SAGES

Reimagining surgical care for a healthier world

Message from the President – Winter 2014

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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

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.

Message from the President – Summer 2013

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Gerald Fried, MD SAGES President 2013-2014It is an incredible honor for me to be SAGES President. This organization is remarkable for its energy and the capacity of its members to work hard to achieve our organizational goals.

SAGES has grown enormously with the laparoscopic revolution, from its roots as a primarily flexible endoscopy society for surgeons. We are currently much more than either an endoscopy society or a laparoscopic surgical society. To some, it is the largest general surgical society in North America after the ACS. To others, it is the largest GI surgical society, or the largest surgical education society, or some combination of all of the above. To me, SAGES is a culture. It is an organization characterized by the energy, collegiality, and imagination of its members. It is unlike any organization to which I belong in allowing and encouraging young surgeons to get involved and to develop their careers. It is a true meritocracy. If you do the work, you rise in the organization.

Our challenge is to maintain the vibrancy and relevance of SAGES to each of you. Whereas the annual meeting remains the cornerstone of the society and the magnet that brings us together, SAGES is extremely active throughout the year through the work of its committees, and the vast array of programs that we offer. I encourage you to visit our website often and take full advantage of the material provided there. There is an enormous amount of added value in your membership, easily found through our website.

There are a number of new initiatives on the way. In his presidential year, Scott Melvin put together a task force called “Open to MIS” dedicated to advancing the transition of surgical care to minimal access approaches, through education of surgeons and marketing the benefits. We will keep this program growing and expand it through generating data to support the benefits of minimal access techniques.

We have several new educational programs that have been recently introduced or are in development. FUSE, championed by Steve Schwaitzberg during his presidential year and chaired by Daniel Jones, is designed to teach surgeons and nurses about the safe use of energy in the surgical environment. This will play a very central role in our efforts in the realm of patient safety, a theme that will be central to the presidency of my successor, Michael Brunt. The Hernia Task Force, under Adrian Park’s leadership is developing our first educational product that is procedure-centered rather than a more general fundamental program. This program will be truly innovative in its delivery and will keep SAGES at the peak of educational organizations, while meeting the current needs of surgeons in practice to advance their knowledge and skills. We will keep you apprised on its development in future issues of SCOPE.

The area that I have chosen to focus on is advancing the quality of surgical care through a better understanding of patient-centered outcomes and what “recovery” means to our patients. Our goal must be to combine excellent operative care with evidence-based perioperative processes, to leverage what we do in the OR to its maximal benefit. In so doing, we can generate the evidence that will move the needle from open to MIS and serve our patients best. I have established a task force that will collate the current data related to GI and abdominal surgery, educate our members in the implementation of enhanced recovery processes in their institution. The task force will also establish a research agenda to better define recovery metrics and the areas where we need to target interventions that will accelerate and enhance the recovery process for our surgical patients.

We will make a strong push to increase our membership this year. Membership is the fuel of any professional organization. This effort will be built around conveying the values that drive SAGES, the opportunities for career development, the interpersonal opportunities to network and expand the community of each of our members, and the excellent value that SAGES membership provides. We will bring this effort to residents and fellows and will extend our reach internationally. I would encourage each of you to bring two new members to SAGES this year. I know that they will thank you for years to come.

Finally, SAGES is your organization. It is essential that the SAGES leadership keep in touch with our members and respond to their needs. Please communicate your ideas to us and get involved!