Telementoring in Emerging Markets

Research Team: Brian Dunkin, MD; S. Wyles, MD
Project Description: To successfully implement a clinically relevant telementoring structure and platform in the surgical setting across the nation.

Image-guided Liver resections using Hepato-Biliary Ductal Coordinates and Smart Trocar

Research Team: Toan Nguyen, Albert Huang, MD; Vid Fikfak, MD
Project Description: Develop and implement a guidance system for solid organ surgical procedures in a minimally invasive environment by building a mechanical model of the tissue based on pre-operative images and simulating the model with the same conditions seen in the surgery.

Cornet 2

Research Team: Marc Garbey, PhD; Barbara Bass, MD; Brian Dunkin, MD; Vadim Sherman, MD; Guillaume Joerger; Remi Salmon, PhD; Juliette Rambourg, Albert Huang, MD; Vid Fikfak, MD
Project Description: Surgical flow is a very complex process involving multiple scales and teams across the hospital system. Some of the critical surgical maneuvers that impact the path to recovery have to be set in context of the global hospital operating room management, the control process in perioperative area and the overall surgery staff organization and performance. One single event in the OR can affect others and vice versa. Combinations of multiple events that would look benign in isolation may result in adverse outcomes for the patient. This proposal is part of an ongoing effort focused on a new method that can handle the complexity of surgical flow, mostly for noninvasive procedures such as laparoscopy, in a large hospital system with dozens of operating rooms.

Anatomic and Functional Analysis of a large-scale database of Endovascular Aortic Repair to address long-term outcome failure

Research Team: Adeline Schwein, MD; Thibault Kensicher; Marc Garbey, PhD
Project Description: Development of an international online network where surgeons provide CT scans from patients undergoing endovascular aortic repair (EVAR) to volunteers (students in computer science or the medical field) who will run our proprietary software in order to semi-automatically:

  1. Get a 3D reconstruction of the aneurysm, aorta and its branches
  2. Extract anatomical features (diameter, length, volume, angles, etc.)
  3. Extract functional features (flow velocity, vorticity, pressure, and wall shear stress)
  4. Compare these data to patient outcomes to find predictors for long-term failure after EVAR

Computational Modeling of the Aortic Arch: Evaluation of Endovascular Device Designs

Research Team: Rosamaria Tricarico; Yong He, PhD; Liza Laquian, MD; Roger Tran-Son-Tay, PhD; Scott Berceli, MD, PhD; Adam Beck, MD
Project Description: Endovascular repair using chimney, branched, or fenestrated stent grafts (SG) represents a significant opportunity for preserving aortic branch perfusion after treatment of aortic arch aneurysms/dissections in high-risk patients. The objective of the study is to evaluate the hemodynamic impact of chimney/branched/fenestrated SG designs using computational fluid-dynamics (CFD) modeling and in-silico modifications through retrospective and prospective analyses.

Esophageal Stent Migration

Research Team: Remi Salmon, PhD; Vid Fikfak, MD; Milos Kojic, PhD; Marc Garbey, PhD
Project Description: Build a computational model of esophageal peristalsis that reproduces the dynamics of esophageal muscles during swallowing motion and also takes into account the mechanical properties of the stent and its interaction with the esophageal wall. This model can be used to determine factors contributing to stent migration.

Predicting Performance: Multimodal Tracking of Surgery Teams

Research Team: Ahmet Omurtag, PhD; Marc Garbey, PhD; Brian Dunkin, MD; Albert Huang, MD; Luc Chatty
Project Description: This project addresses an ongoing challenge in surgery by tackling a fundamental problem: determining the relationship between multimodal variables in the OR (surgeons’ neural-, hemo-, behavioral, and physical dynamics) and the surgical team’s performance on multiple time scales. The project will create new methods of collecting data from the OR, analyzing them, and predicting the performance of surgeons and trainees. The methods will take advantage of the fact that signals of multiple distinct origins often operate synergistically. Multimodal measurements will include scalp EEG and functional near-infrared spectroscopy (FNIRS). Behavioral data will include overt measurements based on fundamentals of laparoscopic surgery and surgical tool trajectories collected continuously by an innovative trocar (Toti et al., 2015).

Augmenting a Wireless Portable Ultrasound with a real-time Flow Solver: Application to Diagnostics of Vascular Conditions

Research Team: Marc Garbey, PhD; Scott Berceli, MD, PhD
Project Description: Wireless light ultrasound systems with competitive accuracy are becoming available. A number of medical applications such as follow-up of fistula maturation and low extremity vascular graft adaptation will take great advantage of that new equipment.
Our goal is to augment this system with real-time flow solver that extracts boundary conditions from ultrasound and provides high definition visualization of hemodynamic flow.

Safety and Feasibility of Autologous Adipose -derived stromal vascular fraction cells (SVF) for Hair Rejuvenation

Research Team: Adam Katz, MD; Hulan Shang, MS; Scott Bercelli, MD, PhD
Project Description: Phase 1: The purpose of this study was to characterize the identity and purity of human adipose-derived SVF cells isolated using the GID SVF-2 device and method, as well as the performance of the device with respect to cell yield and viability of the adipose-derived SVF cells. The GID SVF-2 is closed system disposable device for point-of-care application.
Phase 2: Prepare, submit and initiate a clinical trial to test the safety and feasibility of using SVF cells at the point-of-care for hair rejuvenation.

Application of Drug Coated Balloon Technology to Dialysis Fistula Maturation: A Framework for the Application of Computational Analysis in the Rational Design of Paclitaxel Therapy

Research Team: Hao Liu; Scott Berceli, MD, PhD; Marc Garbey, PhD; Roger Tran-Son-Tay, PhD
Project Description: Using currently available biologic data sets, coupled with current computational framework for hemodynamically-mediated vascular remodeling, the goal is to examine the potential biologic influence of paclitaxel (PTX) on arteriovenous fistula (AVF) remodeling.

  • The first part of this project will investigate a range of PTX concentrations in a preclinical AVF model to develop and understand the upper/lower bounds for PTX administration. PTX will be administrated over a range of time to fully explore therapeutic and deleterious effects. Finally, the influence of shear on the local biologic response will be evaluated.
  • The second part of this project will focus on the differences between human and porcine AVF maturation. We will obtain an understanding of the physiologic processes that are analogous and different between these two scenarios.
  • Third part of this project is to evaluate patient-specific variability.