From STEP to MAGIC: Patient-Inspired Surgical Innovation.

Abstract

Introduction: Much of the current standard of care in surgery was, at some time, thought by many to be radical ideas that would "never work". This paper describes my personal journey in surgical innovation that was largely inspired by the pioneering parents of very sick children who pushed me to consider why there were not better solutions to difficult problems.

Innovations: My path in surgical innovation began with the development of serial transverse enteroplasty, a novel approach for treating children with short bowel syndrome by repurposing traditional surgical methods. Through my clinical practice treating midaortic syndrome, we developed the Tissue Expander-Stimulated Lengthening of Arteries procedure, inspired by the experiment of nature observed when arteries are lengthened by stretching over growing tumors. When confronted with extensive midaortic syndrome too long for Tissue Expander-Stimulated Lengthening of Arteries, we identified the meandering mesenteric artery as an ideal conduit with potential to grow when used as an autologous vessel bypass graft, resulting in the Mesenteric Growth Improves Circulation procedure.

Conclusions: From serial transverse enteroplasty to Mesenteric Growth Improves Circulation, I learned the importance of patient-centered care, interdisciplinary collaboration, curiosity across fields, persistent and iterative testing, and supportive mentors and colleagues. Each of these clinical challenges have allowed me the opportunity to question current standards and work to develop a better solution. As the field of surgery continues to grow and evolve, innovation is critical for advancement. I encourage you all, especially the young and aspiring surgeons, to keep your eyes open, keep your minds open, and to never lose your imagination.