The University of Tennessee Graduate School of Medicine, Knoxville



The Department of Surgery Divisions

Division of Cardiothoracic Surgery

Cardiothoracic Surgery Faculty

The Cardiothoracic Surgery Division offers exposure to the full gamut of adult cardiac and general thoracic surgery, particularly the full spectrum of benign and malignant lung, foregut, and mediastinal disease . Heart and lung transplantation is not offered at this time, although ECMO exposure is available if interested. Approximately 800 surgical procedures are performed annually. Since the UT Medical Center is a level one trauma center, there is ample exposure to chest trauma. Residents rotate through the division for one month as a junior resident, and for one month as a senior resident. The resident's primary responsibility is the care of the general thoracic surgical patients including preoperative evaluation, participation in surgery, and postoperative care. Residents do have an opportunity to participate in the care of cardiac surgical patients depending on their level of interest. An active chest clinic, which attracts patients from a wide referral area, is available to the residents. There is an excellent weekly chest conference where cases are presented to a multidisciplinary group including pulmonologists, surgeons, radiologists, pathologists, and oncologists. There is also a weekly cardiology conference. There is ample case material available for the interested resident to perform a clinical research project. The division is staffed by five full-time faculty surgeons all of whom are certified by the American Board of Thoracic Surgery.



Division of General Surgery

General Surgery Faculty

The Division of General Surgery is a large group of surgeons focusing on providing high level patient care with a minimally invasive focus. It includes multiple fellowship trained minimally invasive surgeons providing foregut, bariatric, and basic and complex hernia care. It also provides a broad breath of general surgical procedures. We also have surgeons participating in our Breast Care service. A fellowship trained endocrine surgeon joined the division recently and is expanding the large endocrine service line. The division also includes a MIS/Bariatric fellowship. The MIS fellow participates with the faculty in providing coverage on the Emergency General Surgery Service. There is also crossover from the Acute care surgeons that provide elective general surgical services. The breath and experience of this service continues to evolve bringing innovative skills to our population of East Tennessee.


Division of Pediatric Surgery

Pediatric Surgery Faculty

The division of pediatric surgery consists of a four-week rotation for interns and a 12-week block for third or fourth year residents. Under staff supervision, residents are responsible for the care of neonates, children, and adolescents at East Tennessee Children’s Hospital and UTMCK. The scope of the practice is very broad including congenital anomalies, general surgery, trauma and burns, thoracic surgery, pediatric oncologic surgery, pediatric endocrine surgery, and some aspects of pediatric urology.

We currently run the chest wall deformities center of excellence for the region with state-of-the-art care for pectus excavatum, pectus carinatum and mixed deformities. As active participants in the clinics, during rounds and consults and in the operating room, the residents are exposed to the nuances of the care of children from birth to age 21. We emphasize hands on participation in the operating room, under direct supervision of pediatric surgeons with decades of experience in the field. Many pediatric surgery index cases and minimally invasive cases are performed with resident participation every month. Two didactic conferences are held every month, namely, pediatric surgery M&M and a grand rounds presentation given by the residents. The emphasis of our practice is excellence in patient care, patient safety, resident education, and professionalism.


Division of Plastic & Reconstructive Surgery

Plactic & Reconstructive Surgery Faculty

The Division of Plastic Surgery is an integral, busy, and essential part of the Department of Surgery. Since there are no plastic surgery residents, the general surgery house staff is afforded firsthand experience with a variety of problems including facial trauma, microsurgical oral cancer reconstruction, cosmetic and reconstructive breast surgery, body contouring after massive weight loss, local and microsurgical flap reconstruction of the lower extremity, and highly complex microsurgical treatment of lymphedema. The service is attended by 5 full-time surgeons. The objectives of the plastic surgery rotation are to teach proper surgical technique, tissue handling, and wound management. It provides an exposure to the field of plastic and reconstructive surgery for those who may wish to further pursue a plastic surgery residency upon completion of the general surgery program.


Division of Surgical Oncology

Surgical Oncology Faculty

The Division of Surgical Oncology consists of eight, fellowship-trained, board-certified surgical oncologists, supported by an accredited Tumor Registry, the University of Tennessee Medical Center Cancer Institute, and the Department of Surgery.  Residents on service are provided opportunities for participation in the evaluation, diagnosis, and multidisciplinary treatment planning for a broad spectrum of malignant and benign diseases. Through specialized surgery for cancer, up-to-date systemic therapy protocols (chemotherapy, targeted therapy, and immunotherapy), and innovative technologies in radiation therapy, residents are exposed to similar educational opportunities offered at larger oncology centers. Residents and faculty participate in weekly multidisciplinary disease site-specific oncology conferences including Breast, Liver-Pancreas, GI, and Melanoma & Soft Tissue to obtain expert consensus, opinions, and recommendations. The result is an evidence-based treatment algorithm for each presented patient.

Procedures

In 2020, during a challenging year, there were a total of 6,000 outpatient clinic consults/visits resulting in 208 inpatient surgical procedures with approximately 1,284 total operative procedures by the Division faculty.  Residents participate in all operative procedures for lesions of the breast, skin and soft tissue, upper gastrointestinal tract, liver and biliary tract, pancreas, colon and rectum, retroperitoneum, head and neck, and adrenal gland. Residents receive significant exposure to evolving techniques in oncologic surgery, including minimally invasive approaches (laparoscopic and robotic), videoscopic lymphadenectomy, peritoneal tumor debulking and hyperthermic intraperitoneal chemotherapy, as well as oncoplastic reconstructive procedures.

Educational Opportunities

In addition to weekly multidisciplinary tumor conferences, a dedicated surgical oncology resident education conference is held weekly, with an emphasis on preparing residents for the general surgery boards, and training oncologically sound surgeons. Residents are encouraged to work with faculty on oncology-focused basic science, translational, and clinical research projects, treatment protocols and clinical trials. Our faculty participate in local, regional, and national venues in their specific areas of expertise. Over the last two years the Division has published over 45 articles, reviews, and book chapters, upholding the institutions mission to serve through healing, education, and discovery. For those who may be interested in pursuing a Surgical Oncology career, a one-year research fellowship is available after completion of the second postgraduate year.

For more information please contact:
James M. Lewis, MD, MEHP, FACS
(865) 305- 9218
jmlewis@utmck.edu


Division of Surgical Rehabilitation

Surgical Rehabilitation Faculty

The mission of the Division of Surgical Rehabilitation is to optimize physical medicine and rehabilitative care through the advancement of knowledge on the University of Tennessee Medical Center campus. The division's current research projects include: shoulder pain in hemiplegia, osteoporosis in spinal cord injury, and sleep apnea in disability. Future research projects include: chemodenervation with Botulinum Toxin B to improve ROM and function of finger flexors and shoulder after brain injury. The role of chemodenervation with Botulinum Toxin combined with aggressive therapy, to restore function of the hemiparetic limb by reversal of reciprocal inhibition.

David Adam Hecht Memorial Memorial Young Hope Fund and the Division of Surgical Rehabilitation Gift Fund

The David Adam Hecht Memorial Young Hope Fund and the Division of Surgical Rehabilitation Gift Fund has been established by faculty, friends and alumni of the Department of Surgery. The goal of the gift fund is to provide the Chairman, faculty and residents with additional resources to insure continued excellence in patient care, education and research. Gifts made to the fund may be utilized for the following:

For further information, call the Office of Development and Alumni Relations at 865-305-6111.

Educational Guides

Educating Families of the Head Injured: A Guide to Medical, Cognitive, and Social Issues by Dana S. DeBoskey, PhD, Jeffrey S. Hecht, MD, and Connie J. Calub

Stroke Rehabilitation by Jeffrey S. Hecht, MD


Division of Transplant Surgery

Division of Transplant Faculty
The Division of Transplantation provides opportunities for resident participation in the diagnosis, evaluation, and surgical management of patients with end-stage renal disease needing kidney transplantation and vascular access creation. The division consists of one full-time transplant surgeon. In addition, there are minimally invasive surgeons from the divisions of General Surgery and Urology who also perform living donor nephrectomy procedures. In addition, very involved nursing, pharmacy, and other allied health care staff support the transplant residents. Thus, the residents participate in all surgical and medical aspects associated with organ donation and transplantation. In addition, residents and faculty participate in a weekly multidisciplinary transplant conference. As a result, the residents will become familiar with the evaluation process of the potential kidney transplant recipient and the practical details of tissue typing, immunosuppression protocols, and live donor selection processes. The Transplant Center at UT Medical Center in Knoxville performs approximately sixty kidney transplants a year and actively participates with UNOS in the Scientific Registry of Transplant Recipients. Residents rotate twice through the division for one month as middle-level residents. The resident's primary responsibility is the kidney transplant recipients' care, leading the multidisciplinary transplant rounds, and participating in the deceased donor, live donor, and transplant recipient surgeries. Residents also perform vascular access procedures while on the rotation.


Division of Trauma & Critical Care Surgery

Trauma & Critical Care Surgery Faculty

The Division of Trauma/Critical Care is organized to provide continuous care for the critically injured and seriously ill surgical patient and to maximize educational experiences for the surgical house staff.

Level I Trauma Center
The University of Tennessee Medical Center provides Level I trauma care for a 21-county area in East Tennessee and adjacent portions of Kentucky and North Carolina. In 2020, there were over 5,000 trauma admissions. Thirty-two percent of these patients required admission to a critical care unit. Approximately 20 percent of these patients arrived via helicopter. Trauma services members take primary care of patients on the trauma service and help coordinate specialty consultants such as neurosurgery, orthopedics, plastic surgery, oral surgery and other services whose help may be necessary. The multi-disciplinary and highly organized team also deals with complex issues and has the Institutions’ only dedicated service to the geriatric patient.

Acute Care Surgery
The Department has formed an Acute Care surgery service in conjunction with the general surgeons to take care of the a patient presenting with urgent and emergent surgical needs.  The 24/7 service has dedicated operative time to expedite the care and offer residents a comprehensive experience from presentation through post-operative care for such issues as perforated viscus, acute cholecystitis, diverticulitis, pancreatitis and the gamut of surgical disease.

Our Faculty
Ten surgical attendings who have a special interest in the care of the trauma patients currently staff the trauma service. All of these faculty are fellowship-trained in trauma and surgical critical care. Residents on the trauma service include a senior resident, mid-level residents, and a first year resident. Advanced practice providers are also a part of the service. Mid-level residents also spend three months on the surgical critical care service. There is an active educational program in trauma including multidisciplinary trauma conferences and a focus on Performance Improvement.  Residents are expected to be educators as well, beyond just to medical students and PA students, but in courses such as ATLS, Stop the Bleed and FCCS. Research in the basic science and clinical aspects of trauma and critical care is ongoing.


Division of Vascular and Endovascular Surgery

Vascular and Endovascular Surgery Faculty

The Division of Vascular and Endovascular Surgery has a long history of providing excellence in clinical care, training the next generation of surgeons, and advancing the field of vascular surgery through clinical and basic science research. The Division is staffed by six full time vascular surgeons who offer medical as well as surgical and endovascular treatment for the full spectrum of vascular pathologies including peripheral arterial, carotid, aortic, visceral, and renal vascular disease as well as vascular access, and venous disease.

The University of Tennessee Medical Center is a tertiary facility resulting in the Division of Vascular Surgery caring for complicated vascular cases that require complex vascular surgical treatment. This includes the treatment of open and endovascular repair for complex aortic pathology. The Division of Vascular Surgery performs over 24,000 noninvasive vascular laboratory studies per year giving the general surgery residents the opportunity to learn non-invasive vascular imaging interpretation. In addition, there is a balanced mix of both open and endovascular procedures allowing the resident the technical training to gain the basics in all vascular surgical procedures.

The Division has a long history of being role models for general surgery residents. Many of our rotating residents go on to seek further vascular training through postgraduate vascular fellowship programs. Each general surgery resident is expected to participate in outpatient care, inpatient clinical care, and both inpatient and outpatient open and endovascular procedures.

The vascular service is divided into three separate sub-services to preserve operative and patient care responsibilities of the general surgery chief resident. Each service is staffed by either a vascular fellow or a PGY-4/5 general surgery resident, as well as an intern. Each general surgery resident typically finishes with over 100 vascular cases resulting in their surgical case log in vascular surgery being at the 85th percentile or higher for all general surgery trainees throughout the United States. The Division of Vascular Surgery also participates in both basic science and clinical research. Each general surgery resident has the opportunity to participate in ongoing studies within the department.

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