Scholars@Duke
Bradley S Kushner

Bradley S Kushner

Assistant Professor of Surgery
Surgery, Minimally Invasive Surgery

Selected Publications

Patient-reported outcomes in robotic vs. open transversus abdominis release.

Journal Article Surg Endosc · November 2025 INTRODUCTION: Large abdominal wall defects are increasingly repaired robotically using bilateral component separation and myofascial release. Existing studies on complication rates and operative variables fail to capture the patient experience, creating a ... Full text Link to item Cite

Bariatric surgery and relevant comorbidities: a systematic review and meta-analysis.

Journal Article Surg Endosc · March 2025 BACKGROUND: Obesity is a growing epidemic in the United States, and with this, has come an increasing volume of metabolic surgery operations. The ideal management of obesity-associated medical conditions surrounding these operations is yet to be determined ... Full text Link to item Cite

Patient expectations and decisional regret in the management of ventral hernias.

Journal Article Surg Endosc · January 2025 INTRODUCTION: Older adult patients have many factors to contemplate when considering elective ventral hernia repair. In this study, we aimed to understand whether our novel shared decision-making (SDM) aid helped reduce this population's decisional regret ... Full text Link to item Cite

SAGES guidelines for the management of comorbidities relevant to metabolic and bariatric surgery.

Journal Article Surg Endosc · January 2025 BACKGROUND: Patients who are under consideration for or have undergone metabolic and bariatric surgery frequently have comorbid medical conditions that may make their perioperative care more complex. These recommendations address routine intraoperative cho ... Full text Link to item Cite

Robotic-Assisted Hiatal Hernia Repair

Chapter · January 1, 2025 Compared to the laparoscopic approach, the robot-assisted treatment of hiatal hernias is associated with fewer postoperative recurrences, less postoperative pain and a shorter length of stay; the robot-assisted approach facilitates high mediastinal esophag ... Full text Cite

Implementation of Flexible Days Off Improves Surgical Resident Attendance of Personal Health Appointments, Perceived Wellbeing, and Sense of Control.

Journal Article J Surg Educ · November 2024 OBJECTIVE: Surgical resident schedules are demanding. Despite ACGME requirements that residents be able to attend personal appointments, many residents put off essential health tasks due to work hours. We designed a method for surgical residents to request ... Full text Link to item Cite

End-Tidal CO2 During Enhanced-View Totally Extraperitoneal Hernia Repair: A Comparison of Retrorectus and Intraperitoneal Insufflation.

Journal Article J Surg Res · October 2024 INTRODUCTION: Although the enhanced-view totally extraperitoneal (eTEP) approach has demonstrated safety, efficacy, and durability for small- to medium-sized hernia repairs, the relationships between retrorectus insufflation, intraoperative respiratory sta ... Full text Link to item Cite

Operative dictations in surgical trainees: an underutilized educational resource?

Journal Article Surg Endosc · November 2023 INTRODUCTION: Accurate operative notes are imperative to patient care and are used for communication, billing, quality assurance, and medical-legal conflicts. However, operative note quality often varies and many lack critical details. Unfortunately, no st ... Full text Link to item Cite

COVID-19 Vaccination Status and Operative Outcomes after Kidney Transplantation.

Journal Article J Am Coll Surg · July 1, 2023 BACKGROUND: Kidney transplantation remains the best available treatment for end-stage renal disease. However, promoting graft longevity and preventing allosensitization requires strict adherence with a stringent immunosuppression regimen. The COVID-19 pand ... Full text Link to item Cite

Minimally invasive management of epiphrenic diverticulum

Chapter · April 21, 2023 Esophageal diverticula are classified by both their anatomic location and by their mechanism of formation. Anatomically, esophageal diverticula are usually present at three locations: the pharyngoesophageal junction, the mid-esophagus, and the epiphrenic r ... Full text Cite

SAGES/AHPBA guidelines for the use of minimally invasive surgery for the surgical treatment of colorectal liver metastases (CRLM).

Journal Article Surg Endosc · April 2023 BACKGROUND: Colorectal liver metastases (CRLM) occur in roughly half of patients with colorectal cancer. Minimally invasive surgery (MIS) has become an increasingly acceptable and utilized technique for resection in these patients, but there is a lack of s ... Full text Link to item Cite

Patient Factors Affect Ergonomic Strain of Endoscopists During Colonoscopy.

Journal Article Dig Dis Sci · March 2023 INTRODUCTION: Endoscopic procedures place a great deal of muscular strain on providers, especially over the span of their careers. In this study we quantitatively analyzed the effects of patient factors such as age, body mass index, and sex on the ergonomi ... Full text Link to item Cite

The efficacy of goal-directed recommendations in overcoming barriers to elective ventral hernia repair in older adults.

Conference Surgery · March 2023 BACKGROUND: Although ventral hernias are common in older adults and can impair quality of life, multiple barriers exist that preclude ventral hernia repair. The goal of this study was to determine if older adults with ventral hernias achieve surgeon-direct ... Full text Link to item Cite

Translational design for limited resource settings as demonstrated by Vent-Lock, a 3D-printed ventilator multiplexer

Journal Article 3D Printing in Medicine · December 1, 2022 Background: Mechanical ventilators are essential to patients who become critically ill with acute respiratory distress syndrome (ARDS), and shortages have been reported due to the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: ... Full text Cite

Minimally invasive versus open hepatectomy for the resection of colorectal liver metastases: a systematic review and meta-analysis.

Journal Article Surg Endosc · November 2022 BACKGROUND: While surgical resection has a demonstrated utility for patients with colorectal liver metastases (CRLM), it is unclear whether minimally invasive surgery (MIS) or an open approach should be used. This review sought to assess the efficacy and s ... Full text Link to item Cite

Polypharmacy is predictive of postoperative complications in older adults undergoing ventral hernia repair.

Journal Article Surg Endosc · November 2022 BACKGROUND: Ventral hernias are common in older adults, and may be repaired via a transversus abdominus release (TAR). Older adults undergoing surgery have unique age-related risk factors, including polypharmacy. Polypharmacy is highly prevalent in older a ... Full text Link to item Cite

Perioperative outcomes of the Geriatric Assessment and Medical Preoperative Screening (GrAMPS) program pilot for older hernia patients: does chronological age predict outcomes?

Journal Article Surg Endosc · July 2022 BACKGROUND: The Geriatric Assessment and Medical Preoperative Screening (GrAMPS) program was an initial attempt to understand and to define the prevalence of age-related risk factors in older patients undergoing elective ventral hernia repair (VHR) or ingu ... Full text Link to item Cite

Smaller hands and less experience are associated with greater ergonomic strain during endoscopic procedures.

Journal Article Surg Endosc · July 2022 INTRODUCTION: Up to 89% of physicians who routinely perform endoscopy experience some type of musculoskeletal pain. In this study, we sought to quantitatively analyze provider factors that influence ergonomic strain during live endoscopic procedures. METHO ... Full text Link to item Cite

Randomized control trial evaluating the use of a shared decision-making aid for older ventral hernia patients in the Geriatric Assessment and Medical Preoperative Screening (GrAMPS) Program.

Journal Article Hernia · June 2022 PURPOSE: Shared decision making (SDM) is ideally suited to abdominal wall surgery in older adults given the breadth of decision making required by the hernia surgeon and the impact on quality of life (QOL) by various treatment options. Given the paucity of ... Full text Link to item Cite

Chronological age does not predict postoperative outcomes following transversus abdominis release (TAR).

Journal Article Surg Endosc · June 2022 BACKGROUND: Transversus abdominis release (TAR) is an effective procedure for the repair of complex ventral hernias. However, TAR is not a low risk operation, particularly in older adults who are disproportionately affected by multiple age-related risk fac ... Full text Link to item Cite

Examination of abdominal wall perfusion using varying suture techniques for midline abdominal laparotomy closure.

Journal Article Surg Endosc · June 2022 BACKGROUND: With a growing interest in the primary prevention of incisional hernias, it has been hypothesized that different suturing techniques may cause various levels of tissue ischemia. Using ICG laser-induced fluorescence angiography (ICG-FA), we stud ... Full text Link to item Cite

Geriatric assessment and medical preoperative screening (GrAMPS) program for older hernia patients.

Journal Article Hernia · June 2022 PURPOSE: The incidence of older adults undergoing inguinal and ventral hernia repairs is increasing. Older adults are disproportionately affected by age-related risk factors, which are often under-recognized and may adversely affect surgical outcomes. Thes ... Full text Link to item Cite

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study).

Journal Article BJS Open · May 2, 2022 BACKGROUND: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. METHODS: CHOLECOVID is an international, multicentre, observational comparative study of patients ad ... Full text Link to item Cite

Infection prevention plan to decrease surgical site infections in bariatric surgery patients.

Journal Article Surg Endosc · April 2022 BACKGROUND: Surgical site infections (SSI) are one of the most common complications of bariatric surgery. The Metabolic and Bariatric Surgery Accreditation and Quality Improvement (QI) Program (MBSAQIP) allows accredited programs to develop processes for q ... Full text Link to item Cite

Transversus abdominis release with posterior component separation in patients with previously recurrent ventral hernias: A single institution experience.

Conference Surgery · March 2022 BACKGROUND: Recurrent hernias pose significant challenges due to violated anatomic planes, resultant scar, and potential prior mesh. Transversus abdominis release has been widely utilized for complex hernias. Transversus abdominis release can provide a nov ... Full text Link to item Cite

Does immunosuppression increase perioperative wound morbidity in patients undergoing transversus abdominis release?

Conference Surgery · March 2022 BACKGROUND: Transversus abdominis release is an effective procedure for complex ventral hernias. As wound complications contribute to hernia recurrences, mitigating risk factors is vitally important for hernia surgeons. Although immunosuppression can impai ... Full text Link to item Cite

Surgical "error traps" of open posterior component separation-transversus abdominis release.

Journal Article Hernia · December 2021 PURPOSE: Past techniques for the repair of complex incisional hernias have been met with unacceptably high recurrence rates and postoperative complications. The transversus abdominis release (TAR) is a versatile and durable solution gaining popularity amon ... Full text Link to item Cite

Systematic Review and Meta-Analysis of the Effectiveness of Insurance Requirements for Supervised Weight Loss Prior to Bariatric Surgery.

Journal Article Obes Surg · December 2021 Many insurance plans impose strict criteria mandating preoperative weight loss attempts to limit patient's access to surgery. Preoperative acute weight loss has been hypothesized to reduce perioperative risk and to identify compliant patients who may have ... Full text Link to item Cite

Reducing Operating Room Cost: Comparing Attending and Surgical Trainee Perceptions About the Implementation of Supply Receipts.

Journal Article J Am Coll Surg · December 2021 BACKGROUND: As operating room (OR) expenditures increase, faculty and surgical trainees will play a key role in curbing future costs. However, supply cost utilization varies widely among providers and, despite requirements for cost education during surgica ... Full text Link to item Cite

Age-Related Risk Factors in Ventral Hernia Repairs: A Review and Call to Action.

Journal Article J Surg Res · October 2021 BACKGROUND: As the population ages, the incidence of ventral hernias in older adults is increasing. Ventral hernia repairs (VHR) should not be considered low risk operations, particularly in older adults who are disproportionately affected by multiple age- ... Full text Link to item Cite

Identifying critical computed tomography (CT) imaging findings for the preoperative planning of ventral hernia repairs.

Journal Article Hernia · August 2021 PURPOSE: Computed Tomography (CT) reports vary in qualitative detail and may not capture the information required for the preoperative planning of ventral hernia repairs. The goals of this study were to first survey general and hernia surgeons to establish ... Full text Link to item Cite

Favorable peri-operative outcomes observed in paraesophageal hernia repair with robotic approach.

Journal Article Surg Endosc · June 2021 BACKGROUND: The robotic surgical approach offers enhanced visualization, dexterity and reach, which may facilitate the more technically demanding portions of paraesophageal hernia (PEH) repair such as hiatal reconstruction and mediastinal dissection. We so ... Full text Link to item Cite

Early drain removal does not increase the rate of surgical site infections following an open transversus abdominis release.

Journal Article Hernia · April 2021 PURPOSE: Intraoperative drain placement during an open transversus abdominis release (TAR) is common practice. However, evidence detailing the optimal timing of drain removal is lacking. Surgical dogma teaches that drains should remain in place until outpu ... Full text Link to item Cite

Approaches to anti-reflux surgery: Laparoscopic, robotic, and endoscopic

Journal Article Annals of Laparoscopic and Endoscopic Surgery · April 1, 2021 Gastroesophageal reflux disease (GERD) is one of the most prevalent gastrointestinal (GI) diseases in the United States (US) affecting approximately 40% of the entire population annually. GERD is a physiologic disorder of the lower esophageal sphincter (LE ... Full text Cite

A Practical Guideline for the Implementation of Shared Decision-making in Complex Ventral Incisional Hernia Repair.

Journal Article J Surg Res · March 2021 BACKGROUND: Although obtaining preoperative procedural consent is required to meet legal and ethical obligations, consent is often relegated to a unidirectional conversation between surgeons and patients. In contrast, shared decision-making (SDM) is a coll ... Full text Link to item Cite

Assessment of postoperative opioid stewardship using a novel electronic-based automated text and phone messaging platform.

Conference Surgery · March 2021 BACKGROUND: Practices of opioid prescribing vary widely across general surgery providers. The goal of this study was to use a text-based platform to assess postdischarge opioid utilization. METHODS: A prospective, cohort study enrolled adult patients under ... Full text Link to item Cite

Rare aggressive solid pseudopapillary neoplasm of the ovary with metastatic disease following surgical resection.

Journal Article BMJ Case Rep · December 9, 2020 Extra-pancreatic solid pseudopapillary neoplasms (SPNs) are rare tumours with an overall favourable prognosis and low malignant potential. SPNs with metastatic spread, distant lymph node metastasis and extrapancreatic origin are exceedingly rare. Significa ... Full text Link to item Cite

Endoscopic treatments for GERD.

Journal Article Ann N Y Acad Sci · December 2020 Gastroesophageal reflux disease (GERD) is a condition with increasing prevalence and morbidity in the United States and worldwide. Despite advances in medical and surgical therapy over the last 30 years, gaps remain in the therapeutic profile of options. F ... Full text Link to item Cite

Robotic Approach to Paraesophageal Hernia Repair Results in Low Long-Term Recurrence Rate and Beneficial Patient-Centered Outcomes.

Conference J Am Coll Surg · November 2020 BACKGROUND: Little is known regarding important long-term outcomes after robotic paraesophageal hernia (PEH) repairs, such as symptom relief and recurrence rates. The aim of this study was to evaluate the long-term clinical outcomes in a large series of pa ... Full text Link to item Cite

Assessment of postoperative nausea and vomiting after bariatric surgery using a validated questionnaire.

Journal Article Surg Obes Relat Dis · October 2020 BACKGROUND: Postoperative nausea and vomiting (PONV) is known to occur after bariatric surgery, with over two thirds of patients affected. However, variability exists in how to objectively measure PONV. OBJECTIVES: The goals of the present study were to us ... Full text Link to item Cite