James G Bittner1,2,3. 1. Department of Surgery, University of Connecticut School of Medicine, Farmington, CT, USA. james.bittner@stfranciscare.org. 2. Quinnipiac University Frank H. Netter MD School of Medicine, North Haven, CT, USA. james.bittner@stfranciscare.org. 3. Department of Surgery, Saint Francis Hospital, 114 Woodland Street, Hartford, CT, 06105, USA. james.bittner@stfranciscare.org.