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Research Overview

Dr. Zendejas has a wide range of clinical and research interest. Dr. Zendejas and his colleagues have developed and implemented a minimally invasive (thoracoscopic) alternative to the Foker (traction induced-esophageal growth) process, classically performed via thoracotomy, for children with long-gap EA. This novel approach allows children to not require muscle paralysis while on traction, which leads to less sedation requirements and shorter hospital stays, with equivalent outcomes. Furthermore, they have studied the role of esophageal perfusion, as measured with indocyanine green fluorescence, and developed an esophageal anastomotic scoring system that is highly predictive of anastomotic outcomes. This predictive ability allows surgeons to developed patient-centered postoperative management pathways based on their perceived risk of complications in order to further streamline patient care.

Dr. Zendejas and his colleagues discovered that children undergoing complex aerodigestive surgery are at great risk of vocal fold movement impairment (VFMI) secondary to recurrent laryngeal nerve (RLN) injury. Hence, they have undertaken an extensive research effort to elucidate the magnitude of the problem, clarify who is at greatest risk, raise awareness, and define the ideal screening program. To improve screening, they have evaluated and introduced laryngeal ultrasound into practice as a less invasive and equally accurate VFMI screening modality when compared with flexible nasolaryngoscopy. More importantly, they have pioneered and implemented the pediatric adaptation of technology originally aimed for use in adults in order to be able to perform intraoperative RLN monitoring in children of all ages. With this emphasis on RLN preservation, they have been able to demonstrate a substantial decrease in RLN injury rates for their patients.

From a surgical education standpoint Dr. Zendejas is actively involved in the implementation of SIMPL (System for Improving and Measuring Procedural Learning), which is a work-placed based operative assessment modality that evaluates pediatric surgery trainee’s operative autonomy and readiness for independent practice. With this data, aggregate metrics can be collated and used to predict future performance. Such efforts are key in the understanding of graduated autonomy and will be instrumental in the move from time-based training to competency-based training.

Research Background

Dr. Zendejas is an Assistant Professor of Surgery at Harvard Medical School. He currently serves as the Surgical Director of the Esophageal and Airway Treatment (EAT) Center at Boston Children's Hospital, as well as the Co-Surgical Director of the Vascular Ring Program. Dr. Zendejas attended medical school at the Universidad Autonoma de Guadalajara (UAG), in Guadalajara, Jalisco Mexico. He later completed a Masters in Biomedical Sciences (MSc) in Clinical and Translational Sciences (CTSA) at the Mayo Graduate School in Rochester MN, where he focused on Surgical Education Research and Simulation-Based Training, and pursued the Surgical Education Research Fellowship of the Association for Surgical Education. He later completed his general surgery training at Mayo Clinic, Rochester, MN and his pediatric surgery fellowship at Boston Children's Hospital, where he stayed as faculty.

Dr. Zendejas has won numerous academic awards including the Mayo Brothers Distinguished Fellowship Award, the Jon van Heerden Award for Meticulous Patient Care, and the Karee K Nygaard Travel Award for Outstanding Surgical Research Achievement. Dr. Zendejas is an active member and serves on several committees with various leadership roles in several national and international organizations, such as the American Pediatric Surgical Association. Dr. Zendejas has coauthored more than 100 original manuscripts and has contributed significantly to the pediatric surgical care of children with esophageal atresia, tracheomalacia and vascular rings.

Education

Medical School

Universidad Autonoma de Guadalajara
2009 Jalisco Mexico

Graduate School

Mayo School of Graduate Medical Education
2011 Rochester MN

Internship

Mayo Clinic
2012 Rochester MN

Residency

Mayo Clinic
2016 Rochester MN

Fellowship

Boston Children's Hospital
2018 Boston MA

Media

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Thanks to vascular ring surgery, Louis can now play with his little sister — and eats as many as three hot dogs in one sitting!

Publications

  1. Surveillance Endoscopy in Pediatric Esophageal Atresia: Toward an Evidence-Based Algorithm. J Am Coll Surg. 2024 May 01; 238(5):831-843. View Abstract
  2. Strategies for evaluating predictive models: examples and implications based on a natural language processing model used to assess operative performance feedback. Global Surgical Education. 2024; 6(3). View Abstract
  3. Retrospective analysis of neurological findings in esophageal atresia: Allostatic load of disease complexity, cumulative sedation, and anesthesia exposure. Birth Defects Res. 2024 Jan; 116(1):e2269. View Abstract
  4. Bronchoscopic Localization of Tracheoesophageal Fistula in Newborns with Esophageal Atresia: Intubate Above or Below the Fistula? J Pediatr Surg. 2024 Mar; 59(3):363-367. View Abstract
  5. Diagnostic Accuracy of Laryngeal Ultrasound for Evaluating Vocal Fold Movement Impairment in Children. J Pediatr Surg. 2024 Jan; 59(1):109-116. View Abstract
  6. How Many Operative Performance Ratings Does a Pediatric Surgery Fellow Need to Be Deemed Practice Ready? J Pediatr Surg. 2024 Jan; 59(1):31-36. View Abstract
  7. Primary Posterior Tracheopexy at Time of Esophageal Atresia Repair Significantly Reduces Respiratory Morbidity. J Pediatr Surg. 2024 Jan; 59(1):10-17. View Abstract
  8. Surgical Treatment of Esophageal Anastomotic Stricture After Repair of Esophageal Atresia. J Pediatr Surg. 2023 Dec; 58(12):2375-2383. View Abstract
  9. Multidisciplinary approach to vascular rings and vascular-related aerodigestive compression: a clinical practice review. Transl Pediatr. 2023 Jun 30; 12(6):1258-1277. View Abstract
  10. Screening for Vocal Fold Movement Impairment in Children Undergoing Esophageal and Airway Surgery. Laryngoscope. 2023 12; 133(12):3564-3570. View Abstract
  11. Predictors of enteral tube dependence in pediatric esophageal atresia. Dis Esophagus. 2023 Feb 24; 36(3). View Abstract
  12. Esophageal Surveillance Practices in Esophageal Atresia Patients: A Survey by the Eastern Pediatric Surgery Network. J Pediatr Surg. 2023 Jun; 58(6):1213-1218. View Abstract
  13. Predicting future meaningful autonomy using prior autonomy ratings for pediatric surgery fellows. Global Surgical Education. 2023; 107(2). View Abstract
  14. Pediatric button battery ingestion: A single center experience and risk score to predict severe outcomes. J Pediatr Surg. 2023 Apr; 58(4):613-618. View Abstract
  15. Evolution of left-sided thoracoscopic approach for long gap esophageal atresia repair. J Pediatr Surg. 2023 Apr; 58(4):629-632. View Abstract
  16. Autoimmune Thyroiditis and Risk of Malignancy in Children with Thyroid Nodules. Thyroid. 2022 09; 32(9):1109-1117. View Abstract
  17. Qualitative features of esophageal fluorescence angiography and anastomotic outcomes in children. J Pediatr Surg. 2023 Jul; 58(7):1359-1367. View Abstract
  18. From the Ground Up: Esophageal Atresia Types, Disease Severity Stratification and Survival Rates at a Single Institution. Front Surg. 2022; 9:799052. View Abstract
  19. Subtype of atypia on cytology and risk of malignancy in pediatric thyroid nodules. Cancer Cytopathol. 2022 05; 130(5):330-335. View Abstract
  20. Predictors and Outcomes of Fully Covered Stent Treatment for Anastomotic Esophageal Strictures in Esophageal Atresia. J Pediatr Gastroenterol Nutr. 2022 02 01; 74(2):221-226. View Abstract
  21. Impact of the COVID-19 pandemic on the clinical training of last year medical students in Mexico: a cross-sectional nationwide study. BMC Med Educ. 2022 Jan 08; 22(1):24. View Abstract
  22. Radiographic assessment of traction-induced esophageal growth and traction-related complications of the Foker process for treatment of long-gap esophageal atresia. Pediatr Radiol. 2022 Mar; 52(3):468-476. View Abstract
  23. Cautionary tales in the use of magnets for the treatment of long gap esophageal atresia. J Pediatr Surg. 2022 Oct; 57(10):342-347. View Abstract
  24. Feeding and Growth Outcomes in Infants with Type C Esophageal Atresia Who Undergo Early Primary Repair. J Pediatr. 2022 02; 241:77-82.e1. View Abstract
  25. Predictors of Bilateral Disease in Pediatric Differentiated Thyroid Cancer. J Clin Endocrinol Metab. 2021 09 27; 106(10):e4242-e4250. View Abstract
  26. Initial Esophageal Anastomosis Diameter Predicts Treatment Outcomes in Esophageal Atresia Patients With a High Risk for Stricture Development. Front Pediatr. 2021; 9:710363. View Abstract
  27. Comparative Effectiveness of Recurrent Laryngeal Nerve Monitoring Techniques in Pediatric Surgery. Laryngoscope. 2022 04; 132(4):889-894. View Abstract
  28. Predictors of anti-reflux procedure failure in complex esophageal atresia patients. J Pediatr Surg. 2022 Jul; 57(7):1321-1330. View Abstract
  29. Nutrition delivery and growth outcomes in infants with long-gap esophageal atresia who undergo the Foker process. J Pediatr Surg. 2021 Dec; 56(12):2133-2139. View Abstract
  30. Current concepts in tracheobronchomalacia: diagnosis and treatment. Semin Pediatr Surg. 2021 Jun; 30(3):151062. View Abstract
  31. Clinical utility of sonographic features in indeterminate pediatric thyroid nodules. Eur J Endocrinol. 2021 May; 184(5):657-665. View Abstract
  32. Evolution, lessons learned, and contemporary outcomes of esophageal replacement with jejunum for children. Surgery. 2021 07; 170(1):114-125. View Abstract
  33. Recurrent Laryngeal Nerve Monitoring in Pediatric Surgery Using a Modified Dragonfly Electrode. Laryngoscope. 2021 11; 131(11):2586-2589. View Abstract
  34. Contemporary outcomes of the Foker process and evolution of treatment algorithms for long-gap esophageal atresia. J Pediatr Surg. 2021 Dec; 56(12):2180-2191. View Abstract
  35. Effect of Posterior Tracheopexy on Risk of Recurrence in Children after Recurrent Tracheo-Esophageal Fistula Repair. J Am Coll Surg. 2021 05; 232(5):690-698. View Abstract
  36. Commentary on "Break the Rule of Three: Critical Thoughts from a Tertiary care Experience with Bougie Dilators". J Pediatr Gastroenterol Nutr. 2021 01 01; 72(1):e29. View Abstract
  37. Prophylactic negative vacuum therapy of high-risk esophageal anastomoses in pediatric patients. J Pediatr Surg. 2021 May; 56(5):944-950. View Abstract
  38. Utility of repeated therapeutic endoscopies for pediatric esophageal anastomotic strictures. Dis Esophagus. 2020 Dec 07; 33(12). View Abstract
  39. Intraoperative Recurrent Laryngeal Nerve Monitoring During Pediatric Cardiac and Thoracic Surgery: A Mini Review. Front Pediatr. 2020; 8:587177. View Abstract
  40. The left-sided repair: An alternative approach for difficult esophageal atresia repair. J Pediatr Surg. 2021 May; 56(5):938-943. View Abstract
  41. Quality of dictated feedback associated with SIMPL operative assessments of pediatric surgical trainees. Am J Surg. 2021 02; 221(2):303-308. View Abstract
  42. Rules Are Meant to Be Broken: Examining the "Rule of 3" for Esophageal Dilations in Pediatric Stricture Patients. J Pediatr Gastroenterol Nutr. 2020 07; 71(1):e1-e5. View Abstract
  43. When to consider a posterolateral descending aortopexy in addition to a posterior tracheopexy for the surgical treatment of symptomatic tracheobronchomalacia. J Pediatr Surg. 2020 Dec; 55(12):2682-2689. View Abstract
  44. Intralesional Steroid Injection Therapy for Esophageal Anastomotic Stricture Following Esophageal Atresia Repair. J Pediatr Gastroenterol Nutr. 2020 04; 70(4):462-467. View Abstract
  45. Endoscopic incisional therapy and other novel strategies for effective treatment of congenital esophageal stenosis. J Pediatr Surg. 2020 Nov; 55(11):2342-2347. View Abstract
  46. Assessment of Operative Autonomy and Readiness for Independent Practice Among Pediatric Surgery Fellows. J Pediatr Surg. 2020 Jan; 55(1):117-121. View Abstract
  47. Great vessel anomalies and their impact on the surgical treatment of tracheobronchomalacia. J Pediatr Surg. 2020 Jul; 55(7):1302-1308. View Abstract
  48. Giant Gastroschisis with Complete Liver Herniation: A Case Report of Two Patients. Case Rep Surg. 2019; 2019:4136214. View Abstract
  49. Minimally Invasive Surgical Approach for Posterior Tracheopexy to Treat Severe Tracheomalacia: Lessons Learned from Initial Case Series. J Laparoendosc Adv Surg Tech A. 2018 Dec; 28(12):1525-1530. View Abstract
  50. Risk factors for recurrence after thoracoscopic repair of congenital diaphragmatic hernia (CDH). J Pediatr Surg. 2018 Nov; 53(11):2087-2091. View Abstract
  51. Personalized Video Feedback and Repeated Task Practice Improve Laparoscopic Knot-Tying Skills: Two Controlled Trials. Acad Med. 2017 11; 92(11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 56th Annual Research in Medical Education Sessions):S26-S32. View Abstract
  52. Colonic mesenteric lymphatic malformation presenting as an intraabdominal abscess in an infant: A case report. Int J Surg Case Rep. 2017; 39:154-158. View Abstract
  53. Swallowing Dysfunction and Quality of Life in Adults With Surgically Corrected Esophageal Atresia/Tracheoesophageal Fistula as Infants: Forty Years of Follow-up. Ann Surg. 2017 08; 266(2):305-310. View Abstract
  54. Simulation, Mastery Learning and Healthcare. Am J Med Sci. 2017 Feb; 353(2):158-165. View Abstract
  55. Laparoscopic skill assessment of practicing surgeons prior to enrollment in a surgical trial of a new laparoscopic procedure. Surg Endosc. 2017 08; 31(8):3313-3319. View Abstract
  56. Malignant transformation of biliary adenofibroma: a rare biliary cystic tumor. J Gastrointest Oncol. 2016 Dec; 7(6):E107-E112. View Abstract
  57. Nuss bar migrations: occurrence and classification. Pediatr Radiol. 2016 Dec; 46(13):1797-1803. View Abstract
  58. A 21-year-old woman with right lower quadrant abdominal pain. Surgery. 2017 05; 161(5):1459-1460. View Abstract
  59. Botulinum toxin A-induced paralysis of the lateral abdominal wall after damage-control laparotomy: A multi-institutional, prospective, randomized, placebo-controlled pilot study. J Trauma Acute Care Surg. 2016 Feb; 80(2):237-42. View Abstract
  60. Annual Surgeon Volume and Patient Outcomes Following Laparoscopic Totally Extraperitoneal Inguinal Hernia Repairs. J Laparoendosc Adv Surg Tech A. 2016 Feb; 26(2):92-8. View Abstract
  61. Minimally Invasive Repairs of Pectus Excavatum: Surgical Outcomes, Quality of Life, and Predictors of Reoperation. J Am Coll Surg. 2016 Mar; 222(3):245-52. View Abstract
  62. Training High-Volume Melanoma Surgeons to Perform a Novel Minimally Invasive Inguinal Lymphadenectomy: Report of a Prospective Multi-Institutional Trial. J Am Coll Surg. 2016 Mar; 222(3):253-60. View Abstract
  63. Optimizing training cost-effectiveness of simulation-based laparoscopic inguinal hernia repairs. Am J Surg. 2016 Feb; 211(2):326-35. View Abstract
  64. Reply to Letter: "Surgical Simulation: Seeing the Bigger Picture and Asking the Right Questions". Ann Surg. 2015 Aug; 262(2):e51-2. View Abstract
  65. Validity evidence for the Fundamentals of Laparoscopic Surgery (FLS) program as an assessment tool: a systematic review. Surg Endosc. 2016 Feb; 30(2):512-520. View Abstract
  66. Self-regulated learning in simulation-based training: a systematic review and meta-analysis. Med Educ. 2015 Apr; 49(4):368-78. View Abstract
  67. Mentor-guided self-directed learning affects resident practice. J Surg Educ. 2015 Jul-Aug; 72(4):674-9. View Abstract
  68. Linking simulation-based educational assessments and patient-related outcomes: a systematic review and meta-analysis. Acad Med. 2015 Feb; 90(2):246-56. View Abstract
  69. Differences in duty hours and their relationship with academic parameters between preliminary and categorical general surgery residents. J Surg Educ. 2015 Jul-Aug; 72(4):636-40. View Abstract
  70. Debriefing for technology-enhanced simulation: a systematic review and meta-analysis. Med Educ. 2014 Jul; 48(7):657-66. View Abstract
  71. Relationship between body mass index and the incidence of inguinal hernia repairs: a population-based study in Olmsted County, MN. Hernia. 2014 Apr; 18(2):283-8. View Abstract
  72. Reconsidering fidelity in simulation-based training. Acad Med. 2014 Mar; 89(3):387-92. View Abstract
  73. Outcomes of chemical component paralysis using botulinum toxin for incisional hernia repairs. World J Surg. 2013 Dec; 37(12):2830-7. View Abstract
  74. Mastery learning for health professionals using technology-enhanced simulation: a systematic review and meta-analysis. Acad Med. 2013 Aug; 88(8):1178-86. View Abstract
  75. Patient outcomes in simulation-based medical education: a systematic review. J Gen Intern Med. 2013 Aug; 28(8):1078-89. View Abstract
  76. Technology-enhanced simulation to assess health professionals: a systematic review of validity evidence, research methods, and reporting quality. Acad Med. 2013 Jun; 88(6):872-83. View Abstract
  77. Feedback for simulation-based procedural skills training: a meta-analysis and critical narrative synthesis. Adv Health Sci Educ Theory Pract. 2014 May; 19(2):251-72. View Abstract
  78. What counts as validity evidence? Examples and prevalence in a systematic review of simulation-based assessment. Adv Health Sci Educ Theory Pract. 2014 May; 19(2):233-50. View Abstract
  79. Predictors of chronic groin discomfort after laparoscopic totally extraperitoneal inguinal hernia repair. J Am Coll Surg. 2013 Jul; 217(1):72-8; discussion 78-80. View Abstract
  80. State of the evidence on simulation-based training for laparoscopic surgery: a systematic review. Ann Surg. 2013 Apr; 257(4):586-93. View Abstract
  81. Incidence of inguinal hernia repairs in Olmsted County, MN: a population-based study. Ann Surg. 2013 Mar; 257(3):520-6. View Abstract
  82. Impact of resident participation on laparoscopic inguinal hernia repairs: are residents slowing us down? J Surg Educ. 2012 Nov-Dec; 69(6):746-52. View Abstract
  83. Comparative effectiveness of technology-enhanced simulation versus other instructional methods: a systematic review and meta-analysis. Simul Healthc. 2012 Oct; 7(5):308-20. View Abstract
  84. Comparative effectiveness of instructional design features in simulation-based education: systematic review and meta-analysis. Med Teach. 2013; 35(1):e867-98. View Abstract
  85. Cost: the missing outcome in simulation-based medical education research: a systematic review. Surgery. 2013 Feb; 153(2):160-76. View Abstract
  86. Trends in emergent inguinal hernia surgery in Olmsted County, MN: a population-based study. Hernia. 2012 Aug; 16(4):397-403. View Abstract
  87. Lessons learned from an unusual case of inflammatory breast cancer. J Surg Educ. 2012 May-Jun; 69(3):350-4. View Abstract
  88. Left subdiaphragmatic paraganglioma supplied by contralateral right renal artery. Int J Surg Case Rep. 2012; 3(7):333-7. View Abstract
  89. Trends in the utilization of inguinal hernia repair techniques: a population-based study. Am J Surg. 2012 Mar; 203(3):313-7; discussion 317. View Abstract
  90. Does simulation training improve outcomes in laparoscopic procedures? Adv Surg. 2012; 46:61-71. View Abstract
  91. Obturator hernia: the Mayo Clinic experience. Hernia. 2012 Jun; 16(3):315-9. View Abstract
  92. Fifty-three-year experience with pediatric umbilical hernia repairs. J Pediatr Surg. 2011 Nov; 46(11):2151-6. View Abstract
  93. Mastery learning simulation-based curriculum for laparoscopic TEP inguinal hernia repair. J Surg Educ. 2012 Mar-Apr; 69(2):208-14. View Abstract
  94. Technology-enhanced simulation for health professions education: a systematic review and meta-analysis. JAMA. 2011 Sep 07; 306(9):978-88. View Abstract
  95. Simulation-based mastery learning improves patient outcomes in laparoscopic inguinal hernia repair: a randomized controlled trial. Ann Surg. 2011 Sep; 254(3):502-9; discussion 509-11. View Abstract
  96. Handing over patient care: is it just the old broken telephone game? J Surg Educ. 2011 Nov-Dec; 68(6):465-71. View Abstract
  97. Cost-effectiveness of contralateral prophylactic mastectomy versus routine surveillance in patients with unilateral breast cancer. J Clin Oncol. 2011 Aug 01; 29(22):2993-3000. View Abstract
  98. Long-term outcomes of laparoscopic totally extraperitoneal inguinal hernia repairs performed by supervised surgical trainees. Am J Surg. 2011 Mar; 201(3):379-83; discussion 383-4. View Abstract
  99. Contralateral metachronous inguinal hernias in adults: role for prophylaxis during the TEP repair. Hernia. 2011 Aug; 15(4):403-8. View Abstract
  100. Teaching first or teaching last: does the timing matter in simulation-based surgical scenarios? J Surg Educ. 2010 Nov-Dec; 67(6):432-8. View Abstract
  101. Impact of childhood inguinal hernia repair in adulthood: 50 years of follow-up. J Am Coll Surg. 2010 Dec; 211(6):762-8. View Abstract
  102. Predicting four or more metastatic axillary lymph nodes in patients with sentinel node-positive breast cancer: assessment of existent risk scores. Ann Surg Oncol. 2010 Nov; 17(11):2884-91. View Abstract

Contact Benjamin Zendejas-Mummert

Phone: 617-355-3038
Fax: 617-730-4690
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