PFDD Faculty Fellows Alumni - 2011

2011 HARVARD CATALYST

PROGRAM FOR FACULTY DEVELOPMENT AND DIVERSITY INCLUSION (PFDD)

FACULTY FELLOWSHIP—MGH

Patricia Sylla, MD, Associate Professor of Surgery, Mount Sinai Beth Israel, The Mount Sinai Hospital; Visiting Assistant Professor of Surgery, Massachusetts General Hospital


Mentor: David Rattner, MD, Warshaw Family Professor of Surgery, Harvard Medical School; Chief of the Division of Gastrointestinal and General Surgery, Massachusetts General Hospital

Department Chair: Andrew Warshaw, MD, W. Gerald Austen Professor of Surgery, Harvard Medical School; Head of the Department of Surgery, Massachusetts General Hospital

Title of Research Project: Transanal Endoscopic Rectosigmoid Resection with Laparoscopic Assistance for Rectal Cancer

Abstract:

The goal of this proposal is to evaluate the safety and efficacy of NOTES (Natural Orifice Translumenal Endoscopic Surgery) transanal endoscopic rectosigmoid resection for rectal cancer. The hypothesis of this project is that NOTES transanal endoscopic resection of node-negative rectal cancer using transanal endoscopic microsurgery (TEM) is feasible, safe, and likely oncologically superior to transanal excision, and substantially less morbid and oncologically equivalent to low anterior resection. Based on the demonstrated feasibility and safety of this approach in swine and a human cadaver model, and on our recent successful performance of the first clinical case of transanal endoscopic rectosigmoid resection and laparoscopic assistance in a patient with rectal cancer, a clinical pilot study will be conducted over the 2-year duration of this project to evaluate the safety and efficacy of transanal endoscopic rectosigmoid resection with laparoscopic assistance in  patients with stage I and IIA rectal cancer. Primary end-points include the adequacy of the total mesorectal excision achieved with this approach, intraoperative and 30-day postoperative complications. Secondary end-points are long-term outcomes including complications and oncologic outcomes. This pilot study will serve as the basis to initiate a larger prospective phase II multicenter clinical trial to evaluate functional and oncologic outcomes following laparoscopically-assisted NOTES transanal endoscopic rectosigmoid resection for rectal cancer. In addition, techniques to achieve pure NOTES colorectal resection with a completely transanal endoscopic approach, will be further developed in the laboratory using human cadavers and commercially available as well as innovative endoscopic platforms and instrumentation. 

Biography:

Dr. Patricia Sylla was raised in Cote d’Ivoire. She came to the United States for college and received her MD from Weill Medical College of Cornell University in 2000. She completed her General Surgery residency at Columbia University Medical Center in 2006. She was awarded a Society of American Gastrointestinal Endoscopic Surgeons (SAGES) grant in 2004 and the Blakemore Prize for best body of research by a graduating chief resident. She subsequently completed a fellowship in colorectal surgery at Mount Sinai Hospital in 2007, before coming to MGH to complete an advanced laparoscopic surgery fellowship. While completing her fellowship training, Dr. Sylla initiated her NOTES (Natural Orifice Transluminal Endoscopic Surgery) research project under Dr. David Rattner, who remains her supportive mentor. She was awarded a SAGES IRCAD travel fellowship award (Institut de Recherche Contre les Cancers de l’Appareil Digestif) and a Natural Orifice Surgery Consortium for Assessment and Research (NOSCAR) research grant for her work on NOTES colorectal resection. She joined the surgical staff at MGH in July 2008 where her clinical expertise includes colorectal surgery and her research interests focus on the development of minimally invasive approaches to colorectal resection. She is former an instructor in Surgery at Harvard Medical School. In 2009, she received a Physician-Scientist Development Award for the project “NOTES Transanal Rectosigmoid Resection using TEM: Study of Feasibility and Safety in Human Subjects”, and an MGH Cancer Center Thematic Priority Grant in 2010 for “NOTES Approach to T1 Rectal Cancer Using TEM: A Pilot Study”.