VCU Department of Surgery

At the Virginia Commonwealth University Medical Campus the research training has continued to be a high priority within the Department of Surgery despite fiscal constraints.

Presently 7 of our 44 faculty members hold RO1 grant support from NIH and at least four others are major investigators on institutional program project grants. To further underscore the importance of research within the Department of Surgery, a recent NIH ranking placed the VCU Department of Surgery number 27 in the country. The department currently has over 12,000 square feet of space committed to research endeavors. Active clinical and laboratory projects are presently ongoing in the Divisions of Cardiothoracic, Plastic & Reconstructive, Pediatric, General, Surgical Oncology, Vascular, Trauma/Critical Care, and Transplantation Surgery.

For decades, the Cardiovascular Laboratories at VCU have been some of the most advanced in the United States. Current investigative activity continues to be at the forefront. Working closely with its medical counterpart, cardiology, research efforts are currently ongoing in electrophysiology, biomechanical cardiac support, heart and lung transplantation, and the development of a clinically useful artificial heart.

An extensive program in the study of fetal and adult wound healing by the joint efforts of the Divisions of Plastic & Reconstructive Surgery and Pediatric Surgery has brought international recognition to VCU. An institutional training grant provided by NIH supporting this effort has allowed dozens of surgical trainees to participate in this rich investigational milieu.

Research projects in the Division of General Surgery involve the role of the gut in serotonin metabolism, how gastric and intestinal epithelium responds to various stresses and toxins, and what role apoptosis and nitric oxide metabolism play in this process. In addition they are looking at factors responsible for gallstone formation and perturbations in splanchnic blood flow and their underlying pathophysiology.

The Division of Surgical Oncology, in conjunction with its medical counterpart, has been a leader in new cancer treatment regimens for over 40 years, as well as conducting research into various immune response mechanisms. Two new faculty have established laboratories investigating tumor angiogenesis. The opening of the Massey Cancer Center in 1974 has assured the continuation of this important role in cancer research. Three surgical oncology faculty have research labs in the cancer center. All surgical oncology faculty are involved in clinical research.

The Division of Trauma/Critical Care is currently involved in a unique research relationship with the Department of Anesthesiology and Emergency Medicine funded by the Department of Defense, the NIH, and industry in which a number of important projects germane to critically injured. These include the development of artificial blood products to manage various bleeding diatheses, research into ARDS, the role of nitrous oxide in various shock-like states, and how best to provide optimal oxygenation at the cellular level when the peripheral circulation is compromised.

The Transplant Division currently has active programs that are at the forefront in liver, kidney, and pancreas transplantation. They are examining the pathophsiology of the rejection process to improve graft survival, more fully understand the pathophysiology of the rejection process and how best to manipulate it pharmacologically to ensure long-term survival in patients needing such transplants. They are also looking at isolated hepatocyte and islet cell preparation.

Active programs also exist within the Division of Vascular Surgery. The role of minimally invasive vascular surgery is an especially important research priority at the present time in defining how best to do these procedures and identify which patients would be best benefited by them rather than the conventional open techniques. These center around endovascular surgery. Basic science investigation focuses on the splanchnic circulation and how perturbations in this vascular bed affect the mesenteric circulation and the viability of the gut under compromised circumstances.

Finally, an active Telemedicine Program that is conducted in conjunction with both the Department of Defense and NASA have enabled the world of virtual medicine to be expanded far beyond Richmond, Virginia to assist third world countries in delivering state of the art care to their patients.

All of these research ventures and opportunities conducted by our surgical faculty are open to our surgical residents who wish to expand their horizons and prepare themselves for academic careers. We make this a high priority in our surgical training program and encourage residents who are serious about becoming academic surgeons to avail themselves of these many investigative opportunities. In this way, the surgical resident can become actively involved in advanced research which is setting the standards for tomorrow.

Residents who wish to pursue such opportunities are encouraged to commit themselves to at least two years in the research laboratory between the second and third clinical years. Several of our residents over the past decade or so have found two years to be too limited and have actually embarked on a larger research program to obtain an advanced degree such as a PhD in a basic science discipline.