Monday, September 24, 2012

Keep It Simple, Surgeons



Frequently, when we talk about innovation, the images that spring to mind are advanced technology, sophisticated and cutting edge approaches, like robotic surgery, image fusion, and on and on. Recently, though, the institute hosted a special innovation rounds with nationally known pediatric surgeon Michael Gauderer, MD, who has been a pioneer in another type of innovation: simplicity.

Dr. Gauderer outlined some of his most successful work to find solutions for surgical challenges, and each example focused on finding the simplest procedure or device to safely address the problem in question.

He gave one example that involved the alteration of a typical surgical needle to aspirate an abscess, or drain a child’s boil. Typically, the person draining the boil has to hold the squirming child with one hand, and manage to insert a long needle to a specific desired depth freehand with the remaining hand—challenging to do with no guide. This increases the risk that the caregiver could stick someone accidentally with the needle, and also, if the needle goes too deep, there is the risk of injury to underlying structures like blood vessels or nerves. Dr. Gauderer altered the existing cap of the needle by removing the plastic cap of the needle, cutting that cap, and then slipping it back over the needle. The level of the cut across the cap pre-determines the depth of penetration of the needle. This holds the needle stable and enables it to be quickly inserted at exactly the right depth with one hand.

The beauty of this idea, says Dr. Gauderer, is that most of the time, it doesn’t require applying for grants, protected research time, or specialized tools. Instead, looking at the existing environment as a resource for new and interesting approaches can be a path to safe,effective, inexpensive, and practical answers to pressing problems.

In his experience, this “simplicity in surgery” can often find solutions that are as elegant as complex ones, and often more readily available. So, his best advice to aspiring innovators, is really, whenever possible, to follow the KISS principle.

Tuesday, September 11, 2012

Spotlight on Immunology – Felix Blanco, MD

By Laura Belazis, MPH

“We all have the same spirit. We all want to fight cancer. We all want to find a cure.” As I spoke with Felix Blanco, MD about the Immunology Initiative in the Sheikh Zayed Institute, passion and teamwork continuously reemerged as the driving force behind the Initiative. After attending medical school in Bolivia and a General Surgery residency at Howard University, Dr. Blanco was drawn to a research position in the Immunology Initiative. “There are really a lot of gaps in the treatments that we provide for patients, especially in cancer and oncology,” he told me, “I thought that joining a place where I could do research would let me grow, not just as a surgeon, but as a person.”

Dr. Blanco’s research involves vaccine therapy to make T cells, or defensive cells, more effective in fighting cancer. Through his work in preclinical models he is able to closely model the human immune system’s response to tumors. He described his research group, led by Anthony Sandler, MD, as poised on the verge of discovery. “Our preliminary results are very encouraging. Our work is getting to something very important.” The Immunology Initiative has spent the last few years laying the groundwork in their research, with each team member targeting tumors in different ways. Dr. Blanco is excited to be in “the right place, with the right people.” Foremost among the “right” people is his Initiative leader, Dr. Sandler. “He is an excellent surgeon, he cares for patients, he provides excellent care, he’s compassionate…and he is very supportive [in the lab].”

In addition to his research in the wet lab, Dr. Blanco continues to hone his skills as a surgeon by taking 5pm to 6am calls in the operating room. For him, the opportunity to continue practicing surgery while undertaking a research experience was a major factor in choosing to work at the Sheikh Zayed Institute. Few programs allow investigators to conduct research and clinical work concurrently. “It keeps me alive. That’s what I love to do: surgery.” Although surgery by itself is a time-consuming, demanding field, Dr. Blanco would like to continue to be involved in research throughout his career. “I think that the work that I developed in the lab, and all the knowledge I acquired is going to be very important when I start my Fellowship, because that will allow me to understand many of the aspects that a transplant surgeon needs to know in terms of immunology, [and] rejection of organs.”

Ultimately Dr. Blanco’s work and the work of the Sheikh Zayed Institute comes down to kids: “It devastates me to see a child with a tumor because most of the time those cancers are incurable. If we can stop that, we can give these children the chance to live a full life. I think about it every day when I am at the bench working and because I think we can come up with something meaningful. That is my main inspiration.”

Laura Belazis is a senior staff assistant at the Sheikh Zayed Institute and a contributor to SurgeryInnovation.org.