will be equipped with the latest in the state-of-the-art technology. The goal is for completion within the next three years.

"Children are not small adults - their health needs are different and are constantly changing. With a proven track record of providing excellent care, we are faced with the need to replace the current Children's Hospital, Navicent Health facility. We are committed to comprehensive, excellent care delivered by highly trained, board-certified pediatric physicians and clinical staff. We look forward to providing care in a new, world-class facility," said Dr. Josh Glenn, Medical Director of Pediatric Surgery for CHNH and CHNH Physician Champion.

 2,800+ SURGERIES PERFORMED  3,000+ CHILDREN ADMITTED

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Hany N. Atalah, M.D., Assistant Professor Robotic Surgery, Mercer University School of Medicine and Director of Robotic Surgery, The Medical Center, Navicent Health. The robotic program has seen significant growth in the past year as well as being academically prosperous. Under his direction, there has been an overall increase in robotic volume, standardization to eliminate waste and improved quality and outcomes. Other achievements in 2016 include:      

Launching Thoracic robotics Training nurses and OR staff on robotics Creating a curriculum for resident training which leads to robotic certification upon completion Participation in STAC committee to evaluate and reduce the costs of new products Training general surgery residents at the SIM lab for laparoscopic training Working with Disruption and Innovation Center to improve patient flow

Academic achievements include:  Feasibility of Robotic-Assisted Laparoscopic Repair of Different Types of Hernia: Early Experience of a Single Center. Asian Pacific Hernia Society 12th International Congress, Presentation. Tokyo, Japan. October, 2016.  Advanced Bipolar Tecn. & Advances Hemostatics in GYN. Invited Speaker. Shaping the Future of Surgery. Doha, Qatar. January 12, 2017.  Summit for Perfusion Imaging and Excellence in Surgery. Moderator. Las Vegas, Nevada. February 11, 2017.  Identification of Ureter and Prevention of Ureteral Injury using Indocyanine Green and Firefly Scope on the DaVinci XI Robot. In Hysterectomy. Oral Presentation. Society of Robotic Surgery. Miami, Florida,. February 26, 2017.  Surgical Research and Innovation Ideas. Panel Discussant. Ibn Al Razi Symposium. Doha, Qatar. April 29, 2017. He also launched the first robotic hernia repair case in Doha, Qatar, as part of the international venture of Navicent physicians.

Number of Procedures by Service Line

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Surgical Critical Care Services at Navicent Health continues its commitment to clinical outcomes research, quality improvement initiatives for hospital associated infections and ICU protocol development, and providing administrative leadership for transitioning to dedicated intensivist staffing in Navicent’s adult critical care units. In 2016, the surgical critical care team received a $19,000 grant from the Navicent Health Foundation to continue our outcomes research in Geriatric trauma. The focus of this research is the longitudinal evaluation of post-injury function, quality of life, discharge disposition, and need for readmissions in geriatric trauma patients initially admitted to the intensive care unit. Additional resident and fellow research includes the utilization of echocardiography for hemodynamic optimization in cliniAmy B. Christie, M.D. Associate Director of Criti- cal scenarios such as acute kidney injury and need for CRRT, as well as the managecal Care Associate Program Director ment of patients with catastrophic brain injury. Surgical Critical Care FellowThe surgical critical care faculty as well as residents, fellows, and ACNPs also conship tinue to serve in leadership roles for ICU-based quality improvement committees including, but not limited to Sepsis, CAUTI, CLABSI, Blood Utilization, and Antibiotic Stewardship. Additionally, our faculty is leading the way in a systems-based effort to improve care delivery to patient’s admitted to non-Trauma/Surgical ICUs. This effort is part of a hospital-wide initiative to provide dedicated intensivist staffing to all of Navicent’s critical care units regardless of geographic location. This is an exciting time for surgical critical care and we look forward to another great year!

S U R G E RY A N D S I M U L AT I O N The 2016-2017 year has been full of new adventures for Dr. Colquitt. After exploring the EMT world by completing a Basic EMT course and earning his NREMT-B certification he proceeded to earn his credential as a Certified Health Simulation Operations Specialist through the Society for Simulation in Healthcare. During this time Dr. Colquitt was also appointed the Chair of the Navicent Health Institutional Review Board and has successfully completed his first FDA site visit.

James Colquitt, Ph.D., RTT Creation Engineer The Medical Center, Navicent Health Mercer University School of Medicine

On the simulation front, Dr. Colquitt has been working with all of the residencies and health professions to develop simulation based training programs and ultimately improve patient care and safety at Navicent Health. This includes starting up a simulation lab on the Macon Campus of Mercer University School of Medicine with the first full day of training being held at the 2017 Capstone Event. Dr. Colquitt has also submitted several abstracts on research in the area of in situ simulations, cognitive fidelity, and creative solutions to simulation training.

In addition, Dr. Colquitt has been working with the Center for Disruption and Innovation to identify opportunities for research and innovation which can be applied to Navicent Health and it's partners. This work includes implementation of new technologies which improve patient monitoring, increases physician training at the bedside, and streamlines processes for hospital systems. Dr. Colquitt has also worked with numerous researchers assisting them with their statistical processes and preparations for their presentations. This includes research on the impact of trauma arrivals on emergency room through-put, the impact of a pain management guideline on patient pain scores, the use of a train the trainer model for delivery of the ACS Stop The Bleed program, and the implementation of the Pit Crew Resuscitation Team Model for the in-hospital setting. Leveraging his skills as a life coach, simulationist, educational technologist and researcher, Dr. Colquitt has expanded his reach to touch almost every aspect of the organization both internal and external. ANNUAL

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Danny Vaughn, M.D.

Robert J. Parel II, M.D. FACS

Michelle Rowell, NP

"The only impossible journey is the one you never begin." - Anthony Robbins My "journey" began the day I realized that I did not have the energy to play with my kids (ages 7 and 9). I was depriving them of something, a mother who actively participates in life with them. Instead, I always found myself on the sidelines, in a chair, because I was always "too tired." I have always struggled with feeling self-conscious about my weight and have never truly felt comfortable about my size. I'm a nurse, and to work a 12 hour shift on my feet exhausted me. I used to hurt all over. I used to perspire with the least amount of exertion and would become easily short of breath. During a routine yearly physical, one of my physicians suggested the option of bariatric surgery during our discussion of weight loss, as I have tried just about every weight loss plan I could think of and would lose a few pounds, but would quickly gain the weight again. I agreed to go for a consultation, and my life has been forever changed for the good. A lot of times, bariatric surgery come with the stigma that it's an "easy way out" or "It's not for me because I'm not the type to need THAT kind of help." Believe me, it's not. There's a reason that one must go through months of rigorous testing, medical clearance, evaluations, and weight loss counseling. The physicians at Bariatric and Metabolic Institute Navicent Health want to make sure that each of their patients has the mind set and the commitment to do their part in undergoing their life-changing weight loss transformations. Surgery is a tool that a person can use to assist them with their weight loss, not a magic cure. My weight loss journey has included and continues to be assisted by the entire team at BMI, Navicent Health. I have been blessed to be a part of a team who encourages me each time I am in the office. By giving me the resources I need to become a healthier me, I have gained the desire to make healthier food choices as well as exercise regularly. Every day is a journey, a mindset that I will put food in my body to give me energy. I follow a high protein, low carb diet and am currently walking every day for exercise. I plan to begin CrossFit (something I'd never dreamed of doing in the past) next month with a friend and am so excited! Since surgery, I have lost approximately 60 lbs., and 6 clothing sizes. I weigh less now than I did on my wedding day! I now enjoy buying clothes! I have danced for four hours without becoming exhausted with my husband at a gala, as well as zip lined with my husband and kids a few weeks ago! I say all of this not to brag, but to explain exactly what I could not do, nor ever dreamed I'd be able to do just 12 months ago. My life is forever changed because of a team of people who believed in me and gave me a chance to become the person I always wanted to be! My journey is far from over, but I know that I can do this because I have the tools I need to continue my new lifestyle!

"I believe that bariatrics is one of the most rewarding specialties in medicine. I have seen these procedures make an immense difference in people's lives.” Danny Vaughn, M.D. Medical Director

BMI, Navicent Health provides our patients with the following options: Gastric Banding

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Gastric Bypass

Gastric Sleeve

ReShape Balloon Nutritional Counseling

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Front: Dr. Amy Christie, Dr. Eric Long, Dr. Macram Ayoub, Dr. Robert Parel Back: Dr. Dudley Christie, Dr. Dennis Ashley, Dr. Danny Vaughn, Dr. William Thompson

S.P.I.N. Program Surgery for People in Need Physicians at Surgical Institute of Navicent Health have joined forces with Macon Volunteer Clinic to provide services to patients in need. Macon Volunteer clinic provides primary medical, dental and eye care to actively employed, uninsured residents of Bibb County. Since the SPIN programs inception in December 2013, 22 outpatient surgeries have been performed thanks to a collection of volunteers of doctors, nurses and other surgical staff. These services include simple cyst excisions, hernia repairs, and cholecystectomies, just to name a few. At Surgical Institute, we are proud to be able to serve our community at all levels. If you would like to learn more about opportunities to assist, please call Angela Millett with Volunteer Macon at (478) 755-1110 or go to www.maconvolunteerclinic.com

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Welcome to our newest provider Brandon Bradley, PA

Brandon is a certified physician assistant from Lilburn, GA. He received his Bachelors of Science in Biology from Georgia College & State University, and his Masters of Physician Assistant Studies from Bethel University. Prior to working at the Surgical Institute, Brandon was employed by Mayo Clinic Health Systems. His is a member of the American Academy of Physician Assistants as well as the Georgia Association of Physician Assistants. Welcome Brandon!!

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As the Chief of the Division of Surgical Oncology, I would like to provide everyone with an update of our activities over the past academic year. This has been a very exciting year of growth for the division of Surgical Oncology. As most of you know, we are located in the Peyton Anderson Cancer Center, and the goal of our division is to provide comprehensive cancer care to the patients that are seen at the cancer center. This year, we expanded our surgical services by welcoming a board certified Colorectal Surgeon, Dr. M. Drew Honaker, to our practice. Dr. Honaker joined us after completing his general surgery residency at the Carolinas Medical Center in Charlotte, North Carolina, and he completed his Colorectal Fellowship at William Beaumont Hospital in Royal Oaks, Michigan. As a Colorectal Surgeon, Dr. Honaker specializes in the care of anorectal, and colorectal disease with a focus on cancer care. Also joining Surgical Oncology, NHPG, in May, 2017, was Dr. Arnold Conforti, and he joined Navicent Health Physician Group as a member of the division of Surgical Oncology. Dr. Conforti, a Surgical Oncologist, completed his fellowship at the John Wayne Cancer Institute, and he has Paul S. Dale, MD, FACS been caring for patients here in the middle Georgia area for the past 14+ Chief of Surgical Oncology The Medical Center Navicent Health years. Dr. Ronald Freeman, specializing in plastic surgery, also in the division Vice Dean of Translations Research of Surgical Oncology which has increased the practice to 4 active members. Mercer University School of Medicine All the growth and change over the past year has been supported by our new practice manager, Samantha Ham. She is completing her Six Sigma Black Belt certification which will allow her to best manage an ever-growing practice in the future. Our surgeons were very active this year with the Cancer Committee at Peyton Anderson Cancer Center, and through the continued support of the amazing team at the Cancer Center under the direction of Mr. Ron Lazar, the Cancer Center attained a full 3-year accreditation with the Commission on Cancer. Of note, Dr. Conforti currently serves as the Commissioner on Cancer Physician Liaison for the Peyton Anderson Cancer Center and has the honor of serving as the state chairman for the Commission on Cancer. Dr. Dale and Dr. Conforti were also physician leaders in the accreditation of the Peyton Anderson Breast Care Center, which recently underwent its 3-year accreditation process. The ability of our cancer care team here at the Cancer Center to gain full accreditation with the Commission on Cancer is a testament to the comprehensive and first class cancer care being delivered at the Peyton Anderson Cancer Center. In addition to providing specialized care for cancer patients, the division is devoted to education and research. Each of our physicians actively participate in teaching general surgery residents and Mercer University School of Medicine students. This past year was a very productive year in research for the division of Surgical Oncology. At this year’s Southeastern Surgical Congress, Dr. Honaker and sponsored resident presented a podium presentation which has been accepted for publication by the American Surgeon. At the same meeting, Dr. Dale, along with 4 residents, had the opportunity to present 4 podium presentations; each of which have also been accepted for publication. Dr. Dale had the following article published in the Breast Journal, “In support of the Choosing Wisely campaign: Perceived higher risk leads to unnecessary imaging in accelerated partial breast irradiation?” Dr. Dale and Dr. Allen also presented a poster entitled, “Evaluating the Incidence of Upgrade to Malignancy following Surgical Excision of High Risk Breast Lesions Identified by Core Needle Biopsy” at the American Society of Breast Surgeons. In addition to his Surgical Oncology duties, Dr. Dale also serves as the Medical Director of the Navicent Health Physician Group. In this role, he has been attending an 18-month fellowship sponsored by the American Hospital Association educating healthcare leaders in the future of healthcare in America. ANNUAL

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Transition to Practice Program

Vincent S. Culpepper, MD

For the past four years the Transition to Practice program, one of the original four programs in the United States, has provided an environment of autonomy combined with mentoring for Junior Associates wishing to further develop their skills and confidence before going to an area with limited support. The program is hosted by three board certified general surgeons with a wide range of experience located in Cordele, Georgia, with a population of about 10,000, and a total service area covering over 4 counties in South Georgia. Participants in the program, known as Junior Associates, are involved in all areas of practice including dedicated office time, daily rounds, and operating time on their own as well as with the other three surgeons. Limited subspecialty coverage provides opportunities for a broad experience.

Our current Junior Associate is Dr. Cindy O’Neal, who will complete her time with us in August 2017. She is currently looking at potential practice sites in the Southeast. Among our alumni are Dr. Priscilla Thomas who now practices in the Savannah area and has organized the second TTP program in our state. Dr. Bamdad Farhad now practices in North Carolina. Our first Junior Associate, Dr. Heidi Haun, is now practicing in Nalerigu, Ghana. As a missionary at Baptist Medical Center, she provides excellent surgical care with minimal supplies in less than optimal conditions. Dr. Culpepper visited Dr. Haun and her family recently and was privileged to practice alongside Dr. Haun for a few days in the remote village in western Africa. It was quite an experience to practice without the benefit of xray or basic lab tests. Anyone wishing to donate supplies or funds to Dr. Haun and her colleagues can contact Dr. Culpepper for more information. We are Dr. Priscilla Thomas looking forward to the coming year as we finalize plans to welcome another and Dr. Vince Culpepper young surgeon to our program. Crisp Regional Hospital is a 65 bed regional hospital located just off Interstate 75 about an hour south of Macon, Georgia. As a Level 4 trauma center, they provide immediate care and stabilization of injured patients in their area. Many are admitted and treated at their facility, but some require transfer to a Level I center. In trauma, as well as general surgery situations, deciding appropriate care with regard to availability and use of resources at smaller facilities versus transfer to a larger hospital is a critical thinking process paramount in rural surgery practice. Junior associates are able to negotiate the decision making process as well as obtain hands-on operating experience in an autonomous environment with the safety net of an experienced surgeon providing back-up when needed.

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Graduation Banquet 2016

“What’s Behind and What’s Ahead?” Charles G. Burton, M.D. After growing up in Miami, Florida, and Atlanta, Georgia, graduated from the University Georgia. He then entered Medical College of Georgia graduated in 1959. Little did he imagine what was in store in July 1959 when he began his internship at the Macon Hospital. He completed his surgery residency interrupted by two years in the Army, and served as Chief Resident his final At that point he focused on serving his community as a busy general surgeon. He was actively involved in Mercer University School of Medicine and truly loved teaching. His love of teaching led him to return to Medical Center Navicent after retiring from private in 2001. His passion and asm for surgery was clearly as he taught the students surgery residents. In 2002, he received the Surgical Residents Teaching Award. In 2003, he received the Award for Mercer University Medical School Class of 2003 Outstanding Surgical Faculty, and he served as President of the Macon Surgical Society from 2001-2003. Dr. Burton’s life would not complete without mentioning his other passions and pursuits namely his collecting knives and restoring antique cars which is most ting for a surgeon.

Elizabeth Almon, MD General Surgery

Jonathan Cudnik, MD General Surgery

Dr. Dennis Ashley, Chair Department of Surgery and Dr. D. Benjamin Christie, Program Director ANNUAL

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Tonya Johnson, MD General Surgery

Brent Bell, MD Surgical Critical Care Fellowship

Kuong Ngann, MD General Surgery

Cecil Brown, MD Surgical Critical Care Fellowship

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EVENTS

Graduation 2016

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26th Annual TRAUMA Symposium

Geriatric Trauma Key Note Speakers Sasha Adams, MD, FACS, is a Trau-

ma Critical Care surgeon at the McGovern Medical School in Houston, Texas. In addition to her clinical duties at the Level 1 Trauma Center, she runs the Surgical Clerkship for rotating 3rd year medical students, and is an inaugural Society leader and advisor for the McGovern Society, mentoring 8-10 students per year throughout their medical school career. Dr Adams’ research is focused on improving the care of geriatric trauma patients through earlier identification of those at risk, changes to inpatient care practices, and early rehabilitation efforts to improve long term outcomes. After receiving her medical degree from the Medical University of South Carolina, she completed a general surgery residency and surgical critical care fellowship at Memorial Hermann Hospital Medical Center in Houston, Texas. Aurelio Rodriguez, MD, FACS. A native of Peru, Dr. Rodriguez received his medical degree from San Marcos University in Lima in 1967. He completed extensive post-graduate training with a surgical internship at the University of Cincinnati Medical Center, general surgery residencies at Henry Ford Hospital and Pontiac General Hospital in Michigan, a fellowship in trauma and critical care medicine at the Maryland Institute for Emergency Medical Service Systems, and a residency in cardiothoracic surgery at Wayne State University. Board certified in general surgery and an active member of numerous professional and scientific organizations, Dr. Rodriquez has lectured worldwide on trauma related issues and has published more than 200 scientific articles, abstracts, and book chapters in the field focusing over the past few years on geriatric trauma care. Richard Ackermann, MD, is Professor of Family Medicine at Mercer University School of Medicine and he currently serves as Director of the Division of Geriatrics, the Geriatrics Fellowship Program, and the Hospice and Palliative Medicine Fellowship at the Medical Center, Navicent Health. He received his medical degree from Duke University and completed his family medicine residency training at the Naval Hospital in Charleston, South Carolina. He is board certified in family medicine and geriatric medicine and is certified in Hospice and Palliative Medicine. He is also a certified medical director of a long-term care facility. He has published on geriatric and palliative medicine topics including his recent book Navicent Textbook of Hospice & Palliative Care published in 2016. His passion is the care of older adult and those facing end-of-life decisions. He is the principal or co-investigator on over $2.5 million in education and research grants. Amy B. Christie, MD, is Assistant Professor of Surgery at Mercer University School of Medicine. She is the Associate Director of Surgical Critical Care and Associate Program Director for the Surgical Critical Care Fellowship Program at the Medical Center Navicent Health. After receiving her medical degree from the Mercer University School of Medicine, she completed her residency in general surgery and a fellowship in surgical critical care at the Medical Center, Navicent Health. Dr. Christie is board certified in both general surgery and surgical critical care. She has been instrumental in implementing an ICU based geriatric trauma quality improvement project in order to standardize the care of the injured elderly and to identify high risk geriatric ICU trauma patients that would benefit from geriatric consultation. Her goal is to extend this PI project to those geriatric patients admitted to the floor trauma service. ANNUAL

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November 3, 2016 7:30 a.m. Registration/Breakfast 8:00 a.m. Welcome and Introductions Dennis W. Ashley, MD 8:05 a.m. A Billion Shades of Gray: Epidemiology, Diagnosis and Management of Geriatric Trauma Aurelio Rodriguez, MD 9:05 a.m. Geriatric Trauma Triage: Considerations for Trauma Activation Sasha Adams, MD 9:40 a.m. Break/Visit Exhibits 10:10 a.m. Geriatric Trauma Injuries: They are Not Just Older Adults Sasha Adams, MD 10:40a.m. Geriatric Frailty: Is Functional Assessment the Answer in Predicting Geriatric Trauma Outcomes Amy B. Christie, MD 11:10a.m. Evil Drugs in Older Adults: Safe Prescribing for Trauma Patients Richard Ackermann, MD

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Celebrating African American History Month Omar Danner, M.D., FACS (left) graduated in 1995 from the University of Alabama School of Medicine where he also completed his General Surgery Residency. He completed advanced fellowship training in 2002 in Surgical Critical Care and Trauma at Johns Hopkins University School of Medicine where he served as an Attending Trauma Surgeon, Surgical Critical Care Specialist and Clinical Instructor from 2002 to 2003. He joined the Surgical Faculty at Morehouse School of Medicine and Grady Memorial Hospital in January 2009 where he has been a practicing trauma surgeon, surgical critical care specialist, and minimally invasive surgeon, and performing investigative research as well as training and teaching MSM surgical residents and medical students. Macon Surgical Society Notable Contributions by African American Surgeons in the 21st Century Wednesday, February 8, 2017 6:30 P.M. Tubman African American Museum

Physiologically-based Predictive Analytics Improves the Efficiency of Sepsis Detection and Treatment Thursday, February 9, 2017 7:30 A.M. Eversole Auditorium, West Tower The Medical Center, Navicent Health

2017 Milford B. Hatcher Lecture April 13, 2017 Frederick L. Greene, MD, FACS, (right) Adjunct Professor of Surgery at the University of North Carolina School of Medicine and Medical Director of the Cancer Data Services at the Levine Cancer Institute in Charlotte, NC. Dr. Greene has participated as an active clinician in surgical oncology and has been involved in organizational work pertaining to cancer over many years. He is a member o a number of editorial boards including the Journal of Clinical Oncology, Surgical Endoscopy, CA-A Cancer Journal for Clinician, is Associate Editor of Annals of Surgical Oncology, and is Senior Editor of General Surgery News. He is also Editor of the 6th, 7th, and 8th Editions of the AJCC Cancer Staging Manual. Dr. Greene’s publications have included approximately 185 papers, 60 book chapters, and two textbooks relating to cancer surgery and, specifically, the use of laparoscopic surgery in the management of cancer patients. He belongs to numerous surgical organizations including the Society of Surgical Oncology, the Southern Surgical Association, and the American Surgical Association. Dr. Greene is a founding member and was president of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) in 1992-93. ANNUAL

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Milford B. Hatcher 1909-1991

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44th ANNUAL DAY OF SURGERY

Keynote Speaker Roy E. Gilbreath, MD, MBA, FACP, SVP

What’s New in Healthcare Quality Improvement in Healthcare: Introduction of the “Quadruple Aim” Roy E. Gilbreath, MD, MBA,FACP, SVP is a Board Certified Internist as Chief System of Care Integration Officer, he is responsible for Navicent Health’s System Quality and Safety, Medical Informatics System of Care Continuum Development and Emergency Management. He has over twenty years experience in physician executive roles and many years in private practice. He has held positions in Medical Informatics for hospitals and Multum. He co-authored the book Health Data Quest: How to Find and Use data for Performance Improvement. He is also certified as a Lean Six Sigma Blackbelt and Medical Review Officer. He received his Bachelor of Science from the University of Florida, medical degree from the University of Miami, and Internal Medicine training at Walter Reed Army Medical Center. Dr. Gilbreath went on to receive an MBA from the University of Nevada, Reno, in 1993.

PGY4 PRACTICE BASED LEARNING and IMPROVEMENT PROJECT

Ahkeel Allen, MD, is a graduate from Florida State University with a degree in Biological Sciences. He attended the Florida State University College of Medicine. He plans to pursue a fellowship in Breast Oncology. He presented “Clostridium Difficile Infection”.

Trine Engebretsen, MD, is a graduate of the University of Miami and attended the Florida International University Herbert Wertheim College of Medicine. She plans to enter a fellowship in Transplantation. She presented “Catheter Associated Urinary Tract Infections.”

Alicia Register MD, is a graduate of University of Georgia where she majored in Biology and Psychology. She attended the Georgia Health Sciences University. She plans to practice at Crisp Regional Hospital. She presented “Sepsis”.

Phillip Rideout, MD, is a graduate of Clemson University where he majored in Biology. He attended the Medical University of South Carolina in Charleston. He plans to pursue a fellowship in Vascular Surgery. He presented “Central Line-Associated Bloodstream Infection”. ANNUAL

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Chief Resident Grand Rounds: In Honor of Our 2017 Graduating Chief Residents (left to right) Brett Howard, Mike Fitzgerald, Joey Jarrard, and Heather Nolan.

Thursday, June 8, 2017 Eversole Auditorium 7:30 A.M.—8:30 A.M. Michael T. Fitzgerald, M.D. “Take My Breath Away! An Overview of Chest Wall Stabilization with Rib Fixation”

Brett M. Howard M.D. “The Missing LINX? Magnetic Sphincter Augmentation Device for Gastroesophageal Reflux ”

Joey A. Jarrard, M.D. “Trimming the Fat: A Review of Bariatric Surgery” Heather R. Nolan, M.D. “Room to Grow: How Fetal Surgery is Redefining What It Means to be a Pediatric Surgeon”

Dr. Vaughn to be Key Note Speaker at 2017 Graduation Danny M.Vaughn, M.D. serves as an Assistant Professor of Surgery and Surgery Clerkship Director at the Mercer University School of Medicine and as Medical Director of the Bariatric Surgery Program here at Navicent Health.

New Robotic Surgery Award The graduates of 2017 will be the first residents to be recognized for their completion of the robotic pathways training. A certificate of completion recognizing them as a robotic trained surgeon will be awarded at graduation. In addition, two physicians, Dr. Hany Atalah and Dr. John Williams, will be giving an award to the “Best Resident in Robotic and Minimally Invasive Surgery” for their outstanding and superior skills. ANNUAL

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G R A N D R O U N D S M E R C E R F A C U LT Y Amy Christie M.D. ,(right), Assistant Professor of Surgery Mercer University School of Medicine and Associate Director Critical Care at The Medical Center, Navicent Health presented the lecture “Targeted Temperature Management in Traumatic Brain Injury: A Neuroprotective Strategy?” at the Thursday Grand Rounds August 11, 2016.

Macram Ayoub, M.D. , (left) Professor of Surgery, Mercer University School of Medicine and Vice-Chair, Department of Surgery at The Medical Center, Navicent Health presented the lecture “ Thyroid Nodule and Thyroid Cancer” at the Thursday Grand Rounds August 18, 2016.

Dr. N. Allen Stokes M.D., NRP Medical Director, Navicent EMS, Medical Director, Macon-Bibb Fire Department, Trauma Liaison, Emergency Center, Department of Emergency Medicine, The Medical Center Navicent Health presented “Emergency, Bedside Ultrasound in Trauma” at the Thursday Grand Rounds August 25, 2016.

William Thompson, M.D., Associate Professor of Surgery, Associate Chair, Clinical Education, Mercer University School of Medicine, Associate Program Director, General Surgery Residency Program, The Medical Center, Navicent Health presented the lecture “Perioperative Optimization” at the Thursday Grand Rounds September, 15, 2016.

Yameika Head, M.D., Assistant Professor, Mercer University School of Medicine, Medical Director, Crescent House, and Program Director, Pediatric Residency, The Medical Center Navicent Health presented “Child Abuse 101” at the Thursday Grand Rounds September 22, 2016.

Paul Dale, M.D. , (left) Dean, Translational Research, Mercer University School of Medicine and Chief, Surgical Oncology at The Medical Center, Navicent Health presented the lecture “Management Of Common (and Not So!) Benign Breast Conditions” at the Thursday Grand Rounds October 13, 2016.

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G R A N D R O U N D S M E R C E R F A C U LT Y Danny Vaughn, M.D., Assistant Professor and Clerkship Director, Mercer University School of Medicine, Medical Director, Bariatric and Metabolic Institute of Georgia at The Medical Center, Navicent Health presented the lecture “Bariatric Surgery in 2016” at the Thursday Grand Rounds November 10, 2016.

Dennis W. Ashley, M.D., FACS, Milford B. Hatcher Professor, Chair of Surgery, Mercer University School of Medicine, Director of Trauma and Critical Care, The Medical Center, Navicent Health, presented the lecture “Georgia Trauma Update” and “Stop the Bleed Campaign” at the Thursday Grand Rounds December 8, 2016.

William Thompson, M.D., Associate Professor of Surgery, Associate Chair, Clinical Education, Mercer University School of Medicine, Associate Program Director, General Surgery Residency Program, The Medical Center, Navicent Health presented the lecture “Duty Hours Revisited” at the Thursday Grand Rounds January 12, 2017.

Joe Sam Robinson, M.D. Professor of Neurosurgery, Mercer University School of Medicine and Clinical Professor, Georgia Regents University presented the lecture “World Brain Revisited” at the Thursday Grand Rounds February 23, 2017.

Paul Dale, M.D. , Dean, Translational Research, Mercer University School of Medicine and Chief, Surgical Oncology at The Medical Center, Navicent Health presented the lecture “The Future of General Surgery and Residency Education” at the Thursday Grand Rounds March 9, 2017.

Macram Ayoub, M.D. , (Professor of Surgery, Mercer University School of Medicine and Vice-Chair, Department of Surgery at The Medical Center, Navicent Health presented the lecture “ Diverticulosis and Diverticulitis” at the Thursday Grand Rounds March 30, 2017.

Eric Long, M.D., presented the lecture “To Bleed or Not to Bleed: An Update on Best-Practice Recommendations for the Trauma (and Surgical) Patient” at the Thursday Grand Rounds April 27, 2017.

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G R A N D R O U N D S M E R C E R F A C U LT Y AND VISITING PROFESSORS Lawrence X. Webb, M.D. , (left) Professor, Chief, Georgia Orthopaedic Trauma Institute, presented the lecture “The Impact of Negative Pressure Wound Therapy on Orthopaedic Infection” at the Thursday Grand Rounds May 11, 2017. Dr. N. Allen Stokes M.D., NRP Medical Director, Navicent EMS, Medical Director, Macon-Bibb Fire Department, Trauma Liaison, Emergency Center, Department of Emergency Medicine, The Medical Center Navicent Health presented “Intubation of the Hemodynamically unstable Patient” at the Thursday Grand Rounds May 18, 2017.

VISITING PROFESSORS Bruce Burr McIntosh, M.D., FACS, (left) Assistant Professor of Surgery, Department of Surgery, Oakland University and Director, GI Oncology, Multi -disciplinary Clinic at William Beaumont Hospital in Troy, Michigan, presented the lecture “Robotic Surgery: Making good surgery better” at the Thursday Grand Rounds July 14, 2016.

B. Todd Heniford, M.D., FACS Chief, Division of Gastrointestinal and MIS Director, Carolinas Hernia Center, Co-”Director, Carolinas Laparoscopic and Advanced Surgery Program, Professor of Surgery, Carolinas Healthcare System presented the lecture “Advances in Abdominal Wall Reconstruction” at the Thursday Grand Rounds September 8, 2016.

Mark Evans, M.D., received his medical degree from the Medical College of Georgia School of Medicine and completed a residency in diagnostic radiology followed by fellowship in Neuroradiology. He has been in private practice of diagnostic radiology since 2011. He presented the lecture “Imaging of Spinal Trauma” at the Thursday Grand Rounds November 17, 2017. Fred Mullins, M.D., FACS, Medical Director, Joseph M. Still Burn Center at Doctor’s Hospital, President, Joseph M. Still Burn Center presented the lecture “Current Trends in Burn Care” at the Thursday Grand Rounds January 26, 3017.

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Virginia “Ginny” Land, Administrative Coordinator for Med Ed Surgery and Trauma Services was chosen as the Non-Clinical Employee of the Quarter on July 15, 2016.

The Medical Center, Navicent Health Trauma Services Inaugural American College of Surgeons Verification Team 2016, was recognized for their work in achieving the ACS Level I Trauma Center verification in 2016. Left to right: Irma Miranda, Josephine Fabico-Dulin, Dennis Ashley, Tracy Johns, Carletta Grace, Senesta Roberson, Ninfa Saunders, Ginny Land, Inez Jordan, and Jimmy Colquitt. Trine Engebretsen, M.D., PGY 4, received Poster of Distinction at the American Society of Transplant Surgeons January 27, 2017. Her poster was entitled “ Hemodynamic Optimization of the Brain-Dead Trauma Patient Utilizing Hemodynamic Transesophageal Echocardiography (hTEE).”

Carletta Grace, Surgery Clerkship Coordinator, received the “Outstanding Clerkship Coordinator” award at the 2017 Mercer University School of Medicine Honors Banquet May 4, 2017. She was selected by the Mercer University School of Medicine Class of 2017. In addition, she received the Professional Achievement, Clinical Excellence award by the Medical Center, Navicent Health for obtaining her Medical Clerkship certification. Justin Vaughn, M.D. PGY 3, was awarded the Gold Medal Paper presentation at the Southeastern Surgical Congress, 85th Annual Scientific Meeting. He presented “Evaluation of Cardiopulmonary Complication Rates Following Port Insertion: Is a Postoperative X-Ray Needed?” February 27, 2017.

Faculty members Drs. Macram Ayoub, Dennis Ashley, and I.J. Shaker received awards along with Drs. Harold Katner and Fred Gaton at the 2017 Navicent Health Physician Recognition Banquet held at the Macon City Auditorium on March 9, 2017. Dr. Ayoub received the “Educator of the Year” award, Dr. Ashley received the “Distinguished Service” award, and Dr. Shaker received the “Lifetime Achievement” award. Left to right: Dr. Macram Ayoub, Dr. I.J. Shaker, Dr. Dennis Ashley, Dr. Harold Katner, and Dr. Fred Gaton

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Heather Nolan, M.D., PGY 5, received Top 20 Poster of Distinction at the 2017 Southeastern Surgical Congress Annual Scientific Meeting. Her poster was entitled “ Use of a Gastroduodenal Tube to Preserve the Common Wall During Excision of a Gastric Duplication.”

Phillip Rideout, M.D., received the “Outstanding Surgery Resident” award in recognition of excellence in student education at the 2017 Mercer University School of Medicine Honors Banquet May 4, 2017. He was selected by the Mercer University School of Medicine Class of 2017.

Benjie Christie, M.D., received the “Outstanding Surgery Faculty” award at the 2017 Mercer University School of Medicine Honors Banquet May 4, 2017. He was selected by the Mercer University School of Medicine Class of 2017.

Devon Tobey, MS4, received the “Outstanding Student in Surgery” Joe Sam Robinson Award at the 2017 Mercer University School of Medicine Class of 2017 Honors Banquet May 4, 2017.

Lindsey Cochran, MS4, received the “Outstanding Student in Surgery” Will C. Sealy Award at the 2017 Mercer University School of Medicine Class of 2017 Honors Banquet May 4, 2017.

Dennis W. Ashley, M.D., FACS, and the Georgia Society of American College of Surgeons was recognized at the 2017 Leadership Summit on May 7, 2017, in Washington, D.C., for the Georgia Chapter Success Story recognition based on Georgia’s “Stop the Bleed” campaign at the state capitol February 7, 2017. Heather Nolan, M.D., PGY 5, was nominated by Dr. Patrick Roche and inducted as a member to the Alpha Omega Alpha Honor Medical Society ~ Georgia Delta Chapter in May 2, 2017.

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Joe Sam Robinson, M.D. , Georgia Neurosurgical Institute, was invited to participate as a Guest Lecturer at the Centre for Neuroscience Education of Cambridge University. The Centre is recognized internationally as the leading research facility in the field of intracranial pressure dynamics, brain compliance, and the development of novel modalities of non-invasive monitoring of patients with various pathologies of the brain. His lecture entitled, “Some Suggestions for Allocation of World Neurosurgery Assets”, focused on the difficulties of achieving worldwide neurosurgical care as the population ages. Dr. Robinson documented the statistics that approximately 90% of the world’s population is unable to obtain the US standard of care for treatment because of cost, supply and cure factors. The lecture particularly compared and addressed the neurosurgical conditions of brain tumors and strokes. He presented some solutions and outlined the need for the developed world to help solve the crisis in the developing world with combined efforts.

Friends of Nursing 3rd Annual Gala Anita Watson, NP-C, RN-BC, received the “Excellence in Advanced Practice” award at the 2017 Navicent Health Nursing Gala Friday, May 12, 2017. Anita is one the trauma surgery nurse practitioners dedicated to serving and caring for the trauma patients on the floor. Anita works with various nursing committees and staff to promote teamwork across multiple disciplines with regard to trauma care. She became board certified in pain management in 2015 and has lectured on multimodal analgesia in managing acute pain across the nation.

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Publications TT Le, HV Vo, LX Webb. Investigation of Kryptonite Bone Cement in Hybrid Screw Configurations of Locking Plate Humeral Midshaft Fixation: A Study of Surrogate Bone Model. Journal of Orthopaedics. April 2016;157-161. AN Miller, D Deal, J Green, W Brown, C Thore, D Stump, lx webb. Use of the Reamer/Irrigator/ Aspirator Decreases Carotid and Cranial Embolic Events in a Canine Model. J Bone Joint Surg Am. April 2016;98(8):658-64. H Nolan, M Griffin, C Wengler, R Begood, DW Ashley. Duodenal Leiomyoma Causing Duodenojejunal Intussusception. The American Surgeon. 2016;82:164-166. H Nolan, J Glenn, A Bozeman. Occult Heterotopic Gastric Mucosa as a Lead Point for Ileocolic Intussusception in an Adolescent: A Rare Finidng with Inherent Diagnostic Challenges. The American Surgeon. 2016;82:78-80. H Nolan, C Wengler, C Hartin, J Glenn. Laparoscopic Excision of an Ascending Colon Duplicaiton Cyst in an Adolescent. Journal of Pediatric Surgery Case Reports. 2016;4:32-34. P Thomas, JP Seale, JA Johnson, J Dhabliwala, D Kitchens, IS Okosun, NA Stokes, DW Ashley. Impact of a Quality Improvement Intervention to Increase Brief Alcohol and Drug Interventions on a Level I Trauma Services. The American Surgeon. May 2016;82:468-473. EB Almon, EO Richter, DW Ashley, DB Christie. Penetrating Spinal Cord Trauma: A Unique Patient Presentation. The American Surgeon. October 2016.;10(1):290-291. MT Fitzgerald, DW Ashley, H Abukhdeir, DB Christie III. Rib Fracture in the 65 Years and Older Population: A Paradigm Shift in Management Strategy at a Level I Trauma Center. J Trauma Acute Care Surg. March 2017;82(3):524-527. H Nolan, DB Christie. Altruism in Surgical Metrics: How a Free Outpatient Surgery Program has Impacted Medical Economics and Redefined Healthcare Language. Journal Perioperative Practice. 2017;27:141-143. LX Webb. The Impact of Negative Pressure Wound Therapy on Orthopaedic Infection. Orthop Clin N Am. April 2017;48(2):167-179.

H Nolan, MT Fitzgerald, B Howard, J Jarrard, D Vaughn. The Trauma Timeout: Evaluating the Effectiveness of Protocol-Based Information dissemination in the Traumatically Injured Patient. Journal of Trauma Nursing. May/June 2017;24:170-173. DW Ashley, EE Pracht, RS Medeiros, et al. A Decade Evaluation of a State Trauma System: Has Access to Inpatient Trauma Care at Designated Trauma Centers Improved? The American Surgeon. July 2017;83. MT Fitzgerald, DW Ashley, DB Christie. Chest Wall Stabilization Leads to Shortened Chest Tube Stay Time in Rib Fracture Patients After Traumatic Chest Wall Injury. The American Surgeon. In press.

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Publications and Book Chapters

Publications—continued RL Lassiter, DW Ashley, RS Medeiros, BL Adam, EG NeSmith, TJ Johns, GRIT Study Group. Descriptive Analysis of Venous Thromboembolism in Georgia Trauma Centers Compared to National Trauma Centers Participating in the Trauma Quality Improvement Program. 2017. The American Surgeon. In press. C Brown, H Nolan, C Cawley, D Nakayama. Use of a Gastroduodenal Tube to Preserve the Common Wall During Excision of a Gastric Duplication. The American Surgeon. 2017. Submitted. A Allen, J Vaughan, A Cauthen, E Long. Evaluation of A Trial of A Desufflation Technique to Decrease the Rate of Postoperative Percutaneous Endoscopic Gastrostomy Pneumoperitoneum. The American Surgeon. Submitted. A Allen, A Cauthen, J Vaughan, P Dale. The Clinical Utility and Cost of Postoperative Mammography Completed within One Year of Breast Conserving Therapy: Is It Worth It? The American Surgeon. In press. C Fancher, T Scott, A Allen, P Dale. Mammographic Screening at Age 40 or 45? What Difference Does It Make? The Potential Impact of American Cancer Society Mammography Screening Guidelines. The American Surgeon. In Press. J Vaughan, A Cauthen, A Allen, P Dale. Evaluation of Cardiopulmonary Complication Rates Following Port Insertion: Is a Post-Operative X-Ray Needed? The American Surgeon. In Press Book Chapters DB Christie, B Howard. Hemodynamic Monitoring in Surgical Critical Care. Principles of Adult Surgical Critical Care. Springer 2016, pp 77-89. C Wengler, H Nolan, J Glenn. Laparoscopic Adrenalectomy in Children. The SAGES Manual of Pediatric Minimally Invasive Surgery. Springer International Publishing, p609-620. H Nolan, C Hartin, M Escobar. Lymphadenopathy. General Surgery: Current Treatment Options in Pediatrics. Springer International Publishing. April 2017. D Von Allmen, H Nolan, F Lim. Eventration of the Diaphragm. Mastery of Surgery. Under editor review. Presentations—Faculty DW Ashley. Ventilation Management for the Trauma Patient. Invited Speaker. Georgia Society American College of Surgeons Annual Meeting and Day of Trauma. Savannah, Georgia. August 19, 2016. DB Christie III. The Complex Trauma Patient. Panel Discussant and Presenter. Georgia Surgical Annual Meeting. Jekyll Island, Georgia. September 16, 2016. ANNUAL

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Presentations

Presentations—Faculty DW Ashley. Interventions for Road Injury. Panel Discussion. Health Connect South. Atlanta, Georgia. September 21, 2016. DW Ashley. Trauma Care in the Non-Trauma Center ED. Medicine Grand Rounds. The Medical Center, Navicent Health. Macon, Georgia. September 28, 2016. A Watson. Acute Traumatic and Post-Operative Pain: A Retrospective Chart Review of Quality of Life Improvement. Grand Rounds. Medical Center Navicent Health. October 27, 2016. HN Atalah. Feasibility of Robotic-Assisted Laparoscopic Repair of Different Types of Hernia: Early Experience of a Single Center. Presentation. Asia Pacific Hernia Society 12th International Congress. Tokyo, Japan. October, 2016. DW Ashley. Will C. Sealy 26th Trauma Symposium. Moderator. The Medical Center, Navicent Health. Macon, Georgia. November 3, 2016. R Parel. Bariatric Surgery. Soaring Together II. CME Lecture. Robins Air Force Base. November 5, 2016

DW Ashley. Georgia Collaborative. Invited Speaker. American College of Surgeons Trauma Quality Improvement Program. Orlando, Florida. November 6, 2016. DW Ashley. The Georgia Trauma System: Past, Present, and Future. Invited Speaker. RTAC II Trauma Conference. Gainesville, Georgia. November 11, 2016. DW Ashley. Region IV ACS COT Resident Paper Competition. Moderator. Louisville, Kentucky. November 12, 2016. DW Ashley. Georgia Collaborative and Stop the Bleed. Georgia Trauma Commission. Atlanta, Georgia. November 17, 2016. DW Ashley. Georgia Trauma Update and Stop the Bleed Campaign. Grand Rounds. Macon, Georgia. December 15, 2016. HN Atalah. Advanced Bipolar Tech. & Advanced Hemostatics in GYN. Invited Speaker. Shaping the Future of Surgery. Doha, Qatar. January 12, 2017. HN Atalah. Summit for Perfusion Imaging and Excellence in Surgery. Moderator. Las Vegas, Nevada. February 11, 2017. ANNUAL

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Presentations—Faculty continued HN Atalah. Identification of Ureter and Prevention of Ureteral Injury Using Indocyanine Green and Firefly Scope on the DaVinci XI Robot in Hysterectomy. Oral Presentation. Society of Robotic Surgery. Miami, Florida. February 26, 2017. DW Ashley. The Impact of Hemodynamic Transesophageal Echography on the Use of Continuous Renal Replacement Therapy in Trauma. Oral Presentation. Southeastern Surgical Congress. Nashville, Tennessee. February 27, 2017.

DW Ashley. Virtual Reality Simulation (VRS): Bringing Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) Closer to the Point of Injury. Invited Discussant. Southeastern Surgical Congress. Nashville, Tennessee. February 27, 2017. J Lawrence, P Dale, A Honaker. Presenting State in Colon Cancer is Associated with Insurance Status. Oral Presentation. Southeastern Surgical Congress. Nashville, Tennessee. February 28, 2017. Nyssa Hattaway, Mary Hoey, and James Colquitt. Is Family Presence at the Bedside During Resuscitation Appropriate in the Trauma Bay. Poster Presentation. Society of Trauma Nurses TraumaCon 2017. St. Louis, Missouri. April 6, 2017.

DW Ashley. Management of Rib Fractures in the Modern Era. Visiting Professor. Grand Rounds. Baptist Hospital. Florida Committee on Trauma. Pensacola, Florida. April 24, 2017. DW Ashley. Management of Rib Fractures in the Modern Era. Visiting Professor. Grand Rounds. Bay Front Medical Center. Florida Committee on Trauma. St. Petersburg, Florida. April 25, 2017. DW Ashley. Management of Rib Fractures in the Modern Era. Grand Rounds. Florida Committee on Trauma. Orlando Regional Medical Center. Orlando, Florida. April 26, 2017. DW Ashley. Management of Rib Fractures in the Modern Era. Grand Rounds. Memorial Medical Center. Florida Committee on Trauma. Hollywood, Florida. April 27, 2017. DW Ashley. Lessons Learned from the Development of the Georgia Trauma System: A 30 Year Journey. Invited Speaker. Florida Committee on Trauma. Orlando, Florida. April 28, 2017. HN Atalah. Surgical Research and Innovation Ideas. Panel Discussant. Ibn Al Razi Symposium. Doha, Qatar. April 29, 2017. DW Ashley. Trauma: It Affects Us All. Invited Speaker. Rotary Club. Macon, Georgia. May 3, 2017. ANNUAL

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Presentations—Faculty Continued DW Ashley. Georgia’s Commitment: “I Can Stop the Bleed”. Invited Speaker. American College of Surgeons 2017 Leadership and Advocacy Summit. Washington, D.C. May 7, 2017. DW Ashley. Trauma: It Affects Us All. Invited Speaker. Macon Rotary Club. Macon, Georgia. May 22, 2017. Presentations—Residents P Rideout, J Cudnik, DB Christie III. Oral Presentation. Treatment of Traumatic Vascular Injury Using Endovascular Techniques: A Paradigm Shift. Georgia Society ACS. Savannah, Georgia. August 20, 2016. JA Jarrard, AB Christie, DW Ashley, R Rowe. Oral Presentation. The Predictive Value of Neuromarker S100B Protein in Determining Optimal Duration of Targeted Normothermia in Traumatic Brain Injury. Georgia Society ACS. Savannah, Georgia. August 20, 2016. T Engebretsen, AB Christie. Oral Presentation. Hemodynamic Optimization of the Brain Dead Trauma Patient Utilizing Hemodynamic Transesophageal Echocardiography (hTEE). Georgia Society ACS. Savannah, Georgia. August 20, 2016. J Vaughan, A Long, K Ngann , DB Christie III, DW Ashley. Oral presentation. Pre-procedural Fasting. Is it Time to Change Practice? Georgia Society ACS. Savannah, Georgia. August 20, 2016. MG Griffin, BM Howard, DB Christie III. Oral Presentation. The Impact of Hemodynamic Transesophageal Echography on The Use of Continuous Renal Placement Therapy in Trauma. Georgia Society ACS. Savannah, Georgia. August 20, 2016. C Jean-Louis, BM Howard, DB Christie III. Oral Presentation. Recurrent Supra Renal Inferior Vena Cava Filter Thrombosis with Acute Renal Failure Successfully Treated with Catheter Directed Thrombolytic Therapy and Stent Exclusion of Filter. Georgia Vascular Society. Greensboro, Georgia. September 16, 2016. T Engebretsen, AB Christie. Poster Presentation. Hemodynamic Optimization of the Brain-Dead Trauma Patient Utilizing Hemodynamic Transesophageal Echocardiography (hTEE). American Society of Transplant Surgeons. Miami, Florida. January 27, 2017. Poster of Distinction Award A Drahos, H Nolan, W Thompson. Poster Presentation. Retained Foreign Body from Remote Penetrating Trauma Presents as Suspicious Radiographic Abnormality on Screening Mammogram. Southeastern Surgical Congress. Nashville, Tennessee. February 26, 2017. J Vaughan, A Long, Kuong Ngann, DB Christie III, DW Ashley. Poster Presentation. Pre-procedural Fasting. Is it Time to Change Practice. Southeastern Surgical Congress. Nashville, Tennessee. February 26, 2017.

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Presentations—Residents H Nolan, C Brown, C Cawley, D Nakayama. Poster Presentation. Use of Gastroduodenal Tube to Preserve the Common Wall During Excision of a Gastric Duplication. Southeastern Surgical Congress. Nashville, Tennessee. February 26, 2017. Top 20 Poster of Distinction Award A Register, M Honaker, DW Ashley. Poster Presentation. Perforation of the Duodenum Secondary to Ingested Toothpick Treated with Primary Repair. Southeastern Surgical Congress. Nashville, Tennessee. February 27, 2017. J Vaughan, AB Cauthen, P Dale. Oral Presentation. Evaluation of Cardiopulmonary Complication Rates Following Port Insertion: Is a Postoperative X-Ray Needed? Southeastern Surgical Congress. Nashville, Tennessee. February 27, 2017. Gold Medal Paper A Allen, A Cauthen, J Vaughan, E Long. Poster Presentation. Evaluation of a Trial of a Desufflation Technique to Decrease the Rate of Post-operative Percutaneous Endoscopic Gastrostomy Pneumoperitoneum. Southeastern Surgical Congress. Nashville, Tennessee. February 27, 2017. M Griffin, J Chapman, J Cudnik, B Howard. Poster Presentation. Diagnosis of Partial Anomalous Pulmonary Venous Connection (PAPVE) by Central Line Placement. Southeastern Surgical Congress. Nashville, Tennessee. February 27, 2017. M Griffin, DW Ashley. Oral Presentation. The Impact of Hemodynamic Transesophageal Echography on Continuous Renal Replacement Therapy Use in the Trauma Population. Southeastern Surgical Congress. Nashville, Tennessee. February, 27, 2017. P Rideout, J Cudnik, DB Christie. Poster Presentation. Treatment of Traumatic Vascular Injury Using Endovascular Techniques: A Paradigm Shift. Southeastern Surgical Congress. Nashville, Tennessee. February 27, 2017. A Scott, H Nolan, E Long. Poster Presentation. Alternative Method of Gastric Foreign Body Removal. Southeastern Surgical Congress. Nashville, Tennessee. February 27, 2017. M Fitzgerald, ZT Skipper, DW Ashley, DB Christie III. Poster Presentation. Chest Wall Stabilization with Rib Plating After Cardiopulmonary Resuscitation. Southeastern Surgical Congress. Nashville, Tennessee. February 27, 2017. M Fitzgerald, EB Almon, DW Ashley, DB Christie III. Poster Presentation. Chest Wall Stabilization and Rib Plating in 15 Year Old Male After Blunt Thoracic Trauma. Southeastern Surgical Congress. Nashville, Tennessee. February 27, 2017. C Fancher, T Scott, A Allen, P Dale. Oral Presentation. Mammographic Screening at Age 40 or 45? What Difference Does it Make? The Potential Impact of American Cancer Society Mammography Screening Guidelines. Southeastern Surgical Congress. Nashville, Tennessee. February 28, 2017. ANNUAL

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Presentations—Residents continued A Allen, A Cauthen, P Dale, J Vaughan. Oral Presentation. The Clinical Utility and Cost of Postoperative Mammography Completed Within One Year of Breast Conserving Therapy: Is it Worth It? Southeastern Surgical Congress. Nashville, Tennessee. February 28, 2017. A Allen, A Cauthen, C Jean-Louis, A Lord, B Smith, P Dale, Poster. Presentation. Evaluating the Incidents of Upgrade to Malignancy Following Surgical Excision of High Risk Breast Lesions Identified by Core Needle Biopsy. The American Society of Breast Surgery. Las Vegas, Nevada. April 28, 2017. H Nolan. Oral Presentation. Robotic Single-Incision Pediatric Cholecystectomy Shortens Postoperative Length of Stay with Equivalent Operative Times Compared to Other Minimally Invasive Techniques. The Pacific Association of Pediatric Surgeons 50th Annual Scientific Meeting. Seattle, Washington. May 29, 2017. H Nolan. Poster Presentation. Operative Time and Length of Stay is Similar Between Robotic-Assisted and Laparoscopic Colon and Rectal Resections. American Society of Colon and Rectal Surgeons Annual Scientific and Tripartite Meeting. Seattle, Washington. May 30, 2017.

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Acknowledgements

Virginia Land, Administrative Coordinator for the Department of Surgery and Trauma Services, Irma Miranda, Residency Coordinator, and Carletta Grace, Department Secretary and Clerkship Coordinator, provide invaluable administrative support. The Department of Surgery recognizes our partners in surgical education, The Medical Center, Navicent Health and the Mercer University School of Medicine.

Mercer University School of Medicine: Jean Sumner, MD, Dean

Medical Center Navicent Health: Dr. Ninfa M. Saunders, President & CEO Dr. Robert DiRenzo, Executive Vice President Mr. Elbert McQueen, Senior Vice President Susan Harris, Senior VP/Chief Operating Officer Dr. Christopher Hendry, Chief Medical/Clinical Officer Rhonda S. Perry, Chief Financial Officer Tracey Blalock, Chief Nursing Executive, Navicent Health Dawn Cole, Chief Nursing Officer Lori Cassidy, Chief Administrative Officer Donald Smith, Assistant Vice President in Nursing

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