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Expanding the Focus on Minimally Invasive Techniques

Expanding the Focus on Minimally Invasive Techniques

Gina Adrales, director of the new Division of Minimally Invasive and Robotic Surgery, received a request from head of gastroenterology Anthony Kalloo: Could she evaluate and treat his longtime patient?

The 63-year-old patient had been coming to The Johns Hopkins Hospital from her home in Florida for many years to receive care for a biliary tree problem. But then she developed a different and unrelated constellation of issues: trouble swallowing, heartburn, chest pain and occasional reflux. An endoscopy showed multiple superficial gastric ulcers. It’s a combination that’s often the result of paraesophageal hernia, a condition that occurs when the stomach bulges through the esophageal hiatus.

To accommodate the patient’s out-of-state travel, Adrales set up an appointment to see her outside of the clinic schedule. The next day, she repaired the hernia and performed a fundoplication to ease the patient’s reflux, both laparoscopically.

“She did great,” remembers Adrales. “She went home the next day and is recovering well.”

This patient’s success story and those like it have become increasingly commonplace as minimally invasive techniques have expanded over the past several decades, becoming the standard of care for many conditions. Improvements in outcomes across the board include less pain and inflammation, lower blood loss, faster recovery and better cosmetic results.

In May 2016, Adrales joined the Johns Hopkins faculty after over a decade at Dartmouth College Geisel School of Medicine, where she directed the bariatric surgery program. Since her fellowship at the University of Kentucky, she’s dedicated her career to minimally invasive approaches to provide its multitude of benefits to patients.

At Johns Hopkins, the majority of her work focuses on the foregut. Coordinating with colleagues in gastroenterology, including Kalloo, motility expert Ellen Stein and Barrett’s esophagus expert Marcia Canto, Adrales provides minimally invasive treatments for hiatal, incisional, inguinal, umbilical and ventral hernias; gallbladder disease; achalasia; gastroesophageal reflux disease; and obesity. She’s also working to integrate minimally invasive programs at Johns Hopkins affiliates, including Howard County General Hospital, Sibley Memorial Hospital and Suburban Hospital.

Adrales also has a strong interest in training the next generations of surgeons in these revolutionary techniques. She serves as the director of Johns Hopkins’ Minimally Invasive Surgery Training and Innovation Center, a facility that provides instruction and practice in minimally invasive techniques for all levels of medical education, including medical students, residents and fellows. Offering wet and dry labs, the center serves trainees within general surgery and surgical specialties.

“Our goal isn’t just to care for the patients that we see,” says Adrales. “It’s to train surgeons in these techniques so they can care for patients far into the future.”

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