Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) 2020 Meeting Highlights
by Leena Khaitan, MD, MPH, FASMBS
Dr. Khaitan is with University Hospitals, Cleveland Medical Center, Digestive Health Institute, Professor of Surgery in Cleveland, Ohio.
FUNDING: No funding was provided for this article.
DISCLOSURES: The authors report no conflicts of interest relevant to the content of this manuscript.
Bariatric Times. 2020;17(10):20
Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) 2020 was truly a unique meeting! SAGES held its first virtual scientific meeting, and it was unprecedented for the society. After an attempted reschedule, the COVID-19 pandemic forced the SAGES program chairs to share the meeting in a new way, and it did not disappoint! The bariatric session that was held live was one of the most highly “virtually” attended sessions of the meeting. One of the benefits of the virtual meeting is that you can still watch every session online until the next meeting.
Session Highlights
LIVE—Masters Bariatrics: Everything Sleeve Gastrectomy. The sleeve gastrectomy (SG), although one of the most commonly performed procedures, has the least consensus as to how to do it. This session, moderated by Cori McBride and Natan Zundel, reviewed the many popular nuances of sleeve creation and technique. Learn how to make the “perfect” SG. The session provided great tips from world experts, including Michel Gagner. You can even see live surgical clips to guide you through the different techniques.
LIVE—Duodenal Switch: Here to Stay? Duodenal switch (DS) is gaining momentum in its various forms, not only as a primary procedure but also for managing failure of weight loss after SG. Session chairs Daniel Cottam and Nicole Fearing walk viewers through the hotly debated topics in this arena, including single anastomosis versus traditional DS, reflux and DS, and nutritional issues.
Adolescent WLS: How to Get them Through College. As everyone knows, obesity in children is one of the biggest health problems facing children today resulting in adult problems, such as diabetes and hypertension, at a very young age. Now, many pediatricians are advocating for weight loss surgery in adolescents. In this session, learn the do’s and don’ts of setting up a program and bringing adolescent weight loss surgery into your practice.
Avoiding and Managing Recidivism after Bariatric Surgery. Moderated by Renee Hilton, this session will help you choose the right procedure for the patient on the initial surgery to avoid weight regain. However, if your patient should gain weight after weight loss surgery (WLS), then get great advice from Drs. Marina Kurian and Michael Ujiki about pharmacotherapy and endoscopic therapies that can be used to help your patients. Dr. Cori McBride shares her experience as a patient and surgeon and tips on avoiding weight regain.
Building a Comprehensive Weight Loss Center. Bariatric surgery is a multidisciplinary endeavor that requires engagement from physicians, hospital leadership, and patients. In this session, the attendees learned to build this comprehensive practice with the essential elements for care. They were given tips on how to build this as a sustainable practice and keep all stakeholders engaged while improving access to care for the growing population of people with obesity.
Devil is in the Details: Roux-en-Y Gastric Bypass (RYGB). This session, moderated by Caitlin Halbert and Mujjahid Abbas, discusses the technical aspects of the RYGB and the details that help surgeons avoid the pitfalls along the way. They discuss making the anastomoses, managing mesenteric defects, as well as how to manage those who have had prior foregut surgery or those seeking concurrent surgeries. All of these situations are not uncommon, and navigating these situations can be challenging.
Gastreoesophageal Reflux Disease (GERD) and Bariatric Surgery: Prevention and Management. GERD has become one of the Achilles heels of bariatric surgery. In this session, Anna Ibele highlights what to do for your patient who has GERD after a bariatric procedure. Jon Thompson gives an in-depth review of gastric physiology that really gives the listener more insight into management of those who have GERD prior to their bariatric surgery.
In Search of the Magic Weight Loss Procedure: Current and Future Endoscopic Procedures for Weight Loss. Weight loss is not easy for our patients. We discuss diet and exercise, and many state this has already been unsuccessful or not sustainable. Not every patient is enthusiastic about, or is not a candidate for, bariatric surgery. Cutting-edge endoscopic therapies fill this gap. The endobarrier has had great success in Europe with weight loss and improvement in diabetes. Aspiration therapy is also showing promise as a sustainable method of weight loss for the right patient. SAGES Past President Aurora Pryor discusses the role of intragastric balloons in 2020. They should be a part of your armamentarium if you are offering weight loss surgery, and endoscopic SG, presented by Erik Wilson, is still a great option for some patients and is here to stay.
Managing Bariatric Complications on Call: The Patient is Too sick to Transfer, Now What Do I Do? In this session, all of the key emergent issues a nonbariatric surgeon should know about bariatric surgery is covered. This session is a do-not-miss for those covering acute care surgery but might not have routine bariatric surgery as a part of their practice. Learn from SAGES Past President Dan Jones about leaks after gastric bypass: prevention, diagnosis, and management. He points out that no test is fool proof, and therefore, keen clinical acumen and a robust management plan can save your patient’s life. Bleeding after bariatric surgery is discussed by John Linn, and he discussed the indications for return to the operating room.
New and Emerging Procedures in Bariatric Surgery: What is the Evidence. The field of bariatric surgery is changing at a fast pace. There are many new procedures that are gaining popularity, especially internationally. The mini gastric bypass is discussed by Dr. Mohit Bhandari, who has performed this procedure over 5,000 times. Why is this being done worldwide and so minimally done in the United States? He presents the latest data surrounding this procedure from his own, as well as the worldwide experience. Dr. Vamsi Alli discusses other single anastomotic bariatric procedures and where they stand relative to other procedures. Endoscopic therapies are also discussed.
Weight Loss Medications and How I Use Them. Multimodal therapy in weight loss surgery is becoming increasingly popular. How does one incorporate these medications into the practice, and which medications should be chosen for your patient? This session was led by Dr. Marina Kurian and features experts from across the country to help answer these questions. Latonya Fore reviews when to introduce medications to your patient after weight loss surgery to help your patient maximize weight loss. Dr. Joe Northup, Chair of the American Society for Metabolic and Bariatric Surgery (ASMBS) Access to Care Committee, shares whether there is a perfect medication for patients after weight loss surgery. The talks in this session are really cutting edge and can help you to be on the forefront of these new additions to bariatric practice. Actual cases are reviewed to further help one determine how to implement this approach.
In addition, do not miss the posters on bariatrics, many of which can be viewed as post quick shots. The plenary session included a paper from Dr. Timothy Dawson discussing disparities in access to care for those who present with problems after weight loss surgery. His data source was the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). There are also sessions run by surgeons who are industry leaders at world class companies who show us the future and how technology is changing our world. What is unique about this meeting is you never have to feel like you missed it. All of the sessions are available on demand on the SAGES 2020 virtual website at https://www.sages2020.org/.
Category: Past Articles, Symposium Synopsis
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