The Department of General Surgery at the Wake Forest University School of Medicine is committed to educating the next generation of health care providers and innovators. Our faculty members provide outstanding educational experiences to more than 75 residents and fellows in general surgery by consistently emulating and instilling the characteristics of perseverance, equanimity, compassion and leadership.
Our department is nationally recognized for excellence in clinical care and research in specialty areas including:
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After completing five years of clinical training, graduates of our General Surgery Residency Program are well prepared for entry into practice as general surgeons or for further training in a variety of surgical fellowships.
General Surgery Research
A wide variety of translational research activities spanning basic science and clinical and population projects are being carried out by faculty in the Department of Surgery. Our faculty are major contributors to many of the institutionally recognized Centers and Cores. Research training opportunities, many of which focus on health access and outcomes research, are available for medical students, undergraduate college students, graduate students, fellows and residents. Our faculty are members of numerous Masters’ and PhD training programs and lead various research training programs in the biomedical sciences.
Research Highlights
The program is led by four surgeons—Bradley Reames, MD; Eleftherios Makris, MD; Russell Howerton, MD; and Perry Shen, MD—each bringing specialized expertise to the team. Operating within the surgical oncology division of the Department of General Surgery, the group is united by a shared mission.
“We are here to give patients with liver and pancreatic cancer the best possible chance for a better and longer life, through personalized cutting-edge care, delivered by a team that desires to treat every patient like family,” said Dr. Shen.
Hepatic Arterial Infusion Pump Chemotherapy: Precision Treatment for Liver Tumors
One of the program’s most impactful offerings is hepatic arterial infusion (HAI) pump chemotherapy, a specialized regional treatment for patients with primary or metastatic liver tumors. A surgically implanted pump delivers chemotherapy directly into the hepatic artery via a catheter, achieving drug concentrations at the tumor site that are several hundred times higher than those achievable with standard systemic chemotherapy—while minimizing whole-body exposure.
This approach is particularly valuable for patients with metastatic colorectal cancer confined to the liver and intrahepatic cholangiocarcinoma. Clinical evidence supports combining HAI pump therapy with systemic chemotherapy to improve survival outcomes over systemic therapy alone. In patients with resectable liver metastases from colorectal cancer, HAI pump therapy combined with systemic treatment has been shown to meaningfully reduce recurrence rates and extend overall survival beyond what surgery and standard chemotherapy can achieve independently.
Because HAI pump therapy requires close coordination across surgical oncology, medical oncology, interventional radiology, and pharmacy, it is offered at only three centers across all of North Carolina. The HPB program is also an active participant in a national clinical trial evaluating outcomes of HAI pump chemotherapy in patients with unresectable colorectal liver metastases—giving our patients access to emerging evidence before it becomes standard of care.
Robotic Whipple Surgery: Minimally Invasive Precision for Pancreatic Cancer
Pancreaticoduodenectomy (the Whipple procedure) is one of the most technically demanding operations in abdominal surgery, traditionally requiring a large upper abdominal incision and hospital stays of a week or more. The HPB Surgery Program now performs this procedure robotically—a capability held by fewer than 2% of HPB surgeons in the country.
“The robotic platform is simply a complex tool the surgeon uses to complete technically challenging operations through small incisions. The surgeon sits at a console separate from the operative field and controls the robotic instruments remotely. The robotic platform uses a 10-times magnified, 3-dimensional camera, and the robotic instruments move with a degree of freedom even greater than my hand. For these technically demanding operations, the robotic platform is clearly superior to even the best laparoscopic instruments,” explained Dr. Reames.
The clinical benefits for patients are significant. The robotic approach results in multiple small incisions of 1 cm or less, leading to less postoperative pain and faster recovery. Patients undergoing robotic Whipple resection are typically discharged within 4 days, compared to 7 or more days with an open approach. This accelerated recovery is not merely a quality-of-life improvement—it enables earlier initiation of adjuvant therapy when indicated, which can be critical in optimizing oncologic outcomes for pancreatic cancer.
The HPB Surgery Program operates under what the team calls the “Loved One Standard”—the conviction that every patient deserves the same level of care a surgeon would want for their own family. With access to therapies that are rare in our region and participation in national clinical trials, the program is a meaningful resource for physicians across specialties who are caring for patients with hepatic and pancreatic malignancies.