Five Questions With: Dr. Emily Ortega Goddard

Dr. Emily Ortega Goddard has joined Brown Surgical Associates in the practice’s Divisions of Bariatric Surgery and General Surgery. Goddard will step into her new role while also serving as a surgeon at the Providence VA Medical Center. Among Goddard’s particular interests are surgical endoscopy, robotic surgery, complex abdominal wall reconstruction and hernia surgery, as well as foregut and bariatric surgery.

Goddard received her medical degree in 2017 from the Drexel College of Medicine and completed her general surgery residency at WellSpan York Hospital before going through fellowship training in minimally invasive and bariatric surgery this year at Brown University’s Warren Alpert Medical School.

PBN: What are some trends you’ve noticed developing for minimally invasive procedures? 

GODDARD: I think all of the branches of minimally invasive surgery are at the forefront of innovation, which is why I love the field. The branch that I am most excited about, and the one that’s really changing the game for patients, is endoscopic surgery. With advances in endoscopy, we are now able to manage a variety of complex diseases without making a single incision.

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The newest trend in endoscopy is in our ability to manage acute surgical problems using the endoscope, and again, potentially avoiding major surgery and morbidity to patients. For example, a hole in the esophagus used to require surgery to repair, but now we can repair the esophagus from the inside out, without incisions, using the endoscope.

PBN: What drew you to specialize in bariatric surgery and how have you noticed the field evolve?

GODDARD: Bariatric surgery is transformative, and I wanted to be a part of that. With these surgeries, we are able to not only alter the anatomy of the intestines but also alter the hormonal regulation of the body’s metabolism, bypassing the genetics people have been fighting all their lives.

Meeting people who have undergone this transformation, going from years of diet struggles and years of increasing medication needs, to then seeing the weight fly off and the medication requirement go to zero is truly just astonishing.

From a surgical-technical perspective, it takes a high level of skill to perform these procedures minimally invasively, so that was appealing to me as well.

We are learning more and more about the genetics that play a role in obesity, which provides more opportunities for innovation. This means both the medical and surgical options for patients are growing but at the same time, the classic surgeries have proven powerful and able to provide great results for patients. It’s an exciting time.

PBN: What are some of the challenges associated with providing robotic procedures? How do you manage them?

GODDARD: Oh, Mr. Robot. The challenge with robotic surgery is similar to anything new and novel; it’s the acceptance and adoption of the platform on a grand scale. The robot is still not everywhere. Insurance companies are behind the times and reimbursements for hospital systems can be tricky. While the robot is a groundbreaking creation and immensely beneficial for patients and surgeons, the system has to adapt to it being here to stay.

PBN: In what ways do you hope to advance the development of minimally invasive procedures in your new role with Brown Surgical Associates?

GODDARD: I hope to continue the groundbreaking endoscopic treatment options the group provides, and my colleagues were the first in Rhode Island to perform, such as per oral endoscopic myotomy and per oral pyloromyotomy.

I also am beginning to work on the research and development of new endoscopic instruments to make endoscopic surgery even safer and more precise.

PBN: How has the demand for bariatric surgery changed since the COVID-19 pandemic? 

GODDARD: Great question. I actually did a project on how the COVID-19 stay-at-home orders affected bariatric surgery patients post-operatively, so I have a special interest in this topic.

During the pandemic, our lives were all thrown off track. We had decreased social interaction, decreased movement and increased stress, all of which led to less weight loss after surgery than we typically see. Of course, we did not perform as many bariatric procedures during the pandemic either.

So now that the pandemic is more or less over, we are seeing a large number of people seek out medical and surgical weight-loss options. With bariatric surgery specifically, we are seeing new patients, but we are also seeing those who had bariatric surgery previously and were not as successful as they had hoped due to the stressors brought on by the pandemic.

Overall, the demand is a bit higher now than previously. I only see it continuing to increase, even with the addition of novel medications on the market.

Katie Castellani is a PBN staff writer. You may contact her at Castellani@PBN.com