Perspectives Spring 2015

PERSPECTIVES • SPRING 2015 26 were comfortable performing a thoraco- scopic lobectomy. Clearly, more effective training of the thoracoscopic lobectomy procedure was needed, and Balderson set out to find bet- ter methods. Cadavers and live pigs were being used as teaching models, and each had significant drawbacks because they were extremely expensive and difficult to prepare, thereby limiting the availability of training sites. Cadaver models had poor tissue quality and were difficult to use, and while live porcine models had better tissue quality, their use necessitated the sacrifice of live animals. Balderson, along with Shari Meyerson, M.D., a former Duke thoracic surgery fel- low now at Northwestern University, clev- erly developed a tissue-simulator model that overcame the problems with the ca- daver and live porcine teaching models. They used a low-cost porcine heart-lung block from pigs that had already been commercially sacrificed for the food sup- ply. The pulmonary artery and veins were suffused with a readily available suffusion material to distend the structures for a more realistic technique of dissection. In addition, a simple and inexpensive thoracoscopic training box was created by the modification of a 10-gallon plastic tote box that could be obtained from any hardware store and reused. Holes were made in the box to simulate the small sur- gical incisions used for thoracoscopy and dissection, and the heart-lung block was situated inside the box to allow dissection of the left upper lobe of the porcine lung because it more anatomically resembles a human lung. Most importantly, the new simulator model was easy to set up, repro- ducible, and inexpensive. Balderson subsequently utilized his sim- ulator for teaching the thoracoscopic lobectomy procedure in courses at numer- ous regional, national, and international conferences. He has since trained many surgeons, surgical residents, and physician assistants and performed research that val- idated the effectiveness of his new simula- tor for teaching purposes. His instruction has aided surgeons to transition from use of a thoracotomy incision with retractors to use of a smaller access incision without retractors. It has also enabled physician as- sistants to have a significant role in per- forming thoracoscopic surgeries. In concert with the aforementioned in- novations, Balderson developed a thoraco- scopic first-assist (TFA) course in order to provide physician assistants the opportu- nity to receive hands-on training for video-assisted thoracic surgery (VATS) cases. The TFA course is given twice per year, one in association with the Masters of Minimally Invasive Thoracic Surgery meeting held annually in September in Orlando, and the other in association with the APACVS annual meeting to be held this March in Las Vegas. “My hope is for physician assistants to make a meaningful impact on the adoption rate of VATS lobectomy by becoming skilled assistants, thereby facilitating the surgeon’s ability to be successful,” Balderson said. Since graduating from the NSU Fort Lauderdale PA Program, Balderson has received additional honors. In 2006, he was inducted into the Pi Alpha National Honor Society by the NSU Fort Laud- erdale PA Program. In 2007, he was given a faculty appreciation award from the Duke University Physician Assistant Pro- gram as well as an Above and Beyond Award from the Duke University Medical Center Department of Surgery. Addition- ally, he was recently inducted into the CHCS’ Alpha Eta Society. He also continues to maintain close ties with his alma mater through frequent contact with his former mentor, Morton Diamond, M.D. “Dr. Diamond was a presence in my life as a PA student who would accept nothing less than excellence, and today he is a beloved mentor and friend who continues to inspire me to be better tomorrow than I am today,” Balderson said. Balderson has made significant contri- butions to the field of thoracic surgical oncology, and his passion, creativity, and hard work have enabled him to promote new techniques in thoracic surgery that will help save the lives of many more pa- tients afflicted with lung cancer. “It was very satisfying to Balderson to see significant pain reduction and much speedier recovery among his patients after they underwent minimally invasive surgery.” STAFFORD SCOTT BALDERSON PA Fort Lauderdale Balderson and Morton Diamond, M.D., enjoy dinner together during Dr. Diamond’s recent visit to Durham, North Carolina.