Message from the President – Winter 2014

Gerald Fried, MD SAGES President 2013-2014

It is now about half-way through my year as President. It has been a busy time, reflecting the energy of SAGES and the commitment of its members to work on behalf of our favourite specialty society. We held a retreat and the mid-year Board meeting in Montreal on October 25-26. The retreat addressed several issues of critical importance to the future of SAGES. Let me use this forum to communicate a summary of our discussions.

Surgical Recovery

SAGES efforts in minimally invasive surgery and flexible endoscopy are to improve and accelerate surgical recovery. Most of the literature supporting the use of MIS and endoscopic procedures emphasizes the benefits to our patients. We are a patient-centered organization, but we have not yet maximized the opportunities to measure and improve the complex metric called ‘recovery’. During the retreat we delved into surgical recovery to discuss how we might measure recovery, how we could influence it, what the opportunities for research and education are in this area, and how SAGES could take a leadership role in this field, especially with respect to patients undergoing GI surgery. We have established a task force to study and improve surgical recovery, led by Dr. Liane Feldman, and have adopted the acronym SMART for this program. The SAGES SMART task force (Surgical Multimodal Accelerated Recovery Trajectory) will address the current knowledge about enhanced recovery programs, areas for research, and develop a course for the upcoming SAGES meeting to teach the principles of accelerated recovery, including how to overcome barriers to change within one’s institution. We also will develop a web resource and a mentorship program for people interested in adopting these strategies in their institutions. Look for an upcoming editorial in Surgical Endoscopy on this topic.


Membership is the lifeblood of the organization. For SAGES to be successful and influential, we need to meet the needs and create value for our membership. One of the retreat groups reviewed membership trends over the past 5 years in each of our membership categories, looked at conversion from candidate to active membership, and tried to understand why some decided to drop their membership. They were charged with developing strategies to reach out to surgeons in private practice and international surgeons to communicate the value of SAGES membership with the goal of ensuring continued growth of SAGES in the future. Dr. Aurora Pryor will lead this effort.

Patient Safety

Continuing with the theme of putting the patient first, another group discussed how SAGES may work to further improve patient safety. This will be a major theme for our next President, Dr. Michael Brunt. This work group reviewed our current offerings, such as the FUSE program, and considered potential future products. The next programs will be directed by data and will use innovative educational methods to communicate these concepts to our members. It is likely that the next SAGES patient safety program will be in the area of biliary surgery, where there is great opportunity for us to make an impact.

Open to MIS

Open to MIS is an initiative started by my predecessor, Dr. Scott Melvin. The aim of this program is to encourage increased adoption of minimally invasive surgical procedures. During the retreat the working group reviewed data on the prevalence of MIS techniques in the management of gallstones, colorectal disease, bariatrics and hernia. They then discussed strategies to influence change through education, marketing and evidence of cost-effectiveness.

Quality Metrics

One of our challenges in demonstrating evidence of the benefit of what we do as MIS surgeons is developing measures of quality that can be used to provide feedback to the surgeon. Most of our traditional outcome measures, such as morbidity and mortality, length of stay, quality of life measures, and symptom scales, are very insensitive to the changes we need to show, or are impractical to be used repeatedly to chart the outcomes after surgery. A working group discussed the development of measures of outcomes after GI surgery, which are sensitive to the operations we do, patient-centered, and can be used in cost-benefit analyses. A group has been formed under the leadership of Dr. Matt Hutter, bringing together representatives from SAGES, SSAT, ASMBS, ASCRS, IPEG, and the ACS to work on this topic. It will be a challenge, but such measures are the most means to enhance the quality of what we do. SAGES is committed to be at the table and to lead this discussion.

Web Presence

Tied to our efforts to create value for our members, in addition to our outstanding annual meeting, we have taken a fresh look at our communication strategy, including the web resources, mobile (social media) communication strategies and our publications. Despite our treasure trove of content, navigating this content to easily find the resources needed has proven challenging. To address this, we will hire a librarian to catalog and classify all our enduring materials and provide them in the most user-friendly format. This will allow our members to access the material they want at the time and place when it is most useful. Our goal is to ensure that SAGES provides value to our members every day and can be the go-to organization to meet all our members’ needs all through the year.

Annual Meeting

The annual meeting is the highlight of the year for SAGES members and guests. Thanks to the efforts of our annual program chairs, Drs. Tonia Young-Fadok and Jeffrey Marks, and the Chair of the Program Committee, Dr. Daniel Herron, we have put together a program for this year’s meeting that is simply outstanding. Our theme this year is “Putting the Patient First: Promoting Innovation and Safety in the OR and Beyond.” We are delighted to welcome an astronaut physician, Dr. Dave Williams, as the Karl Storz Lecturer, and a fighter pilot, turned medical simulation expert, Dr. Amitai Ziv, as our Gerald Marks Lecturer. We will be joined this year by the Military Surgical Symposium. I invite you to look at the Advance Program and look forward to welcoming you in person in Salt Lake City in April.