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Book examines cutting-edge robotic surgery

by John Keenan, UNMC public relations


From left, Nathan Bills, Ph.D., and Dmitry Oleynikov, M.D., have edited “Robotic Surgery for the General Surgeon.” It’s official — Dmitry Oleynikov, M.D., wrote the book on robotic surgery.

Dr. Oleynikov and his Center for Advanced Surgery Technology colleague, Nathan Bills, Ph.D., edited and contributed chapters to “Robotic Surgery for the General Surgeon,” a new textbook that was released earlier this year.

Dr. Oleynikov, director of CAST, said the book focuses on surgical applications of the DaVinci Surgical Robot, which Dr. Bills called the only FDA-approved robot for the general surgeon.

From outline to publication, the project took two years. Dr. Oleynikov created a list of chapters and he and Dr. Bills contacted national and international leaders in the field to contribute.

“It’s an interesting process, writing an academic textbook,” Dr. Oleynikov said. “Science is always moving, so many textbooks on new technology or new techniques become quickly out of date. My goal was to have this book be the foundation for anybody using surgical robotics for at least the next three to five years.”

The goal, he said, was to provide the general surgeon necessary information on performing robotic surgery procedures by getting contributors to lay out the science behind each procedure — hernia repair, gastric bypass, liver resection, etc. — with the established methods for using the technology.

“This is not just a how-to or a cookbook, but a book that looks at each particular application of the robot as it pertains to that surgeon’s practice,” Dr. Oleynikov said. “So while the robot may change a little bit as they come up with newer models, the disease process, the human body and the approach do not change. You still have to fix that hernia or cut out that cancer.”

The book captures a revolution in approaches to surgery.

“We’re moving from open and laparoscopic surgery now to robotic surgery, and how the robot is used — both properly and sometimes not so properly — is going to define the technology in many ways. So I’m hoping that this book, with chapters from some of the brightest and most inventive experts in the field today and likely into tomorrow, will guide those individuals who are starting to do this kind of surgery, use this type of technology.”

Drs. Oleynikov and Bills are pleased with the final product.

“The book distills the state of the art for every specific kind of surgery, with information from a world expert in that particular surgery,” Dr. Bills said.

College ranked in Top 10 for family medicine

by Vicky Cerino, UNMC public relations


Shelley Baldwin, administrator in the UNMC Department of Family Medicine, accepts the award on behalf of the department from AAFP President Reid Blackwelder, M.D.

Shelley Baldwin, administrator in the UNMC Department of Family Medicine, accepts the award on behalf of the department from AAFP President Reid Blackwelder, M.D. The UNMC College of Medicine recently received another accolade for its efforts in boosting the number of family physicians in Nebraska.

Rural recruiting

Some results from UNMC programs that focus on boosting numbers of health professionals in rural Nebraska:

•434 students have graduated from the UNMC Rural Health Opportunities Program (RHOP) since 1990. Currently, 65 percent of the graduates practice in Nebraska. Of those practicing in Nebraska, 73 percent practice in a rural setting.

•172 college students are in the pipeline to attend UNMC through RHOP and the Kearney Health Opportunities Program (KHOP). •100 physician residents have graduated from the UNMC Rural Training Track program making it one of the largest and most successful rural training tracks in the country.

•285 high school students attended UNMC Rural Health Care Career Day last fall.

•419 eighth-grade students participated this spring in six regional competitions across Nebraska to qualify to attend the annual 8th Grade Health/Science Meet in June.

•680 high school and college students have participated in the Behavioral Health Education Center of Nebraska’s (BHECN) Ambassador program since it started in 2012.

The College of Medicine recently received an American Academy of Family Physicians (AAFP) Top 10 Award for its consistent contributions to building the family physician workforce.

The award comes on the heels of U.S. News & World Report rankings, which earlier this year, recognized UNMC as ninth among rural medicine programs and sixth among primary care medical programs.

The AAFP award was presented during a recent conference of the Society of Teachers of Family Medicine. Family physicians are qualified to treat most ailments and provide comprehensive health care for people of all ages — from newborns to seniors.

The award honors medical schools that, during a consecutive three-year period, graduated the greatest percentage of students who chose first-year family medicine residency positions.

“We are pleased to be honored by our peers. This award is a testament of the contributions by many at UNMC, by the full-time and volunteer faculty, the students who ultimately choose family medicine as a career and our health care partners across Nebraska,” said Michael Sitorius, M.D., chairman of the UNMC Department of Family Medicine. “The department has a long-standing commitment to training future family physicians and will continue our efforts to increase the family medicine workforce for all of Nebraska.”

At a time when the United States is facing a shortage of primary care physicians, filling the family physician workforce pipeline is vital to the health of Americans, said AAFP President Reid Blackwelder, M.D.

Awardees employ several initiatives that support students who are interested in and most likely to become family physicians, including:

•student outreach,

•faculty involvement in medical school committees,

•admissions policies that target students from rural and medically underserved areas,

•clinical rotations that emphasize positive experiences in family medicine,

•strong, student-run family medicine interest groups and

•financial aid packages that minimize student debt.

Facility offers state-of-the-art clean space

by Kalani Simpson, UNMC public relations


The 20,000-square-foot Biologics Production Facility opened in 2010.

The 20,000-square-foot Biologics Production Facility opened in 2010. The nondescript brick building on the corner of 42nd and Emile streets is a “clean building,” and it has numerous features and checks and balances in order to make and keep it that way.

It has few crevices in which particles might settle. Its air flows one way, through filter after filter after filter. There are air locks and pressure differentials. The people who work in it sometimes wear gowns and gloves or “bunny suits.”

Equipment, environment and quality are monitored by computer.

Phyllis Warkentin, M.D., the site’s medical director, a professor of hematology and oncology, had dreamed of the possibility of a building like this for a long, long time.


The facility features an in-house United States Pharmacopeia (USP) purified water system for cleaning and terminal sterilization. 

This is the Biologics Production Facility (BPF) at UNMC.

The closest comparable facility is likely the Mayo Clinic. The med center’s 20,000 square-foot facility opened in 2010.

“When it comes to translational research, bench top to bedside,” Dr. Warkentin said, “what we do is somewhere in the middle.”

They store, change and make things. Things like stem cell products, cellular vaccines and gene therapies, tissue therapies, regenerative medicine therapies and nanomedicine.

“The facility strategically equips us to keep up with the rapid expansion of personalized and regenerative medicine,” said operations manager Charlie Branson.

The blood stem cells collected in The Lied Transplant Center (and other places around the country), for example, are processed, frozen and stored here.

Or, the team at BPF can also make more advanced products, products that need to be manipulated, processed, incubated, stored, cultured, transfected, and more.

They can, for example, take a pancreas that isn’t working as it should, and isolate the good stuff — taking out the cells that make insulin, pancreatic islets, and give them back to the patient.

They can select out a certain subpopulation of cells, mix them together with another to make a better product. Using standardized procedures, they can turn individual patients’ blood and marrow cells into personalized vaccines.

The conditions need to be cleaner than an operating room, and are. But the system of quality is “clean” too. Quality isn’t checked at the end, rather, built into everything.

The entire operation is under the auspices of current Good Manufacturing Practices (cGMP).

“I believe that the successful operation of the BPF to date will play an important role in providing a full spectrum of therapeutics to our patients with the advent of the new Fred & Pamela Buffett Cancer Center,” Branson said.

Dr. Romberger named interim chair of internal medicine

by Tom O’Connor, UNMC public relations


Debra Romberger, M.D.

Debra Romberger, M.D. A veteran faculty member of 24 years, Debra Romberger, M.D., has been selected as interim chair of the UNMC Department of Internal Medicine.

The appointment, effective July 1, was announced Friday by Bradley Britigan, M.D., dean of the College of Medicine.

“Dr. Romberger is an outstanding clinician, teacher and investigator who brings a wealth of experience and leadership to the department,” he said. “I am very grateful to Deb for her willingness to take on this highly important leadership position at a time of many challenges in academic medicine.”

For the past nine years, Lynell Klassen, M.D., has served as chair of the department. He announced eight months ago his plans to step down from the position and return to a faculty position in the rheumatology division, continuing his clinical, research and teaching activities.

“I would like to express the college’s and my gratitude to Dr. Klassen for the tremendous job that he has done during his term as chair of the department,” Dr. Britigan said. “Under his leadership the department has seen major growth and development in a number of important areas. We wish him continued success in the next phase of his career.”

This marks Dr. Romberger’s second stint as interim chair of internal medicine. She served in this capacity for 20 months prior to Dr. Klassen becoming chair in 2005.

With more than 180 physicians and scientists, internal medicine is the largest department within the UNMC College of Medicine. The department is organized by disease specialty into 10 divisions.

Dr. Romberger is professor in the division of pulmonary, critical care, sleep and allergy medicine. Since 2000, she has served as vice chair of research for internal medicine. For the past eight years, she also has held the post of associate chief of staff for research for the VA Nebraska-Western Iowa Health Care System.

“I am grateful to be a part of the internal medicine department with its talented faculty, trainees, and staff,” Dr. Romberger said. “Under Dr. Klassen’s leadership, the department has grown in its recognition around the country. It is my goal to help us continue to move forward as a dynamic department through the various changes in academic medicine and health care in general.”

A search committee for the internal medicine chair was announced in February with Carl Smith, M.D., chair of the UNMC Department of OB/GYN and president of UNMC Physicians, heading the committee.

James Armitage, M.D., receives national recognition


Sandra Swain, M.D., past president of the American Society of Clinical Oncology (ASCO), at right, presents James Armitage, M.D., with the Special Achievement Award. (Photo courtesy of ASCO.)

Sandra Swain, M.D., past president of the American Society of Clinical Oncology (ASCO), at right, presents James Armitage, M.D., with the Special Achievement Award. (Photo courtesy of ASCO.) James Armitage, M.D., has received the 2014 American Society of Clinical Oncology’s Special Recognition Award for major accomplishments in the fields of oncology and hematology, as well as his many years of ASCO service.

The award, presented May 30, honors individuals for major contributions in areas of clinical oncology, cancer research, clinical trials, reimbursement, and patient advocacy activities, who have given long-term service to ASCO and to clinical oncology.

“It’s an honor to receive this award,” said Dr. Armitage, Joe Shapiro Professor of Internal Medicine in the UNMC Division of Oncology/Hematology. “My association with ASCO over the last 35 years has been a rewarding part of my career. ASCO has never wavered from its commitment to cancer patients in getting patients the best possible treatment and care.”

Dr. Armitage is globally recognized as a leading expert on non-Hodgkin lymphoma and played a critical role in advancing bone marrow transplantation.

Jeffrey P. Gold, M.D., UNMC chancellor, said the award is a tremendous honor for Dr. Armitage and great recognition for UNMC.

“He is an internationally recognized leader in cancer care. UNMC is proud to have him as a longstanding member of our faculty and in a leadership role in the Fred & Pamela Buffett Cancer Center.”

Lynell W. Klassen, M.D., Henry J. Lehnhoff Professor and chair of UNMC’s Department of Internal Medicine, said Dr. Armitage joins a prestigious group of recipients.

“Dr. Armitage is internationally acknowledged as one of the world’s foremost experts in the treatment of lymphoma. He established, at UNMC, the lymphoma program that grew into a world-renowned program. The award reflects the dedication, expertise and passion Dr. Armitage has for helping patients.

“With Jim receiving ASCO’s Special Recognition Award and with Julie Vose beginning her term as ASCO president, UNMC’s Division of Oncology/Hematology was recognized nationally at the world’s largest oncology meeting,” Dr. Klassen said.

Julie Vose, M.D., said Dr. Armitage has helped shape the progress of treatment and research in lymphoma and has been a key leader in ASCO.

“Dr. Armitage is a pioneer in hematology/oncology, a special teacher and mentor to all of us at UNMC for the last several decades, and he has built the foundation for our future at UNMC,” said Dr. Vose, Neumann M. and Mildred E. Harris Professorial Chair and chief of the division of oncology/hematology.

(Vicky Cerino, UNMC public relations, contributed to this story.)

Meet Dr. Armitage

James Armitage, M.D., developed and directed the bone marrow transplant programs at the University of Iowa and later at UNMC, where he also served as vice chair of internal medicine, chief of the section of oncology and hematology, chair of the Department of Internal Medicine, and dean of the College of Medicine.
The bone marrow transplant program at UNMC was one of the first to focus on autologous transplantation -— a process that involves storing a patient’s bone marrow stem cells so that the cells can be reintroduced after chemotherapy. The process helps patients tolerate higher doses of chemotherapy while reducing rates of complications, such as graft-versus-host disease, that often result when a patient receives donor bone marrow.
Dr. Armitage’s contributions span well beyond his work at UNMC and the University of Iowa. He has held many leadership roles at ASCO and other hematology and oncology associations, including ASCO president and president of the American Society for Blood and Marrow Transplantation.
He contributed to ASCO in many other capacities, including serving multiple terms on the board of directors and chairing the Cancer Education Committee, the Ethics Committee, and the Hematology-Oncology Task Force. Dr. Armitage is presently a member of the Journal of Clinical Oncology editorial board and is editor of The ASCO Post.

Intercampus effort may impact cancer treatment

by Charlie Litton, UNeMed


Surinder Batra, Ph.D., professor and chairman of UNMC’s Department of Biochemistry & Molecular Biology

Surinder Batra, Ph.D., professor and chairman of UNMC’s Department of Biochemistry & Molecular Biology A $250,000 grant from the Nebraska Research Initiative will use complex computer simulations to identify top drug candidates that could lead to the next generation of pancreatic and ovarian cancer treatments. Researchers and resources from three university campuses are involved in the project.

Surinder Batra, Ph.D., professor and chairman of UNMC’s Department of Biochemistry and Molecular Biology, is now on the verge of proving the potential of a molecule he originally discovered more than a decade ago — a gene called pancreatic differentiation factor 2, or PD2. New funding will use supercomputer simulations that researchers hope will demonstrate the potential power of PD2 against cancer.

PD2 is involved in the growth of stem cells, but becomes a problem if it gives cancer cells the same set of growth instructions. Cancer cells that express high levels of PD2 act like stem cells, growing tumors that can resist most forms of treatment.

“It has a lot of potential, this molecule,” said Dr. Batra, a two-time UNMC Distinguished Scientist and the 2012 Scientist Laureate. “It is in many cancers, not only pancreatic stem cells.”

Nick Palermo, a computer expert with the University of Nebraska-Lincoln, will try unlocking PD2’s power with the supercomputer at the Peter Kiewit Institute’s Holland Computing Center at the University of Nebraska at Omaha.

Palermo will build a computer model of PD2 and then simulate its interaction with millions of other known molecules. Renowned UNMC drug development researcher and College of Pharmacy professor Jonathan Vennerstrom, Ph.D., also will collaborate on the project.

“In general, the strength of the university is when people from different disciplines can work together,” said James Linder, M.D., interim president of the University of Nebraska.

Grant funding for the PD2 project will also increase the supercomputer’s “horsepower” — an improvement that will benefit future projects. UNeMed, the technology transfer office at UNMC, already has received interest from drug discovery companies that want to collaborate on other new drugs using the same process.

“If this project works,” said Joe Runge, UNeMed’s director of business development, “then we can take discoveries about diseases and translate them to medicines — all within the university system.”

Even if the perfect fit to PD2 doesn’t appear to exist naturally, Palermo can combine elements of the best matches to custom-build potential candidates.

“I think this is a matter of time and effort,” Palermo said, “and we will get it done.”

ASCO Today: Science and Society

The ASCO Post is pleased to present this special video series of interviews by and with leaders in oncology as recorded live at ASCO’s 50th Annual Meeting in Chicago. Click on the thumbnail to view the entire interview.

Here, James O. Armitage, MD, Editor-in-Chief, The ASCO Post, and Professor of Medicine at the University of Nebraska Medical Center, speaks with Clifford A. Hudis, MD, FACP, ASCO Immediate Past President, about his term as ASCO President, which concluded at the Annual Meeting in June. Dr. Hudis discusses his thoughts on ASCO today and shares his perspective on a number of important issues in oncology today, including value in cancer care, big data, and much more.

‘Space flight’ has UNMC’s Simorov walking on air

by Vicky Cerino, UNMC public relations


Anton Simorov, M.D., gives a thumbs up in a weightless state.

Anton Simorov, M.D., gives a thumbs up in a weightless state. UNMC made history last week when a UNMC surgery fellow and three University of Nebraska-Lincoln students dressed in flight suits boarded a 727 jet modified for zero-gravity experiments with NASA.


Anton Simorov, M.D., practices surgical techniques with the mini surgical robot. 

For more than 10 years, inventors at UNMC and UNL have spent countless hours building, testing, perfecting and patenting miniature surgical robots.

But the robots that fit inside the abdomen were developed for NASA to close medical gaps in space — something a flight surgeon could use in an emergency.

The next frontier for testing would have to be space – at least a simulation of space.

Anton Simorov, M.D., UNMC surgery fellow, and UNL engineering students Kearney Lackas, Walter Bircher and Tom Frederick took off from Johnson Space Center in Houston on a parabolic flight operated by Zero Gravity Corporation.


From left to right: UNL engineering graduate students Walter Bircher, Kearney Lackas and Thomas Frederick and UNMC surgical fellow, Anton Simorov, M.D. 

The flight created a weightless environment to test the robots.

Dr. Simorov practiced surgical techniques during 80 separate 20- to 30-second weightless periods, while engineering students monitored equipment.

“We accomplished our experiment goals. We collected a lot of data which will take several weeks to process and analyze,” Dr. Simorov said. “We learned a lot to further our experiments. It was a great, unforgettable experience.”

The flight was the result of a 2013 visit by a NASA team to learn about university research with potential applications in space, said Marsha Morien, executive director of the UNMC Center for Advanced Surgical Technology. “The NASA visitors saw the project and said it was ready for flight testing. Getting this flight is amazing. It’s highly competitive.”

On the other hand…

Dmitry Oleynikov, M.D., co-inventor of the mini-surgical robots, explained why he wasn’t on the test flight. “Every part of me wanted to be launched into an airplane that flies as high as 34,000 feet and then plummets to earth in an uncontrolled fall and is referred to by the people who fly it as the ‘vomit comet.’ I just couldn’t get away — I’m just too busy,” he joked.  Dmitry Oleynikov, M.D., a co-inventor of the robots, said the flight was a big step.

“We’re very excited. We’ve always felt it was a good idea to take a surgical platform, miniaturize it and use it in places you can’t have a hospital,” said Dr. Oleynikov, director of the Center for Minimally Invasive Surgery and the Center for Advanced Surgical Technology at UNMC. “It’s a natural extension of that concept to use it in space, on the battlefield and in other remote areas.”

Shane Farritor, Ph.D., UNL professor of mechanical and materials engineering and the robots’ co-inventor, said the flight moved the research forward. “It was a great learning experience for the students who successfully deployed a complex field system and operated it in a unique environment. We have more to do, but I really like where we are.”

Dr. Gold recognized nationally as health care leader


Jeffrey P. Gold, M.D.

Jeffrey P. Gold, M.D. UNMC Chancellor Jeffrey P. Gold, M.D., was selected as one of 25 recipients of the Becker’s Healthcare 2014 Leadership Awards by Becker’s Hospital Review.

The awards recognize men and women who have made remarkable contributions and will leave lasting legacies to their respective health systems, hospitals and communities.

Dr. Gold became UNMC’s chancellor on Feb. 1. The Becker’s announcement references his “previous accomplishments as chancellor of the University of Toledo’s health science campus,” adding that his work there suggests his leadership skills and vision for health care delivery will serve him and the University of Nebraska well.

The award announcement notes that under Dr. Gold’s leadership, the University of Toledo opened the Eleanor N. Dana Cancer Center and the Gardner-McMaster Parkinson Center, as well as added an orthopedic center, minimally invasive surgery center, medical pavilion and student library.

Dr. Gold and other awardees will each receive a token of appreciation for their hard work and service, along with recognition at the fifth Annual Becker’s Hospital Review May Conference, which will take place May 15-17 in Chicago.

National Strategic Research Institute reports impressive progress

by Melissa Lee, University of Nebraska


Ken Bayles, Ph.D., is one of the UNMC researchers taking part in the National Strategic Research Institute collaboration.

Ken Bayles, Ph.D., is one of the UNMC researchers taking part in the National Strategic Research Institute collaboration.  •New, more effective vaccines for anthrax and ricin. •Improved information systems that would allow national leaders to make better and faster decisions during security crises or natural disasters. •Stronger assessment tools to allow for timely, thorough responses to outbreaks of foodborne illnesses.

These are the goals of just a few of the projects undertaken since the establishment of the University of Nebraska’s National Strategic Research Institute (NSRI) in the fall of 2012. The institute, a collaboration between NU and the United States Strategic Command (USSTRATCOM), has highlighted numerous accomplishments in its first annual report, available now on the NSRI website.

Key among those: Faculty from across the university, including UNMC, have attracted more than $9 million in contract funding to pursue 22 different projects related to the chief mission of the National Strategic Research Institute to support research for combating weapons of mass destruction.

“We launched the National Strategic Research Institute a year and a half ago with the goal of leveraging the talents and expertise of our faculty for the benefit of our partners at USSTRATCOM and the Department of Defense. I’m pleased that at this early stage, we are doing that very effectively,” said University of Nebraska President James B. Milliken. “NSRI has engaged a range of diverse faculty who are committed to supporting our men and women in uniform and improving national security. Because of their work, and the leadership and commitment of our founding executive director, Bob Hinson, the NSRI is off to an incredible start.”

The National Strategic Research Institute is the newest of 13 University-Affiliated Research Centers (UARCs) across the United States. NSRI focuses on five core areas of expertise demonstrated by NU faculty: nuclear detection and forensics; detection of chemical and biological weapons; passive medical defense against weapons of mass destruction; consequence management; and space, cyber and telecommunications law.

“The establishment of the NSRI at the University of Nebraska has created a significant opportunity for the university faculty and researchers to contribute directly to the combating weapons of mass destruction research and technology requirements of our defense partners and other federal agencies,” said Robert Hinson, a retired U.S. Air Force Lieutenant General and executive director of NSRI. “The established core competencies reflect a very real mission area concern of USSTRATCOM and other federal agencies with assigned roles and responsibilities for addressing significant national security requirements for combating weapons of mass destruction.”