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Esophageal Surgery, Interviews with Thoracic Surgeons

Talking with Dr. Daniela Molena

Baltimore, Maryland

John Hopkin’s newest recruit to the Department of Thoracic Surgery, Dr. Daniela Molena is a bright point in the future of thoracic surgery.  While she has only been at Hopkins for a few short months (since September) she is already innovating and bringing positive changes to the institution.  In fact, there is too much to say about this fascinating and charming surgeon in just one article.

A practicing general surgeon in her native Italy, Dr. Molena rapidly became interested and proficient in the surgical treatment of benign esophageal diseases.  As a specialist in diseases of the esophagus, she has extensive training in both gastrointestinal and thoracic surgery.    Pursuit of this education brought her to the United States.

Once here, Dr. Molena took advantage of the opportunities to train with some of the most renown surgeons in the country; with Dr Marco Patti in San Francisco, with Dr Peters Jeffrey in Rochester, Memorial Sloan Kettering Cancer Center in NY with Dr Rusch Valerie and  Dr. James Luketich at the University of Pittsburgh Medical Center, and now here at John Hopkins with Dr. Stephen Yang.  She believes this gave her a better appreciation for all the different techniques and schools of though in thoracic surgery.  “I don’t just use a specific surgeon’s approach, I can use the best I have learnt from each mentor  and apply it to best fit the individual patient and their needs.”

Once she arrived here, she hit the ground running; gathering research on esophageal surgery; starting a lung cancer screening program for some of Baltimore’s more poverty-stricken communities, arranging for patient outreach sessions for cancer patients, working with Dr. Avo Meneshian’s robot-assisted thoracic surgery (RATS) program at the John Hopkins Bayview facility, and quickly advancing, promoting and heading a new program for minimally invasive esophageal surgery (including minimally invasive esophagectomy (MIE) for esophageal cancer).  She favors the Ivor-Lewis style procedure but performs it via thoracoscopy and laparoscopic approaches.  She thinks it is important to stress that minimally invasive surgery is just the approach or the tool to gain access to the chest to complete a surgical procedure.  Thus, a minimally invasive procedure does not mean a lesser or inferior resection.  “It’s how we get in – once we get in [to the chest], we can do whatever surgery is needed, respecting oncologic principles.”

While the MIE program is young, Dr. Daniela Molena hopes to grow this program with time, as part of a multi-disciplinary program for esophageal cancer patients. This holistic approach which combines diagnosticians, oncologists, dietitians, nutritionists, nurses, and surgeons is also an immensely practical one.  This multi-specialty clinic ensures that the patient/ and their family is able to meet with, consult with and work collaboratively with all of these specialties to determine their course of treatment on the same day during a single trip.  This alleviates much of the financial and transportation hardships experienced by many of the families travelling from around the country (and around the world[1]) for treatment at John Hopkins.

Dr. Molena takes this holistic approach to thoracic disease very seriously.  As she explains, “Even benign (non-cancerous) esophageal diseases are terrible for patients and their families.  They have to learn to adapt and accept that even with treatment, life may never be the same”.  She feels that it is essential that we speak to patients openly, and honestly and set realistic expectations, stating “People, especially our patients, are remarkably resilient if we communicate clearly with them during this process.” She also feels that as a surgeon she is here to do more for her patients that operate, that it’s not just about cutting.  She is here to help patients (and their loved ones) find all the resources they need to regain optimal health and promote wellness.  “It is more than just surviving the surgery.  It’s about health & wellness,” she finishes.

It’s a strong, profound statement and a reminder for surgery but one that reflects the thoughts and feelings of many of the wonderful thoracic surgeons I have met, interviewed or worked with.  But in Medicine, with many of it’s rigid definitions and delineations; too often the surgeons themselves, their motivations, and their desire to heal gets lost among the surgeries, and the procedures.

More about Dr. Daniela Molena

John Hopkins – Department of Thoracic Surgery, Surgeon profile

Medical School: Faculty of Medicine University of Padova (Padova Italy)
(1996)

General Surgery residencies:

University of Rochester Medical Center (Rochester NY) – General Surgery (2009)

Faculty of Medicine University of Padova (Padova Italy) – General Surgery (2001)

Faculty of Medicine University of Padova (Padova Italy) – General Surgery (1999)

Fellowships:

Memorial Sloan-Kettering Cancer Center (New York NY) – Cardiothoracic Surgery (2011)

University of Pittsburgh Medical Center (Pittsburgh PA) – Cardiothoracic Surgery (2010)

New York Presybterian Hospital (New York NY) – Cardiothoracic Surgery (2011)

Memorial Sloan-Kettering Cancer (New York NY) – Cardiothoracic Surgery (2009)

Universita Degli Studi di Padova (Padova Italy) – Minimally Invasive Surgery (2002)

[1] John Hopkins has a separate department called the International Patient Center which is devoted to detangling and simplifying the health care process for overseas patients.

Contact Information:

The Johns Hopkins Hospital

600 N. Wolfe Street

Baltimore, MD 21287

Phone: 410-614-3891

Appointment Phone: 410-933-1233

Selected publications

Dubecz A, Molena D, Peters JH.  Modern surgery for esophageal cancer.  Gastroenterol Clin North Am. 2008 Dec;37(4):965-87, xi. Review.

Zaninotto G, Annese V, Costantini M, Del Genio A, Costantino M, Epifani M, Gatto G, D’onofrio V, Benini L, Contini S, Molena D, Battaglia G, Tardio B, Andriulli A, Ancona E.  Randomized controlled trial of botulinum toxin versus laparoscopic heller myotomy for esophageal achalasia. Ann Surg. 2004 Mar;239(3):364-70.

Zaninotto G, Costantini M, Portale G, Battaglia G, Molena D, Carta A, Costantino M, Nicoletti L, Ancona E. Etiology, diagnosis, and treatment of failures after laparoscopic Heller myotomy for achalasia.  Ann Surg. 2002 Feb;235(2):186-92.

Patti MG, Molena D, Fisichella PM, Whang K, Yamada H, Perretta S, Way LW.  Laparoscopic Heller myotomy and Dor fundoplication for achalasia: analysis of successes and failures.  Arch Surg. 2001 Aug;136(8):870-7.

Williams VA, Watson TJ, Gellersen O, Feuerlein S, Molena D, Sillin LF, Jones C, Peters JH.  Gastrectomy as a remedial operation for failed fundoplication.  J Gastrointest Surg. 2007 Jan;11(1):29-35. [no free full-text available].

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Discussion

2 thoughts on “Talking with Dr. Daniela Molena

  1. I am PGY1 in general surgery here in pakistan. i want to excel in thoracic surgery in future. can someone help me guide regarding this as senior colleagues discourage me to do so due to unpredictable/ unsuccessful future of thoracic surgery.

    Posted by yaqoob urrehman | April 6, 2012, 6:04 pm
    • There will always be a future for thoracic surgery – in fact, I think this is the beginning of a new era for the specialty as the treatments for the ever-growing number of thoracic disease conditions become more and more complex requiring the services of a specialty trained physician. Lung cancer, is unfortunately on the rise, and so is drug-resistant TB, esophageal cancer and several other conditions that will require thoracic surgeons for succesful treatment so I applaud your decision to pursue a career in this specialty.
      Your best best for help – is to find a thoracic surgery fellowship program that you are interested in attending – and to contact them with your questions.

      Posted by cartagenasurgery | April 6, 2012, 9:47 pm

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