Hosted by
SAGES & CAGS

April 14-17, 2010

• Advance Program Home
• General Information about the Meeting
• Registration Information
• Exhibits
• Schedule at a Glance
• Meeting Leaders
• 2010 Hands-on Courses & Panels
• 2010 Postgraduate Courses
• 2010 Scientific Session
• Karl Storz Lecture
• SAGES Presidential Address
• Gerald Marks Lecture
• Lunches
• International Webcast
• Resident and Fellow Scientific Session
• Industry Education Events
• 2010 Learning Center
• Faculty
• Social Programs and Special Events
• Tours - For Accompanying Guests
• Registration and Housing Instructions

SAGES Hands-on Courses & Panels

Hands-on Colon Cadaver Lab **Offsite Lab

Wednesday, April 14, 2010
7:00 AM - 12:00 PM
*Separate Registration Fee

Chair: Mark H. Whiteford, M.D.; Co-Chair: Conor P. Delaney, M.D.

Description:

This half-day practical cadaver lab course is designed for general and colorectal surgeons, fourth year or chief residents and MIS or colorectal fellows. All applicants should be familiar with advanced laparoscopic techniques and wish to expand their skills in laparoscopic colon and rectal surgery. Techniques for straight laparoscopic and single incision colectomies, bowel mobilization, vessel division, and anastomoses will be taught with an emphasis on oncologic principles. The course will emphasize common alternative approaches including lateral-to-medial, medial-to-lateral, and hand-assisted techniques, to facilitate resection of the entire intra-abdominal colon and the rectum. Lab stations will have a 1:3 faculty:participant ratio.

Objectives:

At the conclusion of this session, participants will be able to:

• Discuss multiple approaches to mobilization, resection and anastomosis of the right and left colon
• List techniques, tips and tricks for total mesorectal dissection of the rectum
• Understand the principles in laparoscopic colorectal surgery for both benign and malignant disease

Schedule
6:30 AM	Shuttles Depart Gaylord Hotel
7:00 AM	Introduction	Mark H. Whiteford, M.D. & Conor P. Delaney, M.D.
7:10 AM	Video: Single Incision Laparoscopic Right and Transverse Colectomy	Mark Whiteford, M.D.
7:30 AM	Video:Laparoscopic Left Colectomy and Proctectomy	Conor P. Delaney, M.D.
7:50 AM	Right Colectomy Techniques Transverse Colectomy Techniques Left Colectomy Techniques Rectal Dissection Techniques	Lab Instructors
11:10 AM	Questions/Discussion	All Faculty
11:30 AM	Shuttles Return to Gaylord Hotel

Lab Instructors:

Sonia Ramamoorthy, M.D.
George Chang, M.D.
Jonathan Efron, M.D.
Daniel Geisler, M.D.
John Park, M.D.
Matthew Kalady, M.D.
Laurence Yee, M.D.
Sharon Stein, M.D.
David O’Brien, M.D.
Marty Weiser, M.D.

Hands-on Advanced Suturing and Anastomotic Techniques Lab

Wednesday, April 14, 2010
1:00 PM - 5:00 PM

Chair: Kelvin D. Higa, M.D.; Co-Chair: Aureo L. De Paula, M.D.

Description:

Laparoscopic suturing skills allow smooth transition from basic to advanced surgery. In this lab, world-recognized experts in advanced suturing and anastomotic techniques will provide direct, hands-on training to take your suturing skills to the next level. If you want to take your skills from advanced to expert, this is an opportunity you don’t want to miss.

Objectives:

At the conclusion of this session, participants will be able to:

• Become familiar with advanced suturing techniques: tissue approximation, knot tying, anastomoses.
• Understand the advantages and disadvantages of intracorporal sutures.
• Adopt the principles for continued efficiency and skill.
• Apply these techniques to common surgical problems encountered

Schedule
1:00 PM	Introduction – Overview of Tools and Suture Material	Kelvin D. Higa, M.D. & Aureo L. De Paula, M.D.
1:15 PM	Principles of Efficient Laparoscopic Suturing	Kelvin D. Higa, M.D.
1:30 PM	How to Tie a Knot	Aureo L. De Paula, M.D.
1:45 PM	Specific Applications: Anastomoses, Internal Hernia Closure, Staple-Line Reinforcement	Aureo L. De Paula, M.D.
2:00 PM	Lab Instructions	Kelvin D. Higa, M.D. & Aureo L. DePaula, M.D.
2:05 PM	Hands-On Lab	Faculty

Suggested Faculty:

Nilton Kawahara
J. Ribamar
Dan Swartz
Tony Vine
C. Palenivelu
Pradeep Chowbey
Paresh Shah
Marina Kurian
Surendra Ugale
Ed Felix
Adam Meneghetti
Dan Birch
Elias Chousleb

Pediatrics Session: Next-Generation Pediatric MAS – A Move Toward “Scarless” Surgery

Wednesday, April 14, 2010
1:00 PM - 5:00 PM

Chairs: Sanjeev Dutta, M.D. and Jacob Langer, M.D.

Description:

Pediatric minimal access surgery (MAS) has grown to encompass virtually every pediatric surgical condition, including even complex neonatal anomalies. This has enabled faster recovery and less pain, with smaller scars. The next wave of innovation in pediatric MAS involves further minimizing incisions, transferring them to inconspicuous sites, or avoiding them altogether. Termed “stealth surgery” in the pediatric surgical community, the intent is to perform complex procedures without leaving evidence they occurred, and thereby address the psychological consequences that surgical scars can have on children.

Objectives:

At the conclusion of this session, participants will have a better understanding of current cutting edge minimal access procedures in pediatric surgery. They will be able to:

• Describe the current experience, instruments, and operative techniques relevant to performing transaxillary subcutaneous endoscopic surgery including benign lesions of the neck and chest, as well as thyroid and parathyroid lesions.
• Describe the current experience, instruments, and operative techniques relevant to pediatric single incision laparoscopic surgery including appendectomy, cholecystectomy, splenectomy, and neonatal procedures.
• Describe current experience, instruments, and operative techniques relevant to endolumenal therapies in children including antireflux procedures and gastroduodenal lesions.
• Describe future potential MAS therapies in children such as natural orifice translumenal endoscopic surgery (NOTES).

Schedule
1:00 PM	Introduction	Sanjeev Dutta, M.D.
1:05 PM	Transaxillary Subcutaneous Endoscopic Surgery	Moderator: Sanjeev Dutta, M.D.
	Transaxillary excision of Benign Neck and Truncal Lesions	Sanjeev Dutta, M.D.
1:20 PM	Transaxillary Excision of the Thyroid and Parathyroids	Thom Lobe, M.D.
1:35 PM	Discussion
1:45 PM	Single Incision Laparoscopic Surgery	Moderator: Jacob Langer, M.D.
	Transumbilical Non-Laparoscopic Surgery in the Neonate	Jacob Langer, M.D.
2:00 PM	Overview of SILS Tool Box and Technique	Jeff Ponsky, M.D.
2:15 PM	SILS Splenectomy and Cholecystectomy	Sanjeev Dutta, M.D.
2:30 PM	Neonatal SILS	Carroll “Mac” Harmon, M.D.
2:45 PM	Discussion
2:55 PM	10 min BREAK
3:05 PM	Endolumenal Surgery and NOTES	Moderator: Timothy Kane, M.D.
3:10 PM	Endolumenal to Translumenal: The Prospect of NOTES in Children	Lee Swanstrom, M.D.
3:25 PM	Endolumenal Therapy for GERD in Children – Early Experience with Transoral Incisionless Fundoplication	Michael Thomson, M.D.
3:40 PM	Endolumenal Therapy for Pancreatic and Gastroduodenal Lesions	Timothy Kane, M.D.
3:55 PM	Discussion
	Video Session	Moderators: Panel
4:05 PM	Video – Thyroid	Matias Bruzoni, M.D.
4:15 PM	Video – Gall bladder SILS	Katherine Barsness, M.D.
4:25 PM	Video – Spleen-SILS	Zachary Kastenberg, M.D.
4:35 PM	Video – Endoscopic-assisted Esophagectomy	Jose Prince, M.D.
4:45 PM	Video – SILS Pyloromyotomy	Erik Hansen, M.D.
4:55 PM	Closing Remarks	Jacob Langer, M.D.

Avoid Pitfalls in Cholecystectomy and CBD Exploration

Thursday, April 15, 2010
7:30 AM - 11:30 AM
*included in Registration SuperPass (Option A) or Registration Option B

Chair: Michael B. Edye, M.D.; Co-Chair: Bertrand Millat, M.D.

Description:

The essence of surgery is to be aware of potential pitfalls in advance and to take steps that are known to avoid them. This session will build on a sound anatomic foundation for laparoscopic cholecystectomy and common duct exploration. Practical recommendations for safe techniques that work in straightforward and complicated settings, and a final syntehsis will provide a basis for best practice.

Objectives:

At the conclusion of this session, participants will be able to:

• Describe common anatomic anomalies of the biliary tree that can complicate laparoscopic cholecystectomy and strategies to avoid these complications
• Recognize how new surgical approaches to cholecystectomy can increase the risk of bile duct injury and devise methods to prevent these injuries in their subsequent practice
• Approach complicated presentations of cholecystitis with great confidence
• Review their current approach to common duct stones and recognize the benefits and difficulties of surgical versus endoscopic bile duct clearance

Schedule
7:30 AM	Introduction	Michael B. Edye, M.D. & Bertrand Millat, M.D.
7:35 AM	Anatomic Pitfalls of Cholecystectomy and CBD Exploration	Brice Gayet, M.D.
7:50 AM	Lessons from a High Volume Laparoscopic Biliary Surgeon	Surendra Ugale, M.D.
8:05 AM	Rationale for Cholangiography	William Traverso, M.D.
8:20 AM	Operative Bile Duct Clearance vs. Preoperative ERCP: Other Combined Approaches to Duct Clearance	Augusto Tinoco, M.D.
8:40 AM	Pitfalls of T-Tubes and Other Biliary Drains, and the Place of Primary Duct Closure	Ian Martin, M.D.
9:00 AM	Discussion
9:20 AM	Break
9:40 AM	Cholecystectomy in Chirrhotics: If, When and How?	Luis Burbano, M.D.
9:50 AM	Acute Cholecystitis: Tricks to Success, When to Convert and When to Start Open	Bertrand Millat, M.D.
10:05 AM	Single Port Cholecystectomy: Umbilical Anatomic Techniques and Devices	Paul G. Curcillo, M.D.
10:20 AM	“SKIN” Cholecystectomy (Skinny Instrument i.e. 2-3 mm): The Forgotten Alternatives to NOTES	Michael B. Edye, M.D.
10:35 AM	Synthesis of Recommendations	Michael B. Edye, M.D. & Bertrand Millat, M.D.
10:50 AM	Discussion

Fundamentals of Laparoscopic Surgery Hands-on Course

Thursday, April 15, 2010
7:30 AM - 12:00 PM
*Separate Registration Fee

Chair: Gerald M. Fried, M.D.; Co-Chair: E. Matthew Ritter, M.D.

Description:

The course will be based on the Fundamentals of Laparoscopic Surgery (FLS) Program, a collaborative effort between Society of American Gastrointestinal and Endoscopic Surgeons and the American College of Surgeons. This introductory course will begin with an overview of the history, science, and development of the FLS Program. It will continue with various chapters from the FLS curriculum, such as physiology, intraoperative considerations, basic laparoscopic procedures, and procedural complications. Part of the course will also cover the psychomotor and technical skills required in basic laparoscopic surgery. The course syllabus will outline the contents of the FLS online didactic curriculum.

All course participants will receive online access to the FLS didactic curriculum and will be expected to review the materials prior to the course. The hands-on component will utilize a ratio of 3:1 participants to FLS trainer boxes and faculty for mentored skills practice.

After completing the course, participants will be able to schedule an appointment to take the FLS exam (written and practical). The test fee is included in the course registration, although the test is optional. There will be testing appointments available starting directly after the course and throughout the SAGES meeting. Participants may also opt to take the FLS exam at an upcoming ACS Clinical Congress or SAGES Annual Meeting or one of over 40 FLS Test Centers.

Objectives:

At the conclusion of this session participants will be able to:

• Discuss the important preoperative considerations when faced with a patient requiring laparoscopic surgery.
• List the key intraoperative considerations during laparoscopic operations.
• Discuss the important concepts in postoperative care of patients undergoing laparoscopic surgery.

Schedule
7:30 AM	Introduction and Rationale for FLS	Lee L. Swanstrom, M.D.
7:45 AM	Preoperative Considerations	Ashley Vernon, M.D.
8:05 AM	Intraoperative Considerations	E. Matthew Ritter, M.D.
8:25 AM	Basic Laparoscopic Procedures	Shawn T. Tsuda, M.D.
8:45 AM	Postoperative Considerations	Melina C. Vassiliou, M.D.
9:05 AM	Technical Skills: Development of FLS Curriculum, Validation of Metrics, and Relationship to Operative Performance	Gerald M. Fried, M.D.
9:30 AM	Implementing FLS: The Experience in the U.S. Department of Defense	E. Matthew Ritter, M.D.
9:50 AM	Implementing FLS: The Experience of the Royal Australasian College of Surgeons	Gerald M. Fried, M.D.
10:10 AM	FLS: FAQs – Who, When, Where, and How?	Nathaniel J. Soper, M.D.
10:25 AM	BREAK
10:40 AM	Hands-On Workshop	Lee L. Swanstrom, M.D. Ashley Vernon, M.D. E. Matthew Ritter, M.D. Shawn T. Tsuda, M.D. Daniel J. Scott, M.D. Gerald M. Fried, M.D. Nathaniel J. Soper, M.D. Melina C. Vassiliou, M.D. Allan E. Okrainec, M.D.

Single Port Access Surgery Hands-On Course **Offsite lab

Thursday, April 15, 2010
1:30 PM - 5:00 PM
*Separate Registration Fee

Chair: Paul G. Curcillo II, M.D.; Co-Chair: Daniel J. Scott, M.D.

Description:

This session is designed to familiarize the participants with the developing field of Single Port Access surgery. Exposure to the tools, devices and techniques available will form the foundation for participants to begin to assimilate this technique into their practice.

This course will consist of a hands-on lab in which participants will receive instruction by experts in various single port access laparoscopic techniques and procedures. Techniques for low-profile port layout and insertion, as well as the use of multi-port devices will be demonstrated with practice afforded. Participants will be supervised by experts and perform single port access laparoscopic cholecystectomy, fundoplication, adjustable gastric band placement, splenectomy and nephrectomy. Participants will have the opportunity to use a variety of specialized instrumentation, including novel imaging technologies, retraction devices, suturing instruments, and articulating devices. Lab stations will have a 1:3 faculty to participant ratio

Objectives:

At the conclusion of this session, participants will be able to:

• Reproduce the various access techniques and identify the benefits and drawbacks of the multi-trocared vs. the multi-port devices
• Identify and use the various instruments and tools that may facilitate single port access operations
• Describe the operative strategies for performing single port access laparoscopic procedures (including – cholecstectomy, fundoplication, adjustable gastric band placement, splenectomy and nephrectomy)
• Identify and be aware of the current data addressing the impact in terms of risks and benefits this new field is having on patients
  
  

Schedule
1:30 PM	Introduction	Paul G. Curcillo II, M.D. & Daniel J. Scott, M.D.
1:35 PM	Single Port Access Surgery: Techniques and Approaches
1:35 PM	OPUS – One Port Umbilical Access	Prashanth Rao, M.D.
1:45 PM	SILS – Single Incision Laparoscopic Approach	Homero Rivas, M.D.
1:55 PM	SPA – Single Port Access Approach	Paul G. Curcillo II, M.D.
2:05 PM	Flexible Endoscopic Approach	Julio Teixiera, M.D.
2:15 PM	Bariatric Consierations	Daniel J. Scott, M.D.
2:25 PM	Access Device Considerations	Abhay Rane, M.D.
2:35 PM	Hands On Lab
	Laparoscopic Cholecystectomy Laparoscopic GE Jxn (Nissen / Banding) Laparoscopic Splenectomy / Nephrectomy

Faculty:

Marc Bessler, M.D.
Andrew Gumbs, M.D.
Eric Hungness, M.D.
Shuji Kitashiro, M.D.
Julio Teixiera, M.D.
Prashanth Rao, M.D.
Pascal Bucher, M.D.
Homero Rivas, M.D.
Casey Graybeal, M.D.
Abhay Rane, M.D.

3 Hour MBA for Surgeons Panel: Asset Management and Protection for Surgeons

Thursday, April 15, 2010
1:30 PM - 5:00 PM

Chair: Demetrius E. M. Litwin, M.D.; Co-Chair: Fredrick J. Brody, M.D.

Description:

The rapidly changing economics of practicing medicine will affect all of us. This practical session will help understand what changes you can make in your practice and investments to adjust to these turbulent times. The session will be full of practical, real-world advice and potential solutions to difficult financial problems you face on a daily basis.

Objectives:

At the conclusion of this session, participants will be able to:

• Understand money management options during a practice lifetime.
• Recognize and understand the fundamentals of investment principles during a practice lifetime.
• Identify the importance of leadership in organizations.
• Understand the importance of strategic planning exercises for high performance organizations.
  
  

Schedule
1:30PM	Introduction	Demetrius E. M. Litwin, M.D.; Fredrick Brody, M.D.
Wealth Management, Asset Protection
1:35PM	Methods to Maximize Income, Estate and Gift Taxation	David Field, CFA
1:50PM	Investing 101 – The Business School Perspective	Bruce Behn, M.D.
2:05PM	Investing – Practical Tips	Tim Pitney – Sapers & Wallack
2:20PM	Retirement, Insurance and Estate Management	Aviva Sapers – Sapers & Wallack
How Much Do You Really Need and What Do You Do With It?
2:45PM	Discussion Panel & Questions
3:15PM	BREAK
Leadership
3:30PM	Physician Executive MBA – What Can It Do For You?	Mike Stahl, M.D.
3:45PM	The Leadership Moment – The Business School Perspective	Bruce Behn, M.D.
4:00PM	The Leadership Moment – Practical Examples in the World of Surgery	Isadore Lieberman, M.D.
4:15PM	Strategic Planning To Create High Performance Organizations	Alec Glover
4:30PM	Discussion Panel & Questions
5:00PM	Adjourn

SAGES does not offer CME credits for this Panel

Hands On Endolumenal/NOTES Lab

Thursday, April 15, 2010
1:30 PM - 5:00 PM

Chair: Santiago Horgan, M.D.; Co-Chair: Christopher C. Thompson, M.D.

Description:

This will be a multiple station hands-on course that will allow a technical experience in a variety of endolumenal procedures and technology. This will also include an introduction to NOTES® specifically, a transvaginal and transgastric peritoneal access, and transgastric closure. The latest endolumenal tissue fixation devices, energy application devices and intraluminal stents will be included. Participants should have basic endoscopic skills and be willing to try new procedures and use new technology.

Objectives:

At the conclusion of this session, participants will be able to:

• Experience the use of modern endolumenal techniques for energy ablation (argon plasma coagulation, heater probe, BICAP, etc.) and stent placement
• Demonstrate techniques for Endoscopic Mucosal Resection (EMR) and Endoscopic Submucosal Tunneling
• Recognize the principles of endolumenal tissue fixation
• Evaluate and practice transgastric and transvaginal approaches to peritoneal access (Natural Orifice Translumenal Endoscopic Surgery, NOTES)
• Demonstrate techniques for transgastric closure techniques
  
  

Schedule
1:30 PM	Introduction – Video Demonstration of Basic Technique	Santiago Horgan, M.D. & Christopher C. Thompson, M.D.
	Barrett’s Ablation	Steven Edmundowicz, M.D.
	Endoscopic Mucosal Resection (EMR) and Endoscopic Submucosal Tunneling	Christopher J. Gostout, M.D. & Abraham Matthews, M.D.
	Endoscopic Revision for GERD	Jeffrey W. Hazey, M.D.
	Intraluminal Stents: Placements and Removal, Colonic and Esophageal	Jose Martinez, M.D.
	Treatment of Bleeding	Bipan Chand, M.D.
	Endosuturing Techniques for GERD and Redo Bypass	Garth Jacobsen, M.D.
	NOTES Stations:
	Transgastric and Transvaginal Approaches to Peritoneal Access and Transgastric Closure Techniques	Marc Bessler, M.D., Brian J. Dunkin, M.D., Michael Marohn, M.D., Jeffrey Marks, M.D., Patricia Sylla, M.D., Robert H. Hawes, M.D. Yoav Mintz, M.D.

Robotics Symposium: What’s New?

Thursday, April 15, 2010
1:30 PM - 2:30 PM
*included in Registration SuperPass (Option A) or Registration Option B

Chair: Mehran Anvari, M.D.; Co-Chair: Jacques Marescaux, M.D.

Description:

Robotic surgery has the potential to become a significant force in the future of minimally invasive surgery.This session will demonstrate new applications of robotics with particular emphasis on the application to reduced port surgery and image-guided applications.

Objectives:

At the conclusion of this session, participants will be able to:

• Highlight some of the new developments in application of robotics in surgery
• Discuss the use of robotics in augmented reality and image guided surgery
• Provide and overview of robotic development for NOTES® and SPA
  
  

Schedule
1:30 PM	Introduction	Mehran Anvari, M.D. & Jacques Marescaux, M.D.
1:35 PM	Augmented Reality and Image Guided Robotic Surgery	Luc Soler, M.D.
1:45 PM	New Applications of Surgical Robot	Richard Satava, M.D.
1:55 PM	Intracavity Robotics	Sir Alfred Cuschieri, M.D.
2:05 PM	Flexible Robotic Platform for NOTES® or SPA	Bernard Dallemagne, M.D.
2:15 PM	Discussion

Metabolic Surgery Symposium: Current Status

Thursday April 15, 2010
2:30 PM - 4:00 PM

Chair: Philip R. Schauer, M.D.; Co-Chair: Francesco Rubino, M.D.

Description:

The metabolic syndrome is a worldwide problem – can it be solved by surgery? Internationally-renowned experts will discuss the relevant issues in this rapidly developing field.

Objectives:

At the conclusion of this session, participants will be able to:

• Understand how to diagnose the various stages of Barrett’s
• Understand the different minimally invasive treatment options available
• Discuss new technologies and their impact on the management process
  
  

Schedule
2:30 PM	Introduction	Philip R. Schauer, M.D. & Francesco Rubino, M.D.
2:35 PM	Effect of Gastric Banding and Sleeve Gastrectomy on Metabolic Disease	Alfonso Torquati, M.D.
2:50 PM	Effect of Bypass Procedures	Philip R. Schauer, M.D.
3:05 PM	Mechanisms of Remission of Metabolic Disease	David Cummings, M.D.
3:20 PM	The Diabetes Surgery Summit Guidelines for Surgical Treatment of Diabetes	Francesco Rubino, M.D.
3:35 PM	The American Diabetes Association Guidelines for Surgical Treatment of Diabetes	Sue Kirkman, M.D.
2:50 PM	Discussion

Barrett’s Debate: How to Follow, How to Treat?

Thursday, April 15, 2010
4:00 PM - 5:30 PM

Chair: John Hunter, M.D.; Co-Chair: Karl H. Fuchs, M.D.

Description:

Cancer in Barrett’s esophagus continues to be a serious worldwide problem. Can we identify the patients at high risk to impact this disease? This session will provide a critical update on strategies in the diagnosis and management of Barrett’s.

Objectives:

At the conclusion of this session, participants will be able to:

• Understand how to diagnose the various stages of Barrett’s
• Understand the different minimally invasive treatment options available
• Discuss new technologies and their impact on the management process
  
  

Schedule
4:00 PM	Introduction	John Hunter, M.D. & Karl H. Fuchs, M.D.
4:05 PM	The Indications and Strategy for Screening and Surveillance of Barrett’s Esophagus	Jeffrey Peters, M.D.
4:20 PM	Ablation Therapy – Who Should Have It and Who Should Do It?	C. Daniel Smith, M.D.
4:35 PM	Endoscopic Mucosal Resection of Early Esophageal Neoplasia – The Current State of the Art	Haruhiro Inoue, M.D.
4:50 PM	Limited Surgical Resection – or En-Bloc	Karl H. Fuchs, M.D.
5:05 PM	Emerging Technology in the Diagnosis and Management of Barrett’s Esophagus	Blair Jobe, M.D.
5:20 PM	Discussion