News from the Society of American Gastrointestinal and Endoscopic Surgeons

| March 26, 2014

Bariatric Times. 2014;11(3):26–27.

FUNDING: No funding was provided.
DISCLOSURES: The author reports no conflicts of interest relevant to the content of this article.

The mission of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) is to improve quality patient care through education, research, innovation and leadership, principally in gastrointestinal and endoscopic surgery. SAGES is a leading surgical society, representing a worldwide community of over 6,000 surgeons that can bring minimal access surgery, endoscopy and emerging techniques to patients worldwide. The organization sets the clinical and educational guidelines on standards of practice in various procedures, critical to enhancing patient safety and health. For more information, visit www.sages.org.

SAGES Fundamentals of Endoscopic Surgery (FES) Required by American Board of Surgery
FES Elevates the Standards and Training for Minimally Invasive Surgery
Five years ago, SAGES Fundamentals of Laparoscopic Surgery™ or FLS—the nation’s first ever hands-on skills test for performing minimally invasive surgery —became a requirement for board certification by the American Board of Surgery (ABS), the national certifying body for general surgeons and related specialists. FLS set the stage for FES, the Fundamentals of Endoscopic Surgery™, a new program created by SAGES to assess a surgeon’s skill and knowledge in endoscopy, and now required by the ABS as part of the ABS Flexible Endoscopy Curriculum.

The Flexible Endoscopy Curriculum was developed by the ABS in collaboration with SAGES and the American Society of Colon and Rectal Surgeons (ASCRS), American Society for Metabolic and Bariatric Surgery (ASMBS), and Society for Surgery of the Alimentary Tract (SSAT) to address concerns regarding the variability of endoscopic training obtained by general surgery residents. Surgeons graduating residency in the 2017-2018 academic year or thereafter must complete the ABS Flexible Endoscopy Curriculum to be eligible for board certification in general surgery. The curriculum contains several milestones that must be attained through the course of general surgery residency training, one of which is successful completion of FES.
“Patients undergo endoscopy for a number of conditions including Crohn’s disease, colorectal cancer screening, and numerous other digestive problems,” said Dr. Gerald Fried, SAGES President and Chairman of the Department of Surgery at McGill University. Endoscopic surgery uses scopes going through natural body openings in order to diagnose and treat disease whereas small incisions are used during laparoscopic surgery.

“FES is a comprehensive educational and assessment tool designed to teach and evaluate the fundamental knowledge, clinical judgment, and technical skills required in the performance of basic gastrointestinal (GI) flexible endoscopic surgery (endoscopy) and sets a validated benchmark of understanding and skill in basic endoscopy,” Dr. Fried said.
The FES program provides participants with an opportunity to gain required knowledge in a consistent, scientifically accepted format through a didactic curriculum, available without charge at www.fundamentals-didactics.com and to test cognitive and technical skills—all with the goal of improving the quality of patient care. Over 250 accredited general surgery programs in the United States will fall under this new requirement and 18 FES testing sites are available across the United States and Canada with plans for additional sites underway.
“FLS was created as a first step toward ensuring patient safety and enhancing the innovative treatments that were becoming available in the late 1980’s,” added Dr. Jeffrey Marks, Chair of the SAGES FES Committee. “FLS has been instrumental in single-handedly revolutionizing surgical training worldwide, and requiring FES as a part of the ABS Flexible Endoscopy Curriculum is step two of this collaborative effort to elevate the standards and training for MIS.”
Since launching in 2004, nearly 8,500 surgeons have successfully completed the FLS Program which will mark its 10th anniversary this fall.

For more information about the FLS or FES programs, visit www.fesprogram.org and www.flsprogram.org.

SAGES 2014 Annual Meeting, “Putting the Patient First,”
This year’s SAGES conference, “Putting the Patient First: Promoting Innovation and Safety in the OR and Beyond,” will continue a long-standing tradition of strong didactic sessions by experts, combined with exploration of innovative technology and medical breakthroughs in the fields of general, upper GI, colorectal, endoscopic, robotic and minimally invasive surgery (MIS). The meeting will be held at the Salt Palace Convention Center in Salt Lake City, Utah, April 2 though April 5, 2014.

“The program for 2014 focuses on relevant clinical problems that busy surgeons encounter every day in their respective practices including the management of complications, approaches for reoperative surgical cases, and laparoscopy in the acute care setting,” said Dr. Tonia Young-Fadok, SAGES Annual Meeting Program Co-Chair and Chair of the Division of Colon & Rectal Surgery at the Mayo Clinic. “Combining excellent operative care with evidence-based perioperative processes, we can generate the evidence that will move the needle from open to minimally invasive surgery and serve patients best,” added Dr. Jeffrey Marks, SAGES Annual Meeting Program Co-Chair and program director for the Case General Surgery Program and Associate Director of the Surgical Endoscopy Fellowship at Case.
Conference highlights.
•    Enhanced Recovery After Surgery (ERAS) Pathways—How You Can Optimize Perioperative Care, Improve Outcomes and Decrease Costs.
•    Per Oral Endoscopic Myotomy (POEM) Panel
•    Product Development Panel-Innovations for Patients Benefits
•    NOSCAR™ Symposium – Advances in Natural Orifice Surgery
•    Karl Storz Lecture—Optimizing Simulation and Technology in Graduate Surgical Education: State of the Art 2014.
•    SAGES Military Symposium
•    SAGES Global Webcast Sessions
Friday, April 4th:
•    SAGES Humanitarian Session: Global Perspectives to Hands-On Learning
•    Gerald Marks Lecture – Simulation-Based Education as a Cultural Change Vehicle in Patient Safety & Quality Care
•    MIS for Acute Care Surgeons
•    SAGES Mini Medical School Boot Camp and Interactive Experience
•    Bariatric Complications for the non-Bariatric Surgeon

For online registration visit www.sages2014.org

Weight-Loss Surgery for Overweight Type 2 Diabetes Patients Offers Long Term Benefits
Nine Years After Procedure, Obese Patients with Type 2 Diabetes Continue to Improve or Reverse Their Diabetes and Reduce Cardiovascular Risk Factors
SAGES believes patients should know that weight-loss surgery, or bariatric surgery, offers short and long-term benefits for patients with obesity and type 2 diabetes.

According to new research from Cleveland Clinic’s Bariatric & Metabolic Institute, patients will continue to improve or reverse their diabetes, and reduce their cardiovascular risk factors, nine years after the procedure.1 The biggest predictors of sustained diabetes remission are long-term weight loss, a shorter duration of diabetes prior to surgery (less than five years), and undergoing gastric bypass surgery compared to adjustable gastric banding. Among the study’s authors are SAGES members Drs. Ali Aminian, Stacey Brethauer, Bipan Chand, Matthew Kroh, and Philip R. Schauer.

“The majority of obese patients with type 2 diabetes who undergo bariatric surgery have substantial improvement in the ability to control their blood sugars with reduced medication requirements,” said Dr. Kevin Reavis of the Oregon Clinic Division of Gastrointestinal and Minimally Invasive Surgery who co-chairs SAGES Bariatric Liaison Group. “In fact, many patients undergo remission of their diabetes in which case they no longer require medication to control their blood sugars,” Dr. Reavis added.

Patients with morbid obesity with type 2 diabetes should ask their prescribing physician to consider referral for bariatric surgery to address their weight and diabetes issues. Patients considering weight-loss surgery are encouraged to read Laparoscopic Surgery for Severe (Morbid) Obesity Patient Information from SAGES.

References
1.    Brethauer SA, Aminian A, Romero-Talamás H, et al. Can diabetes be surgically cured? Long-term metabolic effects of bariatric surgery in obese patients with type 2 diabetes mellitus. Annals of Surgery. 2013;258(4):628–637.

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