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Notable Grand Rounds

These assembled papers are edited transcripts of didactic lectures given by mainly senior residents, but also some distinguished attending and guests, at the Grand Rounds of the Michael and Marian Ilitch Department of Surgery at the Wayne State University School of Medicine.

Every week, approximately 50 faculty attending surgeons and surgical residents meet to conduct postmortems on cases that did not go well. That “Mortality and Morbidity” conference is followed immediately by Grand Rounds.

This collection is not intended as a scholarly journal, but in a significant way, it is a peer-reviewed publication by virtue of the fact that every presentation is examined in great detail by those 50 or so surgeons.

It serves to honor the presenters for their effort, to potentially serve as first draft for an article for submission to a medical journal, to let residents and potential residents see the high standard achieved by their peers and expected of them, and by no means least, to contribute to better patient care.

— David Edelman, M.D.

Surgical GI Endoscopy:
52 Years of Experience in the USA

Choichi Sugawa, MD, PhD, FACS, FASA, FASGE, FJGES
Professor Emeritus
Wayne State University
Dr. Sugawa describes and reflects upon his distinguished career in surgical endoscopy, a field in which he was one of the original and leading pioneers.
Read more

Legendary Recollections

Anna Ledgerwood, MD, FACS
Professor of Surgery
Wayne State University
Dr. Ledgerwood, a legend in her own right, acknowledges some of the contributions and recounts some of her experiences with the legendary Dr. Choichi Sugawa.
Read more

Overcoming Challenges in Surgical Training

David R. Farley, MD
Emeritus Professor of Surgery
Mayo Clinic College of Medicine and Science
What are the main challenges of surgical training and how we can counteract them in the midst of a perfect storm of pressure to make money for the institution, the growing complexity of surgery…
Read more

Global Surgery

Todd Lavery, MD, FACS
This paper seeks to elucidate the need globally for surgical care, to describe the challenge of getting global surgery accepted as an essential component of the global health conversation.
Read more

The Changing Face of Oncology: Modern Skill Sets for the Cancer Surgeon and Changing Scientific Paradigms

Donald W. Weaver, MD
Pemberthy Professor of Surgery and
Chair of the Department of Surgery
Wayne State University School of Medicine
The overall objective is to show how and why surgery and especially surgical oncology is changing. This paper looks at where surgery is going and where it’s been.
Read more

The Wonderful World of Calcium

Charles Lucas, MD
Professor of Surgery
Wayne State University School of Medicine
Calcium (Ca) is the most common element in the body. It is present primarily in bone. Non-skeletal ionized Ca (38%) is free, while protein-bound Ca accounts for 50% of the total.
Read more

Medical Malpractice for the Surgeon

John Webber, MD
Professor of Surgery
Wayne State University School of Medicine
This paper discusses medical malpractice as it relates to surgeons and what surgeons should know about it, especially residents just starting to practice.
Read more

Physician Impairment: Disruptive, Disabled, Duped & Depressed

Carl Christensen, MD, PhD, D-FASAM, cMRO
Clinical Associate Professor

Departments of Psychology and OB Gyn

Wayne State University
To the Joint Commission and the board of medicine, “impairment” means that a doctor is essentially unsafe. This paper examines the factors behind it and describes ways it is handled.
Read more

How to Build an Academic Career 
Focused on Research

Phillip D. Levy, MD MPH, FACEP, FAHA, FACC
Professor of Emergency Medicine 
and Assistant VP for Research

Wayne State University
Chief Innovation Officer – Wayne Health
Research is not the only way forward in a physician’s career, but if it is where your interest lies, there is a way to go about it in order to be successful.
Read more

Transcarotid Artery Revascularization for the Treatment of Cerebrovascular Disease in High-Risk Patients

Sun Kim, MD
Vascular Surgery Fellow
Detroit Medical Center/Wayne State University
Background and epidemiology of carotid artery stenosis & an overview of the transcarotid artery revascularization (TCAR) system.
Read more

“Back” to Basics:
Ergonomics and the OR

Ashley Malach, MD
General Surgery Resident
Are ergonomics important to surgeons as they operate in the OR? The answer is “very.” This paper explains why and suggests how to improve surgeons’ ergonomic health.
Read more

Mythbusters, Surgical Edition

Solhee Lee, MD
General Surgery Resident
This paper presents the current literature on common surgical misconceptions concerning C. diff, scrub caps, closing mesenteric defects, male and female surgeons, and surgical smoke.
Read more

Navigating the
Institutional Review Board

James H. Paxton, MD MBA
Associate Professor of Emergency Medicine
Understanding the IRB perspective may help researchers to successfully navigate the IRB review process.
Read more

Dr. Alexander J. Walt:
Historian, Philosopher,
and Surgical Educator

Dr. Charles Lucas
Professor of Surgery
Despite the tragedy of his family’s early history in Eastern Europe, Dr. Alexander Walt rose to become president of the American College of Surgeons and our own beloved chair.
Read more

Management of
Intrahepatic Cholangiocarcinoma

Timothy M. Pawlik, MD, PhD, MPH, MTS, MBA
Professor and Chair, Department of Surgery
The Urban Meyer Ill and Shelley Meyer Chair in Cancer Research
Surgeon in Chief, The Ohio State University Wexner Medical Center
As chemotherapy gets better, previously inoperable patients will become operable. There will be better control of systemic disease enabling us to focus our surgical techniques on the disease.
Read more

Principles and Practice of Bariatric Surgery

Roozbeh Mansour, MD, FACS
Assistant Professor of Surgery
The physiology and complications of bariatric surgery, with an addendum on recent developments contributed by Dr. Alyssa Stroud.
Read more

Management of 
the Open Abdomen

Christopher Dente, MD, FACS
Professor of Surgery, Emory University
Chief, General Surgery, Emory at Grady
The evolution of management of the open abdomen from a technical standpoint and as it relates to changes in resuscitation paradigms over the last 20 years, with an appendix on institutional influence.
Read more

Gastric Cancer

Steve H. Kim, MD, FACS
Chief of Surgical Oncology, Karmanos Cancer Center
Professor of Surgery, Wayne State University School of Medicine
Karmanos Cancer Institute
This paper is primarily about gastric adenocarcinoma but touches also on two other gastric tumors often seen by general surgeons: GI stromal tumors (GIST) and gastric carcinoids.
Read more

Hepatocellular Carcinoma

Eliza W. Beal, MD
Surgical Oncologist

Karmanos Cancer Institute
Discusses the diagnosis and management of hepatocellular carcinoma (HCC) and research concerning barriers to surveillance for HCC that result in late diagnosis.
Read more

Missed Injuries 
in Pediatric Trauma 
and How to Avoid Them

Jonathan I. Groner MD
Professor of Surgery, The Ohio State University College of Medicine
Some injuries or conditions are difficult to detect in pediatric trauma. Dr. Groner discusses biases that increase the risk of missed injuries and a standardized approach to avoid missing them.
Read more

The History, Current Applications and 
Ethical Considerations of Robotic Surgery

Alyssa Stroud, MD
Chief Resident
A fascinating overview of a topic—robotic surgery—that seems poised to intrude more into surgery as robots grow in intelligence.
Read more

Two Dozen Years, Two PD’s and Top Lessons Learned From Surgical Education

Randall W. Smith MD, FACS
J. Scott Thomas MD, FACS
Baylor Scott & White – Temple
Highlights and lessons learned from the authors’ experiences as surgical residency program directors.
Read more

All About Mesh

Solhee Lee, MD
General Surgeon
Dr. Lee reviews the history, types, properties, clinical application, and other aspects of a material all general surgeons are likely to use at some point in their careers to repair a hernia.
Read more

Your Patient is On Fire

Muhammad Jaffar, MD, FASA, FCCM
Professor (Clinical)
Department of Anesthesiology
Dr. Jaffar explores the factors that contribute to surgical fires, focusing on both the personnel involved and the equipment utilized.
Read more

Update on Blunt Cerebrovascular Injuries

Jessica D. McGee, MD
Assistant Professor of Surgery
Signs and symptoms, diagnostic imaging, injury grading scale, incidence and treatment of BCVI
Read more

Liver Transplants: A Primer for the General Surgeon

Miguel Tobon, MD
Assistant Professor of Surgery
Wayne State University
Key things to know about liver transplants for general surgeons caring for patients who have had or will have a liver transplant
Read more

Pathology of the Biliary Tract

Anastasya Chuchulo, MD
PGY 5 Resident, Wayne State University, Dept. of Surgery
A review of current practices, investigational techniques, and decision-making processes in the management of biliary tract diseases,
Read more

Time to Say Goodbye: Historical Perspectives and Contemporary Approaches to Palliative Care at the End of Life

Kelly Zhang, MD
PGY6
Explores the evolution of end-of-life care, examines current practices in the United States, and discusses the concept of a “good death.”
Read more

Gastrointestinal Cancer Disparities

Eliza W. Beal, MD
Surgical Oncologist

Karmanos Cancer Institute
Dr. Beal examines the disparities surrounding gastrointestinal cancers and the systemic inequities and social determinants that contribute to disparate health outcomes among various population groups.
Read more

C. Walton Lillehei: Innovator, Educator, and Pioneer

Jock Thacker, MD
PGY5 Resident
Department of Surgery
Describes the career and key contributions to medicine and cardiology of Dr. Walt Lillehei, arguably the founding father of cardiac surgery.
Read more

The Past, Present and Future of Wellness in Surgery

Molly Belisle, MD
PGY5 Resident
Dept. of Surgery
Wayne State University
Traces milestones in resident well-being and duty hour regulation and adds thoughts and anecdotes concerning the day-to-day challenges faced by surgical residents.
Read more

Global Surgical Education:
A Stamp in the Passport to Academic Pursuit

Rondi M. Kauffmann, MD, MPH, FACS, FCS (ECSA)
Vanderbilt University Medical Center
This annual talk honoring the memory of Dr. Alexander A. Walt discusses the past, present and future of global surgery, a calling for surgeons everywhere.
Read more

Trauma Anesthesia and
Perioperative Volume Resuscitation

Dr. Robert Joslin
Anesthesiologist
Describes the critical role anesthesia plays in the care of the trauma patient, from the ED through the OR to the ICU), encompassing airway management, pain control, and resuscitation.
Read more

Liver Transplantation:

Past, Present, and Future

Shunji Nagai, MD, PhD, FACS
Surgical Director
Liver, Intestine, and Multivisceral Transplantation
Henry Ford Transplant Institute
The past and present of liver transplantation, with a focus on indications and outcomes, transplant oncology, innovations, and multivisceral transplantation.
Read more

Going Green… with ICG

Ashley Malach, MD
John D Dingell VA Medical Center
Dr. Malach discusses the imaging dye indocyanine green (ICG) characteristics, history, preparation, dosing, infrared technology, indications, contraindications, and potential future applications.
Read more

Fertility and Family Planning in Residency and Fellowship

Nicole Budrys, MD
Michigan Center for Fertility and Women’s Health
Explores fertility in general and its implications for residents given the intense demands of medical education and training.
Read more

Notable Sessions at the 2024 ACS Clinical Congress

Chief Residents
DMC Surgical Residency
Summaries of interesting presentations attended at the American College of Surgeons Congress, 2024.
Read more

The Good Ole Days

James G. Tyburski, MD
Professor of Surgery
Reflections on changes Dr. Tyburski has seen in his career, combining personal anecdotes with broader data-driven observations, in an effort to examine where we have been and where we are heading.
Read more

Chest Wall Repair

Scott E. Langenburg MD, FAAP, FACS
Children’s Hospital of Michigan
The history and evolution of surgical approaches to chest wall deformities, focusing primarily on pectus excavatum (funnel chest).
Read more
Load more

Wayne State
Surgical Society

The Wayne State Surgical Society (WSSS) was established during the tenure of Dr. Walt as the chairman of the Department of Surgery. WSSS was designed to create closer contact between the current faculty and residents with the former resident members in order to create a living family of all of the WSU Department of Surgery. The WSSS also supports department activities.
Learn more
News and Events Details

Latest News and
Announcements

Connect With Us on Social

Facebook Twitter Instagram

Notable Grand Rounds

These assembled papers are edited transcripts of didactic lectures given by mainly senior residents, but also some distinguished attending and guests, at the Grand Rounds of the Michael and Marian Ilitch Department of Surgery at the Wayne State University School of Medicine.

Every week, approximately 50 faculty attending surgeons and surgical residents meet to conduct postmortems on cases that did not go well. That “Mortality and Morbidity” conference is followed immediately by Grand Rounds.

This collection is not intended as a scholarly journal, but in a significant way, it is a peer-reviewed publication by virtue of the fact that every presentation is examined in great detail by those 50 or so surgeons.

It serves to honor the presenters for their effort, to potentially serve as first draft for an article for submission to a medical journal, to let residents and potential residents see the high standard achieved by their peers and expected of them, and by no means least, to contribute to better patient care.

— David Edelman, M.D.

Surgical GI Endoscopy:
52 Years of Experience in the USA

Choichi Sugawa, MD, PhD, FACS, FASA, FASGE, FJGES
Professor Emeritus
Wayne State University
Dr. Sugawa describes and reflects upon his distinguished career in surgical endoscopy, a field in which he was one of the original and leading pioneers.
Read more

Legendary Recollections

Anna Ledgerwood, MD, FACS
Professor of Surgery
Wayne State University
Dr. Ledgerwood, a legend in her own right, acknowledges some of the contributions and recounts some of her experiences with the legendary Dr. Choichi Sugawa.
Read more

Overcoming Challenges in Surgical Training

David R. Farley, MD
Emeritus Professor of Surgery
Mayo Clinic College of Medicine and Science
What are the main challenges of surgical training and how we can counteract them in the midst of a perfect storm of pressure to make money for the institution, the growing complexity of surgery…
Read more

Global Surgery

Todd Lavery, MD, FACS
This paper seeks to elucidate the need globally for surgical care, to describe the challenge of getting global surgery accepted as an essential component of the global health conversation.
Read more

The Changing Face of Oncology: Modern Skill Sets for the Cancer Surgeon and Changing Scientific Paradigms

Donald W. Weaver, MD
Pemberthy Professor of Surgery and
Chair of the Department of Surgery
Wayne State University School of Medicine
The overall objective is to show how and why surgery and especially surgical oncology is changing. This paper looks at where surgery is going and where it’s been.
Read more

The Wonderful World of Calcium

Charles Lucas, MD
Professor of Surgery
Wayne State University School of Medicine
Calcium (Ca) is the most common element in the body. It is present primarily in bone. Non-skeletal ionized Ca (38%) is free, while protein-bound Ca accounts for 50% of the total.
Read more

Medical Malpractice for the Surgeon

John Webber, MD
Professor of Surgery
Wayne State University School of Medicine
This paper discusses medical malpractice as it relates to surgeons and what surgeons should know about it, especially residents just starting to practice.
Read more

Physician Impairment: Disruptive, Disabled, Duped & Depressed

Carl Christensen, MD, PhD, D-FASAM, cMRO
Clinical Associate Professor

Departments of Psychology and OB Gyn

Wayne State University
To the Joint Commission and the board of medicine, “impairment” means that a doctor is essentially unsafe. This paper examines the factors behind it and describes ways it is handled.
Read more

How to Build an Academic Career 
Focused on Research

Phillip D. Levy, MD MPH, FACEP, FAHA, FACC
Professor of Emergency Medicine 
and Assistant VP for Research

Wayne State University
Chief Innovation Officer – Wayne Health
Research is not the only way forward in a physician’s career, but if it is where your interest lies, there is a way to go about it in order to be successful.
Read more

Transcarotid Artery Revascularization for the Treatment of Cerebrovascular Disease in High-Risk Patients

Sun Kim, MD
Vascular Surgery Fellow
Detroit Medical Center/Wayne State University
Background and epidemiology of carotid artery stenosis & an overview of the transcarotid artery revascularization (TCAR) system.
Read more

“Back” to Basics:
Ergonomics and the OR

Ashley Malach, MD
General Surgery Resident
Are ergonomics important to surgeons as they operate in the OR? The answer is “very.” This paper explains why and suggests how to improve surgeons’ ergonomic health.
Read more

Mythbusters, Surgical Edition

Solhee Lee, MD
General Surgery Resident
This paper presents the current literature on common surgical misconceptions concerning C. diff, scrub caps, closing mesenteric defects, male and female surgeons, and surgical smoke.
Read more

Navigating the
Institutional Review Board

James H. Paxton, MD MBA
Associate Professor of Emergency Medicine
Understanding the IRB perspective may help researchers to successfully navigate the IRB review process.
Read more

Dr. Alexander J. Walt:
Historian, Philosopher,
and Surgical Educator

Dr. Charles Lucas
Professor of Surgery
Despite the tragedy of his family’s early history in Eastern Europe, Dr. Alexander Walt rose to become president of the American College of Surgeons and our own beloved chair.
Read more

Management of
Intrahepatic Cholangiocarcinoma

Timothy M. Pawlik, MD, PhD, MPH, MTS, MBA
Professor and Chair, Department of Surgery
The Urban Meyer Ill and Shelley Meyer Chair in Cancer Research
Surgeon in Chief, The Ohio State University Wexner Medical Center
As chemotherapy gets better, previously inoperable patients will become operable. There will be better control of systemic disease enabling us to focus our surgical techniques on the disease.
Read more

Principles and Practice of Bariatric Surgery

Roozbeh Mansour, MD, FACS
Assistant Professor of Surgery
The physiology and complications of bariatric surgery, with an addendum on recent developments contributed by Dr. Alyssa Stroud.
Read more

Management of 
the Open Abdomen

Christopher Dente, MD, FACS
Professor of Surgery, Emory University
Chief, General Surgery, Emory at Grady
The evolution of management of the open abdomen from a technical standpoint and as it relates to changes in resuscitation paradigms over the last 20 years, with an appendix on institutional influence.
Read more

Gastric Cancer

Steve H. Kim, MD, FACS
Chief of Surgical Oncology, Karmanos Cancer Center
Professor of Surgery, Wayne State University School of Medicine
Karmanos Cancer Institute
This paper is primarily about gastric adenocarcinoma but touches also on two other gastric tumors often seen by general surgeons: GI stromal tumors (GIST) and gastric carcinoids.
Read more

Hepatocellular Carcinoma

Eliza W. Beal, MD
Surgical Oncologist

Karmanos Cancer Institute
Discusses the diagnosis and management of hepatocellular carcinoma (HCC) and research concerning barriers to surveillance for HCC that result in late diagnosis.
Read more

Missed Injuries 
in Pediatric Trauma 
and How to Avoid Them

Jonathan I. Groner MD
Professor of Surgery, The Ohio State University College of Medicine
Some injuries or conditions are difficult to detect in pediatric trauma. Dr. Groner discusses biases that increase the risk of missed injuries and a standardized approach to avoid missing them.
Read more

The History, Current Applications and 
Ethical Considerations of Robotic Surgery

Alyssa Stroud, MD
Chief Resident
A fascinating overview of a topic—robotic surgery—that seems poised to intrude more into surgery as robots grow in intelligence.
Read more

Two Dozen Years, Two PD’s and Top Lessons Learned From Surgical Education

Randall W. Smith MD, FACS
J. Scott Thomas MD, FACS
Baylor Scott & White – Temple
Highlights and lessons learned from the authors’ experiences as surgical residency program directors.
Read more

All About Mesh

Solhee Lee, MD
General Surgeon
Dr. Lee reviews the history, types, properties, clinical application, and other aspects of a material all general surgeons are likely to use at some point in their careers to repair a hernia.
Read more

Your Patient is On Fire

Muhammad Jaffar, MD, FASA, FCCM
Professor (Clinical)
Department of Anesthesiology
Dr. Jaffar explores the factors that contribute to surgical fires, focusing on both the personnel involved and the equipment utilized.
Read more

Update on Blunt Cerebrovascular Injuries

Jessica D. McGee, MD
Assistant Professor of Surgery
Signs and symptoms, diagnostic imaging, injury grading scale, incidence and treatment of BCVI
Read more

Liver Transplants: A Primer for the General Surgeon

Miguel Tobon, MD
Assistant Professor of Surgery
Wayne State University
Key things to know about liver transplants for general surgeons caring for patients who have had or will have a liver transplant
Read more

Pathology of the Biliary Tract

Anastasya Chuchulo, MD
PGY 5 Resident, Wayne State University, Dept. of Surgery
A review of current practices, investigational techniques, and decision-making processes in the management of biliary tract diseases,
Read more

Time to Say Goodbye: Historical Perspectives and Contemporary Approaches to Palliative Care at the End of Life

Kelly Zhang, MD
PGY6
Explores the evolution of end-of-life care, examines current practices in the United States, and discusses the concept of a “good death.”
Read more

Gastrointestinal Cancer Disparities

Eliza W. Beal, MD
Surgical Oncologist

Karmanos Cancer Institute
Dr. Beal examines the disparities surrounding gastrointestinal cancers and the systemic inequities and social determinants that contribute to disparate health outcomes among various population groups.
Read more

C. Walton Lillehei: Innovator, Educator, and Pioneer

Jock Thacker, MD
PGY5 Resident
Department of Surgery
Describes the career and key contributions to medicine and cardiology of Dr. Walt Lillehei, arguably the founding father of cardiac surgery.
Read more

The Past, Present and Future of Wellness in Surgery

Molly Belisle, MD
PGY5 Resident
Dept. of Surgery
Wayne State University
Traces milestones in resident well-being and duty hour regulation and adds thoughts and anecdotes concerning the day-to-day challenges faced by surgical residents.
Read more

Global Surgical Education:
A Stamp in the Passport to Academic Pursuit

Rondi M. Kauffmann, MD, MPH, FACS, FCS (ECSA)
Vanderbilt University Medical Center
This annual talk honoring the memory of Dr. Alexander A. Walt discusses the past, present and future of global surgery, a calling for surgeons everywhere.
Read more

Trauma Anesthesia and
Perioperative Volume Resuscitation

Dr. Robert Joslin
Anesthesiologist
Describes the critical role anesthesia plays in the care of the trauma patient, from the ED through the OR to the ICU), encompassing airway management, pain control, and resuscitation.
Read more

Liver Transplantation:

Past, Present, and Future

Shunji Nagai, MD, PhD, FACS
Surgical Director
Liver, Intestine, and Multivisceral Transplantation
Henry Ford Transplant Institute
The past and present of liver transplantation, with a focus on indications and outcomes, transplant oncology, innovations, and multivisceral transplantation.
Read more

Going Green… with ICG

Ashley Malach, MD
John D Dingell VA Medical Center
Dr. Malach discusses the imaging dye indocyanine green (ICG) characteristics, history, preparation, dosing, infrared technology, indications, contraindications, and potential future applications.
Read more

Fertility and Family Planning in Residency and Fellowship

Nicole Budrys, MD
Michigan Center for Fertility and Women’s Health
Explores fertility in general and its implications for residents given the intense demands of medical education and training.
Read more

Notable Sessions at the 2024 ACS Clinical Congress

Chief Residents
DMC Surgical Residency
Summaries of interesting presentations attended at the American College of Surgeons Congress, 2024.
Read more

The Good Ole Days

James G. Tyburski, MD
Professor of Surgery
Reflections on changes Dr. Tyburski has seen in his career, combining personal anecdotes with broader data-driven observations, in an effort to examine where we have been and where we are heading.
Read more

Chest Wall Repair

Scott E. Langenburg MD, FAAP, FACS
Children’s Hospital of Michigan
The history and evolution of surgical approaches to chest wall deformities, focusing primarily on pectus excavatum (funnel chest).
Read more
Load more

Wayne State
Surgical Society

The Wayne State Surgical Society (WSSS) was established during the tenure of Dr. Walt as the chairman of the Department of Surgery. WSSS was designed to create closer contact between the current faculty and residents with the former resident members in order to create a living family of all of the WSU Department of Surgery. The WSSS also supports department activities.
Learn more
More info