Research in Surgery: A Brief Historical Overview

Research is a vital component in the advancement of patient care and outcomes, a cornerstone of the surgical program at the Department of Surgery for nearly 100 years. Yale has been on the forefront in advancing research to bring medical breakthroughs from the lab to clinical practice.

Some of our historical surgical and medical contributions to research have provided researchers with the stepping stones needed to pursue new directions in advanced research. These contributions have had significant impact on direct patient care and outcomes seen today.

Chemotherapy

The Department of Surgery has long been recognized as the birthplace of modern chemotherapy. In 1942, Yale scientists Louis Goodman and Alfred Gilman discovered that nitrogen mustard, a gas that had been used as a weapon against Allied troops in the First World War, had the ability to shrink malignant tumors. The researchers and their colleague, thoracic surgeon Dr. Gustav Lindskog, led the first human chemotherapy clinical trial, which resulted in a positive response to treatment. This initial clinical trial was the first of many cancer trials which dramatically improved patients’ quality of life while treating their cancer.

Cardiac Care

Historically, cardiac pacing has been at the forefront of Yale research. In 1959, a medical student and faculty from Cardiac Surgery, developed the first pacing device to maintain normal cardiac rhythm. The original device which is cited as one of the greatest scientific findings of the 20th century, can now be seen at the Smithsonian Museum.

Additionally in 1954, Dr. William Glen was responsible for developing a life-saving, radical remodeling operation for children with congenital heart abnormalities, called the Glenn Procedure, which is still used in practice today.

These are only a few small examples of the rich history of the Department of Surgery which propelled Yale to the forefront of the medical community. These breakthroughs and advances allow us to continue advanced research with the goal of improving patient outcomes and quality of life.

Yale Research Today: New Directions

Yale’s Department of Surgery has continued its role as a global leader in surgical research, in which several ongoing programs are collectively carried out between surgical sections and other departments within Yale. Below are just a few examples of how Yale is continuing its legacy as a leader in surgical research.

Genetic Analysis of Surgical Disease

Genetic identification and analysis is currently of great interest throughout the medical community. Yale is committed to researching the importance of genetic identification of certain diseases, leading to early detection and treatment. This commitment has led to numerous contributions to genetics including the development of the Aortic Institute which is responsible for examining the genetic causes of aneurism and screening for familial traits to improve the overall survival of individuals that suffer from this disease state.

Additionally, Endocrine Surgery has identified a series of genetic abnormalities which increases the risk of both thyroid cancer and hyper-parathyroid disease. These data have led to the early identification and treatment for these potentially lethal diseases.

Genetic Modulation and in Utero Genetic Repair

Pediatric Surgery is leading the development of biomedically engineered nanoparticles to deliver genetic repair to a fetus with an identified genetic defect in utero. Although currently being researched in animal models, current data collection shows successful repair of an identified genetic defect. It is the intention that these data be translated to future human trials.

Biomedical Engineered Nanoparticle Therapy

As discussed, the use of nanoparticles is an important discovery in disease treatment. The Department of Surgery has developed a strategic alliance with the Department of Biomedical Engineering and is also working closely with the our sections of Transplantation and Gastrointestinal Surgery to develop targeted antirejection loaded nanoparticles. The goal of this is to decrease the risks associated with the use of anti-rejection medications, while protecting the newly transplanted organ from rejection.

In addition to this, development of nanoparticles specifically engineered to induce healing for intestinal surgery are also currently underway. Surgical Oncology intends to use this technology in developing targeted chemolytic nanoparticles to be delivered to the site of the tumor in the future.

Vascular Tissue Engineering and 3D Printing of Blood Vessels and Intestinal Tissue

There is a considerable need for viable vascular conduits to replace damaged tissue which has been the research focus of Vascular Surgery. By using a biomedically engineered matrix and cells, it is now possible to generate a replacement vessel for vascular implantation. These studies, which require a bioreactor to house the new vessel prior to implantation, have been conducted in both animal and human trials and may soon be a viable replacement for those with vascular disease.

Due to the amount of time needed to mature the vessels prior to implantation, the department is in the process of developing 3D printed vessels which would be available for transplant within minutes of printing rather than months. This technology is extending to 3D generation of intestinal tissue which can be used during repair and replacement surgery for intestinal diseases and trauma. Currently, this research is in animal models and is intended to be conducted on human models in the future.

The Yale Department of Surgery is committed to improving patient outcomes; a commitment which relies on strong resident education. It is equally important for us to continue our deep commitment to research, where we continue to be a leader in surgical research across the broad disciplines within the Department of Surgery.