Program Outline

6:00 AM – 6:00 PM

Speaker Ready Room

8:00 AM – 2:00 PM

SAGES Military Surgical Symposium Part 1: Evolving Military Surgery – Insights from Ukraine, Addressing Global Challenges, and Shaping the Future

Session Chair: Andrew Schlussel, DO | Session Co-Chairs: Tamara Worlton, MD & Andrew Eppstein, MD, FACS
Military, Acute Care

Step into the forefront of military healthcare at the 2024 SAGES Military Surgical Symposium, where cutting-edge research and quality improvement programs will be presented, aimed at elevating the well-being of our military service members and Veterans. The session will further provide expert knowledge on lessons learned from the war in Ukraine to better prepare for future conflicts. Discover the latest advances in space medicine and explore how innovations in this field can be applied to enhance military medical capabilities. Don`t miss this unique opportunity to gain invaluable insights into both terrestrial and extraterrestrial medical challenges facing military professionals.

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

• Foster the education of Military surgeons through surgical research and its application to worldwide care.
• Prepare for future military conflicts through lessons learned from Ukraine.
• Uncover the latest advancements in space medicine and their potential to revolutionize military medical capabilities.

8:00 AM Introduction:
8:10 AM Research Presentations
9:30 AM Break
9:45 AM Research Presentations
11:15 AM ACS Excelsior Surgery Society – Update from the ACS Governor
11:30 AM Awards
12:00 PM Lunch
1:00 PM Combat Surgical Readiness: Translating Lessons from Ukraine to U.S.
1:30 PM Panel Discussion
2:00 PM Break

8:00 AM – 9:30 AM

Scientific Sessions:

Accepted Oral & Video Presentations

SS01: Bariatric Session 1
SS02: Foregut Session 1
SS03: Hernia Session: Prehabilitation
SS04: Colorectal Session 1
SS05: Benign Biliary Video Session

9:30 AM – 10:00 AM

Morning Break

10:00 AM – 12:00 PM

Devil is in the Details: Revisional Bariatric Surgery (Masters)

Session Chair: Matthew Kroh, MD | Session Co-Chairs: Pearl Ma, MD, FACS & Farah Husain, MD
Bariatric, Endoscopy, DEI, Immunofluorescence, Masters

This master`s level course offers an in-depth exploration into the intricacies of revisional bariatric surgery. Participants will engage with advanced surgical techniques, delve into case-based discussions, and gain insights from leading experts in the field. This course aims to equip surgeons with the knowledge and skills needed to address complex bariatric cases and improve patient outcomes with focus on practical applications and video.

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

• Educate about historical and emerging metabolic and bariatric procedures, including technical construct and indications.
• Discuss revision and conversion options for metabolic and bariatric surgery for weight recurrence, excessive weight loss, GERD, and correction of surgical complications.
• Analyze and discuss complex bariatric case scenarios to enhance technical approaches and optimize patient outcomes post-revisional surgery.

10:00 AM Introduction
10:01 AM Distalization of RYGB
10:16 AM RYGB to DS/SADI for Weight Regain or for Dumping
10:31 AM SG to SADI-S and OAGB
10:46 AM ESG Conversions
11:01 AM SADI and DS Bowel Lengthening for Malnutrition
11:16 AM Reversal Techniques and Indications
11:31 AM Mystery Previous Bariatric Surgery- How to Approach from Work-up to Intra-operative Tips
11:46 AM Q&A
11:59 AM Closing Remarks

10:00 AM – 12:00 PM

Great Debates: The Future of Foregut Surgery

Session Chair: Jon Gould, MD, MBA | Session Co-Chairs: Brant Oelschlager, MD & Andrew Wright, MD
Quality, Business of Surgery, Foregut, Sustainability, Endoscopy, Appropriate Prescribing

Foregut Surgery is an evolving field ripe for technological innovation. Despite the prevalence of foregut diseases such as GERD, advances in the diagnosis and treatment of these conditions have been slow. In this session we will review up and coming devices and evolving treatments for GERD, paraesophageal hernias, and achalasia as we contemplate how the field will evolve in the next few decades. This session is for anyone with an interest in foregut or technology and innovation.

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

• Describe new and evolving devices for the surgical and endoscopic treatment of GERD.
• Prepare for how the practice of foregut surgery may evolve in the future.

10:00 AM The Future of Medical Therapy for GERD
10:10 AM The Future of Diagnostic Technologies in Foregut Diseases
10:20 AM Endoluminal GERD Treatment in 2030 – Will It Be More Common and What Will It Look Like?
10:30 AM New Surgical Devices for GERD – Stimulators, Implants, and What`s Next
10:40 AM Who Will Treat GERD in 2040? Specialists, Generalists, GI, Surgery, Primary Care, or Even the Patients Themselves?
10:50 AM Why Do Hiatal Hernia Repairs Fail and What Can Be Done About It?
11:00 AM The Future of POEM and How Will We Deal with the GERD Issue?
11:10 AM Will Obesity Impact How We Treat GERD in the Future?
11:20 AM Discussion

10:00 AM – 12:00 PM

How I Do It: Uncommon Scenarios in Abdominal Wall Surgery

Session Chair: David Krpata, MD | Session Co-Chairs: Dana Telem, MD & Jorge Daes, MD
Hernia, Pediatric, Acute Care, Medical Errors, Pain Management

This session will explore unique and challenging scenarios in abdominal wall surgery. The focus will be on peri-operative considerations, intra-operative tips and tricks, and post-operative management.

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

• Recognize indications for repair of unique abdominal wall defects.
• Assess post hernia repair challenges that present an uncommon scenario in abdominal wall surgery.
• Evaluate how to manage difficult defects including when to perform surgery and when to recommend a higher level of expertise.

10:00 AM Robotic Redo Abdominal Wall Reconstruction
10:15 AM Management of an Interstitial Hernia from Posterior Rectus Sheath Breakdown
10:30 AM The Perineal Hernia Pit of Despair
10:45 AM Hernia Repair After Kidney Transplant
11:00 AM Recurrence After Posterior Inguinal Hernia Repair: Guidelines and the Role of Laparoscopic or Robotic Re-Do
11:15 AM Triple Neurectomy: Indications, Techniques, and Consequences
11:30 AM Complex Pediatric Abdominal Wall Defects
11:45 AM Q&A

10:00 AM – 12:00 PM

How I Do it: Advanced Techniques in Minimally Invasive Left Colectomy (Masters)

Session Chair: Mark Whiteford, MD | Session Co-Chairs: Melissa Chang, MD & Alex Ky, MD
Colorectal, Immunofluorescence

This intensive masters-level course delves into the cutting-edge realm of minimally invasive left colectomy techniques, encompassing both laparoscopic and robotic approaches. Designed for experienced surgeons seeking to refine their skills and stay at the forefront of surgical innovation, this course covers a comprehensive array of topics ranging from fundamental principles to advanced applications in commonly encountered clinical settings. Join us in this transformative course to elevate your skills in minimally invasive left colectomy and revolutionize patient care through innovative surgical approaches.

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

• Gain in-depth knowledge of both laparoscopic and robotic techniques for left colectomy, enhancing precision and minimizing patient trauma during surgical interventions.
• Apply these techniques effectively in complex clinical scenarios such as colon cancer and diverticulitis, ensuring optimal patient outcomes.
• Understand the intricacies of specimen extraction through natural orifices, minimizing incisions and postoperative pain.
• Understand the techniques and nuances of mobilizing the splenic flexure, crucial for achieving a complete left colectomy and minimizing postoperative complications.
• Acquire proficiency in the SILS approach, utilizing a single incision for laparoscopic left colectomy and reducing visible scarring.

10:00 AM Introduction
10:02 AM Sticking it to Cancer: Single Incision and Lap Colectomy for Cancer
10:12 AM Robo-gut: Robotic Colectomy for Cancer
10:22 AM Sticking it to the Tics: Laparoscopic Approach to Diverticulitis Surgery
10:32 AM RoboTICS: Robotic Approach to Diverticulitis Surgery
10:42 AM Panel Discussion
10:56 AM Laparoscopic Splenic Flexure Mobilization: The Inside Scoop and More
11:06 AM Taking the Corner with the Robot: Robotic Approaches to Splenic Flexure Mobilization
11:16 AM Bottoms Up! Transanal TME
11:26 AM Butts and Guts: Natural Orifice Specimen Extraction (NOSE) in Colorectal Surgery
11:36 AM Call 911: Robotic Colorectal Surgery in the Urgent and Emergent Setting
11:46 AM Panel Discussion

10:00 AM – 11:00 AM

Fellowship Council Session: Advanced Visualization Technologies to Enhance Performance

Session Chair: Brent Matthews, MD | Session Co-Chair: Anne Lidor, MD, MPH
Education, Immunofluorescence, DEI

The Fellowship Council is an association of specialty societies and program directors responsible for the development and accreditation of nonACGME fellowship training programs in gastrointestinal surgery and endoscopy. The Fellowship Council is committed to an improved experience for our stakeholders when accessing critical information or platforms on our web site for accreditation such as assessment (EPA app/analytics, case log system) or education tools (curriculum redesign). During the Fellowship Council Session, we will display and review several of the advanced visualization technologies offered by the Fellowship Council to enhance performance when accessing the virtual platform.

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

• Demonstrate how to optimize the EPA app and analytics for fellow assessment.
• Illustrate how the redesigned Fellowship Council Curriculum can be incorporated into fellow training.

10:00 AM Introduction:
10:05 AM The Fellowship Council Website
10:15 AM Optimizing the EPA App and Analytics to Assess the Fellow
10:25 AM Fellowship Council Case Log System
10:35 AM Fellowship Council Curriculum Redesign
10:45 AM Q&A

11:00 AM – 12:00 PM

HPB Intraoperative Guidance Using Advanced Imaging Modalities

Session Chair: Rohan Jeyarajah, MD, FACS | Session Co-Chair: Erin Baker, MD
Endoscopy, Acute Care, Immunofluorescence, Oncology

In this session, we describe the latest advances in advanced image guidance for hepatobiliary and pancreatic surgery. Technologies discussed will include real-time three-dimensional guidance for microwave ablation, overlayed cross-sectional imaging for surgical planning and tumor localization, and intraoperative fluorescence for anatomical identification. This session is geared towards surgeons in practice hoping to expand their knowledge of these techniques and technologies and those beginning practice looking to use advanced image guidance for liver and pancreas surgery.

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

• Describe the use of minimally invasive ultrasound for intraoperative liver ablation.
• Describe the use of overlayed three-dimensional imaging for intraoperative guidance in liver and pancreas surgery.
• Discuss challenges facing HPB surgeons in underserved populations in terms of access to advanced image guidance and potentially opportunities for increasing access to bridge these hurdles.

11:00 AM Introduction
11:05 AM Three-dimensional Image Guidance for Intraoperative Microwave Ablation
11:15 AM Advanced Image Guidance for Tumor Localization and Surgical Planning in Liver and Pancreas Surgery
11:25 AM Latest Advances in Intraoperative Ultrasound for HPB Surgery
11:35 AM Fluorescence Guided Imaging in HPB Surgery
11:45 AM Panel Discussion

12:00 PM – 1:30 PM

SAGES Foundation Awards Luncheon

This annual ticketed event celebrates and honors distinguished leaders in minimally invasive surgery. Proceeds benefit the SAGES Foundation and its mission to advance endoscopic, laparoscopic, and emerging minimal access surgical methods and patient care. The 2024 Awards Luncheon features awards and research grants presented to outstanding surgeons and educators for their work in minimally invasive surgery and raises funds to keep patient safety and surgical innovation in the forefront.

How to RSVP: To become an event sponsor, purchase individual tickets, tables, or virtual ads, please contact the Foundation office at (310) 347-0544, ext. 114 or [email protected]. Individual tickets are $195 each and tables of eight are available for $1,750. Since this event benefits the SAGES Foundation, a portion of your purchase is tax-deductible to the extent permitted by law.

1:30 PM – 3:00 PM

SAGES/IFSO: The Future of Bariatric Surgery

Session Chair: Aurora Pryor, MD | Session Co-Chair: Abdelrahman Nimeri, MD, FACS, FASMBS
Business of Surgery, Endoscopy, Bariatric, Pediatrics, Education, Sustainability

This session details the latest trends and innovations in bariatric surgery from around the world.

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

• Recognize novel innovations in bariatric surgery and select appropriate patients for these procedures.
• Recommend application of the latest advancements in bariatric surgical technique in the care for the patient with obesity.
• Choose novel techniques to incorporate into local bariatric care.

1:30 PM Introduction
1:32 PM Obesity Care: The Buzz from AMA/CMS
1:42 PM Incorporating Weight Management & Wellness
1:52 PM Will Bariatric Endoscopy Replace MBS Like ERCP Replaced CBDE?
2:02 PM Do I Need FPD, ABOM & Interventional Endoscopy
2:12 PM Will AOMs Do for Bariatric Surgery & Obesity Care What PPIs Did for PUD & GERD
2:22 PM Upcoming MBS Procedures From Around the Globe
2:32 PM Discussion

1:30 PM – 3:00 PM

Foregut Calamities: Videos from the Foregut Facebook Group

Session Chair: Mohammed Al Mahroos, MD, FRCS(C) | Session Co-Chair: Ruchir Puri, MD, MS, FACS
Foregut, Endoscopy, Acute CareRisk Management, Medical Errors

SAGES has an extremely engaged Foregut group on FB. These videos from that group are excellent examples of challenging intra-operative cases that will be beneficial to early as well as the more experienced foregut surgeons. These variable situations are of great value to SAGES attendees.

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

• Demonstrate strategies of handling difficult complications intraoperatively.
• Employ new strategies in treating complicated foregut disease.
• Diagnose rare intraoperative findings in complicated foregut surgery.

1:30 PM Introduction
1:32 PM The Dead Stomach
1:44 PM It`s Stuck, Again!
1:56 PM The Perforated Stomach
2:08 PM TBD
2:20 PM The TIFster
2:32 PM TBD
2:44 PM The Bleeder!
2:56 PM Q&A

1:30 PM – 3:00 PM

Hernia Radiology: How Understanding Imaging Will Improve Your Outcomes

Session Chair: Salvatore Docimo, Jr., DO, MS | Session Co-Chair: Sabrina Drexel
Hernia, Risk Management

The intersection of surgery and radiology is nowhere more important than in the care of patients with hernia. This session will focus on standardizing the approach to hernia radiology, predictive models for hernia planning, loss of domain management using radiology, complications prediction, and the use of radiology to identify iatrogenic injuries. Residents, fellows, and surgical attendings with an interest in incorporating the use of radiology in surgical planning and complications management of complex hernia repair should attend this session. A question and answer session of the expert panel will follow.

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

• Integrate hernia radiology to improve surgical planning and technique.
• Discuss how to evaluate for loss of domain and use preoperative adjuncts to improve hernia repair.
• Employ pre- and post-operative imaging to evaluate for risks and complications.

1:30 PM Understanding Normal Abdominal Wall Anatomy
1:45 PM Predictive Models for Hernia Planning
2:00 PM Identifying Loss of Domain and Indications for Preoperative Adjuncts
2:15 PM Predicting Complications: How Imaging Can Help with Perioperative Planning
2:30 PM Using Radiology to Identify Iatrogenic Injuries: Semilunar Line Injuries, Denervation Injury, Mesh Complications
2:45 PM Q&A

1:30 PM – 3:00 PM

The Big, The Ugly, and The Nasty: Approach to Colorectal Emergencies

Session Chair: Deborah Nagle, MD | Session Co-Chair: Dana Hayden, MD
Colorectal, Immunofluorescence, Acute Care, Oncology

This session will address common colorectal emergencies and challenges such as management of large bowel obstruction and colonic perforations. Newer technologies such as endoscopic stents and perfusion evaluation will be included in the discussion.

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

• Choose when to operate and when to stent in large bowel obstruction.
• Identify options for perfusion status assessment in mesenteric ischemia.
• Plan surgical options in difficult diverticulitis.
• Recognize stoma complications and understand how to avoid them.

1:30 PM Introduction
1:32 PM Colonic Obstruction – Stent, Operate, or Both?
1:44 PM Oh No, It`s a Perforated CANCER…
1:56 PM Dead on Arrival? Evaluating and Operating Mesenteric Ischemia
2:08 PM Twisting the Night Away… Volvulus, Intussusception, Bascule
2:20 PM Challenging Stomas and Complications
2:32 PM Case Presentations/Panel Discussion
2:47 PM Q&A

1:00 PM – 3:00 PM

Devil is in the Details: Necrotizing Pancreatitis

Session Chair: Amy Liepert, MD | Session Co-Chair: Kevin El-Hayek, MD
HPB, Acute Care

Necrotizing pancreatitis is a challenging surgical disease that has undergone significant clinical management changes over the past few decades. The Step-Up approach has become widely recognized as a management strategy, however, the multiplicity of approaches to the management of debridement of necrosis continues to evolve to include multiple specialties, approaches, and technologies. This expert panel will explore the history, wide diversity of necrosectomy options, importance of cooperative multi-disciplinary management, and stimulate the audience to delve into the depths of the dead pancreas.

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

• Appraise a multitude of different options for the debridement of pancreatic necrosis including the Step-Up Approach, Endoscopic Necrosectomy and the emerging role of Robotic Necrosectomy.
• Recognize the importance of a multidisciplinary approach to the debridement of necrotizing pancreatitis from patient selection, pancreatitis etiology, acute and late management of the gallbladder and debridement strategies.
• Develop and formulate the approaches and teams necessary and available at their own institution to build an effective multidisciplinary management team for necrotizing pancreatitis.

1:30 PM Introduction
1:35 PM Nothing New Under the Risen Sun? Updates on Guidelines and Work-up for Necrotizing Pancreatitis
1:50 PM Stepping It Up: IR & Surgery to a Possible VARD
2:05 PM GI Takeover: Endoscopic Necrosectomy is All You Need
2:20 PM Two Birds, One Scope: Combined MIS Necrosectomy and Cholecystectomy
2:35 PM Chariots of Fire Requires a Team: Need for a Multi-D Approach
2:50 PM The Devil Really is in the Details: Panel Rapid Fire

1:30 PM – 5:00 PM

Hands-on Course ADOPT: All Types of Colorectal Intracorporeal Anastomosis

Session Chair: Alan Harzman, MD | Session Co-Chair: Laila Rashidi, MD, FACS, FASCRS

This course is designed for surgeons in practice who perform MIS colon and/or rectal operations and desire to incorporate intracorporeal anastomoses into their practice. The course will include a pre-meeting virtual didactic session, hands-on training in right and left colon intracorporeal anastomoses, and monthly virtual sessions throughout the following year to help participants adopt the skills they have learned.

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

• Describe to a colleague the potential benefits of intracorporeal anastomosis.
• Outline a plan for adopting intracorporeal anastomosis into ones practice and evaluating ones performance.
• Discuss the technique of intracorporeal anastomosis for hemicolectomy, tips and pitfalls.
• Demonstrate technical skills and applications of intracorporeal anastomosis for right and left colectomies.
• Explain technical skills and critical steps for natural orifice extraction in setting of intracorporeal anastomosis.

1:30 PM Introduction
1:35 PM Intracorporeal Anastomosis Lab

2:30 PM – 4:30 PM

SAGES Military Surgical Symposium Part 2: Surgery in Space (Non-CME)

2:30 PM Introduction to Surgery in Space – Opportunities & Challenges (Non CME)
2:45 PM Aerospace Medicine & Surgery Fellowship (Non CME)
3:00 PM SPACE FORCE – Medical Operations (Non CME)
3:15 PM NASA – Holoportation to the International Space Station (Non CME)
3:30 PM MIRA – Surgery in Space (Non CME)
3:45 PM TATRC – Medical Robotics & Autonomous Systems (Non CME)
4:00 PM Security in Space (Non CME)
4:15 PM Panel Discussion (Non CME)

3:00 PM – 3:30 PM

Afternoon Break

3:30 PM – 5:00 PM

It`s JUST an Inguinal Hernia: Managing Complex Hernias of the MPO (Masters)

Session Chair: Jeffrey Blatnik, MD | Session Co-Chairs: Jenny Shao, MD, FACS & Vahagn Nikolian, MD
Hernia, Pediatrics, Acute Care

This session is designed to explore some of the complex situations that are encountered with inguinal hernia repair. This includes pediatric hernias, re-operative groin, large inguinal scrotal hernias and mesh challenges. Content will focus on case and video based presentation with didactics and panel discussion.

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

• Evaluate recurrent inguinal hernia patients for surgical repair.
• Employ minimally invasive approaches for complex inguinal hernias.
• Assess the need for mesh in youth and child inguinal hernias.
• Recognize mesh complications in the groin and who would benefit from surgery.

3:30 PM When is a Kid a Small Adult – The Pediatric Surgeon Perspective on Inguinal Hernia Repair
3:50 PM The Patient That Has Been Told No Too Many Times – Operating in the Challenging Pelvic Environment
4:10 PM Is It Too Big? – Deciding the Right Approach for Large Inguinal Hernias
4:30 PM Mesh Complications in the Groin – Who Needs an Operation?
4:50 PM Q&A

3:30 PM – 5:00 PM

SAGES/AFS: Devil is in the Details: MIS Esophagectomy

Session Chair: Alia Qureshi, MD | Session Co-Chair: Kirsten Newhams, MD, MPH | Moderator: Christy Dunst, MD
Foregut, Immunofluorescence, Endoscopy

This course will focus on all aspects of minimally invasive esophagectomy (MIE) starting with a brief introduction on the history of esophagectomy; trials and tribulations to the state of the art. We will review the oncologic principles of MIE – regardless of approach. Additionally, the technical components of the lap/vats/robotic approach will be discussed with an emphasis on the details for a practicing surgeon performing this complex procedure. We will also discuss the considerations of benign pathology and review evidence discussing the challenges of MIE for benign pathology. Future directions in the realm of MIE will also be reviewed and presented, including the role of SLN biopsy in esophageal cancer as well as advanced intraoperative imaging and the evolving role of AI. The last component of the session will include an audience poll with panel discussion of 10 questions to surgeons routinely performing MIE.

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

• Apply oncologic principles of esophagectomy to the different surgical approaches to esophagectomy – including open/lap/VATS/robotic.
• Develop deeper understanding of the clinical and technical considerations of MIE.
• Evaluate the current evidence for SLN biopsy, advanced imaging, and AI as it relates to esophageal resection.

3:30 PM Introduction and History of Esophagectomy: Standing on the Shoulders of Giants
3:37 PM Oncologic Principles of Esophagectomy – Regardless of How You Do It
3:44 PM Minimally Invasive Esophagectomy – Robotic Ivor Lewis Approach (MIE)
3:51 PM MIS Transhiatal Minimally Invasive Esophagectomy (MIE) Team Based Approach
3:58 PM Evidence and Role for SLN (Sentinel Lymph Node) Biopsy in Esophageal Cancer Resection – Are We There Yet?
4:05 PM MIE for Benign Disease
4:12 PM AI and the Future of MIE
4:19 PM Audience Polling
4:50 PM Q&A

3:30 PM – 5:00 PM

Bariatric Emergencies

Session Chair: Tammy Kindel, MD | Session Co-Chair: Barham Abu Dayyeh, MD, MPH
Endoscopy, Bariatric, HPB

This session will review the clinical, endoscopic and operative management of more commonly encountered bariatric emergencies. The session will be heavily case-based with accompanying video, and is applicable to both bariatric and general surgeons encountering bariatric emergencies.

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

• Describe endoscopic and surgical options for management of a leak after sleeve gastrectomy.
• Describe endoscopic and surgical options for management of an eroded gastric band.
• Evaluate operative management strategies of a marginal ulcer perforation after RYGB.

3:30 PM Introduction and Presentation of First Bariatric Emergency- Acute Sleeve Leak
3:37 PM Management of Acute Sleeve Leaks
3:49 PM Definitive Management of Sleeve Fistula
4:01 PM Case Presentation #2 – Sleeve Fistula
4:08 PM Case Presentation #3 – Band Erosion
4:15 PM Management of Band Erosions
4:27 PM Case Presentation #4 – Perforated Marginal Ulcer After RYGB
4:34 PM Management of Perforated Marginal Ulcer After RYGB
4:46 PM Q&A

3:30 PM – 5:00 PM

Recovery Reimagined: Optimizing Patients & Processes

Session Chair: Elisabeth McLemore, MD | Session Co-Chair: Benjamin Clapp, MD
Colorectal, Bariatric, Foregut, Hernia, Patient Voice, DEI, Sustainability, Pain Management, Use of Controlled Substances, Appropriate Prescribing

This course will cover same-day discharge, including hernia, colorectal, foregut/bariatric, and hepatobiliary surgery. The attendee will learn about advanced enhanced recovery programs, modern discharge readiness assessments, opioid-free pathways and prehabilitation. The course will also cover the weight loss strategies in preparation for major abdominal minimally invasive surgery as a means to reduce BMI and peri-operative morbidity and mortality.

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

• Prepare and implement an opioid free pathway for surgical patients.
• Further evolve and advance their local enhanced recovery protocols including how to assess early discharge readiness following surgery.
• Initiate weight loss strategies in preparation for future surgical needs to accelerate patient readiness and weight loss criterias that are associated with reduced perio-operative risk and complications.

3:30 PM Introduction
3:35 PM Outcomes, Institutional Requirements, and Patient Selection in Same Day Discharge: Colorectal, Bariatric & Hepatobiliary
3:50 PM Prehabilitation: Hype or Help?
4:05 PM Opioid Free Surgery: Nonsense or Next Standard of Care?
4:20 PM BMI 40 Plus! – Effective and Realistic Preoperative Weight Loss Strategies for Patients Who Need Surgery in 3 – 6 Months After Neoadjuvant Therapy or Hernia Surgery
4:35 PM Patient Perspective
4:50 PM Q&A

3:30 PM – 5:00 PM

SAGES/ILLS: How I Do MIS Liver Resection

Session Chair: David Geller, MD, FACS | Session Co-Chair: Jason Hawksworth, MD
HPB, Quality, Oncology

This session will show laparoscopic and robotic major liver resections for HCC, Klatskin`s tumor, and colorectal cancer liver metastases.

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

• Discuss indications, techniques, benefits, and pitfalls of laparoscopic liver resection.
• Summarize the outcomes of laparoscopic liver resection for HCC and metastatic colorectal cancer.
• Observe the technique for robotic liver resection and hepaticojejunostomy for Klatskin`s tumor.

3:30 PM Robotic Liver Resection for Klatskin`s Tumor
3:42 PM Laparoscopic Left Hepatectomy
3:54 PM Laparoscopic Anatomic Liver Sectionectomy for HCC
4:06 PM Laparoscopic Liver Resection for CRLM
4:18 PM Robotic Hepatectomy in Difficult Segments
4:30 PM Robotic Right Hepatic Lobectomy
4:42 PM Q&A

4:00 PM – 5:00 PM

Trainee Town Hall (Non CME)

 5:00 PM – 5:30 PM

Opening Session & Welcome Ceremony 

We encourage everyone to attend the opening session and welcome ceremony where the highlights for the conference and SAGES updates will be presented.

5:30 PM – 7:30 PM

Welcome Reception with Exhibitors

Complimentary to all paid registrants and guests.

6:00 AM – 6:00 PM

Speaker Ready Room

8:00 AM – 9:30 AM

Scientific Sessions:

Accepted Oral & Video Presentations

SS06: Bariatric Short Oral Session I
SS07: Foregut Short Oral Session
SS08: Hernia Short Oral Session
SS09: Colorectal Short Oral
SS10: HPB Short Oral Session
SS11: Diversity/Leadership Short Oral Session

8:00 AM – 9:00 AM

Sustainability Innovations in Surgery (Non CME)

Session Chair: Nova Szoka, MD | Session Co-Chair: Lisa Israelovitch
Emerging Technology, Sustainability

This session will feature research and/or commercial innovations that enable carbon reductions or other sustainability benefits in surgery and the OR. The session may also include a review of protocols for research studies.

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

• Define sustainability as it pertains to surgical practice.
• Describe research and/or commercial innovations that enable carbon reductions or other sustainability benefits in surgery and the OR.

8:00 AM Introduction
8:03 AM Problem Identification and Targeted Needs Assessment for the Development of a Surgical Resident Sustainability Curriculum
8:09 AM Q&A
8:11 AM Environmental Sustainability in the Operating Room: Perspectives and Practice Patters of General Surgeons in Canada
8:17 AM Q&A
8:19 AM The Environmental Impacts of Surgical Care Pathways: Same-Day Discharge Versus Enhanced Recovery Pathways
Following Minimally Invasive Colectomy
8:25 AM Q&A
8:27 AM Quantifying the Carbon Footprint Premium of Robotic Surgery
8:33 AM Q&A
8:35 AM Calculating the Carbon Footprint of Colonoscopy
8:41 AM Q&A
8:43 AM ORDash to Modernize Preference Card and Supply Management
8:49 AM Q&A
8:51 AM Panel Discussion

9:00 AM – 10:00 AM

Gerald Marks Lecture:

10:00 AM – 4:00 PM

Exhibits/Education & Innovation Center

10:00 AM-12:00 PM

SAGES/ASCRS: The Great Leak-Off – Best Strategies for Preventing and Treating Colorectal Anastomotic Leak (Masters)

Session Chair: Steven Wexner, MD | Session Co-Chairs: Jeremie Lefevre & Nicole Bouvy, MD, PhD
Colorectal, Patient Speaker, Dei, Quality, Masters, Endoscopy, Infectious Disease, Medical Errors, Risk Management

This session course will define and describe anastomotic leaks and pose pre-operative and intraoperative strategies to try to prevent them. The material will also include the diagnostic and therapeutic modalities of anastomotic leak as well as review the long-term adverse functional sequelae. The panel will include the perspectives of world-renowned surgeons as well as a patient who has suffered from an anastomotic leak. The discussion will focus upon mitigating against this complication through a variety of evidence based approaches.

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

• Diagnose an anastomotic leakage.
• Integrate all known risk factors of leakage in current practice.
• Select the best treatment for anastomotic leakage.

10:00 AM Defining Anastomotic Leakage May Not Be as Simple as You Thought
10:10 AM Leak Prevention: What Can We Do Before Surgery?
10:20 AM Leak Prevention: What Can We Do During Surgery?
10:30 AM How Do We Best Diagnose a Leak?
10:40 AM What are My Options for Management of Anastomotic Leak?
10:50 AM Vacuum Sponge: Why, When, and How?
11:00 AM Chronic Sequela of Anastomotic Leak
11:10 AM Patient Perception
11:20 AM Panel Discussion

10:00 AM – 12:00 PM

How I Do Revisional Foregut Surgery (Masters)

Session Chair: Christopher DuCoin, MD, MPH | Session Co-Chairs: Kevin Reavis, MD & Tyler Grenda
Foregut, Immunofluorescence, Endoscopy

In this session we will walk through this complex process of how to work-up and treat revisional foregut surgery. No matter where you are in your career or interest in foregut surgery, we have something for you. In this session we are going to review to work up and treatment options of both recurrent hiatal hernias and options after myotomy for achalasia. We will ensure you are prepared for these challenging patients. In conclusion we will review the credentialing process and billing and coding on the topic, to ensure you get the credit for the work that was done.

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

• Understand the pre-operative work up that will set you up for a successful surgery and your patient for the appropriate expectations.
• Review the unique intra-operative techniques and procedures that can add to your surgical tool box.
• Discuss an algorithm in total and how it can be applied to revisional foregut surgery.

10:00 AM Introduction
10:01 AM Revisional Hiatal Hernia: Work-up and Patient Expectations
10:21 AM Revisional Hiatal Hernia: Surgical Approach and Technical Pearls
10:41 AM Achalasia: Post Operative Dysphagia; Workup and Treatment
11:01 AM End Stage Achalasia – What Are My Options, What Drives the Decision Process
11:21 AM When is a Roux-en-Y Reconstruction the Preferred Option – Covering Operative Tips and Tricks
11:41 AM Next Steps: Fellowship Training, Need for Credentials, and Improvement in Coding

10:00 AM – 11:00 AM

Introducing New Hernia Procedures Into Your Practice

Session Chair: Andrea Pakula, MD, MPH, FACS | Session Co-Chair: Clayton Petro, MD
Hernia, Business of Surgery, Sustainability, Ethics

This session will focus on how to safely introduce a variety of modern techniques into a surgeon`s practice. Procedures to be discussed include inguinal hernia, hiatal hernia, IPUM ventral hernia and eTEP approach to ventral hernia repair. Faculty will discuss how to safely get through the learning curve and progress through case complexity.

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

• Describe how surgeons can introduce different ventral hernia techniques safely into practice.
• Demonstrate how to safely adopt robotic inguinal hernia repair into practice.
• Introduce hiatal hernia repair into one’s practice.

10:00 AM Safely Adopting Robotic Inguinal Hernia Repair into Your Practice
10:12 AM Open TAR
10:24 AM Transition from Lap to Robotic IPUM Into Your Practice
10:36 AM eTEP: Overcoming the Learning Curve
10:48 AM Q&A

10:00 AM – 11:00 AM

How I Do Single Anastomosis Duodenal-ileal Bypass with Sleeve (SADI-S)

Session Chair: Rana Pullatt, MD, FACS | Session Co-Chair: Timothy Snow, DO
Endoscopy, Bariatric, Business of Surgery

This session is intended to provide attendees with sufficient information to either start performing or enhance current performance of SADI-S as part of a bariatric surgeon`s surgical practice. The session and presentations will aim to discuss surgical indications/patient selection criteria, billing/coding, variations in surgical technique (robotic vs lap vs stapled vs hand-sewn), options for revision with weight recurrence, and management of potential operative and long term complications.

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

• Identify patients who would be appropriate candidates for SADI-S and how to bill.
• Demonstrate variations in surgical approaches and integrate these techniques into surgical practice.
• Recognize potential complications and apply appropriate patient care interventions for successful management.

10:00 AM Introduction
10:02 AM Patient Selection – Risks/Benefits & How to Bill & Code
10:11 AM Laparoscopic SADI-S: Hand-Sewn Approach
10:20 AM Laparoscopic SADI-S: Stapled Approach
10:29 AM SADI-S: Robotic Approach
10:38 AM SADI-S: Revisions & Complication Management
10:47 AM Q&A

10:00 AM – 12:00 PM

Acute Care Endoscopy (Masters)

Session Chair: Joshua Winder, MD | Session Co-Chairs: Amber Shada, MD & Bryan Sandler, MD
Acute Care, Endoscopy, Foregut, Bariatric, Colorectal, Pediatric

This session will discuss the utility of endoscopy in the acute care setting. This will include in-depth discussion from an expert panel about the use of endoscopy in patients with acute surgical issues including perforations, leaks, volvulus, anastomotic bleeding, foreign bodies, and other issues in the setting of critical care or trauma.

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

• Identify acute surgical issues that can be managed endoscopically.
• Recognize the role of endoscopic evaluation and treatment in the critically ill or traumatized patient.
• Integrate endoscopic techniques to manage common acute surgical problems including hemorrhage, foreign bodies, difficult feeding access, and volvulus.

10:00 AM Introduction
10:04 AM The Role of Intraoperative Endoscopy in Acute Care Surgery
10:16 AM Scopes in the ICU: Endoscopy in the Evaluation and Management of Critically Ill Patients
10:28 AM Scopes in Trauma: ABCD Endoscopy?
10:40 AM Endoscopic Evaluation and Management of Gastric and Colonic Volvulus: When, Where, How?
10:52 AM Endoscopic Management of Anastomotic Bleeding
11:04 AM Enteral Feeding Access: Beyond PEG
11:16 AM Endoscopic Management of Foreign Bodies: How Did That Get There?
11:28 AM Endoscopic Management of Perforations and Leaks
11:40 AM Panel Discussion

10:00 AM – 11:00 AM

Scientific Sessions:

Accepted Oral & Video Presentations

SS13: Acute Care Session: Biliary

10:00 AM – 12:00 PM

Early Innovators Course Part 1 (Non CME)

Session Chair: Dan Azagury, MD, FACS | Session Co-Chairs: Christopher Schlachta, MD & Katherine Blevins, MD, PhD

Have you ever had an idea for a new health technology or medical device? Do you have one now and are wondering what to do with it? This course is for you! This two-part course will consist of a didactic component and a hands-on portion. Part one will be Didactics: A series of short lectures from innovators, entrepreneurs and investors who will explain what it really takes to get an idea to market.

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

• Describe the steps necessary to bring an idea to market in healthcare.

10:00 AM Finding the Need
10:20 AM Intellectual Property Basics
10:35 AM Concept Generation & R&D Strategy
10:50 AM Building a Business: (Business Models, Value Proposition & Fundraising)
11:05 AM Regulatory and Reimbursement Basics
11:20 AM From Surgeon to Startup CEO, What Does It REALLY Take?
11:45 AM Panel Q&A

10:00 AM – 12:00 PM

Exhibit Hall Theater: Hot in Cleveland Abstracts 1 (Non-CME)

11:00 AM – 12:00 PM

Preventing Hernias: Practical Methods to Apply to Your Practice Today

Session Chair: Abhishek Parmar, MD, MS | Session Co-Chair: Eva Deerenberg
Hernia, Bariatrics, Colorectal, Sustainability, Acute Care

The aim of this session is to provide strategies for the practicing surgeon to reduce incisional hernia risk following elective and emergency operations. Specific topics will include prophylactic mesh use, stomal and port site hernia prevention, and hernias as they relate to metabolic surgery. At the conclusion of this session surgeons should be equipped to apply patient considerations and technical approaches to best prevent incisional hernias.

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

• Understand and implement evidence-based techniques for fascial closure.
• Develop strategies to minimize incisional hernia development after an open abdomen.
• Understand the optimal timing and approach to hernias in bariatric patients.
• Understand the use of prophylactic mesh to prevent incisional and stomal site hernia.

11:00 AM Foundational Techniques in Incisional Hernia Prevention – Small Bites, Modern Knots and More!
11:12 AM Open Abdomen Management to Prevent Incisional Hernia
11:24 AM Preventing and Managing Hernias in Bariatric Patients
11:36 AM Mesh for Hernia Prevention
11:48 AM Q&A

11:00 AM – 12:00 PM

Building your Bariatric Program: Expanding Access to Care

Session Chair: Sergio Bardaro, MD, FACS, FASMBS, DABS-MBS | Session Co-Chair: Natan Zundel, MD
DEI, Advocacy, Business of Surgery, Patient Voice, Quality, Ethics

This is a bariatric surgery session that focused on practice development and improved access to care. The session will focus on the new bariatric surgery guidelines and insurance coverage, the improvement of access to care and disparities comparing urban vs rural centers, the challenges of direct to employer partnership as well as mitigating the risks of destination surgery. Finally, a post bariatric surgery patient will give the patient perspective when choosing the right bariatric surgery center. Despite that this session is based on bariatric surgery, the model/concepts could be replicated with other specialties.

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

• Describe the current guidelines on bariatric surgery and access to care issues.
• Understand the different challenges in developing a bariatric surgery practice.
• Understand the patients` perspective when choosing the right bariatric surgery program.

Panelists: Ricard Corcelles, MD, PhD, FACS, IFASMBS, Pearl Ma, MD, FACS
11:00 AM Working on Insurance Coverage Regarding Updated ASMBS/IFSO Guidelines
11:08 AM Eliminating Disparity in Access – Rural vs Urban Centers
11:16 AM Medical Tourism and/in Your Practice
11:24 AM How to Establish Direct to Employer Partnerships?
11:32 AM Choosing the Right Bariatric Program – a Patient Perspective
11:37 AM Panel Discussion

11:00 AM – 12:00 PM

Scientific Sessions:

Accepted Oral & Video Presentations

SS14: Global Surgery Session

12:00 PM – 1:30 PM

Complimentary Lunch in the Exhibit Hall

Enjoy lunch while you explore latest products and technologies offered by our exhibits.

1:30 PM – 3:30 PM

How I Do a Bariatric Surgery Despite Imperfect Scenarios (Masters)

Session Chair: Marina Kurian, MD | Session Co-Chairs: Ann Rogers, MD & Monique Hassan, MD, FACS
Bariatrics

This session will review the technical options of common bariatric operations in unusual or uncommon situations. Discussion during this session will be applicable to minimally invasive surgeons with the aim of optimizing and individualizing care for the patient in bariatric surgery. This session will be video-based with technical tips and tricks.

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

• Identify technical variations for common bariatric operations.
• Recognize the need for specific approaches and alternative adjuncts during uncommon situations.
• Illustrate technical options in specific scenarios.

1:30 PM Introduction
1:35 PM Roux Limb Mishaps
1:47 PM Situs Inversus
1:59 PM Surprise Bleeding and Management
2:11 PM Deep Blue Duodenum
2:23 PM Twisted Sleeve and Repair
2:35 PM My Disaster Du Jour and Recovery
2:47 PM Unexpected Intraoperative Findings
2:59 PM Panel Discussion and Q&A
3:20 PM Closing Remarks

1:30 PM – 2:30 PM

Building Your Reflux Center: Diagnostic Technology for Foregut Surgery

Session Chair: Leena Khaitan, MD, MPH, FACS, FASMBS | Session Co-Chair: Konstantinos Spaniolas, MD
Business of Surgery, Emerging Technology, Foregut, Sustainability, Risk Management, Ethics

This session will describe the diagnostic modalities that facilitate and are essential for the comprehensive evaluation of foregut patients. In addition, the audience will hear how to onboard such technology and testing in their own institution.

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

• Recommend appropriate diagnostic testing for patients with foregut pathologies.
• Recognize the value of different testing for specific clinical scenarios.
• Articulate a plan to adopt such diagnostic modalities in their practice.

1:30 PM How to Get Started with Foregut Diagnostics
1:38 PM The Role of Manometry and Endoflip in Preop Workup
1:46 PM pH Testing: Which Test for Which Patient
1:54 PM Barium Swallow and Gastric Emptying Study
2:02 PM Endoscopic Modalities for Evaluation of Barrett`s
2:10 PM Endoscopic Evaluation, H.Pylori and SIBO
2:18 PM Q&A

1:30 PM – 3:30 PM

SAGES/AHS/EHS Complex Hernia Repairs – How the Experts Do It (Masters)

Session Chair: Charlotte Horne, MD | Session Co-Chairs: Filip Muysoms & Yuri Novitsky, MD
Hernia, Colorectal

Masters from around the world and leaders of various hernia societies share their expertise to demonstrate how they think through complex hernia disease. Learn the optimal MIS and open approaches to parastomal hernias, recurrent hernias after prior retromuscular repairs, perineal and sternal hernias and how to manage approach hernias in the unoptimized patient.

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

• Learn various operative approaches to complex hernia disease.
• Demonstrate MIS approaches to repair uncommon hernias.
• Understand anatomy in re-operative hernia cases.

1:30 PM Loss of Domain Hernias: How to Get the Fascia Closed
1:42 PM eTEP Approach to Flank Hernias
1:54 PM Redo TAR: Tips and Tricks to Approach Reoperative Retromuscular Hernias
2:06 PM Parastomal Hernias: Is There an Optimal Mesh Configuration?
2:18 PM Minimally Invasive Approaches to Sternal Hernias
2:30 PM Hernia Repair and GI Reconstruction: To Stage or Not to Stage
2:42 PM MIS Approaches to Uncommon Hernias: Perineal, Lumbar and Other Atypical Hernias
2:54 PM Hernia Repair in the Obese Patient: Do We Really Need to Say No
3:06 PM Q&A

1:30 PM – 2:30 PM

Catching Up with Rapid Changes in Colorectal Cancer Care

Session Chair: John Marks, MD | Session Co-Chair: Virginia Shaffer, MD
Colorectal, DEI, Quality

This session will be a review of the rapid changes in colorectal cancer care. It will cover a broad range of high yield topics of interest for anyone taking care of patients with colorectal malignancies.

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

• Describe the reasons and benefits of NAPRC.
• Employ TNT strategies and watch and wait protocols.
• Implement new treatments and surveillance strategies in their patients.

1:30 PM Introduction
1:33 PM National Accreditation Program for Rectal Cancer: Implications for Surgeons
1:45 PM Everything You Need to Know About Total Neoadjuvant Therapy and Watch and Wait Protocols
1:57 PM CTDNA and Immunotherapy: What Should You Know?
2:09 PM Pushing the Limits of Sphincter Preservation
2:19 PM Q&A

1:30 PM – 2:30 PM

The Future of Managing Gallstone Disease (Masters)

Session Chair: Ezra Teitelbaum, MD, MEd | Session Co-Chair: Eleanor Fung, MD
HPB, Endoscopy, Immunofluorescence

The last several years have shown rapid advances and a proliferation of options for the treatment of gallstone disease. This session will cover novel surgical, endoscopic, and percutaneous interventions for gallstones to give surgeons a wide array of options to approach complex patients.

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

• Understand steps and options for performing laparoscopic transcystic common bile duct exploration (LCBDE).
• Review novel percutaneous interventions for gallstone disease in patients who are not surgical candidates.
• Understand available endoscopic options for treatment of complex choledocholithiasis and cholecystitis.

1:30 PM Reclaiming the Common Duct: How I Do Transcystic LCBDE
1:42 PM Moving Forwards Not Back!!: Antegrade LCBDE with Balloon Sphincteroplasty
1:52 PM Surgery?? We Dont Need No Stinkin Surgery!: Percutaneous Options for Gallstones
2:02 PM ERCP, EUS-GBD, EDGE, Say What?: What Your GI Can Do for You in 2024
2:12 PM Looks Nice, But Does it Really Help?: Robotics and ICG Cholangiography
2:20 PM Q&A

1:30 PM – 3:30 PM

Family Feud (Non CME)

Session Chair: Ross Goldberg, MD, FACS | Session Co-Chairs: Maria Altieri, MD & Anjali Kumar, MD

Back by popular demand, here comes SAGES Family Feud, the Upgraded Version! See some of your SAGES colleagues square off against one another in a fun game show setting. See them answer SAGES trivia questions, questions on medical topics, and everything in between! Just like the original show, our questions come directly from surveys of SAGES members. See who is going to make it through to the Final Round!

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

• Articulate the most up to date approaches to handling issues from a variety of clinical topics.

1:30 PM Introduction
1:35 PM Team Overachievers vs Team Dynamos
2:20 PM Musical Interlude
2:35 PM Team Bad Asses vs Team The Stomach Slicers
3:25 PM Game Ending

1:30 PM – 5:30 PM

Hands-On Course: Endo Sleeve

Session Chair: Michel Ujiki, MD | Session Co-Chair: Erik Wilson, MD
Lab Instructors: Silvana Perretta, MD, Rachel Moore, MD, FACS, FASMBS, Zachary Callahan, MD, Allison Schulman, MD, MPH

Participants of this hands-on course will have the opportunity to learn endoscopic suturing from experts, and then apply it by learning how to perform an endoscopic sleeve gastroplasty. The course is meant for those interested in applying endoscopic suturing skills for primary or revisional bariatric procedures.

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

• Use an endoscopic suturing device effectively.
• Demonstrate effective skills in endoscopic suturing.
• Apply suturing skills and perform an endoscopic sleeve gastroplasty.

1:30 PM Lab

1:30 PM – 3:30 PM

Early Innovators Course Part 2: What Does It Really Take to Bring an Idea to Market? (Non CME)

Session Chair: Dan Azagury, MD, FACS | Session Co-Chairs: Christopher Schlachta, MD & Katherine Blevins, MD, PhD

Have you ever had an idea for a new health technology or medical device? Do you have one now and are wondering what to do with it? This course is for you! This two-part course will consist of a didactic component and a hands-on portion. The second portion of the course will consist of some real-life (successful or failed) examples of innovations brought to life, with presentations from the inventors themselves. For the hands-on course, Bring your idea! You will be paired with one of our experts/panelists for 1:1 mentoring. They will help evaluate the potential of your idea, ask questions to guide next steps and give you insightful feedback (faculty will sign a non-disclosure agreement to allow you to share your idea with them).

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

• Describe the steps necessary to bring an idea to market in healthcare.

1:30 PM My Innovation Story: Bridging Academics and Innovation
1:50 PM My Innovation Story: Innovating From my Clinical Practice
2:10 PM My Innovation Story: From Resident to Venture Capitalist
2:30 PM Hands-On Mentoring

1:30 PM – 3:30 PM

The Dirty Little Secrets of Surgery: Everything You Wanted to Know About a Career in Surgery But Nobody Was Willing to Tell You (Non CME)

Session Chair: John Paige, MD | Session Co-Chairs: Aimee Gardner, PhD & Mercedeh Baghai, MD
DEI, Business of Surgery

Do you wish you knew more about how to handle finances, to advance in your career path, or brand yourself in an effective manner? This session will help answer these three questions and more for young surgeons through 30 minute interactive discussions between a moderator and panel focusing on the three major topics of finances, clinical practice, and branding, respectively. In the process, attendees will have the opportunity to learn many of those dirty little secrets related to a career in surgery that are often overlooked during training!

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

• Apply best practice principles to making sound financial decisions.
• Formulate effective strategies for advancing during one’s career.
• Employ useful techniques to enhance one’s brand in surgery.

1:30 PM Introduction
1:35 PM Session 1 – Finances
2:05 PM Session 2 – Advancement
2:35 PM Session 3 – Branding
3:05 PM Q&A

2:30 PM – 3:30 PM

SAGES/JSES: Devil is in the Details: MIS Gastrectomy

Session Chair: Suzanne Gisbertz, MD, PhD | Session Co-Chair: Rie Makuuchi
Foregut, Immunofluorescence, Oncology

This session focuses on new techniques and technologies for malignant and benign gastric surgery. Minimally invasive approaches, function preserving gastrectomy, ICG-guided lymphadenectomy and AI navigation will be discussed by speakers from the East and West.

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

• Identify patients who would benefit from minimally invasive gastrectomy and from function preserving gastrectomy and in whom that is safe.
• Implement ICG-guided surgery in clinical practice.
• Recognize different possibilities that AI offers in the operation room.

2:30 PM Minimally Invasive and Robotic Assisted Gastrectomy for Gastric Cancer: Current Evidence and Technical Aspects
2:42 PM Function Preserving Gastrectomy for Early Gastric Cancer
2:54 PM ICG Guided Lymphadenectomy and Sentinel Node Navigation Surgery in Gastric and Esophageal Cancer
3:06 PM Safety Assessment of Robot-Assisted Gastrectomy for Gastric Cancer
3:18 PM Q&A

2:30 PM – 3:30 PM

SAGES/KSERS: Devil is in the Details: Achieving Excellence in Rectal Cancer Surgery

Session Chair: Dana Sands, MD | Session Co-Chair: Gyu-Seog Choi, MD
Colorectal, DEI, Quality, Immunofluorescence, Appropriate Prescribing

This session will review the current status on the minimally invasive methods to treat rectal cancer. Special attention will be placed on reconstructive and advanced techniques.

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

• Compare the minimally invasive surgical techniques available for rectal cancer.
• Review different reconstructive strategies after proctectomy.
• Understand the indication and technique of lateral pelvic node dissection.

2:30 PM LAR: How Low Can You Go? ISR Techniques with Reconstruction
2:40 PM LAR: Reoperative/Recurrent Approaches: Is There Any Role for the Robot in the Management of Complex Rectal Cancer?
2:50 PM Transanal Total Mesorectal Excision: When is it Indicated?
3:00 PM Selective Stoma Use: Watch and Wait Policy to Defer Protective Stoma After Low Anterior Resection
3:10 PM Going Wide: Lateral Pelvic Lymph Node Dissection Technique and Indication
3:20 PM Panel Discussion

2:30 PM – 3:30 PM

Devil is in the Details: Bile Duct Injury

Session Chair: Melissa Hogg, MD | Session Co-Chair: Geoff Kohn, MD, MSurg, FRACS
HPB, Endoscopy, Sustainability, Immunofluorescence, Risk Management, Medical Errors

This session will focus on issues both the General Surgeon and HPB Surgeon may encounter in the OR or on call. We will detail how to effectively handle difficult scenarios, whether you are experienced or still in training. General Surgeons who perform cholecystectomies should attend. Hepatobiliary Surgeons who repair bile duct injuries should attend. All trainees should come!

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

• Discuss what to do and know in preparation for transferring a patient from OR with BDI.
• Determine how to recognize a patient with a delayed presentation for a BDI.
• Discuss how to manage BDI in a center with limited resources to a quaternary referral center.
• Discuss diagnostic and therapeutic modalities for BDI.

2:30 PM Introduction – BDI Guidelines
2:35 PM General Surgeon in OR – Disaster Gallbladder and I See Bile, Where am I?
2:45 PM General Surgeon in OR – Disaster Gallbladder and I See the Hilum, What Do I Do?
2:55 PM HPB Specialist on Call – In the OR with Bile Duct Injury Transfer, How Do I Manage?
3:05 PM HPB Specialist on Call – My POD7 Chole is in Pain and Jaundiced, Help
3:15 PM Q&A

3:30 PM -4:00 PM

Happy Half Hour in the Exhibit Hall

4:00 PM – 5:00 PM

SAGES/EAES: Spectacular Endoscopy Cases: You Did WHAT With An Endoscope???

Session Chair: Jeffrey Marks, MD | Session Co-Chair: Silvana Perretta, MD
Endoscopy, Risk Management, Ethics

This session will be a video based interactive program with world leaders in flexible endoscopy presenting outstanding cases managed with advanced endoscopic techniques. These cases will display endoscopic solutions for foregut and hindgut disease based issues. Participants who manage patients with complex GI disease and those that also perform flexible endoscopy will gain great experience in how to better manage these situations in a minimally invasive fashion, using therapeutic flexible endoscopy.

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

• Describe techniques for endoscopic management of complex GI fistulas.
• Employ new strategies for treatment of complications following GI surgery.
• Recognize the limitations of advanced therapeutic endoscopy in the management of surgical complications.

4:00 PM Introduction
4:05 PM Spectacular Endoscopy Case
4:13 PM Spectacular Endoscopy Case
4:21 PM Spectacular Endoscopy Case
4:29 PM Spectacular Endoscopy Case
4:37 PM Spectacular Endoscopy Case
4:45 PM Q&A

4:00 PM – 5:00 PM

Global Perspective on GERD

Session Chair: Carlos Galvani, MD, FACS, FASMBS | Session Co-Chair: Joerg Zehetner, MD, MMM, FACS
Foregut, Endoscopy, Sustainability

This session will include an international panel of experts involved in the management of gastroesophageal reflux disease highlighting differences in approach and treatment of GERD.

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

• Describe the different treatment options for GERD from an international perspective.
• Employ new strategies to treat GERD.
• Choose the most appropriate procedure for GERD based on best practices.

4:00 PM So You Think You Can Wrap? Total vs Partial Fundoplication
4:10 PM The Lord of the Rings: LINX Procedure
4:20 PM No Scars Left Behind: Endoluminal Management
4:30 PM Wait a Minute: Silicone Implants for GERD?
4:40 PM Two Birds with One Stone? Association Between BMI and GERD
4:50 PM Q&A

4:00 PM – 5:00 PM

SAGES/ASMBS: How I Do One Anastomosis Gastric Bypass (Masters)

Session Chair: Omar Ghanem, MD, FACS | Session Co-Chair: Shanu Kothari, MD
Bariatrics, Business of Surgery

One Anastomosis Gastric Bypass (OAGB) was recently endorsed as a metabolic surgery in the United States. This session aims to highlight the technical aspects of performing OAGB. The session will focus on the indications of the procedure and the benefits and limitations of the loop configuration compared to the traditional Roux-enY anatomy. The presentations will also review the literature and present the data that lead to the recent endorsement. Metabolic and Bariatric surgeons in their early, mid and advanced surgical career will benefit from participating in this session.

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

• Identify the conditions and appraise the data that lead to the recent endorsement of the One Anastomosis Gastric Bypass in the United States.
• Demonstrate the benefits & limitations of the loop configuration of the One Anastomosis Gastric Bypass compared to the traditional Roux-en-Y anatomy.
• Illustrate the technical details involved in performing the One Anastomosis Gastric Bypass.

4:00 PM One Anastomosis Gastric Bypass: From Rejection to Endorsement
4:08 PM Metabolic Surgery: The Revival of the Loop Configuration
4:16 PM What Gap Does the One Anastomosis Gastric Bypass Fill?
4:24 PM One Anastomosis Gastric Bypass: How Do I Do It?
4:32 PM One Anastomosis Gastric Bypass: The Need for Early Standardization
4:40 PM Panel Discussion

4:00 PM – 6:00 PM

Colorectal Calamities

Session Chair: Lawrence Lee, MD, PhD | Session Co-Chairs: Erin Mullins, MD, FACS, FASCRS & Neil Smart
Colorectal, Immunofluorescence, Acute Care, Ethics, Medical Errors

This session will present multiple colorectal nightmare scenarios covering acute, elective, benign, and malignant cases. Attendees will be able to compare what they would do versus what the experts would do in an interactive format.

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

• Describe how to manage complications after parastomal hernia repair.
• Develop strategies to manage perineal wound complications.
• Identify options to manage anastomotic complications.
• Develop strategies to manage intraoperative complications during robotic colectomy.
• Describe strategies to manage deep pelvic bleeding.

Panelists: Beth-Ann Shanker, Jeremy LeFevre, Patricia Tejedor, Matthew Albert, MD
4:00 PM Introduction
4:05 PM Case 1 – NIGRO Gone Wrong
4:15 PM Panel Discussion
4:27 PM Case 2 – Parastomal Hernia Repair Gone Wrong
4:37 PM Panel Discussion
4:49 PM Case 3 – Anterior Resection Gone Wrong
4:59 PM Panel Discussion
5:11 PM Case 4 – Robotic Colectomy Gone Wrong
5:21 PM Panel Discussion
5:33 PM Case 5 – Deep Pelvic Dissection Gone Wrong
5:43 PM Panel Discussion

4:00 PM – 5:00 PM

HBP Catastrophes: Liver Edition

Session Chair: Adnan Alseidi, MD, Ed.M | Session Co-Chair: Erin Gilbert, MD
HPB, Acute Care, Oncology, Medical Errors

Minimally invasive surgical approaches to liver surgery have been increasingly adopted into use. Despite better oncologic results and reduced mortality, surgical morbidity remains significant. Our expert panel will review how to mitigate and prevent peri-operative complications using case studies, video and current best evidence. Learn strategies to keep your patients safe during routine as well as complex procedures. This will be an interactive session, please come and share your tough cases and near misses with us.

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

• Share strategies to manage intraoperative bleeding and gas emboli during minimally invasive hepatic procedures.
• Mitigate and treat post-operative hepatic ischemia.
• More accurately and safely target and resect hepatic metastases.

4:00 PM Bleeding: Avoiding and Stopping the Bloodbath
4:10 PM Gas ‘Emboli’: Expedient Recognition and Resolution
4:20 PM Ischemia (No Flow or Poor Flow in Remnant)
4:30 PM Getting Lost in the Liver (Getting Off Plane)
4:40 PM Getting Into the Tumor or Not Finding the Tumor
4:50 PM Q&A

4:00 PM – 5:00 PM

Educators Session: How Do I Incorporate Trainee Goals Into My Busy Work Schedule?

Session Chair: Ivy Haskins, MD, DABOM, FACS, FASMBS | Session Co-Chair: Rebecca Petersen, MD, M.Sc.
Education, Business of Surgery, DEI

This session is intended for any surgeon who interacts with trainees (fellows, residents, and students) with the goal of better understanding how to incorporate and optimize teaching into your busy daily schedule.

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

• Understand ways to engage different types of learners in their training.
• Recognize the benefits of teaching to both the learner and to you.
• Learn how to adjust teaching based on different clinical scenarios and challenges.

4:00 PM I Have Your Parachute, But You Have to Jump: Meeting the Trainee Where They’re At
4:12 PM Challenge Accepted: Approach to the Difficult Trainee
4:24 PM S**** Going Down: Continuing to Educate When Things Aren’t Going as Planned
4:36 PM ‘Bringing Sexy Back’: Making Education of Trainees Fun Again!
4:48 PM Q&A

4:00 PM – 6:00 PM

Shark Tank (Non CME)

Emerging Technology

SAGES, in partnership with Varia Ventures, is continuing its initiative to educate members on entrepreneurism, and engage and showcase inventors through the Shark Tank business competition. This includes financing promising startups through SAGES Investment Network Collaborative (SINC). AssistIQ was the 2023 winner of Shark Tank.

This year’s finalists will again present both their idea and supporting business model to the Shark Tank judges. All semi-finalists will present their work in-person at the NBT Innovation Weekend in Houston. The Shark Tank Finals will be on Thursday, April 18th, 2024 at the SAGES meeting.

5:00 PM – 6:00 PM

Scientific Sessions:

Accepted Oral & Video Presentations

SS15: 5 Star Videos
SS16: Foregut Session 2
SS17: Hernia Session: Patient Selection
SS18: Malignant HPB Video Session
SS19: Surgical Technology Session

6:00 AM – 6:00 PM

Speaker Ready Room

8:00 AM – 9:00 AM

Great Debates in the Management of Perforated Diverticulitis

Session Chair: Traci Hedrick, MD | Session Co-Chair: Patricia Tejedor
Colorectal, DEI, Sustainability, Quality, Acute Care, Infectious Disease

Join us for an engaging and thought-provoking panel discussion on the management of perforated diverticulitis, where we delve into the pivotal debate between the various techniques including the Hartmann procedure, Damage Control Surgery, Lavage and drainage, as well as Resection with Primary Anastomosis. Our expert panelists will present data-driven insights, practical technical tips, and discuss the critical aspects of surgical decision-making.

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

• Gain a deep understanding of the patient selection criteria for different treatment options, considering factors such as the patient`s overall health, disease severity, comorbidities, and potential long-term outcomes.
• Evaluate and compare various surgical techniques used in the treatment of perforated diverticulitis with a focus on minimally invasive approaches such as laparoscopic and robotic-assisted surgery.
• Learn about the expected short-term and long-term outcomes of these surgical approaches, including quality of life and functional outcomes.

8:00 AM Does Everyone Need an Operation?
8:12 AM Hartmann Procedure or Resection with Primary Anastomosis – Who, What, When, Where, Why?
8:24 AM Damage Control Surgery and Lap Lavage – From One Extreme to Another?
8:36 AM Practical Tips for Minimally Invasive Approach
8:48 AM Q&A

8:00 AM – 9:00 AM

Maintaining Passion and Fun in the Practice of Surgery: Tips on Inspiring Surgeons

Session Chair: Horacio Asbun, MD | Session Co-Chair: Ajita Prabhu, MD
DEI, Business of Surgery

Burnout among the surgical workforce has emerged as a concerning and worsening phenomenon, and various methods to counter it have been emphasized in publications and conferences. Focus on maintaining the joy of the practice of surgery serves as a major intervention in attempting to prevent dissatisfaction and burnout. In this session, the speakers will discuss scalable interventions that may help to recover morale and return enjoyment to our noble profession. Here we invite some well-known surgical leaders to present pragmatic examples of what has worked well for them personally and/or at a leadership level for the members of their surgical team.

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

• Relate to and articulate common strategies to maintain the joy in the practice of surgery in surgical departments around the United States.
• Identify opportunities to offer interventions within local surgical departments.
• Discuss strategies in the decision making of career opportunities to maintain focus on what is important and brings professional satisfaction on a personal level.

8:00 AM Introduction
8:01 AM Looking After the Surgical Members of Your Health System
8:16 AM Boosting Morale Through Professional Development
8:26 AM Inspiring Through Courses and Programs
8:36 AM Effective Teams: Leading Through Change
8:46 AM Q&A

8:00 AM – 9:00 AM

Scientific Sessions:

Accepted Oral & Video Presentations

8:00 AM – 9:00 AM

How to Evolve Your Practice Using AI (Non CME)

Session Chair: Ozanan Meireles, MD | Session Co-Chair: Daniel Hashimoto, MD, MTR
Business of Surgery, Emerging Technology, Sustainability

The rapid advancements in Artificial Intelligence (AI) have ushered in a new era of surgical practice, offering unprecedented opportunities for enhanced decision-making, surgical guidance, and educational assessment. This session aims to provide a comprehensive overview of the transformative impact of AI on surgical practice, elucidating both its potential benefits and ethical considerations. Topics include incorporation of use of AI to improve clinical operations and sustainability, large language models, mHealth for perioperative care, and the evolution of simulation in the era of AI. The course is designed for surgeon-scientists, clinicians, educators, academicians, and healthcare professionals interested in leveraging AI to augment surgical outcomes and patient care.

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

• Articulate the foundational principles of AI and their applicability in surgical practice.
• Evaluate the current and potential applications of AI in surgical decision-making, guidance, and education.
• Formulate strategies for the integration of AI technologies into their own surgical practice or research endeavors.

8:00 AM Introduction
8:03 AM Using AI and Multimodal Datasets for Clinical Predictions
8:13 AM Large Language Models in Surgical Practice
8:23 AM Natural Language Processing and Medical Writing: Instructions for Use
8:33 AM Tech-Enabled Perioperative Care
8:43 AM AI Surgical Navigation in Gastric Cancer Surgery
8:53 AM Panel: Making My Practice AI Ready Today

8:00 AM – 9:00 AM

The Great Debates: International Hernia Collaboration at SAGES (Non CME)

Session Chair: Brian Jacob, MD | Session Co-Chairs: Talar Tejirian, MD & Megan Smith
Hernia

The IHC is now in its 11th year, connecting over 13,000 members with 200 posts a month. With each post there is immediate global hernia education to over 100 countries with subsequent potential patient care optimization. Some of the topics and decisions remain debatable. This session is designed for the learner to see a few of the current hernia debates happening in 2024.

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

• Identify optimal technique for treating diastasis.
• Understand the key differences between the use of data vs real time video for hernia surgery education.
• Understand the different ways to approach an inguinal hernia in patients who have had prostatectomies.

8:00 AM Debate 1 Introduction
8:01 AM Safety First: Open Inguinal Hernia Repair is a Better Choice After Prostatectomy
8:08 AM Danger Exaggerated: Robotic Inguinal Hernia Repair is Safest After Prostatectomy
8:15 AM Debate 2 Introduction
8:16 AM The Original Tummy Tuck for Diastasis: Too Good to be Replaced
8:23 AM I Don`t Want a Large Incision: SCOLA with or without Mesh is the Future for Diastasis Repair
8:30 AM Debate 3 Introduction
8:31 AM Best Way to Learn Hernia Repair: Data is Key – AHSQC Leads the Way
8:38 AM Forging New Paths of Education With IHC: Data is Unnecessary
8:45 AM Q&A

9:00 AM -9:45 AM

Presidential Address: Pat Sylla, MD

9:45 AM – 4:00 PM

Exhibits/Education & Innovation Center

9:45 AM -10:15 AM

Morning Mimosas in the Exhibit Hall

10:15 AM – 11:00 AM

Karl Storz Lecture:

11:00 AM – 12:00 PM

Presidential Session: Innovate and Collaborate for a Sustainable Future (Non CME)

Session Chair: Pat Sylla, MD | Session Co-Chairs: Shaneeta Johnson, MD & Stefania Marconi

The field of surgical practice constitutes a significant global source of pollution, paradoxically serving as an inadvertent contributor to trends that undermine public health. This session aims to analyze the far-reaching consequences of surgical practices on global environmental sustainability. It will also involve a comprehensive exploration of sustainable methodologies and solutions, considering both research and commercial perspectives.

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

• Identify and evaluate the implications of minimally invasive surgery on environmental sustainability.
• Implement equitable solutions to surgical sustainability.
• Apply global best practices for sustainable surgery.
• Identify how innovations in industry can impact sustainable surgery practices.

11:00 AM Introduction
11:05 AM Teamwork for a Sustainable Hospital
11:15 AM Surgical Research to Improve Environmental Sustainability
11:25 AM The Industry Perspective on Environmental Sustainability of Surgical Practice
11:35 AM Reuse and Recycle: Industry Role in Surgical Sustainability
11:45 AM Q&A

11:00 AM – 12:00 PM

Scientific Sessions:

Accepted Oral & Video Presentations

12:00 PM -1:30 PM

Complimentary Lunch in the Exhibit Hall

Enjoy lunch while you explore latest products and technologies offered by our exhibits.

1:30 PM – 3:30 PM

How I do the Perfect Paraesophageal Hernia Repair in Imperfect Scenarios (Masters)

Session Chair: Caitlin Houghton, MD | Session Co-Chairs: Christy Dunst, MD & Thadeus Trus, MD
Foregut, Endoscopy, Medical Errors, Risk Management

A paraesophageal hernia repair is one of the most elegant demonstrations of surgical technique and mastery in the field today. The surgical nuances of this procedure must be executed with precision to avoid injury to major mediastinal structures, avoid early recurrence and maintain physiologic function. The margins between success and failure are narrow even in the most favorable conditions. The complexity of this surgery is only elevated in the imperfect ones. Learn from leaders in the field on how to successfully navigate imperfect scenarios such as difficult crural closures, short esophagus, volvulus and unexpected intra-operative complications. This is a must attend session for anyone serious about Foregut Surgery!

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

• Navigate anatomical challenges that make paraesophageal hernias difficult to maintain successful outcomes.
• Determine best strategies to salvage emergent and unforeseen intra-operative complications.
• Provide successful outcomes to patients in the most challenging patient subgroups.

1:30 PM Introduction
1:35 PM How I Do the Perfect Crural repair in Difficult Scenarios
1:47 PM How I Do the Perfect Collis Gastroplasty
1:59 PM How I Do the Perfect Paraesophageal Hernia Repair After Previous Mesh Implantation
2:11 PM How I Do the Perfect Paraesophageal Hernia Repair in the Obese Patient
2:23 PM How Does Frailty Affect My Paraesophageal Hernia Repair
2:35 PM How I Do the Perfect Paraesophageal Hernia Repair in Emergent Situations
2:47 PM How I Salvage a Paraesophageal Hernia Repair After Intraoperative Complications
2:59 PM Q&A

1:30 PM – 3:30 PM

Bariatric Calamities: Videos from the Bariatric Facebook Group

Session Chair: Allison Barrett, MD, FACS | Session Co-Chairs: Salim Hosein & Victoria Lyo
Bariatric, Endoscopy, DEI, Medical Errors, Ethics

This session will review some exceptional videos from the bariatric surgery social media groups.

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

• Describe bail-out strategies for addressing complications from bariatric surgery.
• Evaluate surgical techniques as they pertain to addressing emergency bariatric surgeries.
• Recognize limitations in current practice patterns with respect to managing bariatric complications.

1:30 PM Laparoscopic Exploration for SBO in RYGB Patient (Posted 9/11/2022)
1:40 PM Laparoscopic Exploration for Jejunal Intussusception (Posted 9/9/2021)
1:50 PM Management of Jejunal Obstruction After RYGB (Posted 5/14/2023)
2:00 PM Robotic and Laparoscopic Stapler Malfunctions (Posted 12/17/2022 and 1/22/2023)
2:10 PM Laparoscopic Exploration for Perforated Stomach After Endoscopic Sleeve Gastroplasty (Posted 7/18/2022)
2:20 PM Robotic Revision of Chronic Marginal Ulcer (Posted 9/18/2022)
2:30 PM Braun Enterostomy for Early Postop Bowel Obstruction (Posted 10/23/22)
2:40 PM Endoscopic Stricture Dilation and PEJ Placement (Posted 11/3/2021)
2:50 PM Management of Sleeve Leak (Posted 3/28/2021)
3:00 PM Panel Discussion

1:30 PM – 3:30 PM

Hall of Shame: Hernia Complications and Their Management

Session Chair: Igor Belyansky, MD | Session Co-Chairs: Vedra Augenstein, MD & Pete Santoro, MD, FACS
Hernia, Acute Care, Infectious Disease, Risk Management, Medical Errors

Hernia experts will share their complicated cases in this session in M&M style presentation. This will conclude with video presentations of several unique complications. Understanding complications is paramount to improving your outcomes.

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

• Articulate common complications in hernia repair.
• Distinguish diagnostic modalities and intervention in delayed complications.
• Illustrate decision making on how to approach a variety of intraoperative complications.

1:30 PM Recognized Bowel Injury During Hernia Repair, Now What?
1:42 PM Missed Bowel Injury During Hernia Repair
1:54 PM Rives Stoppa Repair and Posterior Layer Breakdown
2:06 PM Abdominal Wall Reconstruction Complicated by Mesh Infection
2:18 PM When Robotic TAR has Gone Wrong
2:30 PM I am Doing a Robotic Flank Hernia and This Happens…
2:42 PM You are Doing an Open Removal of Inguinal Hernia Plug and This Happens…
2:54 PM You are Doing a Minimally Invasive Inguinal Hernia and This Happens…
3:06 PM Q&A

1:30 PM – 3:30 PM

SAGES/ASGE: The Future is Organ Preservation – Pushing the Limits of Endoluminal Resection

Session Chair: James Ellsmere, MD | Session Co-Chairs: Erika Fellinger, MD, FACS & Stavros Stavropoulos, MD, FASGE, AGAF, FJGES, NYSGEF
Colorectal, Endoscopy, Sustainability, Quality, Ethics

This session is designed for practicing surgeons, gastroenterologists, trainees and other health care professionals interested in learning more about the endoscopic resections of gastrointestinal neoplasms. The lectures will focus on dilemmas facing therapeutic endoscopists who routinely remove early gastrointestinal neoplasms. Technologies will be discussed that will enable broader adoption of these organ preserving methods. Mid and long term data will be presented to show how these techniques continue to push our understanding of what should be removed endoscopically.

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

• Recognize which patients with gastrointestinal neoplasms are candidates for endoscopic resections.
• Articulate the pros and cons of endoscopic vs transabdominal resections of early gastrointestinal neoplasms.
• Recognize opportunities to adopt techniques that enable the broader adoption of endoscopic resections.

1:30 PM Should We Endoscopically Resect or Ablate Barrett`s Dysplasia?
1:45 PM Innovative Closure Techniques Have Expanded the Role in Endoscopic Gastric Resection
2:00 PM Resecting Non-ampullary Duodenal Polyps Endoscopically Continues to Evolve
2:15 PM Endoscopic Full Thickness Colonic Resection is Effective but Underused
2:30 PM Are We Using Endoscopic Submucosal Dissection (ESD) Enough for Endoscopic Colonic Resections?
2:45 PM TES After Neoadjuvant Treatment for Early Cancer
3:00 PM Discussion

1:30 PM – 2:30 PM

SAGES/AHPBA: The Difficult Gallbladder

Session Chair: Sean Cleary, MD | Session Co-Chair: Sara Hennessy, MD
HPB, Acute Care, Immunofluorescence, DEI

Cholecystectomy is one of the most common general surgery operations with more than 1.2 million gallbladders removed each year in the US. Increasing the safety of this operation has been a major focus on combined efforts of SAGES and the AHPBA. These safety principles and concerns are particularly relevant in cases with significant acute and chronic inflammation. In this session we discuss new and emerging technologies in gallbladder surgery and evaluate their potential to improve the safety of this operation.

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

• Describe the potential new and emerging technologies for cholecystectomy.
• Evaluate these new technologies and their potential to enhance safety.
• Identify situations where new technology may help contribute to reduction in bile duct injury.

1:30 PM Artificial Intelligence in Guiding Safe Cholecystectomy
1:40 PM Debate #1: Which is Safer Robotic vs Laparoscopic Cholecystectomy? – Robotic
1:47 PM Debate #1: Which is Safer Robotic vs Laparoscopic Cholecystectomy? – Laparoscopic
1:54 PM Debate #2: ICG vs Contrast Cholangiography – ICG
2:01 PM Debate #2: ICG vs Contrast Cholangiography – Contrast
2:08 PM Debate #3: Subtotal Cholecystectomy – Fenestrating vs Closure – Fenestrating
2:15 PM Debate #3: Subtotal Cholecystectomy – Fenestrating vs Closure – Closure
2:22 PM Q&A

1:30 PM – 2:30 PM

Up and Coming Robotics (Non CME)

Session Chair: Allan Okrainec, MD | Session Co-Chair: Alexis Grucela, MD
Endoscopy

This is a non CME session designed to give attendees a chance to learn about current and emerging robotic platforms and the new technology that is on the horizon.

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

• Demonstrate new and emerging robotic platforms that are on the horizon.
• Recognize potential benefits and challenges of these new robotic platforms.
• Assess and illustrate how these new platforms may be applied to current and future surgeon`s practice.

1:30 PM Introduction
1:31 PM Hugo RAS
1:41 PM MIRA Virtualincision
1:51 PM CMR Versius
2:01 PM Emerging Robotics Platforms & Incorporating New Robotics Systems Into Your Hospital
2:11 PM Q&A

1:30 PM – 6:00 PM

ADOPT Hands-on Course: Common Bile Duct

Session Chair: Carl Westcott, MD | Session Co-Chairs: Fernando Santos & Frederico Serrot, MD, FACS, FASMBS

Didactics and hands on Lab designed to improve general surgeons management of common bile duct stones.

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

• Recognize and describe the benefits of the “surgery first” approach to common bile duct stones.
• Implement new strategies for attaining and interpreting intraoperative images of the biliary system.
• Improve access to and clearance of common bile duct stones at the time of cholecystectomy.

1:30 PM Introduction
1:35 PM Surgery First Approach to CBD Stones
1:50 PM Intraoperative Cholangiography and Biliary Access
2:05 PM Intraoperative Ultrasound in Cholecystectomy and Choledocolithiasis
2:20 PM Panel Discussion
2:30 PM Balloon Sphincteroplasty and Fluoroscopic Extraction
2:45 PM Biliary Endoscopy
3:00 PM Lithotripsy
3:15 PM Case Presentations and Decision Tree Discussion
3:30 PM Hands-on Lab

1:30 PM – 3:30 PM

Emerging Technology (Non CME)

Emerging Technology

2:30 PM – 3:30 PM

Lessons Learned: Laparoscopy on the Battlefield

Session Chair: Robert Lim, MD | Session Co-Chair: Mary O`Donnell
Military, Acute Care

The use of minimally invasive surgery for trauma care management is growing in popularity and occurrence. Russia’s invasion of Ukraine has presented opportunities to use laparoscopic techniques in combat care as well. Some of this is due to necessity as evacuations are more difficult and CT scanners are not available near the battlefront, so laparoscopy has been used as a diagnostic tool. Injured soldiers can return to duty faster after undergoing a laparoscopic procedure and some serious injuries like penetrating injuries to the bowel or liver can be treated this way. Additionally, while many of Ukraine`s surgeons have been deployed to the battlefield, emergent general surgery care is still needed. Other surgeons have gone to help Ukrainian citizens with these diseases. Use of laparoscopy decreases hospital stay enabling the hospitals to accommodate more of the war-injured. It also allows a faster recovery, meaning citizens can continue their efforts to help against the invasion. The talks of this session will discuss the experience and use of laparoscopy at Role II hospitals in Ukraine and the use of MIS techniques for emergency general surgery care.

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

• Identify the unique challenges of trauma injury diagnosis on the battlefield.
• Learn when to implement laparoscopy on the battlefield.
• Illustrate the benefits of laparoscopy on the battlefield and during war-time.

2:30 PM Introduction
2:32 PM Surgical Care Challenges During War Against a Near-peer Adversary
2:37 PM Why and When to Use Laparoscopy to Treat Combat Injuries on the Battlefield
2:52 PM The Other Surgery of War and How Laparoscopy Helps
3:07 PM 10 Years of Laparoscopy on the Battlefield and Its Future Role in Combat
3:22 PM Q&A

2:30 PM – 3:30 PM

Tips and Tricks: How to Harness Immunofluorescence (Non CME)

Session Chair: Rahila Essani, MD | Session Co-Chair: Emily Miraflor, MD
Acute Care, HPB, Bariatrics, Foregut, Business of Surgery, Immunofluorescence

During this session, a range of applications for Immunofluorescence in surgical procedures will be explored. The discussion is designed to benefit surgeons in general practice, acute care, minimally invasive procedures, and surgical oncology. The session aims to share diverse ways in which Immunofluorescence can be utilized in surgery. Additionally, the session will offer valuable insights and strategies for effectively integrating Immunofluorescence into surgical practice, including guidance on billing and coding. Furthermore, the session will delve into the future prospects of Immunofluorescence in the field of surgery.

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

• Identify and illustrate a range of applications for Immunofluorescence in surgical procedures.
• Provide valuable insights and strategies for effectively integrating Immunofluorescence into surgical practice, including guidance on billing and coding.
• Utilize Immunofluorescence in high risk situations where there is high risk of ureteral injury.

2:30 PM Introduction
2:34 PM Exploring the Lighter Side: Making Immunofluorescence a Ureteral Safety Net
2:46 PM The Illuminated Quest: Does Immunofluorescence Deliver Genuine Perfusion Assessment or Hype?
2:58 PM The Glow-Getter: Immunofluorescence Lighting Up the Stage in Gastrointestinal Cancer!
3:10 PM The Gleaming Crystal Ball: Anticipating the Immunofluorescence Journey in Surgical Frontiers
3:22 PM Q&A

3:30 PM -4:00 PM

Afternoon Break in the Exhibit Hall

4:00 PM – 5:00 PM

Plenary I

Accepted Oral & Video Presentations

5:00 PM – 6:00 PM

Addressing Reflux Before and After Bariatric Surgery

Session Chair: Talar Tatarian, MD | Session Co-Chair: John Romanelli, MD
Bariatric, Endoscopy, Appropriate Prescribing

A surgeon`s guide to addressing reflux before and after bariatric surgery. Surgeons practicing bariatric surgery or those who treat reflux should attend and discuss the nuances of reflux management in the bariatric population.

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

• Review basic preoperative workup for evaluation of reflux in the bariatric patient and identify scenarios warranting additional testing.
• Define clinically significant reflux.
• Compare options for the surgical treatment of reflux in patients with obesity.
• Review endoscopic and surgical options for the management of medically refractory reflux after sleeve gastrectomy.

5:00 PM Introduction
5:05 PM Preoperative Evaluation of Reflux in the Bariatric Patient
5:15 PM My Patient Has Severe Reflux with BMI 35-40, But They Do Not Want Bariatric Surgery – What Now?
5:25 PM Is Sleeve Gastrectomy Contraindicated in Patients with Clinically Significant’ Reflux?
5:35 PM Medically Refractory Reflux After Sleeve Gastrectomy: What are the Treatment Options?
5:45 PM Poll the Panel: Case Vignettes

5:00 PM – 6:00 PM

Devil is in the Details: Managing Gastroparesis

Session Chair: William Richardson, MD | Session Co-Chair: Kellie McFarlin, MD
Quality, Endoscopy, Foregut, Patient Voice, Appropriate Prescribing

We will discuss the etiology, diagnosis and treatment (medical, endoscopic and surgical) of gastroparesis. Practitioners interested in treatment of this disease process are encouraged to attend.

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

• Describe the etiology of gastroparesis.
• Describe the diagnosis of gastroparesis.
• Describe surgical and non surgical treatments for gastroparesis including endoscopic and mis treatments.

5:00 PM Introduction
5:05 PM Patient Experience
5:15 PM Etiology of Gastroparesis
5:22 PM Diagnosis of Gastroparesis
5:29 PM Medical Treatment of Gastroparesis
5:39 PM Surgical and Endoscopic Treatment of Gastroparesis
5:49 PM Q&A

5:00 PM – 6:00 PM

Better Living Through Modern CheMESHtry: Hernia Mesh and Medications

Session Chair: Sean Orenstein, MD | Session Co-Chair: Archana Ramaswamy, MD, MBA
Hernia, Appropriate Prescribing, Use of Controlled Substances, Pain Management

This session will review general concepts of modern hernia mesh prosthetics as well as discuss other contemporary adjuncts to hernia repair and postoperative care, including enhanced recovery pathways, Botox chemical component separation, and more.

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

• Recognize basic mesh characteristics and differences between various mesh products (material, weight/density, porosity, etc) for ventral and inguinal hernia repairs.
• Gain familiarity with enhanced recovery pathway medications that facilitate postoperative recovery and discharge.
• Describe adjuncts that support fascial closure in abdominal wall reconstruction procedures.

5:00 PM Introduction
5:05 PM Overview of Meshes
5:13 PM Groin Mesh Updates
5:21 PM Mesh Labeling
5:29 PM Enhanced Recovery Pathway Medications
5:37 PM Botox Chemical Component Separation
5:45 PM Q&A

5:00 PM – 6:00 PM

Unveiling the Future of Colorectal Surgery: State-of-the-Art Technological Advancements (Non CME)

Session Chair: Sami Chadi, MD, MSc, FRCSC, FACS, FASCRS | Session Co-Chair: Armando Melani, MD
Colorectal, Emerging Technology, Immunofluorescence, Sustainability

During this session, participants will be exposed to state of the art advances in technology in the area of colorectal surgery. The invited speakers will discuss technological advancements in the areas of endoluminal robotics, anastomotic leak prevention, artificial intelligence and enhancements in visualization.

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

• Describe advancements in technology in anastomotic leak prevention.
• Understand the upcoming technological options for enhanced visualization and artificial intelligence.
• Understand current and upcoming options in endoluminal robotic interventions.

5:00 PM Introduction
5:02 PM What`s New in Anastomotic Leak Prevention?
5:14 PM Beyond What Our Eyes Can See – The Use of Dyes and Computer Vision
5:26 PM The Use of Artificial Intelligence in Colorectal Oncology
5:38 PM Robotic Colorectal Interventional Endoscopy – What’s On the Horizon and Where are We At?
5:50 PM Q&A

5:00 PM – 6:00 PM

Scientific Sessions:

Accepted Oral & Video Presentations

5:00 PM – 6:00 PM

No Pain, No Gain: Solutions for a Sustainable OR (Non CME)

Session Chair: Linda Zhang, MD | Session Co-Chair: Gifty Kwakye
Sustainability, DEI

The healthcare industry contributes substantially to the global climate crisis, with the operating room accounting for the largest share. The direct negative impact on the environment and health of people is quite evident, a stark contrast to our oath to first do no harm. This session will raise awareness of how every day practices contribute to the problem and review innovative strategies to mitigate this from a global lens. This session is open to all physicians, trainees and staff engaged in perioperative care.

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

• Identify 1-2 sustainable solutions that can be easily implemented in operating rooms to reduce the carbon footprint.
• Appraise various high-tech monitoring systems utilized in the operating room to improve OR efficiency.
• Identify green technology and low-cost solutions that can be employed by low-resource hospitals to minimize the carbon footprint.
• Demonstrate an understanding of what reprocessing of single use devices comprises and what are the required safety oversights.

5:00 PM Introduction
5:05 PM Planetary Health and Strategies for Sustainable OR
5:15 PM Building Solar-powered Sustainable ORs of the Future
5:25 PM Integrating Green Technology with Low-Cost Solutions in Building Sustainable Surgical Care in Uganda
5:35 PM Reprocessing of Medical Equipment as a Sustainable Supply Alternative
5:45 PM Q&A
5:55 PM Conclusion

6:00 PM – 7:00 PM

Meet the Leadership Reception (Invitation Only)

7:30 PM – 11:30 PM

Main Event at The Rock & Roll Hall of Fame

6:00 AM – 2:30 PM

Speaker Ready Room

8:00 AM – 2:00 PM

SAGES Mini Medical School

8:30 AM – 10:00 AM

Plenary II

Accepted Oral & Video Presentations

10:00 AM – 11:30 AM

Endoluminal Solutions to Foregut Problems

Session Chair: Ryan Juza, MD | Session Co-Chair: Allison Schulman, MD, MPH
Endoscopy, Foregut

Endoluminal Solutions to Foregut Problems includes a medley of advanced therapeutic endoscopic techniques for the management of various upper gastrointestinal issues. Topics will include: endoscopic defect closure, management of surgical complications, eVAC, Feeding tube Tips and tricks, ARMS/Antireflux operations, Primary endoscopic procedures for weight loss, Endoscopic revision of bariatric surgery, POEMS/POP, ERCP in altered anatomy.

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

• Describe the various endoscopic techniques for the management of postsurgical gastrointestinal leaks and complications.
• Discuss therapeutic endoscopy procedures that have the potential to replace surgical interventions.
• Describe advanced endoscopic techniques is surgically altered anatomy.

10:00 AM Endoscopic Defect Closure
10:06 AM Endoscopic Management of Surgical Complications
10:12 AM eVAC
10:18 AM POEM/POP
10:24 AM Primary Endoscopic Procedures for Weight Loss
10:30 AM Endoscopic Revision of Bariatric Surgery
10:36 AM ARMS/Antireflux Operations
10:42 AM ERCP in Altered Anatomy
10:48 AM Feeding Tube Tips and Tricks
10:54 AM Q&A

10:00 AM – 11:30 AM

Weight Regain After Bariatric Surgery

Session Chair: Teresa LaMasters, MD | Session Co-Chair: Yong Choi, MD
Business of Surgery, Bariatric, DEI, Endoscopy, Ethics, Appropriate Prescribing

Participants will learn about options for treating patients with persistent obesity or recurrent obesity following metabolic bariatric surgery including weight regain.

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

• Understand the science behind Metabolic Bariatric Surgery.
• Develop a strategy for surgical options to treat persistent or recurrent obesity.
• Integrate multimodal therapy including behavioral, endoscopic, and medications to enhance surgical outcomes.

10:00 AM Introduction
10:05 AM The Science of Metabolic Bariatric Surgery
10:20 AM Surgical Treatment Options After Sleeve Gastrectomy
10:30 AM Options for Weight Gain After Bypass – Now What?
10:40 AM Endoscopic Intervention Options
10:50 AM Using Your Team Support to Treat Weight Gain
11:00 AM Medications to Enhance Surgical Options
11:10 AM Panel Discussion
11:20 AM Q&A

10:00 AM – 11:30 AM

SAGES/ALACE/AAST: hERnia – Emergency Hernia Surgery Do’s and Don’ts

Session Chair: Arielle Perez, MD, MPH, MS | Session Co-Chairs: Caroline Reinke, MD & Luis Chiroque-Benites, MD, MHSA
Hernia, Acute Care, Colorectal

In this session, SAGES will join our Latin American colleagues from ALACE and colleagues from AAST. Participants will learn how to adeptly handle challenging abdominal wall issues common to the general surgeon when on call.

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

• Manage the care and treatment of a patient presenting with an emergent parastomal (urosotomy/colostomy/ileostomy) hernia related issue.
• Develop an algorithm to handle acute GI issues (ie. cholecystititis, SBO, perforated ulcer, bariatric complications, diverticulitis, etc) in patients who have had prior abdominal wall reconstruction.
• Identify techniques for closing a difficult hernia/abdominal wall after emergency surgery.
• Assess best technique for addressing traumatic flank hernias at time of trauma exploratory laparotomy.
• Evaluate the best strategy to manage an obstructed and/or strangulated inguinal hernia.

10:00 AM Emergent Care of Parastomal Hernias
10:10 AM How to Handle Acute GI Emergencies Following Abdominal Wall Reconstruction
10:20 AM It Won’t Close! – How to Handle a Difficult Abdominal Defect
10:30 AM Traumatic Flank Hernia at the Time of Trauma Ex-Lap
10:40 AM It`s Reduced, Now What Do You Do?
10:50 AM Minimally Invasive Management of Incarcerated Inguinal Hernia
11:10 AM Q&A

10:00 AM – 11:30 AM

Trials and Tribulations: Tackling Inflammatory Bowel Disease

Session Chair: Meagan Costedio, MD | Session Co-Chair: Deborah Keller, MS, MD
Colorectal, Patient Voice, DEI, Pediatrics, Pain Management, Use of Controlled Substances, Appropriate Prescribing

This course is designed for surgeons, trainees, and other providers to learn the current recommendations and best practice updates in medical therapy, trials and surgical approaches for inflammatory bowel disease. We are also excited to include how surgeons can improve the patient experience for patients with inflammatory bowel disease by addressing the transition in care to adulthood, sexuality, and patient fears.

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

• Classify new medications available for IBD and identify which patients benefit from surgery.
• Demonstrate the different types of anastomoses and stricturoplasties, with the reasoning for performing each.
• Implement ways to improve the patient experience by providing guidance for sexuality counseling, transitions to adulthood, and patient advice for easing perioperative anxiety.

10:00 AM Introduction
10:02 AM Surgical Management of Complicated Crohn’s Disease Cases
10:12 AM What Connection and When: Anastomosis or Stricturoplasty?
10:22 AM Transition of Care – Decision Making from Pediatrics to Adulthood
10:32 AM Medications for IBD and When Do We Operate
10:42 AM Trials Update
10:52 AM Fertility and Sexuality in IBD Surgery
11:02 AM The Patient Perspective – Video
11:07 AM Q&A

10:00 AM – 11:30 AM

Residents & Fellows Session

Education

In this session, residents and fellows representing the next generation of SAGES members will present their best research to a panel of expert faculty. A selection of the top submitted abstracts will ensure top quality research with a broad range of current topics.
After each presentation, expert panelists/judges will rank each resident/fellow presenter with regards to study contents, significance in clinical surgery, originality, study designs/methodology, interpretation and analysis of study findings/results, appropriate use of statistical tests, and overall presentation skills (including slides, clarity of presentation, and audience engagement). Awards will be given to two (2) top presenters at the conclusion of the session.

11:30 AM – 12:00 PM

Morning Break

12:00 PM – 1:00 PM

Building Your Reflux Center: How to Accelerate your Program

Session Chair: Robert Catania, Md | Session Co-Chair: Cory Richardson, MD
Business of Surgery, Advocacy, DEI, Foregut, Risk Management, Ethics

This session is designed for all surgeons interested in opening or expanding an existing Reflux Center. We will provide information on the resources needed and give practical information on how to establish, market, and grow your anti-reflux practice.

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

• Describe the infrastructure needed to establish and grow a Reflux Center.
• Develop relationships with providers in their communities to promote the care of patients with reflux disease.
• Recognize the importance of achieving excellent outcomes on program growth and development.

12:00 PM Introduction
12:03 PM Bricks and Mortar: The Infrastructure of a Reflux Center
12:13 PM Picking the Tools for Your Toolbox: What Services Will You Offer
12:23 PM Getting Patients Through the Door: Marketing and Growing Your Practice
12:33 PM Am I Doing This Right? Ensuring Quality in Your Practice
12:43 PM Building the Business: Growing Your Practice and Working with Practice Administration
12:53 PM Q&A

12:00 PM – 1:00 PM

Scientific Sessions:

Accepted Oral & Video Presentations

12:00 PM – 1:00 PM

HERnia: Gender Based Differences in Hernia Management

Session Chair: Shirin Towfigh, MD | Session Co-Chair: Jacob Greenberg, MD, EdM
Hernia, DEI, Patient Voice

Hernias are ubiquitous, but there is a paucity of data on hernia repairs specifically addressing females and their gender-specific situations. Most inguinal hernia didactics are focused on the male patient. Some abdominal hernia discussion has centered around the pregnant patient, though the average surgeon is unaware of a standard of care. We focus on exposing the differences in treating males vs females for both ventral and inguinal hernias with goals of improving gender-based outcomes.

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

• Identify clinical situations relevant to hernia management in females.
• Elucidate data-driven care of hernias in females.
• Provide treatment algorithms to best address hernias and their management among females.

12:00 PM Introduction
12:02 PM Female Pelvic Anatomy Is UnEqual to a Male’s, and Why That Matters
12:10 PM Hernia Management in Females: Where is the Data?
12:18 PM I am a Female with a Hernia: I Wished My Surgeon Treated Me Like a Male
12:26 PM Groin Hernia Repair in Transgender Patients
12:34 PM All the Effects of Pregnancy on Hernia Repair Planning: Before, During & After the Bump
12:42 PM Q&A

12:00 PM – 1:00 PM

Surgical Ergonomics: Practical Tips You Can Take Home Today!

Session Chair: Julie Hallet | Session Co-Chair: Ian Soriano, MD, FACS, FASMBS
DEI, Business of Surgery

Working in an Operating Room is physically demanding and mentally taxing. The importance of ergonomics is often overlooked, leading to increased instances of injuries among healthcare professionals. This session aims to transform the OR experience by focusing on ergonomic principles that promote health and efficiency. Through this session, attendees will gain practical strategies for preventing injuries, insights into early recognition of work-related injuries, and tools to advocate for an ergonomic OR environment. As a special takeaway, a ‘tool kit’ featuring ‘10 Things You Can Do Tomorrow’ will be made available via QR code, summarizing key points from each presentation.

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

• Identify key ergonomic considerations both inside and outside the OR, including the importance of stretches, instrument handling, equipment set-up, and the role of the operative team in ensuring ergonomic safety.
• Prevent injuries, including the value of recovery treatments outside of the OR, and they will gain insight into the early recognition of injuries and steps to take in case of injury related to work in the OR.
• Advocate for ergonomic improvements and support in the OR.

12:00 PM Introduction
12:05 PM Out of the OR: Preparation & Recovery
12:16 PM In the OR: Instruments & Equipment
12:27 PM In the OR: Building on the Team
12:38 PM Managing OR-related Injuries
12:49 PM Q&A

12:00 PM – 1:00 PM

Scientific Sessions:

Accepted Oral & Video Presentations

1:00 PM – 2:00 PM

Scientific Sessions:

Accepted Oral & Video Presentations

2:00 PM – 3:00 PM

Scientific Sessions:

Accepted Oral & Video Presentations

Station 1: Top Gun Laparoscopic Skills Shootout

Station Coordinator(s): Dr. James Rosser

Station Description:

The Top Gun Laparoscopic Skill Shootout has been a cornerstone of the learning center for nearly two decades. This competition-based learning program showcases the demonstration of minimally invasive skills and suturing. The extensive scientific validation of this program is well-documented in the literature. Intracorporeal suturing remains the gateway to adopting advanced procedures. The program has proven to be engaging for both residents and surgeons. On average, over 100 participants navigate the station in six hours. Since its inception, it has consistently been the main attraction in the learning center, drawing a high number of visitors. Qualifying takes place throughout the day on Thursday, with the finals held on Friday. The event always unfolds in front of an enthusiastic crowd, and trophies are awarded for the first, second, and third place, as well as for the fastest suture.

Station 2: LCBDE Laparoscopic Common Bile Duct Exploration

Station Coordinator(s): Drs. B. Fernando Santos and Michael McCormack

Station Description:

The Laparoscopic Common Bile Duct Exploration and Lithotripsy Station will offer participants an opportunity to gain cognitive knowledge and hands-on experience with the techniques and instruments used for transcystic laparoscopic common bile duct exploration and lithotripsy.  The station will feature educational materials displayed on monitor and two hands-on stations for common bile duct exploration utilizing choledochoscopy as well as EHL (electrohydraulic lithotripsy).  The station will be free-standing and not officially combined with any other station but grouped with relevant stations.  There will be no competitive aspect to this year’s station but rather a focus on education.

Station 3: Simulator for Training and Assessment in Laparoscopic Hiatal Hernia Repair

Station Coordinator(s): Dr. Ganesh Sankaranarayanan PhD, Dr. Daniel J Scott, Dr. Carla Holcomb, and Dr. Alexis Desir

Station Description:

The station will consist of two simulators, one physical that is designed to train/asses skill for performing crural closure, a critical task of laparoscopic hiatal hernia repair, and the other will be a virtual laparoscopic hiatal hernia simulator that is being developed from funding from the NIH, were both Nissen fundoplication and crural closure can be performed. The objectives of our station are:

Crural Closure Task Simulator:

• Introduce the low-cost simulator for training in crural closure to the SAGES community including details of how to set up at their own institution using 3D printing.
• Collect data (with IRB approval) to establish validity of the simulator using the developed task-specific simulator.
• Use the collected data to develop a robust AI model for automated assessment. We will also make the data, annotations, and the model available to public, so, it will be beneficial to the entire SAGES community.

Virtual Laparoscopic Hiatal Hernia Simulator:

• Introduce the research simulator to the SAGES community.
• Collect performance data (with IRB approval) to establish the content and discriminant validity.

Station 4: Project Interpret Cholangiogram: Are you brave enough to take the cholangiogram quiz?

Station Coordinator(s): Dr. Steven Schwaitzberg, Dr. Matthew Bloom, Emily Hannah (MS3)

Station Description:

According to the SAGES Safe Cholecystectomy Program, cholangiograms should be used liberally to improve detection of BDI and reduce incidence of BDI in LC. One possible explanation for the current underutilization of cholangiograms is a lack of familiarity in both performing and interpreting cholangiograms, particularly amongst surgical trainees. Prior studies have proposed that assessing current knowledge states of surgeons and targeted educational interventions are possible solutions to improving incidence of BDI. Cholangiography is a critical skill for surgical training and practice. Access to and implementing education on cholangiography is essential to meeting the quality improvement goals outlined by the SAGES Safe Cholecystectomy Taskforce. The data from our station will be utilized for an assessment to further underscore gaps in cholangiography education to inform creation of a cholangiogram curriculum. We hope to turn over our findings to SAGES Safe Cholecystectomy Taskforce in hopes of development of a curriculum readily accessible to the SAGES community, and ultimately, address this educational gap to improve patient safety and reduce incidence of BDI in surgical practice.

Station 5: Trauma Fundamentals: When Bad Things Happen

Station Coordinator(s): Drs. Andrew Schlussel and Katherine Cameron

Station Description:

Unfortunately, disaster events are a part of our daily lives, and at any given moment, we could find ourselves in the middle of one, whether it’s a car accident, an active shooter event, or a natural disaster. As surgeons, it’s imperative that we have the skills to be able to respond and treat the wounded if we find ourselves in one of these situations. Proper tourniquet use, wound packing, and basic field care techniques are essential to help victims of a disaster situation. The ‘Trauma Skills for Disaster Situations’ station will provide you with the opportunity to complete the Stop the Bleed course and learn other field care skills, empowering you to make a difference in disaster situations.

Station 6: ALSA  Advanced Laparoscopic Suturing of Anastomoses

Station Coordinator(s): Dr. Julian Varas

Station Description:

The ALSA station allows the participants to acquire advanced laparoscopic suturing skills to perform permeable and leak-free anastomosis of different sizes and positions.  Participants will practice on validated real-tissue simulation models in high definition endo trainers.  The main goal is to learn how to safely perform hand-sewn and mechanical small bowel anastomosis and the principles to perform small duct-to-mucosa anastomosis.  Instructors will give tips and feedback and also an iOS App with video tutorials will guide participants through the training.  Each exercise has a time goal and all anastomoses performed are tested for permeability and leakage.

Station 7: SimCVS

Station Coordinator(s): Dr. Joseph Liu

Station Description:

The SimCVS station will be showcasing a portable simulation trainer to enhance surgical skill acquisitions for avoiding bile duct injury in laparoscopic cholecystectomy through identifying the critical view of safety.The station objectives are to demonstrating the latest functionalities of the SimCVS system, e.g., visual guided feature; and to provide opportunities for hands-on experience of using the SimCVS system. Those objectives align with the SAGES mission to utilize innovative simulation technology to develop the optimal educational environment for trainees to practice how to identify the critical view of safety, and ultimately improve patient outcomes.

Station 8: VORTeX—Cloud-based VR Team Training

Station Coordinator(s): Drs. Cullen Jackson and Doga Demirel

Station Description:

VORTeX is a networked, collaborative virtual reality (VR) environment for training OR team members in non-technical skills, such as teamwork, communications, and coordination. VORTeX allows the team(surgeons, anesthesiologists, and perioperative nurses) to train together in a distributed manner (i.e., not co-located in the same room or simulation facility) while wearing virtual reality headsets. This shared virtual environment allows for training to be decoupled from expensive, centralized simulation centers while still facilitating high-fidelity and high-quality team training.

The system has several advantages compared to other VR/computer-based training simulators for OR teams: 1) It enables multiple participants to learn together simultaneously and 2) It can assess team performance in near real-time and provide feedback to the team (or observer-trainer) to facilitate debriefing.

At our station at SAGES, participants will don virtual reality (VR) headsets to enter a digital operating room where they will work with standardized participants located at one of our partner institutions (Beth Israel Deaconess Medical Center, Rutgers New Jersey Medical School, Henry Ford Health, Albany Medical Center, Lahey Hospital & Medical Center). This distributed team will work together to solve a surgical crisis over the course of 10-20 minutes. In addition to the VR headsets and computers to run them, the station will include large viewing monitors so that other attendees can observe the active simulation.