Department of Surgery

Surgery

Malachi Sheahan III, MD, FACS
Professor and Head of the Department

The Department of Surgery at the LSU School of Medicine in New Orleans has received recognition for excellence in patient care, resident training, student education, and research.

Students rotate on the Surgical Teams at various hospitals in New Orleans, Baton Rouge, and Lafayette. Six weeks of general surgery and two three-week blocks of surgical subspecialties make up the rotation. Students are expected to learn proper evaluation and management of surgical diseases and participate in operative procedures. Time is spent on the inpatient floors, in outpatient clinics, and in the operating room.

The goal of the surgical experience is to impart an understanding of the basic principles of surgery so that the student will acquire an informational base from which surgical disease can be recognized and appropriate treatment initiated. This is accomplished through direct patient care, faculty and resident teaching, and a series of lectures and conferences. Throughout the course, emphasis is placed on clinical experience and personal interaction with patients. The experience in surgery is intended to prepare students for whatever area of Medicine they ultimately choose for post-graduate residency training.

The clinical clerkship in General Surgery is based on a team concept, wherein students assigned to a service are directly responsible to the residents and attending Faculty on that service. Third year clerks are integrated members of the team and fully participate in the management of patients on the service. The surgical clerks are responsible for the initial workup of hospitalized patients, daily inpatient rounds, and attendance at outpatient clinics. The specific schedule of hospital rounds, surgical clinics, and conferences will be dictated by Chief Residents and attending faculty.

Cardiothoracic Surgery

William Risher, MD, FACS 
Section Chief

Adult cardiothoracic surgery at LSUHSC at New Orleans includes both general thoracic surgery (pulmonary, esophageal, mediastinal, etc) and cardiovascular surgery (CABG, valves, thoracic/thoraco-abdominal aorta, etc). In addition, pediatric cardiac surgery - provided at the Children’s Hospital Medical Center in uptown New Orleans - Department of Surgery. While there is no fellowship training program in cardiothoracic surgery, the service provides a two to three month subspecialty rotation in adult cardiothoracic surgery for PGY3 residents within the five year general surgery training program.

The New Orleans faculty is comprised of one full-time LSUHSC attending and three private practice clinical faculty contracted to provide service on a rotational basis. The third year resident rotating on the service is responsible for the cardiac surgery intensive care unit and patient critical care immediately post operatively, out-of-house night and alternating weekend call, as well as first assisting in the operating room on cardiac cases.

Hands-on operative experience is afforded the third year resident with most major thoracic cases (decortications, lung resections, mediastinal mass resections, etc) and occasional vascular cases (carotids associated with CABG). A separate rotation with our affiliate Hospital (Our Lady of the Lake Hospital, Baton Rouge) also affords a one to two month rotation for PGY3 and PGY4 residents with private practice clinical faculty at that institution. Didactic Grand Rounds presentations on pertinent topics in cardiothoracic surgery appropriate to a general surgical training program are presented by the faculty several times a year.

The broad field of cardiothoracic surgery is presented in overview to third year medical students through a two to three week rotation as part of their surgery subspecialty block rotations. During this time, students participate in morning ICU rounds and as second assistants in selected surgical cases during the day. They also attend clinic once a week as well as make daily consult rounds with the faculty and/or PGY3 surgical resident during which times various diagnostic modalities (coronary angiography, CT scans, nuclear medicine scans, etc) are reviewed and discussed.

The student, under the direction of the PGY3 resident, is also assigned and is responsible for the evaluation and care of specific post-op cardiac and thoracic surgical patients who have transferred to the floor from ICU until their discharge from the hospital. During each of four surgical blocks throughout the year, two lectures are given by the faculty on a topic focusing on broad aspects of the specialty. Longer electives are available in the fourth year and consist of student internships on the cardiothoracic surgical service at University Hospital with levels of increased responsibility and participation commensurate with abilities.

Pediatric General Surgery

Fabienne Gray, MD, FACS
Division Chief

The pediatric surgery course provides third and fourth year students an in-depth clinical experience in the work-up and management of surgical disease in infants, children, and adolescents. Students will be assigned for four weeks to Manning Family Children’s under the supervision of Dr. Fabienne Gray, Dr. Jessica Zagory, and Dr.  Adele Williams. Expected duties include daily rounds with residents and faculty, attending outpatient clinic, and participating in operations focused on common pediatric surgical issues such as inguinal hernia, pyloric stenosis, colorectal diseases including anorectal malformations and Hirschprung’s disease,  and pediatric tumors. Senior students assigned to the service will function as an integral member of the surgical team. The course will be structured to give each student the maximum responsibility possible and to simulate a resident training position.

Plastic & Reconstructive Surgery

Harvey Chim, MD, FACS
Division Chief

The Division of Plastic & Reconstructive Surgery treats patients within the entire broad spectrum of Plastic Surgery. Lectures are presented to students in the surgery blocks during the third year. Patient care covers the various components of plastic surgery, including hand surgery, peripheral nerve surgery, maxillofacial surgery, microvascular surgery, cosmetic surgery, pediatric plastic surgery, and general reconstructive surgery. Electives are available in the fourth year. Students will participate in diagnosis and management of patients in the clinic and operating room. There are opportunities for students to achieve intern level autonomy. A weekly plastic surgery conference and monthly journal club, further enhance the experience for rotating students. Opportunities for clinical research are available.

Simulation

John Paige, MD, FACS
Director, Applied Surgical Simulation

As part of their longitudinal simulation-based educational curriculum within the School of Medicine, students on the surgical rotations have the opportunity to participate in a variety of learning activities using both low and high-fidelity simulators. For example, all third year students participate in sessions with the high fidelity Human Patient Simulator (HPS) learning how to treat important surgical disorders Some third year students also have the opportunity to practice basic minimally invasive surgical (MIS) skills during their OB/GYN rotation using the similar drills on which the general surgical residents train. Finally, fourth year students participating in the senior anatomy elective have the opportunity to practice their team skills working with students from nursing and nurse anesthesia in high fidelity a Virtual Operating Room setting.

Surgical Oncology

Mary A. Maluccio, MD, MPH, FACS
Division Chief

Student and resident education are accomplished through faculty participation in didactic lectures and journal club designed specifically for the student learner as well as through organ/disease specific tumor boards and Surgical Grand Rounds. Surgical residents and students rotate on several services located in New Orleans, Metairie, Baton Rouge, and Lafayette that provide the fundamentals for diagnosis and treatment of common cancers within surgical oncology including: breast, colorectal, non-colorectal GI (stomach, liver, gallbladder, pancreas, and small intestine), and melanoma. Second year and Fourth-year residents can spend a 1-2-month rotation with the Neuroendocrine Tumor Group at the Ochsner-Kenner facility. This rotation includes exposure to the multidisciplinary Cancer Clinic where patients have access to one or multiple allied health professionals in the same clinic space. This clinic will give them intensive exposure to the diagnosis and management of both functional and non-functional tumors of the lung, stomach, pancreas, small bowel, appendix, colon, and adrenal. Residents actively participate in complex cancer surgery, line placement, laparoscopic and robotic surgery and the pre-operative and post-operative management of cancer patients. The division houses a robust clinical and translational research database as well as access to a large network of basic science research collaborators. During these rotations, students and residents may opt to become involved with ongoing research projects under the direct mentorship of one or more of the LSU/Ochsner academic faculty. The goal with student and resident participation in research projects is to enhance opportunities to attend and present their work at local and national conferences and contribute to peer reviewed grant proposals and publications.

Trauma/Critical Care Surgery, Burn Surgery

John P. Hunt, III, MD, MPH, FACS
Division Chief

The Trauma faculty members provide care to injured patients and patients with acute general surgical emergencies. The Trauma service is very busy, with a high percentage of penetrating trauma. Residents obtain extensive experience in evaluating and operating on acute care surgical and injured patients. In addition, training in critical care management is provided by the faculty. Students on the service receive educational benefit from direct patient care and departmental conferences.

Vascular and Endovascular Surgery

Malachi Sheahan, MD, FACS
Division Chief

The Division of Vascular Surgery is dedicated to the comprehensive care of patients with vascular disease. Our faculty is comprised of nine vascular surgeons and is uniquely equipped to offer cutting-edge endovascular therapy as well as traditional open surgical treatment for carotid, aortic and peripheral arterial disease processes. Students will also participate at the Vein Care Center, where minimally invasive techniques are used to treat varicose veins and chronic venous insufficiency.

Third year medical students will actively participate in the diagnosis, treatment, and postoperative management of patients with a fascinating variety of vascular syndromes. “Hands on” training is enhanced with the use of the endovascular simulators in the Cohn Learning Center. Participation in the weekly vascular conference, as well as a monthly journal club, serves to round out the experience.

Fourth year students considering a career in surgery are encouraged to apply for the special one-month vascular apprenticeship. Students will have the opportunity to receive instruction in planning and performing complex surgical and endovascular procedures. Responsible students can achieve intern-level autonomy. Ample clinical research opportunities are also available.