SAGES

Society of American Gastrointestinal and Endoscopic Surgeons

The Fundamental Use of Surgical Energy – FUSE

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By Dr. Daniel B. Jones, President-Elect, SAGES

The Fundamental Use of Surgical Energy(TM) initiative was conceived and initiated in 2010 by then SAGES president-elect Steven Schwaitzberg. He recognized that surgeons have a very rudimentary understanding of the physics behind the surgical energy devices they use every day in the operating room. As such, they were, and still are,  placing their patients at risk.  Every year there are approximately 400 OR fires and 40,000 thermal injuries, with many more that were likely go unreported.  We coined the project “FUSE.”

The Task Force, initially led by Daniel Jones, Liane Feldman, and Pascal Fuchshuber, recruited experts in surgical  energy and the associated risks across many disciplines:  anesthesia, gynecology, urology, bariatrics, colorectal surgery, general surgery, hepatobiliary surgery, flexible endoscopy and very importantly – nursing .  The mantra became “energy injuries are team failures.” One of the initial challenges was that there was no textbook to turn to.  So the Task Force authored the “SAGES Manual on the Fundamental Use of Surgical Energy (FUSE)” by Springer, 2013. This paperback has become the “go- to” reference in our field.

Predictably,  many surgeons were skeptical that FUSE was needed in the surgical community.  They cited that the FUSE program was costly and unnecessary.  It was common to hear, “Surgeons operate every day – of course we are experts,” or “We don’t need another burdensome course.”  So the first thing the Task Force did was identify 20 concepts that all surgeons would need to know to be safe in relation  to energy devices.  This mini-exam was administered to the SAGES Board of Governors.  Nearly 70% failed and did not know basic concepts. [i]   It was no longer OK to ignore the learning gap.

SAGES utilized a professional psychometrician to assist us in creating a blue print for the educational program. Through a rigorous process, we identified critical learning points, which then guided the curriculum.  We envisioned two educational products; the first was an on-line curriculum that would be free to all nurses, anesthesiologists and surgeons to learn about the safe use of energy. The second was a high stakes examination.

Today, learners can log on to FUSEdidactic.org and be taught the principles of energy and safe use of related devices. Punching through a series of slides however, while informative, may not lead to an in-depth understanding of the FUSE principles.  Again, using experts in test-writing and validation, we developed an exam that was relevant and distinguished between those who learned the material and others who had not studied.  All test questions were validated by a cohort of 500 surgeons.  FUSE is catching on.  The last issue of SCOPE highlighted that the country of France leased the FUSE didactic, translated it into French, and is now mandating it for surgeons and nurses, and  Germany is considering moving ahead with a similar model.  The United States military is also considering mandating FUSE for all military surgeons.  An increasing number of hospital credentialing boards are discussing requiring surgeons to review specific modules  to retain operating privileges. Similarly, Kaiser Permanente in Southern California is looking to develop an abbreviated FUSE course for their surgeons and nurses.

We have a learning gap;  FUSE can prevent patient harm with a formal educational curriculum that teaches safety.  Hospitals, residency programs, practicing surgeons all know it’s important and should be done.  Three years ago, Past President Michael Brunt called for all SAGES  Board members to become FUSE certified.  Current President Danny Scott emphasized that all Committee Chairs and Co-chairs should also become FUSE certified.  As President-elect, I hope that all 6000 SAGES members will log on and learn about the FUSE Program and consider learning more about the safe use of energy in their operating room.

Selected readings:

All  FUSE articles listed at https://www.fuseprogram.org/about/fuse-elsewhere/

[i] Feldman LS, Fuchshuber P, Jones DB, Mischna J, Schwaitzberg SD; FUSE (Fundamental Use of Surgical Energy™) Task Force. Surgeons don’t know what they don’t know about the safe use of energy in surgery.

Surg Endosc. 2012 Oct;26(10):2735-9.

Click https://www.sages.org/wp-content/uploads/2013/09/SCOPE-2017-winter.pdf to return to SCOPE Winter 2017.

SAGES Fundamentals Testing Information for ACS 2015

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SAGES and ACS will be conducting FLS Testing at the ACS 2015 Clinical Congress. More information is available at:

FLS Testing Information

SAGES will also be conducting FES and FUSE testing during ACS. For more information, please visit:

FES Testing Information

https://www.fuseprogram.org/testing-information/acs-meeting-2015/

See you there!

FES, FLS And FUSE Test Appointments Are Now Available For SAGES 2015!

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Testing will take place in the SAGES Annual Meeting at the Gaylord Opryland Hotel & Convention Center at the following times:

Wednesday, April 15  8am – 5pm
Thursday, April 16 8am – 5pm
Friday, April 17 8am – 12pm

For more information or to purchase your test voucher and schedule your appointment please click on the relevant link below:

FES –  https://www.fesprogram.org/testing-information/sages-annual-meeting-2015-2/
FLS –  https://www.flsprogram.org/testing-information/sages-annual-meeting-2015-2/
FUSE –  https://www.fuseprogram.org/testing-information/sages-annual-meeting-2015/

Read about how the FUSE Program is making surgery safer in the Wall Street Journal

For the first time ever, you can now take the FUSE exam at Surgical Education Week.  The FUSE exam will be given at The Westin Seattle on Saturday, April 25 from 8am – 6pm.  For more information please click here: https://www.fuseprogram.org/testing-information/surgical-education-week/

FUSE Surgical Training Program Aims to Reduce OR Fires and Enhance Safety around Operating Room Use of Energy Devices

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  • FUSE_logoSAGES has launched the Fundamental Use of Surgical Energy™ (FUSE) program, designed to educate surgeons and affiliated staff about the safe use of surgical energy-based devices in the OR, endoscopy suite and other procedural areas.
  • FUSE meets a crucial need in surgical education as previously, no formal training program has existed that promotes safety when using electrosurgical devices.
  • SAGES formed the FUSE Task Force, with participation by experts from the Association of peri-Operative Registered Nurses (AORN), the American Association of Gynecologic Laparoscopists, and the American Urological Association.
  • “Surgical fires occur several hundred times in the United States annually,” said Dr. Daniel B. Jones, chair of the FUSE Task Force. “ and approximately two-thirds of these OR fires involve electrosurgical equipment.”
  • The FUSE training program includes a web-based didactic curriculum that is available free on-line at fundamentals-didactics.com and covers a number of topics including the fundamental principles of electrosurgical devices, practical aspects of commonly used energy devices in various settings, integration of energy systems with other devices, as well as prevention of operating room fires.
  • To register to take the FUSE exam at the ACS Congress, please click here: https://www.fuseprogram.org/testing-information/acs-meeting-2014/. Testing for the FUSE certification exam will also be available at regional FUSE Test Centers, the SAGES Annual Meeting, and specially designated FUSE testing events.
  • img4The FUSE program is directed toward practicing surgeons regardless of specialty, surgical nurses, and other Allied Health personnel who work in the operating room and other procedural areas. Up to 12 CME and Continuing Nursing Education Contact Hours are available for this activity.
  • For more information on the FUSE program, please go to www.fuseprogram.org