Patrick Codd

Positions:

Associate Professor of Neurosurgery

Neurosurgery
School of Medicine

Assistant Professor in Head & Neck Surgery & Communication Sciences

Head and Neck Surgery & Communication Sciences
School of Medicine

Core Faculty in Innovation & Entrepreneurship

Duke Innovation & Entrepreneurship
Institutes and Provost's Academic Units

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 2008

Harvard Medical School

General Surgery Intern, General Surgery

Massachusetts General Hospital

Neurosurgery Resident, Surgery

Massachusetts General Hospital

Grants:

Augmented Reality Assisted Placement of External Ventricular Drain

Administered By
Neurosurgery
Awarded By
American Association of Neurological Surgeons
Role
Principal Investigator
Start Date
End Date

Publications:

Addressing Surgical Instrument Oversupply: A Focused Literature Review and Case-Study in Orthopedic Hand Surgery.

BACKGROUND: Instrument oversupply drives cost in the operating room (OR). We review previously reported methodologies for surgical instrument reduction and report a pilot methodology for optimizing instrument supply via ethnographic instrument tracking of thumb carpometacarpal (CMC) arthroplasties. Additionally, we report a cost analysis of instrument oversupply and potential savings of tray optimization methods. METHODS: Instrument utilization was tracked over 8 CMC arthroplasties conducted by 2 surgeons at an ambulatory surgery center of a large academic hospital. An optimized supply methodology was designed. A cost analysis was conducted using health-system-specific data and previously published research. RESULTS: After tracking instrument use in 8 CMC arthroplasties, a cumulative total of 59 out of the 120 instruments in the Hand & Foot (H&F) tray were used in at least 1 case. Two instruments were used in all cases, and another 20 instruments were used in at least 50% of the cases. Using a reduced tray with 59 instruments, potential cost savings for tray reduction in 60 cases were estimated to be $2086 without peel-packing and $2356 with peel-packing. The estimated cost savings were lower than those reported in literature due to a reduced scope and exclusion of OR time cost in the analysis. CONCLUSIONS: Instrument oversupply drives cost at our institution's ambulatory surgery center. Ethnography is a cost-effective method to track instrument utilization and determine optimal tray composition for small services but is not scalable to large health systems. The time and cost required to observe sufficient surgeries to enable supply reduction to motivate the need for more efficient methods to determine instrument utility.
Authors
Helmkamp, JK; Le, E; Hill, I; Hein, R; Mithani, S; Codd, P; Richard, M
MLA Citation
Helmkamp, Joshua K., et al. “Addressing Surgical Instrument Oversupply: A Focused Literature Review and Case-Study in Orthopedic Hand Surgery.Hand (N Y), June 2021, p. 15589447211017232. Pubmed, doi:10.1177/15589447211017233.
URI
https://scholars.duke.edu/individual/pub1484809
PMID
34098770
Source
pubmed
Published In
Hand (N Y)
Published Date
Start Page
15589447211017233
DOI
10.1177/15589447211017233

Creation of an Automated Fluorescence Guided Tumor Ablation System

Objective: Create a device that improves the identification and extent of resection at the interface between healthy and tumor tissue; ultimately, using this device would improve surgical outcomes for patients and increase survival. Methods: We have created a contactless tumor removal system that utilizes endogenous fluorescence feedback to inform a laser ablation system to execute autonomous removal of phantom tumor tissue. Results: This completely non-contact surgical system is capable of resecting the tumor boundary of a tissue phantom with an average root mean square error (RMSE) of approximately 1.55 mm and an average max error of approximately 2.15 mm. There is no difference in the performance of the system when changing the size of the internal tumor from 7.5-12.5 mm in diameter. Discussion: Future research steps include creating a more intelligent spectral search strategy to increase the density of points around the resection boundary, and to develop a more sophisticated classifier to predict pathologic diagnosis and tissue subtypes located regionally around the tumor boundaries. We envision this device being used to resect the boundaries of tumors identified by exogenously delivered tumor-labeling fluorophores, such as fluorescein or 5-ALA, in addition to approaches relying on autofluorescence of endogenous fluorophores.
Authors
Tucker, M; Ma, G; Ross, W; Buckland, DM; Codd, PJ
MLA Citation
Tucker, M., et al. “Creation of an Automated Fluorescence Guided Tumor Ablation System.” Ieee Journal of Translational Engineering in Health and Medicine, vol. 9, Jan. 2021. Scopus, doi:10.1109/JTEHM.2021.3097210.
URI
https://scholars.duke.edu/individual/pub1488597
Source
scopus
Published In
Ieee Journal of Translational Engineering in Health and Medicine
Volume
9
Published Date
DOI
10.1109/JTEHM.2021.3097210

Olfactory-Specific Quality of Life Outcomes after Endoscopic Endonasal Surgery of the Sella.

Objective: To assess olfactory outcomes as measured by an olfactory-specific quality of life (QOL) questionnaire in patients undergoing EESBS for sellar lesions. Design: Retrospective case series. Setting: Tertiary academic medical center. Participants: In total, 36 patients undergoing EESBS for lesions limited to the sella were evaluated. Main Outcome Measures: The following were performed before and three months after surgery: 22-Item Sinonasal Outcomes Test (SNOT-22), University of Pennsylvania Smell Identification Test (UPSIT), and the Assessment of Self-reported Olfactory Functioning (ASOF), which has three domains: subjective olfactory capability scale (SOC), smell-related problems (SRP), and olfactory-related quality of life (ORQ). Results: Median age at surgery was 52.5 years, with a median tumor size of 1.8 cm (range: 0.2 to 3.9 cm). Pre- and postoperative median scores were 35 [34, 36.2] and 34.5 [32, 36] for UPSIT, 21 [7.5, 33.5] and 21.5 [6.8, 35.7] for SNOT-22, 10 [9, 10] and 9 [8, 10] for ASOF-SOC, 5 [4.8, 5] and 4.5 [4, 5] for ASOF-SRP, and 5 [5, 5] and 5 [4.5, 5] for ASOF-ORQ. There was no significant change in the two of the three domains of the ASOF. Correlation between ASOF and UPSIT scores were weak. Older age and larger tumor size were associated with worsened olfaction after surgery. Conclusions: Patients did not experience significant changes in olfactory-specific QOL three months after EESBS, as measured by two domains of the ASOF. The ASOF may serve as a useful adjunctive tool for assessing olfaction after surgery. The lack of correlation between UPSIT and ASOF suggests the need for more research in subjective olfactory-related quality of life after surgery.
Authors
Raikundalia, MD; Huang, RJ; Chan, L; Truong, T; Kuchibhatla, M; Merchant, J; Hachem, RA; Codd, PJ; Zomorodi, AR; Teitelbaum, JI; Goldstein, BJ; Jang, DW
MLA Citation
Raikundalia, Milap D., et al. “Olfactory-Specific Quality of Life Outcomes after Endoscopic Endonasal Surgery of the Sella.Allergy Rhinol (Providence), vol. 12, Jan. 2021, p. 21526567211045040. Pubmed, doi:10.1177/21526567211045041.
URI
https://scholars.duke.edu/individual/pub1500543
PMID
34733580
Source
pubmed
Published In
Allergy and Rhinology
Volume
12
Published Date
Start Page
21526567211045041
DOI
10.1177/21526567211045041

Touch-Point Detection Using Thermal Video With Applications to Prevent Indirect Virus Spread.

Viral and bacterial pathogens can be transmitted through direct contact with contaminated surfaces. Efficient decontamination of contaminated surfaces could lead to decreased disease transmission, if optimized methods for detecting contaminated surfaces can be developed. Here we describe such a method whereby thermal tracking technology is utilized to detect thermal signatures incurred by surfaces through direct contact. This is applicable in public places to assist with targeted sanitation and cleaning efforts to potentially reduce chance of disease transmission. In this study, we refer to the touched region of the surface as a "touch-point" and examine how the touch-point regions can be automatically localized with a computer vision pipeline of a thermal image sequence. The pipeline mainly comprises two components: a single-frame and a multi-frame analysis. The single-frame analysis consists of a Background subtraction method for image pre-processing and a U-net deep learning model for segmenting the touch-point regions. The multi-frame analysis performs a summation of the outputs from the single-frame analysis and creates a cumulative map of touch-points. Results show that the touch-point detection pipeline can achieve 75.0% precision and 81.5% F1-score for the testing experiments of predicting the touch-point regions. This preliminary study shows potential applications of preventing indirect pathogen spread in public spaces and improving the efficiency of cleaning sanitation.
Authors
Ma, G; Ross, W; Tucker, M; Hsu, P-C; Buckland, DM; Codd, PJ
MLA Citation
Ma, Guangshen, et al. “Touch-Point Detection Using Thermal Video With Applications to Prevent Indirect Virus Spread.Ieee J Transl Eng Health Med, vol. 9, 2021, p. 4900711. Pubmed, doi:10.1109/JTEHM.2021.3083098.
URI
https://scholars.duke.edu/individual/pub1482596
PMID
34094721
Source
pubmed
Published In
Ieee Journal of Translational Engineering in Health and Medicine
Volume
9
Published Date
Start Page
4900711
DOI
10.1109/JTEHM.2021.3083098

Radiofrequency Identification Track for Tray Optimization: An Instrument Utilization Pilot Study in Surgical Oncology.

BACKGROUND: Surgical instrument tray reduction attempts to minimize intraoperative inefficiency and processing costs. Previous reduction methods relied on trained observers manually recording instrument use (i.e. human ethnography), and surgeon and/or staff recall, which are imprecise and inherently limited. We aimed to determine the feasibility of radiofrequency identification (RFID)-based intraoperative instrument tracking as an effective means of instrument reduction. METHODS: Instrument trays were tagged with unique RFID tags. A RFID reader tracked instruments passing near RFID antennas during 15 breast operations performed by a single surgeon; ethnography was performed concurrently. Instruments without recorded use were eliminated, and 10 additional cases were performed utilizing the reduced tray. Logistic regression was used to estimate odds of instrument use across cases. Cohen's Kappa estimated agreement between RFID and ethnography. RESULTS: Over 15 cases, 37 unique instruments were used (median 23 instruments/case). A mean 0.64 (median = 0, range = 0-3) new instruments were added per case; odds of instrument use did not change between cases (OR = 1.02, 95%CI 1.00-1.05). Over 15 cases, all instruments marked as used by ethnography were recorded by RFID tracking; 7 RFID-tracked instruments were never recorded by ethnography. Tray size was reduced 40%. None of the 25 eliminated instruments were required in 10 subsequent cases. Cohen's Kappa comparing RFID data and ethnography over all cases was 0.82 (95%CI 0.79-0.86), indicating near perfect agreement between methodologies. CONCLUSIONS: Intraoperative RFID instrument tracking is a feasible, data-driven method for surgical tray reduction. Overall, RFID tracking represents a scalable, systematic, and efficient method of optimizing instrument supply across procedures.
Authors
Olivere, LA; Hill, IT; Thomas, SM; Codd, PJ; Rosenberger, LH
MLA Citation
Olivere, Lindsey A., et al. “Radiofrequency Identification Track for Tray Optimization: An Instrument Utilization Pilot Study in Surgical Oncology.J Surg Res, vol. 264, Aug. 2021, pp. 490–98. Pubmed, doi:10.1016/j.jss.2021.02.049.
URI
https://scholars.duke.edu/individual/pub1480386
PMID
33857793
Source
pubmed
Published In
J Surg Res
Volume
264
Published Date
Start Page
490
End Page
498
DOI
10.1016/j.jss.2021.02.049