2010 SAGES Final Program

Table of Contents 

3 Registration Hours, Exhibit Hours 

4 General Information, Shuttle Information 

5-7 Schedule at a Glance 

6 Speaker Prep. & AV Information 

8 CME Worksheet 

9 Conflict of Interest Policy 

11 Childcare Services, CyberCafé 

12-13 National Harbor Map, Gaylord Floor Plan 

14-15 World Congress Meeting Leaders 

15 SAGES Accreditation 

44 International Webcast Sessions 

17 Wednesday, April 14, 2010 

18 Hands-on Colon Cadaver Lab 

19 Postgraduate Course: MIS & Cancer – 

Endocrine/Solid Organ 

19 Postgraduate Course: MIS & Cancer - GI 

20 Postgraduate Course: 

Bariatrics – New Technology, Revisions, 

Endolumenal, Single Port Access Surgery 


Bariatrics Around the World 

21 SAGES Foundation Awards Lunch 

27 Hands-on Course w/Lab: Advanced 

Suturing and Anastomotic Techniques 

28 Pediatric Session: 

Next Generation Pediatric MAS 

28 Exhibits Opening Welcome Reception 

31 Thursday, April 15, 2010 

32 Hands-On Course: Digital Video 

33 Postgraduate Course: Avoid Pitfalls in 

Cholecystectomy and CBD Exploration 


Challenging Hernias 

34 Hands-on Course w/Lab: 

Fundamentals of Laparoscopic Surgery 

35 Educator’s Lunch: Utilizing SAGES 

Educational Offerings for Residents 

36 Device Development Lunch 


Laparoscopic IBD & Colectomy 

39 Hands-On Course w/Lab: 

Single Port Access 

40 MBA for Surgeons Panel 

40 Hands-On Course w/Lab: 

Endolumenal / NOTES® 

41 Symposium: Robotics – What’s New? 

41 Symposium: 

Metabolic Surgery – Current Status 

41 Debate: 

Barrett’s – How to Follow, How to Treat 

32, 42 Industry Symposia 

45 Water Taxi Service 

45 Friday, April 16, 2010: 

Scientific Session 

47 SAGES Presidential Address 

48 Gerald Marks Keynote Lecture 

51 Panel: Endolumenal Therapies 

51 Symposium: NOTES® – 

Alive and Well, or RIP? 

51 Panel: Laparoscopic Education – 

Do MIS Fellowships Have a Future? 

52 Video Complications Lunch 

52 Go Global – Report from the Field 

53 SAGES/EAES Session: 

Peer Review Training 

53 Presidential Debates 

54 Conflict of Interest Panel 

54 Residents/Fellows Scientific Session 

55 Panel: Single Port Access Surgery 

58 Emerging Technology Session 

59 Meet the Leadership Reception 

61 Saturday, April 17, 2010: 

Scientific Session 

62 Panel: Live from Afghanistan: 

Video Conference Military Coalition 

62 Panel: Hernia Debates 

63 Karl Storz Keynote Lecture 

63 Royal College of Physicians and 

Surgeons Lecture 

64 Lunch in Exhibit Hall for 

All Meeting Attendees 

64 Fellowship Council Lunch 

65 Panel: Uh, Oh, What Now? – 

Video Session with the Experts 

65 CAGS Session: 

Simulation in the Training of Surgeons 

70 Panel: FES Roll-Out 

70 IFSES Panel: 

Surgical Education Around the World 

70 World Congress Main Event & 

International Sing-Off 

74 2010 Learning Center 

77 Faculty & Presenters 

83 Faculty & Presenter Disclosures 

94 Social Programs 

95 Tours 

97 Scientific Session Oral Abstracts 

132 Resident/Fellow Oral Abstracts 

136 Video Abstracts 

148 Video Channel Loop Listing 

150 Posters of Distinction Abstracts 

158 Poster Listing 

180 Emerging Technology Oral Abstracts 

189 Emerging Technology Poster Listing 

193 Exhibit Hall Floor Plan 

194 Exhibitor Profiles 

SAGES & CAGS thank IFSES, the IFSES member societies (ALACE, 

CSLES, EAES, ELSA, FELAC, IAGES, JSES) and corporate partners for 

the opportunity to host the World Congress of Endoscopic Surgery. 

IFSES President: Prof. Alberto Chousleb, MD 

IFSES Secretary General/Treasurer: Prof. Tatsuo Yamakawa, MD 

Visit the IFSES website for future IFSES activities and 

World Congress meetings: http://www.ifses.org/ 

12 th World Congress 

of Endoscopic 

Surgery 

Location 

Gaylord National Hotel & 

Convention Center 

201 Waterfront Street 

National Harbor, MD 20745 

Hosted By 

Society of American Gastrointestinal 

and Endoscopic Surgeons (SAGES) 

11300 W. Olympic Blvd., Suite 600 

Los Angeles, CA 90064 

Phone: 310-437-0544 

Fax: 310-437-0585 

Email: sagesweb@sages.org 

Website: www.sages.org 

Canadian Association of General 

Surgeons (CAGS) 

774 Echo Drive 

Ottawa, ON K18 5NB 

Phone: 613-730-6280 

Fax: 613-730-1116 

Email: cags@rcpsc.edu 

Website: www.cags-accg.ca 

World Congress 

Registration Hours 

Tuesday, April 13, 2010: 

12:00 PM - 5:00 PM 

Wednesday, April 14, 2010: 

6:30 AM - 6:00 PM 

Thursday, April 15, 2010: 

6:30 AM - 5:30 PM 

Friday, April 16, 2010: 

6:30 AM - 5:30 PM 

Saturday, April 17, 2010: 

6:30 AM - 2:00 PM 

Exhibit Dates and Times 

Wednesday, April 14, 2010 


Opening Reception: 

5:00 PM - 7:00 PM 

Thursday, April 15, 2010 

Hall Open: 10:00 AM - 2:30 PM 

Friday, April 16, 2010 

Hall Open: 10:00 AM - 2:30 PM 

Saturday, April 17, 2010 

Hall Open: 

10:00 AM - 1:00 PM 

Free Lunch for All Attendees: 

11:30 AM - 12:30 PM 

World Congress exhibits will take place at the 

Gaylord Convention Center in Prince George’s 

Exhibit Hall A-C. 

3 www.12thworldcongress.org 

12 th World Congress of Endoscopic Surgery

12 th World Congress of Endoscopic Surgery 

General Information 

Leadership for the 

2010 World Congress 

World Congress Program Chairs: 

Daniel M. Herron, M.D. 

(SAGES Co-Chair) 

Barry A. Salky, M.D. (SAGES Chair) 

Christopher M. Schlachta, M.D. 

(CAGS Chair) 

World Congress Presidents: 

Gerald M. Fried, M.D. (CAGS) 

David W. Rattner, M.D. (SAGES) 

SAGES President: C. Daniel Smith, M.D. 

CAGS President: Chris Jamieson, M.D. 

IFSES President: Alberto Chousleb, M.D. 

D.C. Shuttle Service From Gaylord National 

World Congress Corporate Supporters 

Diamond Donors 

COVIDIEN 

ETHICON ENDO-SURGERY, INC. 

SAGES EDUCATION AND RESEARCH FOUNDATION 

PLATINUM DONORS 

KARL STORZ ENDOSCOPY-AMERICA 

OLYMPUS 

GOLD DONORS 

ASCENT HEALTHCARE SOLUTIONS 

STRYKER ENDOSCOPY 

SILVER DONORS 

BOSTON SCIENTIFIC DAVOL INC., A BARD COMPANY GORE & ASSOCIATES 

BRONZE Donors 

SYNOVIS SURGICAL INNOVATIONS 

Visit the Transportation Desk (Lobby Level) or Call 301-839-5261 

Hours of Operation: 8:00am - 10:00pm (major credit cards accepted) 

Shuttle management will make every effort to maintain the 

schedule but may experience delays due to traffic conditions 

beyond our control especially during peak business hours. 

Subject to availability. Dates, times, and prices subject to change. 

Additional restrictions may apply. 

Roundabout Tour and Shuttle 

Visit more than a dozen stops in and around the region and jump on 

and off as you please! OnBoard Tours’ Roundabout is the best way to 

see the Capital Region – and at the best value! 3-Day Unlimited Passes 

Start at Just $35 Per Person! 

Sightseeing Tours and 

Roundabout Services 

Choose from the area’s most exciting tours, including “The DC It All 

Tour,” “DC the Lights” (the only downtown night tour), and more! 

Downtown D.C. Shuttle Service 

Featuring continuous service to: 

– Old Post Office (1100 Pennsylvania Avenue NW) 

– Union Station (H. Street and 2nd Street NE) 

Departing every hour, on the hour, from Gaylord National’s main 

entrance 

Seven days a week: 8:00 a.m. - 9:00 p.m. 

One-way tickets: $13 

Round-trip tickets: $20 

Unlimited, 3-Day Pass: $49 

King Street Metrorail Station and Old 

Town Alexandria Shuttle Service 

Enjoy Metrorail’s unparalleled accessibility to the area (including 

the museums and monuments of the National Mall) or the dining, 

shopping, and entertainment of Old Town’s historic waterfront 

community. Metrorail fare-cards may also be purchased at the 

Gaylord National Transportation Desk. 

One-way tickets are $5 per person, with continuous service to: 

– King Street Metrorail Station (Yellow and Blue lines) 

– Old Town Alexandria (King Street and Route 1) 

Departing every 30 minutes* from Gaylord National’s main entrance 

Sunday - Thursday: 6:30am - 9:00pm 

Friday - Saturday: 6:30am - 10:00pm 

Water Taxis to Old Town, 

Georgetown, and Mount Vernon 

Potomac Riverboat Company’s Water Taxis depart regularly 

from Gaylord National’s pier, offering exciting trips along the 

storied Potomac River to and from Old Town Alexandria, historic 

Georgetown, and George Washington’s Mount Vernon Estate and 

Gardens. 

Airport Shuttle Services 

Hourly shuttle service is available from Reagan National Airport 

(DCA). And SuperShuttle service, private sedans, and taxis are 

available to all major airports and most locations locally. 

12 th World Congress of Endoscopic Surgery 4

World Congress Schedule-at-a-Glance 


Time Session Location 

7:00 AM - 11:30 AM Hands-on Colon Cadaver Lab **Offsite Lab 

7:30 AM - 12:00 PM MIS & Cancer Endocrine/Solid Organ Postgraduate Course Potomac Ballroom B 

1:00 PM - 5:00 PM MIS Gastrointestinal Cancer Postgraduate Course Potomac Ballroom B 

7:30 AM - 12:00 PM 

Bariatric Postgraduate Course: New Tech/Revisions/Endolumenal/ 

Single Port Access Surgery 

Potomac Ballroom A 

1:00 PM - 5:00 PM Bariatric Postgraduate Course: Around the World Potomac Ballroom A 

12:00 PM - 1:00 PM SAGES Education and Research Foundation Awards Luncheon Maryland Ballroom C 

1:00 PM - 5:00 PM Hands-on Advanced Suturing and Anastomotic Techniques Lab Maryland Ballroom B-D 

1:00 PM - 5:00 PM 

Pediatrics Session: Next-Generation Pediatric MAS – 

A Move Toward “Scarless” Surgery 

Potomac Ballroom C 

5:00 PM - 7:00 PM World Congress Welcome Exhibit Opening Reception Prince George’s Exhibit Hall A-C 



6:00 AM - 7:15 AM 

7:30 AM - 11:30 AM 

Industry Satellite Symposia 

Covidien – “Advances in SILS Technology, Technique and Evidence” 

Postgraduate Surgeon in the Digital Age: Video Editing Course – Basic 

Video Editing with an Introduction to Advanced Techniques 

Potomac Ballroom D 

Chesapeake Conference Rooms D-E 

7:30 AM - 11:30 AM Avoid Pitfalls in Cholecystectomy and CBD Exploration Potomac Ballroom B 

7:30 AM - 11:30 AM Challenging Hernias Postgraduate Course Potomac Ballroom A 

7:30 AM - 12:00 PM Fundamentals of Laparoscopic Surgery Hands-on Course 

Lectures – Maryland Ballroom C 

Lab – Maryland Ballroom A 

9:30 AM - 11:30 AM SS01 Best of Videos 1 Potomac Ballroom C 

10:00 AM - 2:30 PM World Congress Exhibits, Posters & Learning Center Open Prince George’s Exhibit Hall A-C 

11:30 AM - 1:00 PM BREAK: Exhibits, Posters, Learning Center 

11:30 AM - 1:30 PM 

Educators Luncheon: 

Utilizing SAGES Educational Offerings for Residents 


11:30 AM - 1:30 PM Device Development Luncheon: From Funding to Freedom to Operate Maryland Ballroom C 

1:30 PM - 5:00 PM 

Laparoscopic IBD and Colectomy Postgraduate Course: 

The Status and Direction of Laparoscopic Colorectal Surgery 

in the Treatment of Inflammatory Bowel Disease 


1:30 PM - 5:00 PM Single Port Access Surgery Hands-On Course **Offsite lab 

1:30 PM - 5:00 PM 

MBA for Surgeons Panel: 

Asset Management and Protection for Surgeons 


1:30 PM - 5:00 PM Hands On Endolumenal/NOTES® Lab Maryland Ballroom B-D 

1:30 PM - 2:30 PM Robotics Symposium: What’s New? Potomac Ballroom B 

2:30 PM - 4:00 PM Metabolic Surgery Symposium: Current Status Potomac Ballroom B 

4:00 PM - 5:30 PM Barrett’s Debate: How to Follow, How to Treat? Potomac Ballroom B 

5:30 PM - 7:30 PM Industry Satellite Symposia (No Registration Required) 

Boston Scientific – “Intraluminal Stents and the Surgeon – 

Who, What, Where, When and Why?” 

Covidien – “Insights into the Future of Surgical Stapling: Integrated 

Materials, Tri-Staple Technology, Powered Staplers” 

Davol Inc., a BARD Company – “Advanced Endoscopic Techniques for 

Abdominal Wall Reconstruction” 

Ethicon Endo-Surgery, Inc. – “Minimally Invasive Surgery – 

Where is it Going?” 

Karl Storz Endoscopy – “The Great Debate: S-PORTAL (Single 

Portal Access) Surgery vs. Mini-Laparoscopy” 

Chesapeake D-E 


Maryland Ballroom C 


Maryland Ballroom A 


5 www.12thworldcongress.org





7:00 AM - 8:00 AM Posters of Distinction Potomac Ballroom C 

8:00 AM - 9:00 AM SS02 Plenary Session 1 Potomac Ballroom A-B 

9:00 AM - 9:30 AM 

9:30 AM - 10:00 AM 

SAGES Presidential Address: Everyone Knows Plan A: Its All About Plan B 

C. Daniel Smith, M.D. 

Gerald Marks Lecture: The Making of a Surgeon – Revisited 

Richard H. Bell, M.D. 

Potomac Ballroom A-B 


10:00 AM - 2:30 PM Exhibits, Posters, Learning Center Open Prince George’s Exhibit Hall A-C 

10:00 AM -11:00 AM 

Concurrent Sessions (accepted oral & video presentations) 

SS03 Solid Organ 

Maryland Ballroom B-D 

SS04 Basic Science 


10:00 AM - 11:00 AM Endolumenal Therapies Session Potomac Ballroom C 

10:00 AM - 11:00 AM NOTES® Symposium – Alive & Well or RIP? Potomac Ballroom A-B 

10:00 AM - 11:00 AM Laparoscopic Education Panel – Do MIS Fellowships Have a Future? Potomac Ballroom D 

11:00 AM - 12:30 PM Video Complications Luncheon: What Has Happened and What Do We Have to Do? Maryland Ballroom C 

12:30 PM - 1:30 PM Go Global Report from the Field Panel: Teaching Laparoscopic Surgery Abroad Maryland Ballroom A 

12:30 PM - 2:30 PM Peer Review Training Session Potomac Ballroom D 

12:30 PM - 2:30 PM SAGES Presidential Debates Potomac Ballroom A-B 

1:30 PM - 2:30 PM Conflict of Interest Panel Maryland Ballroom A 

2:30 PM - 5:30 PM Resident and Fellows Scientific Session Maryland Ballroom C 

2:30 PM - 4:00 PM Single Port Access Surgery Panel Potomac Ballroom A-B 

2:30 PM - 4:00 PM 

Concurrent Sessions 

SS05 Hepatobiliary/Pancreatic 


SS06 Hernia 



SS07 Best of Video 2 


4:00 PM - 5:30 PM 

SS08 Education/Simulation 


SS09 NOTES® 


2:30 PM - 5:30 PM Emerging Technology Session Potomac Ballroom C 

6:00 PM - 7:00 PM Meet the Leadership Reception For Residents, Fellows & New Members Pose, 18-19th Floor 

IMPORTANT AV INFORMATION: 

You may now upload your presentation on line at any point during the meeting. Please load your 

presentation online (http://sages.presentationman.com/) or on the show computer in the Speaker 

Prep room no later than 2 hours before your presentation. 

Please Note: Even if you have submitted your presentation online you must visit the Speaker Prep 

room to check in, your session moderator may not allow you to present if you do not. 

Speaker Prep Hours: 

4/13/10: 7:00 am - 5:00 pm 

4/14/10: 5:30 am - 5:00 pm 

4/15/10: 6:00 am - 5:00 pm 

4/16/10: 5:30 am - 5:30 pm 

4/17/10: 5:30 am - 5:00 pm 





7:00 AM - 8:30 AM Live From Afghanistan Session: Video Conference Military Coalition Potomac Ballroom A-B 

7:00 AM - 8:30 AM Hernia Debates Panel: What Has Happened and What Do We Have to Do? Potomac Ballroom C 

8:30 AM - 9:00 AM 

9:00 AM - 9:30 AM 

Karl Storz Lecture: New Trends in Endoscopy – 

What Technology and Techniques are in it for You? 

Christopher J. Gostout, M.D. 

The Royal College of Physicians and Surgeons of Canada Lecture 

VR Systems for Surgical Oncology 

Robert DiRaddo, Ph.D. 




10:00 AM - 1:00 PM 

11:00 AM - 11:30 AM 

Last Chance to Visit Exhibits, Posters, Learning Center Open – 

Please note 1:00 PM Closing Time! 

SAGES Annual General Membership Business Meeting 

All SAGES Members Encouraged to Attend! 

11:00 AM - 1:00 PM BREAK: Exhibits, Posters & Learning Center Open 

11:30 AM - 12:30 PM FREE Lunch in Exhibit Hall for all World Congress Scientific Session Registrants! 

Prince George’s Exhibit Hall A-C 


11:30 AM - 1:00 PM Fellowship Council Luncheon: The Future of Fellowships: How Will They Be Funded Maryland Ballroom C 

1:00 PM - 3:00 PM “Uh Oh! What Now?” Video Panel Potomac Ballroom C 

1:00 PM - 3:00 PM CAGS Simulation in the Training of Surgeons Session Maryland Ballroom B-D 

1:00 PM - 3:00 PM FES Roll-Out Session Maryland Ballroom A 

1:00 PM - 5:00 PM Concurrent Sessions (accepted oral & video presentations) 

1:00 PM - 2:00 PM SS11 Robotics Maryland Ballroom B-D 

1:00 PM - 3:00 PM SS12 Bariatric Potomac Ballroom A-B 

2:00 PM - 3:00 PM SS13 Research Grant Presentations Maryland Ballroom B-D 

3:00 PM - 4:00 PM SS14 Complications/Ergonomics/Instruments Maryland Ballroom B-D 

3:00 PM - 5:00 PM SS15 Esophageal/Gastric Potomac Ballroom D 

3:00 PM - 5:00 PM SS16 Colorectal Potomac Ballroom C 

3:00 PM - 5:00 PM SS17 Best of Video 3 Potomac Ballroom A-B 

3:00 PM - 5:00 PM IFSES Surgical Education Around the World Panel Maryland Ballroom A 

7:30 PM - 11:00 PM 

World Congress Gala, Featuring Dinner & the International Sing-Off 

Shuttles begin departing at 7:15 PM at the Bus Pickup are of the Gaylord hotel ONLY. Go to 

the Group Bus Loading area, located at the Woodrow Wilson exit on the 2nd level, opposite 

of guest parking. Buses will circle all evening until the event ends. 

Newseum 


Interactive Sessions: Featuring Google Moderator! 

Back by popular demand, SAGES is increasing the number of interactive sessions available for the 

2010 meeting. All Scientific Sessions occurring in the MAIN SESSION Room Friday & Saturday, 

April 16-17, 2010 will feature Google Moderator, enabling attendees to participate in the 

presentation as it occurs! The audience will help determine the direction of the discussion by rating 

the submitted comments and suggestions. Moderators will address the highest rated questions. 

The room will be equipped with WIFI connectivity. Please bring your laptop and/or iPhone/ 

Android/Blackberry (newest generation or with Opera Mini). 

Evaluation & CME Credit Claim 

Visit the kiosks next to registration to complete 

your online evaluation and CME credit form on-site. 

Attendees may print CME certificates two weeks 

after the conclusion of the meeting. 

The programs and lectures presented at the 2010 World 

Congress Meeting are copyrighted products of the Society 

of American Gastrointestinal and Endoscopic Surgeons. 

Any reproduction or rebroadcasting without the express 

written consent of SAGES is strictly prohibited. 



CME Worksheet 

SAGES Accreditation 

Accreditation: The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) is accredited by the Accreditation Council for 

Continuing Medical Education (ACCME) to sponsor Continuing Medical Education for physicians. SAGES designates this Continuing Education 

activity for a maximum of 41.5 AMA PRA Category 1 Credit(s). Physicians should only claim credit commensurate with the extent of their 

participation in the activity. 

CME Worksheet for the 12th World Congress of Endoscopic Surgery: This is NOT your CME credit form. Please use the worksheet below to track the 

number of CME hours you attend for each activity. SAGES has instituted a new process for claiming CME credits and printing certificates. All attendees 

wishing to receive a CME certificate for activities attended at the 2010 SAGES Annual Meeting (12th World Congress of Endoscopic Surgery) 

must first complete an on-line meeting evaluation form. Attendees will be able to print and re-print their certificates throughout the year 

beginning two weeks after the conclusion of the meeting. 

• On-site: There will be on-site kiosks located near the registration area to complete the meeting evaluation and credit claim form. Two weeks after the 

conclusion of the meeting, an email will notify attendees that the certificates are available to print. 

• During or after the meeting: Attendees will also have access to the on-line meeting evaluation and credit claim form via a link on the World Congress 

website. 

Be sure to retain your Conference Badge as the ID number will be your online PIN number. An email will also be sent, reminding attendees of 

this service. Those wishing to obtain a simple certificate of attendance may do so at the Evaluation Kiosks. 

Wednesday 

Activity Hours I Attended Credits Available 

Bariatric New Tech/Revisions/Endolumenal/Single Port PG Course 4.25 

MIS & Cancer: Endocrine/Solid Organ Postgraduate Course 4.25 

HO Course: Colon Surgery 4.5 

Bariatrics Around the World Postgraduate Course 3.75 

MIS Gastrointestinal Cancer Postgraduate Course 3.75 

HO Course: Advanced Suturing and Anastomotic Techniques 4.0 

Pediatrics Session 4.0 

SUBTOTAL MAX – 8.5 

Thursday 


Postgraduate Surgeon in the Digital Age: Video Editing Course 3.75 

Challenging Hernias Postgraduate Course 3.75 

HO Course: Fundamentals of Laparoscopic Surgery 4.25 

Avoid Pitfalls in Cholecystectomy and CBD Exploration 3.75 

Scientific Session 1 2.0 

Educators Luncheon: Utilizing SAGES Educational Offerings for Residents 2.0 

Device Development Luncheon: From Funding to Freedom to Operate 2.0 

HO Course: Endolumenal/NOTES 3.5 

HO Course: Single Port Access Surgery 3.5 

Lap IBD & Colectomy Postgraduate Course 3.25 

MBA for Surgeons Panel 

0-NO credit available 

Symposium: Robotics: What’s New? 1.0 

Symposium: Metabolic Surgery :Current Status 1.5 

Barrett’s Debate: How to Follow, How to Treat? 1.5 

SUBTOTAL MAX – 10 

Friday 


Scientific Sessions (panels, debates, lectures and abstract presentations including plenary) 9.0 

Video Complications Luncheon: What has Happened and What We Have to Do 1.5 

Emerging Technology Session 

0-NO credit available 


Saturday 


Learning Center (*although the Learning Center is open Thurs-Sat, only 3.0 credits are available) 3.0 

Scientific Sessions (panels, debates, lectures and abstract presentations including plenary) 8.0 

Fellowship Council Lunch 1.5 



Conflict of Interest Policy 

Revised and approved by SAGES Executive Committee, March, 2010 

A. Identifying Conflicts of Interest 

SAGES has implemented a five-tiered approach towards identifying potential conflicts of interest. 

1. Members of committees involved in the planning of CME activities, including the Board of Governors, must provide a 

financial disclosure. These disclosures are sent to the committee in advance of each committee meeting. Attendees are 

reminded about the disclosure policy at each committee meeting, and any committee member with a conflict is asked to 

recuse him or herself from the discussion of any CME activities. 

2. Course Directors for CME activities must provide their financial disclosures along with their suggested course outline 

and faculty. This information is forwarded to the Conflict of Interest Task Force, who then determines whether or not a 

potential conflict exists and makes suggested edits. 

3. Invited faculty for CME activities must provide their financial disclosures upon invitation to serve as faculty. 

4. For abstract submissions for the scientific session, the presenting and senior authors must provide disclosures. 

Abstracts are peer reviewed in a blinded fashion by multiple reviewers and are selected for presentation based on 

scientific merit. All disclosures are provided to the Program Committee during the “Put-The-Program-Together” 

meeting at which abstracts are selected for presentation. 

5. All speakers at SAGES CME activities must display a list of financial disclosures on the first slide of their presentation. 

B. Managing Potential Conflicts of Interest 

SAGES has implemented several mechanisms to manage conflicts of interest prior to an educational activity. 

1. Self-management, such as the committee member recusing him or herself from discussion of CME activities. 

2. The SAGES Conflict of Interest Task force reviews all Course Director’s disclosures, proposed course outlines and 

faculty lists. The Conflict of Interest Task Force will make edits to the course outline or faculty list if necessary. 

3. The SAGES disclosure form requires faculty to provide management suggestions if there is a relationship with 

a commercial entity. This information is forwarded to the Course Director, who is responsible for determining 

whether or not a conflict exists and if so, how to manage this conflict. 

4. If a conflict is determined, then a letter is sent to the faculty member, requiring them to adhere to the 

management technique or else recuse him or herself from the presentation. 

5. During the session, the Course Director observes the presentations and makes note of commercial bias. 

If any is perceived, this is immediately reported to the staff. 

6. All attendees of CME activities are requested to make note of perceived commercial bias in activity evaluations. 

The Conflict of Interest Task Force and/or the CME Committee will investigate substantive concerns. 


Commercial Bias 

The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has an obligation to the medical profession and 

society as a whole to elucidate bias in order to protect the objectivity, scientific integrity and quality of its continuing medical 

education (CME) programs and to provide CME in an ethical and impartial manner. Bias is defined when a preference 

or predisposition exist toward a particular perspective or result that interferes with an individual’s ability to be impartial, 

unprejudiced or objective in order to further personal gain and disregard for data. Particular preferences may be favorable 

or unfavorable. When bias exists, impartial judgment and neutrality may be compromised. Bias may be minimized through 

a declaration of conflict of interest or commercial interests, an evaluation of peer-reviewed evidence-based medicine with 

an integration of clinical expertise and/or experience, and an assertion of published sources for evidence-based reporting. 

SAGES requires presenters at all educational events to specifically avoid introducing bias, commercial or otherwise, into their 

presentations. 

SAGES Mission Statement 

“Our mission is to provide leadership in surgery, particularly gastrointestinal and 

endoscopic surgery, to optimize patient care through education, research and innovation.” 

– SAGES has evolved over the last 25 years into a leading society for gastrointestinal surgery, 

endoscopy and minimal invasive technology. 

– Not only does SAGES provide leadership in clinical care, but it also helps surgeons optimize patient care by 

providing direction for cutting edge technology, basic and translational science, and educational opportunities. 

– SAGES represents leadership in the surgical world for gastrointestinal disease. 

– SAGES is the society to improve your clinical skills. 



Notes 


General Information (continued) 

Save the Date! 

CAGS Canadian Surgery Forum 

September 2 - 5, 2010, Québec City Convention Centre, Canada 

SAGES Scientific Session & Postgraduate Course 

March 30 - April 2, 2011, San Antonio, Texas 


September 15 - 18, 2011, London Convention Centre, Canada 


March 7 - 10, 2012, San Diego, CA 


April 17 - 20, 2013, Baltimore Convention Center, Baltimore, MD 


April 2 - 5 , 2014, Salt Lake Convention Center, Salt Lake City, UT 

Childcare Services 

White House Nannies 

www.whitehousenannies.com 

(301) 652-8088 Temporary Division 

(800) 266-9024 Toll Free 

White House Nannies, Inc. is owned and managed by Barbara G. Kline. Mrs. 

Kline is a current member and former board member of the International Nanny 

Association (INA). The agency is also a member of the Association of Premier 

Nanny Agencies (APNA). White House Nannies. Inc. was awarded national 

recognition as APNA’s 2000 Agency of the Year. The hallmark of the agency is the 

thoughtful matching of Client and Caregiver needs to assure the best possible inhome 

childcare placements. With 25 years of experience, the agency has become 

the premier agency in the Washington area. 

Caregiver rates: 

Negotiated with Caregiver, generally $16-$20 per hour. 

Additional Agency Referral Rates: 

Hotel Child Care, booked in advance $65.00 per day per Caregiver 

Hotel Child Care, booked within 48hrs of need $75.00 per day per Caregiver 

A free Cyber Café is available for 

all World Congress attendees and 

exhibitors, located in the Registration 

area and open during normal 

registration hours. No message 

center is available this year. 

Please leave the following numbers 

with your offices and families, in 

case they cannot reach you on 

your cell phone: 

World Congress On-Site Office: 

Phone: (301) 965-5343 

Fax: (301) 965-5344 

A Gentle Reminder 

About Safety/Security: 

We have taken every precaution to assure the 

safety and security of our guests and their 

possessions. However, we urge you to be 

aware and take simple steps to guard your 

possessions. 

– Do not leave your purse or briefcase 

unattended. 

– Do not leave your laptop, phone or other 

electronic devices on the floor or out of your 

sight in a darkened room 

– Be aware of your surroundings, in the Gaylord 

Hotel, in and around the National Harbor area 

and in Washington, DC. 

Have a safe & secure meeting! 




National Harbor, MD Map 


Gaylord National Floor Plans 

Maryland & Potomac Ballrooms 

Convention Center | Level 2 

6 

5 

4 

3 

2 

4 

F W hi B d 

B 

A 

D 

Maryland Ballroom 

C 

L K J 

I H G 

F E D 

C B A 

12 11 10 

Chesapeake Conference Rooms 

Escalators 

To Hotel 

Ballroom Level 

9 8 7 

6 5 4 

1 2 3 

B 

Potomac Ballroom 

World Congress Exhibits, Posters, Learning Center (see pg. 193) 

Stage 

A 

D 

C 

6 

5 

4 

3 

2 

1 


Chesapeake Conference Rooms: 

Potomac Ballrooms: 

Speaker Prep 

World Congress Office 

SAGES Foundation Lounge 

FLS Testing 

Thursday Digital Hands-On Course 

Industry Education 

Wednesday through Saturday Main and Concurrent Session Rooms 

Postgraduate Courses 

Scientific Sessions 

Keynote Lectures 

Panels, Symposia 

Lunches 


Maryland 

GaylordNational.com 

Ballrooms: 

| 1-877-677-9352 

Wednesday 

| 

through 

201 Waterfront 

Saturday 

Street, 

Concurrent 

National Harbor, 

Session 

MD 20745 

Rooms 

Hands-On Courses 

(WASHINGTON D.C. AREA ) 

Scientific Sessions 

Panels, Symposia 

Lunches 




Wo r l d C o n g r e s s 2 0 1 0 Le a d e r s 

Program Co-Chair (SAGES): Program Chair (SAGES): Program Chair (CAGS): 

Daniel Herron, M.D. Barry Salky, M.D. Christopher Schlachta, M.D. 

2010 Course Chairs & Unit Coordinators 

Equipment Czar Chair: Kevin M. Reavis, M.D. 

Equipment Czar Co-Chair: 

Gretchen Purcell-Jackson, M.D. 

Poster Chair: Subhash U. Kini, M.D. 

Poster Co-Chair: Melina C. Vassiliou, M.D. 

Video Chair: Donald J. Selzer, M.D. 

Video Co-Chair: Leena Khaitan, M.D. 

Learning Center Chair: Allan E. Okrainec, M.D. 

Learning Center Co-Chair: Brian P. Jacob, M.D. 

Advanced Suturing and Anastomotic 

Techniques HO Course Chair: 

Kelvin D. Higa, M.D. 

Advanced Suturing and Anastomotic 

Techniques HO Course Co-Chair: 

Aureo L. De Pauala, M.D. 

Colon HO Course Chair: 

Mark H. Whiteford, M.D. 

Colon HO Course Co-Chair: 

Conor P. Delaney, M.D. 

Digital Video HO Course Chair: 

Dmitry Oleynikov, M.D. 

Digital Video HO Course Co-Chair: 

John R. Romanelli, M.D. 

Endolumenal/NOTES® HO Course Chair: 

Santiago Horgan, M.D. 

Endolumenal/NOTES® HO Course Co-Chair: 

Christopher C. Thompson, M.D. 

Single Port Access Surgery HO Course Chair: 

Paul G. Curcillo II, M.D. 

Single Port Access Surgery HO Course Co- 

Chair: Daniel J. Scott, M.D. 

Avoid Pitfalls in Cholecystectomy and 

CBD Exploration PG Course Chair: 

Michael B. Edye, M.D. 

Avoid Pitfalls in Cholecystectomy and 

CBD Exploration PG Course Co-Chair: 

Bertrand Millat, M.D. 

Bariatric Around the World PG Course Chair: 

Alfons Pomp, M.D. 

Bariatric Around the World PG 

Course Co-Chair: Manolo Cortez, M.D. 

Bariatric New Techniques PG Course Chair: 

Scott A. Shikora, M.D. 

Bariatric New Techniques PG Course Co-Chair: 

Raul J. Rosenthal, M.D. 

Challenging Hernias PG Course Chair: 

Kristi Lee Harold, M.D. 

Challenging Hernias PG Course Co-Chair: 

Shirin Towfigh, M.D. 

FLS PG Course Chair: E. Matthew Ritter, M.D. 

FLS PG Course Co-Chair: Gerald M. Fried, M.D. 

Lap IBD & Colectomy PG Course Chair: 

John H. Marks, M.D. 

Lap IBD & Colectomy PG Course Co-Chair: 

Eric Glenn Weiss, M.D. 

MIS & Cancer Endocrine/Solid Organ PG 

Course Chair: William Barry Inabnet III, M.D. 

MIS & Cancer Endocrine/Solid Organ PG 

Course Co-Chair: Miguel Herrera, M.D. 

MIS & Cancer GI PG Course Chair: 

Horacio J. Asbun, M.D. 

MIS & Cancer GI PG Course Co-Chair: 

Seigo Kitano, M.D. 

Pediatric Surgery Symposium Chair: 

Sanjeev Dutta, M.D. 

Pediatric Surgery Symposium Co-Chair: 

Jacob Langer, M.D. 

3-Hour MBA for Surgeons Chair: 

Demetrius E.M. Litwin, M.D. 

3-Hour MBA for Surgeons Co-Chair: 

Fredrick J. Brody, M.D. 

Device Development Luncheon Chair: 

Raymond P. Onders, M.D. 

Device Development Luncheon Co-Chair: 

Dennis L. Fowler, M.D. 

Education Luncheon Chair: 

L. Michael Brunt, M.D. 

Education Luncheon Co-Chair: 

Daniel J. Gagne, M.D. 

Fellowship Council Lunch Chair: 

Adrian E. Park, M.D. 

Fellowship Council Lunch Co-Chair: 

Bruce D. Schirmer, M.D. 

Video Complications Lunch Chair: 

Bipan Chand, M.D. 

Video Complications Lunch Co-Chair: 

Manabu Yamamoto, M.D. 

Emerging Technology Session Chair: 

Steven D. Schwaitzberg, M.D. 

Emerging Technology Session Co-Chair: 

Alex Gandsas, M.D. 

Resident’s Day Coordinators: 

Gregory F. Dakin, M.D. & Adheesh A. Sabnis, M.D. 

12 th World Congress of Endoscopic Surgery 14 

SAGES Panel/Session/Symposium/ 

Debates Chairs/Co-Chairs: 

Barrett’s Debate Chair: John Hunter, M.D. 

Barrett’s Debate Co-Chair: Karl H. Fuchs, M.D. 

SAGES Presidential Debate Chair: 

Daniel J. Deziel, M.D. 

SAGES Presidential Debate Co-Chair: 

Nathaniel J. Soper, M.D. 

Hernia Debates Chair: Guy R. Voeller, M.D. 

Hernia Debates Co-Chair: 

Edward H. Phillips, M.D. 

Conflict of Interest Panel Chairs: 

Steve Eubanks, M.D. & Neely Panton, M.D. 

IFSES Panel Chair: Alberto Chousleb, M.D. 

IFSES Panel Co-Chair: Natan Zundel, M.D. 

Lap Education Panel Chair: 

Bruce D. Schirmer, M.D. 

Lap Education Panel Co-Chair: 

Joseph Mamazza, M.D. 

Global Panel Chair: Raul J. Rosenthal, M.D. 

Global Panel Co-Chair: Horacio J. Asbun, M.D. 

Single Port Access Surgery Panel Chair: 

Joel Leroy, M.D. 

Single Port Access Surgery Panel Co-Chair: 

Andrew A. Gumbs, M.D. 

“Uh Oh, What Now?” Video Panel Chair: 

David R. Urbach, M.D. 

“Uh Oh, What Now?” Video Panel Co-Chair: 

David Bryan Earle, M.D. 

Endolumenal Therapies Session Chair: 

Dean J. Mikami, M.D. 

Endolumenal Therapies Session Co-Chair: 

Simon Bergman, M.D. 

FES Roll-out Session Chair: Brian J. Dunkin, M.D. 

FES Roll-out Session Co-Chair: 

Jeffrey M. Marks, M.D. 

Live from Fellujah Session Chair: 

Steven P. Bowers, M.D. 

Live from Fellujah Session Co-Chair: 

Richard M. Satava, M.D. 

CAGS Simulation in the Training of Surgeons 

Session Chair: Liane S. Feldman, M.D. 

CAGS Simulation in the Training of Surgeons 

Session Co-Chair: 

Teodor P. Grantcharov, M.D. 

Peer Review Training Session Chair: 

Abe L. Fingerhut, M.D. 

Peer Review Training Session Co-Chair: 

Sir Alfred Cuschieri, M.D. 

Metabolic Surgery Symposium Chair: 

Philip R. Schauer, M.D. 

Metabolic Surgery Symposium Co-Chair: 

Francesco Rubino, M.D. 

NOTES® Symposium Chair: 

David W. Rattner, M.D. 

NOTES® Symposium Co-Chair: G. V. Rao, M.D. 

Robotics Symposium Chair: 

Mehran Anvari, M.D. 

Robotics Symposium Co-Chair: 

Jacques Marescaux, M.D. 

Conflict of Interest Panel Chair: 

Steve Eubanks, M.D. 

Conflict of Interest Panel Co-Chair: 

Neely Panton, M.D.

Wo r l d C o n g r e s s 2 0 1 0 Le a d e r s 


Program Committee 

Chair: Steven D. Schwaitzberg, M.D. 

Horacio J. Asbun, M.D. 

Yves Bendavid, M.D. 

Simon Bergman, M.D. 

Daniel Birch, M.D. 

Steven P. Bowers, M.D. 

Fredrick J. Brody, M.D. 

Robin Boushey, M.D. 


James Ellsmere, M.D. 

Liane Feldman, M.D. 

Edward L. Felix, M.D. 

Denise W. Gee, M.D. 

Teodor Grantcharov, M.D. 

Carroll M. Harmon, M.D. 

Daniel M. Herron, M.D. 

Michael D. Holzman, M.D. 

Santiago Horgan, M.D. 

Gretchen Purcell Jackson, M.D. 

Timothy D. Kane, M.D. 

Namir Katkhouda, M.D. 

Dimitrios A. Linos, M.D. 

John H. Marks, M.D. 

Brent D. Matthews, M.D. 

Marian P. McDonald, M.D. 

Stephen S. McNatt, M.D. 

Adam Meneghetti, M.D. 

Michael S. Nussbaum, M.D. 

Dmitry Oleynikov, M.D. 

Allan Okrainec, M.D. 

Neely Panton, M.D. 

Edward H. Phillips, M.D. 

William S. Richardson, M.D. 

Raul J. Rosenthal, M.D. 

Barry A. Salky, M.D. 

Cliff Sample, M.D. 

Christopher M. Schlachta, M.D. 

Daniel J. Scott, M.D. 

Paul A. Severson, M.D. 

Neal E. Seymour, M.D. 

Carl J. Westcott, M.D. 

Manabu Yamamoto, M.D. 

Tonia M. Young-Fadok, M.D. 

Natan Zundel, M.D. 

FLS Testing Available! 

Wednesday, April 14 - Saturday, April 17, 2010 

Location: Chesapeake Conference Rooms 7-9 

All testing appointments must be made by April 9 – 

no onsite appointments available 

Contact FLS@sages.org for more details or to schedule your test. 

SAGES Accreditation 

The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) is accredited by 

the Accreditation Council for Continuing Medical Education (ACCME) to sponsor Continuing 

Medical Education for physicians. 

The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) designates this 

educational activity for a maximum of 41.5 hours AMA PRA Category 1 Credit(s). Physicians 

should only claim credit commensurate with the extent of their participation in the activity. 

New Process for Claiming CME Credit for 

Meeting Attendees! 

SAGES has instituted a new process for claiming CME credits and printing certificates. All 

attendees wishing to receive a CME certificate for activities attended at the 2010 SAGES 

Annual Meeting (12 th World Congress of Endoscopic Surgery) must first complete an online 

meeting evaluation form. Attendees will be able to print and re-print their certificates 

throughout the year beginning two weeks after the conclusion of the meeting. 

• On-site: There will be on-site kiosks located near the registration area to complete the 

meeting evaluation and credit claim form. Two weeks after the conclusion of the meeting, 

an email will notify attendees that the certificates are available to print. 

• During or after the meeting: Attendees will also have access to the on-line 

meeting evaluation and credit claim form via a link on the World Congress website 

(www.12thworldcongress.org). 

Be sure to retain your Conference Badge as the ID number will be your online PIN 

number. An email will also be sent, reminding attendees of this service. Those 

wishing to obtain a simple certificate of attendance may do so at the Evaluation 

Kiosks. 

To fully comply with ACCME regulations, 

all World Congress attendees must have their badge 

scanned before entering any course or session room 

in order to receive CME credit for that event. 





7:00 AM - 11:30 AM Hands-on Colon Cadaver Lab **Offsite Lab 

7:30 AM - 12:00 PM 

MIS & Cancer Endocrine/Solid Organ Postgraduate 

Course 

Potomac Ballroom B 

1:00 PM - 5:00 PM MIS Gastrointestinal Cancer Postgraduate Course Potomac Ballroom B 

7:30 AM - 12:00 PM 

Bariatric Postgraduate Course: New Tech/Revisions/ 

Endolumenal/Single Port Access Surgery 


1:00 PM - 5:00 PM Bariatric Postgraduate Course: Around the World Potomac Ballroom A 

12:00 PM - 1:00 PM 

SAGES Education and Research Foundation Awards 

Luncheon 

1:00 PM - 5:00 PM 

Hands-on Advanced Suturing and Anastomotic 

Techniques Lab 

1:00 PM - 5:00 PM 

Pediatrics Session: Next-Generation Pediatric MAS – 

A Move Toward “Scarless” Surgery 




5:00 PM - 7:00 PM World Congress Welcome Exhibit Opening Reception Prince George’s Exhibit Hall A-C 

World Congress Goes Green! 

In an effort to support the environment, you will see less paper for the 12th Annual World Congress. 

The printed Final Program will include the regular schedule and course/panel outlines, as well as 

oral abstracts, Poster of Distinction abstracts and poster listing. However, electronic copies of all 

the abstracts, digital posters, and Postgraduate course syllabi will be available on thumb drive for 

all attendees. The “Electronic Meeting Guide” will be completely navigational and searchable. Print 

kiosks will also be available throughout the Convention Center. 









4/13/10: 7:00 am - 5:00 pm 

4/14/10: 5:30 am - 5:00 pm 

4/15/10: 6:00 am - 5:00 pm 

4/16/10: 5:30 am - 5:30 pm 

4/17/10: 5:30 am - 5:00 pm 




7:00 AM - 11:30 AM *Separate Registration Fee 

Hands-on Colon Cadaver Lab 

Chair: Mark H. Whiteford, M.D.; Co-Chair: Conor P. Delaney, M.D. 

**Offsite Lab 

Location: Washington Institute of Surgical Endoscopy (WISE) 

The George Washington University Medical Center 

2300 I Street, NW, Ross Hall, Washington DC, 20037 

Shuttles for faculty and course registrants will depart at 6:15AM from the Gaylord National Hotel and Convention Center. 

Go to the Group Bus Loading area, located at the Woodrow Wilson exit on the 2 nd level, opposite of guest parking. 

This half-day practical cadaver lab course is designed for general and colorectal surgeons, fourth year or chief residents and MIS or colorectal 

fellows. All applicants should be familiar with advanced laparoscopic techniques and wish to expand their skills in laparoscopic colon and 

rectal surgery. Techniques for straight laparoscopic and single incision colectomies, bowel mobilization, vessel division, and anastomoses will 

be taught with an emphasis on oncologic principles. The course will emphasize common alternative approaches including lateral-to-medial, 

medial-to-lateral, and hand-assisted techniques, to facilitate resection of the entire intra-abdominal colon and the rectum. Lab stations will 

have a 1:3 faculty:participant ratio. 

Objectives: 

At the conclusion of this session, participants will be able to: 

• Discuss multiple approaches to mobilization, resection and anastomosis of the right and left colon 

• List techniques, tips and tricks for total mesorectal dissection of the rectum 

• Understand the principles in laparoscopic colorectal surgery for both benign and malignant disease 

Schedule 

6:30 AM Shuttles Depart Gaylord Hotel 

7:00 AM Introduction Mark H. Whiteford, M.D. & Conor P. Delaney, M.D. 

7:10 AM Video: Single Incision Laparoscopic Right and Transverse Colectomy Mark Whiteford, M.D. 

7:30 AM Video: Laparoscopic Left Colectomy and Proctectomy Conor Delaney, M.D. 

7:50 AM Right Colectomy Techniques 

Transverse Colectomy Techniques 

left Colectomy Techniques 

rectal Dissection Techniques 

Lab Instructors 

11:10 AM Questions/Discussion All Faculty 

11:30 AM Shuttles Return to Gaylord Hotel 

Lab Instructors: 

Christopher Cunningham, M.D. 

Jonathan Efron, M.D. 

Matthew Kalady, M.D. 

Michael K. W. Li, M.D. 

John Park, M.D. 

Sonia Ramamoorthy, M.D. 

SAGES acknowledges educational grants in support of this World Congress course from: 

Applied Medical, Covidien, Ethicon Endo-Surgery, Inc., Olympus and Stryker Endoscopy 

SAGES acknowledges contributions in-kind in support of this World Congress course from: 

Applied Medical, Cambridge Endoscopy, Covidien, Ethicon Endo-Surgery, Inc., Ethicon Inc., 

Karl Storz Endoscopy-America, Microline Surgical, Novare Surgical Systems, Olympus and Stryker Endoscopy 

To fully comply with ACCME regulations, all World Congress 

attendees must have their badge scanned before entering any 

course or session room in order to receive CME credit for that event. 



7:30 AM - 12:00 PM *included in Registration SuperPass (Option A) or Registration Option B 

MIS & Cancer Endocrine/Solid Organ Postgraduate Course 

Chair: William B. Inabnet III, M.D.; Co-Chair: Miguel Herrera, M.D. 

location: Potomac Ballroom B 

Description: 

The Endocrine/Solid Organ course will provide a comprehensive update on disorders of the thyroid, adrenal and pancreas. The course will 

combine didactic presentations with video-based education and panel discussions to emphasize established and novel minimally invasive 

techniques. 

Objectives: 


• Cite the changing paradigm in the work-up and management of thyroid malignancy 

• Describe current minimally invasive techniques for thyroid, adrenal and pancreas surgery 

• Differentiate benign from malignant adrenal pathology 

• Describe the appropriate work-up and treatment of islet cell tumors of the pancreas 

Schedule 

7:30 AM Introduction William B. Inabnet III, M.D. & Miguel Herrera, M.D. 

7:35 AM Thyroid Cancer Update Allan Siperstein, M.D. 

7:50 AM Video-Endoscopic and Robotic-Assisted Thyroidectomy W. Y. Chung, M.D. 

8:05 AM Minimally Invasive Thyroidectomy with Intra-Operative Nerve Monitoring Allan Dackiw, M.D. 

8:20 AM Video-Endoscopic and Thoracoscopic Parathyroidectomy James Lee, M.D. 

8:35 AM Discussion 

8:55 AM Adrenal Incidentaloma Steven Schwaitzberg, M.D. 

9:10 AM Pheochormocytoma Quan Yang Duh, M.D. 

9:25 AM Adrenal Malignancy and MIS Vivian Strong, M.D. 

9:40 AM Laparoscopic Transabdominal and Retroperitoneal Adrenalectomy Martin Walz, M.D. 


10:15 AM BREAK 

10:30 AM Functioning Islet Cell Tumors Juan-Pablo Pantoja, M.D. 

10:45 AM Pancreatic Incidentaloma Horacio Asbun, M.D. 

11:00 AM Gastric Bypass Induced Hyperinsulinemic Hypoglycemia Sayeed Ikramuddin, M.D. 

11:15 AM Laparoscopic Enucleation and Distal Pancreatic Resection Andrew Gumbs, M.D. 

11:30 AM Laparoscopic Resection of Hepatic Neuroendocrine Metastases Brice Gayet, M.D. 


1:00 PM - 5:00 PM *included in Registration SuperPass (Option A) or Registration Option B 

MIS Gastrointestinal Cancer Postgraduate Course 

Chair: Horacio J. Asbun, M.D.; Co-Chair: Seigo Kitano, M.D. 


Description: 

We will discuss on Indication, Procedures of MIS and Outcome etc. of minimally invasive surgery (MIS) for Gastrointestinal Cancer. 

Additionally, we will define the role of MIS for cancer treatment according to the clinical evidences. In this session, we will have a great 

opportunity that World leading surgeons discuss on minimally invasive surgery for gastrointestinal cancer. 

Objectives: 


• Choose appropriate Indication of MIS for Gastrointestinal Cancer 

• Assess what the safe techniques of MIS for Gastrointestinal Cancer 

• Deepen their knowledge on Clinical Evidence related to MIS for Gastrointestinal Cancer 

• Define the problems regarding MIS for Gastrointestinal Cancer and state the prospect for the future 

Schedule 

1:00 AM Introduction Horacio J. Asbun, M.D. & Seigo Kitano, M.D. 

1:05 PM Thoracoscopic Esophagectomy for Cancer Haruhiro Inoue, M.D. 

1:25 PM Laparoscopic TransHiatal Esophagectomy for Early Cancer Abeezar Sarela, M.D. 

1:45 PM Laparoscopic Gastrectomy for Early Cancer Han-Kwang Yang, M.D. 

2:05 PM Laparoscopic Gastrectomy for Advanced Cancer Vivian E.M. Strong, M.D. 

2:25 PM Discussion 

2:45 PM BREAK 

3:05 PM Clinical Evidences of Laparoscopic Surgery for Advanced Colorectal Cancer R. Larry Whelan, M.D. 

3:25 PM Laparoscopic Total Mesorectal Excision for Rectal Cancer Eric Rullier, M.D. 

3:45 PM Laparoscopic Procedures for Rectal Cancer After Radiochemotherapy Joel Leroy, M.D. 

4:05 PM Laparoscopic Approach for Obstructing Colorectal Cancer Nicolas Demartines, M.D. 

4:25 PM Current Status of Robotic Colorectal Surgery Richard M. Satava, M.D. 


SAGES acknowledges an educational grant in support of this World Congress course from Ethicon Endo-Surgery, Inc. 





7:30 AM - 12:00 PM *Included in Registration SuperPass (Option A) or Registration Option B 

Bariatric Postgraduate Course: 

New Tech/Revisions/Endolumenal/Single Port Access Surgery 

Chair: Scott A. Shikora, M.D.; Co-Chair: Raul J. Rosenthal, M.D. 

location: Potomac Ballroom A 

This postgraduate course will review some of the latest and novel technologies being proposed or currently introduced into the field of 

bariatric surgery. These operative techniques and devices all claim to offer less invasive and lower risk options for patients who qualify 

for bariatric surgery. Some even offer new and innovative mechanisms of action. The faculty, all of whom have an experience with these 

procedures, will offer their opinions concerning their feasibility, cost-effectiveness, and clinical relevance. 

Objectives: At the conclusion of this session, participants will be able to: 

• Review the feasibilities and techniques for endolumenal bariatric procedures and in particular, gastric partitioning for weight loss 

• Become familiar with the techniques and applications of single port surgery and to understand the controversy surrounding its benefit 

• Understand the theoretical benefits and clinical results of neuromodulation 

• Become familiar with the current and possible future surgical options for revision of failed bariatric operations 

Schedule 

7:30 AM Introduction Scott A. Shikora, M.D. & Raul J. Rosenthal, M.D. 

7:35 AM Overview of Endolumenal Procedures – Do They Really Work? Jacques M. Himpens, M.D. 

7:55 AM Endolumenal Gastric Partitioning Roberto Fogel, M.D. 

8:15 AM Can a Gastric Bypass be Created Endoscopically? Alfonso Torquati, M.D. 

8:35 AM Single Port Bariatric Surgery – An Analysis of Feasibility and Benefit Julio Teixeira, M.D. 

8:55 AM Single Port is NOT Beneficial Raul J. Rosenthal, M.D. 

9:15 AM Update on Neuromodulation Scott A. Shikora, M.D. 



10:30 AM Banding a Failed Gastric Bypass (Fixed and Adjustable) Matthew Hutter, M.D. 

10:45 AM How to Rescue a Patient After a Failed Band Luigi Angrisani, M.D. 

11:00 AM Are there Any Options for a Failed Biliopancreatic Diversion With or Without Duodenal Switch? Michel Gagner, M.D. 

11:15 AM Endolumenal Pouch and Anastomosis Reduction: An Analysis Christopher Thompson, M.D. 


SAGES acknowledges educational grants in support of this World Congress course from Covidien, Gore & Associates and Stryker Endoscopy. 

1:00 PM - 5:00 PM *Included in Registration SuperPass (Option A) or Registration Option B 

Bariatric Postgraduate Course: Around the World 

Chair: Alfons Pomp M.D.; Co-Chair: Manolo Cortez, M.D. 


Description: 

During this half-day course international surgeons will provide expert commentary on how they choose the appropriate weight loss operation. 

Experienced clinicians will discuss their therapeutic strategy when patients who have been submitted to surgery fail to sustain weight loss. 

Surgeons will discuss the prevention and treatment of complications of bariatric surgery. An introduction to the mechanisms of “metabolic” 

surgery and a brief overview of emerging techniques, including single port access and endoluminal techniques will complete this synopsis 


• Differentiate and compare weight loss surgery options 

• Analyze and compose a strategy to deal with bariatric surgery failures 

• Recognize, assess and treat complications of weight loss surgery 

• Integrate and review the indications of metabolic surgery into a bariatric practice 

• Review and appraise the indications for new therapeutic weight loss surgery options 

Schedule 

1:00 PM Introduction Alfons Pomp, M.D. & Manolo Cortez, M.D. 

1:05 PM Gastric Banding is the Best Weight Loss Operation Amiki Szold, M.D. 

1:20 PM Why I No Longer Perform Gastric Banding Jacques Himpens, M.D. 


1:45 PM Gastric Bypass is the Best Operation for BMI > 50 Ninh Nguyen, M.D. 

2:00 PM Bilopancreatic Diversion is the Best Operation for BMI > 50 Simon Biron, M.D. 


2:25 PM What I Do When the Band Does Not Work John Dixon, M.D. 

2:40 PM What I Do When Gastric Bypass Does Not Work Michel Gagner, M.D. 


3:05 PM BREAK 

3:25 PM Complications of Gastric Banding (and What I DO with Them) Karl Miller, M.D. 

3:40 PM Complications of Gastric Sleeve Antonio Lacy, M.D. 

3:55 PM Complications of Gastric V Bypass Scott Shikora, M.D. 


4:20 PM Metabolic Surgery – What’s it All About Ricardo V. Cohen, M.D. 

4:35 PM Single Access and Endoluminal Bariatric Surgery Marc Bessler, M.D. 


SAGES acknowledges an educational grant in support of this World Congress course from Ethicon Endo-Surgery, Inc. 



12:00 PM - 1:00 PM Location: Maryland Ballroom C 

SAGES Education and Research Foundation Awards Luncheon 

The 2010 Awards Luncheon will recognize distinguished leaders for their work in minimally invasive surgery and raise funds that will keep 

patient safety and minimal access surgery in the forefront. 

Cost: $125 per ticket / $1,100 per table (10 seats) Please bring your ticket or name of company hosting you. 

SAGES Foundation thanks the following sponsors of this event: 

Applied Medical, Atrium Medical, Covidien, Gore & Associates, Karl Storz Endoscopy, Simbionix 

Host: Bruce Schirmer, MD, SAGES Foundation President 

To register on-site, visit the World Congress Registration desk by Wednesday at 10:00 AM. A portion of your contribution is tax-deductible to 

the extent permitted by law. 

SAGES does not offer CME credits for this lunch. 

2010 SAGES Career Development Award & Research Grant Winners 

Presented by: Aurora Pryor, MD, Research Committee Chair & Representatives of Supporting Companies as follows. 

Career Development Award – TBA On-Site 

Research Grant Awards: 

SAGES thanks the SAGES Foundation for their support of this award. 

Name: Sarah Evans, MD 

Institution: Duke University 

Title: Gastric Bypass Surgery Alters the Secretion of the Anorexogenic 

Gut-Derived Hormones Glucagon-like Peptide-1 and Peptide YY 

Supported by Covidien 

Name: Toshitaka Hoppo, MD 

Institution: The Heart, Lung and Esophageal Surgery Institute 

Title: Prevention of Stricture Formation Following Subtotal Endoscopic 

Mucosal Sleeve Resection in the Swine Model 


Name: Kyle Perry, MD 

Institution: The Ohio State University 

Title: Identifying the Optimal Duration of Gastric Ischemic 

Conditioning to Improve Gastroesophageal Anastomotic 

Wound Healing 


Name: Corey Deeken, MD 

Institution: Washington University School of Medicine 

Title: Fixation of Biologic Mesh at the Hiatus with Fibrin or 

Polyethylene Glycol (PEG) Sealeant in a Porcine Model 

Supported by Ethicon Endo-Surgery 

Name: Karem Harth, MD 

Institution: University Hospitals Case Medical Center 

Title: Tension Free Ventral Hernia Repair: Is This the Wrong Operation? 

Supported by Ethicon Endo-Surgery 

Name: Brian Dunkin, MD 

Institution: The Methodist Hospital 

Title: A Pilot Study to Determine the Risk of Graft Contamination 

Following Transvaginal Extraction of the Kidney During 

Laparoscopic Living Donor Nephrectomy 

Supported by Karl Storz Endoscopy 

Name: Liane Feldman, MD 

Institution: McGill University Health Centre 

Title: Mastery Versus Standard Proficiency Laparoscopic Technical 

Skills Training: A Randomized Controlled Trial 

Supported by SAGES Foundation 

Name: Eric Hungness, MD 

Institution: Northwestern University Department of Surgery 

Title: Laparoscopic Common Bile Duct Exploration: Simulator 

Development 


Name: William Richards, MD 

Institution: University of South Alabama 

Title: Downregulation of G6PD Activity is a Mechanism of Action of 

Improvement of Type II Diabetes after Bariatric Surgery 



Honoring Gerald Marks on his 85th Birthday 

He started it all and is considered the father of SAGES. Gerry Marks was and is a man of vision, tenacity and audacity. 

He created the formula for SAGES success and lived by it. SAGES would have a strong founding leadership that would 

rotate so that no one personality would dominate the organization. The organization would cultivate young cutting 

edge surgeons and give them a seat at the table. The organization had the word “American” in its name but would 

begin and continue to be an international society. SAGES would lead in education and research and become a force 

to be reckoned with. He stepped back as president after a few years. He stayed on to serve in many other capacities 

including as an editor of SAGES Journal, our representative to the ACS Board of Governors and as a member of the 

SAGES Foundation board. He was instrumental in organizing the International Federation of Societies Endoscopic 

Surgeons and was its founding president. He is still a voice for visionary thought. He still has a warm smile, quick wit and dreams for better 

endoscopic surgery. 

Why are we telling you this? Gerry Marks is about to celebrate his 85th Birthday. Who could believe it!? Still sporting a bounce in his step, a 

gleam in his eye and looking like he stepped off the cover of GQ, Gerry is still the quintessential surgeon’s surgeon. 

To celebrate 85 years of surgical splendor, please honor Gerald Marks and his work for SAGES by making a contribution in his 

honor to the SAGES Education and Research Foundation. You may donate on line at www.sagesfoundation.org or stop by the 

Foundation Donor Lounge or SAGES membership booth to fill out your commemorative donation form. 

Gerry, we love you. Happy Birthday! 




2010 SAGES Young Researcher Award Winner 

Presented by: Aurora Pryor, MD, Research Committee Chair & representative from Olympus 

Recipient: Vivian Strong, MD 

The Young Researcher Award is given to a SAGES Candidate or Active member in a residency program, fellowship or 

within 5 years of training, who has demonstrated an interest and ability in research. 

Vivian Stong, this year’s Young Researcher recipient, is Assistant Professor of Surgery, Weill Medical College of Cornell 

University, New York, NY and Assistant Attending Surgeon, Memorial Sloan-Kettering Cancer Center, New York, NY. 

Dr. Strong has a research profile that is both broad and deep. She began performing research projects while still in 

secondary school. During her residency she spent time completing productive basic science research related to 

oncology. Following her fellowship in minimally invasive surgery, she was recruited to join the faculty at Memorial Sloan-Kettering Cancer 

Center. There she has distinguished herself by bringing minimally invasive surgery to cancer patients who formerly rarely had that option, 

and then studying the effect of minimally invasive surgery in that setting. She has developed new technology for using a beta probe to 

identify tumor sites intraoperatively during either open or laparoscopic surgery using PET scanning technology (including a SAGES grant 

to study this). She has also focused on minimally invasive treatment of gastric cancer and has recently published a significant series of 

oncologically sound minimally invasive gastric resections. She has developed collaboration with Asian surgeons to further the development 

of better minimally invasive techniques for treating gastric cancer. Her research is a well-rounded body of work including basic science, 

education, and development and assessment of better clinical techniques for cancer patients. 

SAGES gratefully acknowledges Olympus for their support of the Young Researcher Award. 

2010 SAGES Researcher in Training Award Winner 

Presented by: Aurora Pryor, MD, Research Committee Chair 

Recipient: Erica Moran, MD 

The Researcher in Training Award is new this year, given to a SAGES Candidate member in a residency program or 

fellowship, who shows great promise for a career in academic GI/endoscopic practice or potential for significant 

contributions to the advancement of minimally invasive or endoscopic surgery. 

Erica Moran is a General Surgery Resident (PGY4) that has been active in an interdisciplinary research laboratory from 

January 2008 until December 2009. During that time, she completed the Clinician Investigator Training Program at the 

Mayo Medical Foundation. She has conducted research projects in three different units of the Mayo Medical School. The 

research involves the randomized comparisons of laparoscopic and transluminal procedures as well as new applications 

of endoscopic tools. During her laboratory experience, she was instrumental in securing three extramural research grants as the primary 

investigator. She had participated in close to ten different experimental studies. In addition, she has presented the data that she collected at 

regional, national (including SAGES), and international meetings. Her outstanding work has been recognized at the Balfour Surgical Society 

meeting, where she was awarded the Resident Best Paper Award as well as the Minnesota Surgical Society Best Paper Presentation Award, for 

her excellent presentations. 

She has given six oral presentations, presented 16 posters and authored 6 original articles 

Her current research projects include: “Feasibility of translumenal endoscopic omental patch closure of perforated viscus”—Clinical Trial; as 

well as: “Feasibility of transvaginal cholecystectomy “—Clinical Trial. 

2010 SAGES IRCAD Fellowship Award Winner 

Presented by: Lee Swanstrom, MD, Awards Committee Chair & representative from Karl Storz Endoscopy 

Recipient: Basil Yurcisin, MD 

The SAGES IRCAD Traveling Fellowship Award is available to a SAGES Candidate member who is enrolled in a Fellowship 

Council recognized program. 

Dr. Yurcisin first stepped onto the SAGES horizon when he worked in the SAGES Learning Center as a second year clinical 

resident. He is now in the second and clinical year of a two-year fellowship in Minimally Invasive and Bariatric Surgery at 

Duke University Medical Center. In his fellowship he has exposure to a wide range of minimally invasive surgical as well 

as some endoscopic procedures. He believes that the future of surgery lies within minimally invasive surgery. His work to 

date is extraordinary and there is no doubt he will benefit from his fellowship at IRCAD. 

Dr. Yurcisin did his residency training at the University of Pittsburgh Medical Center Mercy Hospital, Pittsburgh, PA. He earned his MD at 

Southern Illinois University School of Medicine, Springfield, IL. 

He has to date served as faculty for the 2006, 2007 and 2008 SAGES Learning Centers and was a recipient of the Resident Achievement Award 

- Society of Laparoendoscopic Surgeons, University of Pittsburgh Medical Center Mercy Hospital, June 2005 & 2007. He has already given 5 

presentations, written 7 peer reviewed papers and published one book chapter. 

SAGES gratefully acknowledges Karl Storz Endoscopy for their support of the IRCAD Fellowship Award. 




2010 SAGES Excellence in Clinical Care Award Winner 

Presented by: Lee Swanstrom, MD, Awards Committee Chair 

Recipient: Paul Hansen, MD 

The Excellence in Clinical Care Award, new this year, is designated for a clinician who is recognized by the surgical/ 

GI community for excellence in patient care and surgical practice, and has significant surgical/endoscopic skills, and 

contributions to the community and/or volunteerism. 

Paul Hansen is Clinical Associate Professor of Surgery, Oregon Health Sciences University and Director, Hepatobiliary 

Program, Providence Portland Medical Center. He also serves as Program Director, HPB postgraduate fellowship program, 

Providence Portland Medical Center. Dr. Hansen is Triple Fellowship trained and has been active in SAGES since he was 

a resident. He helped to pioneer minimally invasive approaches to liver and pancreatic cancers and has done original 

research on technology and approaches for liver tumor ablation (RFA). 

Paul Hansen was a leader in laparoscopic liver resections and has advanced research in Laparoscopic assisted liver chemotheratpy, including 

Laparoscopic chemotherapy pump placement, Laparoscopic assisted chemo-embolization. His work in robotic assisted laparoscopic 

Whipple procedure is well known. 

He was the driving force is the creation of a regional “center of excellence” for pancreatic and liver cancer and established one of the 

few postgraduate fellowships in hepatobiliary/pancreatic surgery. His educational efforts have included local MIS resident, nursing and 

community surgeon courses, national MIS courses as well as having developed and run an annual surgery day for local school children to 

come and tour operating rooms and practice laparoscopic surgery in his training lab. 

He annually volunteers for overseas medical missions: Pakistan, Guatemala, Vietnam, Cambodia, and elsewhere. He is an example of the fully 

realized surgeon: dedicated family man, brilliant clinician, productive researcher, constant teacher and selfless volunteer. He continues to 

push the frontiers of therapy in quest of better care of his patients. He is the paragon for clinical excellence. 

2010 Jeffrey L. Ponsky Master Educator in Endoscopy Award – A SAGES Foundation Award 

Presented by: David Duppler, MD & Jeffrey Marks, MD 

Recipient: Carol Scott-Conner, MD 

Carol Scott-Conner, MD, PhD, MBA, has been selected to receive the Jeffrey L. Ponsky Master Educator in Endoscopy 

Award. The Ponsky Flexible Endoscopy Research Fund was established by the SAGES Foundation in 2007 as a tribute 

to Dr. Jeffrey Ponsky for his outstanding contributions to endoscopy and surgical education. The Master Educator 

award recognizes a distinguished SAGES leader who exemplifies Dr. Ponsky’s visionary leadership and his dedication to 

teaching of surgical endoscopy. 

Dr. Scott-Conner’s lifelong commitment to education and research, and her trailblazing achievements as a scholar and 

surgeon, embody the qualities that define compassionate greatness. As Chair of Surgery at University of Iowa College 

of Medicine from 1995 through 2004, she was only the second woman to lead a surgery department at an academic medical center. She 

currently serves as Professor of Surgery at the University of Iowa’s Roy J. and Lucille A. Carver College of Medicine. 

Carol Scott-Conner has enriched the world as a mentor and many of us have been impacted by her teachings and by volumes of seminal 

writings, including eight medical textbooks that have been translated into at least five languages. 

Since joining SAGES in 1984, she has served as Vice-President, a member of the SAGES Board of Governors, Chair of the Research Grants 

Committee, and has made an invaluable contribution as a key figure in the development and growth of the organization. She edited the first 

SAGES manual and two subsequent volumes, Herculean tasks, all. We are in her debt as our teacher. 

2010 Gerald Marks Rectal Cancer Award – A SAGES Foundation Award 

Presented by: Gerald Marks, MD & Bruce Schirmer, MD 

Recipient: Bastiaan Klarenbeek, MD 

The Gerald Marks Rectal Cancer award is selected from each year’s submitted abstracts. This award is chosen from the 

hundreds of abstracts submitted by a special committee of reviewers and given to one individual each year in honor of 

Dr. Gerald Marks, SAGES first President and Founder. 



2010 SAGES Distinguished Service Award Winner 


Recipient: Nathaniel Soper, MD 

Nat Soper clearly did not have a mentor or parent who told him “don’t volunteer.” Or he did not get the message. Dr. 

Soper was President of SAGES from April 2000-2001. He served on the Board of Governors from 1993 to present and 

is currently SAGES representative to the American College of Surgeons Board of Governors. His work as one of the 

founding fathers of FLS and as its project chair for several years (including currently) has made him one of the major 

forces of surgical education in this country and the world. Along the way he has served on the Development, Continuing 

Education, Program and Publications Committees. He was the Poster Chairman of the 1993 and 1994 annual scientific 

sessions, Postgraduate Course Director of the 1998 meeting, and was the Program Chairman of the 1999 meeting. He is 

on the Editorial Board of eight journals, and his publications include more than 200 manuscripts and book chapters. He was among the first 

academic American surgeons to perform laparoscopic surgery and has been involved in its maturation and development over the ensuing 

years. 

He has distinguished himself by the service he has given to SAGES and the surgical community. He has done it with good humor (sometimes 

a challenge), great patience, common sense and refreshing humility. 

2010 Berci Lifetime Achievement Award Winner 


Recipient: Jacques Marescaux, MD 

If you don’t know who Jacques Marescaux is, you are simply not paying attention. Since his early presentations in the 

mid 1990’s related to laparoscopic surgery he has contributed an enormous amount to the surgical body of knowledge 

and shared that knowledge with literally thousands of surgeons. His world renowned training facility in Strasborg, 

IRCAD, has set the bar for training and the dissemination of clinical training in the world of minimal access surgery. 

IRCAD was founded in 1994 and has run courses covering a wide variety of subjects. These courses attract world class 

faculty to provide high content didactic teaching in addition to one of the finest animal laboratories ever established. Dr. 

Marescaux gave the Karl Storz Keynote Lecture in New Technology at the SAGES 2001 Meeting in St. Louis. 

There is no doubt that Dr. Marescaux is one of the world leaders in terms of innovation in minimally invasive surgery and surgical education. 

His vision and success in creating a world leading center for internet based surgical education is unmatched. The website that he created, 

WebSurg is the #1 source of information for people looking on the internet for educational content about minimally invasive surgery. Many 

such ventures have come and gone, but WebSurg has not only survived the shake out in a dot com industry, but became the world leader in 

this area. Every surgical resident knows about this website and most use it. 


World Congress Corporate Supporters 

Diamond Donors 

COVIDIEN 


SAGES EDUCATION AND RESEARCH FOUNDATION 

PLATINUM DONORS 

KARL STORZ ENDOSCOPY-AMERICA 

OLYMPUS 

GOLD DONORS 

ASCENT HEALTHCARE SOLUTIONS 

STRYKER ENDOSCOPY 

SILVER DONORS 

BOSTON SCIENTIFIC DAVOL, INC., A BARD COMPANY GORE & ASSOCIATES 

BRONZE Donors 

SYNOVIS SURGICAL INNOVATIONS 



Notes 



1:00 PM - 5:00 PM *Separate Registration Fee 

Hands-on Advanced Suturing and Anastomotic Techniques Lab 

Chair: Kelvin D. Higa, M.D.; Co-Chair: Aureo L. De Paula, M.D. 

location: Maryland Ballroom B-D 

Description: 

Laparoscopic suturing skills allow smooth transition from basic to advanced surgery. In this lab, world-recognized experts in advanced 

suturing and anastomotic techniques will provide direct, hands-on training to take your suturing skills to the next level. If you want to take 

your skills from advanced to expert, this is an opportunity you don’t want to miss. 

Objectives: 


• Become familiar with advanced suturing techniques: tissue approximation, knot tying, anastomoses. 

• Understand the advantages and disadvantages of intracorporal sutures. 

• Adopt the principles for continued efficiency and skill. 

• Apply these techniques to common surgical problems encountered 

Schedule 

1:00 PM Introduction – Overview of Tools and Suture Material Kelvin D. Higa, M.D. & Aureo L. De Paula, M.D. 

1:15 PM Principles of Efficient Laparoscopic Suturing Kelvin D. Higa, M.D. 

1:30 PM How to Tie a Knot Aureo L. De Paula, M.D. 

1:45 PM Specific Applications: Anastomoses, Internal Hernia Closure, Staple-Line Reinforcement Aureo L. De Paula, M.D. 

2:00 PM Lab Instructions Kelvin D. Higa, M.D. & Aureo L. DePaula, M.D. 

2:05 PM Hands-On Lab 


Jose Ribamar Azevedo, M.D. 

Daniel Birch, M.D. 

Elias Chousleb, M.D. 

Pradeep Chowbey, M.D. 

Edward Felix, M.D. 

Kazunori Kasama, M.D. 

Nilton Kawahara, M.D. 

Marina Kurian, M.D. 

Adam Meneghetti, M.D. 

Chinnasamy Palenivelu, M.D. 

Paresh Shah, M.D. 

Surendra Ugale, M.D. 

Tony Vine, M.D. 



Covidien, Ethicon Endo-Surgery, Inc., Karl Storz Endoscopy-America, Olympus and Stryker Endoscopy. 











Pencil us in for next year: 








1:00 PM - 5:00 PM *Included in Registration SuperPass (Option A) or Registration Option B 

Pediatrics Session: 

Next-Generation Pediatric MAS – A Move Toward “Scarless” Surgery 

Chairs: Sanjeev Dutta, M.D. and Jacob Langer, M.D. 

location: Potomac Ballroom C 

Pediatric minimal access surgery (MAS) has grown to encompass virtually every pediatric surgical condition, including even complex 

neonatal anomalies. This has enabled faster recovery and less pain, with smaller scars. The next wave of innovation in pediatric MAS 

involves further minimizing incisions, transferring them to inconspicuous sites, or avoiding them altogether. Termed “stealth surgery” in the 

pediatric surgical community, the intent is to perform complex procedures without leaving evidence they occurred, and thereby address the 

psychological consequences that surgical scars can have on children. 

Objectives: 

At the conclusion of this session, participants will have a better understanding of current cutting edge minimal access procedures in 

pediatric surgery. They will be able to: 

• Describe the current experience, instruments, and operative techniques relevant to performing transaxillary subcutaneous endoscopic 

surgery including benign lesions of the neck and chest, as well as thyroid and parathyroid lesions. 

• Describe the current experience, instruments, and operative techniques relevant to pediatric single incision laparoscopic surgery 

including appendectomy, cholecystectomy, splenectomy, and neonatal procedures. 

• Describe current experience, instruments, and operative techniques relevant to endolumenal therapies in children including antireflux 

procedures and gastroduodenal lesions. 

• Describe future potential MAS therapies in children such as natural orifice translumenal endoscopic surgery (NOTES®). 

Schedule 

1:00 PM Introduction Sanjeev Dutta, M.D. 

1:05 PM Transaxillary Subcutaneous Endoscopic Surgery Moderator: Sanjeev Dutta, M.D. 

Transaxillary excision of Benign Neck and Truncal Lesions 

Sanjeev Dutta, M.D. 

1:20 PM Transaxillary Excision of the Thyroid and Parathyroids Thom Lobe, M.D. 


1:45 PM Single Incision Laparoscopic Surgery Moderator: Jacob Langer, MD 

Transumbilical Non-Laparoscopic Surgery in the Neonate 

Jacob Langer, M.D. 

2:00 PM Overview of Single Incision Surgery Tool Box and Technique Jeff Ponsky, M.D. 

2:15 PM Single Incision Surgery Splenectomy and Cholecystectomy Sanjeev Dutta, M.D. 

2:30 PM Neonatal Single Incision Surgery Carroll “Mac” Harmon, M.D. 


2:55 PM 10 min BREAK 

3:05 PM Endolumenal Surgery and NOTES® Moderator: Timothy Kane, M.D. 

3:10 PM Endolumenal to Translumenal: The Prospect of NOTES® in Children Lee Swanstrom, M.D. 

3:25 PM Endolumenal Therapy for GERD in Children – 

Early Experience with Transoral Incisionless Fundoplication 

Michael Thomson, M.D. 

3:35 PM GERD in Children – A Surgical Perspective Steven S. Rothenberg, M.D. 

3:40 PM Endolumenal Therapy for Pancreatic and Gastroduodenal Lesions Timothy Kane, M.D. 


Video Session 

Moderators: Panel 

4:05 PM Video – Thyroid Matias Bruzoni, M.D. 

4:15 PM Video – Gall bladder Single Incision Surgery Katherine Barsness, M.D. 

4:25 PM Video – Spleen-Single Incision Surgery Zachary Kastenberg, M.D. 

4:35 PM Video – Endoscopic-assisted Esophagectomy Jose Prince, M.D. 

4:45 PM Video – Single Incision Surgery Pyloromyotomy Erik Hansen, M.D. 

4:55 PM Closing Remarks Jacob Langer, M.D 

Please join us for the 

World Congress Welcome Exhibit Opening Reception 

5:00 PM - 7:00 PM 

World Congress exhibits will take place at the Gaylord Convention Center in 

the Prince George’s Exhibit Hall A-C. The Learning Center and Posters will NOT 

be open until Thursday. 

13 th World Congress of Endoscopic Surgery leaders will be introduced. 


SAGES 

2011 

Scientific Session & 

Postgraduate Course 

Program Chair: 

Brian Dunkin, MD 

March 30 - April 2, 2011 

San Antonio Convention Center 

San Antonio, TX 

www.sages.org 

Registration & program information will be available Fall, 2010



6:00 AM - 7:15 AM 

7:30 AM - 11:30 AM 

Industry Satellite Symposia 

Covidien – “Advances in SILS Technology, 

Technique and Evidence” 

Postgraduate Surgeon in the Digital Age: 

Video Editing Course – Basic Video Editing 

with an Introduction to Advanced Techniques 


Chesapeake Conference Rooms D-E 

7:30 AM - 11:30 AM Avoid Pitfalls in Cholecystectomy and CBD Exploration Potomac Ballroom B 

7:30 AM - 11:30 AM Challenging Hernias Postgraduate Course Potomac Ballroom A 

7:30 AM - 12:00 PM Fundamentals of Laparoscopic Surgery Hands-on Course 

Lectures – Maryland Ballroom C 

Lab – Maryland Ballroom A 

9:30 AM - 11:30 AM SS01 Best of Videos 1 Potomac Ballroom C 

10:00 AM - 2:30 PM World Congress Exhibits, Posters & Learning Center Open Prince George’s Exhibit Hall A-C 

11:30 AM - 1:00 PM BREAK: Exhibits, Posters, Learning Center 

11:30 AM - 1:30 PM 




11:30 AM - 1:30 PM 

Device Development Luncheon: 

From Funding to Freedom to Operate 


1:30 PM - 5:00 PM 


The Status and Direction of Laparoscopic Colorectal Surgery in 

the Treatment of Inflammatory Bowel Disease 


1:30 PM - 5:00 PM Single Port Access Surgery Hands-On Course **Offsite lab 

1:30 PM - 5:00 PM 

MBA for Surgeons Panel: 

Asset Management and Protection for Surgeons 


1:30 PM - 5:00 PM Hands On Endolumenal/NOTES® Lab Maryland Ballroom B-D 

1:30 PM - 2:30 PM Robotics Symposium: What’s New? Potomac Ballroom B 

2:30 PM - 4:00 PM Metabolic Surgery Symposium: Current Status Potomac Ballroom B 


4:00 PM - 5:30 PM Barrett’s Debate: How to Follow, How to Treat? Potomac Ballroom B 

5:30 PM - 7:30 PM Industry Satellite Symposia (No Registration Required) 

Boston Scientific, Inc. – “Intraluminal Stents and the Surgeon – 


Covidien – “Insights into the Future of Surgical Stapling: 

Integrated Materials, Tri-Staple Technology, 

Powered Staplers” 

Davol Inc., a BARD Company – “Advanced Endoscopic 

Techniques for Abdominal 

Wall Reconstruction” 

Ethicon Endo-Surgery, Inc. – “Minimally Invasive Surgery – 

Where is it Going?” 

Karl Storz Endoscopy – “The Great Debate: S-PORTAL 

(Single Portal Access) Surgery vs. 

Mini-Laparoscopy” 

Chesapeake D-E 





2010 Poster Session 

Posters will be on display, Thursday, Friday & Saturday. 

Poster presenters will be available for Q&A on Friday, from 11:15 AM - 12:15 PM 

SAGES acknowledges our Diamond and Platinum Level Donors for their support of the poster session: 

Diamond: Covidien, Ethicon Endo-Surgery, Inc. and SAGES Education and Research Foundation 

Platinum: Karl Storz Endoscopy, Olympus 

To fully comply with ACCME regulations, all World Congress attendees must have their badge scanned 

before entering any course or session room in order to receive CME credit for that event. 




6:00 AM - 7:15 AM Free for any World Congress Attendee 

Industry Satellite Symposia These events are not planned nor accredited for CME by SAGES. 

Industry presentations will take place on Thursday morning, immediately prior to Congress sessions. 

Registration is FREE for any World Congress attendee. 

Covidien - “Advances in SILS Technology, Technique and Evidence” 

Location: Potomac Ballroom D 

Presenters: Jerry Stirman, MD 

Paul Enochs, MD 

Shawn Garber, MD, FACS 

This is a non-CME activity presented and supported by Covidien. 

7:30 AM - 11:30 AM *Separate registration fee 

Postgraduate Surgeon in the Digital Age: Video Editing Course 

Basic Video Editing with an Introduction to Advanced Techniques 

Chair: Dmitry Oleynikov, M.D.; Co-Chair: John Romanelli, M.D. 

location: Chesapeake Conference Rooms D-E 

This course is a hands-on (1 to a station) PC-based course and workshop using the latest video editing software. This course is designed 

to take users through the basic steps of digital video editing. The skills learned in this course will be applicable to digital video editing on 

most Widows-based computers and editing programs. Led in real time by an experienced surgeon facilitator, participants will import clips, 

edit them, create transitions and add voice-over sound tracks. Additional advanced techniques which are useful in medical videos will be 

reviewed. Final products will be transcoded for a variety of purposes. A CD with the course files is included for later practice. Once this course is 

completed, users should be able to have the skills necessary to create edited digital videos for medical meetings, education or personal use. 

Objectives: 

At the completion of this course the surgeon (or other participant) will be able to: 

• Demonstrate a working knowledge as to how the video signal used to perform laparoscopic surgical procedures is transferred to a variety 

of digital formats (e.g. – CD, DVD, digital tape) for the purposes of creating materials that could be used for: 

– Electronic medical records 

– Formal presentation at medical meeting 

– Patient education 

– Website presentation for patient or physician education 

– Archival needs 

• Manipulate the acquired digitized video material for the purposes above by methods utilizing the following skills in order to create 

effective medical educational materials: 

– Editing 

– Titling 

– Transitions 

– Annotation with audio 

– Addition of still photography 

– Selected special effects 

• Produce output of the acquired and manipulated digital material for specific needs in the medical educational arena including: 

– Videotape 

– CD-ROM 

– Web-based media files 

– DVD 

Schedule 

7:30 AM The Operation 

7:40 AM Image acquisition from different devices 

7:50 AM Getting video footage onto the computer 

8:15 AM Break 

8:30 AM Editing 

8:45 AM Editing Clips in the Timeline 

9:30 AM Transitions 

10:15 AM Outputting Your Project 

10:30 AM Internet Publishing and Podcasting 

11:30 AM Conclusion 

Faculty: 

Shanu Kothari, M.D. 

John Feng, M.D. 

Sergey Kantsevoy, M.D. Matthew Goede, M.D. 

Rhonda Prewitt, M.D. 

SAGES acknowledges an educational grant in support of this World Congress course from Stryker Endoscopy. 



7:30 AM - 11:30 AM *included in Registration SuperPass (Option A) or Registration Option B 

Avoid Pitfalls in Cholecystectomy and CBD Exploration 

Chair: Michael B. Edye, M.D.; Co-Chair: Bertrand Millat, M.D. 


Description: 

The essence of surgery is to be aware of potential pitfalls in advance and to take steps that are known to avoid them. This session will build 

on a sound anatomic foundation for laparoscopic cholecystectomy and common duct exploration. Practical recommendations for safe 

techniques that work in straightforward and complicated settings, and a final syntehsis will provide a basis for best practice. 


• Describe common anatomic anomalies of the biliary tree that can complicate laparoscopic cholecystectomy and strategies to avoid these 

complications 

• Recognize how new surgical approaches to cholecystectomy can increase the risk of bile duct injury and devise methods to prevent these 

injuries in their subsequent practice 

• Approach complicated presentations of cholecystitis with great confidence 

• Review their current approach to common duct stones and recognize the benefits and difficulties of surgical versus endoscopic bile duct clearance 

Schedule 

7:30 AM Introduction Michael B. Edye, M.D. & Bertrand Millat, M.D. 

7:35 AM Anatomic Pitfalls of Cholecystectomy and CBD Exploration Brice Gayet, M.D. 

7:50 AM Lessons from a High Volume Laparoscopic Biliary Surgeon Surendra Ugale, M.D. 

8:05 AM Rationale for Cholangiography William Traverso, M.D. 

8:20 AM Operative Bile Duct Clearance vs. Preoperative ERCP: 

other Combined Approaches to Duct Clearance 

Augusto Tinoco, M.D. 

8:40 AM Pitfalls of T-Tubes and Other Biliary Drains, and the Place of Primary Duct Closure Ian Martin, M.D. 


9:20 AM Break 

9:40 AM Cholecystectomy in Chirrhotics: If, When and How? Luis Burbano, M.D. 

9:50 AM Acute Cholecystitis: Tricks to Success, When to Convert and When to Start Open Bertrand Millat, M.D. 

10:05 AM Single Port Cholecystectomy: Umbilical Anatomic Techniques and Devices Paul G. Curcillo, M.D. 

10:20 AM “SKIN” Cholecystectomy (Skinny Instrument i.e. 2-3 mm): The Forgotten Alternatives to NOTES® Michael B. Edye, M.D. 

10:35 AM Synthesis of Recommendations Michael B. Edye, M.D. & Bertrand Millat, M.D. 


7:30 AM - 11:30 AM *included in Registration SuperPass (Option A) or Registration Option B 

Challenging Hernias Postgraduate Course 

Chair: Kristi L. Harold M.D.; Co-Chair: Shirin Towfigh, M.D. 


Hernia repair remains one of the most common surgical procedures performed around the world. Despite many standardized techniques 

new procedures, instruments, and biomaterials continue to emerge to address the problem of challenging hernias. Surgeons attending 

SAGES will benefit from this half-day course which will utilize evidence- based medicine to cover a wide variety of topics surrounding 

challenging hernias and the modern approaches to their repair. 

Objectives: 


• Discuss uses and shortcomings for various types of synthetic and biological meshes 

• Recognize the role of bariatric operations in hernia patients 

• Distinguish patients who may benefit from a combined approach by general and plastic surgery for hernia repair 

• Formulate a tailored approach to patients with sports hernias 

Schedule 

7:30 AM Introduction Kristi L. Harold, M.D. & Shrin Towfigh, M.D. 

7:35 AM Parastomal Hernia Repair – Best Techniques Kristi Harold, M.D. 

7:50 AM Loss of Domain – Definition and Management Michael Rosen, M.D. 

8:05 AM Biological Meshes – Indications and Shortcomings Gina Adrales, M.D. 


8:30 AM What are we doing to predict and prevent hernias? B. Todd Heniford, M.D. 

8:45 AM Hernias in Difficult Locations: Flank, Supra-pubic, Sub-xyphoid Alfredo Carbonell, D.O. 

9:00 AM LVHR: Dealing with Complications Pradeep Chowbey, M.D. 


9:25 AM BREAK 

9:40 AM Biological Mesh for Paraesophageal Hernia Repair – Pros & Cons Steven P. Bowers, M.D. 

9:55 AM Is There a Role for Synthetic Mesh in an Infected Field? Shirin Towfigh, M.D. 

10:10 AM Options in the Management of Infected Abdominal Wall Mesh Brent Matthews, M.D. 


10:35 AM Ventral Hernia in the Morbidly Obese Patient – Timing of Repair / 

role of Weight Loss Surgery / Hernia During Weight Loss Surgery 

Yuri Novitsky, M.D. 

10:50 AM Chronic Pain Following Inguinal Hernia Repair TBA 

11:05 AM Best Approach to Recurrent Inguinal Hernia Abe Fingerhut, M.D. 


SAGES acknowledges educational grants in support of this World Congress course from: Covidien and Gore & Associates. 





7:30 AM - 12:00 PM *Separate Registration Fee 

Fundamentals of Laparoscopic Surgery Hands-on Course 

Chair: Gerald M. Fried, M.D.; Co-Chair: E. Matthew Ritter, M.D. 

location: Lectures – Maryland Ballroom C 

lab – Maryland Ballroom A 

The course will be based on the Fundamentals of Laparoscopic Surgery (FLS) Program, a collaborative effort between Society of American 

Gastrointestinal and Endoscopic Surgeons and the American College of Surgeons. This introductory course will begin with an overview 

of the history, science, and development of the FLS Program. It will continue with various chapters from the FLS curriculum, such as 

physiology, intraoperative considerations, basic laparoscopic procedures, and procedural complications. Part of the course will also cover 

the psychomotor and technical skills required in basic laparoscopic surgery. The course syllabus will outline the contents of the FLS online 

didactic curriculum. 

All course participants will receive online access to the FLS didactic curriculum and will be expected to review the materials prior to the 

course. The hands-on component will utilize a ratio of 3:1 participants to FLS trainer boxes and faculty for mentored skills practice. 

After completing the course, participants will be able to schedule an appointment to take the FLS exam (written and practical). The test fee 

is included in the course registration, although the test is optional. There will be testing appointments available starting directly after the 

course and throughout the SAGES meeting. Participants may also opt to take the FLS exam at an upcoming ACS Clinical Congress or SAGES 

Annual Meeting or one of over 40 FLS Test Centers. 

Objectives: 

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

• Discuss the important preoperative considerations when faced with a patient requiring laparoscopic surgery. 

• List the key intraoperative considerations during laparoscopic operations. 

• Discuss the important concepts in postoperative care of patients undergoing laparoscopic surgery. 

Schedule 

7:30 AM Introduction and Rationale for FLS Lee L. Swanstrom, M.D. 

7:45 AM Preoperative Considerations Ashley Vernon, M.D. 

8:05 AM Intraoperative Considerations E. Matthew Ritter, M.D. 

8:25 AM Basic Laparoscopic Procedures Shawn T. Tsuda, M.D. 

8:45 AM Postoperative Considerations Melina C. Vassiliou, M.D. 

9:05 AM Technical Skills: Development of FLS Curriculum, 

Validation of Metrics, and Relationship to Operative Performance 

Gerald M. Fried, M.D. 

9:30 AM Implementing FLS: The Experience in the U.S. Department of Defense E. Matthew Ritter, M.D. 

9:50 AM Implementing FLS: The Experience of the Royal Australasian College of Surgeons Gerald M. Fried, M.D. 

10:10 AM FLS: FAQs – Who, When, Where, and How? Nathaniel J. Soper, M.D. 


10:40 AM Hands-On Workshop Lee L. Swanstrom, M.D. 

Ashley Vernon, M.D. 

E. Matthew Ritter, M.D. 

Shawn T. Tsuda, M.D. 

Jonathan Pearl, M.D. 

Gerald M. Fried, M.D. 

Nathaniel J. Soper, M.D. 

Melina C. Vassiliou, M.D. 

Allan E. Okrainec, M.D. 

SAGES acknowledges educational grants in support of this World Congress course from Covidien, Ethicon Endo-Surgery, Inc. and Stryker Endoscopy. 

SAGES acknowledges contributions in-kind in support of this World Congress course from: Covidien and Karl Storz Endoscopy-America. 

World Congress Goes Green! 

In an effort to support the environment, you will see less paper for the 12th Annual World Congress. 

The printed Final Program will include the regular schedule and course/panel outlines, as well as 

oral abstracts, Poster of Distinction abstracts and poster listing. However, electronic copies of all 

the abstracts, digital posters, and Postgraduate course syllabi will be available on thumb drive for 

all attendees. The “Electronic Meeting Guide” will be completely navigational and searchable. Print 

kiosks will also be available throughout the Convention Center. 



9:30 AM - 11:30 AM *included in Registration SuperPass (Option A) or Registration Option B) 

SS01 Best of Videos 1 

Moderators: Donald Selzer, MD and Fredrick Brody, Md 


V001 IMPROVING FUNCTIONAL ESOPHAGEAL SURGERY WITH A “SMART” BOUGIE: ENDOFLIP® Silvana Perretta, MD, Bernard 

Dallemagne, MD, Barry Macmahon, MD, Jacopo D’Agostino, MD, Hurng-Sheng Wu, MD, Jacques Marescaux, MD, IRCAD, University Hospital 

of Strasbourg, France - Show Chwan Memorial Hospital, Changhua, Taiwan 

V002 REPAIR OF A HIATAL DEFECT USING A ROTATIONAL FALCIFORM FLAP Erica Sutton, MD, Adrian Park, MD, University of Maryland 

School of Medicine 

V003 LAPAROSCOPIC CHOLECYSTECTOMY USING INTRAOPERATIVE FLUORESCENT CHOLANGIOGRAPHY Takeaki Ishizawa, MD PhD, 

Nobuhiro Harada, MD, Arata Muraoka, MD, Masayoshi Ijichi, MD PhD, Koji Kusaka, MD PhD, Masayuki Shibasaki, MD PhD, Yasutsugu Bandai, 

MD PhD, Norihiro Kokudo, MD PhD, Department of Surgery, Central Hospital of Social Health Insurance 

V004 LAPAROSCOPIC D2 LYMPH NODE DISSECTION WITH TOTAL GASTRECTOMY AND HUNT LAWRENC JEJUNAL POUCH 

RECONSTRUCTION FOR CARCINOMA STOMACH C Palanivelu, MCh FACS FRCS, P Senthilnathan, MS DNB FRCS, S Rajapandian, MSFRCS, V 

Vaithiswaran, MS MRCS, R Sathiyamurthy, MS, P Praveen Raj, MS, GEM Hospital 

V005 TRANSCERVICAL VIDEOSCOPIC ESOPHAGEAL DISSECTION IN MINIMALLY INVASIVE ESOPHAGECTOMY Michael Parker, MD, Jason 

M Pfluke, MD, Kyle K Shaddix, MD, Leslie A Dowling, BS, Timothy A Woodward, MD, Horacio J Asbun, MD, C D Smith, MD, Steven P Bowers, 

MD, Mayo Clinic Florida, Jacksonville, FL, USA 

V006 NOTES-ASSISTED TRASVAGINAL SPLENECTOMY: THE NEXT STEP FOR THE MINIMAL INVASIVE APPROACH TO THE SPLEEN EM 

Targarona, MD, C Gomez- Oliva, MD, R Rovira, MD, JC Pernas, MD, C Balague, MD, C Guarner-Argente, MD, S Sainz, MD, M Trias, MD, Service 

of Surgery, Digestive Pathology, Gynecology and Radiology. Hospital de Sant Pau, UAB, Barcelona, Spain. 

V007 TOTAL ENDOSCOPIC GASTRIC BAND REMOVAL Kari Thompson, MD, Brian Wong, MD, Tom Savides, MD, Garth R Jacobsen, MD, Bryan 

Sandler, MD, Mark A Talamini, MD, Santiago Horgan, MD, University of California, San Diego, San Diego, California, USA 

V008 LAPROSCOPIC COMPLETION RADICAL CHOLECYSTECTOMY Shailesh Puntambekar, MS, Seema Puntambekar, MD, Geetanjali 

Agarwal, MS, Neeraj Rayate, MS, Galaxy-Care Laparoscopy Institute 

V009 THORACOSCOPIC ESOPHAGECTOMY IN DORSOLATERAL POSITION : AN INNOVATIVE APPROACH - THE PAWAR TECHNIQUE Suraj 

B Pawar, MS FICS FAIS FMAS, Prashant Mullerpatan, MS FRCS, Reshma S Pawar, MBBS DGO, Kolhapur Cancer Centre, India 

V010 SINGLE-INCISION LAPAROSCOPIC PROCTOCOLECTOMY WITH ILEAL J-POUCH-ANAL ANASTOMOSIS Alexandre Bouchard, MD, 

Jesse Lackey, SA, Tonia Young-Fadok, MD MS, Mayo Clinic - Arizona 

10:00 AM - 2:30 PM 

World Congress Exhibits, Posters & Learning Center Open 

11:30 AM - 1:00 PM 

BREAK: Exhibits, Posters, Learning Center 

11:30 AM - 1:30 PM **Separate Registration Fee: $55 



Chair: L. Michael Brunt, M.D.; Co-Chair: Daniel Gagné, M.D. 

location: Potomac Ballroom D 

This session examines the broad array of materials that are available to complement education and skills training in minimally invasive 

surgery and flexible endoscopy. Topics to be covered include the Web Surg model of video education, SAGES video offerings and their 

integration into the SCORE national curriculum, and SAGES Fundamentals of Laparoscopic Surgery (FLS) and Fundamentals of Endoscopic 

Surgery (FES) programs. Practical methods by which these materials can be incorporated into resident and fellow education will be reviewed. 

Objectives: 

At the conclusion of this activity, the participant will be able to: 

• Describe SAGES educational resources available to complement resident and fellow training in minimally invasive surgery 

• Utilize effective strategies for incorporating FLS into residency training 

• Identify new methods for skills development and assessment in flexible endoscopy 

Schedule 

11:30 AM Introduction L. Michael Brunt, M.D. 

11:35 AM The Web Surg Model of Video Education Didier Mutter, M.D. 

11:50 AM From Top 14 to the SCORE Curriculum: Daniel Gagné, M.D. and 

Integrating SAGES Videos into Resident Education 


12:10 PM Strategies for Effective Integration of FLS into Your Skills Program Liane S. Feldman M.D. 

12:30PM FES: The Next Evolution in Endoscopic Skills Training Jeffrey Marks, M.D. 


SAGES acknowledges our Diamond Level Donors for their support of this session: 

Covidien, Ethicon Endo-Surgery, Inc. and SAGES Education and Research Foundation. 






Device Development Luncheon: 

From Funding to Freedom to Operate 

Chair: Raymond P. Onders, M.D.; Co-Chair: Dennis L. Fowler, M.D. 

location: Maryland Ballroom C 

The process from initial “idea or device” to help patient, to funding that idea, to working with the FDA to make sure that idea is safe and finally 

developing a company to manufacture and provide that idea to patients may seem daunting, but this session’s speakers will help make that 

journey easier with their wealth of experience. 


• Describe funding opportunities from the NIH and other sources 

• Understand the role of a university technology transfer office 

• Understand the role of the FDA in regulating devices 

• Appreciate the process of founding and funding enterprises for commercializing devices 

Schedule 

11:30 AM Introduction – The Story of the Diaphragm – Why Surgeons Innovate Raymond P. Onders, M.D. 

11:40 AM Funding – The NIH Can Help with Device Development Dennis Fowler, M.D. 

12:00 PM Technology Transfer – Friend or Foe to the Surgeon Innovator or to Industry Donna See, M.D. 

12:20 PM The Role of the FDA: From Patient Safety, 510(k), and from IDE to PMA – 

Why Designing a Trial and Endpoints are Important 

Markham C. Luke, M.D., Ph.D. 

12:40 PM Business Development – The Device Works – Now What? Baiju R. Shah 


SAGES acknowledges educational grants in support of this World Congress course from: Covidien and Ethicon Endo-Surgery, Inc. 

1:30 PM - 5:00 PM *included in Registration SuperPass (Option A) or Registration Option B) 


The Status and Direction of Laparoscopic Colorectal Surgery 

in the Treatment of Inflammatory Bowel Disease 

Chair: John H. Marks M.D.; Co-Chair: Eric G. Weiss, M.D. 


This course will inform the practicing surgeon and trainee alike on the current status and the role of laparoscopic colorectal surgery in the 

treatment of inflammatory bowel disease. In a video intensive manner, controversies and technical “pearls” will be illustrated in the treatment 

of inflammatory bowel disease. The techniques and rationale for new minimally invasive colorectal surgical approaches as well as the 

implications of medical therapy on surgical approaches will be described. 


• Define the role of laparoscopic colorectal surgery in the treatment of inflammatory bowel disease 

• Restate laparoscopic approaches to ileal pouch-anal anastomosis for adult and pediatric patients 

• Indicate the impact of immunotherapy on the surgical treatment of inflammatory bowel disease 

• Describe the benefits of laparoscopic treatment of Crohn’s Disease 

Schedule 

1:30 PM Introduction John H. J Marks, M.D. & Eric G. Weiss, M.D. 

1:35 PM Presentation and Differentiation: Ulcerative Colitis & Crohn’s Disease John Monson, M.D. 

1:45 PM Medical management, Cancer Risk Surveillance, and 

indications for Surgery for ulcerative Colitis and Crohn’s Disease 

Conor Delaney, M.D. 

1:59 PM Laparoscopic Ileal Pouch-Anal Anastomosis: How to Do It Tonia Young-Fadok, M.D. 

2:13 PM Laparoscopic Pouches: Problem Area, Role of the Hand, Addressing Inadequate Length John H. Marks, M.D. 

2:27 PM Laparoscopic Pouches in the Pediatric Patient: When and How Keith E. Georgeson, M.D. 

2:41 PM Role of Single Port Proctocolectomy and Pouch: Fad? Trend? How I Do It Dan Geisler, M.D. 


3:15 PM BREAK 

3:30 PM Crohn’s Disease: Special Challenges of Surgery: Impact on Surgery of Immuno-Modulation – 

When Should Patients Stop? Port Placement and Planning Future Surgery. Strategy of Approach Toyooki Sonoda, M.D. 

3:44 PM Laparoscopy for Crohn’s Colitis – Total Abdominal Colectomy vs. Segmental Resection Kirk Ludwig, M.D. 

3:58 PM Lapaproscopic Approach to Crohn’s Disease: 

how I Approach Fistulous Disease, Abscess, and Strictures 

Petachia Reissman, M.D. 

4:12 PM Hand Assisted Approaches in Crohn’s Disease: When and Why Eric G. Weiss, M.D. 

4:26 PM Impact of Laparoscopy on Outcome for Crohn’s Disease Andre D’hoore, M.D. 



Notes 




Notes 

Hotel Video Loop 

Attention Guests at the Gaylord Hotel: The World Congress Program Chairs have created an 

additional avenue for excellent videos to be viewed by meeting attendees. You may view these 

videos in your hotel rooms on Thursday, Friday, and Saturday. Please turn to channel 57 (subject 

to change) in your Gaylord Hotel room to view the 2010 Video Channel Loop videos. The Video 

Channel Loop listing is available on page 148 of your program. 



1:30 PM - 5:00 PM *Separate Registration Fee 

Single Port Access Surgery Hands-On Course 

Chair: Paul G. Curcillo II, M.D.; Co-Chair: Daniel J. Scott, M.D. 

**Offsite lab 

Location: Washington Institute of Surgical Endoscopy (WISE) 

The George Washington University Medical Center 

2300 I Street, NW, Ross Hall, Washington DC, 20037 

Shuttles for faculty and course registrants will depart at 12:30 PM from the Gaylord National Hotel and Convention Center. 

Go to the Group Bus Loading area, located at the Woodrow Wilson exit on the 2 nd level, opposite of guest parking. 

This session is designed to familiarize the participants with the developing field of Single Port Access surgery. Exposure to the tools, devices 

and techniques available will form the foundation for participants to begin to assimilate this technique into their practice. 

This course will consist of a hands-on lab in which participants will receive instruction by experts in various single port access 

laparoscopic techniques and procedures. Techniques for low-profile port layout and insertion, as well as the use of multi-port devices 

will be demonstrated with practice afforded. Participants will be supervised by experts and perform single port access laparoscopic 

cholecystectomy, fundoplication, adjustable gastric band placement, splenectomy and nephrectomy. Participants will have the opportunity 

to use a variety of specialized instrumentation, including novel imaging technologies, retraction devices, suturing instruments, and 

articulating devices. Lab stations will have a 1:3 faculty to participant ratio 

Objectives: 


• Reproduce the various access techniques and identify the benefits and drawbacks of the multi-trocared vs. the multi-port devices 

• Identify and use the various instruments and tools that may facilitate single port access operations 

• Describe the operative strategies for performing single port access laparoscopic procedures (including – cholecstectomy, fundoplication, 

adjustable gastric band placement, splenectomy and nephrectomy) 

• Identify and be aware of the current data addressing the impact in terms of risks and benefits this new field is having on patients 

Schedule 

1:30 PM Introduction Paul G. Curcillo II, M.D. & Daniel J. Scott, M.D. 

1:35 PM Single Port Access Surgery: Techniques and Approaches 

1:35 PM OPUS – One Port Umbilical Access Prashanth Rao, M.D. 

1:45 PM Single Incision Surgery – Single Incision Laparoscopic Approach Homero Rivas, M.D. 

1:55 PM Single Incision Surgery – Single Port Access Approach Paul G. Curcillo II, M.D. 

2:05 PM Flexible Endoscopic Approach Julio Teixiera, M.D. 

2:15 PM Bariatric Considerations Daniel J. Scott, M.D. 

2:25 PM Access Device Considerations Abhay Rane, M.D. 

2:35 PM Hands On Lab 

Laparoscopic Cholecystectomy 

laparoscopic GE Jxn (Nissen / Banding) 

laparoscopic Splenectomy / Nephrectomy 


Casey Graybeal, M.D. 

Andrew Gumbs, M.D. 

Eric Hungness, M.D. 

Shuji Kitashiro, M.D. 

Abhay Rane, M.D. 

Prashanth Rao, M.D. 

Homero Rivas, M.D. 

Julio Teixiera, M.D. 


Applied Medical, Covidien, Ethicon Endo-Surgery, Inc., Karl Storz Endoscopy-America, Olympus and Stryker Endoscopy. 



Aesculap, Allergan, Apple Medical, Applied Medical, Cambridge Endoscopy, Cambridge Health Alliance, 

Carefusion, Covidien, Davol Inc., a BARD Company, Ethicon Endo-Surgery, Inc., Karl Storz Endoscopy-America, 

Microline Surgical, Novare Surgical Systems, Olympus, Stryker Endoscopy, Surgiquest and Virtual Ports. 















MBA for Surgeons Panel: Asset Management and Protection for Surgeons 

Chair: Demetrius E. M. Litwin, M.D.; Co-Chair: Fredrick J. Brody, M.D. 


Description: The rapidly changing economics of practicing medicine will affect all of us. This practical session will help understand what 

changes you can make in your practice and investments to adjust to these turbulent times. The session will be full of practical, real-world 

advice and potential solutions to difficult financial problems you face on a daily basis. 


• Understand money management options during a practice lifetime. 

• Recognize and understand the fundamentals of investment principles during a practice lifetime. 

• Identify the importance of leadership in organizations. 

• Understand the importance of strategic planning exercises for high performance organizations. 

Schedule 

1:30PM Introduction Demetrius E. M. Litwin, M.D.; Fredrick Brody, M.D. 

Wealth Management, Asset Protection 

1:35PM Who to Entrust with Your Money and What Relationships Should You Have? David Field, CFA 

1:50PM Investing 101 – The Business School Perspective Bruce Behn, M.D. 

2:05PM Investing – Practical Tips Tim Pitney – Sapers & Wallack 

2:20PM Retirement, Insurance and Estate Management – Aviva Sapers – Sapers & Wallack 

How Much Do You Really Need and What Do You Do With It? 

2:45PM Discussion Panel & Questions 

3:15PM BREAK 

Leadership 

3:30PM Physician Executive MBA – What Can It Do For You? Mike Stahl, M.D. 

3:45PM The Leadership Moment – The Business School Perspective Bruce Behn, M.D. 

4:00PM The Leadership Moment – Practical Examples in the World of Surgery Isadore Lieberman, M.D. 

4:15PM Strategic Planning To Create High Performance Organizations Alec Glover, M.B.A. 

4:30PM Discussion Panel & Questions 

5:00PM Adjourn 

SAGES does NOT offer CME credits for this Panel 

1:30 PM - 5:00 PM **Separate Registration Fee 

Hands On Endolumenal/NOTES® Lab 

Chair: Santiago Horgan, M.D.; Co-Chair: Christopher C. Thompson, M.D. 


Description: This will be a multiple station hands-on course that will allow a technical experience in a variety of endolumenal procedures 

and technology. This will also include an introduction to NOTES® specifically, a transvaginal and transgastric peritoneal access, and 

transgastric closure. The latest endolumenal tissue fixation devices, energy application devices and intraluminal stents will be included. 

Participants should have basic endoscopic skills and be willing to try new procedures and use new technology. 


• Experience the use of modern endolumenal techniques for energy ablation (argon plasma coagulation, heater probe, BICAP, etc.) and 

stent placement 

• Demonstrate techniques for Endoscopic Mucosal Resection (EMR) and Endoscopic Submucosal Tunneling 

• Recognize the principles of endolumenal tissue fixation 

• Evaluate and practice transgastric and transvaginal approaches to peritoneal access (Natural Orifice Translumenal Endoscopic Surgery, NOTES®) 

• Demonstrate techniques for transgastric closure 

Schedule 

1:30 PM Introduction – Video Demonstration of Basic Technique Santiago Horgan, M.D. & Christopher C. Thompson, M.D. 

Barrett’s Ablation 

Steven Edmundowicz, M.D. 

Endoscopic Mucosal Resection (EMR) and 

Endoscopic Submucosal Tunneling 

Christopher J. Gostout, M.D. & Abraham Mathew, M.D., M.Sc. 

Endoscopic Revision for GERD 

Jeffrey W. Hazey, M.D. 

Intraluminal Stents: Placements and Removal, Colonic and Esophageal 

Jose Martinez, M.D. 

Treatment of Bleeding 

Bipan Chand, M.D. 

Endosuturing Techniques for GERD and Redo Bypass 

Garth Jacobsen, M.D. 

NOTES® Stations: 

Transgastric and Transvaginal Approaches to 

peritoneal Access and Transgastric Closure Techniques 

Marc Bessler, M.D., Brian J. Dunkin, M.D., Michael Marohn, M.D., 

Jeffrey Marks, M.D., Patricia Sylla, M.D., Yoav Mintz, M.D. 


BÂRRX Medical, Boston Scientific, Covidien, Endogastric Solutions, Olympus and Stryker Endoscopy. 


Alveolus Inc., Apollo Endosurgery, Aponos Medical Corp., BÂRRX Medical, Boston Scientific, Covidien, Davol Inc., a BARD Company, 

Endogastric Solutions, Endosim, Erbe, Karl Storz Endoscopy-America, Novare Surgical Systems, Olympus, US Endoscopy, Virtual Ports. 



1:30 PM - 2:30 PM *included in Registration SuperPass (Option A) or Registration Option B 

Robotics Symposium: What’s New? 

Chair: Mehran Anvari, M.D.; Co-Chair: Jacques Marescaux, M.D. 


Description: 

Robotic surgery has the potential to become a significant force in the future of minimally invasive surgery.This session will demonstrate new 

applications of robotics with particular emphasis on the application to reduced port surgery and image-guided applications. 


• Highlight some of the new developments in application of robotics in surgery 

• Discuss the use of robotics in augmented reality and image guided surgery 

• Provide and overview of robotic development for NOTES® and single incision surgery 

Schedule 

1:30 PM Introduction Mehran Anvari, M.D. & Jacques Marescaux, M.D. 

1:35 PM Augmented Reality and Image Guided Robotic Surgery Luc Soler, M.D. 

1:45 PM New Applications of Surgical Robot Richard Satava, M.D. 

1:55 PM The EU ARAKNES Robotic System Sir Alfred Cuschieri, M.D. 

2:05 PM Flexible Robotic Platform for NOTES® or Single Incision Surgery Bernard Dallemagne, M.D. 



Metabolic Surgery Symposium: Current Status 

Chair: Philip R. Schauer, M.D.; Co-Chair: Francesco Rubino, M.D. 


Description: 

The metabolic syndrome is a worldwide problem – can it be solved by surgery? Internationally-renowned experts will discuss the relevant 

issues in this rapidly developing field. 


• Understand how to diagnose the various stages of Barrett’s 

• Understand the different minimally invasive treatment options available 

• Discuss new technologies and their impact on the management process 

Schedule 

2:30 PM Introduction Philip R. Schauer, M.D. & Francesco Rubino, M.D. 

2:35 PM Effect of Gastric Banding and Sleeve Gastrectomy on Metabolic Disease Alfonso Torquati, M.D. 

2:50 PM Effect of Bypass Procedures Philip R. Schauer, M.D. 

3:05 PM Mechanisms of Remission of Metabolic Disease David Cummings, M.D. 

3:20 PM The Diabetes Surgery Summit Guidelines for Surgical Treatment of Diabetes Francesco Rubino, M.D. 

3:35 PM The American Diabetes Association Guidelines for Surgical Treatment of Diabetes Sue Kirkman, M.D. 


SAGES acknowledges an educational grant in support of this World Congress panel from Covidien. 



Barrett’s Debate: How to Follow, How to Treat? 

Chair: John Hunter, M.D.; Co-Chair: Karl H. Fuchs, M.D. 


Description: 

Cancer in Barrett’s esophagus continues to be a serious worldwide problem. Can we identify the patients at high risk to impact this disease? 

This session will provide a critical update on strategies in the diagnosis and management of Barrett’s. 


• Understand how to diagnose the various stages of Barrett’s 

• Understand the different minimally invasive treatment options available 

• Discuss new technologies and their impact on the management process 

Schedule 

4:00 PM Introduction John Hunter, M.D. & Karl H. Fuchs, M.D. 

4:05 PM The Indications and Strategy for Screening and Surveillance of Barrett’s Esophagus Jeffrey Peters, M.D. 

4:20 PM Ablation Therapy – Who Should Have It and Who Should Do It? John Hunter, M.D. 

4:35 PM Endoscopic Mucosal Resection of Early Esophageal Neoplasia – The Current State of the Art Haruhiro Inoue, M.D. 

4:50 PM Limited Surgical Resection – or En-Bloc Karl H. Fuchs, M.D. 

5:05 PM Emerging Technology in the Diagnosis and Management of Barrett’s Esophagus Blair Jobe, M.D. 





5:30 PM - 7:30 PM Free for any World Congress Attendee 

Industry Satellite Symposia (No Registration Required) 

Industry presentations will take place on Thursday evening, immediately following the Congress sessions. Three symposia on 

varying topics will be offered in the World Congress session rooms. Registration is FREE for any World Congress attendee. These 

events are not planned nor accredited for CME by SAGES. 

Boston Scientific – “Intraluminal Stents and the Surgeon – 


Location: Chesapeake D-E 

Boston Scientific invites you to join your colleagues for a presentation on the role of stents in managing malignant and benign disease. Topics 

covered will include emerging treatment algorithms, current clinical data, new stent technologies, and case experiences. A Q&A session will 

follow the presentation. 

Light refreshments will be provided as a courtesy for people attending this event. Due to restrictions imposed by Massachusetts and 

Vermont law, we ask that health care professionals who are licensed by Massachusetts or Vermont not partake of them. Thank you for your 

cooperation. 

This is a non-CME activity presented and supported by Boston Scientific. 

Covidien – “Insights into the Future of Surgical Stapling: 

Integrated Materials, Tri-Staple Technology, Powered Staplers” 

Location: Potomac Potomac D-4-5-6 

Presenters: Mark S. Soberman, MD, FACS, Moderator 

Aurora Pryor, MD, FACS 

Garrett M. Nash, MD, MPH 

Samer G. Mattar, MD, FACS 

This is a non-CME activity presented and supported by Covidien. 

Davol Inc., a BARD Company: “Advanced Endoscopic Technique for Abdominal Wall 

Reconstruction” 

Location: Maryland C 

Speaker: J. Scott Roth, MD, FACS 

Associate Professor of Surgery 

Chief, Gastrointestinal Surgery 

Director, Minimally Invasive Surgery 

University of Kentucky Medical Center 

Overview: Dr. J. Scott Roth from the University of Kentucky will discuss the evolution of the Component Separation Technique for complex 

abdominal wall reconstruction. Dr. Roth will walk the attendees through the evolution of his current technique for endoscopic assisted 

component separation, including the advantages of this technique over open component separation. Dr. Roth will also discuss such topics as 

patient selection for component separation and graft selection, as well as current clinical data on the procedure. 

This is a non-CME activity presented and supported by Davol Inc., a BARD Company. 

Ethicon Endo-Surgery, Inc.: “Minimally Invasive Surgery – Where is it Going?” 

Location: Potomac C-1-2-3 

Surgeons will be discussing the following topics: 

Advances in General Surgery: Santiago Horgan, MD 

Advances in Colorectal Surgery: Conor Delaney, MD 

Advances in Bariatric Surgery: Keith Zuccala, MD 

This is a non-CME activity presented and supported by Ethicon Endo-Surgery, Inc. 

Karl Storz Endoscopy-America, Inc.: “The Great Debate: S-PORTAL (Single Portal 

Access) Surgery vs. Mini-Laparoscopy” 

Location: Maryland A-1-2-3 

Dr. Jeffrey Ponsky (Case Western Reserve University, Cleveland, Ohio) will act as moderator as four representatives engage in the debate. 

Proponents of S-PORTAL – 

Dr. Paul Curcillo (Drexel University, Philadelphia, Pennsylvania) 

Professor Giovanni Dapri (Saint-Pierre University Hospital, Brussels, Belgium) 

Proponents of Mini-Laparoscopy – 

Dr. Michel Gagner (Mount Sinai Medical Center, Miami Beach, Florida) 

Dr. Joseph Mamazza (Ottawa Hospital, Ottawa, Canada) 

This is a non-CME activity presented and supported by Karl Storz Endoscopy-America. 



Notes 

2010 World Congress International Webcast Sessions 

To participate in the International Webcast Sessions, please visit: 

http://www.sages.org/meetings/annual_meeting/2010/ 

Password: sages 


TIME SESSION CHAIR (S)/SPEAKER 

8:00 am- 9:00 am Plenary Session C. Daniel Smith, MD & C. Jamieson, MD 

9:00 am - 9:30 am SAGES Presidential Address C. Daniel Smith, MD 

9:30 am - 10:00 m Gerald Marks Keynote Lecture Richard H. Bell, MD 

10:00 am - 11:00 am Symposium: NOTES® - Alive and Well, or RIP? 

12:30 pm - 2:30 pm Presidential Debates 

2:30 pm - 4:00 pm Panel: Single Port Access Surgery 


Chair: David W. Rattner, MD 

Co-chair: Venkat G. Rao, MD 

Chair: Daniel J. Deziel, MD 

Co-chair: Nathaniel Soper, MD 

Chair: Joel Leroy, MD 

Co-chair: Andrew A. Gumbs, MD 


7:00 am - 8:30 am Live from Afghanistan Session: Video Conference Military Coalition 

Chair: Steven P. Bowers, MD 

Co-chair: Richard M. Satava, MD 

8:30 am - 9:00 am Karl Storz Keynote Lecture Christopher J. Gostout, MD 

9:00 am - 9:30 am CAGS / Royal College of Surgeons Lecture Robert DiRaddo, Ph.D. 

9:30 am - 11:00 am Plenary Session II Moderators: J. Buyske, MD & A. Chousleb, MD 

SAGES gratefully acknowledges Covidien, Ethicon Endo-Surgery, Inc. and the SAGES Education & Research Foundation 

for their generous support towards the SAGES Global Proctoring Initiative. 

To fully comply with ACCME regulations, all World Congress attendees must have their badge 

scanned before entering any course or session room in order to receive CME credit for that event. 




Scientific Sessions & Panels 

7:00 AM - 8:00 AM Posters of Distinction Potomac Ballroom C 


9:00 AM - 9:30 AM 

SAGES Presidential Address: Everyone Knows Plan A: 

Its All About Plan B 



9:30 AM - 10:00 AM 




10:00 AM - 2:30 PM Exhibits, Posters, Learning Center Open 

10:00 AM -11:00 AM 






10:00 AM - 11:00 AM Endolumenal Therapies Session Potomac Ballroom C 

10:00 AM - 11:00 AM NOTES® Symposium – Alive & Well or RIP? Potomac Ballroom A-B 

10:00 AM - 11:00 AM 

Laparoscopic Education Panel – 



11:00 AM - 12:30 PM Video Complications Luncheon: 

What Has Happened and What Do We Have to Do? 


12:30 PM - 1:30 PM 

Go Global Report from the Field Panel: 

Teaching Laparoscopic Surgery Abroad 


12:30 PM - 2:30 PM Peer Review Training Session Potomac Ballroom D 

12:30 PM - 2:30 PM SAGES Presidential Debates Potomac Ballroom A-B 

1:30 PM - 2:30 PM Conflict of Interest Panel Maryland Ballroom A 

2:30 PM - 5:30 PM Resident and Fellows Scientific Session Maryland Ballroom C 

2:30 PM - 4:00 PM Single Port Access Surgery Panel Potomac Ballroom A-B 

2:30 PM - 4:00 PM 




SS06 Hernia 





4:00 PM - 5:30 PM 



SS09 NOTES® 


2:30 PM - 5:30 PM Emerging Technology Session Potomac Ballroom C 

6:00 PM - 7:00 PM 

Meet the Leadership Reception For Residents, Fellows & New 

Members 

Pose, 18-19th Floor 


Water Taxi Service 

In addition to cabs and rental cars, the National Harbor offers a fun and practical way to get to various 

destinations…a water taxi! Water taxi service is available to and from points around Washington D.C., Virginia 

and Maryland for your convenience. The Potomac Riverboat Company operates water taxi service between 

National Harbor and Old Town Alexandria, with additional boat service to Mount Vernon and Georgetown. Water 

taxis will run every half hour between National Harbor and Old Town Alexandria. There will be three daily trips to 

Georgetown’s Washington Harbor, and a single daily trip to George Washington’s Mount Vernon Estate. Ask the 

concierge for more information and about pricing. 





Scientific Session Concurrent Sessions (accepted oral & video presentations) 

Description: 

This section of the World Congress includes panels with invited faculty who will speak on specific topics, and sessions of oral & video 

presentations of abstracts selected by the World Congress Program Committee. 

What Is Included: 

The Scientific Session is included in Registration SuperPass (Option A). Thursday sessions (concurrent only) are also included in Registration 

Option B. Friday/Saturday sessions and panels are included in Registration Option C. All fees include entrance to all didactic session rooms 

(not including hands-on course labs or lunches), Final Program, entrance to the Exhibit Hall, Learning Center, Posters, Digital Meeting Guide, 

continental breakfast & breaks, and lunch in the Exhibit Hall on Saturday. 

7:00 AM - 8:00 AM *Included in Registration SuperPass (Option A) or Registration Option C 

Posters of Distinction 

Moderators: Subhash U. Kini, M.D. & Melina C. Vassiliou, M.D. 


P001 EVALUATION OF THE SLEEVE GASTRECTOMY AS A SINGLE-STAGE TREATMENT OF MORBID OBESITY Philippe A Topart, MD, Cyril 

Chazelet, MD, Pierre Verhaeghe, MD FACS, Societe de Chirurgie Viscerale, Clinique de l’Anjou, Angers ; Clinique St Brice, Provins, Chirurgie 

Viscerale, CHU, Amiens, France 

P002 PATIENTS EXPECT TO LOSE MORE THAN AVERAGE WEIGHT AFTER BARIATRIC SURGERY Brad E Snyder, MD, Erik B Wilson, MD FACS, 

Todd Wilson, MD, Connie Klein, RN NP, University of Texas Health Sciences Center at Houston 

P003 ANASTOMOTIC LEAKS AFTER 899 LAPAROSCOPIC COLORECTAL SURGERIES:WAY TO AN OPTIMAL INTESTINAL ANASTOMOSIS 

Song Liang, MD PhD, Morris E Franklin Jr, MD FACS, The Texas Endosurgery Institute 

P004 SINGLE INCISION LAPAROSCOPIC GASTRIC BANDING: EVOLUTION TOWARDS SCARLESS SURGERY DURING 50 CONSECUTIVE 

CASES Sarah C Oltmann, MD, Lauren Mashaud, MD, Stephanie Morris, BS, Arsalla Islam, MD, Homero Rivas, MD MBA, Daniel J Scott, MD, 

Southwestern Center for Minimally Invasive Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX 

P005 CLINICAL OUTCOMES OF ATYPICAL SYMPTOMS FOLLOWING LAPAROSCOPIC ANTIREFLUX SURGERY Shaun R Brown, DO, C. 

Prakash Gyawali, MD, Lora Melman, MD, Eric D Jenkins, MD, Julia Bader, PhD, Margaret M Frisella, RN, L. Michael Brunt, MD, J. Christopher 

Eagon, MD, Michael M Awad, MD PhD, Brent D Matthews, MD, Department of Surgery, Section of Minimally Invasive Surgery, Washington 

University School of Medicine, Saint Louis, MO 

P006 PREOPERATIVE ULTRASOUND AS A PREDICTOR OF GALLBLADDER EXTRACTION DURING TRANSGASTRIC NOTES 

CHOLECYSTECTOMY Byron F Santos, MD, Edward D Auyang, MD, Eric S Hungness, MD, Kush R Desai, MD, Edward S Chan, BA, Darren B van 

Beek, BS, Edward C Wang, PhD, Nathaniel J Soper, MD, Northwestern University, Department of Surgery 

P007 A COMPARISON OF PRE-OPERATIVE COMORBIDITIES AND POST-OPERATIVE OUTCOMES AMONG PATIENTS UNDERGOING 

LAPAROSCOPIC NISSEN FUNDOPLICAITON AT HIGH AND LOW VOLUME CENTERS Oliver A Varban, MD, Thomas McCoy, MS, Carl 

Westcott, MD, Wake Forest University Baptist Medical Center 

P008 102 CONSECUTIVE ROBOTIC ASSISTED MINIMALLY INVASIVE COLECTOMIES – AN OUTCOME AND TECHNICAL UPDATE Franziska 

Huettner, MD PhD, Paul E Pacheco, MD, Jamie L Doubet, RN BS, Michael J Ryan, MS, Danuta I Dynda, MD, David L Crawford, MD, Division of 

Minimally Invasive Surgery, Department of Surgery, University of Illinois College of Medicine at Peoria 

P009 238 LAPAROSCOPIC LEFT-SIDE COLORECTAL SURGERIES WITH N.O.S.E.: A 10-YEAR EXPERIENCE WITH TRANSANAL SPECIMEN 

EXTRACTION Morris E Franklin, Jr, MD FACS, Song Liang, MD PHD, The Texas Endosurgery Institute 

P010 SINGLE-INCISION LAPAROSCOPIC COLECTOMY FOR COLON CANCER: EXPERIENCE OF 35 CASES Bac H Nguyen, PhD, Thinh H 

Nguyen, MD, Viet V Ung, MD, University Medical Center at Ho Chi Minh City 

P011 SAFETY AND USEFULNESS OF LAPAROSCOPIC METHOD FOR TREATMENT OF PERITONITIS DUE TO ANASTOMOSIS SITE 

LEAKAGE AFTER RECTAL CANCER RESECTION Gyu-Seog Choi, MD, Kyoung-Hoon Lim, MD, Jun Seok Park, MD, You Seok Jang, MD, Soo- 

Han Jun, MD, Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Korea 

P012 INDICATIONS, COMPLICATIONS AND LONG TERM OUTCOMES OF REMNANT GASTRECTOMY FOR GASTRO-GASTRIC FISTULA 

AFTER DIVIDED ROUX-EN-Y GASTRIC BYPASS FOR MORBID OBESITY Emeka Acholonu, Jeremy Eckstein, Sheetal Patel, Wasef Abu-Jaish, 

Samuel Szomstein, Raul Rosenthal, Cleveland Clinic Florida 

P013 NEEDLESCOPIC SURGERY: THE COSMETIC ALTERNATIVE TO SILS Morris E Franklin, MD, Karla Russek, MD, Jojy George, MD, Texas 

Endosurgery Institute 

P014 ROLE OF INTERLEUKIN-6 (IL-6) IN THE GROWTH OF CT26 COLORECTAL CANCER IN A MURINE MODEL Melissa A Donigan, BS, Heidi 

Bahna, MD, Bryan D Loh, MD, Laurie S Norcross, MD, John Aversa, DO, Paul R Williamson, MD, Samuel DeJesus, MD, Andrea Ferrara, MD, 

Joseph T Gallagher, MD, Cheryl H Baker, PhD, M. D. Anderson Cancer Center Orlando, University of Central Florida, Colon and Rectal Clinic of 

Orlando, Orlando Regional Medical Center 

P015 LAPAROSCOPIC LIVER SURGERY IN CANCER PATIENTS-EXPERIENCE AT A NATIONAL CANCER INSTITUTE Ronald Matteotti, MD, 

John Hoffman, MD, Elie Chouillard, MD, Veeraiah Siripurapu, MD, Andrew Gumbs, MD, FOX CHASE CANCER CENTER, Philadelphia-PA, USA 

P016 IS SURGERY A BETTER OPTION AS FIRST LINE TREATMENT FOR ACHALASIA?: A COMPARISON OF LAPAROSCOPIC 

ESOPHAGOMYOTOMY WITH FUNDOPLICATION AND ENDOSCOPIC DILATION Jason F Reynoso, MD, Manish M Tiwari, MD PhD MPH, 

Albert W Tsang, MD, Dmitry Oleynikov, MD, Department of Surgery, University of Nebraska Medical Center 

P017 PERFORMANCE RAMIFICATIONS OF SINGLE PORT LAPAROSCOPIC SURGERY: MEASURING DIFFERENCES IN TASK 

PERFORMANCE USING SIMULATION Nathan E Conway, MD, John R Romanelli, MD, Ron W Bush, BS, Neal E Seymour, MD, Baystate Medical 

Center, Tufts University School of Medicine, Springfield, MA 




P018 ONCOLOGIC AND PERIOPERATIVE OUTCOMES OF LAPAROSCOPIC ASSISTED VS HAND-ASSISSTED VS OPEN RESECTIONS FOR 

RECTAL CANCER RESECTION: A CASE MATCH STUDY. Pornthape Prathanvanich, Jirawat Pattana Arun, Chucheep Sahakitrungruang, 

Puttarat Atithansakul, Arun Rojanasakul, Chulalongkorn University 

P019 “INCISIONLESS” LAPAROSCOPIC PROCTECTOMY: AN IDEAL NATURAL ORIFICE AND LAPAROSCOPIC SURGERY HYBRID John 

Marks, MD, Radu Nedelcoviciu, MD, Eileen Larkin, BA, Albert DeNittis, MD, Gerald Marks, MD, Lankenau Hospital and Institute for Medical 

Research: Section of Colorectal Surgery, Wynnewood, PA 

P020 COLORECTAL CANCER RISK REDUCTION IN INFLAMMATORY BOWEL DISEASE WITH AMINOSALICYLATE THERAPY: A META- 

ANALYSIS AND COMPARISON TO COLORECTAL CANCER RISK IN THE GENERAL POPULATION Omer Nasir, MD, Amit Kaul, MD, Tejwant 

Datta, MD, Maryanne Franco, M Gilson, MD, Michael Marohn, DO, Hien Nguyen, MD, Johns Hopkins University School of Medicine 

P021 CONVENTIONAL 4-PORT LAPAROSCOPIC CHOLECYSTECTOMY VERSUS SILS PORT LAPAROSCOPIC CHOLECYSTECTOMY- 

EARLY RESULTS OF THE FIRST PROSPECTIVE RANDOMIZED SHAM CONTROLLED TRIAL Jeffrey Marks, MD, Raymond Onders, MD, 

George DeNoto, MD, Berry Paraskeva, PhD, Homero Rivas, MD, Kurt Roberts, MD, Alexander Rosemurgy, MD, Sajani Shah, MD, Nathaniel 

Soper, MD, Roberto Tacchino, MD, University Hospitals Case Medical Center, North Shore University Hospital, Imperial College of London, 

UT Southwestern Medical Center, Yale New Haven Medical Center, Tampa General Hospital, Tufts Medical Center, Northwestern Memorial 

Hospital, Catholic U 

P022 COLON RESECTIONS IN AN ERA OF NONAGENARIANS: NSQIP PREDICTORS OF MORTALITY Dan Ruiz, MD, Alexander Kraev, MD, 

Darshak Shah, MD, Allapagan W Annamalai, MD, James W Turner, MD, Howard Tiszenkel, MD, New York Hospital Queens 

8:00 AM - 9:00 AM *Included in Registration SuperPass (Option A) or Registration Option C 

SS02 Plenary Session 1 

Moderators: C. Daniel Smith, MD & Christopher Jamieson, Md 

location: Potomac Ballroom A-B 

S001 MOST RECENT NATIONAL SURGICAL QUALITY IMPROVEMENT PROJECT DATA (NSQIP), COMPARISON OF LAPAROSCOPIC VS. 

OPEN COLON RESECTIONS Dan Ruiz, MD, Alexander Kraev, MD, Steven Nurkin, MD, Darshak Shah, MD, James W Turner, MD, Howard 

Tiszenkel, MD, New York Hospital Queens 

S002 INCISIONAL HERNIA – MIDLINE VS LOW TRANSVERSE INCISION: WHAT IS THE IDEAL INCISION FOR SPECIMEN EXTRACTION/ 

HALS? Ashwin L deSouza, MS MRCSEd DNB FCPS MNAMS, Bastian Domajnko, MD, John J Park, MD, Slawomir J Marecik, MD, Leela M Prasad, 

MD MSSurg FRCSE FRCSC FACS FASCRS, Herand Abcarian, MD, Advocate Lutheran General Hospital, Park Ridge, Illinois 

S003 LIMITED VALUE OF HAPTICS IN VIRTUAL REALITY LAPAROSCOPIC CHOLECYSTECTOMY TRAINING Jonathan R Thompson, MD, 

Charles R Doarn, MBA, Matt J Roesch, Brian D Henry, MD, Timothy J Broderick, MD, University of Cincinnati, Department of Surgery 

V011 LAPAROSCOPIC REPAIR OF BOCHDALEK HERNIA Mohamad D Saad, DO, Jonathan Eng, MD, Frances Allocco, MD, Brian J Dunkin, MD, 

Patrick R Reardon, MD, The Methodist Hospital 


Covidien, Ethicon Endo-Surgery, Inc. and SAGES Education and Research Foundation 


9:00 AM - 9:30 AM *included in Registration SuperPass (Option A) or Registration Option C 

SAGES Presidential Address 


Professor and Chair, Department of Surgery, Surgeon in Chief, Mayo Clinic Florida, Jacksonville, FL 

Everyone Knows Plan A: Its All About Plan B 

Location: Potomac Ballroom A-B 




All testing appointments must be made by April 9 – no onsite appointments available 


To fully comply with ACCME regulations, all World Congress 

attendees must have their badge scanned before entering any 

course or session room in order to receive CME credit for that event. 




1994 Prof. Alex Walt 

1995 Prof. Kenneth Forde 

1996 Prof. John Wickham 

1997 Prof. Thomas Dent 

1998 Prof. Jacques J. Perissat 

1999 Prof. Michael Trede 

2000 Prof. Tom R. DeMeester 

2001 Prof. Layton F. Rikkers 






Assistant Executive Director, American Board of Surgery, Philadelphia, PA 

Richard H. Bell Jr., M.D. is the Assistant Executive Director of the American Board of Surgery.Dr. Bell earned his Bachelor’s degree at 

Princeton University and MD degree at Northwestern. He completed his general surgical residency at the University of Colorado 

Medical Center in Denver. Following military service, he served on the faculty at the University of California at San Diego and then as 

Associate Professor, then Chief of General Surgery at the University of Cincinnati College of Medicine. In 1994 he joined the 

University of Washington School of Medicine in Seattle as Vice Chair of Surgery and Chief of Surgery at the Seattle VA Medical 

Center. In 2000 he became the Loyal and Edith Davis Professor and Chair of the Department of Surgery at Northwestern University in Chicago. 

Dr. Bell is a Past President of the Association for Academic Surgery (AAS) and the Central Surgical Association. He has served as Vice-President 

of the Society of Surgery for the Alimentary Tract (SSAT) and is a past member of the Board of Governors of the American College of 

Surgeons. 

He has a long-standing interest in pancreatic diseases and pancreatic cancer. He has written more than 150 articles and book chapters 

and edited a major textbook in digestive tract surgery and a surgical handbook. He has served on the editorial boards of the Journal of 

Gastrointestinal Surgery, Surgery, and Pancreas. 

Dr. Bell was recruited to the American Board of Surgery in August, 2006 to head up an effort to define and implement a national curriculum 

for residency training in general surgery. 

SAGES acknowledges our Diamond and Platinum Level Donors for their support of this lecture: 



The Marks Lecture – A History 

1987 Prof. William Wolfe 

(not named Marks Lecture in ‘87) 

1988 Prof. Worth Boyce 

1989 Prof. Peter Cotton 

1990 Prof. Alfred Cuschieri 

1991 Prof. George Berci 

1992 Prof. Theodore Schrock 

1993 Prof. John Terblanche 

2002 Prof. Hans G. Beger 

2003 Prof. R. Scott Jones 

2004 Prof. Jeffrey L. Ponsky 

2005 Prof. Andrew L. Warshaw 

2006 Prof. Gregory V. Stiegmann 

2007 Prof. Lester Rosen 

2008 Prof. James “Butch” Rosser 

2009 Prof. John Cameron 

10:00 AM - 2:30 PM 

Exhibits, Posters, Learning Center Open 







A Gentle Reminder About Safety/Security: 

We have taken every precaution to assure the safety and security of our guests and their possessions. 

However, we urge you to be aware and take simple steps to guard your possessions. 

– Do not leave your purse or briefcase unattended. 

– Do not leave your laptop, phone or other electronic devices on the floor or out of your sight in a darkened room 

– Be aware of your surroundings, in the Gaylord Hotel, in and around the National Harbor area and in Washington, DC. 






10:00 AM -11:00 AM *included in Registration SuperPass (Option A) or Registration Option C 



Location: Maryland Ballroom B-D 

Moderators: Amir Szold, MD & Allan Siperstein, MD 

S004 UTILIZATION OF LAPAROSCOPIC SPLENECTOMY: AN ANALYSIS FROM THE NATIONAL SURGICAL QUALITY IMPROVEMENT 

PROGRAM DATABASE Vikram Attaluri, MD, Philip I Niles, BA, Louisa W Chiu, MD, Eric D Hixson, MBA, Haris Khwaja, MD, Steven Rosenblatt, 

MD, J Michael Henderson, MD, Allan Siperstein, MD, Cleveland Clinic, Cleveland, OH USA; Case Western School of Medicine and 

Weatherhead School of Management, Cleveland, OH USA 

S005 LAPAROSCOPIC ADRENALECTOMY FOR LARGE TUMORS. SINGLE TEAM EXPERIENCE. Abhay N Dalvi, MS, Pinky M Thapar, MS, Vinay 

M Thapar, MS, Sameer A Rege, MS, Seth G S Medical College & KEM Hospital, Mumbai, INDIA 

V012 PNEUMORETROPERITONEUM: AN ALTERNATIVE APPROACH FOR COMPLETION ADRENALECTOMY IN A HOSTILE ABDOMEN 

David E Skarda, MD, Martin Walz, MD, Sayeed Ikramuddin, MD, University of Minnesota, Minneapolis, USA, Kliniken Essen-Mitte, Essen, 

Germany 

S006 COMPARISON OF OPEN LIVE DONOR NEPHRECTOMY, LAPAROSCOPIC LIVE DONOR NEPHRECTOMY, AND HAND-ASSISTED LIVE 

DONOR NEPHRECTOMY: A COST-EFFECTIVENESS ANALYSIS Derek E Moore, MD MPH, Matthew Landman, MD, Deonna Moore, MSN, 

Irene Feurer, PhD, C W Pinson, MD MBA, Vanderbilt University Medical Center 

S007 MULTICENTER COMPARISON OF INTERMEDIATE ONCOLOGIC OUTCOMES OF LAPAROSCOPIC PARTIAL NEPHRECTOMY AND 

RENAL CRYOABLATION Sean Stroup, MD, John Malcolm, MD, James L’Esperance, MD, Robert Wake, MD, Michael Fabrizio, MD, Ithaar H 

Derweesh, MD, University of California San Diego, University of Tennessee at Memphis Health Science Center, Eastern Virginia Medical 

School 

V013 LAPAROSCOPIC BILATERAL PARTIAL ADRENALECTOMY FOR HEREDITARY PHEOCHROMOCYTOMA William W Hope, MD, Stanton T 

Smith, MD, Damon E Sheneman, DO, Jorge Gonzalez, MD, Cyrus A Kotwall, MD, New Hanover Regional Medical Center 


Location: Maryland Ballroom A 

Moderators: Steven Stain, MD & Frederick Greene, MD 

S008 REAL-TIME INTRAOPERATIVE DETECTION OF TISSUE HYPOXIA IN ENDOSCOPIC GASTROINTESTINAL SURGERY BY A NOVEL 

WIRELESS PULSE OXIMETER (WIPOX) Elliot L Servais, MD, Nabil P Rizk, MD, Luis Oliviera, MS, Marom Bikson, PhD, Valerie W Rusch, MD, 

Prasad S Adusumilli, MD, Department of Thoracic Surgery, Memorial Sloan-Kettering Cancer Center; Department of Biomedical Engineering, 

City College of New York 

S009 A PILOT STUDY OF USING MULTIPHOTON MICROSCOPY TO DIAGNOSE GASTRIC CANCER Jun Yan, MD, Gang Chen, MD, Jianxin 

Chen, PhD, Shuangmu Zhuo, PhD, Hui Yu, MD, Mingang Ying, MD, Fujian Provincial Tumor Hospital, Fuzhou, 350014, China 

S010 EFFICACY OF TURMERIC (CURCUMIN) IN PAIN AND POSTOPERATIVE FATIGUE AFTER LAPAROSCOPIC CHOLECYSTECTOMY 

– A DOUBLE BLIND, RANDOMIZED PLACEBO CONTROLLED STUDY Krishna A Agarwal, C D Tripathi, MD, Brij B Agarwal, MS, VMMC & 

Safdarjung Hospital, Dr. Agarwal’s Surgery & Yoga and Sir Ganga Ram Hospital, New Delhi, India 

S011 3-CCD (CHARGE COUPLED DEVICE) IMAGE ENHANCEMENT FOR BOWEL ISCHEMIA John C Graybill, MD, Nicole Crane, PhD, Susan 

M Gillern, MD, Eric A Elster, MD, Jonathan P Pearl, MD, Naval Medical Research Center; National Naval Medical Center; Walter Reed Army 

Medical Center 

S012 SENSING FORCES IN NATURAL ORIFICE SURGERY Ana Luisa Trejos, MASc, Shiva Jayaraman, MD, Rajni V Patel, PhD, Michael D Naish, 

PhD, Christopher M Schlachta, MD, Canadian Surgical Technologies & Advanced Robotics (CSTAR), Lawson Health Research Institute. 

Departments of Electrical and Computer Engineering, Mechanical and Materials Engineering, Surgery, The University of Western Ontario, 

London, Ontario, Canada 

S013 DOWNREGULATION OF LEPTIN AND RESISTIN EXPRESSION IN BLOOD FOLLOWING BARIATRIC SURGERY Claire Edwards, MD, 

A. Katharine Hindle, MD, Sidney Fu, MD PhD, Fred Brody, MD MBA, Dept. of Surgery, Dept. of Biochemistry & Molecular Biology and 

McCormick Genomics Center, George Washington University Medical Center, Washington, DC 

Interactive Sessions: Featuring Google Moderator! 

Back by popular demand, SAGES is increasing the number of interactive sessions available for the 

2010 meeting. All Scientific Sessions occurring in the MAIN SESSION Room Friday & Saturday, 

April 16-17, 2010 will feature Google Moderator, enabling attendees to participate in the 

presentation as it occurs! The audience will help determine the direction of the discussion by rating 

the submitted comments and suggestions. Moderators will address the highest rated questions. 

The room will be equipped with WIFI connectivity. Please bring your laptop and/ or iPhone/ 

Android/Blackberry (newest generation or with Opera Mini). 





Endolumenal Therapies Session 

Chair: Dean J. Mikami, M.D.; Co-Chair: Simon Bergman, M.D. 


With the emergence of new technology and the refinement of old techniques, the field of endoscopy has rapidly evolved from simple 

diagnostics to cutting edge therapeutics. In this session, international experts will share their experience with endolumenal therapies in the 

care and management of patients suffering from morbid obesity and diseases of the foregut. 

Objectives: 


• Discuss the effectiveness of new endoscopic modalities in the treatment of morbid obesity and foregut disease 

• Identify the patients (and diseases processes) that are best suited for therapeutic management via the endolumenal approach 

• Describe the proper techniques and potential complications of endolumenal therapies 

Schedule 

10:00 AM Introduction Dean J. Mikami, M.D. & Simon Bergman, M.D. 

10:05 AM Endolumenal Bariatrics: Revisional Techniques Sergio Roll, M.D. 

10:15 AM Endolumenal Foregut: Established and Upcoming Technology W. Scott Melvin, M.D. 

10:25 AM EMR and ESD: Techniques, Tips, and Tricks Daniel von Renteln, M.D. 



NOTES® Symposium – Alive & Well or RIP? 

Chair: David W. Rattner, M.D.; Co-Chair: G. V. Rao, M.D. 


Description: 

While intense interest continues in the development of NOTES®, its place as a useful therapy remains to be defined. Is NOTES® alive and well? 

Is it sleeping? Is it dead? This session seeks to provide insight into the current state of NOTES® and its potential for the future. 

Objectives: 


• Understand recent developments in NOTES® 

• Discuss if, when and how NOTES® will be added to the surgical armamentarium 

Schedule 

10:00 AM Introduction David W. Ratther, M.D. & G. V. Rao, M.D. 

10:05 AM Endolumenal or Translumenal Surgery Jeffrey Marks, M.D. 

10:15 AM Time to Abandon NOTES® and Perfect Single Port Surgery Paul G. Curcillo, M.D. 

10:25 AM NOTES® – Steady Progress Has Been Made Eric Hungness, M.D. 

10:35 AM NOTES® in 2020 Yoav Mintz, M.D. 


SAGES acknowledges educational grants in support of this World Congress symposium from Covidien, Ethicon Endo-Surgery, Inc. and Olympus. 

10:00 AM - 11:00 AM 

Laparoscopic Education Panel – 


Chair: Bruce D. Schirmer, M.D.; Co-Chair: Joseph Mamazza, M.D. 


This debate format session will focus on the current state of MIS fellowships in training: are they compatible with strong general surgery 

training programs, or do they conflict with them? Does the current and planned future training experience of general surgery residents 

suggest MIS fellowships are still needed? 

Objectives: 


• Quantify the current breadth and depth of MIS training done by finishing residents of U.S. training programs 

• Describe evidence-based studies which suggest numbers necessary to achieve competence in any given operative procedure 

• Compare and contrast examples of training programs which have encountered conflicts between residents and MIS fellows and those 

that have not 

• Describe the current state of MIS fellowships in North America and their role in MIS training for the General Surgeon 

Schedule 

10:00 AM Introduction Bruce D. Schirmer, M.D. & Joseph Mamazza M.D. 

10:05 AM Can Residents Become Fully Skilled MIS Surgeons During Their Training? YES Fady Balaa, M.D. 

10:15 AM Can Residents Become Fully Skilled MIS Surgeons During Their Training? NO Rebecca Minter, M.D. 

10:25 AM Can a Good MIS Fellowship Co-Exist with a Residency Designed to Train MIS Surgeons? YES Peter Hallowell, M.D. 

10:35 AM Can a Good MIS Fellowship Co-Exist with a Residency Designed to Train MIS Surgeons? NO Ronnie Clements, M.D. 


SAGES acknowledges an educational grant in support of this World Congress panel from Ethicon Endo-Surgery, Inc. 







Video Complications Luncheon: 


Chair: Bipan Chand, M.D.; Co-Chair: Manabu Yamamoto, M.D. 


In this Lunch Session participants will watch popular and rare complications during laparoscopic surgery and discuss its prevention and 

solution. 

Objectives: 


• List the popular/rare complications of laparoscopic surgery 

• Discuss how to manage and prevent the complications 

• Lessen the complications to obtain better patient outcomes 

Schedule 

11:00 AM Introduction Bipan Chand, M.D. & Manabu Yamamoto M.D. 

11:05 AM GERD Lee L. Swanstrom, M.D. 

11:13 AM ARS 

11:20 AM Colon Steve D. Wexner, M.D. 

11:28 AM ARS 

11:35 AM Liver Go Wakabayashi, M.D. 

11:43 AM ARS 

11:50 AM Bariatric Kazunori Kasama, M.D. 

11:58 AM ARS 

12:05 PM Hernia Edward Phillips, M.D. 

12:13 PM ARS 




12:30 PM - 1:30 PM *included in Registration SuperPass (Option A) or Registration Option C 

Global Report from the Field Panel: 

Teaching Laparoscopic Surgery Abroad 

Chair: Raul Rosenthal, M.D.; Co-Chair: Horacio Asbun M.D. 

location: Maryland Ballroom A 

As a result of SAGES growth and evolution, our society has become one of the world’s leaders in minimally invasive and endoscopic surgery. 

The practice and evolution of minimally invasive surgery has been enriched by SAGES members from around the globe, and it is important 

to analyze the challenges that have occurred outside the United States and how SAGES has participated in helping overcome adversity. The 

Global Initiative program was conceived to participate in basic and advanced surgical education worldwide. This symposium will highlight 

the achievements of the Global Initiative since its inception and highlight how surgeons manage some unusual disease processes in other 

parts of the world. 

Objectives: 


• Understand sentinel contributions made by SAGES members in minimally invasive surgery worldwide 

• Identify contributions made by SAGES and the Global Initiative in implementing Minimally Invasive Surgical techniques in other countries 

• Discuss the impact and application of minimally invasive surgical techniques in other parts of the world 

Schedule 

12:30PM Introduction Raul Rosenthal, M.D. & Horacio Asbun, M.D. 

12:35 PM Can We Help Address the Worldwide Burden of Surgical Disease? Ramon Berguer, M.D. 

12:45 PM Problems and Solutions When Dealing with Laparoscopic Equipment: 

humanitarian and Military Experiences 

Steve Bowers M.D. 

12:55 PM A Trainer Perspective: Peru Experience Allan Okrainec, M.D. 

1:05 PM A Trainee Perspective: Peru Experience Edmundo Dedios, M.D. 
















Peer Review Training Session 

Chair: Abe L. Fingerhut, M.D.; Co-Chair: Sir Alfred Cuschieri, M.D. 


The peer review process has been critical to the dissemination of up-to-date scientific knowledge and best practices in medicine. This session 

outlines the issues involved in the peer review process as well as the intent. There will be didactic lectures and an examination and critique of 

several papers previously published in Surgical Endoscopy to provide a practical example to session attendees. 


• Describe what the peer review process entails • Incorporate ways of doing peer review well 

• Understand the critical importance and intent of peer review • Identify ethical issues regarding the peer review process 

Schedule 

1:00 PM Introduction Abe L. Fingerhut, M.D. & Sir Alfred Cuschieri, M.D. 

1:05 PM What is Peer Review? Kenneth A. Forde, M.D. 

1:15 PM What Do We Need It? Sir Alfred Cuschieri, M.D. 

1:25 PM How Should It Be Done? Abe L. Fingerhut, M.D. 

1:35 PM How to Learn to Do It Well Mark A. Talamini, M.D. 

1:45 PM Ethical Issues Peter Crookes, M.D. 


2:10 PM Examples of Articles Published in Surgical Endoscopy Faculty 



SAGES Presidential Debates 

Chair: Daniel J. Deziel, M.D.; Co-Chair: Nathaniel J. Soper, M.D. 


Description: 

This popular session will address practical and philosphical issues that are important to SAGES surgeons in an animated and entertaining 

format. 


• Understand the relevant applications of robotics in general surgery 

• Discuss the issues pertinent to laparoscopic repair of groin hernias 

• Appreciate the practical and ethical concerns about reimbursement for investigational procedures and about the omnipresent 

dissemination of minimal access surgery 

Schedule 

12:30 PM Introduction Daniel J. Deziel, M.D. & Nathaniel J. Soper, M.D. 

Robotics: A Real Role in GI Surgery 

12:35 PM “Right On” Mark A. Talamini, M.D. 

12:45 PM “No Way” David W. Rattner, M.D. 


For My Groin Hernia... 

1:00 PM “Laparoscopy is Lovely” Desmond H. Birkett, M.D. 

1:10 PM “Laparoscopy is Ludicrous” Greg V. Stiegmann, M.D. 


Should Investigational Procedures be Reimbursed? 

1:25 PM “Yes” Steven D. Wexner, M.D. 

1:35 PM “No” Jeffrey H. Peters, M.D. 


The Title Bout 

1:50 PM “Laparoscopy Must be Universal” Lee Swanstrom, M.D. 

2:00 PM “Laparoscopy Cannot be Universal” Kenneth A. Forde, M.D. 


SAGES acknowledges our Silver Level Donors for their support of this debate: Boston Scientific, Davol Inc., a BARD Company, Gore & Associates 


Hotel Video Loop 

Attention Guests at the Gaylord Hotel: The World Congress Program Chairs have created an 

additional avenue for excellent videos to be viewed by meeting attendees. You may view these 

videos in your hotel rooms on Thursday, Friday, and Saturday. Please turn to channel 57 (subject 

to change) in your Gaylord Hotel room to view the 2010 Video Channel Loop videos. The Video 

Channel Loop listing is available on page 148 of your program. 






Conflict of Interest Panel 

Chair: Steve Eubanks, M.D.; Co-Chair: Neely Panton, M.D. 


Description: 

This panel provides a well-rounded perspective of the current issues that revolve around Conflict of Interest. The topics covered outline not 

only the pros and cons of the newly set rules for Physician-Industry Relationships, but also define avenues for healthy partnerships amidst 

strict regulations. 


• Identify the new Conflict of Interest rules affecting Physician-Industry relationships 

• Understand the impetus for current rules and oversight 

• Integrate new approaches to managing Conflict of Interest rules 

• Utilize effective strategies for coping with Conflict of Interest rules 

Schedule 

1:30 PM Introduction Steve Eubanks, M.D. & Neely Panton, M.D. 

1:35 PM The Current Status of Physician-Industry Relationships and Conflict of Interest (COI) Rules Gerald M. Fried, M.D. 

1:45 PM Why Physician-Industry Relationships Require Strict Conflict of Interest (COI) Rules and Oversight Michael D. Holzman, M.D. 

1:55 PM How Excessive COI Rules are Killing Healthy Physician-Industry Relationships R. Larry Whelan, M.D. 

2:05 PM Surviving and Succeeding in an Era of Tightened COI Regulations Bruce D. Schirmer, M.D. 



Resident and Fellows Scientific Session 

Chair: Gregory F. Dakin, M.D.; Co-Chair: Adheesh A. Sabnis, M.D. 


In this session, selected residents and fellows will have the opportunity to present their research to a panel of distinguished faculty – all prominent 

surgeon-scientists who contribute regularly to the field of minimally invasive surgery. The panel will discuss and critique each presentation with 

a particular focus on study design, methodology, and critical review of results. Speakers will be judged not only on the content and originality of 

their work but on their presentation skills as well. An award for the best scientific presentation will be given at the conclusion of the session. 


• Describe methodological pitfalls that detract from scientific studies 

• Identify solutions to these problems and apple them in order to improve study design 

• Optimize communication and transfer of information in the context of a 10 minute presentation 

• Recognize the depth and complexity of current research endeavors of surgeons-in-training 

Schedule 

2:30 PM Introduction Gregory F. Dakin, M.D. & Adheesh A. Sabnis, M.D. 

Discussion 

Frederick L. Greene, M.D., Bruce MacFadyen, Jr., M.D., William Barry Inabnet, M.D., 

William Traverso, M.D., Christopher Jamieson, M.D. 

S093 SINGLE INCISION LAPAROSCOPIC CHOLECYSTECTOMIES COST COMPARISON Katie Love, MD, Michael P Meara, MD, Christopher A 

Durham, MD, Curtis E Bower, MD FACS, ECU Brody School of Medicine 

S094 SINGLE-INCISION LAPAROSCOPIC SURGERY (SILS) VERSUS STANDARD LAPAROSCOPIC SURGERY: A COMPARISON OF 

PERFORMANCE USING A SURGICAL SIMULATOR Byron F Santos, MD, Daniel H Enter, BA, Nathaniel J Soper, MD, Eric S Hungness, MD, 

Northwestern University, Department of Surgery 

S095 DOES SPEED MATTER? THE IMPACT OF OPERATIVE TIME ON OUTCOMES IN LAPAROSCOPIC SURGERY Timothy D Jackson, MD 

MPH, Jeffrey J Wannares, BS, Robert T Lancaster, MD MPH, David W Rattner, MD, Matthew M Hutter, MD MPH, The Codman Center for 

Clinical Effectiveness in Surgery, Massachusetts General Hospital, Boston, MA 

S096 MORTALITY RISK ASSOCIATED WITH INSURANCE DENIALS IN BARIATRIC SURGERY CANDIDATES Raghid S Bitar, MD, Mastafa 

Springston, Geoffrey P Kohn, MD, Lindsee E McPhail, MD, David W Overby, MD, Timothy M Farrell, MD, University of North Carolina at Chapel 

Hill 

S097 INTRAOPERATIVE COLONOSCOPIES WITH LAPAROSCOPIC ASSISTANCE REDUCES UNNECESSARY BOWEL RESECTIONS AND 

HOSPITILIZATION Donald M Davis, MD, Valentine Nfonsam, MD, Jorge E Marcet, MD, Jared C Frattini, MD, University of South Florida 

S098 IMPROVING SURGICAL TRAINING; THE USE OF FEEDBACK TO REDUCE ERRORS AND IMPROVE RETENTION DURING A 

SIMULATED SURGICAL PROCEDURE E Boyle, MRCS, M Al-Akash, MRCS, O Traynor, FRCS, AG Gallagher, PhD Bsc, ADK Hill, MD FRCS, PC 

Neary, MD FRCS, National Surgical Training Centre, RCSI, Dublin, Ireland 

S099 SAFETY OF LAPAROSCOPIC PARAESOPHAGEAL HERNIA REPAIR IN OCTOGENARIANS Heidi L Fitzgerald, MD, Gina L Adrales, MD, 

Thadeus L Trus, MD, Song Li, BA, William S Laycock, MD, Dartmouth Hitchcock Medical Center 

S100 A COMPARATIVE STUDY OF HAND-SEWN VERSUS STAPLED GASTROJEJUNAL ANASTOMOSIS IN LAPARASCOPIC ROUX-EN-Y 

GASTRIC BYPASS Amanda J Kravetz, MD, Subhash Reddy, MD, Shean Satgunam, MD, Panduranga Yenumula, MD, Michigan State University 

Department of Surgery 

S101 HOW RELIABLE IS LAPAROSCOPIC COLORECTAL SURGERY COMPARED TO OPEN SURGERY FOR OCTOGENARIANS? Rodrigo A 

Pinto, Dan Ruiz, Yair Edden, Eric G Weiss, Juan J Nogueras, Steven D Wexner, Cleveland Clinic Florida 

S102 BARRETT’S ESOPHAGUS TREATMENT DILEMMA: PILLS VERSUS OPERATION: STATISTICAL ANALYSIS AND COST/EFFECTIVENESS 

Victor Bochkarev, MD, Dmitry Oleynikov, MD, UNMC 

SAGES acknowledges an educational grant in support of this World Congress session from Ethicon Endo-Surgery, Inc. 





Single Port Access Surgery Panel 

Chair: Joel Leroy, M.D.; Co-Chair: Andrew A. Gumbs, M.D. 


Description: 

Reduced port surgery has generated a tremendous amount of excitement in the surgical community. However, its clinical benefits remain 

poorly defined. This session will provide an update on the latest developments in this rapidly evolving area. 

Objectives: 


• Trace the history and evolution of Single Port Access Surgery in the spectrum of Minimally Invasive Surgery 

• Identify the key concepts in getting Single Port Access and the steps necessary to safely perform appendectomy, cholecystectomy, and 

colectomies 

• Discuss the indications for Single Port Access surgery and when to convert to multiple port laparoscopy 

• Recognize oncologic principles and pitfalls specific to Single Port Access surgery and indications/contraindications to Single Port Access 

surgery in cancer patients 

Schedule 

2:30 PM Introduction Joel Leroy, M.D. & Andrew A. Gumbs, M.D. 

2:35 PM The History of Single Port Access Surgery and Basic Technical Principles Paul G. Curcillo, M.D. 

2:45 PM Single Port Access Appendectomy Elie Chouillard, M.D. 

2:55 PM Single port Cholecystectomy: Techniques and Overview of the Literature Prashanth Rao, M.D. 

3:05 PM Single Port Access Bariatric Surgery: 

Gastric Sleeves and Laparoscopic Adjustable Gastric Band Placement 

Marc Bessler, M.D. 

3:15 PM Colorectal Surgery with Single Port: Techniques and Overview of the Indications Feza Remzi, M.D. 

3:25 PM Single Port Access in Endocrine Surgery (Adrenal, Spleen, Thyroid?) Eduardo Targarona, M.D. 

3:35 PM Single Port Surgery: A Step to NOTES® Ronan Cahill, M.D. 


SAGES acknowledges educational grants in support of this World Congress panel from Covidien, Ethicon Endo-Surgery, Inc. and Olympus. 





Moderators: Namir Katkhouda, MD & Brice Gayet, MD 

S014 COMMON BILE DUCT EXPLORATION IN DECLINE: MAJORITY OF THESE PROCEDURES ARE DONE IN NON-TEACHING HOSPITALS 

IN THE US. Samuel Jacob, MD, Marek Rudnicki, MD PhD, Metropolitan Group Hospitals/University of Illinois Surgery Residency Program 

Chicago, USA 

S015 DISPARITIES IN ACCESS TO BASIC LAPAROSCOPIC SURGERY AT U.S. ACADEMIC CENTERS Esteban Varela, MD FACS, Ninh Nguyen, 

MD FACS, Department of Surgery, Washington University in St. Louis 

S016 REAL-TIME FLUORESCENCE IMAGING OF BILIARY ANATOMY DURING LAPAROSCOPIC CHOLECYSTECTOMY Nobumi Tagaya, 

PhD, Aya Nakagawa, PhD, Akihito Abe, PHD, Yoshimi Iwasaki, PhD, Mitsugi Shimoda, PhD, Masato Kato, PhD, Keiichi Kubota, phD, Second 

Department of Surgery, Dokkyo Medical University, Tochigi, Japan 

V014 LAPAROSCOPIC LEFT HEPATECTOMY WITHOUT INFLOW OCCLUSION USING MODIFIED ANTERIOR APPROACH C Palanivelu, MCh 

FACS FRCS, P Senthilnathan, MS DNB MRCS, N Anand Vijai, MS, R Rohit, MS, P Praveen Raj, MS, GEM Hospital 

S017 INITIAL EXPERIENCES IN 70 CASES OF TOTALLY LAPAROSCOPIC LIVER RESECTION FOR HCC Nguyen Hoang Bac, PhD, Tran Cong 

Duy Long, MD, Nguyen Duc Thuan, MD, Le Tien Dat, MD, Medical University Center at Hochiminh city 

S018 LAPAROSCOPIC MANAGEMENT OF CBD STONES: AN INDIAN EXPERIENCE Jagdish Chander, MD, Pawanindra Lal, 

MDDNBFRCSEdFRCSGlasg, Anubhav Vindal, MD, Vinod K Ramteke, MD, Maulana Azad Medical College, New Delhi, India 

S019 GERIATRIC SURGERY: IMPACT OF AGE ON THE OPERATIVE DECISION IN GALLSTONE DISEASE Simon Bergman, MD MSc, Nadia 

Sourial, MSc, Shannon A Fraser, MD MSc, Wael C Hanna, MD, Isabelle Vedel, MSc, Michèle Monette, Gabriela Ghitulescu, MD, Issie Weissglas, 

MD, Johanne Monette, MD, Department of Surgery, Sir Mortimer B. Davis Jewish General Hospital, Montreal, QC; Solidage Research Group 

on Frailty and Aging, Montreal, QC; Division of Geriatric Medicine, Sir Mortimer B. Davis Jewish General Hospital 

S020 IS THE USE OF T-TUBE NECESSARY AFTER LAPAROSCOPIC CHOLEDOCHOTOMY? Ahmed R El-Geidie, MD, Gastroenterology Surgical 

Center, Mansoura University, Egypt 

S021 BILE DUCT INJURY AFTER LAPAROSCOPIC CHOLECYSTECTOMY IN HOSPITALS WITH AND WITHOUT SURGICAL TRAINING 

PROGRAMS. IS THERE A DIFFERENCE? Vincent L Harrison, MD, Thai H Pham, MD, Brian S Diggs, PhD, Alexander J Greenstein, MD, James P 

Dolan, MD, Brett C Sheppard, MD, John G Hunter, MD, Oregon Health & Science University 

SS06 Hernia 


Moderators: William Laycock, MD & Minhua Zheng, MD 

S022 EVALUATION OF INTRAPERITONEAL PLACEMENT OF ABSORBABLE AND NONABSORBABLE BARRIER COATED MESH SECURED 

WITH FIBRIN SEALANT (NEW ZEALAND WHITE RABBIT MODEL) Eric D Jenkins, MD, Lora Melman, MD, Salil Desai, BA, Shaun R Brown, 

DO, Margaret M Frisella, RN, Corey R Deeken, PhD, Brent D Matthews, MD, Department of Surgery, Washington University, St. Louis, Missouri 

S023 A PROSPECTIVE RANDOMIZED STUDY COMPARING SUTURE MESH FIXATION VS TACKER MESH FIXATION FOR LAPAROSCOPIC 

REPAIR OF INCISIONAL AND VENTRAL HERNIAS Mahesh C Misra, MS FRCS, Virinder K Bansal, MS, Subodh Kumar, MS, Keerthi Y Rao, 

MBBS, Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India 







S024 OPEN VERSUS ENDOSCOPIC COMPONENT SEPARATION – A COST EFFECTIVENESS ANALYSIS Karem C Harth, MD MHS, Conor P 

Delaney, MD PhD, Johnie Rose, MD, Michael J Rosen, MD, University Hospital at Case Medical Center 

V015 LAPAROSCOPIC LUMBAR HERNIA REPAIR WITH BONE ANCHOR FIXATION Vanessa P Ho, MD, Gregory F Dakin, MD, Weill Cornell 

Medical College-NewYork Presbyterian Hospital 

S025 OUTCOMES OF LAPAROSCOPIC VENTRAL HERNIA REPAIR WITH ROUTINE DEFECT CLOSURE USING “SHOELACING” TECHNIQUE 

Sean B Orenstein, MD, Julie Monteagudo, Jillian Fortier, Mun Jye Poi, MD, Yuri W Novitsky, MD, Connecticut Comprehensive Center for 

Hernia Repair, Department of Surgery, University of Connecticut Health Center, Farmington, Connecticut 

S026 OPEN TENSION-FREE MESH-PLUG VERSUS TRANSABDOMINAL PREPERITONEAL(TAPP) VERSUS TOTALLY 

EXTRAPERITONEAL(TEP) LAPAROSCOPIC TECHNIQUES FOR PRIMARY UNILATERAL INGUINAL HERNIA REPAIR: A PROSPECTIVE 

RANDOMIZED CONTROLLED TRIAL Ke Gong, MD, Nengwei Zhang, MD, Yiping LU, MD, Zhanzhi Zhang, MD, Dexiao Du, MD, Beijing 

Shijitan Hospital, Beijing, China 

S027 A COMPARISON OF OUTCOMES IN OPEN VERSUS LAPAROSCOPIC SURGICAL REPAIR OF RECURRENT INGUINAL HERNIAS 

Nilay R Shah, MD, Clayton T Hodges, BS, Vanchad R Memark, MD, Eric T Volckmann, MD, Clinton R Hall, MD, Bradley J Needleman, MD, 

Dean J Mikami, MD, Jeffrey W Hazey, MD, W. Scott Melvin, MD, Vimal K Narula, MD, Center for Minimally Invasive Surgery, Division of 

Gastrointestinal Surgery, The Ohio State University Medical Center, Columbus, Ohio, USA 

S028 30-DAY READMISSION AFTER VENTRAL HERNIA REPAIR: PREDICTABLE OR PREVENTABLE? Jeffrey A Blatnik, MD, Karem C Harth, 

MD MHS, Mark I Aeder, MD, Michael J Rosen, MD, Department of Surgery, University Hospitals Case Medical Center, Cleveland, OH 

V016 RECONSTRUCTION OF THE ANTERIOR ABDOMINAL WALL WITH BILATERAL ENDOSCOPIC COMPONENT SEPARATION, 

LAPAROSCOPIC ASSISTED MEDIALIZATION OF THE RECTUS AND LAPAROSCOPIC MESH PLACEMENT Jawaid Kalim, MD, Scott Philipp, 

MD, Archana Ramaswamy, MD, University of Missouri, Columbia 

4:00 PM - 5:30 PM 




Moderators: Natan Zundel, MD & David Hazzan, MD 

V017 SINGLE INCISION LAPAROSCOPIC RIGHT COLECTOMY Wai Lun Law, MD, Joe Fan, MD, Jensen Poon, MD, The University of Hong Kong 

V018 LAPAROSCOPIC REPAIR OF TRAUMATIC FLANK HERNIA Mun Jye Poi, MD, Yuri W Novitsky, MD, University Of Connecticut Health 

Center, Farmington, Connecticut 

V019 LAPAROSCOPIC REPAIR OF A DUODENAL ATRESIA AND LADD’S PROCEDURE IN A NEONATE Steven S Rothenberg, MD, Rocky 

Mountain Hospital For Children 

V020 LAPAROSCOPIC REPAIR OF ACUTELY INCARCERATED PARAESOPHAGEAL HERNIA Elizabeth Honigsberg, MD, Barry Salky, MD FACS, 

The Mount Sinai Hospital, New York 

V021 GALLBLADDER VOLVULUS: A VIDEO CASE REPORT Justin K Lawrence, MD, Nikhil Pawa, MD, Matthew G Tutton, MD, Antonio 

Privitera, MD, Colchester University Hospital, UK 

V022 TOTALLY EXTRAPERITONEAL REPAIR OF A SPIGELIAN HERNIA Frances Allocco, MD, Patrick Reardon, MD, Mohamed Saad, DO, Brian 

Dunkin, MD, The Methodist Hospital 

V023 LAPAROSCOPIC RESECTION OF A PRESACRAL SCHWANNOMA. Alexander Ramirez, Samuel Szomstein, Raul Rosenthal, Cleveland 

Clinic Florida 



Moderators: Teodor Grantcharov, MD & Michael Nussbaum, MD 

S029 SURGEON IMPRESSIONS AND TECHNICAL DIFFICULTY ASSOCIATED WITH LAPARO-ENDOSCOPIC SINGLE-SITE SURGERY: 

A SAGES LEARNING CENTER STUDY Antonio O Castellvi, MD, Arsalla Islam, MD, Seifu T Tesfay, RN, Alejandro D Castellvi, BS, Andrew S 

Wright, MD, Daniel J Scott, MD, Spartanburg Regional Medical Center, UT Southwestern Medical Center, St. Matthews Medical School, 

University of Washington 

S030 TRENDS AND RESULTS OF THE FIRST FIVE YEARS OF FUNDAMENTALS OF LAPAROSCOPIC SURGERY (FLS) CERTIFICATION 

TESTING Allan Okrainec, MD, Nathaniel J Soper, MD, Lee L Swanstrom, MD, Gerald M Fried, MD, University of Toronto, Toronto, ON, 

Northwestern University Feinberg School of Medicine, Chicago, IL, Legacy Health System, Portland, OR, and McGill University, Montreal, QC 

S031 A NATIONAL TRAINING PROGRAM FOR LAPAROSCOPIC COLORECTAL SURGERY IN THE UK Danilo Miskovic, MD FRCS, Susannah 

M Wyles, MSc MRCS, Mark G Coleman, MD FRCS, George B Hanna, PhD FRCS, Department of Biosurgery and Surgical Technology, Imperial 

College London/UK for the National Training Programme for Laparoscopic Colorectal Surgery 

S032 ANALYSIS OF STANDARD MULTI-PORT VS. SINGLE SITE ACCESS FOR LAPAROSCOPIC SKILLS TRAINING AND ACQUISITION Daniel 

R Cox, BS, Wenjing Zeng, BS, L Michael Brunt, MD, Washington University School of Medicine 

S033 A DEFICIENCY IN KNOWLEDGE OF BASIC PRINCIPLES OF LAPAROSCOPY AMONG ATTENDEES OF AN ADVANCED LAPAROSCOPIC 

SURGERY COURSE Carlos A Menezes, MD, Daniel W Birch, MD, Andrey Vizhul, MD, Xinzhe Shi, MPH, Vadim Sherman*, MD, Shahzeer 

Karmali, MD, Centre for the Advancement of Minimally Invasive Surgery, University Of Alberta, Edmonton, Alberta, Canada; *Baylor College 

of Medicine, Houston, Texas, USA. 

S034 EVALUATION OF SURGICAL PERFORMANCE DURING LAPAROSCOPIC INCISIONAL HERNIA REPAIR- A MULTICENTER STUDY Iman 

Ghaderi, MD, Marilou Vaillancourt, MD, Liane S Feldman, Gideon Sroka, MD, Pepa A Kaneva, MS, Melina C Vassiliou, MD, Jacob Seagull, PhD, 

Erica Sutton, MD, Carlos Godinez, MD, Ivan George, BSc, Adrian E Park, MD, Ian Choy, MD, Allan Okrainec, MD, Rita, Steinberg-Bernstein 

Centre for Minimally Invasive Surgery, McGill University, Montreal, QC, University of Western Ontario, London, ON, University of Maryland, 

Baltimore, MD, University of Toronto, Toronto, ON, Carolinas Medical Center, Charlotte, NC 

S035 SEX ISN’T EVERYTHING: THE ROLE OF GENDER IN EARLY PERFORMANCE OF A FUNDAMENTAL LAPAROSCOPIC SKILL Nicoleta O 

Kolozsvari, MD, Amin Andalib, MD, Pepa Kaneva, MSc, Jiguo Cao, PhD, Liane S Feldman, MD, Gerald M Fried, MD, Steinberg-Bernstein Centre 

for Minimally Invasive Surgery and Innovation, McGill University, Montreal, Qc, Canada



S036 A NOVEL SENSORIZED INSTRUMENT-BASED MINIMALLY INVASIVE SURGERY (SIMIS) TOOL: INITIAL CONSTRUCT VALIDATION OF 

FORCE SENSING Shiva Jayaraman, MD MESc, Ana Luisa Trejos, MASc, Andrew C Lyle, Michael D Naish, PhD, Rajni V Patel, PhD, Christopher 

M Schlachta, MD, CSTAR (Canadian Surgical Technologies & Advanced Robotics), Lawson Health Research Institute and Department of 

Surgery, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada 

S037 MENTORED TRAINEES OBTAIN COMPARABLE OPERATIVE RESULTS TO EXPERTS IN COMPLEX LAPAROSCOPIC COLORECTAL 

SURGERY Federico Costantino, MD, Jacopo D’Agostino, MD, Cosimo Callari, MD, Joël Leroy, MD, Hurng-Sheng Wu, MD, Didier Mutter, MD, 

Jacques Marescaux, MD, IRCAD, University Hospital of Strasbourg, France - Show Chwan Memorial Hospital, Changhua, Taiwan 

SS09 NOTES® 


Moderators: W. Scott Melvin, MD & Dean Mikami, MD 

S038 TRANSGASTRIC APPROACH DOES NOT INCREASE POSTOPERATIVE INFECTIONS OR COMPLICATIONS IN SWINE UTERINE HORN 

RESECTION Asghar Azadani, MD, Henrik Jonsson, MD, Maria Bergstrom, MD PhD, Per-Ola Park, MD PhD, Dept of Surgery, Sahlgrenska 

University Hospital, Gothenburg, Sweden, Dept of Surgery, South Alvsborg Hospital, Boras, Sweden 

S039 STUDY OF HUMAN PERITONEAL BACTERIAL CONTAMINATION AFTER NOTES TRANSGASTRIC AND TRANSVAGINAL 

CHOLECYSTECTOMY Silvana Perretta, MD, Bernard Dallemagne, MD, Pierre Allemann, MD, Gianfranco Donatelli, MD, Cosimo Callari, 

MD, Hurng-Shen Wu, MD, Jacques Marescaux, MD, IRCAD, University Hospital of Strasbourg, France - Show Chwan Memorial Hospital, 

Changhua, Taiwan 

S040 PROSPECTIVE RANDOMIZED TRIAL COMPARING LAPAROSCOPIC AND NOTES CHOLECYSTECTOMY: PRELIMINARY RESULTS 

Alberto R Ferreres, MD PhD MPH FACS, Anibal Rondán, MD, Santiago Horgan, MD, Julieta Paleari, MD, Mariano E Giménez, MD, Oscar O 

Laudanno, MD, Vicente P Gutiérrez, Department of Surgery. University of Buenos Aires 

V024 ENDOSCOPIC TRANSESOPHAGEAL MEDIASTINAL AND THORACIC LYMPH NODE DISSECTION WITH EN BLOC RESECTION (VIDEO 

SUBMISSION) Brian G Turner, MD, Denise W Gee, MD, Sevdenur Cizginer, MD, Min-Chan Kim, MD, Yusuf Konuk, MD, Mari Mino-Kenudson, 

MD, Patricia Sylla, MD, David W Rattner, MD, William R Brugge, MD FASGE, (1) Gastrointestinal Unit, Massachusetts General Hospital, (2) 

Department of Surgery, (3) Department of Pathology, Massachusetts General Hospital, Boston, MA 

S041 FIRST HUMAN EXPERIENCE WITH ENDOLUMINAL, ENDOSCOPIC GASTRIC BYPASS Bryan J Sandler, MD, C. Paul Swain, MD, Roberto 

Rumbaut, MD, Gustavo Torres, MD, Luis Morales, MD, Lizcelly Gonzales, MD, Santiago Horgan, MD, University of California, San Diego, San 

Diego, CA, USA; Imperial College of London, London, England; San Jose Tec de Monterrey, Monterrey, Mexico 

S042 ESOPHAGEAL STENT PLACEMENT PROVIDES SAFE CLOSURE FOLLOWING TRANSESOPHAGEAL ACCESS FOR NOTES® THORACIC 

PROCEDURES Brian G Turner, MD, Denise W Gee, MD, Min-Chan Kim, MD, Sevdenur Cizginer, MD, Mari Mino-Kenudson, MD, Patricia 

Sylla, MD, David W Rattner, MD, William R Brugge, MD FASGE, (1) Gastrointestinal Unit, Dept of Medicine, (2) Department of Surgery, (3) 

Department of Pathology, Massachusetts General Hospital, Boston, MA 

S043 QUANTITATIVE ERGONOMICS ASSESSMENT OF NOTES TECHNIQUES: A STUDY OF PHYSICAL WORKLOAD, BODY MOVEMENT 

AND POSTURE Gyusung Lee, PhD, Erica Sutton, MD, Yassar Youssef, MD, Tameka Clanton, MS, Adrian Park, MD, University of Maryland 

S044 PROSPECTIVE NON-RANDOMIZED STUDY OF ENDOSCOPIC TRANSVAGINAL CHOLECYSTECTOMY VERSUS LAPAROSCOPIC 

CHOLECYSTECTOMY José F Noguera, MD PhD, Angel Cuadrado, MD PhD, Carlos Dolz, MD, José M Olea, MD, Rafael Morales, MD, Luis C 

Lozano, MD, José C Vicens, MD, Hospital Son Llàtzer 

V025 LAPAROSCOPIC SLEEVE GASTRECTOMY AS A TREATMENT OPTION FOR ACUTE GASTRIC FUNDUS NECROSIS AFTER 

LAPROSCOPIC REDO PARAESOPHAGEAL HERNIA REPAIR AND SLIPPED REDO NISSEN FUNDOPLICATION Ismael Court, Omar Bellorin, 

Sheetal Patel, Samuel Szomstein, Raul J Rosenthal, Cleveland Clinic Florida 


Pencil us in for next year: 












4/13/10: 7:00 am - 5:00 pm 

4/14/10: 5:30 am - 5:00 pm 

4/15/10: 6:00 am - 5:00 pm 

4/16/10: 5:30 am - 5:30 pm 

4/17/10: 5:30 am - 5:00 pm 






Emerging Technology Session 

Chair: Steven D. Schwaitzberg, M.D.; Co-Chair: Alex Gandsas, M.D. 


For the 6th year, SAGES, as part of the SAGES Technology Initiative, will present the Emerging Technology Session. Surgeons, physicians, 

scientists from academic centers as well as industry are invited to submit abstracts for consideration. Submissions that reflect “late braking”, 

“cutting-edge” or novel information are greatly encouraged. Submission of preliminary results for new technologies is encouraged as well. 

SAGES does NOT offer CME for this session. 

ET01 NOVEL HANDHELD PET PROBES PROVIDE INTRAOPERATIVE LOCALIZATION OF MALIGNANT LYMPH NODES Segundo J Gonzalez, 

MD, Joyce Wong, MD, Lorena Gonzalez, MD, Peter Brader, MD, Mithat Gönen, Maureen Zakowski, MD, Yuman Fong, MD, Vivian Strong, MD, 

Departments of Surgery,1 Radiology,2 Pathology,3 and Epidemiology and Biostatistics,4; Memorial Sloan-Kettering Cancer Center, New 

York, NY, 10065 USA 

ET02 SINGLE CENTER EXPERIENCE WITH A NOVEL PURELY ENDOLUMINAL FUNDOPLICATION DEVICE Ozanan R Meireles, MD, Julietta 

Paleari, MD, Noam Belkind, MD, Kari Thompson, MD, Michael Sedrak, MD, Garth Jacobsen, MD, Mark A Talamini, MD, Santiago Horgan, MD, 

University of California-San Diego 

ET03 CLEANOSCOPE: A CLEAR IMAGE AT ALL TIMES Barry Salky, MD, Daniel Sherwin, Mr, Ori Nesher, Mr, Noam Danenberg, Mr, Gadi Lotan, 

MD, Cleanoscope, Ltd; The Mount Sinai Hospital, New York 

ET04 LAPAROSCOPIC INFRARED IMAGING – THE FUTURE VASCULAR MAP Noam Shussman, MD, Mahmoud Abu Gazala, MD, Avraham 

Schlager, MD, Ram Elazary, MD, Abed Khalaileh, MD, Gideon Zamir, MD, Avraham I Rivkind, MD FACS, Yoav Mintz, MD, Department of 

General Surgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel 

ET05 TRANSGASTRIC SMALL BOWEL RESECTION WITH A NEW MULTITASKING PLATFORM ENDOSAMURAI(TM) Karl H Fuchs, Wolfram 

Breithaupt, title, Markus-Krankenhaus, Dept of Surgery 

ET06 A NOVEL FLEXIBLE BIPOLAR HEMOSTASIS FORCEPS (BELA, ETHICON ENDO-SURGERY, NOTES TOOLBOX) OVERCOMES THE 

CURRENT SHORTCOMINGS OF ENDOSCOPIC ZENKER´S DIVERTICULOTOMIES: AN EXPERIMENTAL MODEL. Erwin Rieder, MD, Danny V 

Martinec, BS, Christy M Dunst, MD, Lee L Swanstrom, MD, Dept. of Minimally Invasive Surgery, Legacy Health, Portland, OR 

ET07 INSERTABLE ROBOTIC EFFECTOR PLATFORM Dennis L Fowler, MD MPH, Peter Allen, PhD, Jayson Ding, PhD, Roger Goldman, BA, 

Austin Reiter, BA, Nabil Simaan, PhD, Columbia University 

ET08 INTRA-LUMINAL INJECTION OF FERROMAGNETIC GLUE-BASED MEDIA FOR BOWEL RETRACTION IN LAPAROSCOPIC SURGERY 

Z Wang, PhD, A W Brown, S I Brown, PhD, D Liu, L Wang, PhD MD, A Cuschieri, Professor, Institute for Medical Science and Technology, 

University of Dundee, UK 

ET09 “THE DUNDEE ENDOCONE”: A NEW REUSABLE SILS DEVICE Andrea Pietrabissa, MD, Mario Alessiani, MD, Andrea Peri, MD, Sandro 

Zonta, MD, Lorenzo Cobianchi, MD, Paolo Dionigi, MD, SI Brown, MD, TG Frank, MD, Alfred Cuschieri, MD, Department of Surgical Science, 

University of Pavia; Institute for Medical Science and Technology - Dundee U.K 

ET10 FLEXIBLE CO2 LASER AND SUBMUCOSAL GEL INJECTION FOR SAFE ENDOSCOPIC AND LAPAROSCOPIC SURGERY OF THE 

INTESTINES Joyce T Au, MD, Arjun Mittra, MD, Joyce Wong, MD, Iain Nixon, MD, Paula Ezell, DVM, Snehal Patel, MD, Yuman Fong, MD, 

Memorial Sloan Kettering Cancer Center 

ET11 TOWARDS INTRA OPERATIVE DIAGNOSIS OF MESENTERIC TISSUE OXYGENATION WITH HYPERSPECTRAL IMAGING David James, 

MRCS MBBS BSc, Vincent Sauvage, Neil T Clancy, James Clark, MRCS MBBS, Ara W Darzi, KBE FRCS FACS MD, Guang-Zhong Yang, PhD, Daniel 

S Elson, PhD, Dept. Biosurgery and Surgical Technology and Institute of Biomedical Engineering, Imperial College, London 

ET12 LAPAROSCOPIC INTESTINAL ANASTOMOSIS WITH THE CAIMAN LEKTRAFUSE DEVICE Dirk W Meijer, MD MSc PhD, H Jaap Bonjer, 

MD PhD, BRG, VUMC 

ET13 NOVEL METHODOLOGY FOR COMPARING TISSUE ANALOGS Jenna Turocy, John Hryb, Danyel Racenet, Andrew Miesse, Thomas 

Wenchell, Covidien 

ET14 BETA TESTING OF A V-BAND SIMULATOR Jamie D Adair, MD, Ganesh Sankaranarayanan, PhD, Tansel Halic, MS, Zhonghua Lu, 

MS, Woojin Ahn, PhD, Mark A Gromski, BA, Daniel B Jones, MD, Suvranu De, ScD, Beth Israel Deaconess Medical Center and Rensselaer 

Polytechnic Institute 

ET15 WIRELESS ENDOLUMINAL APPLICATION OF A MAGNETIC DRIVEN CAMERA Nicola Di Lorenzo, MD Phd, Arianna Menciassi, Prof, 

Pietro Valdastri, Eng Phd, Livia Cenci, MD, Luca Iezzi, Eng Phd, Achille Lucio Gaspari, Prof, Paolo Dario, Prof, Scuola superiore Sant’ Anna Pisa - 

Department of surgey-University of Rome Tor Vergata 

ET16 AUGMENTED REALITY SYSTEM FOR ENDOSCOPIC AND NOTES PROCEDURES Luc Soler, PhD, Vincent Agnus, PhD, Stephane 

Nicolau, PhD, Julien Waechter, Eng, Oliver Burckhardt, MD, Silvana Perretta, MD, Bernard Dallemagne, MD, Didier Mutter, MD PhD, Jacques 

Marescaux, MD, IRCAD 

ET17 360° IMMERSIVE PANOMORPH ENDOSCOPIC DEVICE: A NEW ADVANCED VISION SYSTEM CONCEPT Pierre Garneau, MD, Patrice 

Roulet, Pierre Konen, Mathieu Villegas, Simon Thibault, MSc PhD ing, Sacré-Coeur Hospital of Montreal, ImmerVision, Université Laval 

ET18 ROBOTIC TRANSAXILLARY THYROIDECTOMY: REPORT OF TWO CASES AND DESCRIPTION OF THE TECHNIQUE Katherine B 

Heiden, MD, Allan Siperstein, MD, Mira Milas, MD, Joyce Shin, MD, Jamie Mitchell, MD, Eren Berber, MD, Cleveland Clinic 

ET19 TRANS-ORAL ENDOSCOPIC RESTRICTIVE IMPLANT SYSTEM (TERIS) FOR THE TREATMENT OF MORBID OBESITY: A 12 MONTHS 

REVIEW OF SAFETY AND RESULTANT WEIGHT LOSS Fady Moustarah, MD MPH, Stéfane Lebel, MD, Laurent Beirtho, MD, Frédéric-Simon 

Hould, MD, Simon Biron, MD, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval 

ET20 HEMORRHOIDAL LASER PROCEDURE (HELP) IN THE TREATMENT OF SYMPTOMATIC HEMORRHOIDS Paolo Giamundo, MD, Maria 

Geraci, MD, Livio Tibaldi, MD, Marco Valente, MD, Department of General Surgery -Hospital S. Spirito - Bra (CN) - ITALY 




ET21 TRANSCOLONIC NOTES- PRELIMINARY HUMAN EXPERIENCE: NOTES TRANSRECTAL RECTOSIGMOID RESECTION AND TME 

Ricardo Zorron, Djalma Coelho, Luciana Flach, Fabiano Lemos, Moacyr Moreira, Priscila Oliveira, Alain Barbosa, Department of Surgery – 

University Hospital Teresópolis HCTCO-FESO;Hospital Municipal Lourenco Jorge, Rio de Janeiro, Brazil 

ET22 DUAL CONSOLE ROBOTIC SURGERY ENHANCES OPERATIVE TASK EFFICIENCY Michael M Awad, MD PhD, Eric Jenkins, MD, Lora 

Melman, MD, Brent Matthews, MD, Washington University in St. Louis - School of Medicine 

SAGES acknowledges our Gold Level Donors for their support of this World Congress session: Ascent Healthcare Solutions, Stryker Endoscopy 

Friday Evening 

6:00 PM - 7:00 PM 

Meet the Leadership Reception For 

Residents, Fellows & New Members 

Location: Pose, 18-19 th Floor 


In addition to cabs and rental cars, the National Harbor offers a fun and practical way to get to various 

destinations…a water taxi! Water taxi service is available to and from points around Washington D.C., Virginia 

and Maryland for your convenience. The Potomac Riverboat Company operates water taxi service between 

National Harbor and Old Town Alexandria, with additional boat service to Mount Vernon and Georgetown. Water 

taxis will run every half hour between National Harbor and Old Town Alexandria. There will be three daily trips to 

Georgetown’s Washington Harbor, and a single daily trip to George Washington’s Mount Vernon Estate. Ask the 

concierge for more information and about pricing. 

2010 World Congress International Webcast Sessions 

To participate in the International Webcast Sessions, please visit: 

http://www.sages.org/meetings/annual_meeting/2010/ 

Password: sages 



8:00 am- 9:00 am Plenary Session C. Daniel Smith, MD & C. Jamieson, MD 

9:00 am - 9:30 am SAGES Presidential Address C. Daniel Smith, MD 

9:30 am - 10:00 m Gerald Marks Keynote Lecture Richard H. Bell, MD 

10:00 am - 11:00 am Symposium: NOTES® - Alive and Well, or RIP? 

12:30 pm - 2:30 pm Presidential Debates 

2:30 pm - 4:00 pm Panel: Single Port Access Surgery 


Chair: David W. Rattner, MD 

Co-chair: Venkat G. Rao, MD 

Chair: Daniel J. Deziel, MD 

Co-chair: Nathaniel Soper, MD 

Chair: Joel Leroy, MD 

Co-chair: Andrew A. Gumbs, MD 


7:00 am - 8:30 am Live from Afghanistan Session: Video Conference Military Coalition 

Chair: Steven P. Bowers, MD 

Co-chair: Richard M. Satava, MD 

8:30 am - 9:00 am Karl Storz Keynote Lecture Christopher J. Gostout, MD 

9:00 am - 9:30 am CAGS / Royal College of Surgeons Lecture Robert DiRaddo, Ph.D. 

9:30 am - 11:00 am Plenary Session II Moderators: J. Buyske, MD & A. Chousleb, MD 


SAGES gratefully acknowledges Covidien, Ethicon Endo-Surgery, Inc. and the SAGES Education & Research Foundation 

for their generous support towards the SAGES Global Proctoring Initiative. 




7:00 AM - 8:30 AM 

Live From Afghanistan Session: 


Hernia Debates Panel: 

7:00 AM - 8:30 AM 


Karl Storz Lecture: New Trends in Endoscopy – What 

8:30 AM - 9:00 AM Technology and Techniques are in it for You? 


The Royal College of Physicians and 

9:00 AM - 9:30 AM Surgeons of Canada Lecture 









10:00 AM - 1:00 PM 

Last Chance to Visit Exhibits, Posters, Learning Center 

Open – Please note 1:00 PM Closing Time! 

11:00 AM - 11:30 AM 



11:00 AM - 1:00 PM BREAK: Exhibits, Posters & Learning Center Open 

11:30 AM - 12:30 PM 

FREE Lunch in Exhibit Hall for all World Congress 

Scientific Session Registrants! 

11:30 AM - 1:00 PM 

Fellowship Council Luncheon 

The Future of Fellowships: How Will They Be Funded 




1:00 PM - 3:00 PM “Uh Oh! What Now?” Video Panel Potomac Ballroom C 

1:00 PM - 3:00 PM CAGS Simulation in the Training of Surgeons Session Maryland Ballroom B-D 

1:00 PM - 3:00 PM FES Roll-Out Session Maryland Ballroom A 

1:00 PM - 5:00 PM Concurrent Sessions (accepted oral & video presentations) 

1:00 PM - 2:00 PM SS11 Robotics Maryland Ballroom B-D 


1:00 PM - 3:00 PM SS12 Bariatric Potomac Ballroom A-B 

2:00 PM - 3:00 PM SS13 Research Grant Presentations Maryland Ballroom B-D 

3:00 PM - 4:00 PM SS14 Complications/Ergonomics/Instruments Maryland Ballroom B-D 

3:00 PM - 5:00 PM SS15 Esophageal/Gastric Potomac Ballroom D 

3:00 PM - 5:00 PM SS16 Colorectal Potomac Ballroom C 

3:00 PM - 5:00 PM SS17 Best of Video 3 Potomac Ballroom A-B 

3:00 PM - 5:00 PM IFSES Surgical Education Around the World Panel Maryland Ballroom A 

7:30 PM - 11:00 PM 

World Congress Gala, Featuring Dinner & 

the International Sing-Off 

Shuttles begin departing at 7:15 PM at the Bus Pickup are of the Gaylord 

hotel ONLY. Go to the Group Bus Loading area, located at the Woodrow 

Wilson exit on the 2nd level, opposite of guest parking. Buses will circle all 

evening until the event ends. 

Newseum 












Live From Afghanistan Session: 


Chair: COL (ret) Steven P. Bowers, M.D.; Co-Chair: COL (ret) Richard M. Satava, M.D. 


Description: 

The military has adapted laparoscopic and endoscopic technologies to the battlefield setting. This session will provide a unique window into 

how active duty military personnel use new surgical technologies in challenging environments. 

Objectives: 


• To understand how the military uses minimally invasive surgical techniques 

• To learn how surgery in challenging military environments differs from the elective setting 

Schedule 

7:00 AM Introduction 

7:05 AM Live from Salerno Afghanistan – Use of MIS and Endoscopy in the Field Hospital Josh Alley, M.D., USAF 

7:20 AM Live from Kandahar – Humanitarian Care and Care of Host Nationals Ron Brisebois, M.D., Canadian Forces 

7:35 AM Management of the Abdominal Wall in Combat Casualties Scott Rehrig, M.D., Army 

7:50 AM Military Battlefield Surgery Hon Ward Casscels, Immediate Assistant Secretary of Defense for Health Affairs 



Hernia Debates Panel: 


Chair: Guy R. Voeller, M.D.; Co-Chair: Edward H. Phillips, M.D. 


Description: 

Is laparoscopic therapy for the treatment of hernia better, worse, or equivalent to the open approach? This question remains incompletely 

answered even in 2009. This panel will address recent advances in the evaluation and treatment of inguinal, paraeshophageal, incisional and 

sportsman’s hernia. 

Objectives: 


• Learn treatment options for sportsman hernia 

• Learn the best surgical approach for paraesophageal hernia repair 

• Learn if mesh fixation is required for laparoscopic inguinal hernia repair 

• Learn if lapaoroscopic repair of incisional hernia adequately reconstructs the abdominal wall 

Schedule 

7:00 AM Introduction Guy R. Voeller, M.D. & Edward H. Phillips, M.D. 

Debate 1 – Biologic Mesh Should Be Widely Applied 

7:05 AM Biologic Mesh Should Be Widely Applied TBA 

7:15 AM Biologic Mesh Should NOT Be Widely Applied Shirin Towfigh, M.D. 

Debate 2 – Paraesophageal Hiatal Hernia 

7:25 AM Laparoscopic Approach is Preferred James D. Luketich, M.D. 

7:35 AM Open Thoracic Approach is Preferred Jeffrey Peters, M.D. 

Debate 3 – Fixation of Mesh for Laparoscopic Inguinal Hernia Repair 

7:45 AM Fixation of Mesh is Required Bruce Ramshaw, M.D. 

7:55 AM Fixation of Mesh is Not Required Craig Taylor, M.D. 

Debate 4 – Laparoscopic Repair of Incisional Hernia Cannot Adequately Reconstruct the Abdominal Wall 

8:05 AM Agree and Believe the Open Approach is Preferred Jean Bernard Flament, M.D. 

8:15 AM Disagree and Believe the Laparoscopic Approach is Preferred Michael J. Rosen, M.D. 


SAGES acknowledges educational grants in support of this World Congress panel from Covidien and Gore & Associates. 





Karl Storz Lecture: New Trends in Endoscopy – 

What Technology and Techniques are in it for You? Location: Potomac Ballroom A-B 


Mayo Clinic, Rochester, MN 

Associate Professor of Medicine, Mayo Clinic 

Dr. Gostout attended Medical School at the State University of New York, Brooklyn, NY and completed is residency at the Mayo 

Graduate School of Medicine, Mayo Clinic, Rochester, MN 

His clinical and research interests have been therapeutic endoscopy, gastroenterology and hepatology. His work in innovative 

flexible endoscopic procedures has made him a leader in his field. Dr. Gostout served as President, American Society for 

Gastrointestinal Endoscopy, in 2004-2005. 

He has 187 peer reviewed papers and has presented all over the world. He holds two US Patents 

- Apparatus and methods for internal surgical procedures 03-12-2009 and (2) Methods And 

- Systems For Performing Submucosal Medical Procedures 01-15-2009. 

His recent research protocols include: Function and comparative evaluation of flexible monopolar endoscopic scissors; Anatomical 

Considerations for NOTES® surgery 


The Royal College of Physicians and Surgeons of Canada Lecture 




Group Leader, Simulation of Deformable Materials 

National Research Council of Canada 

Robert DiRaddo graduated from McGill University in Engineering in the early 1980’s. He obtained his PhD in Engineering in the use 

of computer-systems for manufacturing processes. Dr DiRaddo worked in the petrochemical sector for several years, before joining 

the National Research Council of Canada (NRC). He currently leads a team working on the development of simulation technology 

for both industrial manufacturing operations and surgery. Since 2008 he has led a large pan-Canadian effort on the development 

of surgical simulation technology focused on surgical oncology. The program includes the participation of teaching hospitals from across 

Canada, from Halifax to Victoria. Part of Dr. Di Raddo’s project development includes a new simulator that lets neurosurgeons rehearse before 

operating--like pilots on a flight simulator. It is said that this idea could revolutionize how doctors train for and handle brain surgery. The 

prototype simulator developed by and several other research groups under his tutelage, gives surgeons a dry run in virtual reality before 

entering the operating room, potentially reducing mistakes. 


SS10 Plenary Session 2 

Moderators: Jo Buyske, MD & Alberto Chousleb, M.D. 


S045 HIATAL MESH IS ASSOCIATED WITH MAJOR RESECTION AT REVISIONAL OPERATION. Michael Parker, MD, Jillian M Bray, MD MPH, 

Adam S Harris, MD, Erol V Belli, MD, Jason M Pfluke, MD, Susanne S Preissler, Horacio J Asbun, MD, C D Smith, MD, Steven P Bowers, MD, 

Mayo Clinic Florida, Jacksonville, FL, USA 

S046 SAFETY, EFFICACY AND COST-EFFECTIVENESS OF COMMON LAPAROSCOPIC PROCEDURES Manish M Tiwari, MD PhD MPH, Jason F 

Reynoso, MD, Albert W Tsang, MD, Dmitry Oleynikov, MD FACS, Department of Surgery, University of Nebraska Medical Center, Omaha, NE 

V026 THE FEAR OF TRANSGASTRIC CHOLECYSTECTOMY: MISINTERPRETATION OF THE BILIARY ANATOMY Silvana Perretta, MD, Bernard 

Dallemagne, MD, Gianfranco Donatelli, MD, Didier Mutter, MD, Pierre Allemann, MD, Hurng-Sheng Wu, MD, Jacques Marescaux, MD, IRCAD, 

University Hospital of Strasbourg, France - Show Chwan Memorial Hospital, Changhua, Taiwan 

S047 LIFETIME MEDICATION COST-SAVINGS FOR TREATING HYPERTENSION AND DIABETES AFTER GASTRIC BYPASS Saber Ghiassi, MD 

MPH, John Morton, MD MPH, Dan Eisenberg, MD MS, Stanford school of medicine and Palo Alto VA Health Care System 

S048 MINILAPROTOMY APPROACH TO PERFORATED DUODENAL ULCER Tomonori Ohsawa, MD, Toru Ishiguro, MD, Norimichi Okada, MD, 

Keiichiro Ishibashi, PhD, Norihiro Haga, PhD, Hideyuki Ishida, PhD, Department of Digestive Tract and General Surgery, Saitama Medical 

Center, Saitama Medical Schoo 

V027 LAPAROSCOPIC MEDIAN ARCUATE LIGAMENT RELEASE FOR CELIAC ARTERY DECOMPRESSION Arthur Rawlings, MD MDiv, 

Margaret Frisella, RN, L. Michael Brunt, MD, Washington University 



10:00 AM - 1:00 PM 

Last Chance to Visit Exhibits, Posters, Learning Center Open 

Please note 1:00 PM Closing Time! 






11:00 AM - 11:30 AM 



Location: Potomac Ballroom C 

Agenda 

President’s Introduction 

Report of Ballots, Explanation of Bylaws Changes, Introduction of new Officers/Board Members 

Committee Reports 

Finance/Assets 

development 

Membership 

legislative 

publications / Journal 

Guidelines 

Flexible Endoscopy 

Endolumenal Task Force / NOTES® 

Educational Resources 

resident Education 

Continuing Education 

FLS & FES 

research & Career Development 

Quality, Outcomes & Safety 

program 

Technology & Web Task Force 

Global Affairs 

Military Working Group 

liaison Groups (Bariatric, Ethics, Pediatric) 

advisory Groups (Business Development, Communications, Industry Relations) 

Remarks by Incoming President 

C. Daniel Smith, MD 

Adrian Park, MD 

Jo Buyske, MD 

11:00 AM - 1:00 PM 

BREAK: Exhibits, Posters & Learning Center Open 

11:30 AM - 12:30 PM 

FREE Lunch in Exhibit Hall for all 

World Congress Scientific Session Registrants! 


Fellowship Council Luncheon 

The Future of Fellowships: How Will They Be Funded 

Chair: Adrian E. Park, M.D.; Co-Chair: Bruce D. Schirmer, M.D. 


Description: 

New guidelines in the funding of fellowships will pose great challenges to Program Directors and fellows alike. This session will bring our 

members up to date with the current status of fellowship funding and discuss options that may be available for the future. 

Objectives: 


• To understand the recent changes in industry that will affect fellowship funding 

• To learn of alternative funding approaches for MIS fellowships 

Schedule 

11:30 AM Introduction Adrian E. Park, M.D. & Bruce D. Schirmer, M.D. 

11:35 AM Non-ACGME Fellowships: How Many & What Types Are Out There?! Samer Matter, M.D. 

11:50 AM Current Funding of Non-ACGME Fellowships: A Variety of Options Daniel J. Scott, M.D. 

12:05 PM The Industry Perspective on Funding of Fellowships Pamela Martin (Ethicon) & Chuck Kennedy (Covidien) 


SAGES acknowledges an unrestricted educational grant in support of this session from Covidien. 





“Uh Oh! What Now?” Video Panel 

Chair: David R. Urbach, M.D.; Co-Chair: David B. Earle, M.D. 


This panel invovles interactive case presentations with video and still photos of intraoperative findings. Both the audience and the expert 

panel will weigh in on solutions to the problems. The audience will be able to interact with an audience response system, and microphones 

on the floor. The moderator will poll the expert panel, and review recent, pertinent literature related to the topic. 

Objectives: 


• Develop a strategy for emergent conversion to open surgery 

• Resolve an intraoperative exposure during single port cholecystectomy 

• Improve operative exposure during single port cholecsystectomy 

• Understand and implement strategies for controlling hemorrhage laparoscopically 

Schedule 

1:00 PM Introduction David R. Urbach, M.D. & David B. Earle, M.D. 

1:05 PM Leaking Anastomosis After Gastric Bypass John Romanelli, M.D. 

1:20 PM Laparoscopic Treatment of Ruptured Diverticulitis Morris Franklin, M.D. 

1:35 PM Enhancing Operative Exposure During Gastric Bypass with Larger Liver Daniel Birch, M.D. 

1:50 PM Enhancing Operative Exposure During Single Port Cholecystectomy L. Michael Brunt, M.D. 

2:05 PM Difficult Fundus Mobilization and Bleeding Short Gastrics During Foregut Surgery Allan Okrainec, M.D. 

2:20 PM Rapid Conversion to Open Surgery – Pro Sports Team or Circus Circus? David Earle, M.D. 



CAGS Simulation in the Training of Surgeons Session 

Chair: Liane S. Feldman, M.D.; Co-Chair: Teodor P. Grantcharov, M.D. 


While growing evidence supports the transfer of skills from the simulated to the operating room environment, barriers remain to its wide 

adoption and integration into clinical training practices. This session will review recent evidence supporting the use of simulation for surgical 

training (including integration in comprehensive curricula) and assessment (selection, certification, re-certification), as well as discuss current 

obstacles to implementation. 

Objectives: 


• Summarize the evidence supporting transfer of skills from the simulated to the operating room environment [competence] 

• List important factors required for effective teaching in the simulated environment [competence] 

• Integrate comprehensive simulation-based training and assessment curricula unto clinical training [performance] 

• Discuss what level of evidence is required for the use of simulation for certification [competence] 

• Apply the principles of objective assessment and evidence-based training to improve quality of surgical education at their center 

[outcomes] 

Schedule 

12:30 PM Introduction Liane S. Feldman, M.D. & Teodor P. Grantcharov, M.D. 

12:35 PM Transfer of Skills from the Simulation Lab to the Operation Room – What is the Evidence? Liane S. Feldman, M.D. 

12:50 PM How to Provide Effective Teaching in a Simulated Environment Karim Qayumi, M.D., Ph.D. 

1:05 PM Integrating Comprehensive Simulation-Based Curricula Into Clinical Training Teodor P. Grantcharov, M.D. 

1:20 PM Introducing Team Training Into Residency Training – 

What Can We Teach and How Can We Measure It? 

Daniel B. Jones, M.D. 

1:35 PM Simulation as a Tool for Certification – Are We Ready? Jo Buyske, M.D. 

1:50 PM Fulfilling the Promises of Simulation Training – What are the Obstacles? Carlos Pellegrini, M.D. 


















FES Roll-Out Session 

Chair: Brian J. Dunkin, M.D.; Co-Chair: Jeffrey M. Marks, M.D. 


This session will introduce the new FES testing program – the first validated test of flexible endoscopy skills. FES is modeled after FLS 

(Fundamentals of Laparoscopic Surgery) with web-based reference material, a written examination, and a hands-on skills test. The process for 

developing FES, data on its validation, and plans for making it available to the medical community will be described. 

Objectives: 


• Recognize the current requirements for endoscopic training 

• Describe the components of FES 

• Define the overall goals of FES 

Schedule 

1:00 PM Introduction Brian J. Dunkin, M.D. & Jeffrey M. Marks, M.D. 

1:05 PM The Numbers Game – Current Requirements for Training & Credentialing in Flexible Endoscopy John Mellinger, M.D. 

1:20 PM Why Create FES? – Inspiration and Timeline Brian J. Dunkin, M.D. 

1:35 PM What is FES – Web-Based Didactic Material, Cognitive Exam, Hands-on Skills Test Jeffrey M. Marks, M.D. 

1:55 PM How was FES Validated? – Cognitive Exam Benjamin Poulose, M.D. 

2:10 PM How was FES Validated? – Hands-on Skills Test Melina Vassilou, M.D. 

2:25 PM Future of FES – Linking to Clinical Performance, Requirement in Surgery Training Gerald Fried, M.D. 




1:00 - 2:00 PM SS11 Robotics Location: Maryland Ballroom B-D 

Moderators: Mehran Anvari, MD & Alessio Pigazzi, MD 

S049 ROBOTIC GASTRECTOMIES OFFER A SOUND ONCOLOGIC SURGICAL ALTERNATIVE FOR THE TREATMENT OF EARLY GASTRIC 

CANCERS COMPARING FAVORABLY WITH LAPAROSCOPIC RESECTIONS Yanghee Woo, MD, Kazuki Inaba, MD, Woo Jin Hyung, MD PhD, 

Sung Hoon Noh, MD PhD, Yonsei University Health System, Seoul Korea. Columbia University Medical Center , NY NY USA 

S050 NEUROERGONOMIC ASSESSMENT OF THE ROBOTIC ENHANCEMENT OF MINIMALLY INVASIVE SURGERY David James, MRCS 

MBBS BScHons, Felipe Orihuela-Espina, PhD, Daniel R Leff, PhD MRCS MBBS, George Mylonas, Ka-Wai Kwok, Ara W Darzi, KBE MD FACS 

FRCS, Guang-Zhong Yang, PhD, Dept Biosurgery and Surgical Technology and Royal Wolfson Royal Wolfson Image Computing Laboratory, 

Imperial College London, United Kingdom 

S051 ROBOTIC GASTRIC BYPASS: THE FUTURE OF BARIATRIC SURGERY? Chan W Park, MD, Edward Lam, BS, Cedric Lorenzo, MD, Kenric 

Murayama, MD, Racquel Bueno, MD, University of Hawaii, Queen’s Medical Center 

S052 A COMPARISON OF SHORT-TERM OUTCOMES FOR OPEN, LAPAROSCOPIC, AND ROBOT-ASSISTED RECTAL RESECTION FOR 

CANCER Gyu-Seog Choi, MD, Jun Seok Park, MD, Kyoung Hoon Lim, MD, You Seok Jang, MD, Soo Han Jun, MD, Department of Surgery, 

School of Medicine, Kyungpook National University, Daegu, Korea 

S053 MULTI-FUNCTIONAL ROBOT FOR LAPAROENDOSCOPIC SINGLE-SITE SURGERY Amy C Lehman, MS, Tyler D Wortman, BS, Kyle W 

Strabala, MS, Nathan A Wood, MS, Manish M Tiwari, MD, Matthew R Goede, MD, Shane M Farritor, PhD, Dmitry Oleynikov, MD, University of 

Nebraska-Lincoln, University of Nebraska Medical Center 

S054 ROBOTIC VS. CONVENTIONAL LAPAROSCOPIC GASTRIC BANDING: A COMPARISON OF 407 CASES Paula K Edelson, BSc, Kristoffel 

R Dumon, MD, Seema S Sonnad, PhD, Bilal M Shafi, MD, Noel N Williams, MD, Bariatric Surgery Program, Deptartment of Surgery, University 

of Pennsylvania School of Medicine 

1:00 - 3:00 PM SS12 Bariatric Location: Potomac Ballroom A-B 

Moderators: William Richards, MD & Alfons Pomp, MD 

S055 PROPHYLACTIC INFERIOR VENA CAVA FILTERS IN HIGH-RISK BARIATRIC SURGERY Khashayar Vaziri, MD, John D Watson, BS, Amy P 

Harper, MSN ACNPBC, Juliet Lee, MD, Fred Brody, MD, Shawn Sarin, MD, Elizabeth A Ignacio, MD, Albert Chun, MD, Anthony C Venbrux, MD, 

Paul P Lin, MD, The George Washington University Medical Center 

S056 B-TYPE NATRIURETIC PEPTIDE INCREASES AFTER GASTRIC BYPASS AND CORRELATES TO WEIGHT LOSS Eric Changchien, MD, 

Gavitt A Woodard, BS, Tina H Boussard, PhD, John M Morton, MD MPH, Stanford University 

S057 LAGB WITH TRUNCAL VAGOTOMY: ANY INCREASED WEIGHT LOSS? Kristen R Earle, MD, Matt B Martin, MD, Moses H. Cone Hospital 

Systems, Central Carolina Surgery, PA 

V028 LAPAROSCOPIC GASTRIC ACCESS FOR ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP) FOLLOWING ROUX- 

EN-Y GASTRIC BYPASS (RYGB) Sachin S Kukreja, MD, Matthew I Goldblatt, MD, James R Wallace, MD PhD, Froedtert Memorial Lutheran 

Hospital and the Medical College of Wisconsin 

S058 NUTRITIONAL EFFECT OF ORAL SUPPLEMENT ENRICHED IN BETA-HYDROXY-BETA -METHYLBUTYRATE, GLUTAMINE AND 

ARGININE ON RESTING METABOLIC RATE AFTER LAPAROSCOPIC GASTRIC BYPASS. R H Clements, MD, N Saraf, MPH, M Kakade, MPH, M 

White, RN, J Hackett, RN, Division of Gastrointestinal Surgery, University of Alabama at Birmingham, AL 




S059 DETERMINANTS OF RESOURCE UTILIZATION IN LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS: A MULTICENTER ANALYSIS OF 

6322 PATIENTS Prateek K Gupta, MD, Himani Gupta, MD, Weldon J Miller, MS, Robert A Forse, MD PhD, Creighton University Medical Center 

S060 GASTROJEJUNOSTOMY STENOSIS FOLLOWING LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS: 21 VS. 25-MM CIRCULAR 

STAPLER, A FOLLOW-UP STUDY OF LONG TERM WEIGHT LOSS. Carter T Smith, MD, Michael Garren, MD, Jon Gould, MD, University of 

Wisconsin School of Medicine and Public Health, Department of Surgery, Madison, WI, USA 

V029 SLEEVE GASTRECTOMY WITH ILEAL INTERPOSITION FOR TYPE 2 DIABETES Augusto C Tinoco, Luciana J El-Kadre, Renam Tinoco, 

São Jose do Avaí Hospital 

S061 EARLY GHRELIN AND GLP-1 CHANGES AFTER SLEEVE GASTRECTOMY IN DIABETIC OBESE PATIENTS. Nicola Basso, MD, Frida 

Leonetti, MD, Paola Mariani, MD, Mario Rizzello, PhD, Francesca Abbatini, MD, Giorgio Alessandri, MD, Giovanni Casella, MD, Danila 

Capoccia, MD, Gianluca Borgonuovo, MD, Maria L De Luca, MD, Policlinico “Umberto I”, University of Rome “Sapienza” 

S062 OUTCOMES OF LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS AS A PRIMARY VERSUS REVISIONAL BARIATRIC SURGERY. Balaji 

Jangam, MD, Kristine M O’Hara, MD, Bruce Bernstein, PhD, Ravi Chhatrala, MD, Ioannis Raftopoulos, MD PhD FACS, Bariatric Center at Saint 

Francis Hospital and Medical Center, Hartford, CT. 

S063 LONG-TERM RESULTS AFTER LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING IN ADOLESCENT PATIENTS. Gerd R Silberhumer, 

Karl Miller, Professor, Antonia Pump, Stefan Kriwanek, Professor, Kurt Widhalm, Professor, Gerhard Prager, Medical University Vienna, Austria; 


V030 LAPAROSCOPIC RESECTION OF AN OCCLUDED ROUX LIMB Frances Allocco, MD, Patrick Reardon, MD, Brian Dunkin, MD, Mohamed 

Saad, DO, The Methodist Hospital 

2:00 - 3:00 PM SS13 Research Grant Presentations Location: Maryland Ballroom B-D 

Moderators: Aurora Pryor, MD & Tehemton Udwadia, MD 

S064 COLLAGEN TYPE I/III RATIO IN THE SUPPORTING LIGAMENTS OF THE GASTROESOPHAGEAL JUNCTION IN PATIENTS WITH 

PARAESOPHAGEAL HERNIAS Shaun R Brown, DO, Lora Melman, MD, Eric D Jenkins, MD, Corey R Deeken, PhD, Margaret M Frisella, RN, 

L. Michael Brunt, MD, J. Christopher Eagon, MD, Brent D Matthews, MD, Department of Surgery, Section of Minimally Invasive Surgery, 

Washington University School of Medicine, Saint Louis, MO. Discussant: Alfredo Carbonell, D.O. 

S065 IN VIVO FLUORESCENCE IMAGING OF STAPHYLOCOCCUS AUREUS BIOLOGIC MESH INFECTION – A 30 DAY ANALYSIS Karem C 

Harth, MD MHS, Ann-Marie Broome, PhD, Michael R Jacobs, MD PhD, Jeffrey A Blatnik, MD, Michael J Rosen, MD, University Hospitals Case 

Medical Center. Discussant: Yuri Novitsky, MD 

S066 FIBRIN GLUE FOR INTRAPERITONEAL LAPAROSCOPIC MESH FIXATION: A COMPARATIVE STUDY IN A SWINE MODEL Namir 

Katkhouda, MD, Tatyan Clarke, MD, Jeffrey Algra, MD, Bon C Cheng, BA, Rodney J Mason, MD, Maryam Balouch, BS, Helen J Sohn, MD, 

Ashkan Moazzez, MD, Jaisa Olasky, MD, Thomas V Berne, MD, USC Keck School of Medicine, Department of Surgery, Los Angeles, CA, USA. 

Discussant: Namir Katkhouda, MD 

S067 INITIAL EXPERIENCE WITH SENTINEL LYMPH NODE BIOPSY FOR ESOPHAGEAL CANCER Sarah K Thompson, MD, Dylan 

Bartholomeusz, MBBS MD, Peter G Devitt, MBBS, University of Adelaide, Royal Adelaide Hospital, South Australia, Australia. 

Discussant: John Hunter, MD 

S068 THE SELF-APPROXIMATING TRANSLUMENAL ACCESS TECHNIQUE (STAT) RELIABLY PERMITS TRANSGASTRIC ORGAN RESECTION 

AND RETRIEVAL Eric M Pauli, MD, Jegan Gopal, MD, Matthew T Moyer, MD, Abraham Mathew, MD, Randy S Haluck, MD, Ann M Rogers, MD, 

Penn State Milton S. Hershey Medical Center. Discussant: Mark Talamini, MD 


3:00 - 4:00 PM SS14 Complications/Ergonomics/Instruments Location: Maryland Ballroom B-D 

Moderators: Maurice Arregui, MD & Aaron Fink, MD 

S069 SHORT-STAY SURGERY: WHAT REALLY HAPPENS AFTER DISCHARGE? Tung T Tran, MD, Pepa Kaneva, MSc, Nancy E Mayo, PhD, 

Gerald M Fried, MD, Liane S Feldman, MD, Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University, Montreal, Quebec, 

Canada 

V031 LAPAROSCOPIC HEPATICODUODENOSTOMY David J Kaczorowski, MD, Steven J Hughes, MD, University of Pittsburgh Medical Center 

S070 LAPAROSCOPIC APPENDECTOMY IS SAFE AND EFFICACIOUS IN THE ELDERLY: AN ANALYSIS USING THE NSQIP DATABASE. 

Michael J Kim, MD MA, Fergal J Fleming, MD, Douglas D Gunzler, MS MA, Susan Messing, MA MS, Rabih M Salloum, MD MPH, John R 

Monson, MD, University of Rochester 

V032 USE OF A NOVEL PERCUTANEOUS RETRACTION DEVICE AND MAGNETIC ANCHORING AND GUIDANCE SYSTEM (MAGS) HELPS 

RE-ESTABLISH THE CRITICAL VIEW AND IMPROVES SURGEON PERFORMANCE WHILE MIMICKING THE FOUR PORT TECHNIQUE IN 

SINGLE SITE LAPAROSCOPIC (SSL) CHOLECYSTECTOMY Rohan A Joseph, MD, Nilson A Salas, MD, Michael A Donovan, MS, Patrick R 

Reardon, MD, Barbara L Bass, MD, Brian J Dunkin, MD, Methodist Institute for Technology Innovation and Education (MITIE), Department 

of Surgery, The Methodist Hospital, Houston- TX 

S071 SINGLE SITE LAPAROSCOPIC (SSL) CHOLECYSTECTOMY IN HUMAN CADAVERS USING NOVEL PERCUTANEOUS RETRACTION 

AND A MAGNETIC ANCHORING AND GUIDANCE SYSTEM (MAGS): RE-ESTABLISHING THE CRITICAL VIEW Rohan A Joseph, MD, Nilson 

A Salas, MD, Michael A Donovan, MS, Patrick R Reardon, MD, Barbara L Bass, MD, Brian J Dunkin, MD, Methodist Institute for Technology 

Innovation and Education (MITIE), Department of Surgery, The Methodist Hospital,Houston- TX 

S072 LAPAROSCOPIC CHOLECYSTECTOMY POSES PHYSICAL INJURY RISK TO SURGEONS: ANALYSIS OF HAND TECHNIQUE AND 

STANDING POSITION Yassar Youssef, MD, Gyusung Lee, PhD, Carlos Godinez, MD, Erica Sutton, MD, Rosemary Klein, MA, Ivan George, 

Jacob Seagull, PhD, Adrian Park, MD, Sinai Hospital of Baltimore, MD, USA and University of Maryland Medical Center, Baltimore, MD, USA. 





3:00 - 5:00 PM SS15 Esophageal/Gastric Location: Potomac Ballroom D 

Moderators: Raul Rosenthal, MD & Estuardo Behrens, MD 

S073 EFFECTS OF NISSEN FUNDOPLICATION ON ABLATION OF BARRETT’S ESOPHAGUS WITH ENDOSCOPIC, ENDOLUMINAL 

RADIOFREQUENCY ABLATION Kathleen O’Connell, BS, Vic Velanovich, MD, Henry Ford Hospital, Detroit, Michigan 

S074 LAPARO-ENDOSCOPIC SINGLE SITE (LESS) HELLER MYOTOMY AND ANTERIOR FUNDOPLICATION FOR ACHALASIA Linda Barry, 

MD, Sharona B Ross, MD, Sujat Dahal, MD, Melissa Rosas, Chinyere Okpaleke, BS, Desiree Villadolid, MPH, Alexander S Rosemurgy, MD, 

Department of Surgery, University of South Florida, Tampa, Florida 

S075 DAY TO DAY DISCREPANCY IN BRAVO CAPSULE PH MONITORING: THE IMPACT OF MANOMETRIC PLACEMENT AND STATUS OF 

LOWER ESOPHAGEAL SPHINCTER Shahin Ayazi, MD, Jeffrey A Hagen, MD, Farzaneh Banki, MD, Joerg Zehetner, MD, Florian Augustin, MD, 

Helen J Sohn, MD, Steven R DeMeester, MD, John C Lipham, MD, Tom R DeMeester, MD, University of Southern California 

S076 REOPERATIVE ANTIREFLUX SURGERY FOR DYSPHAGIA Andras Legner, MD, Kazuto Tsuboi, MD, Lokesh Bathla, MD, Morrow E Lee, MD 

MS, Tommy Lee, MD, Sumeet K Mittal, MD FACS, Creighton University Medical Center Department of Surgery, Creighton University Medical 

Center Pulmonary and Critical Care Division 

S077 CAN DYSPHAGIA BE OBJECTIVELY CHARACTERIZED USING MULTICHANNEL INTRALUMINAL IMPEDANCE? Ushast Dhir, MD, Leena 

Khaitan, MD MPH, University Hospitals Case Medical Center 

V033 RECURRENT PARAESOPHAGEAL HERNIA WITH GASTROBRONCHIAL FISTULA: LAPAROSCOPIC REPAIR Brian P Jacob, MD, Anthony 

Vine, MD, Mark Reiner, MD, L. Brian Katz, MD, Mount Sinai Medical Center 

S078 LAPAROSCOPIC REPAIR OF LARGE HIATAL HERNIAS – IMPACT ON PULMONARY FUNCTION Jacqui C. Zhu, MBBS, Guillemo Becerril, 

MBBS, Gregory L. Falk, MBBS, Deptartment of Upper Gastrointestinal Surgery and Endosurgery, Concord Hospital 

S079 THE RISK OF RECURRENCE IN LAPAROSCOPY-ASSISTED RADICAL GASTRECTOMY Young-Joon Lee, PhD, Sang-Ho Jeong, MD, 

Soon-Tae Park, PhD, Sang-Kyung Choi, PhD, Soon-Chan Hong, PhD, Young-tae Joo, PhD, Chi-Young Jeong, MD, Hyeong-Gon Moon, MD, 

Woo-Song Ha, PhD, Department of Surgery, Gyeongsang National University Hospital, Gyeongnam Regional Cancer Center, Gyeongsang 

Institute of Health Sciences, Jinju, South Korea. 

S080 INTRAOPERATIVE INJECTION OF BUPIVACAINE TO THE DIAPHRAGMATIC CRURA SIGNIFICANTLY ELIMINATES THE NEED FOR 

OPIOIDS AFTER LAPAROSCOPIC NISSENS FUNDOPLICATION Ismail H Ozerhan, MD, Onur C Kutlu, MD, Yusuf Meker, MD, Sadettin Cetiner, 

MD, GATA Medical Academy Ankara Turkey, Etimesgut 600 Bed Army Hospital Etimesgut Ankara Turkey 

S081 OUTCOMES AFTER REPAIR OF THE INTRA-THORACIC STOMACH: OBJECTIVE FOLLOW-UP UP TO 5 YEARS Jai Bikhchandani, MD, 

Ona Gurney, F Yano, Tommy Lee, MD, Sumeet K Mittal, MD, Creighton University Medical Center 

S082 REOPERATIVE LAPAROSCOPIC PARAESOPHAGEAL HERNIORRAPHY CAN PRODUCE EXCELLENT OUTCOMES Albert W Tsang, MD, 

Manish M Tiwaria, MD PhD MPH, Jason F Reynoso, MD, Dmitry Oleynikov, MD, Department of Surgery, University of Nebraska Medical 

Center 

V034 TAILORED APPROACH TO MINIMALLY INVASIVE RESECTION OF GASTIRC GIST S. Al-Sabah, MD MBA, GM Fried, MD, MC Vassiliou, 

MD MEd, Y. Kurashima, MD PhD, LE Ferri, MD PhD, LS Feldman, MD, Steinberg- Bernstein Centre for Minimally Invasive Surgery and 

Innovation, McGill University Health Centre, Montreal, Canada 

3:00 - 5:00 PM SS16 Colorectal Location: Potomac Ballroom C 

Moderators: James Fleshman, MD & TBA 

S083 THE IMPACT OF SURGEON BEHAVIOR ON THE COST OF PERFORMING LAPAROSCOPIC APPENDECTOMY Ryan A Chandhoke, BS 

MS, Thomas Chu, BA, Paul C Smith, BA, Steven D Schwaitzberg, MD, Cambridge Health Alliance, Tufts University School of Medicine, Heller 

School for Social Policy & Management and Harvard Medical school 

S084 TRANSANAL ENDOSCOPIC MICROSURGERY VERSUS LAPAROSCOPIC RESECTIONS IN 100 T2-N0 RECTAL CANCERS FOLLOWING 

NEOADJUVANT TREATMENT: A PROSPECTIVE RANDOMIZED TRIAL WITH FIVE YEARS MINIMUM FOLLOW-UP Emanuele Lezoche, 

Professor Phd, Maddalena Baldarelli, MD, Massimiliano Rimini, MD, Alessandro Maria Paganini, Professor Phd, Roberto Campagnacci, MD, 

Mario Guerrieri, Professor, Department of Surgery University Politecnica delle Marche “Ancona” Italy 

S085 LAPAROSCOPIC VERSUS OPEN ELECTIVE SIGMOID RESECTION IN DIVERTICULAR DISEASE: SIX MONTHS FOLLOW-UP OF THE 

RANDOMIZED CONTROL SIGMA-TRIAL Bastiaan R Klarenbeek, MD, Roberto Bergamaschi, MD PhD FRCS, Alexander A Veenhof, MD, 

Donald L van der Peet, MD PhD, Wim T van der Broek, MD PhD, Elly S de Lange, PhD, Willem A Bemelman, MD PhD, Piet Heres, MD, Antonio 

M Lacy, MD PhD, Miguel A Cuesta, MD, VU University Medical Center, Amsterdam, The Netherlands; Forde Health System, Bergen University, 

Forde, Norway; Academic Medical Center, Amsterdam, The Netherlands; Waterland Hospital, Purmerend, The Netherlands; Hospital Clinic, 

Barcelona, Spain 

S086 TOTAL INTRACORPOREAL COLON SURGERY USING THE N.O.S.E. (NATURAL ORIFICE SPECIMEN EXTRACTION) TECHNIQUE. Morris 

E Franklin, MD, Karla Russek, MD, Allen Alvarez, MD, Texas Endosurgery Institute 

S087 SINGLE INCISION LAPAROSCOPIC TOTAL PROCTOCOLECTOMY WITH ILEOANAL ANASTOMOSIS: INITIAL OPERATIVE EXPERIENCE 

Daniel P Geisler, MD, Hasan T Kirat, MD, Feza H Remzi, MD, Department of Colorectal Surgery Cleveland Clinic Foundation 

V035 SINGLE PORT ANTERIOR RESECTION Hester Cheung, MD, Catherine Co, MD, Cliff Chung, MD, KK Yau, MD, Michael Li, Prof, Pamela 

Youde Nethersole Eastern Hospital 

S088 STAGED LAPAROSCOPIC ADJUVANT INTRAPERITONEAL CHEMOHYPERTHERMIA (IPCH) AFTER COMPLETE RESECTION FOR 

LOCALLY ADVANCED COLORECTAL OR GASTRIC CANCER Elie K Chouillard, MD, Poissy Medical Center (FRANCE) 

S089 A CASE CONTROL COMPARISON OF LAPAROSCOPIC (LX) AND OPEN (OP) APPROACH FOR THE SURGICAL MANAGEMENT OF 

SMALL BOWEL OBSTRUCTION (SBO) Eran Itzkowitz, MD, Yehuda Kariv, MD, Boaz Sagie, MD, Joseph Koriansky, MD, Joseph Klausner, MD, 

Tel Aviv Sourasky Medical Center, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 




S090 140 CASES EXPERIENCE OF SELF-EXPANDABLE METALIC STENT INSERTION FOR COLON AND RECTUM Yoshihisa Saida, MD, 

Toshiyuki Enomoto, MD, Kazuhiro Takabayashi, MD, Ayako Otsuji, MD, Yoichi Nakamura, MD, Miwa Katagiri, MD, Sayaka Nagao, MD, Shinya 

Kusachi, MD, Manabu Watanabe, MD, Koji ASAI, MD, Yasushi Okamoto, MD, Jiro Nagao, MD, Third Department of Surgery, Toho University 

Ohashi Medical Center 

S091 DO DIETARY SPICES IMPAIR THE PATIENT REPORTED OUTCOMES IN STAPLED HEMORRHOIDOPEXY ? A RANDOMIZED 

CONTROLLED STUDY Brij B Agarwal, MS, Kumar Manish, MBBS, Tapish Sahu, MBBS, Rathindra Sarangi, MS, Krishan C Mahajan, FRCS, Dr. 

Agarwal’s Surgery & Yoga and Sir Ganga Ram Hospital, New Delhi, India 

S092 IMPLEMENTATION OF COLONOSCOPIC PROCESS MEASURES: DOES IT IMPROVE QUALITY? Theodor Asgeirsson, MD, Anthony J 

Senagore, MD MBA FACS FASCRS, Martin A Luchtefeld, MD FASCRS, Spectrum Health Research, Michigan State University, Ferguson Clinic 

V036 THE ADVANTAGES OF LAPAROSCOPIC APPROACH FOR INTERSPHINCTERIC RESECTION M Hamada, MD, T Matsumura, MD, T 

Matsumoto, MD, F Teraishi, MD, K Ozaki, MD, T Nakamura, MD, Y Fukui, MD, Y Nishioka, MD, T Taniki, MD, T Horimi, MD, Kochi Health Sciences 

Center 

3:00 - 5:00 PM SS17 Best of Video 3 Location: Potomac Ballroom A-B 

Moderators: Roberto Gallardo, MD, Atul Madan, MD, Kenric Murayama, MD 

V037 LAPAROSCOPIC PARAESOPHAGEAL HERNIA REPAIR WITH BIOSYNTHETIC MESH AND COLLIS GASTROPLASTY Angel M Caban, 

MD, Daniel J Scott, MD FACS, UT Southwestern, Dallas Texas 

V038 LAPAROSCOPIC NISSEN FUNDOPLICATION: IT’S ROLE IN THE TREATMENT OF A FAILED ESOPHYX PROCEDURE Barry A Salky, MD 

FACS, The Mount Sinai Hospital, New York 

V039 LAPAROSCOPIC DUODENAL POLYPECTOMY WITH INTRAOPERATIVE ENDOSCOPY IN PEUTZ-JEGHERS SYNDROME Eugenius J 

Harvey, MBBS, Kervin Arroyo, MD, Blair Lewis, MD, Lester Katz, MD, Mount Sinai School of Medicine 

V040 SINGLE PORT ACCESS: A FEASIBLE ALTERNATIVE TO CONVENTIONAL LAPAROSCOPIC SPLENECTOMY EM Targarona, MD, C 

Balague, MD, L Pallares, MD, F Marinello, MD, C Rodriguez-Luppi, MD, C Martinez, MD, MP Hernandez, MD, M Trias, MD, Hospital Santpau, 

UAB, Barcelona, Spain. 

V041 USE OF A NOVEL, SELF-CONTAINED TISSUE RETRACTION DEVICE TO REDUCE TROCAR SITE NUMBER IN LAPAROSCOPIC AND 

NOTES-BASED SURGICAL PROCEDURES Trudie A Goers, MD, Richard A Pierce, MD PhD, Danny V Martinec, BS, Lee L Swanstrom, MD FACS, 

Legacy Health System, Portland, OR 

V042 AGAINST OCCAM’S RAZOR: TAP REPAIR OF RECURRENT INGUINAL HERNIA WITH CONCOMITANT INVERSION OF ORIGINAL 

POLYPROPYLENE PLUG Antonio D Lassaletta, MD, Erika Fellinger, MD, Steven D Schwaitzberg, MD FACS, Beth Israel Deaconess Medical 

Center, Cambridge Health Alliance, Harvard Medical School 

V043 LAPAROSCOPIC AND THORACOSCOPIC IVOR LEWIS ESOPHAGECTOMY Kazunori Sato, MD, Beemen N Khalil, MD, Pierre Theodore, 

MD, David Jablons, MD, Guilherme M Campos, MD, University of Wisconsin School of Medicine and Public Health and University of 

California San Francisco 

V044 LAPAROSCOPIC TREATMENT OF RECTOCELE BY ANTERIOR RECTOPEXY David Lechaux, PhD, Adrian Marius Nedelcu, Aurelie 

Lemarrec, MD, “Yves Le Foll’ Hospital - Saint Brieuc 

V045 LAPAROSCOPIC SPLEN-PANCREATECTOMY, FOR MUCINOUS PANCREATIC-CYST Jorge E Nefa, MD, Pablo E Omelanczuk, MD, Mario 

D Masrur, MD, Sergio E Bustos, MD, Surgical Service, Hospital Italiano, Mendoza-Argentina 

V046 LAPAROSCOPIC EXTIRPATION OF A FORK FROM THE DUODENUM Konrad W Karcz, MD, Birte Kulemann, MD, Gabriel J Seifert, MD, 

Hans J Schrag, MD, Simon Küsters, MD, Goran Marjanovic, MD, Jodok M Grüneberger, MD, Cheng Zhou, MD, Philipp Holzner, MD, Alexander 

Braun, MD, Videosurgery Division, Department of General and Abdominal Surgery, University Hospital Freiburg, Hugstetter Str 55, D-79106 

Freiburg, Germany 





All testing appointments must be made by April 9 – no onsite appointments available 


A Gentle Reminder About Safety/Security: 

We have taken every precaution to assure the safety and security of our guests and their possessions. 

However, we urge you to be aware and take simple steps to guard your possessions. 

– Do not leave your purse or briefcase unattended. 

– Do not leave your laptop, phone or other electronic devices on the floor or out of your sight in a darkened room 

– Be aware of your surroundings, in the Gaylord Hotel, in and around the National Harbor area and in Washington, DC. 







IFSES Surgical Education Around the World Panel 

Chair: Alberto Chousleb, M.D.; Co-Chair: Natan Zundel, M.D.; Co-Chair: Tatsuo Yamakawa 


Description: 

Each member society of IFSES has educational challenges as related to laparoscopic/endoscopic surgery. This session will feature a variety 

of educational issues amongst our member societies. How do we compare with each other? Can we offer similar solutions from different 

backgrounds? This is an international, star-studded cast to peak your interest in education. 

Objectives: 


• Realize the different ways and options for surgical education around the world 

• Explain how new technologies are being implemented and their impact in surgical training 

• Recognize what the widespread use of new technologies is in different parts of the world 

Schedule 

3:00 PM Introduction Alberto Chousleb, M.D. & Natan Zundel M.D. 

3:05 PM Telementoring and Telemedicine as an Educational Tool Mehran Anvari, M.D. 

3:15 PM Fellowship Training in the United States, Where Do We Stand? Steve Eubanks, M.D. 

3:25 PM Minimally Invasive Surgery Training in Latin America Samuel Shuchleib, M.D. 

3:35 PM How to Adapt Surgical Education to New Technology Sir Alfred Cuschieri, M.D. 

3:45 PM 3-D/Robotic Surgery as Emerging Technologies Current Applications and Near Future Expectation Seigo Kitano, M.D. 

3:55 PM Application of Advanced Minimally Invasive Techniques in Rural Areas Pradeep Chowbey, M.D. 


4:15 PM Training Residents Versus training Surgeons – Should They be Trained the Same? Michael Li, M.D. 

4:25 PM Should Single Incision Surgery, NOTES®, and Robotics Integrate the 

Current Surgical Curriculum or be Part of a Fellowship Program? 

Natan Zundel, M.D. 

4:35 PM What is the Role of International Surgical Societies in Education Gerald Marks, M.D. 

4:45 PM 1990 - 2010 Twenty Years of Minimally Invasive Surgery Extensive Development; 

present and Future of Their Educational Programs – A European Viewpoint 

Jacques Perissat, M.D. 


SAGES acknowledges educational grants in support of this World Congress panel from Covidien and Ethicon Endo-Surgery, Inc. 

Saturday Evening 

7:30 PM - 11:00 PM 

Don’t miss the World Congress Gala, 

Featuring Dinner & the International Sing-Off 

Location: Newseum. See page 94 for details. 

Shuttles begin departing at 7:15 PM at the Bus Pickup are of the Gaylord hotel ONLY. 

Go to the Group Bus Loading area, located at the Woodrow Wilson exit on the 2 nd level, 

opposite of guest parking. Buses will circle all evening until the event ends. 

To purchase tickets on-site, please visit the Registration Desk. 


Presenting…SAGES Media Madness! 

SAGES iMAGES Library 

SAGES SUR 

The SAGES Image Resource Library 

i MAGES at SAGES 

S-WIKI 

what does it do? 


iMAGES provides SAGES Members with 

access to various digital images, photos 

and graphics. All images are donated by 

SAGES Members to be used by other 

SAGES Members to advance education 

and excellence in minimally invasive 

surgery. 

Content may be uploaded, shared, downloaded, 

edited and used for publication 

and presentation by any SAGES member 

as long as appropriate credit is given to 

SAGES and the original submitter(s). 

S-WIKI is a surgical “Wikipedia” 

editable by all SAGES 

members. 

This has significant potential to 

become the most authoritative 

and frequently accesses 

surgical reference on the web. 

The SAGES Wiki will be open 

for public viewing but may be 

edited only by SAGES 

membership.

...Now available on sages.org 

GICAL WIKI 

SAGES Video Library 

tV 

Share your own videos 

with the Surgical Community. 

2010 

sages.org 


SAGES TV is a central “searchable and fully 

navigational” depository for SAGES related videos. 

SAGES members will be able to submit, view, and 

rate videos on the site. 

The SAGES Surgical WIKI 

SAGES TV is the new home for all official SAGES 

videos including the existing the classic SAGES 

video library and past SAGES meeting content. 

Features: 

· 305 free videos and counting 

· Narrated by leading laparoscopic surgeons 

· Free access with no registration required 

· Classic videos from 1995-2003 

· Keynote Lectures 

· SAGES PG Courses 

· And much more!!


2010 Learning Center Chair: Allan Okrainec, M.D.; Co-Chair: Brian Jacob, M.D. 

Hours of Operation: 

Thursday, April 15, 2010 10:00 AM - 2:30 PM 

Friday, April 16, 2010 10:00 AM - 2:30 PM 

Saturday, April 17, 2010 10:00 AM - 1:00 PM 

The Learning Center is a set of educational 

classrooms where attendees can gain 

knowledge and practice skills relevant to 

minimally invasive surgery. Station coordinators 

instruct individuals and small groups on topics 

that range from basic instrumentation to 

advanced laparoscopic skills. Participants may 

visit one or more stations that address their 

educational objectives and spend whatever 

time is necessary to meet their learning 

objectives 

1. Natural Orifice Transluminal 

Endoscopic Surgery (NOTES®) 

Coordinator: Kai Matthes, MD, PhD 

Natural Orifice Transluminal Endoscopic Surgery 

(NOTES®) is an emerging research area of 

minimally-invasive surgery. The development 

of new surgical procedures and devices can 

be simulated effectively in a training model. 

For the NOTES® Station of the SAGES learning 

center, a novel ex-vivo simulator is used to 

provide a realistic training experience using 

commercially available laparoscopic and flexible 

endoscopic devices. The ex-vivo model consist 

of a complete porcine peritoneal cavity explant, 

which is harvested from the meat production 

industry, thoroughly cleaned, embalmed and 

modified to closely resemble human anatomy. 

Real tissue provides a realistic tactile feedback, 

which is essential to assess and train new 

techniques such as NOTES®. Laparoscopic 

surgeons without flexible endoscopic 

experience can learn how to operate a flexible 

endoscope and how to establish transgastric, 

transvaginal or transcolonic access in order 

to perform a peritoneal exploration. For the 

more advanced ‘digestivists’ with flexible 

endoscopic experience, organ resection 

(appendectomy, cholecystectomy, distal 

pancreatectomy, nephrectomy, liver lobe 

resection, hysterectomy, oophorectomy) 

or gastrointestinal anastomosis techniques 

(gastrojejunostomy, partial gastrectomy, 

colectomy) will be simulated. 

Objectives: 

At the conclusion of this activity, the participant 

will be able to: 

• Perform transluminal access of the peritoneal 

cavity by using a transgastric, transcolonic 

or transvaginal approach using flexible 

endoscopes with or without laparoscopic 

assistance 

• Perform NOTES® appendectomy, 

cholecystectomy, distal pancreatectomy, 

nephrectomy, liver lobe resection, 

hysterectomy, oophorectomy 

• Perform a secure closure of the transluminal 

access port using various techniques such as 

t-tags, clips or sophisticated closure devices 

• Review the limitation of currently available 

standard endoscopic devices and the 

advantage of additional laparoscopic ports 

for visualization and retraction using a hybrid- 

NOTES® approach 

2. Single Incision Surgery: 

Entry Methods 

Coordinators: Gregg Kai Nishi, MD & 

Marina Kurian, MD 

Single incision or single port access is emerging 

as an optional technique for entry into the 

abdominal cavity to perform a variety of 

different laparoscopic procedures. To date, 

there is dominantly-preferred entry method, 

but instead a variety of options exist that 

include using multiple trocars through a single 

skin incision or using one of many specially 

designed single port access devices. At this 

station, you will become familiar with both 

options. A variety of low-profile trocars that 

are routinely used in single incision surgery 

will be available for use in an inanimate model. 

Additionally, you will be able to practice 

inserting and setting up a variety of single 

port access devices that are currently available 

for clinical use. By the end of your visit, you 

will be more familiarized with and more able 

to compare and contrast the different entry 

methods available to perform single incision 

surgery operations. 

Objectives: 



• Compare and contrast different entry 

methods available to perform single incision 

surgery operations 

• Demonstrate how to insert and set up a 

variety of single port access devices 

3. Single Incision Surgery: 

Instruments & Techniques 

Coordinators: Brian Jacob, MD, 

Greg Dakin, MD, & 

Julio Teixeiria, MD 

In conjunction with the single incision 

surgery Entry Methods Station, at this station 

participants will gain experience with the ability 

to perform single incisions procedures. The 

highlight of this station will be an opportunity 

to suture using single incision techniques in a 

trainer box and then to compare your skill to 

traditional laparoscopic suturing. Both straight 

instruments and articulating instruments will 

be compared. In addition, you will learn to 

insert liver and gallbladder retractors, and then 

practice performing different single incision 

tasks like suturing, running bowel, or dissecting. 

Participants will have the opportunity to use a 

variety of single incision surgery instruments. 

In addition, at this station, experts in the 

various single incision surgery procedures like 

lap adjustable gastric banding, gallbladder, 

colon, and hernia, will be showing videos 

that demonstrate their techniques and offer a 

unique one-on-one opportunity to learn and 

ask questions. 

Objectives: 



• Perform different single incisions tasks such as 

suturing, running bowel, or dissecting 

• Demonstrate how to insert and set up a 

variety of single port access devices 

4. Fundamentals of Laparoscopic 

Surgery 

Coordinator: Melina Vassiliou, MD 

This station will introduce participants to the 

Fundamentals of Laparoscopic Surgery (FLS) 

didactic and technical skills modules. FLS was 

designed to teach the physiology, fundamental 

knowledge, and technical skills required to 

perform basic laparoscopic surgery, and is a 

joint ACS-SAGES program. Participants will 

use the interactive web-based format and the 

lap trainer boxes to become familiar with the 

program while working on their laparoscopic 

knowledge and skills. This station will also give 

new program directors the opportunity to have 

hands-on time with the module and to learn 

about the Covidien Educational Fund. 

Objectives: 



• Describe the components of the FLS program 

• Explain some of the preoperative, 

intraoperative, and postoperative 

considerations fundamental to laparoscopic 

surgery 

5. Fundamentals of Endoscopic 

Surgery 

Coordinators: Brian Dunkin, MD & 

Thadeus Trus, MD 

Come get hands-on experience in flexible 

endoscopy. This station will showcase the newly 

developed Fundamentals of Endoscopic Surgery 

(FES) testing platform (the flexible endoscopy 

equivalent of FLS) - the first validated hands-on 

test for gastrointestinal endoscopic skills. FES 

will be loaded on a Simbionix virtual reality 

simulator for you to “test drive”. Finally, video 

based education material is available to review 

the new SAGES flexible endoscopy hands-on 

training curriculum and preview the developing 

FES website. 

This is your chance to practice your endoscopic 

skills with the help of expert proctors, or throw 

your hat into the ring to pit your skills against 

others in an FES shootout. The winner of the 

FES shootout will receive a SAGES Top 14 DVD 

video set. 

Objectives: 



• Evaluate the FES manual skills testing module 

• Assess his/her flexible endoscopy skills 

• Develop basic endoscopic skills on virtual 

reality and real tissue simulation platforms 

• Evaluate the SAGES flexible endoscopy handson 

training curriculum 


2010 Learning Center 

6. Laparoscopic Ventral Hernia 

and Inguinal Hernia Repair 

Coordinator: Adrian Park, MD, 

Yo Kurashima, MD, 

Gerald Fried, MD 

The laparoscopic ventral hernia repair 

has become a very commonly performed 

procedure. Both virtual reality and box trainer 

hernia modules will allow participants to 

practice and become facile with this technique. 

This station will also feature new simulation 

models for laparoscopic inguinal hernia repair. 

Participants will gain experience with the steps 

of the procedures, as well as positioning and 

securing the mesh. 

Objectives: 



• To learn normal anatomic relationships. 

• Practice mesh deployment and securing 

techniques. 

7. Suturing 

Coordinators: Zoltan Szabo, PhD & 

Neal Seymour, MD 

Participants receive intense hands-on suturing 

including intracorporeal techniques with 

instantaneous feedback. Laparoscopic tissue 

handling and complex suturing maneuvers will 

also be demonstrated. Virtual reality suturing 

simulators will be used to allow “virtual” 

suturing practice – no suture required, just a 

fancy videogame with needle driver handles 

instead of joysticks. Trainees will be able to 

compare their scores with established expert 

levels for both types of simulators. 

Objectives: 



• To describe the key steps for intracorporeal 

suturing and knot-tying. 

• To practice intracorporeal suturing and 

knot-tying in inanimate and virtual reality 

environments. 

• To demonstrate proficiency compared to 

“experts”. 

8. Top Gun 

Coordinator: James “Butch” Rosser, MD 

The Top Gun Laparoscopic Skill Shootout Station 

will allow participants to establish and enhance 

basic laparoscopic skills and suturing ability. 

All participants can gain skill advancement 

no matter their baseline. The station will 

feature the validated “Rosser TOP GUN” skill 

development stations developed by Dr. Rosser 

and made famous at Yale. To date, over 6000 

surgeons have participated around the world. 

Instructors will show tactics and techniques 

that will transfer readily into the clinical 

environment. In addition, participants will be 

competing for slots in the Top Gun Shoot Out 

that will crown one SAGES 2010 TOP GUN. 

Objectives: 



• To review the Rosser suturing algorithm and 

be able to list and recite 

• To perform dexterity skills and suturing 

excercises using the “Rosser TOP GUN” training 

stations 

• To perform with other surgeons in the Top 

Gun Shoot Out (no CME credits will be given 

for this competition) 

9. Laparoscopic Common Bile 

Duct Exploration 

Coordinator: Benjamin Poulose, MD, 

Brian Katz, MD 

At this station, participants will gain exposure 

to the laparoscopic transcystic method of 

common bile duct stone management. The 

station utilizes the latest in inanimate model 

technology to simulate an actual situation for 

the management and retrieval of common bile 

duct stones. 

Objectives: 



• Identify the indications for laparoscopic 

common bile duct exploration. 

• Describe the necessary equipment utilized 

during laparoscopic transcystic common bile 

duct exploration including common bile duct 

access instrumentation, choledochoscopy, 

and stone retrieval methods. 

• Work as part of a simulated operating room 

team to perform laparoscopic transcystic 

common bile duct exploration. 

10. Intraoperative Ultrasound 

Coordinator: Leonardo Villegas, MD & 

David Sindram, MD 

This station will focus on Intraoperative 

Ultrasound techniques and applications. 

Participants will use the latest ultrasound 

technology with a new inanimate phantom 

that was developed to mimic the ultrasound 

properties of abdominal organs. Instructors will 

demonstrate and help participants perform 

intraoperative ultrasound for liver, biliary and 

pancreatic disease, as well as discuss their 

surgical applications. 

Objectives: 

• To describe basic ultrasonography techniques. 

• To describe how ultrasound may be used 

to diagnose and treat biliary and pancreatic 

disease. 

11. Laparoscopic Weight Loss 

Surgery 

Coordinator: Shanu Kothari, MD & 

John Morton, MD 

The learning curve for gaining proficiency in 

weight-loss procedures may be shortened 

with an effective simulator. The Laparoscopic 

Adjustable Gastric Band Simulator allows 

participants to introduce a laparoscopic 

adjustable band, “run” the tubing, place the 

band in its correct anatomic position, and fixate 

the port into the subcutaneous tissue. The 

technical aspects of laparoscopic adjustable 

gastric band placement may be enhanced by 

simulation and allow a greater preprocedural 

understanding for the trainee and expert alike. 

A virtual laparoscopic gastric bypass trainer will 

similarly allow for participants to familiarize 

themselves with the steps and techniques 

necessary to perform gastric bypass. 

Objectives: 



• To review laparoscopic adjustable gastric 

band anatomy, structure, and function. 

• To describe the basic steps of placing a 

laparoscopic adjustable gastric band. 

• To explain the steps and techniques necessary 

to perform laparoscopic gastric bypass 

surgery. 

(Please note this does not meet the FDA 

requirements for qualifications to perform lap 

band surgery) 

12. Robotic Surgery 

Coordinators: Dmitry Oleynikov, MD & 

Matt Goede, MD 

Surgical robotic systems allow for the 

surgeon to comfortably sit at a console and 

ergonomically manipulate and control the 

robotic arms and instruments. This offers the 

surgeon increased range of motion, threedimensional 

imaging, the benefit of motion 

scaling, as well as eliminating tremor. The 

purpose of this station will be to all participants 

to have hands-on exposure to the latest 

technologies in robotic surgery. Participants 

will be able to perform various simulated tasks 

using a surgical robot. Additionally, new invivo 

robots, including deployable robotically 

controlled laparoscopic visualization systems 

will be demonstrated. 

Objectives: 



• Perform various simulated tasks using a 

surgical robot 

• Identify latest technologies in robotic surgery 

13. Video Editing 

Coordinators: Adheesh Sabnis, MD, 

Yuri Novitsky, MD 

The presentation of surgical videos is now 

an integral component of scientific meetings 

both for educational reasons, as well as for the 

demonstration of new techniques. The purpose 

of this station will be to learn the basic tools 

needed for capturing video in the operating 

room, and become familiar with the various 

software available for video editing on both PC 

and Mac platforms. Participants will have the 

opportunity to perform basic video editing of 

short videos as the station. 




2010 Learning Center 

Objectives: 



• Identify basic tools needed to capture video 

in operating room 

• Perform basic video editing of short videos 

14. Team Simulations 

Coordinator: Shawn Tsuda, MD 

Team training is on the forefront of the 

surgical simulation revolution. Patient safety, 

health care cost, decreased training time, and 

advances in learning theory are driving forces 

for the optimization of multi-disciplinary team 

performance in a safe environment. This station 

will feature a mock endosuite that will allow 

surgeons to plan, execute, debrief, and improve 

upon best practices during surgery, with a focus 

on cost-containment, compliance, and quality 

of care. 

Objectives: 



• utilize team-based concepts in optimizing 

time, compliance, performance, and quality 

during a common surgical procedure 

• become familiar with technology and 

techniques in team-based training, including 

video-capture and debriefing 

• simulate a laparoscopic cholecystectomy in a 

mock endosuite 

15. Patient Safety 

Coordinator: Gretchen Purcell Jackson, MD, 

PhD & Joshua Glenn, MD 

The last decade has seen increasing emphasis 

on patient safety and quality of care from 

government agencies, regulatory bodies, 

and payers. At this station, participants can 

explore a variety topics related to surgical 

SAGES acknowledges educational grants in support of this World Congress educational venue from: 

Aloka Ultrasound, B-K Medical Systems, Covidien and Olympus. 

patient safety including proper use of 

operative instrumentation, informed consent, 

care-team communications, and avoiding 

malpractice lawsuits through videos, webbased 

instructional modules, and interactive 

instruction. 



• Identify critical patient safety issues relevant 

to the practicing surgeon 

• Enumerate educational resources for learning 

about surgical patient safety 

• Demonstrate competencies in one or more 

areas of patient safety 

SAGES acknowledges contributions in-kind in support of this World Congress educational venue from: 

3-DMED, Allergan, Aloka Ultrasound, Apollo Endosurgery, B-K Medical Systems, Cambridge Endoscopy, Carefusion, 

Covidien, Endosim, Ethicon Endo-Surgery, Inc., Ethicon Inc., Gore & Associates, Karl Storz Endoscopy-America, Kyoto Kagaku, 

Novare Surgical Systems, Olympus, Ovesco, Simbionix, Simulab and Stryker Endoscopy. 

d 


World Congress Invited Faculty List 

Gina L. Adrales, MD, Assistant Professor, 

Dartmouth Medical School, Dartmouth- 

Hitchcock Medical Center, Lebanon, NH 

Luigi Angrisani, MD, Consultant surgeon, 

University of Naples Federico II, Laparoscopic 

Surgery Unit, S.Giovanni Bosco Hospital, 

Napoli, Italy 

Mehran Anvari, MD, Professor of Surgery, 

McMaster University, Hamilton, ON, Canada 

Maurice E. Arregui, MD, Chairman 

Department of General Surgery, Director of 

Adult MIS, Director of Fellowship in Advanced 

La, St. Vincent Hospital, Indianapolis, IN 

Horacio J. Asbun, MD, Director of 

Hepatobiliary and Pancreas Program, Mayo 

Clinic Florida, Mayo Clinic, Jacksonville, FL 

Sharon L. Bachman, MD, Assistant Professor 

of Clinical Surgery, University of Missouri, 

Columbia, MO 

Fady Kamal Balaa, MD, Assistant Professor 

of Surgery, University of Ottawa, The Ottawa 

Hospital, Ottawa, ON, Canada 

Katherine A. Barsness, MD, Assistant 

professor of Surgery, Northwestern 

University’s Feinberg School of Medicine, 

Attending physician, Pediatric Surgery, 

Northwestern University, Chicago, IL 

Bruce Behn, MD, Ergen Professor and CBER 

Faculty Fellow, The University of Tennessee, 

Knoxville, TN 

Estuardo J. Behrens, MD, FACS, General 

Surgeon / Bariatric Surgeon, Hospital de las 

Américas, Miami, FL 

Richard H. Bell, MD, Assistant Executive 

Director, The American Board of Surgery, Inc., 

Philadelphia, PA 

Simon Bergman, MD, Assistant Professor 

of Surgery, McGill University, Faculty, 

Department of Surgery and Associate 

Member, Division of Gastroenterology, Sir 

Mortimer B Davis Jewish General Hospital, 

Montreal, PQ, Canada 

Ramon Berguer, MD, FACS, Clinical Professor 

of Surgery, University of California Davis, Chief 

of Surgery, Contra Costa Regional Medical 

Center, Martinez, CA 

Marc Bessler, MD, Assistant Professor of 

Surgery, Columbia University, Director 

Minimal Access Surgery Center, New York 

Presbyterian Hospital, New York, NY 

Daniel W. Birch, MD, Associate Professor 

of Surgery, University of Alberta, Medical 

Director, CAMIS, Royal Alexandra Hospital, 

Edmonton, AB, Canada 

Desmond H. Birkett, MD, Clinical Professor of 

Surgery, Tufts University School of Medicine, 

Chairman, Department of General Surgery, 

Lahey Clinic Medical Center, Burlington, MA 

Simon Biron, MD, Professor, Laval University, 

Director General Suregery Division, Laval 

University, Quebec City, Quebec, Canada 

Steven P. Bowers, MD, Assistant Professor, 

Mayo Clinic, Florida, Senior Associate 

Consultant, Mayo Clinic, Jacksonville, FL 

Fredrick J. Brody, MD, Associate Professor of 

Surgery, The George Washington University 

Medical Center, Director of Minimally Invasive 

Surgery, Washington, DC 

L. Michael Brunt, MD, Professor of Surgery, 

Washington University School of Medicine, 

Barnes-Jewish Hospital, St Louis, MO 

Matias Bruzoni, MD, Palo Alto, CA 

Luis E. Burbano, MD, Professor of Surgery, 

Metropolitan Hospital Quito, Ecuador, Quito, 

Ecuador 

Jo Buyske, MD, Adjunct Professor of Surgery, 

University of Pennsylvania School of Medicine, 

Associate Executive Director, American Board 

of Surgery, Philadelphia, PA 

Ronan A. Cahill, MD, Oxford Radcliffe 

Hospitals, John Radcliffe Hospital, Sh’llorgan, 

Dublin, Ireland 

Alfredo M. Carbonell, DO, Assistant 

Professor of Clinical Surgery, University of 

South Carolina School of Medicine, Division 

of Minimal Access and Bariatric Surgery, 

Greenville Hospital System University Medical 

Cent, Greenville, SC 

Bipan Chand, MD, Director of Surgical 

Endoscopy, Cleveland Clinic Foundation, Staff 

Surgeon, Cleveland Clinic Hospital, Cleveland, 

OH 

Elie Chouillard, MD, President, 

Intercontinental Society of Natural Orifice, 

Endoscopic, and Laproscopic Surgery 

(i-NOELS), Chief of Surgery, Poissy-Saint- 

Germain-En-Laye Medical Center, Poissy, 

France 

Elias Chousleb, MD, Clinical Fellow, Cleveland 

Clinic Florida, Hallandale Beach, FL 

Alberto Chousleb, MD, Chief Experimental 

Surgery, ABC Medical Center, Medical Director, 

ABC Medical Center, Mexico, Mexico City, 

Mexico 

Pradeep K. Chowbey, MD, Chief of Surgery, 

Director, Max Healthcare Institute, New Delhi, 

India 

W. Y. Chung, MD, Yonsei University College of 

Medicine, Seoul, Seodaemun-gu, South Korea 

Ronald Hanson Clements, MD, Professor of 

Surgery, University of Alabama-Birmingham, 

Director Bariatric Surgery, University Hospital, 

Nashville, TN 

Ricardo V. Cohen, MD, Director, The Center for 

the Surgical Treatment of Morbid Obesity and 

Metabolic Disorders, Baros Surgical Associates, 

Sao Paulo, Brazil 

Manolo Cortez, MD, Medical Doctor, 

International University of Ecuador, General 

& Bariatric Surgeon, Metropolitano Hospital, 

Quito, Ecuador 

David Cummings, MD, Professor of Medicine, 

University of Washington, Deputy Director, 

Diabetes Endocrinology Research Center, 

University of Washington, Seattle, WA 

Christopher Cunningham, MD, Consultant 

Colorectal Surgeon, Oxford Radcliffe 

Hospitals, Oxford, United Kingdom 

Paul G. Curcillo II, MD, Associate Professor & 

Vice Chairman of Surgery, Drexel University, 

Director, Robotics and Minimally Invasive 

Surgery, Flourtown, PA 

Alfred Cuschieri, MD, Professor Sir, University 

of Dundee, Sir Alfred, Institute for Medical 

Science and Technology, Dundee, Scotland, 

United Kingdom 

Allan Dackiw, MD, Assistant Professor of 

Surgery, Johns Hopkins University, Baltimore, 

MD 

Gregory F. Dakin, MD, Assistant Professor 

of Surgery, Weill Cornell Medical College, 

Attending Surgeon, New York Presbyterian 

Hospital, New York, NY 

Bernard Dallemagne, MD, Scientific 

Co-Director, Digestive Cancer Research 

Institute (IRCAD), MD, University Hospital of 

Strasbourg, Strasbourg - France, Strasbourg, 

France 

Aureo L. De Paula, MD, Hospital de 

Especialidades, Goiania, Goias, Brazil 

Edmundo Dedios Orozco, MD, General 

Surgeon, Universidad Nacional , Chief 

Surgeon, Hospital II EsSalud , Piura, Peru 

Conor P. Delaney, MD, PhD, Professor of 

Surgery, Case Western Reserve University, 

Chief, Division of Colorectal Surgery, 

University Hospitals Case Medical Center, 

Cleveland, OH 

Nicolas Demartines, MD, Professor , University 

of Lausanne, Switzerland, Chairman, 

University Hospital CHUV, Lausanne, 

Switzerland, Switzerland 

Daniel J. Deziel, MD, Professor of Surgery, 

Rush University, Senior Attending Surgeon, 

Rush University Medical Center, Chicago, IL 

Andre Dhoore, MD, Professor, University 

Hospital Leuven Belgium, UZ Gasthuisberg, 

Leuven, Belgium 

Robert DiRaddo, MD, Group Leader, 

Simulation of Deformable Materials, Industrial 

Materials Institute, National Research Council 

Canada, Boucherville, Québec, Canada 

Quan-Yang Duh, MD, Professor, University of 

California, San Francisco, Attending Surgeon, 

VA Medical Center, San Francisco, San 

Francisco, CA 

Brian J. Dunkin, MD, Professor of Clinical 

Surgery, Weill Cornell Medical College, Head, 

Section of Endoscopic Surgery, The Methodist 

Hospital, Houston, TX 

Sanjeev Dutta, MD, Assistant Professor, 

Stanford University, Lucile Packard Children’s 

Hospital, Stanford, CA 





David Bryan Earle, MD, Assistant Professor of 


Director of Minimally Invasive Surgery, 

Baystate Medical Center, Springfield, MA 

Steven Edmundowicz, MD, Professor of 

Medicine, Washington University, Chief of 

Endoscopy, Barnes Jewish Hospital, St. Louis, 

MO 

Michael B. Edye, MD, FACS, Adjunct Associate 

Professor of Surgery, Mount Sinai School of 

Med, Attending, The Mount Sinai Hospital, 

New York, New York, NY 

Jonathan E. Efron, MD, Associate Professor 

of Surgery, Mayo Clinic College of Medicine, 

Consultant Surgeon, Mayo Clinic Arizona, 

Scottsdale, AZ 

Steve Eubanks, MD, Professor, University of 

Missouri- Columbia, University of Missouri- 

Columbia, Columbia, MO 

Liane S. Feldman, MD, Associate Professor of 

Surgery, McGill University, surgeon, McGill 

University Health Centre, Montreal, PQ, 

Canada 

Edward L. Felix, MD, Assistant Clinical 

Professor of Surgery UCSF, UCSF- Fresno, 

Director of Bariatric Surgery, Clovis Hospital, 

Fresno, CA 

John J. Feng, MD, Director, Bariatric Surgery, 

Sequoia Hospital, Redwood City, CA 

David Field, CFA, Chicago, IL 

Abe L. Fingerhut, MD, Professor, College 

de médecins de Paris, past chief of Surgery, 

Centre Hospitalier Intercommunal, Poissy, 

France 

Aaron S. Fink, MD, Professor, Department of 

Surgery, Emory University School of Medicine, 

VISN Chief Surgical Consultant, VAMC - 

Atlanta, Decatur, GA 

Jean Bernard Flament, MD, 1st Class 

Professor, University Hospital of Rheims, Staff 

Surgeon, Hopital Robert Debre, France 

James W. Fleshman, MD, Professor of Surgery, 

Chief Section of Colon and Rectal Surgery, 

Washington University in St. Louis, St Louis, 

MO 

Roberto Fogel, MD, Endoscopic Specialist, 

Jackson South Hospital, Miami, FL 

Kenneth A. Forde, MD, Jose M. Ferrer 

Professor Emeritus of Surgery, Columbia 

University, Dobbs Ferry, NY 

Dennis L. Fowler, MD, Professor of Clinical 

Surgery, Columbia University College of 

Physicians and Surgeons, NA, NA, Boston, MA 

Morris E. Franklin Jr, MD, Director, Texas 

Endosurgery Institute, General Surgeon, 

Southeast Baptist Hospital, San Antonio, TX 

Gerald M. Fried, MD, Adair Family Professor 

and Chairman, Department of Surgery, McGill 

University Faculty of Medicine, Surgeonin-Chief, 

McGill University Health Centre 

Hospitals, Montreal, PQ, Canada 

Karl H. Fuchs, MD, Prof. Dr., Goethe University 

Frankfu, Markus-Krankenhaus, Frankfurt, 

Germany 

Daniel J. Gagne, MD, Clinical Associate 

Professor of Surgery, Temple University School 

of Medicine, Director of Bariatric Surgery, The 

Western Pennsylvania Hospital, Pittsburgh, PA 

Michel Gagner, MD, Clinical Professor of 

Surgery, Florida International University, 

Chairman, Department of Surgery, Mount 

Sinai Medical Center, Scarsdale, NY 

Roberto Gallardo, MD, President of ALACE 

/ President of FECCAP, ALACE Asociación 

Latinoamericana de Cirujanos Endoscopistas 

AND FECCAP Federacion de Cirugia de 

Centroamerica y Panamá, Titular Surgeon, 

Sanatorio Nuestra Señora del Pilar , Ciudad De 

Guatemala, Guatemala 

Alex Gandsas, MD, Professor of Surgery, 

UMDNJ-SOM, Chairman, Department of 

Surgery, UMDNJ - SOM, Statford, NJ 

Brice Gayet, MD, Professor of surgery, 

Université Paris Descartes, Head of 

department, Institut Mutualiste Montsouris 

(IMM), Paris, France 

Daniel P. Geisler, MD, Associate Professor, 

Cleveland Clinic Foundation, Cleveland, OH 

Keith E. Georgeson, MD, Professor of Surgery, 

University of Alabama School of Medicine, 

Director, Division of Pediatric Surgery, The 

Children’s Hospital of Alabam, Birmingham, AL 

Alec Glover, MBA, Palo Alto, CA 

Matthew Randall Goede, MD, Assistant 

Professor of Surgery, University of Nebraska 

Medical Center, Omaha, NE 

Christopher J. Gostout, MD, Professor of 

Medicine, Mayo Clinic School of Medicine, 

Director of Developmental Endoscopy, Mayo 

Clinic, Rochester, MN 

Teodor P. Grantcharov, MD, Assistant 

Professor, University of Toronto, Staff Surgeon, 

St. Michael’s Hospital, Toronto, ON, Canada 

Casey J. Graybeal, MD, Northeast Georgia 

Medical Center, Gainesville, GA, Gainesville, 

GA 

Frederick L. Greene, MD, Clinical Professor of 

Surgery, University of North Carolina School of 

Medicine, Chairman, Department of Surgery, 

Carolinas Medical Center, Charlotte, NC 

Andrew A. Gumbs, MD, Assistant Professor 

of Surgery, Fox Chase Cancer Center, Director 

of Minimally Invasive HPB Surgery, Fox Chase 

Cancer Center, Philadelphia, PA 

Peter T. Hallowell, MD, Assistant Professor, 

University of Virginia, Staff, University of 

Virginia Health System, Charlottesville, VA 

Erik N. Hansen, MD, Senior Pediatric 

Surgery Resident, University of Alabama 

at Birmingham, The Children’s Hospital of 

Alabama, Birmingham, AL 

Carroll M. Harmon, MD, Professor of Surgery, 

Division of Pediatric Surgery, University of 

Alabama at Birmingham, Pediatric Surgeon, 

Children’s Hospital of Alabama, Birmingham, 

AL 

Kristi Lee Harold, MD, Associate Professor 

of Surgery, Mayo Clinic Arizona, Director 

of Minimally Invasive Surgery, Mayo Clinic 

Arizona, Phoenix, AZ 

Jeffrey W. Hazey, MD, Associate Professor of 

Surgery, The Ohio State University, Attending 

Surgeon, The Ohio State University Medical 

Center, Columbus, OH 

David Hazzan, MD, Director, Minimally 

Invasive Surgery, Carmel Medical Center, 

Haifa, Israel 

B. Todd Heniford, MD, Professor, University 

of North Carolina, Chief, Division of 

Gastrointestinal and Minimally Invasive 

Surgery, Carolinas Medical Center, Charlotte, 

NC 

Miguel Herrera, MD, Profesor of Endocrine 

/ Minimally Invasive Surgery, Universidad 

Nacional Autónoma de México, Attending 

Surgeon, Instituto Nacional de la Nutrición, 

Mexico DF, Mexico 

Daniel M. Herron, MD, Associate Professor 

of Surgery, Mount Sinai School of Medicine, 

Chief, Bariatric Surgery, Mount Sinai Medical 

Center, New York, NY 

Kelvin D. Higa, MD, Clinical Professor of 

Surgery, UCSF, Director of Minimally Invasive 

and Bariatric Surgery, Fresno Heart and 

Surgical Hospital, Fresno, CA 

Jacques M. Himpens, MD, Vinderhoute, OV, 

Belgium 

Michael D. Holzman, MD, Lester & Sara 

Jayne Williams, Chair of Academic Surgery; 

Associate Professor of Surgery, Vanderbilt 

University, Vanderbilt University Medical 

Center, Nashville, TN 

Santiago Horgan, MD, Professor of Surgery., 

University of California San Diego, Director 

Minimally Invasive Surgery, UCSD Medical 

Center, San Diego, CA 

Eric Steven Hungness, MD, Assistant Professor 

of Surgery, Northwestern University, Chicago, 

IL 

John Hunter, MD, Mackenzie Professor and 

Chair, Dept. of Surgery, Oregon Health & 

Science University, Portland, OR 

Matthew M. Hutter, MD, Assistant Professor, 

Harvard Medical School, Director, Codman 

Center for Clinical Effectiveness in Surgery, 

Mass. General Hospital, Boston, MA 

Sayeed Ikramuddin, MD, Director, Bariatric 

Surgery, University of Minnesota, Co-Director, 

Center for Minimially Invasive Surgery, 

University of Minnesota, Minneapolis, MN 

William Barry Inabnet III, MD, FACS, 

Associate Professor of Clinical Surgery, 

Columbia University, New-York Presbyterian , 

New York, NY 



Haruhiro Inoue, MD, Professor, Digestive 

Disease Center, Showa University Northern 

Yokohama Hospital, Professor, Digestive 

Disease Center, Showa University Northern 

Yokhama Hospital, Japan 

Gretchen Purcell Jackson, MD, Assistant 

Professor of Surgery and Biomedical 

Informatics, Vanderbilt University, Assistant 

Professor of Surgery, Monroe Carell Jr. 

Children’s Hospital at Vanderbil, Nashville, TN 

Brian P. Jacob, MD, Attending, Assistant 

Clinical Professor of Surgery, Mt. Sinai 

Hospital, New York, NY 

Garth R. Jacobsen, MD, Assistant Professor, 

UCSD, Rancho Santa Fe, CA 

Christopher Jamieson, MD, Professor, Dept of 

Surgery., Dalhousie University, Staff Surgeon, 

Victoria General Hospital 

Blair A. Jobe, MD, Professor of Surgery , 

University of Pittsburgh , Surgeon, UPMC 

Shadyside, Pittsburgh, PA 

Daniel Bougere Jones, MD, Associate 

Professor, Harvard Medical School, Chief, 

Minimally Invasive Surgical Services; 

Director,Simulation and Skills Center; 

Director, Ba, Beth Israel Deaconess Medical 

Center, Boston, MA, USA 

Matthew F. Kalady, MD, Staff Surgeon, 

Cleveland Clinic, Cleveland Heights, OH 

Timothy D. Kane, MD, Assistant Professor of 

Surgery, University of Pittsburgh School of 

Medicine, Pediatric Surgeon; Clinical Director 

/ Div. of Pediatric Gen. & Thoracic Surgery; 

Director, Minimall, Children’s Hospital of 

Pittsburgh of UPMC, Pittsburgh, PA 

Sergey V. Kantsevoy, MD, Director of 

Theapeutic Endoscopy, Institute for Digestive 

Health and Liver Disease, Mercy Medical 

Center, Baltimore, MD 

Kazunori Kasama, MD, Director, Dept of 

Weight Loss Surgery, Minimally Invasive 

Surgery Center, Yotsuya Medical Cube, Tokyo, 

Japan 

Zachary Kastenberg, MD, Surgical Resident, 

Surgical Resident, Stanford University Hospital 

and Clinics 

Namir Katkhouda, MD, Professor and Vice 

Chairman , University of Southern California, 

Chief, Division of General and Laparoscopic 

Surgery; Director, Bariatric surgery program, 

USC University hospital and LAC -USC Medical 

Cente, Los Angeles, CA 

L. Brian Katz, MD, Attending, Associate Clinical 

Professor, General and Laparoscopic Surgery, 

Mt. Sinai Hospital, New York, NY 

Nilton Kawahara, MD, Assistant Professor, 

MD PhD, University of Sao Paulo School of 

Medicine, General Surgeon, Hospital das 

Clinicas da FMUSP, Brazil 

Chuck Kennedy, Global VP Professional Affairs 

& Clinical Education, Covidien, Norwalk, CT 

Leena Khaitan, MD, Associate Professor of 

Surgery, University Hospitals, Case Medical 

Center, Director of Minimally Invasive and 

Bariatric Surgery, University Hospital, Geauga 

Medical Center, Chagrin Falls, OH 

Subhash U. Kini, MD, Asst. Professor Division 

of Laparoscopic Surgery, Mount Sinai Medical 

Center, Scarsdale, NY 

Sue Kirkman, MD, Vice President, Clinical 

Affairs, American Diabetes Association, 

Staff Physician, Washington Hospital Center, 

Indianapolis 

Seigo Kitano, MD, Professor, Department of 

Surgery I, Oita University Faculty of Medicine, 

Chairman, Oita University Hospital, Yufu, 

Japan 

Shuji Kitashiro, MD, Director of Surgery, 

Center for Digestive Disease, Tonan Hospital, 

Sapporo, Japan 

Shanu N. Kothari, MD, Director of Minimally 

Invasive Bariatric Surgery, Gundersen Clinic, 

Gundersen Lutheran, La Crosse, WI 

Yo Kurashima, MD, Research Fellow, 

Steinberg-Bernstein Center for Minimally 

Invasive Surgery, McGill University, Japan 

Marina Kurian, MD, Asst Professor of surgery, 

NYU School of Medicine, Attending Surgeon, 

NYU medical center, New York, NY 

Antonio M. Lacy, MD, Professor of 

Surgery, University of Barcelona, Chief of 

Gastrointestinal Surgery, Hospital Clínic, 

Barcelona, Spain 

Jacob C. Langer, MD, Professor of Surgery, 

University of Toronto, Chief, Paediatric General 

Surgery, Hospital for Sick Children, Toronto, 

ON, Canada 

James Lee, MD, Chief, Endocrine Surgery, 

Columbia University Medical Center, Assistant 

Professor of Surgery, New York Presbyterian 

Hospital- Columbia University, New York, NY 

Joel Leroy, MD, Associated Professor, 

University Hospital of Starsbourg, France, 

MD, University Hospital of Strasbourg, France, 

Strasbourg, Cedex, France 

Michael K.W. Li, MD, FRCS, FRCSE, FCSHK, 

FHKAM (Surgery), The University of Hong 

Kong, The Chinese University of Hong Kong, 

Chief of Service, Department of Surgery, 

Pamela Youde Nethersole Eastern Hospital, 

Hong Kong, China 

Isador Lieberman, MD, Professor of Surgery, 

Cleveland Clinic Lerner College of Medicine, 

Chairman Spine Department, Cleveland Clinic 

Florida, Weston, FL 

Demetrius E.M. Litwin, MD, Professor and 

Chairman, Department of Surgery, University 

of Massachusetts Medical School, Professor 

and Chairman, Department of Surgery, UMass 

Memorial, Worcester, MA 

Thom E. Lobe, MD, Professor, University of 

Tennessee Health Sciences Center, Memphis, 

TN, Blank Children’s Hospital, Des Moines, IA 

Kirk Allen Ludwig, MD, Associate Professor of 

Surgery, Medical College of Wisconsin, Chief 

of Colorectal Surgery, Froedtert Memorial 

Lutheran Hospital, Milwaukee, WI 

Markham C. Luke, MD, Clinical Deputy Office 

Director/Chief Medical Officer, Food and Drug 

Administration, HHS, Bethesda 

James D. Luketich, MD, Henry T. Bahnson 

Professor of Cardiothoracic Surgery, University 

of Pittsburgh, Chief, The Heart, Lung, and 

Esophageal Surgery Institute, University of 

Pittsburgh Medical Center, Pittsburgh, PA 

Bruce V. MacFadyen Jr, MD, Professor of 

Surgery, Medical College of Surgery, Chairman 

of Surgery, Medical College of Georgia 

Hospital, Augusta, GA 

Atul K. Madan, MD, Miami, FL 

Joseph Mamazza, MD, Chairman, Division 

of General Surgery, Director of Minimally 

Invasive Surgery, University of Ottawa, Chief 

General Surgery, The Ottawa Hospital, Ottawa, 

ON, Canada 

Jacques Marescaux, MD, Professor of Surgery, 

University Louis Pasteur Strasbourg, Chairman 

Department Digestive and Endocrine Surgery, 

University Hospital of Strasbourg, Strasbourg, 

France 

Gerald Marks, MD, Professor, Lankenau 

Institute for Medical Research, Surgeon, 

Section of Colorectal Surgery, Lankenau 

Hospital, Wynnewood, PA 19096, Wynnewood, 

PA 

Jeffrey M. Marks, MD, Associate Professor, 

Case Medical Center, Director of Surgical 

Endoscopy, University Hospital, Cleveland, OH 

John H. Marks, MD, Professor, Lankenau 

Institute for Medical Research, Chief, Section 

of Colorectal Surgery, Main Line Health 

System (3 hospitals), Wynnewood, PA 

Michael R. Marohn, MD, Associate Professor 

of Surgery, Johns Hopkins University School of 

Medicine, Director, Minimally Invasive Surgery 

Fellowship, Johns Hopkins, Baltimore, MD 

Pamela Martin, MD, Director of Medical 

Education, Ethicon Endo-Surgery 

Jose M. Martinez, MD, Assistant Professor of 

Surgery, University of Miami, Miller School 

of Medicine, Chief, Section of Surgical 

Endoscopy, Jackson Memorial Hospital, 

Miami, FL 

Abraham Mathew, MD, Associate Professor of 

Medicine, Penn State Hershey Medical Center, 

Director of Endoscopy, The Milton S Hershey 

Medical Center, Hershey, PA 

Samer G. Mattar, MD, Associate Professor of 

Surgery, Indiana University, Medical Director, 

Clarian Bariatrics, Clarian North Medical 

Center, Indianapolis, IN 

Kai Matthes, MD, Chief Resident, Harvard 

Medical School, Beth Israel Deaconess Medical 

Center, Berlin, MA 





Brent D. Matthews, MD, Professor of 

Surgery, Department of Surgery, Washington 

University in St Louis, Chief, Section of 

Minimally Invasive Surgery, Barnes-Jewish 

Hospital, St Louis, MO 

John D. Mellinger, MD, Professor of 

Surgery, Medical College of Georgia, Chief 

Gastrointestinal Surgery, Residency Program 

Director, Medical College of Georgia, Augusta, 

GA 

W. Scott Melvin, MD, Professor of Surgery, 

The Ohio State University, Director, Center 

for Minimally Invasive Surgery, Tho Oho State 

University Medical Center, Columbus, OH 

Adam T. Meneghetti, MD, Assistant 

Professor, Director- Research, Education 

and Development, Centre of Excellence for 

Surgical Education and Innovation, University 

of British Columbia, Vancouver, BC, Canada 

Dean J. Mikami, MD, Assistant Professor of 

Surgery, The Ohio State University, Assistant 

Professor of Surgery, The Ohio State University 

Medical Center, Columbus, OH 

Bertrand Millat, MD, Head of Department 

of Surgery, Saint Eloi Hospital, Montpellier, 

France 

Karl A. Miller, MD, Associate Professor of 

Surgery, Hallein Clinic, General Surgeon, 

Bariatric Surgeon, Hallein Clinic, Hallein, 

Austria 

Rebecca Manget Minter, MD, Assistant 

Professor of Surgery, University of Michigan 

Department of Surgery, Ann Arbor, MI 

Yoav Mintz, MD, Senior Physician, Dept of 

General Surgery, Hadassah-Hebrew University 

Medical Center, Jerusalem, Israel 

John R.T. Monson, MD, Chief of Colorectal 

Surgery, Vice Chair of Dept of Surgery, 

University of Rochester Medical Center, 

Rochester, NY 

John M. Morton, MD, Associate Professor, 

Stanford University, Director of Bariatric 

Surgery and Surgical Quality, Stanford 

University Medical Center, Menlo Park, CA 

Kenric M. Murayama, MD, Professor of 

Surgery, Univ. of Pennsylvania, Chief of 

Surgery, Penn Presbyterian Medical Center, 

Philadelphia, PA 

Didier Mutter, MD, IRCAD/EITS Digestive and 

Endocrine Surgery, Strasbourg Cedex, France 

Leslie K. Nathanson, MD, VMO, Royal 

Brisbane Womens Hospital, Brisbane, QLD, 

Australia 

Ninh Tuan Nguyen, MD, Professor of Surgery, 

University of California Irvine Medical Center, 

Chief, Division of Gastrointestinal Surgery, 

University of California, Irvine Medical Center, 

Orange, CA 

Gregg K. Nishi, MD, Assistant Clinical Professor 

of Surgery, UCLA/Cedars-Sinai Medical Center, 

Director of Outcomes, Minimally Invasive 

Surgery, Cedars-Sinai Medical Center, Los 

Angeles, CA 

Yuri W. Novitsky, MD, Assistant Professor of 

Surgery, University of Connecticut School 

of Medicine, Chief, Laparoscopic Surgery; 

Director, Connecticut Comprehensive Center 

for Hernia Repair, University of Connecticut 

Health Center, Farmington, CT 

Michael S. Nussbaum, MD, Professor and 

Chair Department of Surgery, University of 

Florida College of Medicine - Jacksonville, 

Surgeon-in-Chief, Shands Jacksonville, 

Jacksonville, FL 

Brant K. Oelschlager, MD, Associate Professor, 

University of Washington Department of 

Surgery, Seattle, WA 

Allan E. Okrainec, MD, Assistant Professor, 

University of Toronto, Deputy Head, Division 

of General Surgery, Toronto Western Hospital - 

University Health Netwo, Toronto, ON, Canada 

Dmitry Oleynikov, MD, Associate profesor 

of surgery, University of Nebraska Medical 

Center, Director of Minimally Invasive and 

Computer Aided Surgery, nebraska medical 

center, Omaha, NE 

Raymond P. Onders, MD, Associate Professor 

of Surgery, Case Western Reserve University, 

Director of Minimally Invasive Surgery, 

University Hospitals Case Medical Center, 

Shaker Heights, OH 

Chinnasamy Palanivelu, MCH(GE), GEM 

Hospital and Research Center, Coimbatore, 

Tamil Nadu, India 

Juan P. Pantoja, MD, Attending Surgeon, 

Instituto Nacional de Ciencias Medicas 

y Nutricion Salvador Zubiran, Attending 

Surgeon, Instituto Nacional de Ciencias 

Medicas y Nutricion, Mexco DF, Mexico 

Neely Panton, MD, Clinical Professor, Head, 

Division of General Surgery, UBC, University 

of British Columbia, Head, Division of 

General Surgery, Vancouver General Hospital, 

Vancouver, Canada 

Adrian E. Park, MD, Campbell & Jeannette 

Plugge Professor of Surgery, University of 

Maryland, Head General Surgery, University of 

Maryland Medical Center, Baltimore, MD 

John J. Park, MD, Clinical Assistant Professor of 

Surgery, University of Illinois, Clinical Assistant 

Professor of Surgery, University of Illinois 

Medical Center, Park Ridge, IL 

Carlos A. Pellegrini, MD, The Henry N. Harkins 

Professor and Chair, University of Washington, 

Seattle, WA 

Jacques J. Perissat, MD, Professeur Emeritus, 

DETERCA Université Victor Ségalen Bordeaux 

II, Bordeaux, France 

Jeffrey H. Peters, MD, Professor & Chairman 

Department of Surgery, University of 

Rochester, Surgeon in Chief, Strong Memorial 

Hospital, Rochester, NY 

Edward H. Phillips, MD, Clinical Associate 

Professor of Surgery, University of Southern 

California, Los Angeles County Hospital, 

Executive Vice-Chairman, Department of 

Surgery, Cedars-Sinai Medical Center, Los 

Angeles, CA 


Alessio Pigazzi, MD, Assistant Professor of 

Surgery, City of Hope , City of Hope National 

Medical Center, Duarte, CA 

Tim Pitney, Vice President, Investment 

Advisory, Sapers & Wallack, Inc., Newton, MA 

Alfons Pomp, MD, Leon C. Hirsch Professor 

of Surgery, Weill Medical College of Cornell 

University, Attending Surgeon, New York 

Presbyterian Hospital, New York, NY 

Jeffrey L. Ponsky, MD, Professor and Chairman, 

Department of Surgery, Case Western Reserve 

University School of Medicine, Surgeonin-Chief, 

University Hospitals Case Medical 

Center, Moreland Hill, OH 

Benjamin K. Poulose, MD, MPH, Vanderbilt 

University, Assistant Professor, Surgery, 

Vanderbilt University Medical Center, 

Nashville, TN 

Rhonda J. Prewitt, MIS Program Associate, MIS 

Fellowship Coordinator, University Nebraska 

Medical Center, Omaha, NE 

Jose Manuel Prince, MD, Fellow, University 

of Pittsburgh, Fellow, Children’s Hospital of 

Pittsburgh, Pittsburgh, PA 

Aurora Dawn Pryor, MD, Associate Professor 

of Surgery, Duke University Medical Center, 

Division Chief, General Surgery, Durham 

Regional Hospital, Durham, NC 

Karim Qayumi, MD, Professor of Surgery 

Director of the Center of Excellence for 

Simulation Education & Innovation, University 

of BC, VGH, Vancouver General Hospital, 

Vancouver, B.C., Canada 

Sonia L. Ramamoorthy, MD, Assistant 

Professor of Surgery, UC San Diego Medical 

Ctr., UCSD Medical Center, La Jolla, CA 

Bruce J. Ramshaw, MD, Associate Professor, 

Surgery, University of Missouri, Chief, General 

Surgery, University of Missouri, Columbia, MO 

Abhay Rane, MD, Consultant Urological 

Surgeon, East Surrey Hospital, United Kingdom 

Prashanth Prabhakar Rao, MD, Chief, Dept. of 

MAS, Mamata Hospital, Dombivli (E), India 

G. V. Rao, MS, MAMS, Chief of GI and 

Minimally Invasive Surgery, Asian Institute of 

Gastroenterology, Director, Asian Institute of 

Gastroenterology, Sohajiguda, Hyderabad, 

India 

David W. Rattner, MD, Professor of Surgery, 

Harvard Medical School, Chief Division 

of General and Gastrointestinal Surgery, 

Massachusetts General Hospital, 15 Parkman 

St #460, MA 

Kevin M. Reavis, MD, Assistant Clinical 

Professor, University of California, Irvine 

Medical Center, Assistant Clinical Professor, 

University of California, Irvine Medical Center, 

Orange, CA 

Petachia Reissman, MD, Associate Professor 

of Surgery, Hebrew University School of 

Medicine Jerusalem, Israel, Chairman, 

Department of General Surgery, Shaare-Zedek 

Medical Center, Jerusalem, Israel, Jerusalem, 

Israel


Feza Remzi, MD, MD, FACS, FASCRS, Ed and 

Joey Chair in Colorectal Surgery, Chairman, 

Dept. of Colorectal Surgery, The Cleveland 

Clinic, Department of Colorectal Surgery, The 

Cleveland Clinic, Cleveland, OH 

Jose Ribamar Azevedo, MD, Doctor of 

General Surgery from Federal University of 

Rio de Janeiro-RJ-Brazil, Private, Teacher of 

General Surgery from Federal University of Rio 

de Janeiro-RJ-Brazil, Samaritano Hospital and 

Copa D’Or Hospital (both in Rio de Janeiro), 

Sao Paulo, Brazil 

William O. Richards, MD, Ingram Professor 

of Surgical Sciences, Vanderbilt University, 

Director of Center for Surgical Weight Loss, 

Vanderbilt University Medical Center, Mobile, 

AL 

E. Matt Ritter, MD, Chief, Minimally Invasive 

Surgery and Emerging Technologies Assistant 

Professor of Surgery, Uniformed Services 

University, Chief, Laparoscopic Surgery, 

National Naval Medical Center, Gaithersburg, 

MD 

Homero Rivas, MD, Assistant Professor, 

Stanford University, MD, MBA, FACS, Stanford 

University Medical Center, Dallas, TX 

Sergio Roll, MD, MD, PhD, Clinical Professor 

of Surgery, University Positivo-School of 

Medicine, Brazil, O. Cruz German Hospital, O. 

Cruz German Hospital, Sao Paulo, Brazil 

John R. Romanelli, MD, Assistant Professor of 


Medical Director, Bariatric Surgery, Baystate 

Medical Center, Springfield, MA 

Michael J. Rosen, MD, Assistant Professor of 

Surgery, Case Medical Center, Chief, Division 

of Gastrointestinal and General Surgery, 

University Hospitals of Cleveland, Cleveland, 

OH 

Raul J. Rosenthal, MD, Associate Professor 

of Surgery, University of South Florida , 

Chairman, Bariatric and metabolic Institute 

and Section Head of Minimally Invasive 

Surgery, Cleveland Clinic Florida, Weston, FL 

James B. Rosser Jr, MD, Professor of Clinical 

Surgery, Morehouse School of Medicine, 

Attending Surgeon, Grady Memorial Hospial, 

Spring, TX 

Francesco Rubino, MD, Associate Professor of 

Surgery, Weill-Cornell Medical College, Chief, 

Section of Gastrointestinal Metabolic Surgery, 

New York Presbyterian Hospital, Strasbourg, 

France 

Eric Rullier, MD, Professor of Surgery, 

University of Bordeaux, Chairman department 

of colorectal surgery, Saint-Andre Hospital, 

France 

Adheesh A. Sabnis, MD, Co-Driector of 

Minimally Invasive and Laparoscopic Surgery, 

Good Samaritan Hospital, Baltimore, MD 

Barry A. Salky, MD, Professor of Surgery; 

Division of Laparoscopic Surgery, Mount 

Sinai School of Medicine, Attending Surgeon, 

Mount Sinai Hospital, New York, NY 

Aviva Sapers, CEO, Sapers & Wallack, Inc., 

Newton, MA 

Abeezar I. Sarela, MD, Honorary Senior 

Lecturer, The University of Leeds, Consultant 

in Upper GI & Bariatric Surgery, St James’s 

University Hospital, Leeds, United Kingdom 

Richard M. Satava, MD, Professor of Surgery, 

University of Washingotn Medical Center, 

Professor of Surgery, University of Washington 

Medical Center, Seattle, WA 

Philip R. Schauer, MD, Professor of Surgery, 

Lerner College of Medicine, Director, 

Advanced Laparoscopic & Bariatric Surgery, 

Clevleand Clinic, Cleveland, OH 

Bruce D. Schirmer, MD, Stephen H. Watts 

Professor of Surgery, University of Virginia 

Health System, Vice Chair, Department of 

Surgery, University of Virginia Health System, 

Charlottesville, VA 

Christopher M. Schlachta, MD, Associate 

Professor, Departments of Surgery and 

Oncology, University of Western Ontario, 

Medical Director, CSTAR (Canadian Surgical 

Technologies and Advanced Robotics), 

London Health Sciences Centre, London, ON, 

Canada 

Steven D. Schwaitzberg, MD, Associate 

Professor of Surgery, Harvard Medical School, 

Chief of Surgery, Cambridge Health Alliance, 

Cambridge, MA 

Daniel J. Scott, MD, Associate Professor of 

Surgery, University of Texas Southwestern 

Medical Center, Director, Southwestern Center 

for Minimally Invasive Surgery, Dallas, TX 

Carol E. Scott-Conner, MD, Professor, Division 

of Surgical Oncology and Endocrine Surgery, 

University of Iowa Hospitals & Clinics, Iowa 

City, IA 

Donna See, MD, Columbia University Science & 

Technology Ventures, New York, NY 

Don J. Selzer, MD, Associate Professor 

of Surgery, Indiana University School of 

Medicine, General Surgeon, Clarian Health 

Partners, Inc., Indianapolis, IN 

Neal E. Seymour, MD, Professor, Tufts 

University, Division Chief General Surgery, 

Baystate Medical Center, Springfield, MA 

Paresh C. Shah, MD, Program Director 

General Surgery, Lenox Hill Hospital, Chief 

of Laparoscopic Surgery, Lenox Hill Hospital, 

New York, NY 

Baiju R. Shah, CEO, BioEnterprise, Cleveland, OH 

Scott A. Shikora, MD, Professor of Surgery, Tufts 

University School of Medicine, Chief, Divisions 

of General, Bariatric and Minimally Invasive 

Surgery, Tufts Medical Center, Sharon, MA 

Samuel Shuchleib, MD, Professor, National 

University of Mexico, Executive Director, Latin 

American Federation of Surgical Societies, 

Mexico City, Mexico 

Allan E. Siperstein, MD, Professor of Surgery, 

Cleveland Clinic, Chair, Surgery Institute, 

Cleveland Clinic, Cleveland, OH 

C. Daniel Smith, MD, Professor and Chair, 

Mayo School of Medicine, Mayo Clinic - 

Florida, Jacksonville, FL 

Luc Soler, MD, Research Project Manager, 

IRCAD, Strasbourg, France 

Toyooki Sonoda, MD, Assistant Attending 

Surgeon, NewYork-Presbyterian Hospital/Weill 

Cornell Medical Center, Assistant Professor of 

Surgery, Weill Cornell Medical College, New 

York, NY 

Nathaniel J. Soper, MD, Loyal and Edith Davis 

Professor and Chair of Surgery, Northwestern 

University Feinberg School of Medicine, 

Surgeon-in-Chief, Northwestern Memorial 

Hospital, Chicago, IL 

Mike Stahl, MD, Distinguished Professor of 

Management, Director of Physician Executive 

MBA Program, University of Tennessee, 

Knoxville, TN 

Steven C. Stain, MD, Professor and Chair, 

Albany Medical College, Chief of Surgery, 

Albany Medical Center Hospital, Albany, NY 

Greg V. Stiegmann, MD, Professor of Surgery, 

University of Colorado Denver School of 

Medicine, Vice President Clinical Affairs, 

University of Colorado Hospital, Aurora, CO 

Vivian E.M. Strong, MD, Assistant Attending 

Surgeon, Memorial Sloan-Kettering Cancer 

Center, Assistant Professor of Surgery, Weill 

Medical College of Cornell University, New 

York, NY 

Lee L. Swanstrom, MD, Clinical Professor of 

Surgery, Oregon Health Sciences University, 

Director, Division of Minimally Invasive 

Surgery, Legacy Health System, Portland, OR 

Patricia Sylla, MD, Instructor in Surgery, 

Harvard University, Assistant in Surgery, 

Massachusetts General Hospital, Boston, MA 

Zoltan Szabo, PhD, Visiting Professor, Institute 

of Surgical Research, University of Szeged 

Medical School, Hungary, Director, MOET 

Institute, San Francisco, CA, San Francisco, CA 

Amir Szold, MD, Senior Lecturer, Sackler 

School of Medicine, Tel Aviv University, 

Department of Surgery B, Tel Aviv Sourasky 

Medical Center, Tel Aviv, Israel 

Mark A. Talamini, MD, Professor and 

Chairman, Department of Surgery, University 

of California, San Diego, Surgeon-in-Chief, 

UCSD Medical Center, San Diego, CA 

Eduardo Targarona, MD, Professor of Surgery, 

Autonomous University of Barcelona, Director 

Unit Gastrointestinal & Hematological Surgery, 

Hospital de Santpau, Barcelona, Spain 

Craig J. Taylor, MD, Dr, University of Sydney, 

Dr, Concord General Hospital, Balgowlah, 

NSW, Australia 

Julio A. Teixeira, MD, Associate Clinical 

professor of Surgery, Columbia University, 

Chief Division of Minimally :invasive Surgery, 

St.Luke’s-Roosevelt Hospital Center, New York, 

NY 





Michael H. Thomson, MD, Consultant 

in Pediatric Gastroenterology, Sheffield 

Childrens NHS Trust, Bristol, United Kingdom 

Christopher C. Thompson, MD, Assistant 

Professor of Medicine, Harvard Medical 

School, Director of Developmental Endoscopy, 

Brigham and Women’s Hospital, Boston, MA 

Augusto Almeida Tinoco, MD, Chief of 

Laparoscopic Surgery, Hospital Sao Jose do 

Avai, Itaperuna, Brazil 

Alfonso Torquati, MD, Associate Professor of 

Surgery, Duke University, Director Minimally 

Invasive Surgery Research, Durham, NC 

Shirin Towfigh, MD, Visiting Associate 

Professor of Clinical Surgery, Cedars-Sinai 

Medical Center, Los Angeles, CA 

L. William Traverso, MD, Clinical Professor of 

Surgery, University of Washington, Director 

Digestive Disease Institute - Pancreas Section, 

Virginia Mason Medical Center, Seattle, WA 

Thadeus L. Trus, MD, Associate Professor 

of Surgery, Dartmouth-Hitchcock Medical 

Center, Dartmouth-Hitchcock Medical Center, 

Lebanon, NH 

Shawn T. Tsuda, MD, Assistant Professor 

of Surgery, University of Nevada School of 

Medicine, Surgeon, University Health System, 

Las Vegas, NV 

Surendra M. Ugale, MD, Director of Metabolic 

& Advanced Laparoscopic Surgery, Kirloskar 

Hospital, Hyderabad, India 

David R. Urbach, MD, Associate Professor 

of Surgery and Health Policy, Management 

and Evaluation, University of Toronto, Staff 

Surgeon, University Health Network, Toronto, 

ON, Canada 

Melina C. Vassiliou, MD, Assistant Professor 

of Surgery, McGill University Health Centre, 

Assistant Professor of Surgery, Montreal 

General Hospital, Montreal, PQ, Canada 

Ashley Vernon, MD, Instructor, Harvard 

Medical School, Associate Surgeon, Brigham & 

Women’s Hospital, Boston, MA 

Leonardo Villegas, MD, General Surgery, 

UMKC, Durham, NC 

Anthony J. Vine, MD, Attending, Assistant 

Clinical Professor, General and Laparoscopic 

Surgery, Mt. Sinai Hospital, New York, NY 

Guy R. Voeller, MD, Professor of Surgery, 

University of Tennessee, Memphis, TN 

Daniel Von Renteln, MD, Department of 

Interdisciplinary Endoscopy, University 

Hospital Hamburg-Eppendorf, Hamburg, 

Germany 

Go Wakabayashi, MD, Professor and 

Chairman, Department of Surgery, Iwate 

Medical University, Surgeon-in-Chief, Iwate 

Medical University Hospital, Morioka-city, 

Japan 

Martin Walz, MD, Prof. Dr. Dr., University of 

Essen, Kliniken Essen-Mitte, Germany 

Eric Glenn Weiss, MD, Vice Chairman, 

Department of Colorectal Surgery, DIO & 

Chairman of Graduate Medical Education, 

Residency Program Director, Cleveland Clinic 

Florida, Weston, FL 

Steven D. Wexner, MD, Professor of Surgery, 

Ohio State University, Chief Academic Officer, 

Cleveland Clinic Florida, Weston, FL 

R. Larry Whelan, MD, Professor of Surgery, 

Columbia University, Chief Of Surgical 

Oncology, St. Luke’s Roosevelt HospitaL, New 

York, NY 

Mark H. Whiteford, MD, Clinical Associate 

Professor, Oregon Health & Science University, 

Director, Colorectal Surgery Program, 

Providence Portland Medical Center, Portland, 

OR 

Tatsuo Yamakawa, MD, Emeritus Professor 

of of Surgery, Teiyo University School of 

Medicine, Professor of Surgery, Teikyo 

Uiversity Hospita, at Mizonokuchi, Tokyo, 

Japan 

Manabu Yamamoto, MD, Director and 

Chairman, Adachi Kyosai Hospital, Tokyo, 

Japan 

Han-Kwang Yang, MD, Professor, Seoul 

National University College of Medicine, 

Professor, Seoul National University Hospital, 

South Korea 

Tonia M. Young-Fadok, MD, Professor of 

Surgery, Mayo Clinic, Chair, Division of Colon 

and Rectal Surgery, Mayo Clinic, Phoenix, AZ 

Natan Zundel, MD, Clinical Professor of 

Surgery, F I U, Miami Beach, FL 


World Congress Faculty & Presenter Disclosures 

The following presenters, faculty, SAGES Board of Governors, Program and Continuing Education Committee Members do not have any relevant 

financial relationships or significant commercial interests associated with their participation at the 2010 World Congress meeting. If name is not listed 

below, please refer to the following pages. 

Brij B Agarwal 

Krishna A Agarwal 

Rajesh Aggarwal 

Craig T. Albanese 

Frances Allocco 

S. Al-Sabah 

Luigi Angrisani 

Chandrakanth Are 

Maurice E. Arregui 

Theodor Asgeirsson 

Vikram Attaluri 

Shahin Ayazi 

Asghar Azadani 

Jose Ribamar Azevedo 

Sharon L. Bachman 

Heidi Bahna 

Fady Kamal Balaa 

Virinder K Bansal 

Limaris Barrios 

Linda Barry 

Katherine A. Barsness 

Nicola Basso 

Bruce Behn 

Estuardo J. Behrens 

Richard H. Bell 

Simon Bergman 

Jai Bikhchandani 

Daniel W. Birch 

Simon Biron 

Raghid S Bitar 

James G. Bittner 

Victor Bochkarev 

Alexandre Bouchard 

Steven P. Bowers 

Matias Bruzoni 

Luis E. Burbano 

Angel M Caban 

Michael J. Cahalane 

Ronan A. Cahill 

Guilherme M Campos 

Antonio O Castellvi 

Rose S.M. Chan 

Bipan Chand 

Ryan A Chandhoke 

Eric Changchien 

Hester Cheung 

Gyu-Seog Choi 

Elie Chouillard 

Elie K Chouillard 

Alberto Chousleb 

Elias Chousleb 

Pradeep K. Chowbey 

W. Y. Chung 

Tatyan Clarke 

Ricardo V. Cohen 

Nathan E Conway 

Manolo Cortez 

Federico Costantino 

Ismael Court 

Angel Cuadrado 

Christopher Cunningham 

Sir Alfred Cuschieri 

Allan Dackiw 

Gregory F. Dakin 

Bernard Dallemagne 

Abhay N Dalvi 

Donald M Davis 

Aureo L. De Paula 

Edmundo Dedios Orozco 

Nicolas Demartines 

Ithaar H Derweesh 

Ashwin L deSouza 

Daniel J. Deziel 

Ushast Dhir 

Andre Dhoore 

Robert DiRaddo 

Quan-Yang Duh 

Kristen R Earle 

Paula K Edelson 

Claire Edwards 

Michael B. Edye 

Jonathan E. Efron 

Ahmed R El-Geidie 

Casey J. Grabeal 

Timothy M. Farrell 

Nicole M. Fearing 

John J. Feng 

Alberto R Ferreres 

David Field 

Abe L. Fingerhut 

Aaron S. Fink 

Heidi L Fitzgerald 

Jean Bernard Flament 

Roberto Fogel 

Kenneth A. Forde 

Morris E Franklin 

Karl H. Fuchs 

Daniel J. Gagne 

Roberto Gallardo 

Alex Gandsas 

Denise W. Gee 

Daniel P. Geisler 

Keith E. Georgeson 

Iman Ghaderi 

Saber Ghiassi 

Matthew Randall Goede 

Trudie A Goers 

Ke Gong 

Jon Gould 

Teodor P. Grantcharov 

John C Graybill 

Frederick L. Greene 

Andrew A. Gumbs 

Prateek K Gupta 

Peter T. Hallowell 

M Hamada 

Erik N. Hansen 

Kristi Lee Harold 

Vincent L Harrison 

Eugenius J Harvey 

David Hazzan 

Vanessa P Ho 

Elizabeth Honigsberg 

William W Hope 

John Hunter 

Matthew M. Hutter 

Haruhiro Inoue 

Takeaki Ishizawa 

Eran Itzkowitz 

Gretchen Purcell Jackson 

Timothy D Jackson 

Samuel Jacob 

Garth R. Jacobsen 

David James 

Christopher Jamieson 

Balaji Jangam 

Shiva Jayaraman 

David J Kaczorowski 

Matthew F. Kalady 

Jawaid Kalim 

Timothy D. Kane 

Sergey V. Kantsevoy 

Kazunori Kasama 

Zachary Kastenberg 

Nilton Kawahara 

Leena Khaitan 

Michael J Kim 

Subhash U. Kini 

Sue Kirkman 

Seigo Kitano 

Shuji Kitashiro 

Bastiaan R Klarenbeek 

Amanda J Kravetz 

Sachin S Kukreja 

Birte Kulemann 

Yo Kurashima 

Antonio M. Lacy 

Pawanindra Lal 

Jacob C. Langer 

Antonio D Lassaletta 

Wai Lun Law 

Gyusung Lee 

James Lee 

Young-Joon Lee 

Andras Legner 

Eli N. Lerner 

Joel Leroy 

Emanuele Lezoche 

Michael K.W. Li 

Song Liang 

Dimitrios A. Linos 

Demetrius E.M. Litwin 

Markham C. Luke 

Bruce V. MacFadyen Jr 

Atul K. Madan 

Jacques Marescaux 

Gerald Marks 

Michael R. Marohn 

Abraham Mathew 

Ronald Matteotti 

David A. McClusky 

Marian P. McDonald 

Stephen S. McNatt 

Adam T. Meneghetti 

Carlos A Menezes 

Bertrand Millat 

Karl A. Miller 

Rebecca Manget Minter 

Danilo Miskovic 

Derek E Moore 

John M. Morton 

Didier Mutter 

Omer Nasir 

Leslie K. Nathanson 

Adrian Marius Nedelcu 

Scott Quy Nguyen 

Thinh H Nguyen 

Juan J. Nogueras 

Michael S. Nussbaum 

Kathleen O’Connell 

Tomonori Ohsawa 

Allan Okrainec 

Pablo E Omelanczuk 

Sean B Orenstein 

Ismail H Ozerhan 

John T. Paige 

C Palanivelu 

Chinnasamy Palanivelu 

Juan P. Pantoja 

Chan W Park 

John J. Park 

Michael Parker 

Marco G. Patti 

Eric M Pauli 

Nikhil Pawa 

Suraj B Pawar 

Jacques J. Perissat 

Silvana Perretta 

Edward H. Phillips 

Alessio Pigazzi 

Rodrigo A Pinto 

Timothy Pitney 

Mun Jye Poi 

Benjamin K. Poulose 

Pornthape Prathanvanich 

Rhonda J. Prewitt 

Jose Manuel Prince 

Shailesh Puntambekar 

Karim Qayumi 

Abhay Rane 

G. V. Rao 

Prashanth Prabhakar Rao 

Petachia Reissman 

Feza Remzi 

Jason F Reynoso 

William S. Richardson 

Homero Rivas 

Sergio Roll 

John R. Romanelli 

Raul Rosenthal 

James B. Rosser Jr 

Dan Ruiz 

Eric Rullier 

Mohamad D Saad 

Adheesh A. Sabnis 

Aviva Sapers 

Abeezar I. Sarela 

Bruce D. Schirmer 

Wayne H. Schwesinger 

Carol E. Scott-Conner 

Donna See 

P Senthilnathan 

Elliot L Servais 

Paul A. Severson 

Neal E. Seymour 

Baiju R. Shah 

Scott A. Shikora 

Samuel Shuchleib 

Gerd R Silberhumer 

Allan E. Siperstein 

C. Daniel Smith 

Brad E Snyder 

Luc Soler 

Michael Stahl 

Steven C. Stain 

Vivian E.M. Strong 

Erica Sutton 

John F. Sweeney 

Nobumi Tagaya 

Eduardo Targarona 

EM Targarona 

Craig J. Taylor 

Sarah K Thompson 

Michael H. Thomson 

Augusto Almeida Tinoco 

Augusto c Tinoco 

Manish M Tiwari 

Shirin Towfigh 

L. William Traverso 

Albert W Tsang 

David R. Urbach 

Kent R. Van Sickle 

Oliver A Varban 

Esteban Varela 

Melina C. Vassiliou 

Khashayar Vaziri 

Ashley Vernon 

Leonardo Villegas 

Daniel Von Renteln 

Go Wakabayashi 

Martin Walz 

Carl J. Westcott 

Yanghee Woo 

Tatsuo Yamakawa 

Manabu Yamamoto 

Jun Yan 

Han-Kwang Yang 

Tonia M. Young-Fadok 

Yassar Youssef 

Jacqui C. Zhu 





The following presenters, faculty, SAGES Board of Governors, Program and Continuing Education Committee Members provided information indicating 

they have a financial relationship with a proprietary entity producing health care goods or services, with the exemption of non-profit or government 

organizations and non-health care related companies. (Financial relationships can include such things as grants or research support, employee, 

consultant, major stockholder, member of speaker’s bureau, etc.) 

Name Commercial Interest What was received For what role Other 

Gina L. Adrales WL Gore Honoraria Speaking/Teaching 

Ethicon Endosurgery Honoraria Speaking/Teaching 

Mehran Anvari 

Astra-Zeneca Honoraria Speaking/Teaching 

Enteromedics Honoraria Advisory Committee 

Ethicon Endosurgery Honoraria Advisory Committee 

Horacio J. Asbun Doctors Company Honoraria Consultant 

Ziad T. Awad Genzyme Biosurgery Honoraria Speaking/Teaching 

Simon Bergman 

Paladin Labs Consulting Fee Consulting 

Covidien Consulting Fee Consulting 

Ramon Berguer Ethicon Honoraria Speaking/Teaching 

Covidien Consulting Fee Consultant 

Marc Bessler 

Satiety Other Other Investigator in Trial 

GI Dynamics Consulting Fee Advisory Committee 

Olympus Consulting Fee Consultant 

Jeffrey A Blatnik 

LifeCell Honorarium Speaking and/or Teaching 

Covidien Honorarium Speaking and/or Teaching 

Ethicon Honoraria Other Educational grant 

Fredrick J. Brody Nutricia North America Consulting Fee Consultant 

Covidien 

Consulting Fee 

Muskuloskeletal Transplant 

Foundation 


Consulting 

Shaun R Brown 

Ethicon EndoSurgery Consulting Fee Consulting 

Atrium Medical Consulting Fee Consulting 

Covidien Honoraria Speaking/Teaching 


Ethicon Endosurgery Other Other 

L. Michael Brunt 

Karl Storz Endoscopy Other Other 

Lifecell Corp Other Other 

Stryker Honoraria Consultant 

Stryker Endoscopy Other Other 

Cook Medical Honoraria Speaking/Teaching 

American Board of Surgery Salary Employment 

Jo Buyske 

Sunstones Biotech Ownership Interest Other 

my spouse is chief 

scientific officer 

W.L. Gore and Associates Honoraria Speaking/Teaching 

Alfredo M. Carbonell W.L. Gore and Associates Consulting Fee Consultant 

Ethicon Inc. Consulting Fee Advisory Committee 

Abbott Ross Laboratories Other Financial Benefit Other Activities Grant/Financial Support 

Ronald Hanson 

Clements 

Cardinal Healthcare/ 

Snowden-Pencer 

Honoraria 

Advisory Committee 

Covidien Consulting Fee Review Panel 


Karl Storz Endoscopy Other Financial Benefit Other Activities 

Educational grant 

support 

Daniel R Cox 


Ethicon Endosurgery Honorarium Speaking and/or Teaching 

David L. Crawford Intuitive Surgical Honoraria Other Preceptor/Proctor 

Storz Honoraria Speaking/Teaching 

Paul G. Curcillo II 

Olympus Honoraria Speaking/Teaching 

Ethicon Honoraria Speaking/Teaching 

Microline Honoraria Speaking/Teaching 

Conor P. Delaney 


Adolor Honoraria Advisory Committee 




Brian J. Dunkin 

Covidien 


Ethicon Consulting Fee Consultant 

Sanjeev Dutta 

Stryker Endoscopy Consulting Fee Consultant 

Novare Consulting Fee Advisory Committee 

Lifeguard Other Advisory Committee 

David Bryan Earle 

Covidien Other Other Fellowship Grant 

Atrium Medical Consulting Fee Consultant 

Surgiquest Honoraria Advisory Committee 

David W. Easter 

Cubist 

Honoraria 

MedWaves Other Advisory Committee 


Steven Edmundowicz Boston Scientific Consulting Fee Advisory Committee 

BARRX Consulting Fee Speaking/Teaching 

Barosense Ownership Interest Other Major Stockholder 

Steve Eubanks 

Ethicon Other Other Grant Funding 

Stryker Other Other Grant Funding 

Transenterix Honoraria Advisory Committee 

Ethicon Canada Other Other 

Unrestricted Educational 

grant 

Liane S. Feldman Covidien Canada Consulting Fee Speaking/Teaching 

Covidien Canada Other Other 

Unrestricted education 

grant 

Paré Surgical Other Consultant 

Edward L. Felix 

Power Medical Consulting Fee Consultant 

Cardica Consulting Fee Consultant 


Dennis L. Fowler Applied Medical Ownership Interest Board Member 

W.L. Gore Other Advisory Committee 

Cook Consulting Fee Speaking/Teaching 

Morris E. Franklin Jr Covidien Honoraria Speaking/Teaching 

Stryker Other Advisory Committee 


Synovis Other Consultant 


Bariatric Times Honoraria Speaking/Teaching 

Michel Gagner 

Cine Med Inc. Honoraria Speaking/Teaching 

Gore Honoraria Speaking/Teaching 


Olympus Other Advisory Committee 

EndoMetabolic Solutions Ownership Interest Board Member 

Brice Gayet Olympus Consulting Fee Consultant 

Daniel P Geisler Covidien Consulting Fee Consulting 

Dpeartment of Surgery, Consulting Fee Consultant 

Alec Glover 

UMass-Memorial Medical Center/ 

School 

Vysera Royalty Advisory Committee 

Christopher J. Gostout Softscope Medical Consulting Fee Consultant 

Apollo Endosurgery Royalty Advisory Committee 

Carroll M. Harmon Stryker Endoscopy Other Advisory Committee 

Karem C Harth 

Covidien Honorarium Consulting 

Lifecell Honorarium Consulting 

Stryker Endoscopy Other Other Research Grant 


Jeffrey W. Hazey 

Boston Scientific Other Other 

Fellowship funding 

support 

Ethicon Endosurgery Other Speaking/Teaching 






MTF-Musculoskeletal Transplant 

Foundation 

Other Other Research Grant 

B. Todd Heniford WL Gore Other Other Research Grants 

Ethicon Endo Surgery Other Other Research Grant 

Ethicon, Inc. Other Speaking/Teaching 

Miguel Herrera 

Johnson & Johnson Medical Mexico Other Other Education grant 

Enteromedics Inc Other Other Research grant 

Covidien Other Other Educational grant 

Daniel M. Herron Gore Consulting Fee Consultant 

Hourglass Technology Consulting Fee Advisory Committee 

Kelvin D. Higa Surgiquest Other Advisory Committee 

Jacques M. Himpens 

Ethicon Consulting Fee Speaking/Teaching 

Covidien Consulting Fee Speaking/Teaching 

Michael D. Holzman UK Specialty Hospitals Consulting Fee Advisory Committee 

USGI Other Advisory Committee 

Stryker Other Consultant 

Olympus America Honoraria Consultant 

Santiago Horgan 

Novare Other Advisory Committee 

intuitive surgical Honoraria Speaking/Teaching 


Ethicon 


Valentx Other Advisory Committee 

Franziska Huettner Intuitive Honorarium Speaking and/or Teaching 

Boston Scientific Consulting Fee Consultant 

Eric Steven Hungness Olympus America Consulting Fee Consultant 

Terumo Consulting Fee Consultant 

Allergan Consulting Fee Consultant 

Sayeed Ikramuddin Covidien Consulting Fee Consultant 

Ethicon Endo-Surgery Honoraria Speaking/Teaching 

William Barry Inabnet 

III 

Covidien Other Other 


Brian P Jacob 



Ethicon EndoSurgery Consulting Fee Consulting 

Atrium Medical Consulting Fee Consulting 

Eric D Jenkins 

Muskuloskeletal Transplant 

Foundation 



Consulting 

4th will be emailed to 

SAGES office 

Olympus Other Other research support 

Crospon Other Other research support 

Blair A. Jobe 

Sandhill Other Other research support 

Torax Medical Other Other research support 

Covidien Other Other Research 

Covidien 


Access Surgical 

Royalty 

Daniel Bougere Jones 

Surgiquest 


Cine-Med 

Royalty 

Ethicon 

Other 

Allergan 


Rohan A Joseph 

Ethicon Endo Surgery Consulting Fee Consulting 

Ethicon Endo-Surgery Consulting Fee Consulting 


Namir Katkhouda 

Ethicon Endosurgery Honoraria Consultant 

WL Gore Honoraria Speaking/Teaching 

Storz Consulting Fee Consultant 

L. Brian Katz Neat Stitch Ownership Interest Advisory Committee 

Chuck Kennedy Covidien Salary Employment



Nicoleta O Kolozsvari Covidien Canada Other Financial Benefit Other Activities 

Unrestricted 

educational grant 


Shanu N. Kothari ValleyLab Consulting Fee Speaking/Teaching 

Lifecell Consulting Fee Consultant 

Marina Kurian 


Allergan Honoraria Speaking/Teaching 

Axiomed Spine Corp Royalty Consultant 

Isador Lieberman 

Mazor Surgical Royalty Consultant 

Merlot OrthopediX Royalty Board Member 

Stryker Spine Royalty Consultant 

Thom E. Lobe 

Visual Medical Solutions Ownership Interest Other Partner 

Neatstich Ownership Interest Board Member 

Katie Love Covidien Consulting Fee Consulting 

Kirk Allen Ludwig Applied Medical Honoraria Speaking/Teaching 

Stryker, Covidien, Axcan 

Speaking/Teaching 

Accuray Other Other 

Research Grant/Principal 

Invesitgator 

Intuitive Surgical, Boston Other Other Stock 

James D. Luketich 

Scientific, Covidien, 

Options/Recipient 

Stryker, Axcan, 

Covidien, Stryker and Other Other Research 

Oncotech 

Grant/Principal Investigator 


Minimally Invasive 

Surgery program 

Joseph Mamazza 

support 

Minimally Invasive 

Storz Other Other 

Surgery program 

support 

Ethicon Honoraria Consultant 


Jeffrey M. Marks Olympus Consulting Fee Consultant 

WL Gore Consulting Fee Consultant 

Apollo Endusurgery Consulting Fee Advisory Committee 

SurgiQuest Honoraria Advisory Committee 

Wolf Consulting Fee Consultant 

Stryker Consulting Fee Consultant 

John H. Marks 

Glaxo Smith Kline Consulting Fee Consultant 



Zassi Consulting Fee Consultant 

Pamela Martin Ethicon Endo-Surgery Salary Employment 

Transenterix Other Advisory Committee 

Ethicon Inc 

Other 

Boston Scientific Honoraria Speaking/Teaching 

Jose M. Martinez Lifecell Honoraria Speaking/Teaching 


Transenterix Consulting Fee Advisory Committee 

Covidien Other Speaking/Teaching 

Samer G. Mattar 



Kai Matthes 

EndoSim, LLC Ownership Interest Management Position 

Olympus America Inc. Other Other equipment support 


Atrium Medical Consulting Fee Consultant 

Brent D. Matthews Musculoskeletal Transplantation 

Foundation 


Consultant 

Ethicon Endosurgery Other Speaking/Teaching 






John D. Mellinger Gore Honoraria Speaking/Teaching 

Endogastric Solutions Other Advisory Committee 

Transenterix Other Advisory Committee 

Surgiquest Other Advisory Committee 

W. Scott Melvin 


research and training 

grants 

W L Gore Other Other research funding 

Stryker Consulting Fee Consultant 

Endogastric Solutions Honoraria Speaking/Teaching 

Dean J. Mikami Gore Consulting Fee Consultant 


EasyLap Consulting Fee Advisory Committee 

Yoav Mintz 

Virtual Ports Other Advisory Committee 

Lumenis Consulting Fee Consultant 

Ethicon Endosurgery Israel Honoraria Speaking/Teaching 

John R.T. Monson Covidien Honoraria Speaking/Teaching 

Kenric M. Murayama Covidien Honoraria Speaking/Teaching 

Stryker 

Honorarium 

Membership on Advisory 

Committees or Review Panels 

Radu Nedelcoviciu Covidien Honorarium Speaking and/or Teaching 

Adolor Honorarium Speaking and/or Teaching Surgiquest, Wolfe, 

Olympus 

Ninh Tuan Nguyen 

Surgiquest Other Consultant 


LifeCell Consulting Fee Speaking/Teaching 

Yuri W. Novitsky 

Nerites Consulting Fee Review Panel 

Davol, Inc Consulting Fee Consultant 


Cook Surgical Other Speaking/Teaching 

W.L. Gore Other Other Educational grants 

Torax Medical Other Other Research grant 

Brant K. Oelschlager 

Sandhill Scientific Other Other Educational grant 

Educational grants, 


research grants, 

honorarium 

Allan E. Okrainec Ethicon Honoraria Speaking/Teaching 

Gore Other Other Research Grant 

life cell Honoraria Speaking/Teaching 

Dmitry Oleynikov Virtual Incision corp Ownership Interest Board Member 


Virtual Incision Corporation Ownership Interest Board Membership 

Ethicon 

Licensing agreement, 

research grants 

Sarah C Oltmann 

Allergan 

Speaking and/or Teaching 

Covidien Speaking and/or Teaching Research Grants 

Raymond P. Onders 

Covidian Consulting Fee Consultant 

Synapse Biomedical Ownership Interest Board Member 

Neely Panton 

Ethicon EndoSurgical Consulting Fee Advisory Committee 

Ethicon EndoSurgical Consulting Fee Consultant 

WL Gore Honoraria Consultant 

Adrian E. Park 

Surgiquest Honoraria Advisory Committee 

Stryker Endoscopy Honoraria Advisory Committee 

Apollo Endosurgery Other Advisory Committee 




Cook Other Other 

Received: Grant 

Role: PI 

Covidien (Spouse) Salary Employment 

Carlos A. Pellegrini 

METI Other Other 

Received:Grant 

Role:PI 

Stryker Other Other 

Received: Grant 

Role:PI 

MediGus Inc Other Other Grant Support 

Jeffrey H. Peters 

Ethicon Endosurgery Honoraria Advisory Committee 

Torax Inc Other Other Grant Support 

EndoVx Inc. Ownership Interest Consultant 


Alfons Pomp 


W.L. Gore and Associates Honoraria Speaking/Teaching 

Jeffrey L. Ponsky US Endoscopy Consulting Fee Consultant 

Barosense Ownership Interest Advisory Committee 

Immersion Consulting Fee Consultant 

Aurora Dawn Pryor Synecor Consulting Fee Consultant 

TransEnterix Ownership Interest Advisory Committee 


Sonia L. Ramamoorthy Applied MEdical Honoraria Speaking/Teaching 

LifeCell Honoraria Speaking/Teaching 

MTF Consulting Fee Advisory Committee 

Bruce J. Ramshaw 

Atrium Other Other Research support 




David W. Rattner 

TransEnterix Honoraria Advisory Committee 

Olmpus Honoraria Speaking/Teaching 

Covidien Consulting Fee Speaking and/or Teaching Education Grant 

Arthur Rawlings 

Support 

Stryker Endoscopy Consulting Fee Speaking and/or Teaching Grant Support 

Ethicon Endosurgery Consulting Fee Speaking and/or Teaching Education Grant Support 

Gore Honoraria Speaking/Teaching 

Kevin M. Reavis Endogastric Solutions Honoraria Speaking/Teaching 


William O. Richards Covidien Honoraria Advisory Committee 



Grants and Equipment 

via Henry M. Jackson 

Foundation 

ConMed Linvatec Other Other 

Video Imaging 

equipment for skills 

E. Matt Ritter 

training lab 



Grants and Equipment 

via Henry M. Jackson 

Foundation 

Henry M. Jackson Foundation Other Other 


Grants 

Michael J. Rosen 

Lifecell Consulting Fee Consultant 


Sinovys Consulting Fee Speaking/Teaching 

Karl Storz Endoscopy Consulting Fee Consultant 

Karl Storz Consulting Fee Speaking/Teaching 

Raul J. Rosenthal 

Ethicon Endosurgery Consulting Fee Consultant 

Ethicon Consulting Fee Speaking/Teaching 



Synovis Consulting Fee Consultant 






Steven S Rothenberg Storz Consulting Fee Consulting 

Francesco Rubino 



GI Dynamic Consulting Fee Consultant 

NGM Biotech Consulting Fee Advisory Committee 

Yoshihisa Saida Boston JAPAN Consulting Fee Consulting 

Barry A Salky 

NeatStitch, LTD 

Ownership Interest 

Membership on Advisory 

Committees or Review Panels, 

Board Member 

Cleanoscope, LTD Shares in Company Advisory Board 

Bryan J Sandler ValenTx Consulting Fee Consulting 

Ethicon Endosurgery Other Financial Benefit Speaking and/or Teaching Research funding for lab 

Ethicon Endosurgery Other Financial Benefit Contracted Research Research funding for lab 

Byron F Santos Covidien Honorarium Speaking and/or Teaching 

Karl Storz Other Financial Benefit Contracted Research Equipmnt for research 

Karl Storz Other Financial Benefit Contracted Research Received Equipment 

Richard M. Satava 

InTouch Technologies Ownership Interest Other own stock in company 

Karl Storz Consulting Fee Consultant 

SurgiQuest Ownership Interest Advisory Committee 

Ethicon Endosurgery Consulting Fee Advisory Committee 

Gore Consulting Fee Consultant 

Philip R. Schauer Covidien Honoraria Speaking/Teaching 

Barosense Ownership Interest Advisory Committee 

Bard-Davol Other Other Research Funding 

Stryker Consulting Fee Advisory Committee 

Christopher M. 

Schlachta 

Steven D. 

Schwaitzberg 

Daniel J. Scott 

Niazy M. Selim 

Don J. Selzer 

Nilay R Shah 

Johnson and Johnson Medical 

Products 


Advisory Committee 


Surgiquest Ownership Interest Advisory Committee 

Stryker Honoraria Advisory Committee 

Endocore Consulting Fee Independent Contractor 

MITI Ownership Interest Advisory Committee 

Cambridge Endo Ownership Interest Advisory Committee 

Neatstitch Ownership Interest Advisory Committee 

MMDI Consulting Fee Consultant 


Accelerrated Technologies, Inc. Consulting Fee Consultant 


Sponsored research, 

advisory panel, teaching 

Ethicon Other Other sponsored research 

Magnetically Anchored Instruments IP Rights Other Co-inventor 

NeatStitch Consulting Fee Consultant 

Storz Other Other Equipment Grant 

Luxor Software Services, LLC Ownership Interest Other Owner 

Intuitive Surgical Honoraria Speaking/Teaching 

Cambridge Endo Ownership Interest Advisory Committee 

Cook Biotech, Inc. Salary Advisory Committee 

Covidien Other Other Educational Grant 

Elemental Healthcare /Cambridge 

Endo 

Honoraria 

Speaking/Teaching 

Ethicon Endosurgery Other Other Educational grant 

MMDI Other Financial Benefit Contracted Research 

Covidien Other Financial Benefit Contracted Research 

BarrX Other Financial Benefit Contracted Research 




Suturtek Ownership Interest Consultant 

transenterix Ownership Interest Consultant 

Paresh C. Shah Ventralfix Ownership Interest Management Position 



David E Skarda 

Covidien Consulting Fee Speaking and/or Teaching 

Ethicon Consulting Fee Speaking and/or Teaching 


Toyooki Sonoda Applied Medical Honoraria Speaking/Teaching 

Tyco Honoraria Speaking/Teaching 

Terumo Honoraria Advisory Committee 

Nathaniel J. Soper 

TransEnterix Consulting Fee Advisory Committee 

Karl Storz Other Other 

equipment used for 

education and research 

Greg V. Stiegmann Valley Lab Honoraria Speaking/Teaching 

Lee L. Swanstrom 

Boston Scientific 

Other 

Ethicon Other Other education grants 

Patricia Sylla Covidien Consulting Fee Consultant 

Zoltan Szabo Karl Storz Endoscopy Royalty 

Surgica Structure 

Ownership Interest 

MST 


Amir Szold 

Nicast 


Niti Medical 


Visionsense 

Other 

Virtual Ports 

IP Rights 

Apollo Endosurgery Other Consultant 

Mark A. Talamini 

Covidien Other Advisory Committee 

Max Endoscopy Other Advisory Committee 

Sanofi-Aventis Other Consultant 

Novare Consulting Fee Consultant 

Julio A. Teixeira 


Allergan Inc. Honoraria Advisory Committee 

Ethicon Endosurgery Consulting Fee Consultant 

USGI Medical Consulting Fee Consultant 

USGI Medical Honoraria Advisory Committee 

Power Medical Honoraria Advisory Committee 

Covidien Honoraria Advisory Committee 



Christopher C. 

Thompson 

Bard Royalty Other Licensing Agreement 

Bard Other Other 

Grants for research 

support 

Bard Honoraria Consultant 

Bard Honoraria Advisory Committee 

Bard Consulting Fee Consultant 

Valentx Consulting Fee Consultant 

Jonathan R Thompson Ethicon Endosurgery Consulting Fee Consulting 

Allergan Other Financial Benefit Speaking and/or Teaching 

Kari Thompson Olympus Honorarium Consulting 

Ethicon Other Financial Benefit Speaking and/or Teaching 

Philippe A Topart 

ETHICON Honorarium Speaking and/or Teaching 

GORE Other Financial Benefit Other Activities 

Alfonso Torquati 

Duke 

Covidien Consulting Fee Advisory Committee 






Tung T Tran Covidien Other Financial Benefit Other Activities 

Unrestricted educational 

grant 

Thadeus L. Trus 



Shawn T. Tsuda 



Surendra M. Ugale Ethicon Endosurgery Other Speaking/Teaching 

Anthony J. Vine Ethicon Endosurgery Consulting Fee Speaking/Teaching 

W.L. Gore Consulting Fee Consultant 

Guy R. Voeller 

Atrium Consulting Fee Consultant 


Davol Honoraria Speaking/Teaching 

Century Medical Incorporated Consulting Fee Consultant 

Signalomics Gmbh Consulting Fee Consultant 

Power Medical Interventions IP Rights Other inventor 

Niti Consulting Fee Consultant 

Neatstitch Ownership Interest Board Member 

Neatstitch Consulting Fee Consultant 

Medtronics Consulting Fee Consultant 

Karl Storz Endoscopy America IP Rights Other inventor 

Karl Storz Endoscopy America Consulting Fee Consultant 

Intuitive Surgical Ownership Interest Consultant 

Steven D. Wexner 

Renew Medical Consulting Fee Consultant 

Incontinence Devices Inc Consulting Fee Consultant 

EZ Surgical Ownership Interest Consultant 

EZ Surgical Consulting Fee Consultant 

Ethicon Inc Consulting Fee Consultant 

Unique Surgical Innovations Ownership Interest Management Position 

Covidien IP Rights Other inventor 

Advanced Surgical Innovations Ownership Interest Management Position 

Adolor/Glaxo Smith Kline Honoraria Speaking/Teaching 

SurgRX Consulting Fee Consultant 

SurgRX Ownership Interest Consultant 

Cr Bard Consulting Fee Consultant 

Bristol Meyers Squibb Other Other PI on Phase 1 Drug trial 

Olympus Corporation Honoraria Speaking/Teaching 

R. Larry Whelan Applied Medical Other Other multi-center study 

PolyE Pharma Corporation Other Other 

Murine and human study 

testing drug 

Sanofi Aventis Honoraria Speaking/Teaching 

Mark H. Whiteford Richard Wolf Medical Instruments Consulting Fee Consultant 

Applied Medical Honoraria Speaking/Teaching 

Natan Zundel 

Ethicon Endosurgery Honoraria Consultant 

Cinemed Honoraria Speaking/Teaching 


Notes 




World Congress Social Programs 

Welcome Reception 

Date: Wednesday evening, April 14, 2010 

Time: 

Place: 

Fee: 

Dress: 

5:00 - 7:00 PM 


No Fee for Registrants & registered guests. 

Ticketed Event. 

Business casual 

Special promotions, presentations and entertainment. 

Great food! Open bar! 

Note: Children under the age of 14 will not be permitted in the Exhibit Hall due to safety considerations. 

SAGES Meet the Leadership Reception 

for New SAGES Members 

Residents and Fellows 

Date: Friday Evening, April 16, 2010 

Time: 

Place: 

Dress: 

6:00 - 7:00 PM 

Gaylord Hotel, Pose 18 th -19 th floor 

Casual 

“All The News” World Congress Gala 

An Evening at “The Newseum” 

Dinner and Sing-Off 

Date: Saturday Evening, April 17, 2010 

Place: 

Time: 

Dress: 

Fee: 

Tickets: 

“The Newseum” Pennsylvania Ave & Sixth St. NW, Washington 

7:30 - 11:30 PM 

Business Casual 

Included in Registration for SAGES SuperPass (Option A), & registered guests. 

$140.00 (for additional guests and SAGES Registration Options B & C) available at Registration desk until Friday 5:00 PM 

Join us for an international evening at “The Newseum” – a museum of news that blends five centuries of news history with up-to-the-second 

technology and hands-on exhibits. As you enter you’ll see a 74-foot-high marble engraving of the First Amendment. With seven levels of 

galleries and theaters, The Newseum is a unique environment where we go behind the scenes to experience how and why news is made. 

Fabulous food by world renowned caterer Wolfgang Puck and plenty of bars. 

The evening will conclude with the World Congress International Sing-Off. 


World Congress Tours 

Tour 1: Wonders of Washington 

Date: Thursday, April 15, 2010 

Time: Depart 9:00 AM – 4 1/2 hours 

Buses load beginning at 8:45 AM 

Fee: 

$50.00 per person 

Includes: Deluxe Climate-Controlled 

Motor coach D.C. Licensed, 

Uniformed Tour Guide, All 

Admissions and Appointments 

Washington, DC, is one of only three planned 

federal capitals. George Washington chose 

this site in 1790, and selected Pierre Charles 

L’Enfant to design the city as the capital for the 

new United States. 

One of the city’s finest tour guides will 

introduce you to the history, architecture 

and grandeur of Washington, DC. Engaging 

stories, little known facts, and trivia will be told 

as you explore the monuments, memorials 

and notable buildings. Drive by the The 

“Church of the Presidents”, the White House, 

Smithsonian Institution Complex and the 

Washington Monument. See the Capitol 

Dome and travel the inaugural parade 

route and see the FBI Building. Then stop at 

one of the most visited areas of the city, the 

National Park that boasts as its centerpieces 

the Lincoln, Vietnam War and Korean War 

Veterans Memorials. See the National World 

War II Memorial and walk where Martin Luther 

King gave his “I Have a Dream” speech. Enjoy a 

short ride along the Tidal Basin to the Jefferson 

and Franklin Delano Roosevelt Memorials. 

Tour 2: Where Fabulous Lives – 

Hillwood Museum and Gardens 

Date: Friday, April 16, 2010 

Time: Depart 9:00 AM – 5 hours 


Fee: 



Motor coach, D.C. Licensed, 

Uniformed Tour Guide, Tour of 

Estate, All Admissions, Elegant 

lunch at Hillwood 

Travel to the former home of Marjorie 

Merriweather Post to experience the opulent 

lifestyle and aristocratic luxury of her 25-acre 

estate, known as Hillwood. Mrs. Post was the 

heiress of the Post cereal fortune and mother 

of famous actress Dina Merrill. She furnished 

her 40-room Georgian-Style Mansion with a 

collection of 18th and 19th century Russian 

and French decorative art, including Fabergé 

eggs, Russian Imperial icons, rare tapestries 

and priceless objects d’art. See period pieces 

from the reign of Catherine the Great and 

the nuptial crown worn by Empress Alexandra 

at her wedding to Nicolas II in 1894. A stroll 

through the lavish gardens and greenhouse will 

charm you. A Russian dacha (summer house) 

and Greenhouse shelters a stunning display 

of 5000 orchids. You will enjoy lunch in the 

beautiful café on the grounds of the estate. 

Tour 3: Washington’s 

Great Private Museums – 

The Kreeger and the Phillips 

Date: Saturday, April 17, 2010 

Time: Depart 9:30 AM – 6 hours 


Fee: 



Motor coach, D.C. Licensed, 

Uniformed Tour Guide, Tours of 

Both Museums, All Admissions, 

(Lunch on your own) 

Begin with a docent-led tour of the Kreeger 

Museum. Renowned architect Philip Johnson, 

famous for such masterpieces as the pre- 

Columbian gallery at Dumbarton Oaks in 

Georgetown and the Lincoln Center in New 

York, designed this magnificent home for David 

Kreeger, the insurance magnate. Completed 

in 1967 the Kreeger is a Showcase for 

its collection of 19th- and 20th-century 

Masters, with more than 180 works by Picasso, 

Monet, Miro, Rodin and Kandinsky, as well 

as other contemporary artists. The 66-foot 

great hall was designed for chamber music 

ensembles where artists such as Isaac Stern 

have performed. The Phillips Collection was 

the first permanent museum of Modern art 

in the U.S. and served as the home of Duncan 

Phillips. This Georgian Revival Style Mansion 

boasts as the centerpiece of its collection, 

Renoir’s “Luncheon of the Boating Party”. 

This outstanding collection concentrates on 

French Impressionist, Post Impressionist and 

American Modernist paintings. 


Tour tickets 

may be 

purchased at 

Registration 

desk until tours 

are sold out 

FYI! Getting Around National Harbor: 


In addition to cabs and rental cars, the National Harbor offers a 

fun and practical way to get to various destinations…a water taxi! 

Water taxi service is available to and from points around Washington 

D.C., Virginia and Maryland for your convenience. The Potomac 

Riverboat Company operates water taxi service between National 

Harbor and Old Town Alexandria, with additional boat service to Mount 

Vernon and Georgetown. Water taxis will run every half hour between 

National Harbor and Old Town Alexandria. There will be three daily 

trips to Georgetown’s Washington Harbor, and a single daily trip to 

George Washington’s Mount Vernon Estate. Ask the concierge for more 

information. 



Notes 


Scientific Session Oral Abstracts 

S001 

MOST RECENT NATIONAL SURGICAL QUALITY IMPROVEMENT 

PROJECT DATA (NSQIP), COMPARISON OF LAPAROSCOPIC VS. OPEN 

COLON RESECTIONS Dan Ruiz, MD, Alexander Kraev, MD, Steven Nurkin, 

MD, Darshak Shah, MD, James W Turner, MD, Howard Tiszenkel, MD New 

York Hospital Queens 

BACKGROUND. The ACS National Surgical Quality Improvement Program 

(ACS NSQIP) is the first nationally validated, risk-adjusted, outcomesbased 

program to measure and improve the quality of surgical care. The 

program employs a prospective, peer controlled, validated database 

to quantify 30-day risk-adjusted surgical outcomes, which allows valid 

comparison of outcomes among all hospitals in the program. The most 

recent 2008 National Surgical Quality Improvement Project (NSQIP) 

database, contains over 240,000 surgical cases. 

METHODS. The 2008 NSQIP database was queried for all patients 

undergoing colon resection. Patients were divided into laparoscopic and 

open groups based on CPT procedure codes. Difference in 30-day survival 

between subgroups was evaluated using Kaplan-Meier and logistic 

regression analysis. Pre-operative morbidity was compared using the 

unpaired t-test. 

RESULTS. There were 17224 patients who underwent colon resection in 

2008. Patients who underwent laparoscopic operation had a significantly 

better survival at thirty days over open (98.8% vs 94.7%, logrank p-value 



procedural tasks one time with haptics engaged at the default setting. 

The haptics trained group was sequentially trained to proficiency in the 

basic tasks and then performed each of the procedural tasks one time 

with haptics engaged. The non-haptics group used the same training 

protocol except haptics was disengaged. Proficiency was to previously 

published expert values. Each group was assessed in the performance 

of ten laparoscopic cholecystectomies (alternating with and without 

haptics). Performance was measured via automatically collected simulator 

data. Unpaired student t-test was used to compare the groups. A p value 


3 months after surgery. The mean follow up is 26 months. The series 

shows that mere size should not be considered as a contraindication 

to laparoscopic approach in large adrenal masses. Graded approach to 

LA1, adherence to strict anatomical principles, minimum handling of 

the tumor and dissection of the body away from the tumor is the key 

to success. We suggest that large adrenal masses should be tackled by 

experienced laparoscopic surgeons. 

1. Laparoscopic adrenalectomy:Gaining experience by graded approach. 

Dalvi A, Thapar P et al. J Minimal Access Surgery 2006;2:59-66 

S006 

COMPARISON OF OPEN LIVE DONOR NEPHRECTOMY, LAPAROSCOPIC 

LIVE DONOR NEPHRECTOMY, AND HAND-ASSISTED LIVE DONOR 

NEPHRECTOMY: A COST-EFFECTIVENESS ANALYSIS Derek E Moore, MD 

MPH, Matthew Landman, MD, Deonna Moore, MSN, Irene Feurer, PhD, C W 

Pinson, MD MBA Vanderbilt University Medical Center 

INTRODUCTION: Live donor kidney transplantation is the treatment of 

choice for end-stage renal failure. Open Donor Nephrectomy (ODN) was 

the standard until the introduction of Laparoscopic Donor Nephrectomy 

(LDN) in 1995. Hand-Assisted Laparoscopic Donor Nephrectomy 

(HALDN) was added shortly thereafter. While decreasing post-operative 

analgesic requirements and speeding return to normal activity, the 

laparoscopic techniques are associated with longer operative times and a 

minor increase in peri-operative complications. The aim of this study is to 

evaluate the cost-effectiveness of the different techniques. 

METHODS: A decision analytic model was created to simulate outcomes 

for donors undergoing ODN, LDN, and HALDN. Baseline values and 

ranges were determined from the SRTR database and a literature 

review. Sensitivity analyses were conducted to test model strength and 

parameter variability. 

RESULTS: Donors undergoing LDN and HALDN accrued less cost and had 

a superior quality of life when all factors were considered in this model. 

HALDN costs are lower $13,000 vs LDN $15,000 and ODN $17,000. HALDN 

was the dominant scenario in all models. 

CONCLUSIONS: By requiring less post-operative analgisia, returning 

to normal activity faster, and having a more favorable peri-operative 

complication rate; the HALDN was the more cost-effective procedure for 

live donor nephrectomy. 

S007 

MULTICENTER COMPARISON OF INTERMEDIATE ONCOLOGIC 

OUTCOMES OF LAPAROSCOPIC PARTIAL NEPHRECTOMY AND RENAL 

CRYOABLATION Sean Stroup, MD, John Malcolm, MD, James L’Esperance, 

MD, Robert Wake, MD, Michael Fabrizio, MD, Ithaar H Derweesh, MD 

University of California San Diego, University of Tennessee at Memphis 

Health Science Center, Eastern Virginia Medical School 

Introduction: The surgical paradigm for small renal masses has evolved 

towards less invasive nephron sparing intervention. While partial 

nephrectomy remains the gold standard for the management of most 

small renal masses, increasing experience with renal cryoablation has 

suggested a viable alternative with a favorable morbidity profile and good 

efficacy. We compare intermediate-term oncologic outcomes following 

laparoscopic partial nephrectomy (LPN) and renal cryoablation (RC) from 

a multi-center experience. 

Methods: We performed a retrospective review of our LPN and RC 

experience between 9/1998 and 3/2008. Patients with at least 6 months 

follow-up were included in the analysis. LPN was performed via a 

transperitoneal approach. RC was performed via a percutaneous or 

transperitoneal laparoscopic approach. Follow-up consisted of imaging 

and laboratory studies at regular intervals. Persistent mass enhancement 

or interval tumor growth was considered a treatment failure following 

RC, and repeat biopsy and retreatment were recommended. Residual 

enhancing tumor was evidence of treatment failure following LPN. 

Results: 119 patients (60%male, 39%black, mean BMI: 29.3) underwent 

RC with a mean follow-up of 29.5 months (range: 7-120). 123 patients 

(41%male, 34%black, mean BMI: 27.5) underwent LPN with a mean followup 

of 23.8 months (range: 7.7-74.6). Average patient age was 58 for LPN 

and 68 for RC (p



Conclusions: We have validated a novel wireless pulse oximeter capable 

of detecting intraoperative tissue hypoxia. A clinical trial in esophageal 

and gastric anastomotic surgery is planned in order to test the efficacy of 

the WiPOX in reducing anastomotic complications. 

S009 

A PILOT STUDY OF USING MULTIPHOTON MICROSCOPY TO DIAGNOSE 

GASTRIC CANCER Jun Yan, MD, Gang Chen, MD, Jianxin Chen, PhD, 

Shuangmu Zhuo, PhD, Hui Yu, MD, Mingang Ying, MD Fujian Provincial 

Tumor Hospital, Fuzhou, 350014, China 

Introduction: Using a combination of autofluorescence from cells 

and second harmonic generation signal from collagen, multiphoton 

microscopy (MPM) imaging can provide detailed information on 

tissue architecture and cellular morphology. The purpose of this 

study was to evaluate the feasibility of using MPM to diagnose gastric 

cancer, compared with gold standard hematoxylin-eosin (H-E) stained 

histopathology. 

Methods: A pilot study was performed between June 2009 and 

September 2009. 10 cases with gastric cancer confirmed by pre-op 

endoscopic biopsy underwent gastrectomy in Fujian Provincial Tumor 

Hospital. Each fresh specimen was opened by an attending pathologist. 

Cancer area and normal area in the specimen received examination 

under MPM in Key Laboratory of Optoelectronic Science and Technology 

for Medicine of Fujian University. After MPM examination, the same 

cancer area and the normal area in the specimen were received routing 

histopathological examination. MPM images and H-E stained images were 

compared by the same attending pathologist. 

Results: MPM images were acquired in two channels: broadband 

autofluorescence from cells, and second harmonic generation from tissue 

collagen. Cancer cells were identified in MPM images in the cancer area of 

10 specimens, which were confirmed by H-E stained slides. Normal area 

in 10 specimens didn’t have cancer cells in MPM images and H-E stained 

images. 

Conclusions: It is feasible to use Multiphoton microscopy to diagnose 

gastric cancer. With development and equipped into endoscopy, 

multiphoton microscopy maybe provide a real-time diagnosis without 

invasive biopsy for gastric cancer in the future. 

S010 

EFFICACY OF TURMERIC (CURCUMIN) IN PAIN AND POSTOPERATIVE 

FATIGUE AFTER LAPAROSCOPIC CHOLECYSTECTOMY - A DOUBLE 

BLIND, RANDOMIZED PLACEBO CONTROLLED STUDY Krishna A 

Agarwal, C D Tripathi, MD, Brij B Agarwal, MS VMMC & Safdarjung Hospital, 

Dr. Agarwal’s Surgery & Yoga and Sir Ganga Ram Hospital, New Delhi, 

India 

Objective of Study: Popularity of laparoscopic surgery owes largely 

to improved patient reported outcomes (PRO). Postoperative pain and 

fatigue are important indices of return to activity based quality of life 

PROs. Turmeric has been successfully used in India as a monotherapy 

for traumatic pain & fatigue. Curcumin, the active ingredient of turmeric 

has anti-inflammatory / anti-oxidant & tissue modulation / healing 

properties reported even at nanomolar levels without any toxicity & a 

wide therapeutic window. We studied the effect of curcumin on pain and 

postoperative fatigue in patients of Laparoscopic cholecystectomy (LC), 

an index Laparoscopic procedure. 

Methods and procedures: From July - September 2009 fifty unselected 

consecutive day care LC candidates were enrolled for this prospective, 

double blind randomized placebo (well matched & label blind) controlled 

study with ethics and informed consent protocol. Pregnant / lactating 

ladies, patient with psychosis/ neuropathic pain / alcohol or drug 

dependence / on self-administered analgesics /on regular analgesics or 

immunosuppressive or cytotoxic or steroid therapy were excluded. 

Any perioperative adverse event was the withdrawal criteria. A standard 

general anesthesia and perioperative analgesia protocol was followed for 

the LCs. No analgesic was prescribed at discharge except for either of the 

label blinded curcumin / placebo in 6 hourly dosage. Patients were asked 

to maintain pain / fatigue / any adverse event diaries based upon 100 

point visual analog scale (VAS) for pain and 10-point interval rating scale 

(IRS) for fatigue. Paracetamol 650 mg was the rescue analgesic. Patients 

were asked to record the number of tablets used during the 3 weeks. 

Patients were followed up on 3 rd day (D3), 1 st week (W1), 2 nd week (W2) 

and 3 rd week (W3) for prospective data. The random labels assigned were 

opened & entered for the corresponding patients only at the end of study 

for analysis. 

Results: The patients in the study (n=25) and the control group (n=25) 

were well matched for demographics, co-morbidity and gallbladder 

inflammation parameters. There was no withdrawal. All patients were pain 

free at W3 follow up. Analgesic tablet usage in 3 weeks was 7 (5-11) in the 

study group versus 39 (18-79) in the control group. 



Table showing the mean (range) scores of post-operative pain & fatigue. 

Group Pain Scores Fatigue Scores 

D3 W1 W2 D3 W1 W2 W3 

Study 45(30-85) 15(10-25) 15(10-25) 6(4-10) 2(1-8) 1 0 

Control 40(35-80) 30(15-50) 32(18-56) 6(5-10) 5(4-9) 4(1-7) 1 

Conclusions: Turmeric (Curcumin) improves the postoperative pain & 

fatigue related PROs in patients of laparoscopic cholecystectomy. In view 

of encouraging results, benefits of a non-toxic common food ingredient 

i.e. turmeric (Curcumin) need to be studied in large, multi-centric, multiethnic 

studies. 

S011 

3-CCD (CHARGE COUPLED DEVICE) IMAGE ENHANCEMENT FOR 

BOWEL ISCHEMIA John C Graybill, MD, Nicole Crane, PhD, Susan M 

Gillern, MD, Eric A Elster, MD, Jonathan P Pearl, MD Naval Medical Research 

Center; National Naval Medical Center; Walter Reed Army Medical Center 

Introduction: Determination of bowel perfusion in cases of strangulating 

hernias, SMA occlusion, and other ischemic states is currently a subjective 

decision of surgeons. 3-CCD image enhancement allows objective and 

quantitative criteria to be included in a surgeon’s decision as to whether 

bowel resection is warranted secondary to ischemia. 3-CCD technology 

separates visible light into its three primary wavelength regions (red, 

green, and blue); by using an easily implemented mathematical 

algorithm, the amount of light detected by the red, green, and blue CCDs 

can be directly correlated with tissue oxygenation. We have previously 

demonstrated the utility of this approach in vessel identification, partial 

nephrectomy, donor nephrectomy, and now extend these studies to 

bowel ischemia. 

Materials and Methods: In a pilot study, two cases of ischemic bowel 

were analyzed using 3-CCD laparoscopic images and 3-CCD image 

enhancement. Ischemic bowel presented with lower values than healthy 

bowel. Watershed areas were then designated as either ischemic or 

well-perfused. To adjust for variations in brightness and clarity inherent 

to laparoscopic imaging, images were standardized such that fat always 

received a value of “1”. Fat is ubiquitous and well-perfused due to its 

numerous capillaries. 

Results: In this scenario, healthy bowel received a value of “0.727” while 

ischemic bowel received a value of “0.486,” with a p-value



medications. Post-operatively, mean leptin expression was decreased 

for all morbidly obese patients. However, this value was not significantly 

decreased (p=0.16). Post-operatively, mean resistin expression was 

unchanged for the entire cohort (p=0.36). However, resistin expression 

was significantly lower (p=0.05) after surgery in diabetic morbidly obese 

patients. Post-operative resistin expression in non-diabetic morbidly 

obese patients was not significantly different from pre-op values (p=0.32). 

Conclusions: This unique data shows that decreased gene expression 

of resistin and leptin may play a significant role in normalizing insulin 

resistance in morbidly obese patients following bariatric surgery. Also, this 

preliminary data suggests that modulation of resistin expression plays 

a role in diabetic obese patients and not necessarily in morbidly obese 

patients without T2D. Patient recruitment is ongoing to further elucidate 

these trends. Specific understanding of the pathways by which these 

adipocytokines contribute to both obesity and T2D could potentially lead 

to novel therapies for these conditions. 

S014 

COMMON BILE DUCT EXPLORATION IN DECLINE: MAJORITY OF 

THESE PROCEDURES ARE DONE IN NON-TEACHING HOSPITALS IN 

THE US. Samuel Jacob, MD, Marek Rudnicki, MD PhD Metropolitan Group 

Hospitals/University of Illinois Surgery Residency Program Chicago, USA 

BACKGROUND: Common bile duct (CBD) exploration used to be one 

of the relatively frequent procedures in armamentarium of the general 

surgeon. With raise of minimally invasive techniques one may expect 

diminished needs and fewer indications for that surgery. 

OBJECTIVE: The purpose of this study was to determine nationwide 

trends of cholecystectomy and common bile duct exploration over 10 

years period. In addition, this investigation was designed to evaluate 

utilization of these procedures in the teaching and non-teaching US 

Hospitals contributing to the National Inpatient Sample database. 

METHODS: The National Inpatient Sample from the Healthcare Cost and 

Utilization Project was analyzed for 1997-2007 nationwide trends for open 

and laparoscopic cholecystectomy using ICD-9 procedure codes 51.22, 

51.23 respectively, and exploration of CBD with and without CBD stone 

removal (51.41, 51.51). The data was subcategorized based on two main 

hospital characteristics: teaching or non-teaching hospitals. Analyzed 

data were weighted to provide national estimates. Statistical testing was 

performed using Z-test. The trends were studied using trendlines with 

R-square values as the coefficient of determination. 

RESULTS: Number of cholecystectomies did not change over the 

observed period and ranged from 442,260 in 1997 to 429,805 in 

2007 (R=0.0005). Open cholecystectomies declined from 138,116 

in 1997 to 86,582 in 2007 (p


S017 

INITIAL EXPERIENCES IN 70 CASES OF TOTALLY LAPAROSCOPIC LIVER 

RESECTION FOR HCC Nguyen Hoang Bac, PhD, Tran Cong Duy Long, MD, 

Nguyen Duc Thuan, MD, Le Tien Dat, MD Medical University Center at 

Hochiminh city 

Initial experiences in 70 cases of 

Totally Laparoscopic Liver resection for HCC 

Background: Laparoscopic surgery now is commonly applied for several 

kinds of different operations, but laparoscopic liver resection is still under 

survey. The objective of this study was to evaluate the feasibility and 

safety of this technique for HCC 

Patients and methods: Perspective and descriptive study. From Sep 2005 

to Feb 2008, we performed laparoscopic liver resections for 70 patients 

with HCC.The accompanied cirrhosis was in fifty two patients – 74% (51 

with Child A and 1 with Child B); mean tumor size 3.75 cm (2-10) and 

tumor locations were as follows: 

• 31 (44.3%) in left lateral segment, 

• 4 (5.7 %) in segment IVb, 

• 13 (18.6%) in segment V, 

• 12 (17.1%) in segment VI, 

• 2 (2.9%) in segment VII, 

• 1 (1.4%) in segment VIII 

• 3 (4.3%) in the posterior segments 

• 4 (5.7%) in segment V and VI 

Results: We performed 31 cases of one segmentectomy include: 

• 4 cases of segment II, 2 of segment III, 4 of segment IV, 8 of segment V, 

11 of segment VI, 1 of segment VII and 1 of segment VIII. 

There were 33 cases of bisegmentectomy include: 

• 24 (34.3%) cases of left lateral segmentectomies, 

• 3 (4.3%) posterior segmentectomy, 

• 6 (8.6%) V-VI bisegmentectomy. 

After Laparoscopic Diagnostic operation, three (4,3%) patients were 

not suitable for liver resection because of severe cirrhosis. One of them 

underwent RFA and 2 had TACE after operation. 

We had 3 (4.3%) patients converted to other procedures because 

of severe intraoperative bleeding. We converted to open operation 

after right hepatic vein was injured in one patient, or performed 

Minilaparotomy to control bleeding and continued to transect the 

parechymal laparoscopically in one, and converted to hand-assissted to 

define the tumor and divided the parechymal in the other. 

Mean operation time was 118 minutes (30-240). 

Mean Blood loss was 221 ml (0-1000ml) that required no blood 

transfusion. 

Hospital stay was 6.23 days (4-17 days). 

The Surgical margin less than 1cm was in 13 (18.5%) patients; from 1 to 

2cm was in 37 (61.5%) and more than 2cm in 14 (20%) patients. But we 

had only one positive surgical margin. 

There was no postoperative complication and no mortality. 

After 10-month follow-up (1–31 months) there are 3 recurrence cases and 

two of them can be reoperated (one open and 1 laparscopic operations). 

Conclusion: Laparoscopic liver resection is feasible and safe for selective 

patients with peripheral tumors located in the left lobe or in the segment 

IVb, V, VI, VII of the right liver. 

S018 

LAPAROSCOPIC MANAGEMENT OF CBD STONES: AN 

INDIAN EXPERIENCE Jagdish Chander, MD, Pawanindra Lal, 

MDDNBFRCSEdFRCSGlasg, Anubhav Vindal, MD, Vinod K Ramteke, MD 

Maulana Azad Medical College, New Delhi, India 

Introduction: India has a high incidence of gall stones and consequently 

of CBD stones (CBDS) which are very different from that seen in the west. 

It is not infrequent to see multiple, large, impacted stones in a hugely 

dilated CBD. Therefore many of these patients have been managed by 

open CBD exploration, even after advent of laparoscopic cholecystectomy 

(LC), since these large stones pose significant challenges for extraction by 

ERCP. This series presents the largest experience of managing CBDS using 

a laparoscopic approach from the Indian subcontinent. 

Material and Methods: Over the last 7 years, 150 patients of 

documented CBDS were treated laparoscopically in a single surgical unit 

at a tertiary care hospital in New Delhi. Of these 4 patients were managed 

through transcystic route and 140 through the trans-choledochal route. 

Of the latter, 29 patients were managed with a T-tube, 60 patients with 

an endobiliary stent, 31 patients had a primary closure of CBD, and 20 

had a choledochoduodenostomy. There were 6 conversions to open 

procedures. 

Results: There were 34 male and 116 female patients with age ranging 

from 15 to 72 years (mean of 46.9±12.4 years). The mean size of the CBD 

on ultrasound was 11.7±3.7mm (range of 4.0mm to 23.0mm) while that 

on MRCP was 13.8±4.7mm (range of 4.1mm to 30.0mm). The average 

number of stones extracted per patient was 7.5±11.8 with a range of 

1 to 70. The size of the extracted stones varied from 2mm to 30mm, 

with the average stone size being 11.5±4.8mm.The average duration of 

surgery was 139.9±26.3 min with a range of 90 to 205 min. The maximum 

duration was seen with conversion to open procedures followed by those 

with T-tube drainage. The mean intra-operative blood loss was 103.4±85.9 

ml (range 10 to 500 ml). 

In patients with T-tube drainage, the average duration for which the 

T-tube was kept was 13.1±5.0 days (range 9 to 36 days). There was one 

post-operative death (0.7%). Twenty three patients (15%) had nonfatal 

postoperative complications (25 events in total) ranging from minor 

complications like wound infection to more serious ones like bile leakage. 

There were 3 cases of retained stones (2%), all of which were managed 

effectively with post-operative ERCP.Post-operative stay ranged from 2 to 

33 days with an average of 4.6±4.1 days. The patients with conversion to 

open procedures had the longest stays, while those with primary closure 

had the shortest stays. 96% of the procedures could thus be completed by 

laparoscopic techniques. 

Conclusions: This study shows that for the subgroup of patients with 

multiple, large, impacted stones in a dilated CBD who were traditionally 

subjected to open CBD exploration owing to inefficiency of ERCP, 

minimally invasive procedure with its attendant benefits, in the form 

of laparoscopic CBD exploration (LCBDE) is highly effective and safe 

procedure. LCBDE when performed by an experienced surgeon results in 

no additional morbidity or mortality as compared to open surgery, with 

excellent success rates and 98% stone clearance from the CBD. 

S019 

GERIATRIC SURGERY: IMPACT OF AGE ON THE OPERATIVE DECISION 

IN GALLSTONE DISEASE Simon Bergman, MD MSc, Nadia Sourial, MSc, 

Shannon A Fraser, MD MSc, Wael C Hanna, MD, Isabelle Vedel, MSc, 

Michèle Monette, Gabriela Ghitulescu, MD, Issie Weissglas, MD, Johanne 

Monette, MD Department of Surgery, Sir Mortimer B. Davis Jewish General 

Hospital, Montreal, QC; Solidage Research Group on Frailty and Aging, 

Montreal, QC; Division of Geriatric Medicine, Sir Mortimer B. Davis Jewish 

General Hospital 

Introduction: Elderly patients with gallstone disease often present and 

are treated differently than their younger counterparts. We hypothesize 

that these differences also exist within age subgroups of elderly patients. 

The purpose of this study is to evaluate the relationship between age and 

disease severity and management of gallstone disease, and to identify the 





predictors of performing a cholecystectomy. 

Methods: This is a single institution retrospective chart review of hospital 

visits for patients ≥65 with biliary colic, cholecystitis, choledocholithiasis, 

cholangitis, or biliary pancreatitis, between April 2004 and April 2008. All 

prior visits for these patients were also reviewed. Disease severity 

outcomes were diagnosis (colic vs. complicated) at first visit, visit type 

(emergency department (ED) visit only vs. urgent admission vs. elective 

admission) and clinical severity score (calculated upon presentation to ED 

and based on temperature, pulse, BP, WBC, and symptom duration). 

Management outcomes were occurrence of cholecystectomy, occurrence 

of cholecystostomy tube, and admitting ward at first visit. Stratified age 

groups (Group 1: 65-75, Group 2: 75-85, and Group 3: ≥85) were compared 

using Mantel-Haenszel for proportions. Multivariable logistic regression 

was used to identify predictors of undergoing cholecystectomy. 

Results: 433 patients over 622 hospital visits were included in the analysis. 

Mean Charlson Comorbidity Index (CCI) for Group 1 (n=203), Group 2 

(n=169), and Group 3 (n=61) were 1.5±1.8, 2.2±2.1, and 2.3±1.9, 

respectively. Disease severity: At first visit, diagnosis was complicated 

disease in 34.0%, 63.1%, and 70.5% of patients (p


Conclusion: Our data suggest that bile duct injury rates are not 

influenced by the presence of a surgical training program. In addition, 

there were no significant differences in mortality for LC done at hospitals 

with surgical training programs when compared to hospitals without 

surgical training programs. There was a significant difference noted in 

admission type and conversion rates but this did not appear to affect the 

rate of bile duct injury. 

S022 

EVALUATION OF INTRAPERITONEAL PLACEMENT OF ABSORBABLE 

AND NONABSORBABLE BARRIER COATED MESH SECURED WITH 

FIBRIN SEALANT (NEW ZEALAND WHITE RABBIT MODEL) Eric D 

Jenkins, MD, Lora Melman, MD, Salil Desai, BA, Shaun R Brown, DO, 

Margaret M Frisella, RN, Corey R Deeken, PhD, Brent D Matthews, MD 

Department of Surgery, Washington University, St. Louis, Missouri 

Introduction: The purpose of this study is to evaluate the acute and 

chronic fixation strength of fibrin sealant as an alternative fixation method 

for laparoscopic ventral hernia repair (LVHR). 

Methods: Representative mesh types for LVHR included one 

nonabsorbable barrier mesh (Composix), and three absorbable barrier 

meshes (Sepramesh, Proceed and Parietex Composite). Macroporous 

polypropylene mesh (Prolite Ultra) served as control. Three methods of 

fixation were used, 0-polypropylene suture + fibrin sealant (ARTISS 4IU, 

Baxter Healthcare Corp.), fibrin sealant alone (ARTISS) or tacks alone, to 

secure 3x4cm pieces of mesh (n=10 each combination) to the peritoneal 

surface of New Zealand white rabbit abdominal wall. After 2 hours of 

incubation at 37C, specimens underwent acute testing, described below. 

Subsequently, a chronic phase was completed using the aforementioned 

fixation methods (n=10 each combination), where two 4x4cm pieces of 

mesh were secured intraperitoneally in each of 75 New Zealand white 

rabbits and survived eight weeks until sacrifice. A transparent grid overlay 

was utilized to measure mesh area and adhesion area. Adhesion tenacity 

was characterized using the Garrard adhesion scale. For both acute and 

chronic samples, a 3x3cm area of mesh-tissue interface underwent lap 

shear testing at a rate of 0.42mm/sec using a tensiometer (Instron 5542, 

Norwood, MA), for both acute and chronic samples. The maximum load 

sustained by the mesh-tissue construct was recorded as the acute fixation 

strength in Newtons (N). Data are given as means ± SEM. Statistical 

significance (p



impact of open versus endoscopic component separation in complex 

abdominal wall reconstruction. 

METHODS: All patients undergoing open and endoscopic CST between 

2005 and 2009 by a single surgeon at Case Medical Center were 

retrospectively identified. Length of stay and financial data were obtained 

for the primary admission. Direct and Indirect costs were evaluated. Direct 

costs were itemized as: operating room supplies/time, anesthesia, ICU, 

floor care, laboratory, imaging, pharmacy and supportive therapy. Median 

and interquartile ranges (IQR) were evaluated by Wilcoxon rank sum test 

with a p-value of


S027 

A COMPARISON OF OUTCOMES IN OPEN VERSUS LAPAROSCOPIC 

SURGICAL REPAIR OF RECURRENT INGUINAL HERNIAS Nilay R Shah, 

MD, Clayton T Hodges, BS, Vanchad R Memark, MD, Eric T Volckmann, 

MD, Clinton R Hall, MD, Bradley J Needleman, MD, Dean J Mikami, MD, 

Jeffrey W Hazey, MD, W. Scott Melvin, MD, Vimal K Narula, MD Center for 

Minimally Invasive Surgery, Division of Gastrointestinal Surgery, The Ohio 

State University Medical Center, Columbus, Ohio, USA 

Introduction: Inguinal hernia recurrence following surgical repair is a 

major concern. There are conflicting views in the surgical community 

regarding the best treatment approach to prevent recurrence. We report 

our experience with open and laparoscopic repair of recurrent inguinal 

hernias. 

Methods: After obtaining Institutional Review Board (IRB) approval, we 

retrospectively reviewed the charts of 98 patients who had surgical repair 

of recurrent inguinal hernias from January 2004 through July 2009. Repair 

techniques included open with mesh, transabdominal pre-peritoneal 

(TAPP), or totally extraperitoneal (TEP). Surgical variables and clinical 

outcomes were compared using Chi-square, Fisher’s exact, and Mann- 

Whitney U test. 

Results: Ninety-eight patients with a mean age of 55 years underwent 

either open mesh repair (N=16) or laparoscopic mesh repair (N=82) for 

recurrent inguinal hernias. Hernia recurrence was found on the right side 

in 51 patients, left in 41 patients, and bilaterally in 6 patients. The mean 

operative time was 75 minutes in the open repair and 66 minutes in the 

laparoscopic (TAPP or TEP) repair (p = 0.15). The mean follow-up was 

18.4 months. There were no re-recurrent hernias in the open group and 4 

(4.8%) re-recurrent hernias in the laparoscopic group (p=0.5). Two patients 

(12.5%) in the open group and 10 patients (12.1%) in the laparoscopic 

group had ongoing pain in the inguinal region (p=0.8). Five patients 

(31.3%) in the open group and 6 patients (7.3%) in the laparoscopic group 

had post-operative complications (p=0.02). 

Conclusions: Both the open and laparoscopic mesh approaches 

are acceptable in the treatment of recurrent inguinal hernias. In this 

retrospective review, there is no statistical difference in the re-recurrence 

rate between the two techniques. In this study, the complication rate in 

the open group is greater than in the laparoscopic group. Prospective, 

randomized multicenter clinical trials are required to determine the ideal 

approach for the treatment of recurrent inguinal hernias. 

S028 

30-DAY READMISSION AFTER VENTRAL HERNIA REPAIR: 

PREDICTABLE OR PREVENTABLE? Jeffrey A Blatnik, MD, Karem C Harth, 

MD MHS, Mark I Aeder, MD, Michael J Rosen, MD Department of Surgery, 

University Hospitals Case Medical Center, Cleveland, OH 

Introduction: Thirty-day readmission has become an increasingly 

scrutinized event in the field of surgery, especially in light of projected 

cuts in reimbursement. Our objective was to determine if any factors are 

predictive of 30-day readmission in patients undergoing ventral hernia 

repair. 

Methods: We retrospectively reviewed consecutive charts of patients 

who underwent laparoscopic or open ventral hernia repair from 

September 1st, 2005 through June 30th, 2009 by one surgeon at our 

institution. Perioperative variables included: age, gender, ASA score, BMI, 

# comorbidities (smoking, diabetes mellitus, COPD, immunosupression), 

number of prior abdominal surgeries, type of surgery and active 

abdominal infection at the time of surgery. The primary outcome measure 

was all cause 30-day readmission. Univariate analysis consisted of Mann- 

Whitney and Fischer’s or Chi-squared statistics. Multiple logistic regression 

was performed on significant variables followed by the likelihood ratio 

test to assess model significance. A p-value of



supported these impressions regarding increased technical difficulty, 

as LAP scores were significantly better than both LESS Straight and 

LESS Articulating scores. Furthermore, 59% indicated that articulating 

instruments did not help in performing the Peg task and the LESS Straight 

scores were significantly better than LESS Articulating scores. Despite 

these obstacles, 82% believe that LESS will be adopted by surgeons in 

the next 5 years, 97% believe that LESS will provide better cosmesis, and 

100% would offer LESS to their patients if appropriately trained. 

FLS PEG TRANSFER NORMALIZED SCORES 

LESS 

Conventional Laparoscopic Straight Instruments 

LESS 

Articulating 

Instruments 

N= 45 62.8 ± 62.1 34.6 ± 29.0* 18.9 ± 114.9* 

*p< 0.001 comparing LAP vs. LESS Straight, LAP vs. LESS Articulating, and LESS 

Straight vs. LESS Articulating; high scores indicate superior performance 

Conclusion: Despite the increased technical difficulty associated with a 

LESS approach, the majority of surgeons feel that LESS will be adopted. 

Further improvements in instrumentation and operative strategies 

are needed, in conjunction with robust training methods, including 

simulation, such that LESS procedures can be safely and efficiently 

performed. 

S030 

TRENDS AND RESULTS OF THE FIRST FIVE YEARS OF FUNDAMENTALS 

OF LAPAROSCOPIC SURGERY (FLS) CERTIFICATION TESTING Allan 

Okrainec, MD, Nathaniel J Soper, MD, Lee L Swanstrom, MD, Gerald M 

Fried, MD University of Toronto, Toronto, ON, Northwestern University 

Feinberg School of Medicine, Chicago, IL, Legacy Health System, Portland, 

OR, and McGill University, Montreal, QC 

Introduction: FLS is an educational program developed by the Society 

of American Gastrointestinal and Endoscopic Surgeons and endorsed by 

the American College of Surgeons. The goal of the FLS program is to teach 

and assess the basic cognitive and psychomotor skills required to perform 

laparoscopic surgery. The purpose of this study was to review the results 

from the first five years of FLS certification testing. 

Methods: FLS test data were prospectively collected for all participants 

taking the FLS certification examination since its inception. De-identified 

data were reviewed and analyzed using standard descriptive statistics. 

Results: The FLS examination was taken by 2189 participants between 

October 2004 and July 2009. There was a yearly increase in the number of 

individuals seeking FLS certification, with 13 participants tested in 2004, 

65 in 2005, 141 in 2006, 366 in 2007, 588 in 2008, and 1016 in the first 7 

months of 2009. Complete demographic information was available for 

approximately 1500 participants: 13% were junior residents (PGY 1-3), 

67% were senior residents (PGY 4-5) or fellows, and 20% were attending 

surgeons. A breakdown of participants by specialty revealed that 84% 

were general surgeons, 7% gynecologists, 2% urologists, and 7% were 

labeled as other. The mean (SD) score on the cognitive exam was 519 

(157) with a 93% pass rate. The mean score on the technical skills exam 

was 525 (117) with a 92% pass rate. After combining both scores, the 

overall FLS certification passing rate was 87%. 

Conclusions: The FLS certification exam has gained widespread 

acceptance among laparoscopic surgeons in training and practice with a 

marked increase in testing since the American Board of Surgery mandate 

for certification was announced. The overall pass rate of 87% on the 

examination approaches the target pass rate of 90%, established during 

the test-setting process. 

S031 

A NATIONAL TRAINING PROGRAM FOR LAPAROSCOPIC COLORECTAL 

SURGERY IN THE UK Danilo Miskovic, MD FRCS, Susannah M Wyles, 

MSc MRCS, Mark G Coleman, MD FRCS, George B Hanna, PhD FRCS 

Department of Biosurgery and Surgical Technology, Imperial College 

London/UK for the National Training Programme for Laparoscopic 

Colorectal Surgery 

Introduction: The aim of this study was to investigate the educational 


impact of a national training programme (NTP) for laparoscopic colorectal 

surgery by analysing peer- and self- assessments of trainers and trainees. 

Methods: Colorectal surgeons enrolled in the NTP (trainees) were trained 

in a series of individual live cases by expert laparoscopic surgeons 

(trainers). Trainers rated their trainees after each supervised case, 

using a Global Assessment Score form. Trainees completed a similar 

self-assessment form. The target score was set at 5 (=independent 

performance). Proficiency gain curves were analysed by CUSUM charts 

and interrater agreement by Bland Altman plots. 

Results: Analysis involved data of 252 cases (38 trainees and 20 trainers). 

The median number of training cases per trainee was 5.5 (range 

1-25). Trainers rated slightly higher then the trainees self-assessment 

[Variation +0.02 (2 SD=+/-1.3)]. On average the target score was reached 

approximately after case 15. A more detailed analysis of the CUSUM charts 

showed that theatre setup, exposure of the operating field, exteriorisation 

of the specimen and anastomosis was completed independently after 

five supervised sessions, whereas dissection of the vascular pedicle, 

mobilisation of the colon/ rectum took more than 15 procedures. 

Conclusions: These early results are supportive evidence for the efficacy 

of the National Training Programme in Laparoscopic Colorectal Surgery. 

Trainees scored themselves slightly lower than their trainers suggesting 

adequate insight. Furthermore, when planning training it should be noted 

that different stages of the operation are learnt at different rates. 

Figure: CUSUM chart of peer assessments by the trainer, with breakdown 

of the different components. 

S032 

ANALYSIS OF STANDARD MULTI-PORT VS. SINGLE SITE ACCESS FOR 

LAPAROSCOPIC SKILLS TRAINING AND ACQUISITION Daniel R Cox, BS, 

Wenjing Zeng, BS, L Michael Brunt, MD Washington University School of 

Medicine 

Introduction: Single site access (SSA) laparoscopy is gaining popularity 

but is more challenging to perform than laparoscopy using multiple 

separate port sites. This study examined the effect of standard multi-port 

(MP) laparoscopic skills training versus SSA training on laparoscopic skills 

acquisition and performance in surgically nave individuals. 

Methods: Forty end-of-first year medical students were randomized into 

two groups. Both groups were then trained on 4 laparoscopic drills (peg 

transfer [Peg], cobra rope [Rope], bean drop [Bean] and pattern cutting 

[Pattern]) using either a standard MP laparoscopic setup (Group 1) or an 

SSA skill approach (Group 2). Students then practiced the skills exclusively 

using the approach on which they were trained until a pre-determined 

proficiency level was reached. Training time to proficiency and number 

of repetitions (reps) for each drill were recorded. Each group then crossed 

over to the alternate approach where the sequence was repeated. 

Statistical analysis was performed using a two-tailed, unpaired t-test. 

Results: Mean skills times and numbers of repetitions to proficiency 

are in the table. Four students (3 in Gr. 1, one in Gr. 2) were unable to


complete the study. Total combined times to proficiency for the SSA and 

MP approaches was not significantly different between groups (Group 

1 MP 234.0 ± 114.9 min vs Group 2 SSA 216.4 ± 106.5 min, p=0.67). The 

MP-trained group took less time to reach proficiency on the standard 

MP setup than the SSA group did on the SSA approach (119.1 ± 69.7 min 

vs 178.0 ± 93.4 min, p=0.058) with significantly fewer repetitions (77.6 ± 

42.6 vs. 118.8 ± 54.3, p=0.027). When the SSA-trained group crossed over 

to the MP setup, they took significantly less time to reach proficiency for 

the MP setup than the standard MP-trained group (38.4 ± 29.4 min vs. 

119.1 ± 69.7 min; p=0.0013), reaching proficiency in a mean of only 26.9 

(range 11-65) total repetitions. Similarly, when the standard MP group 

crossed over to the SSA setup, they took significantly less time to reach 

proficiency with the SSA approach than the SSA-trained group (114.8 

±50.5 min vs. 178.0 ± 93.4 min, p=0.026) but with more total repetitions 

than was needed to achieve proficiency with the M-P approach (86.2± 

35.2 vs 77.6 ± 42.6, p= NS). 

Group Task Peg Peg Rope Rope Bean Bean Pattern Pattern Total Total 

Setup Time Reps Time Reps Time Reps Time Reps Time Reps 

1 (MP 

Trained 

MP 17.3 12.8 5.6 8.8 20.8 13.9 67.2 36.6 119.1 77.6 

1 SSA 35.4 29.6 8.8 13.1 21.3 14.2 51.7 29.7 114.8 86.2 

2 (SSA 

Trained 

SSA 53.9 38.2 13.8 19.3 29.2 19.6 81.9 42.1 178.0 118.8 

2 MP 5.4 4.5 0.8 1.4 4.9 3.2 28.4 18.7 38.4 26.9 

MP= multiport, SSA = Single site access 

Conclusions: Laparoscopic single site access skills training initially results 

in longer times and more repetitions to achieve proficiency than standard 

multi-port training, but the skills acquired transfer well to the multi-port 

approach. Both modalities should be used in training surgical residents 

for single incision laparoscopy in patients. 

S033 

A DEFICIENCY IN KNOWLEDGE OF BASIC PRINCIPLES OF 

LAPAROSCOPY AMONG ATTENDEES OF AN ADVANCED 

LAPAROSCOPIC SURGERY COURSE Carlos A Menezes, MD, Daniel W 

Birch, MD, Andrey Vizhul, MD, Xinzhe Shi, MPH, Vadim Sherman*, MD, 

Shahzeer Karmali, MD Centre for the Advancement of Minimally Invasive 

Surgery, University Of Alberta, Edmonton, Alberta, Canada; *Baylor 

College of Medicine, Houston, Texas, USA. 

Introduction: Advanced laparoscopic courses serve as a comprehensive 

and very popular Continuing Medical Education (CME) activity. 

Knowledge of basic laparoscopy is an assumed prerequisite for 

attendance at these courses. 

Objective: To determine the baseline laparoscopic knowledge of 

attendees at an advanced laparoscopic surgical course. 

Methods: A seventeen question exam was designed utilizing 

data from the basic laparoscopic quizzes on the Society of American 

Gastroenterological Surgeons (SAGES) website (www.sages.org/ 

education/quiz). The questions covered four realms of basic laparoscopy: 

access, pneumoperitoneum, camera navigation and surgical 

instrumentation. The questionnare was distributed to all attendees at 

an advanced laparoscopic course at the 2009 Canadian Surgical Forum 

organized by the Canadian Association of General Surgeons. 

Results: Forty three respondents completed the survey. Fifty-three 

percent (53%) of responders had been in practice for more than 10 

years and 65% had over 5 years experience. Fifty five percent (55%) 

[24/43] of respondents listed laparoscopic courses as the sole means of 

laparoscopic training. Sixty-one percent (61%)[28/43] were performing 

>50 laparoscopic cases per year. The median score on the knowledge 

based questions was 70.6% [12/17]. In terms of overall score, respondents 

with more than 5 years experience performed similarly to respondents 

with less than 5 years experience (73% correct answers) [Figure 

1]. Interestingly, in sub-group analysis, respondents performed well in 

camera skills and pneumoperitoneum themed questions (84% correct 

answers) but faired poorly on questions pertaining to instrumentation or 

access (52% correct answers)[Figure 2]. 

Conclusion: Basic laparoscopic knowledge among the attendees of an 

advanced laparoscopic course is sub-optimal. Review of basic principles 

of laparoscopy particularly pertaining to instrumentation and 

access should form part of these CME activities. 

S034 

EVALUATION OF SURGICAL PERFORMANCE DURING LAPAROSCOPIC 

INCISIONAL HERNIA REPAIR- A MULTICENTER STUDY Iman Ghaderi, 

MD, Marilou Vaillancourt, MD, Liane S Feldman, Gideon Sroka, MD, Pepa 

A Kaneva, MS, Melina C Vassiliou, MD, Jacob Seagull, PhD, Erica Sutton, 

MD, Carlos Godinez, MD, Ivan George, BSc, Adrian E Park, MD, Ian Choy, 

MD, Allan Okrainec, M Steinberg-Bernstein Centre for Minimally Invasive 

Surgery, McGill University, Montreal, QC, University of Western Ontario, 

London, ON, University of Maryland, Baltimore, MD, University of Toronto, 

Toronto, ON, Carolinas Medical Center, Charlotte, NC 

Introduction: Laparoscopic incisional hernia repair (LIHR) is a relatively 

common procedure yet requires advanced laparoscopic skills. There is no 

reliable or valid measure of performance during this procedure. The aim 

of this study was to develop a procedure-specific objective rating scale 

to assess performance of LIHR, and to evaluate its reliability and validity. 

Methods: The Global Operative Assessment of Laparoscopic Skills- 

Incisional Hernia Module (GOALS-IH) is a global rating scale developed 

by content experts consisting of 7 items evaluating the critical steps of 

LIHR (placement of trocars, adhesiolysis, estimation of size and shape of 

the mesh, introduction, orientation and positioning of the mesh, fixation 

of the mesh, knowledge and autonomy in the use of instruments, overall 

competence) each rated on a 5-point Likert scale (maximum possible 

score =35). During LIHR, 10 experienced and 12 intermediate level 

surgeons (PGY3 to 5) were evaluated at 4 University hospital centers 

by the attending, a trained observer and by self-assessment using the 

GOALS-IH, and by a previously validated 5-item general laparoscopic 

rating scale (GOALS). Interrater reliability was assessed by intraclass 

correlation (ICC), internal consistency of rating items by Cronbach’s 

alpha. Known-groups construct validity was assessed by t-test and by 

correlating the number of self-reported LIHR cases with total score; 

concurrent validity by correlating the procedure-specific rating scale with 

the GOALS general rating scale. Data are shown as mean (95% CI). Results: 

Interrater reliability for the total GOALS-IH score was 0.80 (0.56-0.92) 

between observer and attendings, 0.81 (0.58-0.92) between participants 





and attendings, and 0.89 (0.76-0.96) between participants and observer. 

Internal consistency was high, with Cronbach’s alpha 0.97. The correlation 

of each domain with total score ranged from 0.83 to 0.93. There was 

strong correlation between GOALS-IH and generic GOALS total scores 

(r =0.90, p


Materials and methods: Fourty-two LRHP were performed between 

2000 and 2008. The procedure was standardized by an expert in colorectal 

surgery. This included port placement, adhesiolysis, rectal stump 

management, splenic flexure mobilization, and colorectal anastomosis 

with early introduction of the anvil through the stoma. Trainee surgeons 

(experience inferior to 20 colorectal surgeries) were mentored by an 

expert surgeon (experience over 2,000 colorectal procedures). Operative 

time, conversion, complications and post-operative outcome were 

measured. The group of patients operated upon by the senior colorectal 

surgeon was compared to the group of patients operated upon by the 

trainee surgeons while being mentored by the senior surgeon. 

Results: Each group included 21 patients. All patients underwent LRHP 

successfully and no mortality occurred. No intra-operative significant 

difference was observed between the group of trainees and experts: 

operative time was of 131 minutes (range: 70-230) vs. 132 minutes 

(range: 60-240); conversion rate: 2 (1 ureteral injury in the trainee’s group, 

repaired intra-operatively and 1 difficult adhesiolysis in the expert’s 

group). Complications occurred in 6 patients (14%), 3 requiring reoperation 

(7%). Two complications occurred in the trainee’s group (1 early 

anastomotic stricture requiring re-operation, 1 late stenosis requiring 

endoscopic dilation). Four complications occurred in the expert’s group 

(two patients were re-operated upon during the first 30 days, 1 for a postoperative 

obstruction and 1 for an early post-operative fistula) and two 

were treated medically (1 port site infection, 1 rectorrhagia). The patient 

post-operative outcomes were comparable in both groups: oral intake: 3 

vs. 2 days; hospital stay: 6 vs. 7.5 days. 

Conclusion: Performing these difficult but standardized laparoscopic 

procedures offers the same results as when performed by trainees 

mentored by an expert surgeon, or carried out by an expert. The observed 

complication rate (14%) was comparable to that of experienced centres 

(131 to 48%2, including anastomotic leaks2; ureteral injury1, anastomotic 

strictures1,2 and re-operations (3.31 to 19%2). The expert mentoring does 

not prevent all intra-operative complications in challenging procedures, 

but can solve intra-operative technical problems that make the trainee 

more confident. Additionally, no intra-operative complication was 

encountered. Trainee mentoring and procedure standardization will 

probably increase their ability to perform more advanced procedures 

without any additional risk for the patient. Mentoring should be 

promoted as it can be performed locally or remotely through modern 

interactive technology. 

References 

1. Haughn C, Ju B, Uchal M, Arnaud JP, Reed JF, Bergamashi R. 

Complication rates after Hartmann’s reversal: open vs. laparoscopic 

approach. Dis Col Rect 2008;51:1232-1236. 

2. Aydin HN, Remzi FH, Tekkis PP, Fazio VW. Hartmann’s reversal is 

associated with high postoperative adverse effects. Dis Col Rect 

2005;48:2117-2126. 

S038 

TRANSGASTRIC APPROACH DOES NOT INCREASE POSTOPERATIVE 

INFECTIONS OR COMPLICATIONS IN SWINE UTERINE HORN 

RESECTION Asghar Azadani, MD, Henrik Jonsson, MD, Maria Bergstrom, 

MD PhD, Per-Ola Park, MD PhD Dept of Surgery, Sahlgrenska University 

Hospital, Gothenburg, Sweden, Dept of Surgery, South Alvsborg Hospital, 

Boras, Sweden 

Introduction: Doubts have been raised versus NOTES surgery concerning 

intra abdominal infectious complications. The aim of this study was to 

compare the postoperative course in open, laparoscopic and transgastric 

surgery, specially concerning infections and postop well being in a 

randomized porcine survival study. 

Methods & Procedures: 30 landrace pigs were randomized to open, 

laparoscopic or NOTES (transgastric) uterine horn resection with a survival 

time of 4 weeks. All animals were prepared with liquid diet for 2 days 

and fasted for 12 hours prior to surgery. They received a single dose of 

prophylactic antibiotics, Cefuroxim, at start of the procedure. No washing 

of the stomachs was performed in the transgastric group. All surgical 

procedures were performed by trained surgeons, NOTES operations 

were performed by trained surgical endoscpists. Open and laparoscopic 

surgery was performed using standard surgical techniques. Transgastric 

surgery was performed using the Olympus R-scope together with 

conventional endoscopic accessories. The gastric access site was closed 

using TAS T-tags (Ethicon Endosurgery). Peritoneal fluid was sampled for 

bacterial culture at the time of peritoneal access, prior to closure and at 

post mortem. The operating time and the postop time till standing up 

and eating were recorded. During the first postop week temperature 

and weight were recorded daily. Blood samples were taken every other 

day during one week and then every week until post mortem. CRP was 

analysed using porcine specific ELISA. 

Results: 27 animals survived until euthanised at 4 weeks. Three animals, 

one from each group, were euthanized earlier; one due to a hoof 

infection, one omental bleeding, one abdominal wound dehiscence. The 

operating time was significantly longer in the NOTES-group, mean 124 

min versus 35 min for lap surgery and 23 min for open surgery. However, 

the groups did not differ concerning postop time to standing up or 

eating, postop temperature or weight-gain. 

At post mortem 3/9 animals in the open surgery group had wound 

infections and 2/9 in the laparoscopic group. No intra abdominal 

infections were recorded in either group and there was no significant 

difference in bacterial cultures at any time-point. The CRP was equal prior 

to surgery and at its conclusion, but at postop day one the NOTES group 

had significantly lower CRP than open or lap surgery. From day 3 until day 

28 no differences were seen. 

Conclusion: Despite a long operating time the transgastrically operated 

animals recovered just as quickly as the other animals and showed no 

infectious complications. The lower CRP at day 1 indicates a reduced 

stress response in the NOTES group. 

S039 

STUDY OF HUMAN PERITONEAL BACTERIAL CONTAMINATION AFTER 

NOTES TRANSGASTRIC AND TRANSVAGINAL CHOLECYSTECTOMY 

Silvana PERRETTA, MD, Bernard DALLEMAGNE, MD, Pierre ALLEMANN, 

MD, Gianfranco DONATELLI, MD, Cosimo CALLARI, MD, Hurng-Shen WU, 

MD, Jacques MARESCAUX, MD IRCAD, University Hospital of Strasbourg, 

France - Show Chwan Memorial Hospital, Changhua, Taiwan 

Introduction: The recent literature has questioned the infectious risk of 

natural orifice translumenal endoscopic surgery (NOTES). One important 

requirement of this technique is the need to minimize the risk of eritoneal 

contamination. 

Our study examines the resultant microbial contamination of the human 

peritoneum after transgastric and transvaginal cholecystectomy. 

Methods and procedures: From April 2007 to September 2009, 

22 patients undergoing transgastric (n 11) and transvaginal (n 11) 

cholecystectomy for non complicated cholelithiasis were prospectively 

studied as part of a database approved by our Institutional Review 

Board. Intraoperative samplings of peritoneal fluid were collected before 

and after transgastric (n=11) and transvaginal (n=6/11) access and 

sent for anaerobic, aerobic and fungal cultures. Each sample was sent 

for bacterial colony counts, culture, and identification of species. No 

gastric decontamination was performed and the vagina was prepped 

with betadine. All patients received single-shot intraoperative antibiotic 

prophylaxis. Operative times, clinical course and biological parameters 

were recorded. 

Results: Patients undergoing cholecystectomy had peritoneal exposure 

after trasngastric access for an average of 150 minutes, versus 113 

minutes for patients undergoing transvaginal approach. Two of 11 

patients (18%) had evidence of novel bacterial contamination of the 

peritoneum after transgastric approach (Escherichia Coli and Staph. 

Coagulase -). No patient had a positive anaerobic culture or fungal culture 

from the peritoneum in the transvaginal group. Total operative time did 

not predict peritoneal contamination. No clinically significant infectious 

complications or leaks were noted at 30-day follow-up. 

Conclusions: Prolonged peritoneal exposure to gastric content 

demonstrates minimal contamination of the abdominal cavity and is 

without postoperative infectious significance. Transvaginal incision would 

effectively be a clean portal of entry for NOTES. 





S040 

PROSPECTIVE RANDOMIZED TRIAL COMPARING LAPAROSCOPIC AND 

NOTES CHOLECYSTECTOMY: PRELIMINARY RESULTS Alberto R Ferreres, 

MD PhD MPH FACS, Anibal Rondán, MD, Santiago Horgan, MD, Julieta 

Paleari, MD, Mariano E Giménez, MD, Oscar O Laudanno, MD, Vicente P 

Gutiérrez Department of Surgery. University of Buenos Aires 

Introduction: the feasibility of hybrid NOTES cholecystectomy has 

been demonstrated. The recommendations from the 4th International 

Conference on NOTES (Boston, 2009) encouraged randomized trials to 

prove the advantages of this approach. 

Methods: Between January and July 2009, a prospective randomized 

trial of hybrid NOTES cholecystectomy (H-NC) versus laparoscopic 

cholecystectomy (LC) for patients with symptomatic gallstone disease 

was undertaken in compliance with our IRB and Ethics Committee´s 

approval. Mean age was 42.5 years. The inclusion criteria specify: a) 

Age between 18 and 65 years, b) Previous pregnancy/ies, and negative 

pregnancy tests, c) Informed consent process, d) Symptomatic gallbladder 

stones with surgical indication, e) Absence of common bile obstruction, 

f) Body mass index below 25, j) Non relevant ultrasound findings. The 

patients were allocated randomly in 2 groups of 20 patients each: Group 

I (LC): a laparoscopic cholecystectomy was performed with a 3 5 mm 

trocars and in cases, an additional 2 mm forceps for retraction of the 

gallbladder fundus was used. Group II (H-NC): placement of a 5 mm 

umbilical trocar for insuflation and visualization, insertion of a 2 channel 

trocar through the right posterior vaginal cul de sac and introduction of a 

flexible videoendoscope (Olympus GIF-160) and long forceps and diverse 

instruments (Novare®). Disecction of the cystic elements (duct and artery) 

and the Calot´s triangle was performed with electrocautery, scissors and 

Maryland forceps through the umbilical port, in a laparoscopic fashion as 

well as the ligaclip instrument. Removal of the gallbladder through the 

vagina using an endoscopic loop placed at its neck. The access was closed 

with a running suture of absorbable vycril 2/0 from the vagina. Antibiotic 

prophylaxis was used with cefazolin 1g before anesthetic induction and 

post-operative analgesia was standardized for the 2 groups. 

Results: 1) the procedure was completed as intended in both groups, 

2) Mean operative time was 38 +/- 8.5 minutes for LC and 56 +/- 12 for 

H-NC, 3) Length of stay was similar for both groups, 4) No intraoperative 

complications were achieved, 5) In two of the H-NC an additional 2 mm 

forceps was required, 6) No infectious or parietal complications developed 

during follow-up, 7) Postoperative pain was less in the N-HC group as 

well as the need for additional painkiller medication, but not statistically 

significant, 8) Cosmetic results were excellent in the H-NC group, 9) 

Patients´ preferences were inclined to the H-NC procedure and 10) 9) 

Return to work was in average 39 hours earlier for the H-NC. 

Conclusions: Our initial results conclude that H-NC is superior to LC for 

less postoperative pain and better cosmetic results, though it is associated 

with longer operative time and additional instruments. Nonetheless, 

H- NC can be performed safely and has an excellent outcome and high 

patient acceptability, comparable to LC for the treatment of cholelithiasis 

and intraoperative complications and total hospital stay. 

S041 

FIRST HUMAN EXPERIENCE WITH ENDOLUMINAL, ENDOSCOPIC 

GASTRIC BYPASS Bryan J Sandler, MD, C. Paul Swain, MD, Roberto 

Rumbaut, MD, Gustavo Torres, MD, Luis Morales, MD, Lizcelly Gonzales, 

MD, Santiago Horgan, MD University of California, San Diego, San Diego, 

CA, USA; Imperial College of London, London, England; San Jose Tec de 

Monterrey, Monterrey, Mexico 

Introduction: Here we report the first human experience with an 

endoluminal, endoscopically delivered and retrieved gastro-duodenojejunal 

bypass sleeve (ValenTx, Inc. Carpinteria, CA), including the shortterm 

weight loss and changes in co-morbidities. 

Methods and Procedures: The gastro-duodeno-jejunal bypass sleeve 

(GJBS) is a 120cm sleeve secured at the esophago-gastric junction with 

endoscopic and laparoscopic techniques, and is designed to create 

an endoluminal gastro-duodeno-jejunal bypass. The patients are 


morbidly obese individuals who meet NIH criteria for bariatric surgery. A 

prospective, single-center, 12 week trial was designed. At the completion 

of this trial, the device was explanted with endoscopic retrieval. The 

primary endpoints were safety and incidence of adverse events. The 

secondary outcomes included the percentage of excess weight loss (EWL) 

and changes in co-morbidities, specifically glucose control, use of antihyperglycemics, 

and changes in hemoglobin A1C levels. 

Results: From July 2008 until September 2009, 24 patients were enrolled. 

The device was implanted, left in-situ, and then retrieved. The study 

included 7 men and 17 women with a mean pre-operative BMI of 41.0 

kg/m2. The GJBS was successfully delivered in 22 of the 24 patients (92%) 

and retrieved endoscopically in all 22 patients in whom it was implanted 

(100%). One patient was excluded pre-operatively secondary to failure 

to lose weight on the pre-op liquid diet. One device was not attempted 

endoscopically due to significant inflammation at the gastro-esophageal 

junction at the time of laparoscopic evaluation. 

In the first phase of the study, 12 patients had the device placed. Nine of 

these patients maintained the device for the full 12 weeks of the study. 

These patients had 39.9% excess weight loss at the completion of the 

study. In the second phase of the trial, 12 patients were enrolled; at eight 

weeks the EWL is 40.5%. 

Of the 22 patients with the device implanted, 17 have maintained it (77%). 

Nine patients completed the 12-week trial and eight are ongoing at 8 

weeks. The primary reason for early explantation of the device was early 

post-operative dysphagia. 

The seven patients with pre-operative diabetes mellitus all had normal 

blood glucose levels throughout the trial and none required antihyperglycemic 

medications. All seven patients with elevated Hemoglobin 

A1C levels pre-operatively showed improvement by the end of the trial. 

Conclusions: This trial demonstrates that the endoluminal gastroduodeno-jejunal 

bypass sleeve can achieve excellent weight loss at 

12 weeks. No patient safety issues were encountered. Adverse effects 

were minimal and resolved upon endoscopic device removal. Effective 

glycemic control was demonstrated through use of the device during the 

trial. Long-term results are needed. 

S042 

ESOPHAGEAL STENT PLACEMENT PROVIDES SAFE CLOSURE 

FOLLOWING TRANSESOPHAGEAL ACCESS FOR NOTES® THORACIC 

PROCEDURES Brian G Turner, MD, Denise W Gee, MD, Min-Chan Kim, MD, 

Sevdenur Cizginer, MD, Mari Mino-Kenudson, MD, Patricia Sylla, MD, David 

W Rattner, MD, William R Brugge, MD FASGE (1) Gastrointestinal Unit, Dept 

of Medicine, (2) Department of Surgery, (3) Department of Pathology, 

Massachusetts General Hospital, Boston, MA 

INTRODUCTION: Safe esophageal closure remains a challenge in 

transesophageal Natural Orifice Transluminal Endoscopic Surgery (NOTES) 

procedures. Suturing or t-tag devices are time consuming and risk organ 

injury due to their blind deployment. Endoclips are difficult to place in 

the narrow esophagus and submucosal tunneling techniques do not 

necessarily prevent leakage of esophageal contents into the mediastinum 

or thorax. In this survival animal series, we demonstrate safe esophageal 

closure with a prototype retrievable, anti-migration stent. 

METHODS: Nine Yorkshire swine underwent thoracic NOTES procedures. 

A double-channel gastroscope equipped with a mucosectomy 

device was used to create a small esophageal mucosal defect. A 5-cm 

submucosal tunnel was created and a needle-knife was used to incise 

the muscular esophageal wall and permit entry into the mediastinum 

and thorax. Mediastinoscopy and thoracoscopy were performed in all 

swine; lymphadenectomy was performed in 7 swine. A prototype small 

intestinal submucosal (surgiSIS®) covered stent was deployed over the 

mucosectomy site and tunnel. Three versions of the prototype stent were 

developed (Table 1). Pre-necropsy endoscopy was performed to confirm 

stent location and retrieve the stent. Explanted esophagi were sent to 

pathology for review. 

RESULTS: Esophageal stenting was successful in all animals. Stent 

placement took 15.8±5 min and no stent migration occurred in any swine.


Pre-necropsy endoscopy revealed ingrowth of esophageal mucosa and 

erosion at the proximal portion of Stent A. Mucosal inflammation and 

erosion was observed at the proximal site of Stent B. No esophageal 

erosion or pressure damage from high radial forces was seen during 

stent retrieval in the swine receiving Stent C. On necropsy, swine 5 had 

a 0.5cm peri-esophageal abscess. Histology revealed a localized lesion 

at the esophageal exit site consisting of acute inflammatory cells in the 

esophageal wall in swine 4, 7, and 9. The mucosectomy site was partially 

healed in 3 swine and poorly healed in 6. All swine thrived clinically, 

except a brief period of mild lethargy in swine 9 on postoperative day 3. 

This particular swine improved with short-term antibiotic therapy. The 

submucosal tunnels were completely healed and no esophageal bleeding 

or stricture formation was observed in any swine. All swine survived 

13.8±0.4 days and gained weight in the postoperative period. 

CONCLUSION: Esophageal stenting provides safe closure for NOTES 

thoracic procedures, but may impede healing of the mucosectomy site. 

Table 1: Prototype Stent Specifications for Esophageal Closure 

Swine 

No 

Diameter 

Proximal 

Cage 

Diameter 

(body) 

Stent 

Length, 

mm 

Plastic 

covered 

proximal 

cage 

SIS/Plastic 

Covered 

body 

cage 

Stent A 1-5 45mm 28mm 80mm No Yes Yes 

Stent B 6-7 45mm 28mm 80mm Yes Yes Yes 

Stent C 8-9 37mm 22mm 65mm Yes Yes Yes 

S043 

Plastic 

covered 

distal cage 

QUANTITATIVE ERGONOMICS ASSESSMENT OF NOTES TECHNIQUES: 

A STUDY OF PHYSICAL WORKLOAD, BODY MOVEMENT AND POSTURE 

Gyusung Lee, PhD, Erica Sutton, MD, Yassar Youssef, MD, Tameka Clanton, 

MS, Adrian Park, MD University of Maryland 

Introduction: This study investigates through biomechanical analyses 

NOTES and laparoscopic physical workloads. Research confirms that 

surgeons experience physical symptoms due to the unfavorable 

ergonomics of MIS performance. The ergonomics of NOTES—potentially 

the next evolutionary surgical step—is only now being quantitatively and 

systematically assessed 

Methods and Procedures: Six surgeons with varying MIS experience 

were recruited for this IRB-approved study. Each participant performed 

two tasks 1) transferring rings between two sets of pegs by using two 

graspers; 2) transferring a triangle with attached eyelet between two 

circles by using a needle held by a needle driver. These tasks were 

performed using two surgical platforms: 1) traditional laparoscopy 

employing rigid instruments; 2) NOTES employing a dual-working 

channel flexible endoscope. With NOTES, the surgeon instructed an 

assistant in opening and closing the graspers. The NOTES approach was 

simulated by an upper torso mannequin placed at the trainer box front; 

an endoscope was introduced through the mannequin’s mouth. Motion 

capture, sixteen-channel electromyography (EMG), and force plate 

systems recorded biomechanical data. Integrated percentage maximum 

voluntary contraction (%MVC) obtained from EMG data collected 

throughout performance permitted identification of accumulated 

muscular workload. Mean %MVC was calculated for average muscular 

activation level. The postural stability demand (PSD) and the sway areas 

calculated from center of mass (COM) and center of pressure (COP) 

allowed postural sway quantification. A parallel study investigated 

surgical grasper force transfer mechanisms. Six electrodes placed on each 

subject’s forearm muscle groups and a force sensor located between each 

instrument’s jaws acquired data. Participants performed an opening/ 

closing task using 1) two different-sized hemostats, 2) Maryland and Park 

laparoscopic graspers, and 3) endo-graspers and biopsy forceps. Force 

transfer was calculated by dividing &MVC by maximum tip force. 

Results: Integrated %MVC was substantially higher with NOTES 

performance (1305 %MVC) than with laparoscopy (375 %MVC) (p



S045 

HIATAL MESH IS ASSOCIATED WITH MAJOR RESECTION AT 

REVISIONAL OPERATION. Michael Parker, MD, Jillian M Bray, MD MPH, 

Adam S Harris, MD, Erol V Belli, MD, Jason M Pfluke, MD, Susanne S 

Preissler, Horacio J Asbun, MD, C D Smith, MD, Steven P Bowers, MD Mayo 

Clinic Florida, Jacksonville, FL, USA 

Introduction: The use of mesh to potentiate the hiatal closure during 

laparoscopic foregut surgery is increasing among surgeons, as some 

consider this the standard of care. Our objective is to evaluate the 

incidence of mesh removal during revisional foregut surgery and to 

examine the complications that can arise from the use of mesh near the 

esophageal hiatus. Our objective is to compare indications for surgery 

and perioperative outcomes between those patients with and without 

prior mesh hiatoplasty. 

Methods and Procedures: Our design is an IRB-approved retrospective 

cohort study from a single tertiary-care referral center. Between 

December 2006 and September 2009, sixty-nine (69) patients underwent 

revisional foregut surgery at the esophageal hiatus. Patients undergoing 

planned operations for obesity or achalasia were excluded from analysis. 

Of these sixty-nine (69) patients, ten (10) had previous hiatal mesh (PHM). 

Results: The patients in each group were similar with regard to age 

(range 17-76 yrs), BMI (range 17.7-48.1), and ASA (median 3). PHM and 

NM patients had similar rates (70% and 68%, respectively) and types 

of anatomic failure (misplaced, slipped, herniated and/or twisted 

fundoplication). There was no statistically significant difference in 

outcomes between PHM and NM patients with regard to estimated 

blood loss (430 cc vs. 105 cc, p=0.09), operative time (4.19 hrs vs. 2.74 hrs, 

p=0.07), blood transfusion (1.1 units vs. 0.2 units, p=0.29), or length of stay 

(6.2 days vs. 3.2 days, p=0.16). Of the ten PHM patients, four required a 

major resection with anastomosis, whereas only four of 59 required such a 

resection in the NM group. Therefore, the relative risk of requiring a major 

resection is 5.9 times as high in PHM patients as compared to NM patients 

(95% CI = 1.754, 19.84; p=0.01). The rate of major resection was similar 

between those patients with biological and permanent mesh. 

Conclusions: Our study demonstrates that the presence of mesh at 

the esophageal hiatus is associated with an increased risk of requiring 

a major resection during a revisional procedure. The pattern of failure 

was not different in patients with hiatal mesh, suggesting that the use of 

mesh at initial repair does not eliminate the potential need for revisional 

operation. Thus, when performing an initial hiatal hernia repair, the risk of 

increased hiatal hernia recurrence if not using mesh should be weighed 

against the potential risk of a subsequent major resection if using mesh. 

S046 

SAFETY, EFFICACY AND COST-EFFECTIVENESS OF COMMON 

LAPAROSCOPIC PROCEDURES Manish M Tiwari, MD PhD MPH, Jason 

F Reynoso, MD, Albert W Tsang, MD, Dmitry Oleynikov, MD FACS 

Department of Surgery, University of Nebraska Medical Center, Omaha, 

NE 

Introduction: Although several single-center studies on the outcomes of 

laparoscopic surgery have shown better surgical outcomes, a large multicenter 

study on outcomes of common laparoscopic surgical procedures 

has not been performed. The objective of this study was to retrospectively 

examine multi-center outcomes of common laparoscopic procedures. 

Methods: The University HealthSystem Consortium (UHC) is an alliance 

of more than 100 academic medical centers and nearly 200 affiliate 

hospitals. UHC’s Clinical Data Base / Resource Manager (CDB/RM) allows 

member hospitals to compare patient-level risk-adjusted outcomes 

for performance improvement purposes. This study is a multi-center, 

retrospective analysis of the outcomes of common surgical procedures 

using the UHC database. Three-year discharge data from the UHC 

database was accessed using International Classification of Diseases (ICD- 

9) codes for commonly performed surgical procedures between January 

2006 and December 2008. Discharge data on six common open (O) and 

laparoscopic (L) surgical procedures, including cholecystectomy (C), 

appendectomy (A), reflux surgery (RS), gastric bypass (GB), ventral hernia 

repair (VHR) and colectomy (CO) was collected. Main outcome measures 

analyzed were mortality, morbidity, 30-day readmission, intensive care 

unit (ICU) admission, length of ICU stay, overall length of hospital stay and 

costs. 

Results: A total of 207,984 patients underwent either open or 

laparoscopic surgery for one of the six surgical procedures included in 

the study. Lower mortality index, reduced length of stay and reduced 

costs were observed with laparoscopic procedures compared to open 

procedures. Patients in the laparoscopic group had lower mortality index 

(0.82 for LC vs. 1.01 for OC; 0.82 for LA vs. 0.85 for OA; 0.23 for LRS vs. 0.72 

for ORS; 0.68 for LGB vs. 0.95 for OGB; 0.00 for LVHR vs. 0.89 for OVHR; 

0.61 for LCO vs. 1.16 for OCO). Laparoscopic group showed significantly 

reduced length of stay (in days) for all six procedures (3.89 for LC vs. 10.11 

for OC; 2.26 for LA vs. 4.26 for OA; 2.94 for LRS vs. 7.38 for ORS; 2.62 for 

LGB vs. 5.95 for OGB; 3.71 for LVHR vs. 7.89 for OVHR; 7.13 for LCO vs. 

13.12 for OCO; p


S048 

MINILAPROTOMY APPROACH TO PERFORATED DUODENAL ULCER 

Tomonori Ohsawa, MD, Toru Ishiguro, MD, Norimichi Okada, MD, Keiichiro 

Ishibashi, phD, Norihiro Haga, PhD, Hideyuki Ishida, PhD Department of 

Digestive Tract and General Surgery, Saitama Medical Center, Saitama 

Medical Schoo 

Background and Purpose: Although the technical feasibility of 

laparoscopic approach to perforated duodenal ulcer is well established, 

this procedure has not been widely performed because of several 

limitations. This retrospective study was performed to clarify the 

feasibility, safety, and minimal invasiveness of a minilaparotomy for 

perforated duodenal ulcer. Patients and Methods: We retrospectively 

analyzed data on 40 patients with perforated duodenal ulcer, who 

were attempted to undergo simple closure and/or omentopexy via 

minilaparotomy (skin incision,



design was employed with subjects performing the task for 20 seconds 

followed by 30 seconds rest, repeated 5 times. Accuracy was determined 

by the distance from the tool tip to the target. 

Results: 21 right-handed novices completed the task with and 

without GCMC. Subjects were more accurate with GCMC assistance 

versus unassisted performance (p=0.008). Greater changes in cortical 

haemodynamics were observed with GCMC, with 8 fNIRS channels 

demonstrating statistically significant activity (?=5%) compared to zero 

channels without GCMC. The activation occurred in the medial prefrontal 

cortex. 

Conclusion: It has been demonstrated that GCMC enhances novice 

performance and that this requires greater medial prefrontal cortical 

activity. It is possible that in using GCMC, the user focussed more on 

the quality and accuracy of movement. In order to achieve this, the 

medial prefrontal cortex which is involved in performance monitoring, 

is recruited to a greater extent. This work demonstrates how changes 

in brain behaviour can be used to assess the impact of novel surgical 

technology. 

1 - Mylonas G.P. et al. MICCAI. 2008: 11, 676-683 

2 - Parasuraman R. Theoretical Issues in Ergonomics Science. 2003 4, 5-20 

S051 

ROBOTIC GASTRIC BYPASS: THE FUTURE OF BARIATRIC SURGERY? 

Chan W Park, MD, Edward Lam, BS, Cedric Lorenzo, MD, Kenric Murayama, 

MD, Racquel Bueno, MD University of Hawaii, Queen’s Medical Center 

Objective: Compare robotic versus laparoscopic roux-en-Y gastric bypass 

(RYGB) for the treatment of morbid obesity in a community hospital. 

Introduction: Since receiving Food and Drug Administration approval 

in 2000, surgery utilizing a robot (da Vinci® Surgical System) has been 

successfully performed in numerous procedures including RYGB. 

However, despite the proven safety profile, reported lower complication 

rates, and technical benefits of robotic surgery, only a few of the over 200 

robotic surgery centers in the United States have consistently applied this 

technology to RYGB. In addition, there are limited studies with relatively 

small sample sizes that have compared robotic vs. laparoscopic RYGB in 

the literature. 

Methods: Through a retrospective analysis of a prospectively collected 

database, we compared outcomes and complication rates of robotic vs. 

laparoscopic RYGB in the treatment of morbid obesity. All patients who 

underwent robotic RYGB performed through the Comprehensive Weight 

Management Program of Queen’s Medical Center (Honolulu, HI) between 

December 2006 to July 2009 were compared to a matched cohort of 

patients who received laparoscopic RYGB during the same study period. 

Outcomes data included weight loss, operative times, and hospital length 

of stay. All complications encountered by both groups were reported. 

Results: Eighty patients who underwent robotic RYGB were compared 

to 80 patients who received laparoscopic RYGB. Rate of weight loss and 

reduction in body mass index (BMI) over time were similar in both groups. 

There were no mortalities in either group. The robotic group experience a 

12.5% complication rate. Robotic complications included post-operative 

anemia (2 patients), marginal ulcer (2 patients), anastomotic stricture (4 

patients), and anastomotic leaks (2 patients). The laparoscopic group also 

experienced a 12.5% complication rate for a range of issues including 

wound infections (2 patients), anastomotic stricture/ulcer (2 patients), 

aspiration pneuomonia (1 patient), anastomotic leak (1 patient) requiring 

re-operation, small bowel obstruction (1 patient), etc. Hospital length 

of stay and operative times were similar in both groups, but there was a 

trend towards a shorter length of stay with robotic RYGB. 

female/ 

male 

age 

(range) 

BMI 

(range) 

Robotic 59/21 44 (21-69) 

46.4 (33- 

75) 

Laparoscopic 52/28 44 (20-64) 

49 (35- 

87) 

Operative 

time 

length 

of stay 

174 2.9 

minutes days 

164 3.1 

minutes days 

complications 

12.5% 

12.5% 

Conclusion: Robotic RYGB is a safe and effective procedure for the 

surgical treatment of morbid obesity, and this approach can be utilized 


effectively in a community hospital setting. Robotic RYGB resulted in the 

same overall complication rate as the laparoscopic approach with a trend 

towards a shorter length of stay. Operative times decreased after the 

initial few robotic RYGB, and this may be due to a more favorable learning 

curve for robotic RYGB. Future studies comparing actual cost comparisons 

and analysis of outcomes are needed. 

S052 

A COMPARISON OF SHORT-TERM OUTCOMES FOR OPEN, 

LAPAROSCOPIC, AND ROBOT-ASSISTED RECTAL RESECTION FOR 

CANCER Gyu-Seog Choi, MD, Jun Seok Park, MD, Kyoung Hoon Lim, MD, 

You Seok Jang, MD, Soo Han Jun, MD Department of Surgery, School of 

Medicine, Kyungpook National University, Daegu, Korea 

Introduction: In recent years, robotic-assisted surgery using the da Vinci 

System ® has been proposed as an alternative to the traditional open or 

laparoscopic procedures. The aim of this study was to compare the shortterm 

outcomes for open, laparoscopic, and robot-assisted rectal resection 

for cancer. 

Methods: Two hundred sixty-three patients with rectal cancer who 

underwent curative resection between 2007 and 2009 were included. 

Patients were divided into an open surgery group (OPEN, n = 88), a 

laparoscopic surgery group (LAP, n = 123) and a robot-assisted group 

(ROBOT, n = 52). Data include operative time, length of recovery, 

methods of specimen extraction, quality of total mesorectal excision, and 

morbidity. 

Results: The mean operation time was 233.8 ± 59.2 for OPEN group, 

158.0 ± 49.2 for LAP group and 232.6 ± 52.4 for Robot group (p < 0.001). 

Patients from the LAP group and ROBOT group recovered significantly 

faster than those from the OPEN group (p < 0.05). The proportion of cases 

done by natural orifice surgery-intracorporeal anastomosis with transanal 

or transvaginal retrieval of specimens-were significantly higher in the 

ROBOT group (p < 0.001). There were no differences in specimen quality 

among the three groups, with distal resection margin, harvested lymph 

node, and circumferential margin. The overall complication rate in OPEN, 

LAP, and ROBT group were 20.5, 11.4, and 19.2% (p = 0.160). 

Conclusions: Robot-assisted rectal resection is equivalent to open and 

laparoscopy approach with respect to short-term outcomes. Furthermore, 

the technical advantages of robot surgical system are helpful to adopt a 

method of natural orifice surgery. 

S053 

MULTI-FUNCTIONAL ROBOT FOR LAPAROENDOSCOPIC SINGLE-SITE 

SURGERY Amy C Lehman, MS, Tyler D Wortman, BS, Kyle W Strabala, MS, 

Nathan A Wood, MS, Manish M Tiwari, MD, Matthew R Goede, MD, Shane 

M Farritor, PhD, Dmitry Oleynikov, MD University of Nebraska-Lincoln, 

University of Nebraska Medical Center 

Introduction: This study demonstrates the effectiveness of using a multifunctional 

miniature in vivo robot to perform complex tasks, such as 

intracorporeal suturing, through a single incision. Existing technologies 

for Laparoendoscopic Single-Site Surgery (LESS), such as articulating, 

bent, and flexible instrumentation, are limited in visualization and tissue 

manipulation capabilities by multiple tools working through a single 

access point. A robotic platform that is completely inserted into the 

peritoneal cavity through a single incision mitigates these constraints and 

provides a more intuitive approach than standard LESS methods. 

Methods: A robotic platform consisting of a miniature in vivo robot and 

a remote surgeon interface has been designed and built. The basic robot 

design consists of two arms each connected to a central body. The body 

of the robot contains a mounting assembly and a maneuverable camera 

pair that provides images to the remote surgeon interface. The robot arms 

have two degree-of freedom rotational shoulder and elbow joints. Each 

forearm is fitted with specialized grasper or cautery end effectors. These 

end effector tools can be interchanged depending on the particular task 

being performed. For example, when performing a cholecystectomy, the 

robot forearms are fitted with standard cautery and grasper end effectors. 

Then, for performing intracorporeal suturing, laparoscopic needle holders 

are used in place of the cautery and grasper end effectors. The surgeon


interface, located remotely within the operating room, consists of a 

monitor, a foot pedal for locking and clutching, and two PHANTOM Omni® 

(SensAble, Woburn, MA) devices for manipulation of the robot arms. 

Results: This robot has been demonstrated in multiple non-survival 

procedures in a porcine model, including three cholecystectomies. 

All procedures were performed at the University of Nebraska Medical 

Center with experimental protocols approved by the institutional review 

committee. For each procedure, the robot was inserted and then mated 

with a mounting rod that was advanced through the insertion incision. 

This rod was used with an external supporting assembly mounted 

to the rails of the operating table. The surgeon at the user interface 

manipulated the robot to perform the cholecystectomy, with stapling 

of the cystic duct and supplementary retraction being performed with 

standard laparoscopic tools that were advanced into the peritoneal cavity 

through the incision. At completion of the cholecystectomy, the robot 

was removed from the peritoneal cavity and then fitted with needle 

holder end effectors. The robot was then reintroduced into the peritoneal 

cavity to successfully perform intracorporeal suturing of the bowel. Also, 

students performed benchtop tasks using both the robot platform and 

standard LESS. The results showed that the tasks were performed faster 

and more accurately using the robot. 

Conclusions: The widespread adoption of NOTES and LESS for complex 

surgeries is dependent on the development of devices that provide 

a stable multi-tasking platform. A multi-functional robot provides a 

completely insertable platform that addresses the triangulation and 

visualization limitations of existing instrumentation for LESS. The two 

degree-of-freedom rotational elbow joint enhanced surgical dexterity and 

enabled the performance of the complex surgical task of intracorporeal 

suturing with access through a single incision. 

S054 

ROBOTIC VS. CONVENTIONAL LAPAROSCOPIC GASTRIC BANDING: A 

COMPARISON OF 407 CASES Paula K Edelson, BSc, Kristoffel R Dumon, 

MD, Seema S Sonnad, PhD, Bilal M Shafi, MD, Noel N Williams, MD Bariatric 

Surgery Program, Deptartment of Surgery, University of Pennsylvania 


INTRODUCTION: The current indications and rationale for using a 

robotic technique in bariatric surgery, specifically gastric banding, 

remain unclear. The objective of this study was to quantify the safety and 

potential benefits of this novel technology in the context of both patient 

and surgeon outcomes as compared to the conventional laparoscopic 

approach. 

METHODS AND PROCEDURES: A retrospective database of obese 

patients undergoing laparoscopic gastric banding (LGB) between 

December 2006 and June 2009 was examined. During this period 

407 consecutive patients underwent LGB: 287 robotically and 120 

conventionally. The procedures were performed by two primary surgeons 

in a teaching hospital setting. The conventional laparoscopic approach 

had been practiced since 2004, and the robotic approach had been 

practiced since 2006. Patient demographics, operative complications, 

operating times, and clinical outcomes were examined. 

RESULTS: The patients in the robotic and conventional cohorts did not 

vary significantly in demographic composition. The robotic cohort had 

a mean age of 47 ± 25 years, was 230/287 (80.1%) female and 57/287 

(19.9%) male and had a mean pre-operative Body Mass Index (BMI) of 

45.4 kg/m². The conventional cohort had a mean age of 45 ± 24 years, 

was 89/120 (74.2%) female and 31/120 (25.8%) male, and had a mean 

pre-operative BMI of 45.1 kg/m². The prevalence of pre-operative comorbidities 

was similar between the two groups: hypertension was 56% 

and 67%, hypercholesterolemia was 29% and 33%, sleep apnea was 

54% and 52%, diabetes mellitus was 28% and 33%, and osteoarthritis 

was 41% and 29% in the robotic and conventional cohorts respectively. 

The rates of intra-operative and post-operative complications did not 

differ significantly between the two approaches (Table 1). The length of 

post-operative hospital stay did not differ significantly between the two 

approaches (1.3 ± 2.7 days for both approaches). The operating time 

from incision to wound closure did not differ significantly between the 

two approaches (91.5 minutes vs. 92.1 minutes robotic and conventional 

respectively). However, for patients with a pre-operative BMI of ≥ 50 kg/ 

m² (N = 89: 64 robotic, 25 conventional), the operating time is significantly 

lower using the robotic approach (91.3 ± 63.7 minutes, SD = 19.7 vs. 101.3 

± 49.7 minutes, SD = 23.7; p=0.04). 

CONCLUSIONS: In this series, robotic and conventional approaches were 

similar in intra-operative or post-operative complication rates, operating 

time, and length of post-op hospital stay. However, for patients with a 

pre-operative BMI of ≥ 50 kg/m², the operating time is significantly lower 

using the robotic approach despite the adoption of the new technique. 

These data suggest that the robotic approach is at least as safe as 

conventional laparoscopic approach, and that robotic approach should 

be considered for gastric banding candidates with BMI ≥ 50 kg/m². 

Table 1: Complications of robotic vs. conventional approaches 

Complication 

Robot (N=287) 

Conventional 

(N=119) 

Conversion to open 0 1 

Reoperation: Band removal or replacement 9 3 

Port removal or replacement 2 2 

Band slippage 8 3 

GI complaints not resulting in admission 28 10 

S055 

PROPHYLACTIC INFERIOR VENA CAVA FILTERS IN HIGH-RISK 

BARIATRIC SURGERY Khashayar Vaziri, MD, John D Watson, BS, Amy P 

Harper, MSN ACNPBC, Juliet Lee, MD, Fred Brody, MD, Shawn Sarin, MD, 

Elizabeth A Ignacio, MD, Albert Chun, MD, Anthony C Venbrux, MD, Paul P 

Lin, MD The George Washington University Medical Center 

Objective: High-risk patients are at significant risk for venous 

thromboembolism (VTE) and may benefit from the addition of retrievable 

inferior vena cava filters (rIVCF) to chemoprophylaxis. However, the 

optimal VTE prophylaxis has not been established in morbidly obese 

patients undergoing bariatric surgery. This observational study examines 

the use of rIVCFs in combination with chemoprophylaxis for high-risk 

bariatric surgery patients. 

Methods: A retrospective review was performed of all high-risk morbidly 

obese patients who underwent bariatric surgery between February 2007 

and July 2009. Patients were considered high-risk for the development of 

a peri-operative VTE if they had a prior history of VTE, a BMI ≥ 55 kg/m2, 

were severely immobile, or had preexisting hypercoaguable condition. 

All patients underwent a preoperative venous duplex study. RIVCF 

placement was performed preoperatively on the day of the bariatric 

procedure. Standard chemoprophylaxis was initiated preoperatively and 

continued throughout the hospital stay. Clinical, demographic, operative 

and postoperative data were recorded. A venogram was performed prior 

to removal of the rIVCFs. 

Results: Forty-four patients (12 men and 32 women) with a mean age 

of 47.9 ± 12.1 years and a mean BMI of 58 ± 9.5 kg/m2 underwent 

roux-en-y gastric bypass with concomitant rIVCF placement. Mean 

follow up was 184 days. One patient (2.3%) was found to have a deep 

venous thrombosis (DVT) on preoperative venous duplex. All patients 

received VTE chemoprophylaxis preoperatively and successful rIVCF 

placement. Indications for rIVCF placement were BMI (68%), history 





of prior VTE (30%), and/or severe immobility (2%). The operation 

was performed laparoscopically in 41 patients (93%). Three patients 

(two revisional surgeries and one conversion secondary to intestinal 

adhesions) underwent open gastric bypass. The mean operative time 

was 111.1 ± 30.2 minutes and the mean length of stay was 3.2 ± 1.2 

days. A postoperative venous duplex for the clinical suspicion of VTE was 

performed in four patients (9%), of which 2 were positive for the presence 

of a DVT. Retrieval was successful in 25 patients (57%). A venogram was 

performed prior to removal of each rIVCF. No significant thrombus was 

found, however, one filter had migrated to the right common iliac vein. 

Overall, there were two complications of rIVCF placement (4.5%), one 

during insertion and the other due to migration. One mortality (2%) 

occurred as the result of an arrhythmia; no pulmonary emboli were found. 

Conclusions: This study documents that rIVCFs in high-risk bariatric 

surgery patients is associated with a low incidence of DVT (4.5%) and 

filter-related complications (4.5%) without pulmonary emboli. However, a 

significant portion of patients continue to have their filters in place. Long 

term effects of rIVCFs in patients who do not undergo retrieval are largely 

unknown. These long term effects need further investigation in order to 

appreciate the true benefit of rIVCFs in this patient population. 

S056 

B-TYPE NATRIURETIC PEPTIDE INCREASES AFTER GASTRIC BYPASS 

AND CORRELATES TO WEIGHT LOSS Eric Changchien, MD, Gavitt A 

Woodard, BS, Tina H Boussard, PhD, John M Morton, MD MPH Stanford 

University 

Background: B-type natriuretic peptide (BNP) is a recognized serologic 

marker of heart failure and has been associated with cachexia of heart 

failure. In addition, BNP is positively correlated to adiponectin which is 

inversely correlated to weight gain. We are aware that gastric bypass leads 

to early satiety and increases in adiponectin. Our study hypothesis is that 

surgically induced weight loss will lead to an increase in BNP. 

Methods: At a single academic institution (2008-2009), we measured 

BNP in 100 consecutive gastric bypass patients preoperatively and at 12 

months postoperatively. All RNYGB surgeries were performed by a single 

surgeon with a 30cc pouch and a 100cm Roux limb. Post-operatively, all 

patients discontinued diuretics and statins. Weights and BNP levels were 

measured pre-op and at 3, 6 and 12 months and compared by a paired 

t-test of equal variance. 

Results: Preoperatively, patients were representative of a bariatric surgery 

population with an average BMI 47, age 43, % female (82), % history of 

coronary artery disease (5), % hypertension (56), % diabetes (37) and % 

Sleep Apnea (41). At 12 months post-op, patients had lost 86% of their 

excess weight. There were significant increases in BNP from pre-op (57) 

to post–op: 3 months (87) to 6 months (84) to 12 months (119). These 

increases in BNP correlated to post-operative weight loss. 

Conclusion: This novel study demonstrates that surgically induced 

weight loss leads to increases in B-type natriuretic peptide correlating to 

weight loss. This correlation of BNP and weight loss may potentially serve 

as an additional marker and mechanism for satiety. 

S057 

LAGB WITH TRUNCAL VAGOTOMY: ANY INCREASED WEIGHT LOSS? 

Kristen R Earle, MD, Matt B Martin, MD Moses H. Cone Hospital Systems, 

Central Carolina Surgery, PA 

Objective: Does truncal vagotomy enhance weight loss when combined 

with LAGB? Laparoscopic adjustable gastric banding (LAGB) causes 

weight loss primarily through a mechanical restrictive mechanism. 

The vagus nerve provides connections between the brain and the 

gut through afferent and hormonal signals that regulate fullness and 

satiation. Published studies demonstrate clinically significant weight loss 

in subjects undergoing open surgical truncal vagotomy for ulcer disease 

and morbid obesity. The primary objectives of this study were to evaluate 

the safety and efficacy of adding truncal vagotomy to LAGB and compare 

weight loss to LAGB alone. 

Methods: This open-label case controlled study was conducted at Central 

Carolina Surgery, PA, a private surgery practice in Greensboro, NC. Since 

May 2006, 47 subjects with Class II and III obesity underwent LAGB with 


truncal vagotomy. The anterior and posterior nerves were divided and 

resected just below the diaphragm and sent to pathology. The primary 

safety variable was the number of procedure-related adverse events. The 

primary efficacy variable was the percent excess weight loss (%EWL). 

Completeness of vagotomy was assessed by direct inspection, pathology 

confirmation and endoscopic Congo red testing after intravenous 

Baclofen stimulation. 47 cohorts who were matched for age, sex, and 

preop BMI were used for the ongoing comparison. 

Results: The average enrollment BMI was 45 and average age was 46. 

There were no intra-operative or unanticipated adverse events. All 

subjects were discharged in ≤ 24 hours. There was one case of incomplete 

vagotomy confirmed via pathology. The LAGB/Vagotomy group had an 

average 34.8 % excess weight loss at an average 17 months post op. The 

cohort group had an average weight loss of 38.5% of excess body weight 

at an average 21 months postop. All of the LAGB/vagotomy patients 

reported an absence of hunger; no diarrhea, gastric outlet obstruction, or 

dumping was seen. 

Conclusions: This data does not support the hypothesis that vagotomy 

when added to LAGB augments weight loss. None of the vagtomy 

patients had any of the complications usually attibuted to vagotomy 

without drainage. 

S058 

NUTRITIONAL EFFECT OF ORAL SUPPLEMENT ENRICHED IN BETA- 

HYDROXY-BETA -METHYLBUTYRATE, GLUTAMINE AND ARGININE ON 

RESTING METABOLIC RATE AFTER LAPAROSCOPIC GASTRIC BYPASS. R 

H Clements, MD, N Saraf, MPH, M Kakade, MPH, M White, RN, J Hackett, RN 

Division of Gastrointestinal Surgery, University of Alabama at Birmingham, 

AL 

Objective- To evaluate the nutritional effect of an oral supplement 

enriched in beta-hydroxy-beta-methylbutyrate, glutamine and arginine 

(HMB/Glu/Arg) on resting metabolic rate (RMR) following laparoscopic 

gastric bypass (LGB). Although, LGB is a highly effective approach to 

induce weight loss in morbid obesity, most patients regain 10-15% of this 

weight over time. Studies indicate, this is due to a decrease in RMR which 

is largely determined by loss in lean body mass (LBM) after LGB. There is 

evidence that HMB/Glu/Arg helps restore LBM in cachexia due to cancer 

and critically ill trauma patients. If this effect can help modulate RMR in 

bariatric patients, more stable weight maintenance may be achieved. 

Method- Patients scheduled to undergo LGB were randomized to an 

experimental arm receiving (HMB/Glu/Arg) and to a control arm not 

receiving it. The experimental group was required to consume 24g of 

supplement dissolved in water, twice daily and record their consumption. 

Primary outcomes of interest included weight loss, LBM determined 

by double emission x-ray aborptiometry (DXA) and RMR measured by 

indirect calorimetry. These were assessed at baseline, 2 and 8 week 

intervals. 

Results- 27 morbidly obese patients with mean age 46 + 8.5 years (78% 

Whites, 22% African Americans, 96% females) and mean BMI 43.2 +4.1 kg/ 

m2 were enrolled. Paired t test was used to compare means in all subjects 

(N=27) and the results are depicted in the table below. 

Variable Baseline 8 week Change p value 

Weight(kg) 112.7 +11.8 96.8 +12.0 - 15.7 +2.6


Conclusion- There was a significant decrease in weight, BMI, LBM and 

RMR in all subjects after LGB, and these changes were not affected by the 

use of supplement. Potential preservation of LBM as a result of HMB/Glu/ 

Arg requires further investigation. Its consumption (78cal/serving) did not 

adversely affect weight loss in the experimental group. 

S059 

DETERMINANTS OF RESOURCE UTILIZATION IN LAPAROSCOPIC 

ROUX-EN-Y GASTRIC BYPASS: A MULTICENTER ANALYSIS OF 6322 

PATIENTS Prateek K Gupta, MD, Himani Gupta, MD, Weldon J Miller, MS, 

Robert A Forse, MD PhD Creighton University Medical Center 

Objective: Treatment of chronic diseases such as obesity by resource 

intensive therapy such as Laparoscopic Roux-en-Y Gastric Bypass surgery 

(LRYGB) is associated with early increases in healthcare costs. With the 

increasing frequency of LRYGB being performed and the rising cost of 

health care, preoperative optimization may reduce resource utilization 

and these early costs. We sought to investigate the independent 

contributions of modifiable and non-modifiable factors to resource 

utilization in LRYGB. 

Methods: American College of Surgeons’ 2007 National Surgical Quality 

Improvement Program (NSQIP) database was used. 6322 patients of 

this multicenter (183 academic and private US hospitals participating), 

prospective database who underwent LRYGB were studied. Resource 

variables were operative time (OT), hospital length of stay (LOS), as 

well as occurrence of 17 postoperative complications comprising of 

wound infection, organ space infection, wound dehiscence, pneumonia, 

reintubation, on ventilator > 48 hours, pulmonary embolus, deep venous 

thrombosis, renal insufficiency, renal failure, stroke, coma, cardiac 

arrest, myocardial infarction, bleeding, sepsis and return to operating 

room. Bivariable and multivariable linear and logistic regressions were 

performed. 

Results: Mean age was 44.2±11.2 years. Mean BMI was 49.3±8.6. 

Male:female ratio was 1212:5126. Mean LOS was 2.59±2.88 days. Mean 

OT was 139.3±55.9 minutes. Being a male increased OT by 7.8 minutes 

(p



and after IVGTT . These changes are independent from the food passage 

through the gastro-intestinal tract or weight loss. The Ghrelin and GLP-1 

changes seem to be directly related to the fundus ablation. 

S062 

OUTCOMES OF LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS AS A 

PRIMARY VERSUS REVISIONAL BARIATRIC SURGERY. Balaji Jangam, 

MD, Kristine M O’Hara, MD, Bruce Bernstein, PhD, Ravi Chhatrala, MD, 

Ioannis Raftopoulos, MD PhD FACS Bariatric Center at Saint Francis 

Hospital and Medical Center, Hartford, CT. 

BACKGROUND: The purpose of this study was to compare the outcomes 

of laparoscopic Roux-en-Y gastric bypass (LRYGB) as a primary (CG) versus 

revisional bariatric surgery (RBS). 

METHODS: Data of 514 consecutive patients who underwent LRYGB by 

one surgeon between August 2004 and June 2009 as primary (n=481, 

93.6%) or RBS (n=33, 6.4%) were compared. Collected data included age, 

body mass index (BMI), operative time (OT), length of hospital stay (LOS), 

conversion to open surgery, early (< 30 days), or late (> 30 days) major 

complications, % excess weight loss (%EWL), status of comorbidities 

including hypertension (HTN), diabetes (DM), gastro-esophageal reflux 

disease (GERD), obstructive sleep apnea (OSA) and dyslipidemia, as well 

as score change of SF-36 quality of life (QoL) questionnaire. Indications 

for RBS included inadequate weight loss (n=13), intractable GERD (n=12), 

weight regain (n=10), abdominal pain (n=6), intractable or perforated 

ulcer (n=3), and anastomotic stricture (n=1). RBS procedures included: 

1) conversion to Roux-en-Y gastric bypass of jejuno-ileal bypass (n=2), 

adjustable gastric band (n=5), sleeve gastrectomy (n=1), vertical 

banded gastroplasty (n=8), Nissen fundoplication (n=4), 2) revision of 

gastrojejunostomy (n=8), 3) Roux limb lengthening (n=5), 4) resection 

of Roux limb blind loop end (n=2) and 5) revision of gastric pouch (n=1). 

Differences in continuous and categorical variables between groups were 

explored with analysis of covariance (ANCOVA) and multinomial logistic 

regression respectively, both models adjusting for BMI, age and gender. P 

< 0.05 was considered significant. 

RESULTS: There was a significant difference between CG and RBS groups 

in relation to BMI (47.2 vs. 38.6 Kg/m2, p


Conclusion: Evaluation of the esophageal hiatus revealed that patients 

with Type III PEH have a different biologic environment in regards to 

collagen resulting in a higher collagen ratio (I/III) compared to control 

patients. Collagen Deficiency in the GE junction supporting ligaments 

does not appear to be an etiology of PEH formation. 

S065 

IN VIVO FLUORESCENCE IMAGING OF STAPHYLOCOCCUS AUREUS 

BIOLOGIC MESH INFECTION - A 30 DAY ANALYSIS Karem C Harth, 

MD MHS, Ann-Marie Broome, PhD, Michael R Jacobs, MD PhD, Jeffrey A 

Blatnik, MD, Michael J Rosen, MD University Hospitals Case Medical Center 

BACKGROUND: Infection in the setting of hernia repair poses a difficult 

challenge, and biologic mesh might perform favorably in this setting. 

The specific response of different biologic mesh constructs to infection is 

unclear. Using fluorescent-labeled bacteria and innovative in vivo imaging 

quantitative bacterial analysis, we evaluated the response of two biologic 

mesh prosthetics to staphylococcus aureus infection. 

METHODS: Twenty-four rats underwent creation of a chronic hernia. 

They were randomly assigned to underlay bridge repair with Permacol 

(cross linked porcine dermis) (n=12) or Surgisis (noncrosslinked porcine 

submucosa) (n=12). Half in each group were repaired in sterile fashion 

(clean cases; n=6) and half were inoculated with 10 4 CFU/ml of a clinical 

strain of green fluorescent protein (GFP) labeled Staphylococcus aureus 

(SA) (clean contaminated cases; n=6). Animals were allowed to survive 

30-days, euthanized and the explanted abdominal wall underwent 

immediate in vivo fluorescent imaging. A 6mm punch biopsy of both 

tissue and mesh was obtained after imaging. This was followed by 

homogenizing, serial diluting, plating in blood agar dishes, incubation 

for 24 hours at 37° C and CFU/gm estimates. Validation of our imaging 

was performed by in vitro fluorescence imaging of serial concentrations 

of GFP SA (10 3 – 10 8 CFU/ml) to determine the minimal level of GFP signal 

detection. Fisher’s exact statistic was performed. 

RESULTS: All animals survived 30 days following repair. CLEAN CASES: 

Culture results for both clean groups did not reveal evidence of infection 

(0 CFU/gm). CLEAN CONTAMINATED CASES: One of six (17%) Permacol 

animals had residual GFP SA infection (8 x 10 2 CFU/gm; n=1) while the 

remainder had no GFP SA (0 CFU/gm; n=5). Three of six (50%) Surgisis 

animals had residual GFP SA infection (1.3 x 10 2 CFU/gm; n=3) while the 

others had no detectable GFP SA infection (p-value = 0.55). IMAGING: 

In vivo imaging corroborated our low bacterial counts and was unable 

to detect presence of GFP SA or a difference in signal between clean 

contaminated cases of Permacol or Surgisis (0 RFU signal/group; n=12). 

IN VITRO VALIDATION: There was a positive linear correlation (R 2 = 0.9121; 

Y=715X+186) between imaging device signal and bacterial counts above 

a concentration of 10 5 CFU/ml. This was determined to be the lower limit 

of GFP SA detection with our in vivo fluorescence-imaging device. 

CONCLUSIONS: This study confirms that biologic mesh can tolerate clean 

contaminated situations. In these settings most animals were able to clear 

the bacterial contamination as demonstrated by low quantitative cultures 

and corroborated with in vivo fluorescent imaging. Further analysis as to 

the exact mechanism of bacterial clearance and biomechanical alterations 

of the mesh in infected fields is ongoing. 

S066 

FIBRIN GLUE FOR INTRAPERITONEAL LAPAROSCOPIC MESH 

FIXATION: A COMPARATIVE STUDY IN A SWINE MODEL Namir 

Katkhouda, MD, Tatyan Clarke, MD, Jeffrey Algra, MD, Bon C Cheng, BA, 

Rodney J Mason, MD, Maryam Balouch, BS, Helen J Sohn, MD, Ashkan 

Moazzez, MD, Jaisa Olasky, MD, Thomas V Berne, MD USC Keck School of 

Medicine, Department of Surgery, Los Angeles, CA, USA 

Introduction: A conventional method of mesh fixation in laparoscopic 

ventral hernia repair is transfascial sutures with tacks. This method has 

been associated with low recurrence rates, but yields significant morbidity 

from pain and bleeding. Fibrin glue has been used successfully in inguinal 

hernia repairs with decreased incidence of chronic pain without an 

increase in recurrence rates, but its utility is unknown for laparoscopic 

ventral hernia repairs. Our aim is to evaluate the efficacy of fibrin glue for 

laparoscopic mesh fixation to the anterior abdominal wall compared to 

other fixation methods. 

Methods and Procedures: Four different laparoscopic mesh fixation 

methods were randomly assigned to midline positions along the 

abdominal wall of 12 female pigs and compared: 1. fibrin glue only (GO), 

2. transfascial sutures with tacks (ST), 3. fibrin glue with tacks (GT), and 

4. tacks only (TO). At four weeks post-implantation, tensile strength, 

adhesions, migration, contraction, and buckling/folding were assessed 

using the Kruskal-Wallis one-way analysis by ranks test. 

Results: There were no significant differences in tensile strength, 

adhesions, 

or buckling/folding among the four fixation methods. A significant 

increase in mean migration (3.3 vs. 0.0mm, p=0.03) and percent 

contraction (28 vs. 14%, p=0.02) were identified in the GO group when 

compared to ST. 

GO GT TO ST p-value 

Tensile Stress 

N/m 2 x10 4 5.2 (1.8) 5.0 (2.0) 6.4 (2.2) 6.8 (1.3) NS 

mmHg 393 (132) 373 (149) 478 (165) 514 (99.0) 

Migration (mm) 3.3 (4.4) 0.8 (2.9) 0.4 (1.4) 0 p=0.03* 

Contraction (%) 28.0 (12.5) 18.9 (11.9) 17.2 (11.3) 14.2 (8.10) p=0.02* 

Buckling Score 0.42 (0.67) 0.75 (0.62) 0.58 (0.51) 0.50 (0.52) NS 

Adhesion Score 4.7 (4.0) 1.8 (3.0) 4.3 (3.7) 4.1 (4.3) NS 

All values are reported as mean (standard deviation); *p-value comparing 

GO to ST 

Conclusion: Mesh fixation using fibrin glue has comparable tensile 

strength and adhesion rate to sutures with tacks in the swine model. 

Increased contraction and migration rates associated with fibrin glue 

alone may be an issue and warrants further study. On the other hand, 

the GT group showed similar biomechanical characteristics as the 

other groups and may represent a reasonable alternative to the use of 

transfascial sutures. 

S067 

INITIAL EXPERIENCE WITH SENTINEL LYMPH NODE BIOPSY FOR 

ESOPHAGEAL CANCER Sarah K Thompson, MD, Dylan Bartholomeusz, 

MBBS MD, Peter G Devitt, MBBS University of Adelaide, Royal Adelaide 

Hospital, South Australia, Australia 

Introduction: There is emerging evidence that isolated tumor cells and 

micrometastases in lymph nodes have prognostic value in esophageal 

cancer. To facilitate a detailed examination of a limited number of 

lymph nodes by the pathologist, we report our initial experience with 

sentinel lymph node biopsy in patients undergoing resection for invasive 

esophageal cancer. 





S068 

THE SELF-APPROXIMATING TRANSLUMENAL ACCESS TECHNIQUE 

(STAT) RELIABLY PERMITS TRANSGASTRIC ORGAN RESECTION AND 

RETRIEVAL Eric M Pauli, MD, Jegan Gopal, MD, Matthew T Moyer, MD, 

Abraham Mathew, MD, Randy S Haluck, MD, Ann M Rogers, MD Penn State 

Milton S. Hershey Medical Center 

Introduction: Several studies have shown that the Self-Approximating 

Translumenal Access Technique (STAT) allows safe abdominal access 

and a reliable means of gastric closure for per-oral NOTES. Little is 

known, however, about the durability of the STAT tunnel under the 

mechanical forces required for organ resection and specimen retrieval. 

We hypothesized that simple extirpative abdominal operations (including 

specimen resection and retrieval) could be performed via STAT so that the 

tunnel would maintain its integrity for the conclusion of the procedure, 

permitting a secure gastrotomy closure. 

Methods: 14 domestic swine (mean wt 26kg) underwent transgastric 

organ resection (7 cholecystectomy, 7 left uterine horn resection). 

Abdominal access was obtained using STAT (as previously described) with 

the submucosal tunnel directed at the target organ. The resected surgical 

specimen, a fully inflated 2 cm endoscopic balloon and an 8x3x3cm 

manufactured ‘standard specimen’ (a simulated human gallbladder with 

large gallstone) were sequentially retrieved through the submucosal 

tunnel. Evaluation of tunnel integrity and an assessment of the ease of 

specimen extraction were performed following each retrieval. Physiologic, 

operative and clinical data were collected. All procedures were video 

recorded. After a two-week observation period, animals were euthanized 

and necropsy performed for documentation of gross findings. 

Results: The mean operative time was 4.1h (range 2.4-5.5hr). The mean 

abdominal access time (mucosal incision to serotomy) was 51min (range 

26-78). A mean tunnel length of 12cm (6-23cm) with a width 4cm (2.5- 

5cm) was created. The STAT tunnel remained fully intact in: 14/14 after 

organ resection and retrieval, 13/13 after balloon extraction and 11/14 

after standard specimen extraction. All three tears occurred early in our 

experience. Two small mucosal tears still permitted the STAT tunnel to 

be closed by standard endoscopic clip technique. One significant gastric 

tear required a single laparoscopic suture for secure closure. The ease 

in specimen extractions can be seen in Table 1. None of the standard 

specimens were able to be endoscopically delivered past the gastroesophageal 

junction (GEJ). Post-operatively all animals gained weight. 

One animal, sacrificed at post-operative day 12 due to lethargy, had a 

cystic duct leak and biloma. Other necropsy findings included: adhesions 

(4), bile leak (1), laparoscopic port site abscess (1), small submucosal 

abscess(1). 

Type of 

Specimen 

No 

Difficulty 

Mild 

Difficulty 

Moderate 

Difficulty 

Severe 

Difficulty 

Surgical Specimen 14 0 0 0 

Balloon 12 1 0 0 

Standard Specimen 7 0 3 4 (Early Cases) 

Conclusions: The submucosal tunnel created using STAT is capable of 

withstanding the mechanical forces of transgastric organ resection and 

retrieval. STAT also permitted the removal of rigid specimens (simulate 

large gallstone). None of these standard specimens could be delivered 

past the GEJ, suggesting that tunneling methods of transgastric access 

are not the size-limiting factor in per-oral specimen retrieval. One 

significant mucosal tear occurred early in the study, suggesting that there 

is a learning curve inherent in making the STAT tunnel wide enough to 

accommodate large, rigid specimens. 

S069 

SHORT-STAY SURGERY: WHAT REALLY HAPPENS AFTER DISCHARGE? 

Tung T Tran, MD, Pepa Kaneva, MSc, Nancy E Mayo, PhD, Gerald M Fried, 

MD, Liane S Feldman, MD Steinberg-Bernstein Centre for Minimally 

Invasive Surgery, McGill University, Montreal, Quebec, Canada 

Introduction: Innovations in surgery and perioperative care enable rapid 

hospital discharge after a variety of procedures. While length of hospital 

stay is commonly used as a surrogate outcome for surgical recovery, it 


is not applicable in the setting of short-stay surgery (


group compared to the laparoscopically treated group (median 4 days 

vs. 2 days, p < 0.05). Rates of incisional infections were also significantly 

higher in the open vs. the laparoscopic group (5.9% vs. 2.2%, p < 0.05). 

When controlling for other patient characteristics, open appendectomy 

was still significantly associated with a higher rate of incisional wound 

infection. 

Conclusion: Laparoscopic appendectomy in elderly patients is a 

safe procedure with regards to 30-day post-operative morbidity and 

demonstrates a benefit of decreased wound infection rates as compared 

to the open approach. 

S071 

SINGLE SITE LAPAROSCOPIC (SSL) CHOLECYSTECTOMY IN HUMAN 

CADAVERS USING NOVEL PERCUTANEOUS RETRACTION AND A 

MAGNETIC ANCHORING AND GUIDANCE SYSTEM (MAGS): RE- 

ESTABLISHING THE CRITICAL VIEW Rohan A Joseph, MD, Nilson A 

Salas, MD, Michael A Donovan, MS, Patrick R Reardon, MD, Barbara L Bass, 

MD, Brian J Dunkin, MD Methodist Institute for Technology Innovation 

and Education (MITIE), Department of Surgery, The Methodist 

Hospital,Houston- TX 

Introduction: SSL, though promising, introduces ergonomic challenges 

due to loss of instrument triangulation as obtained in conventional 

laparoscopy. This limitation makes establishing the critical view during 

dissection of the Triangle of Calot (TOC) difficult and has resulted in a 

variety of strategies to overcome the problem. This study investigates 

use of a novel percutaneous grasper that mimics a standard laparoscopic 

instrument and MAGS in aiding surgeons to perform SSL cholecystectomy 

more easily and with a technique that closely mimics four-port 

cholecystectomy. 

Methods: SSL cholecystectomy was performed on four female cadavers 

by an expert laparoscopic surgeon with limited experience in SSL. A 

15–18mm incision was made at the umbilicus and the MAGS introduced 

into the abdomen. MAGS consists of an oblong (7.8cm × 14mm) magnetic 

internal effector with a retractable monopolar cautery hook (6.3cm) and 

is coupled across the abdominal wall to an external hand-held magnet. 

By sliding the external magnet over the abdominal wall and applying 

external pressure, subtle motions of the hook can be achieved. Following 

MAGS introduction, a commercially available port comprised of a foam 

cuff and three 5mm trocars was placed. Next, the novel grasper was 

introduced percutaneously in the RUQ. The device’s 3mm transabdominal 

shaft is mated to a 5mm end effector intra-corporeally and can grasp 

tissue with the purchase and security of a standard laparoscopic 

instrument while providing 360° rotation and locking jaws. Retraction 

was accomplished using the percutaneous grasper to manipulate the 

fundus and a standard 5mm grasper through the umbilical port for the 

infundibulum. Dissection was done using a combination of the MAGS and 

a standard Maryland dissector. Total procedure time, time from procedure 

start to obtain a critical view of the TOC and clipping and dividing the 

cystic duct/ artery, time for dissection of the gall bladder from the liver 

bed, and thickness of the abdominal wall at the umbilicus were measured. 

A multi-institutional survey was also administered among surgeons 

having experience with these devices to gauge satisfaction. 

Results: The critical view was obtained in each case and all 4 procedures 

were completed successfully. Both devices performed optimally to 

allow smooth flow of the procedure. Mean procedure time was 40min 

(33-51min); time from procedure start to obtaining the critical view and 

clipping and dividing the cystic duct/ artery was 33 min (28-38min) and 

time for dissection of the gall bladder from the liver bed was 6.7min (3- 

13min). The mean abdominal wall thickness was 1.9cm (1.5-2cm). The 

survey found that MAGS increased surgeon satisfaction in performing SSL 

cholecystectomy by 73% (18% satisfaction standard SSL, 100% MAGS). 

Conclusions: The use of a novel graspers and MAGS overcomes the 

limitations of SSL cholecystectomy and improves surgeon dexterity. 

Making SSL feel more like traditional laparoscopy will enable a wider 

adoption of this procedure in the community. 

S072 

LAPAROSCOPIC CHOLECYSTECTOMY POSES PHYSICAL INJURY RISK 

TO SURGEONS: ANALYSIS OF HAND TECHNIQUE AND STANDING 

POSITION Yassar Youssef, MD, Gyusung Lee, PhD, Carlos Godinez, MD, 

Erica Sutton, MD, Rosemary Klein, MA, Ivan George, Jacob Seagull, PhD, 

Adrian Park, MD Sinai Hospital of Baltimore, MD, USA and University of 

Maryland Medical Center, Baltimore, MD, USA. 

Introduction: This study compares the effects of surgical techniques 

(one-handed versus two-handed) and surgeon’s standing position (sidestanding 

versus between-standing) during laparoscopic cholecystectomy 

(LC) and its outcomes on surgeons’ learning, performance, and 

ergonomics. There is little homogeneity in how to perform and train for 

LC. Variations in standing position (“American” or side-standing technique 

where the surgeon stands on the patient’s left versus “French” or betweenstanding 

technique where the surgeon stands between the patient’s 

legs) as well as hand technique (one-handed versus two-handed) exist. 

The two-handed technique refers to the surgeon providing his own 

exposure using one hand for dissection and the other for retraction while 

the assistant hold the camera. The one-handed technique refers to the 

situation during which the surgeon dissects with one hand and manages 

the camera with the other with the assistant helping in providing 

exposure and gallbladder retraction. 

Methods: Thirty-two LC procedures performed by a total of eight subjects 

on a virtual reality simulator were video recorded and analyzed. All 

eight subjects were right-handed. Each subject performed four different 

procedures so as individual assessment of the following methods was 

possible: one-handed/side-standing, one-handed/between-standing, 

two-handed/side-standing, and two-handed/between-standing. Physical 

ergonomics were evaluated using the Rapid Upper Limb Assessment 

(RULA) tool. Mental workload assessment was achieved through the use 

of the National Aeronautics and Space Administration-Task Load Index 

(NASA-TLX). Performance evaluation data generated by both the virtual 

reality simulator and a subjective survey were also analyzed. 

Results: The RULA scores for all procedures were statistically significantly 

better for the between-standing technique compared to the sidestanding 

technique. Regardless whether the technique used was one- or 

two-handed, the between-standing technique was associated with better 

ergonomics than the side-standing technique. The median RULA scores 

for different anatomical area was significantly worse for the upper arms 

and trunk in the side-standing position (upper arms: 3.5 – trunk: 3.5) 

when compared with the between-standing position (upper arms: 2 and 

trunk: 1.5). This showed that the main disadvantage of the side-standing 

position to be its detrimental effect on both the upper arms and trunk. 

There was no significant difference in other body parts including the 

lower arms, wrist, neck and legs. 

Using the NASA-TLX tool, the side-standing position was associated with 

statistically significantly higher effort, frustration, and physical demand 

(p< 0.05). The objective, simulator-generated performance metrics 

demonstrated no differences in either operative time or complication rate 

among the four methods for performing LC. Survey answers indicated the 

subjects’ choice to be the two-handed/between-standing technique as 

the best procedural method for teaching and standardization. 

Conclusion: Laparoscopic cholecystectomy poses a risk of physical injury 

to the surgeon. As it is currently commonly performed in the United 

States, the left side-standing position leads to increased physical demand 

and effort, thus resulting in ergonomically unsound operative conditions. 

Until further investigations are made, adopting the between-standing 

position deserves serious consideration as it presents the best short-term 

ergonomic alternative. 





S073 

EFFECTS OF NISSEN FUNDOPLICATION ON ABLATION OF BARRETT’S 

ESOPHAGUS WITH ENDOSCOPIC, ENDOLUMINAL RADIOFREQUENCY 

ABLATION Kathleen O’Connell, BS, Vic Velanovich, MD Henry Ford 

Hospital, Detroit, Michigan 

Background: Endoscopic, endoluminal radiofrequency ablation is 

achieving increasing acceptance as a mode of eliminating Barrett’s 

metaplasia and, thus, reducing the risk of developing esophageal 

adenocarcinoma. It is believed that reducing the exposure of the 

esophageal epithelium to acid is essential to achieve long-term ablation 

of Barrett’s esophagus. However, it is unclear whether the use of proton 

pump inhibitors or antireflux operations are more effective to accomplish 

this goal. 

Methods: A review of all patients who underwent endoscopic, 

endoluminal radiofrequency ablation with the BARRx device (BARRx 

Medical, Sunnyvale, CA) were reviewed for date of initial ablation, 

length of Barrett’s epithelium, presence or performance of a 

Nissen fundoplication, all follow-up endoscopy and treatment, and 

posttreatment biopsy results. Patients were categorizes by the presence 

of a Nissen fundoplication and presence of Barrett’s metaplasia or 

dysplasia by biopsy at least 12 months following ablation and at last 

endoscopic follow-up. Data was analyzed by Fisher’s exact test and the 

Mann-Whitney U-test. 

Results: Of 77 patients ablated, 47 had documented endoscopic followup 

at 12 months or longer following the ablation. Of these, 19 patients 

had Nissen fundoplications before, at the same time, or after ablation. 

The median length of Barrett’s epithelium, with interquartile range (IQR) 

was 3 (2-12) in patients with fundoplications compared to 3 (2-7) without 

fundoplications (p=NS). Median follow-up in months was 15 (12-24) in 

fundoplication patients compared to 12.5 (12-17) without (p=NS). One 

of 19 patients with fundoplications had persistent or recurrent Barrett’s 

epithelium, compared to 7 of 28 without fundoplications (p=0.03). Of 

patients without fundoplications, those who had persistent or recurrent 

Barrett’s had a median Barrett’s length of 10 cm (6-12 cm), compared to 

3 cm (2-5 cm) in patients who had ablated Barrett’s (p=0.03). Follow-up 

length was similar in those with ablated epithelium, 15 (12-19), compared 

to those with persistent or recurrent Barrett’s, 12 (12-13) (p=NS). 

Conclusions: Patients who had fundoplications in conjunction with 

endoluminal radiofrequency ablation were more likely to achieve 

durable ablation compared to patients who were treated with proton 

pump inhibitor therapy. It appears that patients with long-segment 

Barrett’s esophagus are at higher risk or persistent or recurrent Barrett’s 

metaplasia. Consideration for an antireflux operation should be 

given in patients with long-segment Barrett’s esophagus and planned 

endoluminal radiofrequency ablation. 

S074 

LAPARO-ENDOSCOPIC SINGLE SITE (LESS) HELLER MYOTOMY AND 

ANTERIOR FUNDOPLICATION FOR ACHALASIA Linda Barry, MD, 

Sharona B Ross, MD, Sujat Dahal, MD, Melissa Rosas, Chinyere Okpaleke, 

BS, Desiree Villadolid, MPH, Alexander S Rosemurgy, MD Department of 

Surgery, University of South Florida, Tampa, Florida 

Introduction: Laparo-Endoscopic Single Site (LESS) surgery is beginning 

to include advanced laparoscopic operations, such as Heller myotomy 

with anterior fundoplication. However, the feasibility and efficacy of LESS 

Heller myotomy and anterior fundoplication has not been established. 

This study was undertaken to evaluate our initial experience with LESS 

Heller myotomy and anterior fundoplication for achalasia. 

Methods: Transumbilical LESS Heller myotomy with concomitant anterior 

fundoplication for achalasia was undertaken in 51 patients since October 

2007. Outcomes, including operative time, complications, and length of 

stay were recorded and compared to an earlier consecutive contiguous 

group of 51 patients undergoing conventional multi-incision laparoscopic 

Heller myotomy with anterior fundoplication. Symptoms before and after 

myotomy were scored by patients using a Likert scale (0=never / not 

severe to 10=always / very severe). Data were analyzed using the Mann- 

Whitney test, Wilcoxon matched pairs test, and Fisher exact test, where 


appropriate. Data are presented as median (mean ± SD). 

Results: Patients undergoing LESS Heller myotomy vs. conventional 

laparoscopic Heller myotomy were similar in gender, age, BMI, blood 

loss, and length of hospital stay (Table). However, patients undergoing 

LESS Heller myotomies had operations of significantly longer duration. 

With LESS myotomy, 10 patients (20%) required an additional port / 

incision. No patients were converted to “open” operations. No patients 

had procedure specific complications. Symptom reduction was dramatic, 

satisfying, and similar after both LESS and conventional laparoscopic 

myotomy and fundoplication (Table). Patients undergoing Heller 

myotomy and anterior fundoplication using LESS approach had no 

apparent scars. 

Conventional lap 

Heller 

LESS Heller 

Patients (N): 51 51 

Gender: 25 m / 26 f 25 m / 26 f NS 

Age: 

50 years (52 years 

± 19.1) 

57 years (55 

years ± 16.0) 

NS 

BMI: 

24 kg/m 2 (24 kg/m 2 

± 4.2) 

25 kg/m2 (24 

kg/m2 ± 3.8) 

NS 

Length of Operation: 

106 min (109 min ± 133 min (131 

32.4) 

min ± 41.5) 

0.002 

Blood Loss: 

47 (


Results: The study population consisted of 310 patients with a median 

age of 52 (IQR:42-63). No significant difference was found between day 1 

and day 2 composite pH score (13.1, 14.4, p=0.66), this was also true for all 

the esophageal pH monitoring components (p>0.17). A strong correlation 

was found between composite pH score in day 1 and day 2 [r = 0.83 (95% 

CI: 0.79 - 0.86, p



S078 

LAPAROSCOPIC REPAIR OF LARGE HIATAL HERNIAS - IMPACT ON 

PULMONARY FUNCTION Jacqui C. Zhu, MBBS, Guillemo Becerril, MBBS, 

Gregory L. Falk, MBBS Deptartment of Upper Gastrointestinal Surgery and 

Endosurgery, Concord Hospital 

Introduction: This study is to examine the impact of laparoscopic repair 

of large hiatal hernia on patient’s respiratory function and quality of life. 

Methods: From 2004 to 2008, 30 consecutive patients with large 

paraesophageal hernia defined as >50% of stomach in the intrathoracic 

cavity with a minimum follow-up of 2 years were included in this 

study. All patients graded their dyspnoea severity as an index of 1=no 

dyspnoea, 2=dyspnoea with exertion, 3=dyspnoea with basic activities or 

4=dyspnoea at rest. All patients had a formal respiratory function test 1 

week prior and 3 months after their laparoscopic hiatal hernia repair. The 

patients had to rate their symptom severity and complete a quality of life 

questionnaire in the form of Gastrointestinal Quality of Life Index (GIQLI) 

preoperatively and then at 3-month, 6-month and thereafter yearly 

intervals postoperatively. 

Results: There were no hospital mortality and the morbidity rate was 

10%. In 26 patients with preoperative dyspnoea, 22 had complete 

resolution while the remaining 4 had experienced improvement in 

dyspnoea severity postoperatively. The mean dyspnoea severity index 

reduced from 2.4 to 1.3(p


Conclusion: Our series are of relatively limited number and our results 

need to be verified by larger series. In our double blinded study, pain 

control was easily achieved by NASIDs in the study group. The need 

for opioids were significantly higher in the control group as well as 

the VAS scores. We have found crural Bupivacaine injection to be an 

effective treatment for the management of perioperative pain in patients 

undergoing Laproscopic Nissens Fundoplication. 

S081 

OUTCOMES AFTER REPAIR OF THE INTRA-THORACIC STOMACH: 

OBJECTIVE FOLLOW-UP UP TO 5 YEARS Jai Bikhchandani, MD, 

Ona Gurney, F Yano, Tommy Lee, MD, Sumeet K Mittal, MD Creighton 

University Medical Center 

Introduction: Laparoscopic surgery is a viable treatment option for intrathoracic 

stomach (ITS); however doubts have been raised regarding its 

efficacy. Routine use of mesh has been advocated. The aim of this study is 

to look at long term objective and symptomatic outcomes after repair of 

ITS with selective use of mesh and fundoplication. 

Methods: A retrospective review of prospectively collected data was 

performed to identify patients who underwent surgical treatment of ITS 

from Jan 2004 to Sep 2008 at Creighton University Medical Center. ITS was 

defined as herniation of greater than 75% of the stomach into the chest 

on a barium swallow. A standardized foregut symptom questionnaire was 

administered along with contrast study at 1, 3 and 5 yrs post-surgery. 

Results: Sixty-nine patients with a mean age of 71.2 years (44-88) had 

surgical treatment of ITS. There were 46 (67%) females. There were 7 

trans-thoracic and 62 trans-abdominal repairs (59 laparoscopic and 3 

open conversions). There was one intra-op death due to bleeding. Antireflux 

surgery was performed in 38 patients (21 Nissen, 13 Toupet, 1 Dor 

and 3 Roux-en-Y gastric bypass). Of these 10 patients also had Collis 

gastroplasty for a short esophagus. In the remaining 30 patients excision 

of the hernia sac and crural repair was done. Mesh was used in 6 (8.7%) 

patients for crus reinforcement. Objective follow-up was available for 

89%, 76% and 75% at 1, 3 and 5 years respectively. There were 7% (4/59) 

radiological failures (one patient required emergent re-operation) within 

the first year. No additional recurrences were noted at 3 and 5 years. There 

was no significant difference in mean symptom and satisfaction scores or 

use of PPI between the patients with and without fundoplication. Mean 

satisfaction scores were 9.4, 9.0 and 9.3 at 1, 3 and 5 years respectively 

Conclusion: Laparoscopic repair of ITS is feasible, safe and durable with 

selective use of mesh and fundoplication and results in a high degree of 

patient satisfaction. Low recurrence rates at 1 year were achieved with no 

incremental failures up to 5 years. Longer follow-up with larger number of 

patients is needed to confirm these findings. 

S082 

REOPERATIVE LAPAROSCOPIC PARAESOPHAGEAL HERNIORRAPHY 

CAN PRODUCE EXCELLENT OUTCOMES Albert W Tsang, MD, Manish 

M Tiwaria, MD PhD MPH, Jason F Reynoso, MD, Dmitry Oleynikov, MD 

Department of Surgery, University of Nebraska Medical Center 

Introduction: Patients undergoing laparoscopic paraesophageal 

herniorraphy, either initial or recurrent, present with a myriad of 

esophageal and extra-esophageal symptoms. Given an overall recurrence 

rate of approximately 8%, reoperative paraesophageal herniorraphy is 

necessary on a significant number of patients. The goal of this study is to 

determine whether patients proceeding with laparoscopic reoperative 

paraesophageal herniorraphy experienced symptom resolution equal to 

or better than patients undergoing a first-time repair. 

Methods: A comprehensive, symptom frequency based clinical tool 

consisting of 24 esophageal and extra-esophageal reflux symptoms 

was developed and administered to patients undergoing an initial 

or reoperative paraesophageal herniorraphy between February 2002 

and September 2009. This was administered pre-operatively and 

post-operatively. From individual symptom scores, a composite score 

for esophageal reflux and extra-esophageal reflux was calculated. A 

retrospective analysis of patient records including history and physical 

examination, laboratory investigations, operative and post-operative 

follow-up progress notes was reviewed. Data on age, gender, twentyfour 

symptom frequencies, manometry results, pH testing results was 

collected and analyzed using appropriate statistical tests. 

Results: Patients included in the study had a mean age of 53.6 years 

and 57.4% of patients were female. Analysis of composite symptom 

scores of 195 patients demonstrated that paraesophageal herniorraphy 

results in a significant resolution of both esophageal (16.1 ± 8.5 preop 

vs. 3.5 ± 5.0 at 6 months post-op; p



reimbursements ranged from $264-$504 and $0-$545 respectively for 

patients discharged on day 1. 

The surgeon with the lowest average disposable cost per case ($329.18) 

utilized clips, pre-tied loops, and hand-ties as their predominant 

techniques. The surgeon with the highest average disposable cost per 

case ($552.33) predominantly used a linear stapler with 3 cartridges. 

DISCUSSION: Disposable costs incurred during each case frequently 

exceeded the hospital reimbursement. Currently, there is no scientific 

literature that suggests a superior surgical method for performing 

these portions of LA. Therefore additional costs are incurred without 

demonstrable clinical benefit. Practice amongst individual surgeons 

can be quite variable. This study suggests surgeons should review the 

cost implications of their practice and to find ways to provide the same 

effective care without unwarranted expenditures. Certain patients may 

present with complex pathology that merits individual approaches, yet 

routine LA procedures can be performed with less-expensive techniques 

that provide the same quality of care. 

S084 

TRANSANAL ENDOSCOPIC MICROSURGERY VERSUS LAPAROSCOPIC 

RESECTIONS IN 100 T2-N0 RECTAL CANCERS FOLLOWING 

NEOADJUVANT TREATMENT: A PROSPECTIVE RANDOMIZED TRIAL 

WITH FIVE YEARS MINIMUM FOLLOW-UP Emanuele Lezoche, Professor 

Phd, Maddalena Baldarelli, MD, Massimiliano Rimini, MD, Alessandro 

Maria Paganini, Professor Phd, Roberto Campagnacci, MD, Mario Guerrieri, 

Professor Department of Surgery University Politecnica delle Marche 

“Ancona” Italy 

Background: Aim of this study was to compare the oncological results of 

local excision performed with Transanal Endoscopic Microsurgery (TEM) 

versus Laparoscopic Resection (LR) with total mesorectal excision in the 

treatment of T2 N0, G1-2 rectal cancer following NT in both arms, with a 5 

years minimum follow-up. 

Methods: In the period comprised between April 1997 and April 2004, 

100 patients staged at admission as T2 N0, G1-2 rectal cancer with a 

tumour diameter lower than 3 cm and located within 6 cm from the anal 

verge were enrolled: 50 were randomized to TEM and 50 to LR. Patients in 

both groups were previously underwent high dose radiotherapy (5,040 

cGy in 28 fractions over 5 weeks) combined with continuous infusion of 

5-Flurouracil (200 mg/m2/day). 

Results: At minimum follow-up of 5 years 4 local recurrence (8.0 %) were 

observed after TEM and 3 (6 %) after LR . Distant metastases occurred 

in 2 (4%) case after TEM and in 2 (4%) pts after LR. The probability of 

disease-free survival at the end of follow-up was 91% in TEM group (95% 

Confidence Interval=79%-99%) and 93 % in LR group B (95% Confidence 

Interval=78%-99%). 

Conclusions: The study shows similar results between the two arms in 

terms of local recurrences, distant metastases and probability of survival 

for rectal cancer. 

S085 

LAPAROSCOPIC VERSUS OPEN ELECTIVE SIGMOID RESECTION 

IN DIVERTICULAR DISEASE: SIX MONTHS FOLLOW-UP OF THE 

RANDOMIZED CONTROL SIGMA-TRIAL Bastiaan R Klarenbeek, MD, 

Roberto Bergamaschi, MD PhD FRCS, Alexander A Veenhof, MD, Donald 

L van der Peet, MD PhD, Wim T van der Broek, MD PhD, Elly S de Lange, 

PhD, Willem A Bemelman, MD PhD, Piet Heres, MD, Antonio M Lacy, 

MD PhD, Miguel A Cues VU University Medical Center, Amsterdam, The 

Netherlands; Forde Health System, Bergen University, Forde, Norway; 

Academic Medical Center, Amsterdam, The Netherlands; Waterland 

Hospital, Purmerend, The Netherlands; Hospital Clinic, Barcelona, Spain 

Background: The short-term results of the Sigma-trial, comparing 

laparoscopic (LSR) versus open (OSR) elective sigmoid resection for 

diverticular disease, showed a 15.4% reduction in major complication 

rates, less pain, and shorter hospitalization at the cost of a longer 

operating time. Present data complements these results with six months 

follow-up. 

Methods: This was a prospective, multi-center, double-blind, parallelarm, 

randomized control trial, eligible patients were randomized to either 

LSR or OSR. Short-term results of the Sigma-trial have been published 

previously, methodological and operative details can be found in this 

original article. Patients attended the outpatient clinic six weeks and 

six months after surgery. Physical examination was carried out and the 

quality of life questionnaires were completed. In case of readmission, 

medical records were prospectively evaluated. Primary endpoints were 

mortality and late complications occurring between 30 days from surgery 

until six months postoperative. 

Results: From 2002 to 2006, 104 patients were randomized in five centers. 

All patients underwent the allocated intervention. 52 LSR patients were 

comparable to 52 OSR patients for gender, age, BMI, ASA grade, comorbid 

conditions, previous abdominal surgery, and indication for surgery. 

Conversion rate was 19.2%. LSR was associated with short-term benefits 

like a 15.4% reduction in major complication rates, less pain, and shorter 

hospitalization at the cost of a longer operating time. At six months 

follow up no significant differences in morbidity and mortality rates were 

found. Two patients died of cardiopulmonal causes (overall mortality 3%). 

Late complications (LSR 7 vs. 12 OSR; p = .205) consist of three incisional 

hernias, five times ileus, four fistulas, one abscess, two anastomotic 

stenoses and three recurrent episodes of diverticulitis. Nine of these 

patients underwent additional surgical interventions. Only 30% of ten 

ostomies were reversed during the follow-up period. The Short Form-36 

(SF-36) questionnaire showed significantly better quality of life for LSR at 

the six weeks follow-up, but at the six moths follow-up these differences 

were decreased. 

Conclusions: Six months follow-up showed an overall mortality rate of 

3% and a complication rate of 18%. No significant differences were found 

between LSR and OSR in terms of complications, re-interventions or 

ostomy reversal. 

S086 

TOTAL INTRACORPOREAL COLON SURGERY USING THE N.O.S.E. 

(NATURAL ORIFICE SPECIMEN EXTRACTION) TECHNIQUE. Morris E 

Franklin, MD, Karla Russek, MD, Allen Alvarez, MD Texas Endosurgery 

Institute 

Introduction: Laparoscopic surgery for colonic disease has experienced 

an increased utilization by surgeons owing to decreased morbidity, less 

pain, earlier ambulation, earlier bowel function, fewer complications, 

decreased narcotic use, and improved cosmesis compared with open 

colon surgery. The ability to perform a totally intracorporeal anastomosis 

will be an initial step to allow surgeons to perform natural orifice colon 

surgery in the future. Natural orifice specimen extraction eliminates 

the need for any enlargement of extraction abdominal incisions. 

The transvaginal site for specimen extraction is a safe alternative to 

transabdominal specimen extraction where enlargement of incisions are 

needed during laparoscopic colorectal surgery. 

Methods: The objective of this study was to report our experience with 

patients requiring a laparoscopic right hemicolectomy using a totally 

intracorporeal technique. We designed a nonrandomized prospective 

study of all consecutive female patients requiring a right hemicolectomy 

for both benign and malignant disease. 

Results: Forty-nine patients were entered into the study from December 

2007 to August 2009; 24 patients in the transvaginal (NOSE) group, and 

25 patients in the counter incision group. Mean age was 69.9 +/- 14.8. 

Operative time 159 +/- 27.1 min NOSE group vs 133.5 +/- 29 min counter 

incision group. Estimated blood loss was 83.3 +/- 14.4 mL NOSE group 

vs.133 +/- 65.5 mL. Length of hospital stay was similar at 5.5 +/- 2.5 

days NOSE group vs. 5.9 +/- 2.2 days. There was one intraoperative 

complication in the NOSE group (4.1%) and two minor postoperative 

complications (6.6%). There was one incisional hernia, one wound 

infection and two minor postoperative complications in the counter 

incisional group (13%). The overall complication rate was 8.3% for the 

NOSE group vs. 13% for the counter incision group. 

Conclusion: We consider the Natural orifice extraction approach after a 

laparoscopic right hemicolectomy to be feasible and safe. 



S087 

SINGLE INCISION LAPAROSCOPIC TOTAL PROCTOCOLECTOMY WITH 

ILEOANAL ANASTOMOSIS: INITIAL OPERATIVE EXPERIENCE Daniel 

P Geisler, MD, Hasan T Kirat, MD, Feza H Remzi, MD Department of 

Colorectal Surgery Cleveland Clinic Foundation 

Introduction: Single incision laparoscopic surgery (SILS) has been 

described in the urologic, gynecologic, bariatric and, more recently, 

colorectal surgical literature. Single-port colectomies have only been 

described as case-reports. We herein describe our experience to date with 

the use of single incision laparoscopic surgery for total proctocolectomy 

with ileoanal anastomosis. 

Patients and Methods: All patients who have undergone SILS total 

proctocolectomy and ileoanal anastomosis were identified from an IRBapproved 

laparoscopic database. Data was collected via chart review. All 

procedures were performed with use of the 5mm Olympus EndoEye and 

traditional laparoscopic instruments. 

Results: 5 patients were identified between June 2009 and September 

2009. Mean age was 36 years (range 13 to 47). There were 3 males and 2 

females. Mean body mass index was 21.2 (range 15.5 to 25.9). Diagnoses 

included ulcerative colitis (n=4) and familial adenomatous polyposis 

(n=1). Mean American Society of Anesthesiologists score (ASA) was 2. 3 of 

the 5 patients had previous abdominal surgery. All 5 patients had a SILS 

(Covidien, Mansfield, MA) port placed at the planned ileostomy site. No 

other abdominal incisions were made. Average operative time was 219 

minutes (range 137 to 278). Average estimated blood loss was 117 mL. 

There were no conversions to either a conventional laparoscopic or an 

open procedure. Average time to return of bowel function was 2 days and 

average length of stay was 4 days (3-6). Post-operative complications 

included two patients that were admitted to an outside hospital on 

postoperative day 15 with partial small bowel obstructions at the stoma 

site. Both resolved with conservative management. Two patients had their 

ileostomies reversed at 4 weeks and 6 weeks postoperatively with the 

other three scheduled in the near future. 

Conclusion: SILS total proctocolectomy with ileoanal anastomosis is a safe 

minimally invasive technique. Additional studies are needed to compare 

SILS approach to conventional laparoscopy and open surgery with 

respect to operative times, convalescence and outcomes. 

S088 

STAGED LAPAROSCOPIC ADJUVANT INTRAPERITONEAL 

CHEMOHYPERTHERMIA (IPCH) AFTER COMPLETE RESECTION FOR 

LOCALLY ADVANCED COLORECTAL OR GASTRIC CANCER Elie K 

Chouillard, MD Poissy Medical Center (FRANCE) 

Purpose: Cytoreductive surgery followed by intraperitoneal 

chemohyperthermia (IPCH) is a promising treatment for patients with 

peritoneal malignancies. Usually, IPCH is performed concomitantly 

with cytoreductive surgery for peritoneal cancinomatosis (PC) or more 

occasionally as an adjuvant treatment after gastric resection for cancer. In 

this report, we describe our experience with staged adjuvant laparoscopic 

IPCH after complete resection in patients with advanced colorectal or 

gastric cancer. 

Methods: 25 patients underwent resection for colorectal (16 patients) 

or gastric cancer (9 patients) followed by staged laparoscopic IPCH. 

Operative technique, complications, as well as more than 2-year follow-up 

findings were assessed. 

Results: Mean intraperitonel temperature was 41.9° C. The homogeneity 

of the hyperthermia across the abdominal cavity was electronically 

maintained throughout the procedure by input and output flow 

regulation. No conversion to laparotomy was performed. No major 

operative incident was encountered. 

The mean hospital stay was 11 days (6-24). No 30-day mortality 

occurred. Five patients developed complications (20 %). One patient was 

reoperated (4 %). 

Mean follow-up was 30.5 months (24-49). Six patients died including 

4 of cancer related causes (distant metastases). 17 patients (68 %) had 

some form of second look laparoscopy or laparotomy and 4 patients had 

autopsy (16 %). All patients had PET scans every 6 months. No patient 

developed PC. 

Conclusion: Staged laparoscopic adjuvant IPCH after open or 

laparoscopic resection in selected patients with colorectal or gastric 

cancer is safe and feasible. After more than 2-year follow-up, no patient 

seemed to have developed PC. Additional survival data are still needed. 

S089 

A CASE CONTROL COMPARISON OF LAPAROSCOPIC (LX) AND OPEN 

(OP) APPROACH FOR THE SURGICAL MANAGEMENT OF SMALL 

BOWEL OBSTRUCTION (SBO) Eran Itzkowitz, MD, Yehuda Kariv, MD, Boaz 

Sagie, MD, Joseph Koriansky, MD, Joseph Klausner, MD Tel Aviv Sourasky 

Medical Center, and Sackler Faculty of Medicine, Tel Aviv University, Tel 

Aviv, Israel. 

Background: LX offers enhanced recovery and better cosmesis. 

Reduction in postoperative adhesions and incisional hernia rates 

are potential long term benefits. Previous studies have shown that 

laparoscopic management of SBO is feasible and associated with 

acceptable morbidity. However, rates of conversion to OP are higher than 

in other laparoscopic procedures. Data comparing short and long term 

results of LX and OP in SBO are limited. 

Objectives: To identify risk factors for conversion, investigate its 

consequences, and compare short and long term outcomes of LX and OP. 

Methods: Patients who were operated for a diagnosis of SBO in either 

an attempted LX or OP were retrospectively identified. Data collected 

included patients demographics and comorbidities, indication for surgery, 

operative details, and postoperative recovery. Long term data including 

recurrent SBO, reoperations, and incisional hernias were obtained using 

patient charts and a telephone survey. LX and OP patients were matched 

(1:1) for age and the extent of previous abdominal operations (no surgery; 

minor surgery; laparotomy; multiple laparotomies). Short and long term 

results in both groups were analyzed according to intension to treat. 

Results: From 1998 to 2007, 202 patients were operated for SBO (90 

attempted LX, 112 OP). Most common etiologies for SBO in the LX group 

included adhesions (85.5%), malignancy (2.2%), and internal hernia 

(2.2%). 29 (32%) patients in the LX group were converted to an open 

procedure. Causes of conversion were dense adhesions (31%), need for 

bowel resection (17%), unidentified etiology (24%), and iatrogenic injury 

(28%). 

Preoperative patient characteristics and the extent of previous surgery 

were not associated with conversion (previous laparotomy 27% vs. 18%, 

p=0.3, conversion vs. non-conversion, respectively). 

Patients converted from laparoscopy to open surgery had longer 

operations (92.0±28.7 vs. 48.7±22.0 min, p



rate of postoperative complications (32% vs. 51%, p=0.03), and earlier 

passage of flatus (median postoperative day 2 vs. 3, p


Group Total Withdrawal Studied 

Pain,peri-anal burning/ 

irritation 

AnalgesicTablets 

used in 3 Weeks 

D3 W1 W3 Mean Range 

Study 32 7 25 20 2 0 7 5-31 

Control 35 12 23 16 5 0 11 10-27 

Conclusion: Resumption of normal spicy diet has no adverse impact on 

patient reported outcomes in stapled hemorrhoidopexy. Its apparent 

benefits in the present study and its impact on patient reported quality of 

life need to be studied in larger studies. 

S092 

IMPLEMENTATION OF COLONOSCOPIC PROCESS 

MEASURES: DOES IT IMPROVE QUALITY? Theodor 

Asgeirsson, MD, Anthony J Senagore, MD MBA FACS FASCRS, Martin 

A Luchtefeld, MD FASCRS Spectrum Health Research, Michigan State 

University, Ferguson Clinic 

Purpose: Although screening colonoscopy has significantly reduced 

the incidence of colorectal cancer due to removal of clinically significant 

adenomatous polyps, the clinical benefit of removing micro adenomas is 

of unclear benefit. As a result basing the value of increasing withdrawal 

time on adenoma detection rate may not be a good surrogate quality 

indicator for colonoscopic cancer screening. The aim of this study was to 

compare colonoscopic screening prior to and after full implementation of 

6 minute withdrawal time. Specifically assess polyp detection rate (PDR) 

and adenoma detection rate (ADR) during both time frames and the 

incidence of interval cancers in the earlier study population. 

Methods: Data from all out-patient screening colonoscopies during the 

first 6 months of 2006 (pre 6 minute withdrawal) and 2009 (post 6 minute 

withdrawal) were reviewed. Pathology reports were correlated with 

endoscopic findings. A retrospective chart review was performed on all 

screening colonoscopies from 2006 to evaluate for primary diagnosis of 

colorectal cancer in the 3 year period after there screening. Chi-square 

and T-test was used for quantitative and categorical data respectively. 

Confidence interval was used to compare difference in proportions and 

repeated measures ANOVA for data with Poisson distribution. P value was 

set at 0.05 

Results: 900 screening colonoscopies were performed during the first 6 

months of ‘06 and 750 in ‘09. Mean age 58.7 vs 57.7 years (p0.05). Visualization was documented 

as good in over 99.5% of screening colonoscopies in both years. Neither 

PDR 14.9% vs 13.9% nor ADR 7.2% vs 9.6% were statistically significant 

between pre and post 6 minute withdrawal time, (p>0.05). Interval 

colorectal cancer rate at 3 years was 0%. 

Conclusion: The data indicate that implementation of the 6 minute 

withdrawal time did no significantly alter PDR or ADR. Importantly 

there was no incidence of interval colon cancer in the 3 years following 

a screening colonoscopy in the pre 6 minute withdrawal group. These 

results occurred in a population with a high rate of cecal intubation 

and removal of clinically significant adenomatous lesions. Therefore the 

optimal quality measure may be interval colon cancer incidence rather 

than reliance on surrogate measures not clearly tied to the desired 

outcome. 




Residents/Fellows Scientific Abstracts 

S093 

SINGLE INCISION LAPAROSCOPIC CHOLECYSTECTOMIES COST 

COMPARISON Katie Love, MD, Michael P Meara, MD, Christopher A 

Durham, MD, Curtis E Bower, MD FACS ECU Brody School of Medicine 

Objective: Cholecystectomy performed using the Single Incision 

Laparoscopic Surgery (SILS) technique should not cost significantly 

more or less than standard multiport cholecystectomy. Single access 

techniques are becoming more common for a multitude of laparoscopic 

procedures. Criticism has revolved around potential costs associated with 

increased operative time and use of innovative equipment. 

Methods: Retrospective cost data was collected from the accounting 

records of a single institution. A direct comparison of standard multiport 

cholecystectomies to SILS cholecystectomies was conducted. Data on 

the SILS cases that were converted to multiport cholecystectomies was 

included. Total operating room (OR) cost (actual cost to the hospital for 

equipment, time, and personnel) and total OR charges (the “list” price, or 

what the patient was billed, for equipment, time, and personnel) were 

examined. Total hospital charges (OR charges plus hospital charges 

accrued in the perioperative period) were also included. Descriptive 

statistics were used to analyze the data with p-values of statistical 

significance 25 LAP operations but no SILS procedures. The SILS-experience group 

(SE) consisted of attending LAP surgeons who had also performed at 

least 5 SILS operations. Each subject performed standardized tasks from 

FLS including peg transfer (PEG), pattern cutting (CIRCLE), placement 

of ligating loop (LOOP), and intracorporeal suturing (SUTURE) using 

a standard, three-port, FLS box-trainer with standard laparoscopic 

instruments. For SILS, the subjects used an FLS box modified to accept 

a Covidien SILS Port with two working ports for instruments and one 

port for a 30-degree 5mm laparoscope. SILS tasks were performed with 

Covidien Roticulator instruments capable of unilateral articulation. 


SILS suturing was performed using a Covidien SILS Stitch (articulating 

Endostitch device). Performance of FLS tasks was graded using standard 

time and accuracy metrics. Individual task scores as well as overall 

laparoscopic FLS score (LS) and overall SILS FLS score (SS) were calculated 

for each participant, and normalized to previously published FLS scoring 

criteria used to distinguish competent (>54%) and non-competent 

surgeons (


CONCLUSION: Increasing operative time was associated with increased 

odds of complications and so it appears that speed may matter in 

laparoscopic surgery. These analyses are limited in their inability to 

adjust completely for all patient factors, potential confounders and 

case complexity. Additional multivariate and hierarchical surgeon level 

analyses are required to examine this relationship further. 

S096 

MORTALITY RISK ASSOCIATED WITH INSURANCE DENIALS IN 

BARIATRIC SURGERY CANDIDATES Raghid S Bitar, MD, Mastafa 

Springston, Geoffrey P Kohn, MD, Lindsee E McPhail, MD, David W Overby, 

MD, Timothy M Farrell, MD University of North Carolina at Chapel Hill 

Introduction: Increasing numbers of Americans meet medical candidacy 

criteria for bariatric surgery; however many are denied or delayed 

because of absence of insurance benefits or administrative hurdles in the 

pre-approval process. In many cases, patients endure months of delay 

before coming to a surgical date or giving up. Since morbid obesity carries 

inherent medical risk, we set about to define the mortality rate among 

those patients who were deemed acceptable candidates by our surgeons 

but who were declined or delayed in the insurance process. 

Methods: Retrospective review of a single institution bariatric surgery 

database between June 2002 and December 2008 was performed. Of 538 

total patients who were deemed surgical candidates in our preoperative 

clinic, 114 were denied and did not undergo surgery (subject group) 

compared with 424 who came to operation (control group) during the 

same time frame. Following IRB approval, patient identifiers were used 

to query the Social Security death index to assess whether patients were 

dead or alive as of August 10, 2009. Survival analysis with Kaplan-Meier 

plot was performed using SPSS (SPSS Inc. Chicago, IL) with log-rank test 

for statistical significance. 

Results: The subject group and control group were similar 

demographically (85.3% vs 85.6% females, mean age 44.7 vs 45.9 years). 

Mean follow up was 44.3 (range 8-86) months for subjects and 44.5 (range 

4-108) months for controls. Two medical deaths occurred in the subject 

group and 12 deaths occurred in the surgical group. Of these, 3 occurred 

within 30 days of surgery for a perioperative mortality of 0.71%, but 9 

others died during extended follow-up. Cumulative survival analysis using 

Kaplan-Meier plot is shown below. Curves are statistically similar. 

Conclusions: About 21% of patients who satisfy medical and surgical 

criteria for bariatric surgery failed to achieve insurance approval and 

follow-through with operation at our institution. Among these, there was 

a 1.8% mortality rate over 44.3 months follow-up, which is similar to the 

risk in early postoperative surgical patients. Over time, those patients with 

insurance denials are expected to suffer increasing mortality, although 

our data do not yet demonstrate this separation in survival curves. 

Longitudinal studies are necessary. 

S097 

INTRAOPERATIVE COLONOSCOPIES WITH LAPAROSCOPIC 

ASSISTANCE REDUCES UNNECESSARY BOWEL RESECTIONS AND 

HOSPITILIZATION Donald M Davis, MD, Valentine Nfonsam, MD, Jorge E 

Marcet, MD, Jared C Frattini, MD University of South Florida 

Objective of the Study: Colonic polyps found during colonoscopy are 

typically biopsied or removed using cold or hot snares. At times it is very 

difficult to remove these polyps because they may be large or flat, risking 

bowel perforation in the process. In addition, access to the polyp may 

be difficult due to adhesion from previous surgeries, redundancy of the 

colon, or location of the polyp. Traditionally, these patients are referred to 

a surgeon for bowel resection. At our institution, repeat colonoscopies are 

performed in the operating room. If warranted, laparoscopic assistance 

is used for enhanced colonic visualization, mobilization of the bowel 

and take-down of adhesions if required. This allows access to polyps that 

we not previously accessible with traditional colonoscopy. We can be 

much more aggressive in our polypectomies due to the fact that any full 

thickness injuries can immediately be repaired laparoscopically. Through 

this process we believe unnecessary bowel resections and its associated 

complications have been avoided. We have therefore undertaken this 

retrospective review to demonstrate the safety and efficacy of perform 

intraoperative colonoscopies with laparoscopic assistance in patients with 

benign disease. 

Methods: The names of patients scheduled for intraoperative 

colonoscopies from 2001 through September 2009 were collected. 

The respective electronic medical records were then reviewed. The 

data obtained included age, gender, whether laparoscopic assistance 

was utilized, operation performed (if applicable), location of tumor, 

intraoperative and postoperative complications, and length of hospital 

stay. The demographics were then analyzed and the data was then 

compared between operative or nonoperative (including laparoscopic 

assisted colonoscopies) groups. 

Results: Between March 2001 and September 2009, 106 patients 

with a diagnosis of benign polyps by colonoscopy underwent repeat 

intraoperative colonoscopies. The average age was 65 (median 65) with 

56% male patients. Of these patients, 74 patients (70%) were successfully 

treated with colonoscopic polypectomy, 10 of which utilized laparoscopy 

for mobilization and positioning of the colon. 

Of the 32 operative patients (30%), there were 17 colectomies, 7 

cecectomies, 5 transanal excisions, 2 low anterior resections, and one 

colotomy with mass excision. In all but two of the operative patients, 

laparoscopic assistance was not needed during colonoscopy. These 

patients underwent formal resections due to size or appearance 

suspicious for malignancy. In the two patients who underwent 

laparoscopic assistance, one underwent formal resection after the polyp 

was determined to be cancerous, while the other could still not be 

adequately accessed even after mobilization. 

There was a significant difference in the length of hospital stay between 

these groups (p



S098 

IMPROVING SURGICAL TRAINING; THE USE OF FEEDBACK TO REDUCE 

ERRORS AND IMPROVE RETENTION DURING A SIMULATED SURGICAL 

PROCEDURE E Boyle, MRCS, M Al-Akash, MRCS, O Traynor, FRCS, AG 

Gallagher, PhD Bsc, ADK Hill, MD FRCS, PC Neary, MD FRCS National 

Surgical Training Centre, RCSI, Dublin, Ireland 

Introduction: It is known that feedback enhances the learning process, 

although the optimal type and frequency of feedback is not established. 

The ProMIS hand-assisted laparoscopic colectomy (HALC) simulator uses 

a combination of virtual reality (VR) and and physical models of intraabdominal 

organs to simulate a left-sided hemicolectomy. It can be used 

to train surgeons to perform a complete procedure in a safe environment. 

The purpose of this study was to determine if giving trainees feedback 

during a training session would improve their performance. 

Methods: We tested 16 residents (Group 1) who performed 5 HALC 

procedures on the ProMIS simulator. Efficiency of instrument use and predefined 

intra operative error scores were assessed. Facilitators assisted 

their performance and answered questions when asked. A similar cohort 

of 12 trainee surgeons (Group 2) then performed the same 5 cases, but 

with standardized feedback and the chance to review errors after every 

procedure. Eight subjects in Group 2 completed retention testing which 

consisted of two further repetitions of the HALC procedure. Data were 

analyzed using SPSS version 15. Means were compared using Mann- 

Whitney-U tests, with a p-value of


the average age was 42.67 in the stapled group. 87% were female and 

the average age was 43.45 in the hand-sewn group (p=0.68 and p=0.67 

for gender and age respectively). BMI was 48.06 in the stapled group and 

48.01 in the hand-sewn group (p=0.76). The rate of stricture formation 

in the stapled group was 8% (8/100) and 1% in the hand-sewn group, 

and this finding was statistically significant with a p value of 0.017. No 

statistical difference of stricture formation based on age (those younger 

than versus those older than 40 years) was noted between the two groups 

(p=0.88 and p=0.32 for the stapled and the hand-sewn anastomoses 

respectively). The average length of time from the operation to the 

EGD with balloon dilatation was 40.9 days in the stapled group and 

108 days in the hand-sewn group (p=0.004). One patient with a stapled 

anastomosis required 2 dilatations. Two patients in the stapled group had 

a GJ anastomotic leak (p=0.16) and did not require eventual dilatation. All 

patients were followed up for at least 4 months. 

CONCLUSION: The incidence of anastomotic stricture is significantly 

higher with a linear stapled technique compared to a hand-sewn 

gastrojejunal anastomosis in patients undergoing laparoscopic Roux-en 

-Y gastric bypass. 

S101 

HOW RELIABLE IS LAPAROSCOPIC COLORECTAL SURGERY COMPARED 

TO OPEN SURGERY FOR OCTOGENARIANS? Rodrigo A Pinto, Dan Ruiz, 

Yair Edden, Eric G Weiss, Juan J Nogueras, Steven D Wexner Cleveland 


Background: Considering today’s increased longevity in the elderly 

population, and the increased size of that population major abdominal 

intervention is more frequently performed in octogenarians. 

Objective: To compare the surgical and postoperative outcomes of 

laparoscopic colorectal resections to open surgery in the octogenarian 

population. 

Methods: A retrospective analysis based on a prospectively maintained 

database of octogenarians who underwent laparoscopic or open elective 

colorectal resections from 2001 to 2008 was performed. Diagnosis, 

comorbidities, operative data and early postoperative complications were 

analyzed in this report. 

Results: One hundred ninety-nine octogenarians underwent colon 

resection. Laparotomy was performed in 116 patients (group I) and 

laparoscopic surgery in 83 (group II). The mean age was 84.3 vs. 84.7 

and the mean ASA score was 2.8 vs. 2.6 in groups I and II, respectively. 

Colorectal adenoma was the most common indication for surgery in both 

groups (77.6% vs. 54.2% in groups I and II, respectively) And right-hemi 

colectomy was the most frequently performed operation in group II (31% 

vs. 57.8% in groups I and II, respectively; p=0.0003). Open resections had 

a higher mean blood loss (286ml vs. 152ml, in groups I and II respectively; 

p=0.0002), and more patients required intraoperative transfusions 

(p=0.005), despite similar operative times. The conversion rate in the 

laparoscopic group was 25.3%. The laparoscopic patients had less overall 

complications, and clinical morbidity (p0.05) and mortality rates were 3.4% vs. 2.4% in groups I 

and II respectively. 

Conclusions: Laparoscopic colorectal resection is effective and safe for 

octogenarians with less blood loss and faster postoperative recovery 

associated with lower morbidity when compared to laparotomy. 

S102 

BARRETT’S ESOPHAGUS TREATMENT DILEMMA: PILLS VERSUS 

OPERATION: STATISTICAL ANALYSIS AND COST/EFFECTIVENESS Victor 

Bochkarev, MD, Dmitry Oleynikov, MD UNMC 

INTRODUCTION: Controversy over the management of barrett’s 

esophagus has been difficult to resolve due to the low incidence 

of progression to adenocarcinoma. A prospective study comparing 

thousands of patients with barretts esophagus randomized either into 

PPI or antireflux surgery group is costly and no likely to be perfomed. This 

study examined possible clinical outcomes of the two strategies and cost/ 

effectiveness associated with treatment of Barrett’s esophagus. 

METHODS: A decision analysis tree (Markov Monte Carlo model) was 

used to track hypothetical cohort of patients with Barrett’s esophagus. 

The input variables were estimated by a pooled analysis of 74 published 

studies on a total of 23,368 patients. Possible clinical outcomes of the 

two treatment strategies, laparoscopic Antireflux procedure (LARP) vs. 

proton pump inhibitors (PPI), were analyzed. Cost/effectiveness ratio was 

calculated based on average cost and expected effectiveness of the two 

treatment strategies. 

RESULTS: Expected utility score for laparoscopic antireflux surgery 

was calculated to be .93 compared to that for PPI of .89. The model was 

sensitive to alterations in the probabilities of Regression, Progression 

and Death rates demonstrating preference to antireflux surgery over PPI 

alone. Cost/utility ratio for antireflux surgery was 38.9, and for PPI – 28.7, 

indicating favorable cost/effectiveness for PPI treatment. 

CONCLUSIONS: Our model, based on a comprehensive literature review, 

predicted that laparoscopic antireflux surgery was more effective strategy 

to achieve regression of Barrett’s esophagus. At the same time, PPI alone 

was less costly treatment strategy for patients with Barrett’s esophagus. 




Scientific Session Video Abstracts 

V001 

IMPROVING FUNCTIONAL ESOPHAGEAL SURGERY WITH A “SMART” 

BOUGIE: ENDOFLIP® Silvana PERRETTA, MD, Bernard DALLEMAGNE, 

MD, Barry MACMAHON, MD, Jacopo D’AGOSTINO, MD, Hurng-Sheng WU, 

MD, Jacques MARESCAUX, MD IRCAD, University Hospital of Strasbourg, 

France - Show Chwan Memorial Hospital, Changhua, Taiwan 

Introduction: In order to improve the results of functional surgical 

procedures on the esophagus, the use of intraoperative esophageal 

manometry has been described to document the ablation of the lower 

esophageal sphincter (LES) high-pressure zone (HPZ) and to calibrate the 

pressure of the fundal wrap. An emerging physiology tool, the functional 

lumen imaging probe (Endoflip®, Crospon Ltd.), combines measurements 

of the EGJ resistance to distention and provides a geometrical 

reconstruction of the EGJ. The FLIP therefore represents a promising 

entirely new method to dynamically profile the EGJ that can show a live 

modification on EGJ capacity and diameter which would be of particular 

interest when performing functional operation on the esophagus such 

as antireflux procedures and Heller myotomy. Here we shows the clinical 

application of this emerging physiology tool in the surgical tratment of 

achalasia and GERD. 

Methods: The first case is that of a young woman with achalasia 

undergoing heller myotomy for persistent dysphagia after 2 failed 

endoscopic dilatation using the Endoflip® to follow the extend of 

the myotomy. The second case demonstrates its use to assess the 

configuration and quality of a posterior partial and Nissen fundoplication. 

In order to do this the EndoFLIP® catheter was placed transorally 

straddling the esophagogastric junction (EGJ). For the distension protocol 

the balloon was inflated to 30ml at a rate of 40ml per minute and data 

on 16 cross-sectional areas and pressure in the balloon was recorded. 

Two distensions were carried out at each stage of the procedure. 

Measurements were taken at the key steps of the heller myotomy and 

total and partial fundoplication . 

Results: Before the myotomy pressure in the balloon rose to 15 cmH20 

at a cross sectional area (CSA) of 25mm2 indicating that the EGJ is closed 

and tight. After dissection of the longitudinal muscle and the clasp fibres 

the pressure only rises to 8 cmH2O and the minimum CSA opens to 34 

mm2 indicating that the EGJ is now very compliant and flaccid. After the 

Heller wrap is complete the junction has become less compliant but it 

can open at its narrowest point to 35 mm2 at a pressure of 20 cmH2O. 

This suggests that the EGJ is tight but not as rigid as before so that 

when a bolus passes through it will stretch and open. The second part of 

the video demonstrates that the the Endoflip® acts as a “smart bougie” 

evaluating the orientation and position of a properly constructed floppy 

Nissen and posterior partial fundoplication. 

Conclusions: EndoFLIP can quantify changes in the distensibility of the 

EGJ. This “smart bougie” could be integrated into the surgical routine 

of esophageal functional surgery providing a good and immediate 

physiological visual feed-back of the surgical manoeuvres and could 

therefore improve outcome and facilitate surgical training and learning 

curve in this arena. 

V002 

REPAIR OF A HIATAL DEFECT USING A ROTATIONAL FALCIFORM 

FLAP Erica Sutton, MD, Adrian Park, MD University of Maryland School of 

Medicine 

Background: Closure of the hiatal defect in laparoscopic surgery of the 

foregut remains a challenging problem. Over the years, several materials 

have been used- varying compounds of nonabsorbable synthetics as 

well as absorbable biologic material. Yet, there is a high recurrence 

rate associated with primary closure and an unacceptably high rate of 

esophageal erosion and stricture associated with both synthetic and 

biologic material. Adding to the complexity of hiatal hernia repairs is 

the highly dynamic nature of the region, in which exists esophageal 

peristalsis and constant diaphragmatic excursion. We describe the use of 

the falciform ligament as a rotational flap for repair of such hiatal defects. 

Method: To create a rotational flap of the falciform ligament, ultrasonic 

dissection is used to detach the falciform from the anterior abdominal 


wall. Once fully mobilized, the flap is rotated to reach the esophageal 

hiatus. The flap is secured to the right crus using 2-3 interrupted sutures 

of 2-0 silk. On the left side, the flap is broadly attached to the diaphragm 

posteriorly and the crus anteriorly to provide overlapping coverage of the 

defect. Once the flap is sewn to the left crus, the flap completely covers 

the hiatal defect. As experience accrues, we are engaged in longitudinal 

follow-up. 

V003 

LAPAROSCOPIC CHOLECYSTECTOMY USING INTRAOPERATIVE 

FLUORESCENT CHOLANGIOGRAPHY Takeaki Ishizawa, MD PhD, 

Nobuhiro Harada, MD, Arata Muraoka, MD, Masayoshi Ijichi, MD PhD, Koji 

Kusaka, MD PhD, Masayuki Shibasaki, MD PhD, Yasutsugu Bandai, MD 

PhD, Norihiro Kokudo, MD PhD Department of Surgery, Central Hospital of 

Social Health Insurance 

OBJECTIVE: Although intraoperative cholangiography (IOC) has 

been recommended for avoiding bile duct injury during laparoscopic 

cholecystectomy (LC), radiographic IOC is time-consuming and the 

procedure itself may cause bile duct injury. We have developed a novel 

fluorescent cholangiography technique by applying the principle that 

indocyanine green (ICG) is excreted into bile and emits light with a peak 

wavelength of around 830 nm when illuminated with near-infrared 

light. The aim of this study was to evaluate the ability of fluorescent 

cholangiography to detect the bile duct anatomy during LC, especially in 

patients with accessory bile ducts. 

METHODS: In 43 patients undergoing laparoscopic cholecystectomy, 

ICG (2.5 mg) was intravenously injected before surgery. A fluorescent 

imaging system (prototype; Hamamatsu Photonics Co., Hamamatsu, 

Japan) comprised of a xenon light source and a laparoscope with a 

charge-coupled device camera, which can filter out light wavelengths 

below 810 nm, was utilized. Fluorescent cholangiography was performed 

before and during the dissection of the triangle of Calot by changing 

from color images to fluorescent images using a foot switch. The ability 

of fluorescent cholangiography to detect the bile duct anatomy was 

evaluated by comparing the fluorescent images with preoperative 

cholangiography findings. 

RESULTS: Fluorescent cholangiography delineated the cystic duct 

in all 43 patients and the cystic duct - common hepatic duct (CHD) 

junction in 41 patients prior to the dissection of the triangle of Calot 

(FIGURE). This technique also identified all the accessory bile ducts that 

were preoperatively diagnosed in 7 patients. We will present videos 

demonstrating the dissection of the triangle of Calot using fluorescent 

cholangiography in a patient with the normal bile duct anatomy and 

another two patients with an accessory hepatic duct draining the right 

lateral sector or the left paramedian sector of the liver and directly 

entering the CHD. No adverse reactions to the ICG or postoperative bile 

leaks were encountered. 

CONCLUSIONS: Fluorescent cholangiography enables real-time 

identification of accessory hepatic ducts as well as the cystic duct and 

the common hepatic duct during the dissection of the triangle of Calot. 

This safe and simple technique has the potential to become a standard 

practice for avoiding bile duct injury during LC, replacing conventional 

radiographic IOC. 

FIGURE 

Fluorescent cholangiography (A) before the dissection of the triangle of 

Calot clearly delineates the bile duct anatomy, which are unidentifiable on 

color images (B). Arrow shows the cystic duct - CHD junction.


V004 

LAPAROSCOPIC D2 LYMPH NODE DISSECTION WITH TOTAL 

GASTRECTOMY AND HUNT LAWRENC JEJUNAL POUCH 

RECONSTRUCTION FOR CARCINOMA STOMACH C Palanivelu, MCh 

FACS FRCS, P Senthilnathan, MS DNB FRCS, S Rajapandian, MSFRCS, V 

Vaithiswaran, MS MRCS, R Sathiyamurthy, MS, P Praveen Raj, MS GEM 

Hospital 

Introduction: D2 lymph node dissection for early gastric cancer was 

popularized by the Japanese, though it is still controversial. The adequacy 

of laparoscopic node harvest remains doubtful. In this video, we present 

a laparoscopic D2 dissection with total gastrectomy and jejunal pouch 

anastamosis. 

Methods: The patient is placed supine with legs apart so that the surgeon 

stands between the legs. The dissection is commenced by disconnecting 

the greater omentum off the transverse colon, proceeding to clear the 

nodes at the splenic hilum (#10), gastrocolic (#6), nodes around superior 

mesenteric vein (#14v), and subpyloric nodes. Next, the duodenum was 

transected and the hepatoduodenal (#12a & 5), celiac axis (#9), and nodes 

around portal vein (#8p) were cleared. The nodes around left gastric 

artery (#7) were then cleared, and the dissection was continued up to the 

median arcuate ligament to clear nodes at the gastroesophageal junction 

(#1& 2). Nodes around the splenic artery (#11) were cleared. At this point, 

the esophagus is divided at the junction with a stapler. Esophagealpouch 

anastomosis was performed laparoscopically, while the pouch 

construction was done extracorporeally. 

Conclusion: Laparoscopic D2 dissection with total gastrectomy and 

jejunal pouch anastomosis is safe and feasible. It is comparable with the 

open technique regarding lymph node harvest and superior because of 

lower morbidity. 

V005 

TRANSCERVICAL VIDEOSCOPIC ESOPHAGEAL DISSECTION IN 

MINIMALLY INVASIVE ESOPHAGECTOMY Michael Parker, MD, Jason 

M Pfluke, MD, Kyle K Shaddix, MD, Leslie A Dowling, BS, Timothy A 

Woodward, MD, Horacio J Asbun, MD, C D Smith, MD, Steven P Bowers, 

MD Mayo Clinic Florida, Jacksonville, FL, USA 

Introduction: Currently, minimally invasive esophagectomy (MIE) is 

being performed using Video-Assisted Thoracoscopic Surgery (VATS) for 

mediastinal esophageal dissection. The VATS approach is still associated 

with pulmonary and cardiovascular morbidity, as well as incisional pain. 

This study investigates the feasibility of MIE using a single-incision 

transcervical videoscopic esophageal dissection (TVED). A simultaneous 

laparoscopic and transcervical videoscopic approach would allow MIE 

without the need for patient repositioning or single lung ventilation. 

Methods: Technical steps of the procedure include a standard cervical 

incision large enough to accommodate a modified hand-assisted access 

device. Cervical esophageal dissection was done in standard fashion. 

The modified access device was placed, and pneumomediastinum was 

established with laparoscopic trocars placed through the access port. The 

tracheoesophageal plane was developed above and below the thoracic 

inlet. Vagal nerves were identified, dissected, and divided distal to the 

recurrent branches. Standard minimally invasive laparoscopic techniques 

were used for the esophagogastric dissection routinely performed in 

MIE. Following specimen extraction, the animals were euthanized as per 

protocol. 

Results: A full circumferential dissection of the mediastinal esophagus 

was successfully accomplished in both animals using a single-incision 

TVED for MIE. 

Conclusions: Our research describes a novel approach for mediastinal 

dissection of the esophagus using a TVED approach that may avoid the 

potential morbidity of VATS while providing better visualization of the 

upper mediastinal esophagus when compared to the transabdominal, 

transhiatal approach. 

V006 

NOTES-ASSISTED TRASVAGINAL SPLENECTOMY: THE NEXT STEP FOR 

THE MINIMAL INVASIVE APPROACH TO THE SPLEEN EM Targarona, 

MD, C Gomez- Oliva, MD, R Rovira, MD, JC Pernas, MD, C Balague, MD, 

C Guarner-Argente, MD, S Sainz, MD, M Trias, MD Service of Surgery, 

Digestive Pathology, Gynecology and Radiology. Hospital de Sant Pau, 

UAB, Barcelona, Spain. 

Laparoscopic splenectomy (LS) is the gold standard for treatment of 

normal-medium sized spleens, but spleen morcellation and removal 

requires an enlargement of the wound port, specially for extraction of 

the intact spleen. Transvaginal extraction of the resected spleen was 

described in early 90’, but rarely used, and it didn’t avoid the use of 

multiple large diameter trocars (3-5 of 5-12 mm) trough the abdominal 

wound. NOTES description have favored hybrid less invasive approaches 

to the abdomen, but it has not been applied for spleen pathology. The 

Aim of this videopresentation is to show the technique used for a hybrid 

NOTES assisted transvaginal splenectomy: 

Case report and surgical technique: A 65 yrs. woman, multipara, 

without previous abdominal surgery diagnosed of a 6 cm multicystic 

splenic lesion. BMI: 30. Surgical steps: 1.- : Preoperative planning: Body 

CT in right lateral decubitus and 3D body reconstruction measuring the 

distance from the tip of the vagina to the splenic hilum (27,5 cm) . 2.- 

Table position: Patient placed in right decubitus with free access to the 

vulvar introitus. 3.- Pneumoperitoneum and 3 subcostal mininstruments 

ports (1 of 5 mm and 2 of 3 mm). 4.- Transvaginal 15 mm trocar insertion 

under laparoscopic control (5 mm scope), 5.- Insertion of a 13 mm 

colonoscope transvaginally for control of the dissection of the spleen 

with the subcostal instrumentation (Ucision and 3 mm instruments). 

6.- Transvaginal stapling transection of the splenic hilum with standard 

flexible tip 60 mm extralong (44 cm) endostapler (Ethicon). 7.- Insertion 

transvaginally of a bag (Endocatch II, Covidien) to recover the spleen, and 

extraction trough the Douglasl pouch. 8.- Closure of the vagina. Operative 

time was 180’, with uneventful recovery and discharge at 48 hrs. 

Conclusion: Transvaginal acces can be safely used for operative 

visualization, hilum transection and spleen removal, reducing at minimum 

the parietal wall trauma. Clinical, esthetic and functional advantages 

require further analysis. 

V007 

TOTAL ENDOSCOPIC GASTRIC BAND REMOVAL Kari Thompson, MD, 

Brian Wong, MD, Tom Savides, MD, Garth R Jacobsen, MD, Bryan Sandler, 

MD, Mark A Talamini, MD, Santiago Horgan, MD University of California, 

San Diego, San Diego, California, USA 

Introduction: Multiple surgical options are available for patients 

undergoing treatment for obesity. One of the most popular, due to short 

surgical times and low morbidity, is laparoscopic gastric band placement. 

Complications necessitating reoperation include prolapse and gastric 

band erosion. In our video we present a totally endoscopic removal of an 

eroded gastric band. 

Methods: A 61 year old female presented to bariatric surgery clinic with 

the complaint of abdominal pain. She had had a laparoscopic gastric 

band placed two years ago by a surgeon in Mexico. On endoscopy, the 

patient was found to have a complete erosion of her gastric band into 

her stomach. The patient was taken to the operating room and her port 

was first removed from her abdominal wall. Next, the endoscope was 

advanced into her stomach and the decision was made to remove the 

band endoscopically. An endoscopic guide wire was placed through a 

hole in the band that was easily accessed though the endoscope. An 

endoscopic snare then grasped the end of the wire, wrapping it around 

the band, and pulled it out of the patient’s mouth. An endoscopic 

lithotripsy overtube was then placed and the ends of the wire attached 

to the lithotripsy device. Using gentle pressure through the lithotripsy 

device, the band was divided. With the band completely divided, an 

end of the band was grasped using the endoscopic snare and removed 

through the patient’s mouth. On final endoscopy, the stomach showed no 

sign of perforation or bleeding. 

Results: The patient was kept overnight for observation and was 





discharged home on postoperative day 1. She had no perioperative 

complications. At one month follow up, she had no complaints. 

Conclusion: A total endoscopic removal of an eroded gastric band is 

important for a bariatric surgeon to have in their armamentarium due to 

the low morbidity of the procedure. 

V008 

LAPROSCOPIC COMPLETION RADICAL CHOLECYSTECTOMY Shailesh 

Puntambekar, MS, Seema Puntambekar, MD, Geetanjali Agarwal, MS, 

Neeraj Rayate, MS Galaxy-Care Laparoscopy Institute 

LAPROSCOPIC COMPLETION RADICAL CHOLECYSTECTOMY 

We describe a of a case of 60 years old female who underwent 

laparoscopic cholecystectomy elsewhere and incidentally on 

histopathology was diagnosed as adenocarcinomas of gall bladder 

with invasion up to the serosa. She was referred to our institute for 

laparoscopic completion radical cholecystectomy. 

Method : Five ports were placed with camera post at umbilicus (10mm 

0 degree ) 2 working ports a 10mm port placed at midline and5mm 

port placed in mid clavicular line and two 5mm ports for retraction 

one in epigastrium and one in subcoastal region in mid clavicular line. 

Laparoscopic segment 4A of liver was resected with total lymph nodal 

cleareance of the porta with excision of the cystic duct margin. 

Results : The operation time was 120 min and blood loss was 200 ml. 

Pathological examination revealed deposits of adenocarcinoma with 

moderate sclerosis. Lymph node at porta showed 8 positive nodes with 16 

lymph node harvested. 

Conclusion : Video shows that lap radical cholecystectomy is a feasible 

and oncological adequate treatment for carcinoma gall bladder. 

V009 

THORACOSCOPIC ESOPHAGECTOMY IN DORSOLATERAL POSITION : 

AN INNOVATIVE APPROACH - THE PAWAR TECHNIQUE Suraj B Pawar, 

MS FICS FAIS FMAS, Prashant Mullerpatan, MS FRCS, Reshma S Pawar, 

MBBS DGO Kolhapur Cancer Centre, India 

Aims: To assess the feasibility of Thoracoscopic Esophagectomy in the 

Dorso-Lateral position with the intention of reducing the disadvantages 

and increasing the benefits of lateral approach and prone approach which 

are the two conventional approaches. 

Methods : Thoracoscopic Esophagectomy is routinely performed in two 

positions. The left lateral decubitus position is the most commonly used 

position at most of the centres. However prone jack-knife position as 

described by Cushieri is another alternative. 

To combine the advantages and reduce the disadvantages of the two 

above mentioned positions we started performing this procedure in a 

Dorso-Lateral position since 1st October 2008 . This is a position midway 

between the Lateral and Prone position i.e. Left lateral position with an 

inclination making an angle of 45 degrees with the horizontal. Operating 

Surgeon and assistant are positioned anteriorly facing the ventral aspect 

of the patient. A three-port approach is taken with port placements in 

the 5th, 7th and 9th intercostals spaces in the posterior, mid and anterior 

axillary lines. Pneumothorax is created with CO2 pressure of 5 – 7 mm Hg. 

Although single lung ventilation is preferable the procedure can be done 

with routine dual lung ventilation with a 4th port being used to retract 

the lung if necessary. 

Esophagus is mobilized en-block with posterior mediastinal 

lymphadenectomy. The Azygous vein and right Bronchial artery are 

preferably preserved to maintain vascularity of right bronchus. 

Following this patient is turned supine and Stomach mobilization and 

coeliac dissection is done laparoscopically. Left neck incision is taken and 

esophagus is divided in the neck. Specimen is delivered in the abdomen 

and extra-corporeally through a mini-laparotomy. Gastric tube is prepared 

and brought in the neck through posterior mediastinum underneath the 

azygous vein and rt.bronchial artery for anastamosis in the neck. 

Results: In our experience of 24 cases, it was technically easier to do 

posterior mediastinal , especially the infra-azygous dissection in the 

dorso-lateral approach as compared to the lateral approach. Also bilateral 

recurrent laryngeal nerve lymph node dissection were carried out with 


technically the same ease as in lateral approach. 

The position kept the lung and blood away from the posterior 

mediastinum . 

One patient (4.16%) was converted to open procedure due to pulmonary 

adhesions. Duration of the thoracoscopic dissection was a mean 160 

min (100 – 250min) and thoracic blood loss was 100ml (50 – 300ml). 

Lymph nodes dissected were a median 19 (14-32). Anastamotic leak was 

seen in 2 patients (8.3%) both minor , which settled with conservative 

management. There was no mortality and the overall pulmonary 

complication rate was 21%. 

The video shows the procedure in the Dorso-Lateral Position as we 

routinely perform at our centre. 

Conclusion: Thoracoscopic Esophagectomy with Mediastinal 

Lymphadenectomy in the Dorso-Lateral position is a feasible , more 

convenient and a safe option which can combine the benefits of the 

conventional left lateral and prone approaches. Surgeon comfort is 

enhanced in terms of more comfortable operating position and improved 

ergonomics. 

V010 

SINGLE-INCISION LAPAROSCOPIC PROCTOCOLECTOMY WITH ILEAL 

J-POUCH-ANAL ANASTOMOSIS Alexandre Bouchard, MD, Jesse Lackey, 

SA, Tonia Young-Fadok, MD MS Mayo Clinic - Arizona 

Laparoscopic assisted proctocolectomy and ileoanal pouch-anal 

anastomosis is performed with multiple ports and an extraction incision. 

When compared to the traditional open procedure, the laparoscopic 

approach shortens the postoperative recovery and reduces adhesion 

formation. 

To further reduce the number of incisions and abdominal wall trauma, 

we used a single-incision device to perform this operation. This device 

permits the introduction of 3 instruments through the same small 

abdominal opening. 

This video presents a single-incision laparoscopic proctocolectomy with 

ileal J-pouch-anal anastomosis on a 19-year-old female with familial 

adenomatous polyposis syndrome. We introduced the single-incision 

device at the planned site for the diverting loop ileostomy. 

Key steps of the procedure demonstrated in this video are: 

1- Placement of single-port device via the planned ileostomy site. 

2- Establishment of the pneumoperitoneum and introduction of 3 trocars. 

3- Complete mobilization of the left and right colon with visualization and 

protection of duodenum, inferior vena cava and both ureters. 

4- Complete mobilization of the base of the terminal ileum to facilitate 

pouch creation. 

5- Complete rectal mobilization and transection at the pelvic floor. 

6- Ligation of the mesenteric vessels, using a bipolar device. 

7- Extraction of the specimen through the ileostomy site. 

8- Ileoanal J-pouch construction. 

9- Anastomosis. 

10- Diverting loop ileostomy 

At the end of the procedure, the only incision on the patient’s abdomen 

was that used for the diverting loop ileostomy. A single-incision 

proctocolectomy and ileoanal pouch-anal anastomosis is feasible, and can 

be performed safely. 

V011 

LAPAROSCOPIC REPAIR OF BOCHDALEK HERNIA Mohamad D Saad, 

DO, Jonathan Eng, MD, Frances Allocco, MD, Brian J Dunkin, MD, Patrick R 

Reardon, MD The Methodist Hospital 

Bochdalek hernia develops from mal-development in the fusion of the 

cephalic fold of the pleuroperitoneal membrane. It was first described 

by Bochdalek in 1848. It is most frequently diagnosed in neonates or 

children, while its presence in adult is rare. Perforation or necrosis of the 

involved organ is a feared complication and surgical repair constitutes the


gold standard of treatment. Cadaveric examination discovered 1 in 7000. 

Yet, other attempts to study the incidence of Bochdalek hernia based on 

prospective CT studies found the incidence of about 13%. 

Here, we present a 42 year old male who presented with left flank pain, 

nausea, and vomiting. Initial CT was interpreted as upside down stomach 

and a hiatal hernia. During laparoscopy, the stomach, greater omentum, 

and the transverse colon were herniated through the defect into the right 

chest cavity. The defect measure about 13 cm in length. Fresh edges were 

initially obtained in order to anchor the mesh and the defect we closed 

primarily. A Gore-Tex soft mesh is placed with the ePTFE side facing the 

viscera. 

Post operatively, the patients symptoms resolved completely and was 

discharged the following day. Laparoscopic repair of Bochdalek hernia by 

closing the defect primarily and utilizing mesh is an effective and a safe 

approach. 

V012 

PNEUMORETROPERITONEUM: AN ALTERNATIVE APPROACH FOR 

COMPLETION ADRENALECTOMY IN A HOSTILE ABDOMEN David 

E Skarda, MD, Martin Walz, MD, Sayeed Ikramuddin, MD University of 

Minnesota, Minneapolis, USA, Kliniken Essen-Mitte, Essen, Germany 

A 43-year-old woman developed morning headaches, sweating, 

palpitations and uncontrolled hypertension for 12 months. She was 

known to have Von Hippel-Lindau and had previously had a left 

adrenalectomy in 1995 (open anterior approach) and a partial right 

adrenalectomy in 2000 (open lateral approach). She required an 

exploratory laparotomy in 1991 for a gunshot wound to the epigastrium. 

She suffered from type II diabetes mellitus, obesity (body mass index of 

42), hypothyroidism, gastritis, cirrhosis (Child’s-Pugh class A) and recurrent 

right renal stones. 

Her biochemical evaluation revealed elevated norepinephrine, 

normetanephrines, and vanillylmandelic acid. Computed tomography 

imaging revealed a heterogenous right adrenal mass (1.9 x 1.7 cm), bullet 

fragments in the right psoas, and absence of the right rectus abdominal 

muscle. Metaiodobenzylguanidine scan revealed a focal area of intense 

uptake within a retroperitoneal mass adjacent to the aorta and right 

kidney. 

We made the presumptive diagnosis of recurrent right 

pheochromocytoma and recommended right completion adrenalectomy. 

After preoperative blood pressure control with phenoxybenamine, 

propranolol and hydration, we performed a completion right 

adrenalectomy using a posterior retroperitoneoscopic approach. The 

operative time was 2.5 hours and our blood loss was less than 5 mL. 

Pathology revealed a 1 mm pheochromocytoma focus in a 3 x 2.5 cm 

specimen of normal adrenal gland, inflammatory tissue, and old surgical 

clips. 

The patient was discharged to home 3 days after her operation. 

Her symptoms resolved and she has required no antihypertensive 

medications. 

V013 

LAPAROSCOPIC BILATERAL PARTIAL ADRENALECTOMY FOR 

HEREDITARY PHEOCHROMOCYTOMA William W Hope, MD, Stanton T 

Smith, MD, Damon E Sheneman, DO, Jorge Gonzalez, MD, Cyrus A Kotwall, 

MD New Hanover Regional Medical Center 

Hereditary syndromes are responsible for a small number of 

pheochromocytomas. These hereditary pheochromocytomas are 

frequently bilateral and rarely malignant. Surgical treatment remains 

controversial secondary to the risk of Addisonian crisis and need 

for lifelong corticosteroid therapy associated with bilateral total 

adrenalectomy. Recently it has been reported that cortical sparing 

bilateral adrenalectomy is safe and can successfully avoid the need for 

replacement therapy. 

We present a case of a 21 year Hispanic male who presented with 

headaches, palpitations, and severe hypertension and was found to 

have bilateral pheochromocytomas by biochemical analysis, MIBG, and 

computed tomography scanning. The patient’s brother had previously 

undergone a right adrenalectomy and removal of extra adrenal 

pheochromocytoma. Patient underwent a laparoscopic bilateral cortical 

sparing adrenalectomy. The technique including pertinent positives, 

trocar placement, dissection, and method of excision are demonstrated. 

The patient had no postoperative morbidity and was discharged home 

on postoperative day 2. Pathology revealed a 23 gm/33 gm right cortical 

benign pheochromocytomas, both with low Ki67 proliferation indices. 

Two month follow-up ACTH stimulation test has shown normal 30 min 

aldosterone and 60 min cortisol stimulation levels. The patient has 

remained asymptomatic thus far, and has avoided the need for adrenal 

cortical replacement. 

Laparoscopic bilateral cortical sparing adrenalectomy is a safe, technically 

feasible treatment for hereditary pheochromocytoma. These patients 

must have long term follow-up including monitoring of the remnant 

gland for recurrence and yearly biochemical screening studies. 

V014 

LAPAROSCOPIC LEFT HEPATECTOMY WITHOUT INFLOW OCCLUSION 

USING MODIFIED ANTERIOR APPROACH C Palanivelu, MCh FACS FRCS, 

P Senthilnathan, MS DNB MRCS, N Anand Vijai, MS, R Rohit, MS, P Praveen 

Raj, MS GEM Hospital 

INTRODUCTION: Laparoscopic liver surgery requires high degree of 

anatomical knowledge, laparoscopic skills and technical know how of 

latest state of the art haemostatic and parenchymal split instruments, 

more so for major hepatic procedures like right hepatectomy .We describe 

the technique of laparoscopic left hepatectomy by anterior approach 

performed by single surgeon using two hand technique. 

METHOD: The patient is placed in modified lithotomy position and the 

surgeon stands between legs of the patient. We insert 6 ports and a 

hand port for parenchymal split or specimen retrieval. We begin with the 

division of falciform ligament and cystic duct and artery. Gall bladder is 

used to retract the liver cranially which exposes the porta hepatis. The left 

branch of hepatic artery, bile duct and portal vein dissected and divided, 

preserving branches to caudate lobe. Retrohepatic veins are then divided, 

followed by parenchymal division along the Cantlie’s line using different 

haemostatic and parenchymal splitting instruments which include 

ultrasonic shears, CUSA, Ligasure, clips and APC. As we reach the posterior 

surface of liver, left hepatic vein is dissected and divided using endoGIA 

stapler. Finally, attachments of the left lobe are divided and specimen 

retrieved. The intra and post operative variables by this approach 

compares favorably with open approach. 

CONCLUSION: We conclude that laparoscopic left hepatectomy using 

modified anterior approach without inflow occlusionis safe and feasible, 

but should be performed only when expertise and equipments are 

available. 

V015 

LAPAROSCOPIC LUMBAR HERNIA REPAIR WITH BONE ANCHOR 

FIXATION Vanessa P Ho, MD, Gregory F Dakin, MD Weill Cornell Medical 

College-NewYork Presbyterian Hospital 

INTRODUCTION: Lumbar hernias are rare defects of the posterolateral 

abdominal wall. Surgical repair of lumbar hernias is challenging because 

they are bounded inferiorly by the iliac bone, which makes adequate 

mesh fixation difficult. We demonstrate a method of a laparoscopic 

lumbar hernia repair utilizing bone anchor fixation at the inferior border. 

METHODS: The patient is a 37-year old male with a history of motor 

vehicle collision who presented with a large left lumbar hernia and 

nonspecific abdominal pain. The patient had a Petit-type hernia, bordered 

by the external oblique muscle, the latissimus dorsi and the iliac crest. We 

opted to perform a laparoscopic mesh repair. Two Mitek GII QuickAnchor 

sutures were placed in the anterior superior iliac crest to provide inferior 

fixation of the mesh, with sufficient overlap of the mesh to prevent 

recurrence. The remainder of the mesh is fixed with standard laparoscopic 

tacks and transfascial sutures. 

RESULTS: The patient did well postoperatively and left the hospital on the 

first post-operative day. He has had no signs of recurrence at followup. 





CONCLUSIONS: The anatomic features of lumbar hernias creates several 

challenges. A number of surgical approaches have been described, 

including laparoscopic and open methods, as well as intraperitoneal 

and preperitoneal approaches and the use of flaps to cover the defects. 

However, limited fixation points for the mesh can lead to high recurrence 

rates. We demonstrated a method utilizing bone anchor fixation in a 

laparoscopic approach to overcome the challenge of inferior fixation. 

This provides a secure repair with good coverage of the defect, while 

maintaining the benefits of the minimally-invasive approach. 

V016 

RECONSTRUCTION OF THE ANTERIOR ABDOMINAL WALL WITH 

BILATERAL ENDOSCOPIC COMPONENT SEPARATION, LAPAROSCOPIC 

ASSISTED MEDIALIZATION OF THE RECTUS AND LAPAROSCOPIC 

MESH PLACEMENT Jawaid Kalim, MD, Scott Philipp, MD, Archana 

Ramaswamy, MD University of Missouri, Columbia 

Introduction: Standard laparoscopic repair of a large midline ventral 

hernia with mesh is frequently associated with seroma formation. In 

addition the rectus muscles cannot be medialized in large defects, 

thereby potentially leading to a less functional abdominal wall. 

We present a novel approach of repairing the midline abdominal wall 

defect while repairing the hernia laparoscopically with a mesh. We begin 

with bilateral endoscopic component separation and then medialize the 

rectus muscles with laparoscopically placed transfascial sutures. With 

bilateral component separation, we are able to completely close the hernia 

defect. We then reinforce the repair with a laparoscopically placed mesh. 

Method: A transverse skin incision is made two fingerbreadths below 

the costal margin at the anterior axillary line. The external oblique 

aponeurosis is identified and incised. A space is created between the 

external and internal oblique aponeurosis, by blunt finger dissection. A 

balloon dissector is then introduced in this space and further dissection 

is done under vision, with a 10mm 0-degree scope in the balloon. The 

balloon dissector is then removed and 10mm balloon port is placed. 

Carbon Dioxide is then insufflated into this space to a pressure of 12 to 

15mm of Hg. A 5mm port is placed inferiorly at the lateral aspect of the 

space created. The lateral border of the rectus sheath is identified and the 

external oblique aponeurosis one to two cm lateral to the rectus sheath is 

incised with a hook or scissors connected to electrocautery. Scarpa’s fascia 

is also incised to obtain additional release. The release incision extends 

from the pubic tubercle inferiorly to several centimeters above the 

costal margin superiorly. After completion of the myofascial release and 

advancement, this technique is repeated on the opposite side. 

We then enter the peritoneal cavity using the same skin incisions and 

pneumoperitoneum is created. After the hernia is reduced and all 

adhesions are taken down, we make tiny stab incisions in the midline 

and use transfascial sutures with laparoscopic assistance to bring the 

rectus sheath to the midline. After medialization of the rectus muscle, 

we proceed with laparoscopic placement and fixation of mesh in the 

standard fashion. 

Result: We have successfully performed this procedure on 4 patients and 

on follow up, have one small asymptomatic seroma with excellent patient 

satisfaction. 

V017 

SINGLE INCISION LAPAROSCOPIC RIGHT COLECTOMY Wai Lun Law, 

MD, Joe Fan, MD, Jensen Poon, MD The University of Hong Kong 

The video shows a single incision laparoscopic right colectomy for a 

patient with a big sessile polyp at the ascending colon, which could not 

be removed endoscopically. 

The patient was a 49-year-old lady with good past health. She underwent 

colonoscopy because of change in bowel habit. A 3-cm sessile polyp was 

found at the ascending colon and it could not be removed endoscopically. 

Biopsy of the polyp showed foci of intramucosal adenocarcinoma. She 

underwent a laparoscopic right colectomy using the single port. The 

video shows the operation and the operation was successfully performed 

and the patient recovered uneventfully. 

V018 

LAPAROSCOPIC REPAIR OF TRAUMATIC FLANK HERNIA Mun Jye 

Poi, MD, Yuri W Novitsky, MD University Of Connecticut Health Center, 

Farmington, Connecticut 

Introduction: Traumatic flank hernias are caused by a blunt abdominal 

trauma with resultant detachment of the oblique musculofascial 

complex at the iliac crest and/or costal margin. Given such proximity 

to the bony structures and essential absence of the healthy fascia to 

anchor the mesh, traumatic flank hernias represent a challenging surgical 

problem. Although laparoscopic repair of ventral hernias has become 

very common, laparoscopic approach to traumatic flank hernias has not 

been established well. We present a video detailing the technique of 

laparoscopic repair of traumatic flank hernia. 

Methods: The patient was placed in the decubitus position. Entrance 

to the abdomen was performed using Optiview trocar in the subcostal 

area. Operative steps included a complete reduction of the hernia sac, 

pre/retroperitoneal dissection to expose the entire lateral edge of a 

psoas muscle, defect closure with trans-abdominal sutures, wide mesh 

overlap, transabdominal suture fixation followed by the use of Mitek bone 

anchors. 

Results: The operative time was 180 minutes. Estimated blood loss was 

100ml. The defect size was 12 cm x 6 cm and the size of the mesh used 

was 20cm x 15cm. There were no perioperative complication. Hospital 

stay was 5 days. The patient returned to full activities by 1 month. At 

follow-up of 11 months, there was no recurrence. 

Conclusions: Laparoscopic approach to traumatic flank hernia is feasible 

and safe. It is associated with minimal hospital stay and fast functional 

recovery. The key components of our approach include wide pre/ 

retro-peritoneal dissection with subsequent wide mesh coverage with 

mandatory fixation to bony structures using anchors/screws. We believe 

the laparoscopic approach should be considered for most patients with 

traumatic flank hernias. 

V019 

LAPAROSCOPIC REPAIR OF A DUODENAL ATRESIA AND LADD’S 

PROCEDURE IN A NEONATE Steven S Rothenberg, MD Rocky Mountain 

Hospital For Children 

Purpose: To demonstrate current refinements of technique in 

performing a duodenal anastomosis in a neonate with duodenal atresia. 

Methods: A 33 week premature infant with a prenatal diagnosis of 

Duodenal atresia was explored laparoscopically on day two of life for 

repair. The patients weight was 2 Kg. Two 3mm ports and one 4mm 

port were used for the procedure. The patient was also found to have 

malrotation at the time of surgery. The procedure consisted of a Ladd’s 

procedure and duodenoduodenostomy. Techniques of abdominal wall 

retraction sutures are demonstrated. 

Results: The procedure was completed successfully laparoscopically. The 

procedure took 60 minutes. An NG tube was used for 5 days and feeds 

were started on post-op day 6. 

Conclusion: This video demonstrates that a laparoscopic 

duodenoduodenostomy and Ladd’s procedure is efficacious and safe 

even in a small premature infant. 

V020 

LAPAROSCOPIC REPAIR OF ACUTELY INCARCERATED 

PARAESOPHAGEAL HERNIA Elizabeth Honigsberg, MD, Barry Salky, MD 

FACS The Mount Sinai Hospital, New York 

This is an 80 year old male who presented with acute incarceration 

of a known paraesophageal hernia. He was reduced by emergency 

endoscopy. The past history is significant for hypothyroidism and GERD, 

long standing. The video demostrates the amount of stomach that can 

necrose if this emergent condition is not operated quickly. The edema 

in the tissues, especially at the hernia sac/crural fiber junction, can make 

the dissection difficult. This is clearly demonstrated. The importance of 

adequate esophageal length is demonstrated, as well as why complete 



mobilization of the posterior attachments along with sac excision, are so 

important in acheiving reduction of the stomach. The proper dissection 

planes are demonstrated in this video. The technique of biodegradable 

mesh placement is shown. 

V021 

GALLBLADDER VOLVULUS: A VIDEO CASE REPORT Justin K Lawrence, 

MD, Nikhil Pawa, MD, Matthew G Tutton, MD, Antonio Privitera, MD 

Colchester University Hospital, UK 

Summary: We present a case report from September 2009 at our 

Laparoscopic Institution. The case attended as an emergency in an 84 

year old female. Initially treated under medical care with generalised 

abdominal pain, an abdominal ultrasound scan demonstrated an 

inflamed, thick-walled gallbladder and a diagnosis of cholecystitis 

was made. At laparoscopy, the gallbladder was clearly necrosed and 

seemingly torted. We proceeded to laparoscopic cholecystectomy and 

following literature review, felt that this would represent an interesting 

video case report. 

V022 

TOTALLY EXTRAPERITONEAL REPAIR OF A SPIGELIAN HERNIA Frances 

Allocco, MD, Patrick Reardon, MD, Mohamed Saad, DO, Brian Dunkin, MD 

The Methodist Hospital 

TOTALLY EXTRAPERITONEAL REPAIR OF A SPIGELIAN HERNIA 

Allocco, Frances MD; Reardon, Patrick MD; Saad, Mohamed MD; Dunkin, 

Brian MD 

Spigelian hernias are rare and account for up to 2% of abdominal wall 

hernias. In the past these were repaired using an open technique, but 

over the past two decades, there have been a growing number of reports 

of laparoscopic repairs. Over the past decade we have seen these reports 

to include totally extraperitoneal repairs. 

Here we present a video of a totally extraperitoneal repair of a Spigelian 

hernia and briefly review Spigelian hernias and their laparoscopic repair, 

based on review of the literature. 

The patient is a 65 year old female with a bulge in the right lower 

quadrant of her abdomen. She noted the bulge a year previous but did 

not seek medical attention at that time. Over the course of six months, 

she began experiencing occasional pain in the area which was becoming 

more frequent, and presented to us. 

Our plan was to perform a totally extraperitoneal repair of this hernia. At 

the beginning of the procedure we placed a 2mm trocar and insufflated 

the peritoneal cavity, and confirmed the hernia to be a Spigelian hernia. 

We then repaired the hernia using a totally extraperitoneal approach, 

using a 2mm and a 5mm port. After reducing the hernia sac we measured 

the defect to be 1.2 x 4 cm. Our dissection allowed for a 6 x 6 inch piece of 

mesh to be tacked in place. At the end of the procedure we re-insufflated 

the peritoneal cavity and saw our mesh lying completely flat. 

The patient went home the same day and was seen in follow-up with an 

intact repair and no further complaints. 

Spigelian hernias usually present in patients 40 to 80 years old. Physical 

exam correctly identifies approximately 50%, as many are interparietal 

hernias, and so do not present with a bulge. Most are 1 to 2 centimeters 

with a risk of incarceration as high as 24.1% and a strangulation risk of 2.4- 

14%. Recurrence is low for open and laparoscopic repair. Currently there is 

one prospective randomized controlled trial of open versus laparoscopic 

elective Spigelian hernia repair by Moreno-Egea et al in 2002. It showed 

decrease in morbidity and hospital stay and concluded TEP repair to offer 

the best results. 

Here we show how a Spigelian hernia can be laparoscopically diagnosed 

and treated with a totally extraperitoneal approach, using 2 and 5 mm 

ports, in a manner similar to an inguinal hernia repair. 

V023 

LAPAROSCOPIC RESECTION OF A PRESACRAL SCHWANNOMA. 

Alexander Ramirez, Samuel Szomstein, Raul Rosenthal Cleveland Clinic 

Florida 

Background: Benign shwannomas are tumors arising from the neural 

sheath of peripheral nerves (schwannoma cells).The Schwannoma is the 

most common benign retroperitoneal tumor in adults. Few cases have 

been reported in the presacral space. Complete resection is treatment of 

choice for these tumors. To our knowledge not many reports describe the 

laparoscopic approach for resection of this unusual neoplasm. 

Case report: This is a 27 year-old female that was presented in 

consultation after she had been diagnosed 2 years ago with a right 

adnexal paramedian mass. An MRI showed a mass in the presacral space 

measuring 4.3 x 4.4 x 4.4 cm with demonstrated low signal intensity 

and did blush with dye. After obtaining informed consent, the patient 

underwent a diagnostic laparoscopy and biopsy by a gynecologist. 

Pathology report showed spindle cell neoplasm, possibly a benign nerve 

sheath tumor. The patient underwent a re-laparoscopy. The pelvic and 

presacral space was opened by means of blunt and sharp dissection. The 

mass was dissected from attachments to the retroperitoneal area, placed 

in an Endobag and extracted through the enlarged infraumbilical trocar 

site. The peritoneal floor was suture closed with a running 2-0 Vycril 

suture. 

Results: No perioperative complication, the patient was discharged home 

on postoperative day three with an intact neurological exam. 

Conclusions: The laparoscopic approach appears to be a safe, feasible 

option to treat presacral schwannomas. The benefit of this approach was 

evident by achieving a complete resection of the tumor, short hospital 

stay, no complications and high patient satisfaction. 

V024 

ENDOSCOPIC TRANSESOPHAGEAL MEDIASTINAL AND THORACIC 

LYMPH NODE DISSECTION WITH EN BLOC RESECTION (VIDEO 

SUBMISSION) Brian G Turner, MD, Denise W Gee, MD, Sevdenur Cizginer, 

MD, Min-Chan Kim, MD, Yusuf Konuk, MD, Mari Mino-Kenudson, MD, 

Patricia Sylla, MD, David W Rattner, MD, William R Brugge, MD FASGE (1) 

Gastrointestinal Unit, Massachusetts General Hospital, (2) Department of 

Surgery, (3) Department of Pathology, Massachusetts General Hospital, 

Boston, MA 

This video demonstrates a novel, transesophageal endoscopic technique 

for mediastinal and thoracic lymph node dissection and en bloc 

lymphadenectomy using a Natural Orifice Transluminal Endoscopic 

Surgery (NOTES®) technique. Using a swine model, a double-channel 

gastroscope equipped with an endoscopic cap band mucosectomy 

device is used to create a small esophageal mucosal defect. Next, a 

short submucosal tunnel is created using the tip of the endoscope and 

closed biopsy forceps. A hook knife is then used to incise the muscular 

esophageal wall and to enter the mediastinum. Subsequently, endoscopic 

scissors are used to create a small hole in the visceral pleura and the 

endoscope is passed through it and into the thorax. Once in the thorax, 

the endoscope is carefully advanced up the thoracic wall and lymph 

node stations are identified high in the apex of the lung near the trachea. 

The parietal pleura overlying the target lymph node is then incised with 

the hook knife to better expose the lymph node. Prototype endoscopic 

Maryland dissectors are used to dissect the LN away from surrounding 

structures. Care is taken to preserve the lymph node architecture and to 

not damage the lymphovascular bundle. After lymph node dissection is 

complete, an electrocautery snare is placed around the entire node and 

closed around the lymphovascular bundle, while a second snare is used to 

secure the body of the lymph node and facilitate retrieval. This technique 

prevents the resected node from falling freely into the thoracic cavity 

where retrieval can be challenging. The lymph node is then removed 

by withdrawing the endoscope through the thorax, mediastinum, 

submucosal tunnel, esophagus and ultimately out of the natural orifice. 

Necropsy photos are shown demonstrating one of the surgical sites where 

a paratracheal node was removed. Histology slides also demonstrate the 





preserved, architecturally intact, lymph node specimens. The procedure 

is carried out with minimal bleeding and trauma to the lymph node. In 

summary, this video demonstrates that transesophageal NOTES® can 

accomplish mediastinal and thoracic lymph node dissection and resection 

and provide architecturally intact specimens for histologic examination. 

V025 

LAPAROSCOPIC SLEEVE GASTRECTOMY AS A TREATMENT OPTION 

FOR ACUTE GASTRIC FUNDUS NECROSIS AFTER LAPROSCOPIC REDO 

PARAESOPHAGEAL HERNIA REPAIR AND SLIPPED REDO NISSEN 

FUNDOPLICATION Ismael Court, Omar Bellorin, Sheetal Patel, Samuel 

Szomstein, Raul J Rosenthal Cleveland Clinic Florida 

Introduction: This video illustrates the use of laparoscopic techniques 

to resolve an acute gastric fundus necrosis after laparoscopic redo 

Paraesophageal Hernia Repair (PHR) and redo Nissen Fundoplication (NF) 

for a slipped NF. 

Case Report: A sixty six-year-old female 24 hours status post a redo 

procedure for recurrent paraesophageal hernia with slipped NF and 

high-grade dysphagia, who presents with CT Scan showing large pleural 

effusion, worsening of the respiratory status and an upper gastro 

intestinal series showing contrast extravasation. The patient underwent 

a diagnostic laparoscopy. During the procedure the fundoplication was 

taken down, identifying two areas of perforation of the gastric fundus, 

most likely due to ischemic necrosis. A 32-French Ewald tube was passed 

into the distal stomach, and with the aid of a green cartilage linear stapler, 

the stomach was vertically transected, and the gastric fundus resected. 

The staple line was reinforced with a running 2-0 absorbable suture and a 

sub hepatic drain was placed as well. 

Results: The patient tolerated the procedure well. The postoperative 

course was remarkable for a slow recovery of the pulmonary status. 

The patient was started on oral feeds on postoperative day # 3 and was 

discharged home on postoperative day #17. The long term follow-up and 

recovery were uneventful. 

Conclusion: Acute gastric necrosis after PHR and NF is an unusual 

complication resulting most likely due to an error in judgment. Early 

recognition and surgical treatment are paramount to decrease mortality. 

The laparoscopic approach and sleeve gastrectomy are feasible options in 

the management of this complication. 

V026 

THE FEAR OF TRANSGASTRIC CHOLECYSTECTOMY: 

MISINTERPRETATION OF THE BILIARY ANATOMY Silvana PERRETTA, 

MD, Bernard DALLEMAGNE, MD, Gianfranco DONATELLI, MD, Didier 

MUTTER, MD, Pierre ALLEMANN, MD, Hurng-Sheng WU, MD, Jacques 

MARESCAUX, MD IRCAD, University Hospital of Strasbourg, France - Show 

Chwan Memorial Hospital, Changhua, Taiwan 

Introduction: The prevention of major injury at cholecystectomy relies 

on the accurate dissection of the cystic duct and artery, and avoidance of 

major biliary and vascular structures. 

The advent of NOTES cholecystectomy has led to a new look and insights 

into biliary anatomy especially of the Calot’s triangle. Here we show the 

clinical case of a NOTES transgastric cholecystectomy for uncomplicated 

cholelithiasis, in which misinterpretation of biliary anatomy occurred. 

Methods and procedure: After induction of pneumoperitoneum using 

a Veress needle, a single 5mm transparietal port was introduced at the 

umbilicus to ascertain the feasibility of transgastric cholecystectomy 

ensure safe gastrotomy creation and closure, insufflation and monitoring 

of the pneumoperitoneum and to allow the use of a 5mm laparoscopic 

clip applier. Transgastric access was obtained using a double channel 

endoscope (KARL STORZ® Endoskope, Germany) under laparoscopic 

visual control. An endoscopic needle-knife was used to create a full 

thickness puncture on the anterior wall in the mid-body of the stomach 

expanded using a 18mm balloon dilator to allow passage of the 12mm 

gastroscope. The laparoscopic optic could then be switched to a 5mm 

laparoscopic grasper to expose the gallbladder. Dissection started using 

the endoscopic flexible tools at the junction between the infundibulum 

and what was thought to be the cystic duct. During the dissection the 


size and the orientation of the cystic duct appeared unclear. Decision was 

made to switch to a laparoscopic view to re-orient the dissection and 

define the correct planes. At this point we realized that the dissection 

of the triangle of Calot although started in close proximity to the 

gallbladder, was far to low and that we had mistaken the common bile 

duct with the cystic duct. Fortunately the dissection maneuvers had 

been performed with extreme care and no injury to the CBD occurred. 

Once the biliary anatomy was clarified the vision was switched back to 

the endoscope but a 2mm grasper was introduced to improve retraction. 

Cholecystectomy was performed in a standard fashion. A laparoscopic 

hook was used to skeletonized, the cystic duct and artery that were 

clipped using a laparoscopic clip applicator. At the end of the dissection, 

the operative site was checked to ensure haemostasis and biliostasis. The 

gallbladder was extracted through the gastrotomy under laparoscopic 

control and the gastrotomy closed with extracorporeal stitches by means 

of a 2mm laparoscope and a 3mm needle holder inserted side by side into 

the 5mm umbilical port. 

Conclusions: Specific anatomical distortions due to the NOTES technique, 

along lack of exposure,with the present methods of retraction tend to 

distort the Calot’s triangle by actually flattening it rather than opening 

it out. Their contribution in producing injury and a preventive strategy 

based need to be investigated . At this stage whenever the anatomy 

of the biliary tract is confusing as happened in this case, a temporary 

“conversion” to a laparoscopic view, more familiar to the surgeon’s eye and 

therefore clearer that will provide a better understanding of the location 

of the common bile duct in respect to the cystic duct. 

V027 

LAPAROSCOPIC MEDIAN ARCUATE LIGAMENT RELEASE FOR CELIAC 

ARTERY DECOMPRESSION Arthur Rawlings, MD MDiv, Margaret Frisella, 

RN, L. Michael Brunt, MD Washington University 

Median arcuate ligament syndrome is a rare cause of abdominal pain 

that results from the celiac artery being narrowed by the insertion of 

the muscle fibers of the diaphragm or fibrous bands of the celiac nerve 

plexus. Patients typically have symptoms of weight loss, postprandial 

abdominal pain, and nausea or vomiting. Operative management, 

laparoscopic or open, involves completely dividing these fibers to release 

the compression of the celiac artery. There have been few reports to date 

of laparoscopic treatment of this condition. In this video, laparoscopic 

release of the median arcuate ligament is shown in a 36 year old female 

who had a one year history of abdominal pain and a 35 pound weight 

loss resulting in a BMI of 17.5 kg/m 2 . The patient had a history of MALT 

lymphoma but an extensive workup was otherwise negative. She 

ultimately had an MR angiogram which showed a celiac artery stenosis 

with post-stenotic dilatation and collateral pancreatoduodenal vessels. 

Laparoscopic exploration and decompression of the celiac artery was 

performed. Intraoperative ultrasound showed improved flow in the celiac 

artery after decompression. The patient was discharged the day after 

surgery without any complications. At follow-up, her symptoms were 

significantly improved. 

V028 

LAPAROSCOPIC GASTRIC ACCESS FOR ENDOSCOPIC RETROGRADE 

CHOLANGIOPANCREATOGRAPHY (ERCP) FOLLOWING ROUX-EN-Y 

GASTRIC BYPASS (RYGB) Sachin S Kukreja, MD, Matthew I Goldblatt, MD, 

James R Wallace, MD PhD Froedtert Memorial Lutheran Hospital and the 

Medical College of Wisconsin 

Patients who have undergone roux-en-y gastric bypass may require upper 

endoscopic evaluation for a variety of reasons which may or may not 

be related to their surgical procedure. The ability to access the remnant 

stomach or biliary tree by the traditional transoral route may be only 

possible through specialized endoscopic or percutanous procedures, or 

even laparotomy due to the altered foregut anatomy. The following video 

demonstrates a method of accessing the gastric remnant and performing 

percutaneous Endoscopic Retrograde Cholangiopancreatography (ERCP) 

through a laparoscopic gastrostomy. Such an approach provides access to 

the papilla without the need for specialized equipment. In our particular 

patient, cholangiography and sphincterotomy were required for


Sphincter of Oddi dysfunction; however, the approach could also be used 

to evaluate the biliary tree for evaluation of a multitude of either benign 

or malignant pathologies. 

V029 

SLEEVE GASTRECTOMY WITH ILEAL INTERPOSITION FOR TYPE 2 

DIABETES Augusto C. Tinoco, Luciana J El-Kadre, Renam Tinoco São Jose 

do Avaí Hospital 

This video shows technical details for the surgical treatment of type 2 

diabetes in a no-obese population . This surgery, sleeve gastrectomy with 

ileal interposition, was done under approved protocol in 20 patients. The 

principle used was the ileal-brake. 

V030 

LAPAROSCOPIC RESECTION OF AN OCCLUDED ROUX LIMB Frances 

Allocco, MD, Patrick Reardon, MD, Brian Dunkin, MD, Mohamed Saad, DO 

The Methodist Hospital 

Allocco, Frances MD; Reardon, Patrick MD; Dunkin, Brian MD; Saad, 

Mohamed MD 

The purpose of of our video is to present a patient who had a laparoscopic 

roux-en-Y gastric bypass, who years later developed occlusion of her 

roux limb. This is demonstrated endoscopically and was repaired 

laparoscopically. 

The patient is a 38 year old woman with a history of a laparoscopic rouxen-Y 

gastric bypass. She presented seven years later with nausea and 

vomiting. She had an open internal hernia repair at an outside hospital, 

but her symptoms persisted. She was treated by the author, with a 

laparoscopic lysis of adhesions. Following that surgery, her symptoms 

persisted. Preoperative endoscopy revealed severe ulceration with 

complete obstruction of the roux limb. 

We performed intraoperative endoscopy to confirm this and 

laparoscopically resected the occluded portion of the roux limb. We 

reanastomosed the distal end of the remaining roux limb distal to the 

previous jejunojejunostomy. 

In follow-up, the patient has done well and is tolerating a diet without any 

problems. 

This is a first report of an occluded roux limb after roux-en-Y gastric 

bypass. Bowel obstruction after gastric bypass has many etiologies, 

including internal hernias and adhesions, both of which this patient was 

surgically treated for. Obstruction may occur early or late. This patient 

presented years later with a complete obstruction of her roux limb from 

severe ulceration. Most ulcers in gastric bypass patients are marginal 

ulcers at the gastrojejunostomy and usually do not present years later. 

These can often be treated medically with proton pump inhibitors. 

If stenosis develops, it may be able to be managed endoscopically 

by dilation. Here endoscopy served as a helpful diagnostic tool and 

confirmed the location of the segment of bowel which we removed 

laparoscopically. 

V031 

LAPAROSCOPIC HEPATICODUODENOSTOMY David J Kaczorowski, MD, 

Steven J Hughes, MD University of Pittsburgh Medical Center 

INTRODUCION: Rapid weight loss following bariatric surgery can result 

in cholelithiasis and related complications, including choledocholithiasis. 

Furthermore, a Roux-en-Y gastric bypass can complicate the management 

of choledocholithiasis. CASE HISTORY: Here, we present the case of a 

72 year-old woman with a history of morbid obesity who underwent a 

Roux-en-Y gastric bypass and a cholecystectomy for cholelithiasis. She 

subsequently developed recurrent choledocholithiasis complicated 

by cholangitis, which was managed conservatively with the use of 

percutaneous transhepatic cholangiocatheter (PTC). She developed 

a biliary stricture secondary to false passage of a PTC and went on to 

suffer further episodes of cholangitis. After over a year and a half of 

further conservative management, she was offered a laparoscopic 

hepaticoduodenostomy. 

OPERATIVE COURSE: After placing trocars, dense omental adhesions 

were dissected from the undersurface of the liver. A liver retractor was 

then placed. The bile duct was then dissected circumferentially. Next, a 

ductotomy was made approximately 1 cm proximal to the insertion of 

the bile duct into the pancreatic head. The PTC catheter was grasped 

and pulled from the duct. The catheter was then cut so that it would 

retract back into the duct away from the intended site of anastomosis. 

A white load of the Endo GIA stapling device was used to divide the 

duct distal to the ductotomy. Next, an enterotomy was then created 

on the cephalad antimesenteric border of the duodenum. Using a 4-0 

PDS suture and diamond dust coated graspers, we performed a running 

hepaticoduodenostomy, starting on the duct side to allow forehand 

suturing. The right upper quadrant was irrigated and hemostasis was 

assured. The 12 mm trocar site and skin incisions were then closed. 

RESULTS: A postoperative cholangiogram revealed free passage of 

contrast into the duodenum. The patient did well and was discharged 

home on the third postoperative day. 

CONCLUSIONS: Laparoscopic hepaticoduodenostomy can serve as a safe 

and effective management option for patients with distal biliary strictures. 

V032 

USE OF A NOVEL PERCUTANEOUS RETRACTION DEVICE AND 

MAGNETIC ANCHORING AND GUIDANCE SYSTEM (MAGS) HELPS 

RE-ESTABLISH THE CRITICAL VIEW AND IMPROVES SURGEON 

PERFORMANCE WHILE MIMICKING THE FOUR PORT TECHNIQUE 

IN SINGLE SITE LAPAROSCOPIC (SSL) CHOLECYSTECTOMY Rohan 

A Joseph, MD, Nilson A Salas, MD, Michael A Donovan, MS, Patrick R 

Reardon, MD, Barbara L Bass, MD, Brian J Dunkin, MD Methodist Institute 

for Technology Innovation and Education (MITIE), Department of 

Surgery, The Methodist Hospital, Houston- TX 

Introduction: SSL, though promising, introduces ergonomic challenges 

due to loss of instrument triangulation as obtained in conventional 

laparoscopy. This limitation makes establishing the critical view during 

dissection of the Triangle of Calot (TOC) difficult and has resulted in a 

variety of strategies to overcome the problem. This study investigates 

use of a novel percutaneous grasper that mimics a standard laparoscopic 

instrument and MAGS in aiding surgeons to perform SSL cholecystectomy 

more easily and with a technique that closely mimics four-port 

cholecystectomy. 

Methods: SSL cholecystectomy was performed on four female cadavers 

by an expert laparoscopic surgeon with limited experience in SSL. A 

15–18mm incision was made at the umbilicus and the MAGS introduced 

into the abdomen. MAGS consists of an oblong (7.8cm × 14mm) magnetic 

internal effector with a retractable monopolar cautery hook (6.3cm) and 

is coupled across the abdominal wall to an external hand-held magnet. 

By sliding the external magnet over the abdominal wall and applying 

external pressure, subtle motions of the hook can be achieved. Following 

MAGS introduction, a commercially available port comprised of a foam 

cuff and three 5mm trocars was placed. Next, the novel grasper was 

introduced percutaneously in the RUQ. The device’s 3mm transabdominal 

shaft is mated to a 5mm end effector intra-corporeally and can grasp 

tissue with the purchase and security of a standard laparoscopic 

instrument while providing 360° rotation and locking jaws. Retraction 

was accomplished using the percutaneous grasper to manipulate the 

fundus and a standard 5mm grasper through the umbilical port for the 

infundibulum. Dissection was done using a combination of the MAGS and 

a standard Maryland dissector. Total procedure time, time from procedure 

start to obtain a critical view of the TOC and clipping and dividing the 

cystic duct/ artery, time for dissection of the gall bladder from the liver 

bed, and thickness of the abdominal wall at the umbilicus were measured. 

A multi-institutional survey was also administered among surgeons 

having experience with these devices to gauge satisfaction. 

Results: The critical view was obtained in each case and all 4 procedures 

were completed successfully. Both devices performed optimally to 

allow smooth flow of the procedure. Mean procedure time was 40min 

(33-51min); time from procedure start to obtaining the critical view and 

clipping and dividing the cystic duct/ artery was 33 min (28-38min) and 

time for dissection of the gall bladder from the liver bed was 6.7min (3- 





13min). The mean abdominal wall thickness was 1.9cm (1.5-2cm). The 

survey found that MAGS increased surgeon satisfaction in simplifying SSL 

cholecystectomy by 73% (18% satisfaction standard SSL, 100% MAGS). 

Conclusions: The use of a novel graspers and MAGS overcomes the 

limitations of SSL cholecystectomy and improves surgeon dexterity. 

Making SSL feel more like traditional laparoscopy will enable a wider 

adoption of this procedure in the community. 

V033 

RECURRENT PARAESOPHAGEAL HERNIA WITH GASTROBRONCHIAL 

FISTULA: LAPAROSCOPIC REPAIR Brian P Jacob, MD, Anthony Vine, MD, 

Mark Reiner, MD, L. Brian Katz, MD Mount Sinai Medical Center 

Introduction: The optimal method to manage a second recurrence of 

a paraesophageal hernia and a simultaneous gastrobronchial fistula 

is debatable. This video demonstrates a laparoscopic approach to this 

complex revisional operation performed on a 62 year old female who 

presented to our office with this diagnosis. 

History: This patient’s surgical history began with a laparoscopic 

paraesophageal hernia repair performed at an outside institution that 

recurred immediately. During the reoperation, there was a perforation to 

the stomach and esophagus that was managed using a left thoractomy 

to perform both the resection of the perforated portion of the stomach 

and a Nissen fundoplication. Recovery was prolonged by a left empyema 

and gastric fistula managed by a chest tube. The drainage stopped after 

2 months, but the patient continued to have symptoms of significant 

dysphagia and a 50 pound weight loss over 10 months. She then 

presented to our institution, where she also reported the history of a 

post-prandial cough for the past several months. An endoscpopy showed 

a benign ulcer in the stomach fundus but her upper GI series showed 

a second recurrence of a paraesophageal hernia with a slipped Nissen 

Fundoplication and a left gastrobronchial fistula. 

Results: The patient was managed with a laparoscopic revisional surgery. 

The video demonstates the adhesiolysis required in a reoperative 

situation as well as the identification and division of the gastrobronchial 

fistula. The previsous Nissen is then identified and taken down. The 

redundant fundus is resected, and finally the crural defect is repaired 

using standard laparoscopic techniques. The patient fortunately had 

an uneventful recovery and at her 3 month follow up visit reported no 

dysphagia and had already regained 15 pounds. A post operative upper 

GI demonstrates the results. 

Conclusion: Laparoscopic revisional foregut surgery is feasible, even in 

the setting of very complex situations such as what is demonstrated here 

with a second recurrence of a paraesophageal hernia with a herniated 

Nissen fundoplication and a gastrobronchial fistula. Using laparoscopic 

techniques in these complicated scenarios can provide the patients the 

known benefits of minimally invasive surgery. 

V034 

TAILORED APPROACH TO MINIMALLY INVASIVE RESECTION OF 

GASTIRC GIST S. Al-Sabah, MD MBA, GM Fried, MD, MC Vassiliou, MD 

MEd, Y. Kurashima, MD PhD, LE Ferri, MD PhD, LS Feldman, MD Steinberg- 

Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill 

University Health Centre, Montreal, Canada 

The goal of surgical resection of gastric gastrointestinal stromal tumor 

(GIST) is to achieve a negative pathologic surgical margin while limiting 

morbidity. In most cases, nonanatomic wedge resections are sufficient. 

Laparoscopic surgery is an acceptable option as long as standard 

oncologic principles are followed, with multiple case series demonstrating 

similar oncological outcomes as open resection. Preoperative computed 

tomography (CT) scans, gastroscopy and endoscopic ultrasound allow 

for selection of a specific operative strategy based on tumor location, size 

and growth pattern. This video outlines a tailored approach for minimally 

invasive gastric GIST resection using five cases. The use of intraoperative 

endoscopy is highlighted as an adjunct, which helps in tumor localization, 

facilitates identification of tumor margins, and allows for verification 

of the integrity of the staple line post resection. In most cases, wedge 

resection is feasible. For GISTs with exophytic growth patterns, wedge 


resection may first require gastric mobilization. Transgastric resection 

is used for intraluminal posterior wall GISTs. Avoidance of direct 

tumor handling using stay sutures and endoloops is demonstrated. In 

conclusion, this video will demonstrate a selective approach and helpful 

hints for laparoscopic resection of gastric GIST. 

V035 

SINGLE PORT ANTERIOR RESECTION Hester Cheung, MD, Catherine 

Co, MD, Cliff Chung, MD, KK Yau, MD, Michael Li, Prof Pamela Youde 

Nethersole Eastern Hospital 

Objective: To determine the technical feasibility and clinical outcomes 

of laparoscopic anterior resection using combined single-port and 

endoluminal technique. 

Methods: A single port was placed at the umbilicus. Sigmoid colon was 

retracted using transabdominal sutures. After adequate mobilization, the 

colon was stapled distal to the lesion using non-cutting endo-stapler, and 

the rectum was opened distal to the staple line. The transanal endoscopic 

operation (TEO) device was placed transanally and the anvil of a circular 

stapler was then delivered via the device into the peritoneal cavity. The 

anvil was placed intraluminally via a colotomy made proximal to the 

lesion; following this the colon was transected above the colotomy site. 

The specimen was next delivered transanally via the TEO device. Finally, 

the rectum was closed with endo-stapler and intra-corporeal side-to-end 

colorectal anastomosis was constructed using the circular stapler. 

Results: This technique was attempted in an 82 with an ulcerative 

tumor growth over the sigmoid colon. Single port anterior resection 

was performed. The operative time was 150 minutes. There was no intraoperative 

complication. The patient was discharged on post-operative 

day 6, with a maximum pain score of 2. Histological examination revealed 

T2N0 moderately differentiated adenocarinoma with 11 lymph nodes 

harvested. 

Conclusion: Laparoscopic anterior resection using this combined 

single-port and endoluminal technique is feasible for small lesions in the 

sigmoid colon or upper rectum. The technique avoids multiple trocar 

incisions and a minilaparotomy for specimen retrieval. 

V036 

THE ADVANTAGES OF LAPAROSCOPIC APPROACH FOR 

INTERSPHINCTERIC RESECTION M Hamada, MD, T Matsumura, MD, T 

Matsumoto, MD, F Teraishi, MD, K Ozaki, MD, T Nakamura, MD, Y Fukui, MD, 

Y Nishioka, MD, T Taniki, MD, T Horimi, MD Kochi Health Sciences Center 

Purpose: The most difficult steps of Intersphincteric resection (ISR) 

are circular dissection and separation of the internal sphincter muscle 

from the external sphincter and puborectalis by the perineal approach. 

Further dissection of the intersphincteric space by the abdominal 

approach may reduce the problems associated with the perineal 

approach. We present our techniques of Laparoscopic ISR using three 

cases of ISR for rectal tumor (Male /Female 2:1) by the video presentation. 

Presented Cases 

Case 1 is a 68-year-old male with a large, laterally spreading rectal 

adenoma. 

Case 2 is a 61-year-old male with rectal cancer whose tumor was located 

4.0 centimeter from the anal verge. Laparoscopic surgery was performed 

after neoadjuvant chemo-radiotherapy. 

Case 3 is a 71-year-old female with T1 rectal cancer whose tumor was 

located just above the dentate line. After dissecting the intersphincteric 

space, the prolapsing technique was useful in case it was a small-size 

tumor. 

Technique: In case of male patient, First, we dissected the rectum 

with the mesorectum to the anal hiatus, initially on the posterior side 

along the avascular plane. Second, we dissected Denonvilliers’ fascia 

and exposed the seminal vesicle.The third step was dissection of the 

lateral tissues followed by incision of Denonvilliers’ fascia with rectal wall 

exposure taking care not to injure the neurovascular bundle. It was easier 

to perform this step on the left side than on the right side. Along this 

dissection plane, we could reach the puborectalis, which was separated 

from the rectal wall, and we entered the intersphincteric space from the 

lateral side of the rectal wall. Dissection of the intersphincteric space


should be performed in the posterior to anterior direction and to the 

anal side as much as possible. The final step was dissection of the hiatus 

ligament at the posterior side of the rectum. Nearly circular dissection of 

the interspincteric space could be completed. 

The difficulties associated with the perineal approach were reduced by 

this abdominal approach, and the tumor could be exteriorized easily. 

Results: Laparoscopic ISR with total mesorectal excision was performed 

in a total of 15 patients (10 males, 5 females). The median age was 60.5 

years. The T categories of the TNM classification of the rectal cancers were 

Tis 2, T1 1, T2 4, T3 8. The median distance from the anal verge to the 

tumor was 3.7 centimeter.The mean duration of surgery was 386 minutes. 

The mean blood loss was 108 miliiter, and mean postoperative hospital 

stay was 18 days. The diverting ileostomy was closed at a mean of 7.3 

postoperative months. No remarkable perioperative complication was 

encountered. 

Conclusion: laparoscopic ISR enabled us to reduce the difficulties 

associated with the perineal approach. An advantage of laparoscopic ISR 

was the ability to clearly visualize anatomical structures in the deep pelvic 

cavity. 

V037 

LAPAROSCOPIC PARAESOPHAGEAL HERNIA REPAIR WITH 

BIOSYNTHETIC MESH AND COLLIS GASTROPLASTY Angel M Caban, 

MD, Daniel J Scott, MD FACS UT Southwestern, Dallas Texas 

Surgical treatment of paraesophageal hernias has changed significantly 

in the last decade. Laparoscopy has decrease the risk associated with 

open surgery and today a larger number of high risk cases are being 

performed. The minimally invasive surgeon is faced with many challenges 

and controversies during these procedures. One of the major issues is 

recognition of a shortened esophagus, which affects only 3 to 5 percent 

of cases. Recognition of inadequate intraabdominal esophageal length 

is critical in providing effective treatment. Additionally, recent data 

support the use of a biosynthetic mesh buttress to decrease hernia 

recurrence rates. In this video we present a fifty year-old female with a 

giant paraesophageal hernia and a true short esophagus. A laparoscopic 

paraesophageal hernia repair with biosynthetic mesh and “wedge” 

Collis gastroplasty was performed. The patient was discharged home on 

postoperative day number five and at 6-month follow up demonstrate 

dramatic improvement in her symptoms and had no signs of recurrence. 

V038 

LAPAROSCOPIC NISSEN FUNDOPLICATION: IT’S ROLE IN THE 

TREATMENT OF A FAILED ESOPHYX PROCEDURE Barry A Salky, MD 

FACS The Mount Sinai Hospital, New York 

This is a 52 year old male, 9/11 responder who developed GERD and 

respiratory related issues from 9/11. He had a NDO plicator in 2006 with 

no effect, and an Esophex in November, 2008. This was complicated 

by abdominal pain, free air, and mediastinal air. He was treated 

conservatively and eventually responded over one week in hospital. 

However, the GERD increased markedly. He consented for a Nissen which 

was accomplished in June, 2009. At laparoscopy, the blue plastic pins 

where inserted through the esophagus, left crus of the diaphragm, and 

sometimes into the cardia of the stomach. Clearly, the hiatal hernia had 

not been reduced completely before the applications of the pins. This will 

be demonstrated in the video. The patient developed an abscess post 

operatively thought to be secondary to a sealed off perforation at one of 

the pin site. This is shown in the video. As IR could not drain the abscess, 

laparoscopic drainage was performed. This is shown in the video as well. 

The dissection was surprising difficult because of the fixation of the pins 

to the esophagus, crus and stomach. The construction of the Nissen, 

while shown, is not the thrust of this video. 

V039 

LAPAROSCOPIC DUODENAL POLYPECTOMY WITH INTRAOPERATIVE 

ENDOSCOPY IN PEUTZ-JEGHERS SYNDROME Eugenius J Harvey, MBBS, 

Kervin Arroyo, MD, Blair Lewis, MD, Lester Katz, MD Mount Sinai School of 

Medicine 

We present a video of a laparoscopic resection of a 6cm hamartomatous 

polyp arising from the 3rd part of the duodenum and intraoperative 

endoscopy in a 15 year old female with Peutz-Jeghers syndrome. 

The patient has a history of multiple small hamartomatous polyps 

removed endoscopically. She now presents with symptoms of 

intermittent postprandial abdominal pain. At upper endoscopy she was 

found to have a large pedunculated polyp arising from the third part of 

the duodenum which could not be endoscopically resected. 

A combined laparoscopic and endoscopic procedure was elected. 

Initial laparoscopy demonstrated a chronically dilated duodenum and 

proximal jejunum. An intraluminal mass was encountered in the proximal 

jejunum with a transition to normal jejunum distally. The remaining small 

bowel appeared normal. 

A transverse enterotomy was made in the dilated jejunum and the 

pedunculated polyp resected. 

An intraoperative upper endoscopy/ push enteroscopy was performed 

which demonstrated the base of the polyp in the duodenum and the 

closed enterotomy in the jejunum. 

Patients with benign polyposis syndromes often require multiple 

intestinal operations during their lifetime. The laparoscopic approach 

can minimize the adverse effects of multiple surgeries. Intraoperative 

endoscopy helps to assess the adequacy of resection, hemostasis and 

closure of the enterotomy or anastomosis. 

V040 

SINGLE PORT ACCESS: A FEASIBLE ALTERNATIVE TO CONVENTIONAL 

LAPAROSCOPIC SPLENECTOMY EM Targarona, MD, C Balague, MD, L 

Pallares, MD, F Marinello, MD, C Rodriguez-Luppi, MD, C Martinez, MD, MP 

Hernandez, MD, M Trias, MD Hospital Santpau, UAB, Barcelona, Spain. 

Laparoscopic approach is the gold standard for splenectomy . There 

is currently a trend to reduce the invasiveness of minimally invasive 

procedures. Single port access is alternative to NOTES but no reports have 

yet been published in relation to the spleen. AIM: To describe the SAP 

technique for splenectomy MAT. & METH.. 2 patients were approached 

by SAP: a 26-yr male diagnosed of IPT and a 45-yr male with recurrent 

Hodgkin disease. Surgical technique: It was divided into 5 steps: 1.- 

Patient position: standard right decubitus with the table flexed at the 

flank, 2. - Transumbilical trocar insertion: A 15 mm periumbilical incision 

and a flexible tip 10 mm HD scope through a 12 mm bladeless trocar 

bluntly introduced under optic contro. Two 5 mm trocar with a flexible 

corrugate shaft was inserted to the right and left. 3.- Splenic dissection. 

A 5 mm curved grasper used for TEM was placed through the left trocar 

and a 5 mm Ultracision on the right. Using this approach it was possible 

to mobilize the splenic colon flexure and to section the short vessels, The 

table was tilted to the left and the posterior spleno-renal attachments 

were freed. 4.- Splenic hilum transection: The flexible scope was retrieved 

and visual control was changed to a 5 mm scope introduced through 

the right 5 mm trocar. A 6 cm cartridge stapler was inserted through 

the 12 mm trocar and was applied several times to sever the splenic 

hilum. 5.- Spleen extraction. Once the spleen was completely free, a 15 

mm endobag was inserted, replacing the 12 mm trocar. The spleen was 

grasped and introduced in the bag and the spleen was morcellated The 

mean op time was 90’ and blood loss was minimal. Spleen weight was 

200 gr. and 450 gr..RESULTS: The postoperative course was uneventful. 

Both patients had minimal postoperative pain and scarring, and were 

discharged on the second postoperative day. CONCLUSIONS: SAP access 

can be safely used for operative visualization, hilum transection and 

spleen removal with conventional instrumentation, reducing parietal wall 

trauma to a minimum. The clinical, esthetic and functional advantages 

require further analysis. 





V041 

USE OF A NOVEL, SELF-CONTAINED TISSUE RETRACTION DEVICE 

TO REDUCE TROCAR SITE NUMBER IN LAPAROSCOPIC AND NOTES- 

BASED SURGICAL PROCEDURES Trudie A Goers, MD, Richard A Pierce, 

MD PhD, Danny V Martinec, BS, Lee L Swanstrom, MD FACS Legacy Health 

System, Portland, OR 

In an effort to make laparoscopic surgical procedures even less invasive, 

single port access and natural orifice transgastric endoscopic surgical 

(NOTES) approaches have been developed over the past several years. 

However, the need to maintain basic surgical working principles, such 

as proper tissue retraction to create tension and counter-tension, is 

still of critical importance if emerging techniques are to be successfully 

implemented. New self-retaining retraction devices that do not require 

dedicated trocar placement represent a technology that could help 

to bridge the gap between traditional laparoscopy and less invasive 

techniques. One such device (EndoGrab, Virtual Ports Ltd) utilizes a 

fully insertable, self-contained, double hook configuration to generate 

tissue retraction by providing a means of atraumatic tissue attachment 

between either 2 adjacent visceral structures or between the viscera and 

the abdominal wall. The device can be repositioned at will throughout 

the operative case, and allows for both the elimination of a dedicated 

transabdominal port and the need for active assistant retraction. 

Additionally, a flexible applicator will allow the device to be introduced 

through an overtube via a natural orifice. This video shows the use of the 

EndoGrab device in both basic and advanced laparoscopic procedures, 

as well as in a technically challenging NOTES operative case. 

When used in a laparoscopic cholecystectomy, the EndoGrab is 

introduced through a 5 mm port. One of four usual operating ports 

is eliminated such that only two working ports and a camera port are 

needed. The device allows for initial suspension of the fundus, and 

subsequently, the gall bladder body, from the abdominal wall above. 

Consequently, critical operating views of the structures within Calot’s 

triangle are well-visualized with the cephalad retraction provided by the 

device. 

Similarly, in more complex laparoscopic cases such as repair of 

paraesophageal hernia, the EndoGrab is again be used in lieu of 

placement of a port for assistant retraction. The device is placed on the 

stomach in various locations to allow for adequate visualization of critical 

structures during dissection, crural closure and fundoplication creation. 

Use of the EndoGrab allows the procedure to be completed with four 

rather than five incisions. 

Not only does the EndoGrab allow for the reduction in number 

of incisions, but in certain cases, it can help eliminate the need for 

transabdominal ports. With the continued development of NOTES 

equipment and technology, tools like the EndoGrab can play critical 

roles in procedures accomplished with access exclusively through 

natural orifices. Given that currently available NOTES platforms make 

lateral retraction and dissection of the gall bladder difficult during 

cholecystectomy, the EndoGrab serves a novel solution in this video. 

In conclusion, the EndoGrab represents a valuable technological 

advance that allows traditional laparoscopy to be done with fewer trocar 

sites, and may facilitate NOTES procedures in becoming truly externally 

incisionless. 

V042 

Because of her complaints of a mass protruding while her bladder was 

full, it was decided to perform a TAP repair so that the bladder could be 

filled and visualized during the operation. The patient had two concurrent 

issues noted intra-operatively: 1. Her full bladder was pushing the 

previously placed prolene plug, everting it through her repair and likely 

represented the mass which the patient was feeling. 2. In addition, there 

was a clear and separate recurrent left inguinal hernia just medial to the 

previous repair. There was no evidence of plug migration. We removed 

the plug, reduced her recurrent hernia and used a soft polyester mesh 

placed extra-peritoneally to cover both defects. 

V043 

LAPAROSCOPIC AND THORACOSCOPIC IVOR LEWIS 

ESOPHAGECTOMY Kazunori Sato, MD, Beemen N Khalil, MD, Pierre 

Theodore, MD, David Jablons, MD, Guilherme M Campos, MD University 

of Wisconsin School of Medicine and Public Health and University of 

California San Francisco 

Minimally invasive (MIS) Ivor-Lewis Esophagectomy is a technically 

challenging procedure, but series from expert centers have described 

its feasibility and safety. The benefit in terms of long-term oncologic 

outcomes is being investigated. The extent of MIS techniques has ranged 

from a laparoscopic abdominal component with a thoracotomy, minithoracotomy, 

or thoracoscopic component. This video describes the main 

steps of a MIS laparoscopic and thoracoscopic Ivor Lewis esophagectomy 

with upper abdominal and subcarinal lymph nodal dissection and 

the circular stapled anastomosis with the transoral anvil. We have 

performed MIS Ivor Lewis Esophagectomy in thirty-seven patients (mean 

age 67 years; range 45 to 85) with distal esophageal adenocarcinoma 

(n=29), squamous cell cancer (n=5), or high-grade dysplasia in Barrett’s 

Esophagus (n=3) between October 2007 and August 2009. The abdominal 

portion of the operation was completed laparoscopically in 30 patients 

(81.1%). The thoracic portion was completed using a mini-thoracotomy 

in 23 patients (62.2%) and thoracoscopic techniques in 14 (37.8%). 

Proximal and distal margins were negative in all patients. A median of 

15 lymph nodes (range 8 to 33) were dissected from each specimen, 

with a median of 3 (range 0 to 18) histologically positive nodes. No 

intra-operative technical failures of the anastomosis or deaths occurred. 

The average hospital stay was 11 days (range 7 to 30). Five patients had 

strictures (13.5%) and all were successfully treated with either two or 

three endoscopic dilations. One patient had an anastomotic leak that 

was successfully treated by re-operation and endoscopic stenting. The 

operation shown includes laparoscopic hiatal, distal esophageal, and 

gastroesophageal junction dissection and lymph nodal dissection of the 

porta-hepatis, left gastric artery, and supra-pancreatic lymph stations. 

Gastric conduit preparation was performed using multiple firings of 

a 4.8mm linear stapler. A pyloroplasty was performed and a feeding 

jejunostomy placed. The thoracic portion was completed using standard 

thoracoscopic ports and techniques and included mobilization of the 

esophagus from the esophageal bed, subcarinal lymph node dissection 

and transection of the most superior aspect of the thoracic esophagus 

at the level of the thoracic inlet with a 4.8mm linear stapler above the 

divided azygous vein. The esophagogastric anastomosis was performed 

using a 25mm anvil passed trans-orally, in a tilted position, and connected 

to a 90cm long PVC delivery tube through a small opening in the stapled 

esophageal stump. The anastomosis was completed by joining the anvil 

to a circular stapler (EEA 25mm with 4.8mm Staples) inserted into the 

gastric conduit. Then, the gastric conduit opening was closed using an 

additional firing of a 4.8mm linear stapler. 

While long-term oncologic outcomes are still being evaluated, MIS Ivor 

Lewis Esophagectomy is feasibe and seems safe in high volume centers. It 

also seems to offer superior visualization of the operative field in addition 

to the usual benefits of MIS techniques. 

AGAINST OCCAM’S RAZOR: TAP REPAIR OF RECURRENT 

INGUINAL HERNIA WITH CONCOMITANT INVERSION OF ORIGINAL 

POLYPROPYLENE PLUG Antonio D Lassaletta, MD, Erika Fellinger, MD, 

Steven D Schwaitzberg, MD FACS Beth Israel Deaconess Medical Center, 

Cambridge Health Alliance, Harvard Medical School 

The patient is a 42 year old female who had undergone an open left 

inguinal hernia repair 13 years ago. She presents to clinic with a 1 year V044 

history of a recurrent left groin mass in the area of her previous repair. LAPAROSCOPIC TREATMENT OF RECTOCELE BY ANTERIOR 

Interestingly, she states that at night when her bladder is full she feels a RECTOPEXY David LECHAUX, PhD, Adrian Marius NEDELCU, Aurelie 

hard mass protruding from her left groin. In addition, she has pain in the LEMARREC, MD “Yves Le Foll”’Hospital - Saint Brieuc 

area with straining or heavy lifting. 

The patient is a 53 yo F with stage III symptomatic rectocele. 



1. Installation/ Positioning 

The patient is in gynecological position. We used 4 trocars. 

2. Exposure to/of the operative field 

Thanks to a pronounced Trendelenburg position the sigmoid loop is 

retracted appropriately. The uterus is fixed on the anterior abdominal wall. 

Findings: Douglas pouch is enlarged. Excces peritoneum is excised 

allowing for the exposure of the pelvic floor. 

3. Dissection of the rectovaginal space 

We used an intravaginal buggy. The dissection was performed to the 

deepest part of the pelvic floor and lateral, to the pararectal fossa 

4. Promontorium approach 

There are 3 risks: 

- median sacral artery; 

- intervertebral disk; 

- the hypogastric plexus; 

In the same time the right ureter must be identified, being localized 

very close to the area of dissection. Scissor were used to make a 3-4 cm 

peritoneal incision 

5. Tunnelissation 

The blunt dissection was used to create a bridge/space/oppening 

between the promontorium and the Douglas pouch. 

6. Lower fixation of the prosthesis 

The prosthesis is 6/6 cm inferiorly and the superior part is 2,5 /9 cm. 

The fixation is performed with Protack device and with the help of an 

intralumenal finger. 

7. Fixing the prosthesis to posterior vaginal pouch/fornix is stretching / 

is putting tension on the posterior vaginal wall. We used an intravaginal 

finger for contrapressure 

7. Suspension to the posterior vaginal pouch(fund de sac post vaginal) 

allow (punerea in tensiune) a tension of posterior vaginal wall. 2 agrafes 

are put with the control of an intravaginal finger>>>.aici tre schimbat ca 

m-a apucat oboseala…sper ca totusi ai inteles 

8. Fixation to the promontorium 

Is realized by Protrack device avoiding the intervertebral disk. 

It’s about a technique without tension of the prosthesis 

9 Peritoneal closure 

Is performed using Vicryl 2/0 continuous suture both at the level of 

Douglas pouch and promontorium. 

No drainage, no naso gastric tube are needed. 

Postoperatively, first bowel movement was on day one which allows for 

progressive realimentation/ feeding. Hospital stay was 4 days. 

V045 

LAPAROSCOPIC SPLEN-PANCREATECTOMY, FOR MUCINOUS 

PANCREATIC-CYST Jorge E Nefa, MD, Pablo E Omelanczuk, MD, Mario 

D Masrur, MD, Sergio E Bustos, MD Surgical Service, Hospital Italiano, 

Mendoza-Argentina 

BACKGROUND: Among pancreatic cysts, mucinous cystadenoma, 

and intraductal papillary mucinous neoplasms have the potential for 

malignant transformation. Differentiation between benign and potentially 

malignant cysts remains difficult at the preoperative time. Majority 

of these tumors must be resected and the laparoscopic approach is 

nowadays a valid option. 

OBJECTIVE of this presentation was to show in a video the laparoscopic 

excision of a multiple pancreatic mucinous cyst. In this was necessary the 

simultaneous splenectomy. 

METHODS: A 54 years-old female was diagnosed for Pancreatic mucinous 

Cyst by CTA, NMR, PET Scan and Tumor Markers. Using four trocars the 

spleen and pancreatic Cysts were successfully removed. Pancreatic section 

was carried out using stapler. Both splenic artery and vein, were occluded 

by ligature and clips. 

RESULTS: The operating room time was 4 hours, transfusion of 500Ml 

of Red Cells was necessary. Hospital stay was 5 days. Pathologic study 

informed Adenocarcinoma mucinous of the pancreas. 

CONCLUSIONS: Simultaneous resection of pancreas and spleen is 

possible by Laparoscopy as many authors have reported. 

On the other hand, neither laboratory exams nor Imagines were able to 

confirm the malignant condition of the tumor at the preoperative time. 

V046 

LAPAROSCOPIC EXTIRPATION OF A FORK FROM THE DUODENUM 

Konrad W Karcz, MD, Birte Kulemann, MD, Gabriel J Seifert, MD, Hans 

J Schrag, MD, Simon Küsters, MD, Goran Marjanovic, MD, Jodok M 

Grüneberger, MD, Cheng Zhou, MD, Philipp Holzner, MD, Alexander 

Braun, MD Videosurgery Division, Department of General and Abdominal 

Surgery, University Hospital Freiburg, Hugstetter Str 55, D-79106 Freiburg, 

Germany 

BACKROUND: A woman who had accidentally swallowed a fork during a 

dinner party was admitted to our Department of General and Abdominal 

surgery. Different techniques have been described for removing foreign 

bodies (FB) from the stomach or the duodenum. Endoscopical techniques 

are widely and successfully used, but not in each case. 

Here, we present the laparoscopic retrieval of a 15 cm fork from the 

duodenal bulb. 

METHODS: A 23-year-old woman was admitted with progressive 

abdominal pain two weeks after swallowing a plastic fork while 

attempting to induce vomiting during a party. 

On the day of admission to our emergency room, she presented with 

leukocytosis, otherwise normal laboratory findings and mild epigastric 

tenderness without peritonism. She was afebrile with normal vital 

signs and had no significant events in her past medical history. Prior to 

admission, she ate normal meals. 

A routine X-ray examination did not show the expected FB. The 

preoperative upper endoscopy, on the other hand, showed a plastic fork, 

tines up, right behind the pylorus in the duodenal bulb: The tines were 

deeply buried in the wall of the intestine. The handle was irremovably 

lodged in the opposite part of the duodenum. In consequence, the 

indication for laparoscopic extirpation was given, especially due to 

uncertainty concerning further lesions or the presence of an abscess 

within the abdominal cavity. Perforating objects and objects larger than 7 

cm ought to be removed surgically to prevent oesophageal perforation. 

The patient was placed in supine position with the surgeon standing 

between her legs. Four trocars, two 10-mm and two 5-mm, were used 

(ApplyMedical, USA). We expected peritonitis and extreme tissue 

swelling with adhesions in the upper abdominal cavity, but only saw a 

slightly swollen duodenum with very few fibrin stripes and roughly 250 

ml of white, exudative, intraperitoneal fluid. The fork tines, which had 

perforated the duodenal bulb, could be seen. There were no liver injuries. 

The tines were held with a clamp, and the perforated intestinal wall was 

carefully dissected with the monopolar hug (STORZ, Germany) and later 

with the ACE Harmonic Scalpel (ETHICON, USA) due to bleeding. 

After the tines were freed, the 15cm plastic fork was extracted in proximal 

direction through the perforation injury. There was no severe necrosis, 

and debridement was not necessary. The bowel was irrigated and 

continuously sutured with 3-0 PDS. 

Finally, the fork was retrieved without problems from the abdominal 

cavity through the 10mm trocar incision. 

RESULTS: Operating time was 60 minutes, blood loss estimated at 

roughly 100 ml with no blood transfusion. The patient’s postoperative 

course was uneventful. Hospital stay was 4 days. The patient tolerated 

a gradual reintroduction of liquid and solid foods; she was well and 

asymptomatic one year after the operation. 

CONCLUSION: A fork may be swallowed, but cannot spontaneously pass 

through the gastrointestinal tract. Early removal should be advised to 

avoid perforation and to minimize morbidity. 

Laparoscopic removal is a safe and feasible method of managing FBs that 

are not removable endoscopically. 




Video Channel Loop Listing 

Full abstract texts available in the Electronic Meeting Guide 

V047 LAPBAND PLACEMENT WITH REPAIR OF INCIDENTAL HIATAL 

HERNIA USING CURVED LAPAROSCOPIC INSTRUMENTS THROUGH 

A SINGLE INCISION Shabirhusain S Abadin, MD MPH, Rami Lutfi, MD 

FACS, St. Joseph Resurrection Hospital 

V048 LAPAROSCOPIC REVISION OF GASTRIC BANDING TO ROUX- 

EN-Y GASTRIC BYPASS: TECHNICAL PEARLS. Maher El Chaar, MD, 

Neal Agee, MD, Dimitrios Stefanidis, MD, Gray Hughes, MD, Timothy 

Kuwada, MD, Keith Gersin, MD, Carolinas Medical Center, Division of 

Minimally Invasive and Bariatric Surgery 

V049 SIMULTANEOUS LAPAROSCOPY AND CO2 COLONOSCOPY FOR 

FULL-THICKNESS EXCISION OF A SUBMUCOSAL CECAL LESION 

Vanessa P Ho, MD, Anjali S Kumar, MD MPH, Jun Yan, MD, Olival de 

Oliveira, Jr., MD, Christopher W Towe, MD, Paul Basuk, MD, Jeffrey W 

Milsom, MD, New York Presbyterian Hospital- Weill Cornell Medical 

Center 

V050 SINGLE PORT LAPAROSCOPIC SIGMOIDECTOMY FOR 

SIGMOID VOLVULUS John Marks, MD, Eileen Larkin, BA, Rahila Essani, 

MD, Lankenau Hospital and Institute for Medical Research: Section of 

Colorectal Surgery, Wynnewood, PA 

V051 PERORAL ENDOSCOPIC SUBMUCOSAL PYLOROMYOTOMY 

IN IN ANIMAL MODEL FOR A NEW CONCEPT OF MINIMALLY 

INVASIVE SURGERY FOR PYLORIC STENOSIS Masaru Kawai, MD, 

Silvana Perretta, MD, Oliver Burckhardt, MD, Gianfranco Donatelli, MD, 

Bernard Dallemagne, MD, Hurng-Sheng Wu, MD, Jacques Marescaux, 

MD, IRCAD, University Hospital of Strasbourg, France - Show Chwan 

Memorial Hospital, Changhua, Taiwan 

V052 DS (DISK SUSPENSION) METHOD: NOVEL AND SAFE 

TECHNIQUE FOR THE RETRACTION OF THE LIVER IN 

LAPAROSCOPIC SURGERY Kazunori Shibao, MD PhD, Aiichiro Higure, 

MD PhD, Koji Yamaguchi, MD PhD, University of Occupational and 

Environmental Health 

V053 LAPAROSCOPIC RADICAL CHOLECYSTECTOMY AND ROUX- 

EN-Y CHOLEDOCHOJEJUNOSTOMY FOR GALLBLADDER CANCER 

Andrew A Gumbs, MD, John P Hoffman, MD, Fox Chase Cancer Center 

V054 LAPAROSCOPIC REDO HEPATICO-JEJUNOSTOMY FOR BILIARY 

STRICTURE AFTER OPEN HEPATICOJEJUNOSTOMY FOR CBD 

INJURY Mariano Palermo, MD PhD, Nelson Trelles, MD, Michel Gagner, 

MD FACS FRCSC, Department of Surgery, Mount Sinai Medical Center. 

Miami Beach, FL. USA. 

V055 SINGLE INCISION LAPAROSCOPIC SURGERY (SILS): BILATERAL 

TOTAL EXTRAPERITONEAL (TEP) INGUINAL HERNIA WITH 

SIMULTANEOUS UMBILICAL HERNIA REPAIR Brian P Jacob, MD, 

Catherine Madorin, MD, Anthony Vine, MD, Mark Reiner, MD, Mount 

Sinai Medical Center 

V056 DEGARENGEOT’S HERNIA: LAPAROSCOPIC REDUCTION, 

REPAIR & RESECTION OF AN INCARCERATED APPENDICEAL 

MUCOCELE David D Odell, MD, Alexandre Y Derevianko, MD, 

Benjamin E Schneider, MD, John T Mullen, MD, Beth Israel Deaconess 


V057 LOOP SNARE TECHNIQUE FOR TRANSFASCIAL SUTURING Brian 

D Layton, DO, Carl J Westcott, MD, Wake Forest University 

V058 GALLBLADDER VOLVULUS: CASE REPORT AND REVIEW 

OF THE LITERATURE Terri R Martin, MD, Jennifer Keller, MD, John 

Martinie, MD, Carolinas Medical Center 

V059 THREE PORT ROBOTIC RIGHT HEMICOLECTOMY: A 

SYSTEMATIC APPROACH TO SET UP AND SURGERY Jeffrey A Neale, 

MD, Eric Szilagy, MD FACS FASCRS, Melissa Times, MD FACS FASCRS, 

Surya P M Nalamati, MD FACS, Henry Ford Health System 

V060 SINGLE-INCISION LAPAROSCOPIC SPLENECTOMY FOR ITP 

Bac H Nguyen, MD PhD, Tuan A Le Quan, MD, Thinh H Nguyen, MD, 

University Medical Center at Ho Chi Minh City 

V061 DIAGNOSIS AND TREATMENT OF OCCULT GI BLEEDING AFTER 

LAPAROSCOPIC ROUX-EN- Y GASTRIC BYPASS (LRYGB). A CASE 

REPORT OF A GIST AS BLEEDING SOURCE. Jesus E Hidalgo, Omar 

Bellorin, Ismael Court, Katharina Schmidt, Samuel Szomstein, Raul J 

Rosenthal, Cleveland Clinic Florida 

V062 LAPAROSCOPIC CONVERSION OF LAPAROSCOPIC 

ADJUSTABLE GASTRIC BANDING (LAGB) TO SLEEVE 

GASTRECTOMY (LSG) FOR MORBID OBESITY Omar Bellorin, Ismael 

Court, Samuel Szomstein, Raul J Rosenthal, Cleveland Clinic Florida 

V063 SINGLE-INCISION LAPAROSCOPIC SIGMOIDECTOMY FOR 

CANCER Bac H Nguyen, MD PhD, Thinh H Nguyen, MD, Khanh C 

Pham, MD, University Medical Center at Ho Chi Minh City 

V064 SINGLE INCISION LAPAROSCOPIC RIGHT HEMICOLECTOMY 

USING STANDARD LAPAROSCOPIC INSTRUMENTS Joshua A 

Waters, MD, Michael J Guzman, MD, Don J Selzer, MD, Bruce W Robb, 

MD, Eric A Wiebke, MD, Virgilio V George, MD, Indiana Univerisity 


V065 ENDOSCOPIC TREATMENT FOR GASTRIC PERFORATION 

USING T-TAG AND PLASTIC PROTECTION CHAMBER Kiyoshi 

Hashiba, MD PhD, Sergio Roll, MD PhD, Pablo r Siqueira, MD, Marco 

A DÀssunção, MD, Horus A Brasil, MD, Hospital Sírio Libanês 

Endoscopic Unit. S.Paulo. Brazil. 

V066 LAPARO-ENDOSCOPIC SINGLE SITE (LESS) TOUPET 

FUNDOPLICATION WITH REDUCTION OF A GIANT HIATAL HERNIA 

Sharona B Ross, MD, Connor A Morton, BS, Desiree Villadolid, MPH, 

Sujat Dahal, MD, Linda K Barry, MD, Andy Roddenbery, MD, Alexander 

S Rosemurgy, MD, Department of Surgery, University of South Florida, 

Tampa, Florida 

V067 TOTAL LAPAROSCOPIC WHIPPLES 

PANCREATICODUODENECTOMY –EARLY EXPERIENCE WITH 3 

CASES Varghese Chalissery, MS FMAS, Alfie Kavalakat, MS DNB, 

Center for Laparoscopic Surgery&Minimallly Invasive Procedures, 

West Fort Hospital,Thrissur,Kerala,India 

V068 LAPARO-ENDOSCOPIC SINGLE SITE (LESS) PANCREATIC CYST 

ENUCLEATION Andy S Roddenbery, MD, Sharona B Ross, MD, Connor 

A Morton, BS, Leigh Ann Humphries, Harold Paul, BS, Alexander S 

Rosemurgy, MD, Department of Surgery, Tampa, Florida 

V069 LAPAROSCOPIC PARADUODENAL HERNIA REPAIR Faisal M 

Al-Mufarrej, MD, Jason Kasza, MD, Bruce Abell, MD, Frederick Brody, 

MDMBA, George Washington University Medical Center 

V070 LAPAROSCOPIC REMOVAL OF INGUINAL PLUG AND PATCH 

MESH FOR CHRONIC GROIN PAIN Jeffrey A Blatnik, MD, Michael J 

Rosen, MD, Department of Surgery, University Hospitals Case Medical 

Center, Cleveland, OH 

V071 LAPAROSCOPIC MEDIAN ARCUATE LIGAMENT RELEASE Mun 

Jye Poi, MD, Robert J. Lowe, MD, Pavlos K. Papasavas, MD, Darren S. 

Tishler, MD, Hartford Hospital , Hartford, Connecticut 

V072 ROBOTIC ASSISTED ESOPHAGECTOMY FOR TREATMENT OF 

ESOPHAGEAL HEMANGIOMA Philip WY Chiu, Prof, Anthony YB Teoh, 

Dr, Simon KH Wong, Dr, Tiffany CL Wong, Dr, Enders KW Ng, Prof, The 

Chinese University of Hong Kong 

V073 LAPAROSCOPIC SPLEEN PRESERVING DISTAL 

PANCREATECTOMY Shailesh P Puntambekar, MS, Geetanjali Agarwal, 

MS, Anjali Patil, MS, Sourabh Joshi, MS, Galaxy CARE Laparoscopy 

Institute 

V074 SURGICAL MANAGEMENT OF CHRONIC ABDOMINAL PAIN 

AFTER LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS. Jeremy 

Eckstein, Sheetal Patel, Emeka Acholonu, Wasef Abu-Jaish, Alexander 

Ramirez, Samuel Szomstein, Raul Rosenthal, Cleveland Clinic Florida 

V075 HYBRID TRANSVAGINAL SLEEVE GASTRECTOMY Michel 

Gagner, MD FRCSC FACS, Florida International University 


Video Channel Loop Listing 


V076 GELPOINTTM SINGLE INCISION INTRACORPOREAL 

ANASTOMOTIC TECHNIQUES Eric M Paul, MD, John Weaver, MD, 

Scott Davis, MD, Jahnavi Srinivasan, MD, John Sweeney, MD, Edward 

Lin, DO, Emory Endosurgery Unit 

V077 ENDOSCOPIC REMOVAL OF PARTIALLY ERODED ADJUSTABLE 

GASTRIC BAND WITH COMMON ENDO-HOUSEHOLD ITEMS 

Seiichi Kitahama, MD, Katayun Irani, MD, Valerie J Halpin, MD FACS, 

Lee L Swanström, MD PhD FACS, Legacy Good Samaritan Hospital, 

Portland, OR 

V078 SINGLE-INCISION LAPAROSCOPIC CHOLECYSTECTOMY USING 

NOVEL POWERED ARTICULATING INSTRUMENTS (TERUMO) Byron 

F Santos, MD, Nathaniel J Soper, MD, Eric S Hungness, Northwestern 

University, Department of Surgery 

V079 LAPAROSCOPIC TRANSHIATAL RESECTION OF ESOPHAGEAL 

DIVERTICULUM Kervin Arroyo, MD, John Harvey, MD, Daniel M 

Herron, MD, Michael Edye, MD, Mount Sinai School of Medicine 

V080 LAPAROSCOPIC REPAIR OF A COMMON BILE DUCT INJURY 

Elyssa J Feinberg, MD, Adam J Nadelson, MD, Diego R Camacho, 

MD FACS, Montefiore Medical Center, The Albert Einstein College of 

Medicine, Bronx, New York 

V081 SINGLE INCISION LAPAROSCOPIC PARTIAL HEPATECTOMY 

Juliana E Meyer, MD, Richard A Arenas, MD, Francis Cannizzo Jr., MD 

PhD, John R Romanelli, MD, Baystate Medical Center, Tufts University 


V082 LAPAROSCOPIC COMPONENT SEPARATION FOR INCISIONAL 

HERNIA REPAIR AND REMOVAL OF INFECTED MESH Dennis F Diaz, 

MD, John Scott Roth, MD, University of Kentucky Chandler Medical 

Center 

V083 SINGLE INCISION LAPAROSCOPIC RESECTION OF A GASTRIC 

GASTROINTESTINAL STROMAL TUMOR Philip Omotosho, MD, 

Christopher Myers, MD, Dana Portenier, MD, Duke University Medical 

Center 

V084 SINGLE PORT ACCESS LAPAROSCOPIC LOOP ILEOSTOMY; 

A FEASIBILITY STUDY Diana Cheng-Robles, Zuri Murrell, Rodrigo 

Alban, Som Kohanzadeh, Phillip Fleshner, Cedars Sinai Medical Center 

V085 LAPAROSCOPIC ROBOTIC POSTERIOR RETROPERITONEAL 

ADRENALECTOMY:TECHNICAL DETAILS Eren Berber, MD, Hizir 

Akyildiz, MD, Jamie Mitchell, MD, Mira Milas, MD, Allan Siperstein, MD, 

Cleveland Clinic 

V086 ENDOSCOPIC UNROOFING OF A POSTRAUMATIC SPLENIC 

CYST THROUGH A TRANSUMBILICAL SINGLE PORT ACCESS 

EM Targarona, MD, C Balague, MD, L Pallares, MD, F Marinello, D, C 

Rodriguez-Luppi, MD, L Estalella, MD, C Martinez, MD, MP Hernandez, 

MD, M Trias, M, Hospital Santpau, UAB, Barcelona, Spain. 

Videos in the Video Channel Loop 

can be viewed in the dedicated viewing area 

set up in the Exhibit Hall. The viewing area will be 

set up next to the Learning Center. 


Look for the hanging sign 

“2010 Video Channel Loop Viewing Area.” 

Viewing hours are subject to the Exhibit Hall hours. 



Posters of Distinction Abstracts 

P001 

EVALUATION OF THE SLEEVE GASTRECTOMY AS A SINGLE-STAGE 

TREATMENT OF MORBID OBESITY Philippe A Topart, MD, Cyril Chazelet, 

MD, Pierre Verhaeghe, MD FACS Societe de Chirurgie Viscerale, Clinique 

de l’Anjou, Angers ; Clinique St Brice, Provins, Chirurgie Viscerale, CHU, 

Amiens, France 

Objectives: A multicenter, retrospective study reviewed the current 

practice of the sleeve gastrectomy in Europe to assess the early 

postoperative outcome as well as the effect on weight loss. 

Methods and procedures 

446 sleeve gastrectomies were performed by 14 centers between 

September 2000 and October 2007. Operative data, postoperative 

outcomes as well as 2 year weight loss were reviewed. 

Results: The initial mean BMI of the patients was 46 (range 30-71) and 

their mean age 43 (18-70). 83% were women. 45% had at last 1 comorbid 

condition and 25% were gastric band failures. 99% of the procedures were 

performed laparoscopically with a 0.7% conversion rate. The sleeve was 

fashioned on a 34 to 50 Fr bougie. Methylene blue test was routine and 

25% of the patients kept a naso-gastric tube for 48 hours. The staple line 

was oversewn or reinforced with buttressing material in 263 patients. The 

mean operative time was 105 mn (30-550) without difference according 

to the BMI. The overall rate of complications was 16.7% with 5.3% major 

(19/20 were gastric leaks) but none were fatal. Although the leak rate was 

reduced with staple line reinforcement (0 vs 4.5%) and oversewing (3.3 

vs 6.3%), this was not significant and the only prognostic factor was the 

operation duration (p=0.03). The percentage of excess weight loss was 

stable after 1 year and 64% at 2 years. Male gender, comorbidities and BMI 

>50 significantly and adversely influenced weight loss. 

Conclusion: This large series demonstrates the safety of the sleeve 

gastrectomy. Although 2 year weight loss seems on par with gastric 

bypass, long term assessment is needed and limitating factors may exist. 

P002 

PATIENTS EXPECT TO LOSE MORE THAN AVERAGE WEIGHT AFTER 

BARIATRIC SURGERY Brad E Snyder, MD, Erik B Wilson, MD FACS, Todd 

Wilson, MD, Connie Klein, RN NP University of Texas Health Sciences 

Center at Houston 

Background: While most bariatric surgeons try to help patient achieve 

a realistic goal weight after surgery, patients are often disappointed 

that they have not reached “ideal” body weight. We propose that this is 

because patients begin the surgical process with inflated self expectations 

and set themselves up for disappointment. 

Methods and Procedures: At the University of Texas in Houston, we 

recorded the patient expected % excessive weights of 125 preoperative 

gastric banding patients and 36 gastric bypass patients. Frequencies of 

expected weight loss were graphed for different percentages of weight 

loss. Patient expectations were separated by gender and compared using 

Student’s t-test. 

Result: Despite abundant education about the procedure and the 

average weight loss for our patients in our program, patients drastically 

overestimated the %EWL they would obtain. In the banding group, 88 out 

of 125 patients (70%) expected to lose more than 80% excessive weight 

(EW). For the bypass group, 24 of the 36 (67%) patients expected to lose 

more than 90% EW. 82% of the banding group and 89% of the bypass 

group were women. Women had significantly higher expectations for 

weight loss than men for both banding and bypass (p


P004 

SINGLE INCISION LAPAROSCOPIC GASTRIC BANDING: EVOLUTION 

TOWARDS SCARLESS SURGERY DURING 50 CONSECUTIVE CASES 

Sarah C Oltmann, MD, Lauren Mashaud, MD, Stephanie Morris, BS, Arsalla 

Islam, MD, Homero Rivas, MD MBA, Daniel J Scott, MD Southwestern 

Center for Minimally Invasive Surgery, Department of Surgery, University 

of Texas Southwestern Medical Center, Dallas, TX 

INTRODUCTION: Single incision laparoscopic surgery (SILS) may prove 

beneficial but techniques are still evolving. The purpose of this study was 

to assess outcomes associated with a SILS approach for adjustable gastric 

banding (AGB) for morbid obesity. 

METHODS: We conducted an IRB-approved retrospective review of our 

first 50 consecutive SILS AGB procedures attempted over an 18-month 

period. All patients were managed by a single attending surgeon at an 

academic center. A modified SILS approach was used in 44 cases, in which 

a separate subxyphoid incision was used for Nathanson liver retractor 

placement; a “pure” SILS approach, in which only a single incision was 

used for insertion of all laparoscopic instruments, was used in 6 cases. 

A Nathanson retractor was used in 45 cases and intracorporeal liver 

retraction was achieved using suture and/or umbilical tape in 5 cases. 

Operating instruments included straight and articulating tools placed 

through 3 separate working ports (n=48) or a multiport access device 

(n=2), via a LUQ (n=41) or umbilical (n=9) incision. Data are displayed as 

mean ± standard deviation, unless otherwise stated. 

RESULTS: Patient age was 41.4 years (range 18 – 69); 42 patients were 

female and 8 male. Pre-operative weight was 122 ± 22 kg, with a BMI of 

45.5 kg/m² (35 – 67). 28 patients had previous abdominal surgery, most 

commonly hysterectomy (n=10) or cholecystectomy (n=9). Operative 

time was 110 minutes (48 – 165), and 18 cases had additional procedures 

performed: 15 hiatal hernia repairs, 1 umbilical hernia repair, 1 EGD, and 

1 liver biopsy. Estimated blood loss was 23 cc ± 22. Incision length for 

working port(s) was 4.5 cm ± 0.9. In 4 cases, an additional port (separate 

from single-incision operative site) was required for placement of 

additional liver retractor (n=2), suction irrigator for bleeding (n=1), or 

additional grasper for retrogastric tunnel creation (n=1). There was one 

conversion to traditional 5-port laparoscopic approach in a patient with 

severe hepatomegaly, and no conversions to open. 4 complications (1 

major, 3 minor) were noted in 3 patients. The major complication was a 

mid-esophageal perforation secondary to calibration tube manipulation, 

successfully treated with esophageal stenting and left chest drainage. 

Minor complications included: gastric obstruction secondary to postop 

edema managed expectantly, a liver laceration treated with direct 

pressure, an upper extremity DVT secondary to PICC line for TPN in 

the esophageal perforation patient managed with line removal and 

anticoagulation. Routine POD 1 imaging was normal except in two cases, 

as noted above. Median hospital stay was 1 day (1-28). BMI reduction 

averaged 4.4 ± 3.8 kg/m2 over a mean follow-up of 6.8 ± 4 months. 

CONCLUSION: Although techniques are still evolving, SILS AGB appears 

to be feasible for achieving satisfactory band placement and safe from 

the viewpoint of intra-abdominal tissue manipulation. Continued work 

is needed to further improve operative strategies, determine relative 

benefit compared to traditional approaches, and to investigate long-term 

outcomes. 

P005 

CLINICAL OUTCOMES OF ATYPICAL SYMPTOMS FOLLOWING 

LAPAROSCOPIC ANTIREFLUX SURGERY Shaun R Brown, DO, C. Prakash 

Gyawali, MD, Lora Melman, MD, Eric D Jenkins, MD, Julia Bader, PhD, 

Margaret M Frisella, RN, L. Michael Brunt, MD, J. Christopher Eagon, MD, 

Michael M Awad, MD PhD, Brent D Matthews, MD Department of Surgery, 

Section of Minimally Invasive Surgery, Washington University School of 

Medicine, Saint Louis, MO 

Introduction: Gastroesophageal reflux disease (GERD) can manifest with 

both typical (heartburn, regurgitation) and atypical symptoms (cough, 

hoarseness, wheeze). While it is well established that antireflux surgery 

is effective in relieving typical symptoms, it is currently unclear whether 

atypical symptoms foreshadow a less satisfactory outcome following 

laparoscopic antireflux surgery (LARS). The purpose of this study is to 

critically analyze the clinical outcomes of atypical symptoms in patients 

undergoing LARS. 

Methods: Patients scheduled for LARS were prospectively enrolled in 

this IRB-approved study over a 5 year period. All subjects included in 

this study underwent preoperative high resolution manometry (HRM) 

and had evidence of GERD on an ambulatory pH study. For the purpose 

of this study, cough, wheeze and hoarseness were considered atypical 

symptoms. During preoperative and postoperative examinations, patients 

completed detailed foregut symptom questionnaires, using both 5-point 

Likert and 10-point visual analog scales (VAS) to document typical as well 

as atypical symptoms. Atypical symptom burden was calculated as a sum 

of VAS for the three atypical symptoms, termed the atypical score (ATS). 

HRM patterns were grouped into normal, spastic and hypomotile. Data 

are expressed as mean ± standard errors of mean. Statistical significance 

(p



(LGS). Multiple logistic regression was performed to determine whether 

ultrasound findings and patient characteristics (age, BMI, and sex) 

predicted the ability of the specimen to pass through the overtube. 

Results: Specimens from 57 patients were examined. Forty-four 

patients (35 female, 9 male) had preoperative ultrasounds that were 

available for electronic review and were included in the analysis. Mean 

± standard deviation for age and BMI were 42 ± 12 years, and 32 ± 8 kg/ 

m2. Ultrasound dimensions for gallbladder length, width, depth, and 

wall thickness were 80 ± 17mm, 35 ± 12mm, 28 ± 10mm, 3 ± 1mm. 

CBD diameter was 4 ± 2 mm. Gallstones were absent in 11 patients, 

and present in 35. In patients with gallstones, measurement of LGS 

was successful in 23 patients with a mean diameter of 12 ± 8mm. LGS 

was indeterminate (IGS) in the remaining 12 patients due to artifact 

from multiple stones. Eighteen gallbladders were perforated during 

the operation. Rate of passage for perforated versus intact gallbladders 

was not statistically different (40% v. 23%, p = 0.054 with Fisher’s exact 

test). Weight, BMI, LGS, and IGS were predictors of passage through the 

overtube on univariate logistic regression. However, only LGS (Odds ratio 

1.167, 95% confidence interval 1.023-1.332, p = 0.021) and IGS (Odds 

ratio 22.965, 95% confidence interval 1.986 – 265.629, p = 0.025) were 

significant predictors of passage on multivariate logistic regression. 

Passage rate was 80% when LGS < 10mm or no stones were present, 18% 

when LGS was greater than or equal to 10mm, and 8% with IGS (Pearson 

Chi-Square, p value < 0.001). 

Conclusion: Preoperative ultrasound findings predict gallbladder 

extraction during transgastric NOTES cholecystectomy. IGS, or LGS greater 

than or equal to 10mm should be considered relative contraindications to 

transgastric NOTES cholecystectomy. 

P007 

A COMPARISON OF PRE-OPERATIVE COMORBIDITIES AND 

POST-OPERATIVE OUTCOMES AMONG PATIENTS UNDERGOING 

LAPAROSCOPIC NISSEN FUNDOPLICAITON AT HIGH AND LOW 

VOLUME CENTERS Oliver A Varban, MD, Thomas McCoy, MS, Carl 

Westcott, MD Wake Forest University Baptist Medical Center 

Objective: Peer reviewed data is often published by single centers that 

are affiliated with teaching institutions with a high volume of cases. 

As operations grow in popularity, they are performed at a wide variety 

of institutions with the potential to produce inconsistent results. The 

purpose of this study is to compare pre-operative comorbidities and postoperative 

outcomes between patients that have undergone laparoscopic 

Nissen fundoplication (LNF) at high and low volume centers across North 

Carolina. 

Methods: This is a retrospective study using the North Carolina 

Hospital Association Patient Data System database. Selected patients 

include adults (>17 years old) that have undergone laparoscopic Nissen 

fundoplication for gastroesophageal reflux disease (GERD). Patients 

that underwent operative management for emergent purposes, or had 

associated diagnoses of esophageal cancer or achalasia were excluded 

from the study. High volume centers are defined as institutions that 

performed ten or more LNFs per year averaged over a period of four years. 

Comparative statistics are performed on a number of variables between 

high and low volume centers. 

Results: A total of 1019 patients underwent laparoscopic Nissen 

fundoplication for GERD in North Carolina between 2004 and 2008. High 

volume centers performed 530 LNFs (52%) while low volume centers 

performed 489 LNFs (48%). Patients at high volume centers were older 

(52.5 yo vs. 49.0 yo, p=0.019), had a higher incidence of diabetes (13.4% 

vs. 8.8%, p=0.026), chronic obstructive pulmonary disease (5.1% vs. 2 %, 

p=0.015), hyperlipidemia (9.6% vs. 4.7%, p=0.004) and cystic fibrosis (2.8% 

vs 0.8%, p=0.03). Patients with a history of transplantation were also more 

likely to undergo LNF at a high volume center (15.8% vs. 1.6%, p=3.1 x10- 

15). There were no deaths among the two groups and also no difference 

between median length of stay (2 days). Low volume centers had a higher 

incidence of intraoperative accidental puncture or laceration (3.3% vs. 

0.9%, p=0.017) while high volume centers had a higher incidence of 

pulmonary collapse (5.3% vs 2.5%, p=0.031). 


Conclusions: Patients undergoing LNF at high volume centers tend to be 

older and have more comorbidities than patients at low volume centers. 

Although there was a higher incidence of intraoperative accidental 

puncture or laceration among patients at the low volume centers, there 

was no difference between median length of stay and there was no 

associated mortality. Although patient selection and complications are 

different, overall outcomes are the same at high and low volume centers. 

P008 

102 CONSECUTIVE ROBOTIC ASSISTED MINIMALLY INVASIVE 

COLECTOMIES - AN OUTCOME AND TECHNICAL UPDATE Franziska 

Huettner, MD PhD, Paul E Pacheco, MD, Jamie L Doubet, RN BS, Michael 

J Ryan, MS, Danuta I Dynda, MD, David L Crawford, MD Division of 

Minimally Invasive Surgery, Department of Surgery, University of Illinois 

College of Medicine at Peoria 

Objective: The purpose of the study was to review 102 consecutive 

robotic-assisted laparoscopic colectomies at our institution. We evaluated 

the eight-year experience (2002–2009) of one minimally invasive surgery 

(MIS) fellowship trained surgeon using the da Vinci Telerobotic system. 

Colon procedures are 6th most commonly performed procedure of the 

senior author annually. 

Methods: An IRB approved retrospective review of prospectively 

collected data from 2002–2009 representing 102 colon operations 

was performed. Data analyzed were: procedure performed; indication 

for surgery; gender; age; body mass index (BMI); estimated blood loss 

(EBL); port setup time (PST); robot operating time (ROT); total case time 

(TCT); length of stay (LOS); complications; conversions; and resident 

involvement. Statistical Analysis using the Anova test was performed. 

The changes in technique and operative approach for right and sigmoid 

colectomy over the years were evaluated. The results were compared with 

the current literature. 

Results: One-hundred and two robotic colectomies, right (59) and 

sigmoid (43), were performed in 49 males and 53 females. Average patient 

age was 63.5 + 13.6 (22-86) years. Mean BMI was 27.4 + 4.3 (17.0-40.5) kg/ 

m². Preoperative indications included: polyps (53); diverticular disease 

(27); cancer (19); and carcinoid (3). Mean total operative time for all cases 

was 219.6 ± 45.1 (50-380) min, with a mean robot time of 126.6 + 41.6 

(12-306) min. Operative times for right colectomies were: PST 32.4 ± 10.5 

(20-64) min; ROT 145.2 ± 39.6 (53-306) min; and TCT 212.3 ± 46.4 (50-380) 

min. Times for sigmoid colectomies were: PST 31.2 ± 9.6 (10-57) min; ROT 

101.2 ± 29.2 (12-165) min; and TCT 229.7 ± 41.6 (147-323) min. Mean EBL 

for right colectomies was 58.6 + 80.8 (15-500) ml and 77.6 + 54.7 (15-250) 

ml for left colectomies. Overall median length of stay for all patients was 

3 days with a range of 2 to 27 days. Complications occurred in 19 patients 

with an overall complication rate of 18.6%. Nine cases were converted – 

four to laparoscopic and five to open for a total conversion rate of 8.8%. 

Anastomotic leak occurred in one patient (0.98%). Residents PGY levels 

1-5 participated in 61 cases (59.8%). 

Conclusion: We demonstrate with this series that robotic colectomy is 

safe and feasible. Procedural sequence and technical alterations have 

been made that have improved efficiency. Senior author experience has 

allowed resident participation to evolve to the level of primary surgeon 

in both procedures. Our results compare favorably with other series in 

the robotic literature. Resident participation is critical if we hope to bring 

robotic procedures into the mainstream of surgical practice. 

P009 

238 LAPAROSCOPIC LEFT-SIDE COLORECTAL SURGERIES WITH 

N.O.S.E.: A 10-YEAR EXPERIENCE WITH TRANSANAL SPECIMEN 

EXTRACTION Morris E Franklin, Jr, MD FACS, Song Liang, MD PHD The 

Texas Endosurgery Institute 

BACKGOUND AND OBJECTIVE: Natural Orifice Specimen Extraction 

(NOSE) has been postulated as an alternative approach to deliver 

the resected specimen out of peritoneal cavity through an anatomic 

passage rather than any abdominal incision after laparoscopic 

colorectal resections. This prospective study focused on the patients 

who underwent various laparoscopic left-side colorectal surgeries 

with intracorporeal anastomosis and transanal specimen extraction at


our institute in the past 10 years with the specific aim to investigate if 

transanal approach can be accepted as a safe and effective method for 

extracting the specimen from abdominal cavity in laparoscopic colorectal 

surgeries. 

METHODS: A prospectively designed database of a consecutive series 

of patients undergoing various laparoscopic colorectal surgeries with 

transanal specimen extraction for different left-side colonic as well 

rectal pathologies between April 1995 and May 2006 was analyzed 

on categories of age, gender, co-morbidities, preoperative diagnosis, 

indications for surgery, American Society of Anesthesiology Class, 

types of surgery, operating time, intraoperative blood loss, intra- and 

postoperative complications, tumor size, lymph node status, results of 

postoperative pathology, AJCC TMN Stage, length of hospitalization, 

cancer recurrence, and causes of death. Patient selection for laparoscopic 

colorectal surgeries with intracorporeal anastomosis and transanal 

specimen extraction was made on the basis of entities of diseases, size of 

the tumor, and distance of colorectal lesions to the anal verge. 

RESULTS: 238 various colorectal procedures including 6 left 

hemicolectomy (2.5%), 83 sigmoidectomy (34.9%), and 149 low anterior 

resection (62.6%) were completed laparoscopically with intracorporeal 

anastomosis (ICA) and transanal specimen extraction (TASE). The straight 

and circular surgical stapling devices including Endo-GIA and EEA were 

used to create anastomosis intracorporeally in all 238 laparoscopic 

colorectal resections. Pathological evaluation of all the surgical specimens 

demonstrated 167 malignant tumors with various AJCC TMN stages 

(70.2%) and 69 diverticulitis (29%). The operating time for laparoscopic 

colorectal resections with ICA and TASE was 157.3 +/- 51.4 minutes, blood 

loss during the surgeries was 96.8 +/- 76.5 ml, and distance from the lower 

edge of the lesion to the anal verge was measured to be 11.8+/- 8.2 cm. 

One patient developing postoperative anastomotic leakage with leak 

rate of 0.42%, and overall rate of major complications after the surgeries 

is 2.1%. The length of hospital stay was 6.9 +/- 2.8 days. 2-year followup 

showed the development of anal stenosis in 3 patients (2.0%) and 

erectile dysfunction in one patient (0.67%) after the procedures. Lastly 7 

out of 149 patients underwent laparoscopic low anterior resection with 

ICA and TASE were confirmed to have cancer recurrences with the 2-year 

local cancer recurrence rate of 4.7%, furthermore the patients having 

preopeative chemoradiation therapy had higher recurrence rate (11.3%) 

than that of the patients without (1.0%). 

CONCLUSIONS: As a bridge to NOTES, transanal specimen extraction in 

laparoscopic colorectal surgeries is a safe and effective approach with low 

local cancer recurrence and other long as well as short-term postoperative 

complication rates, suggesting it can be integrated into laparoscopic 

colorectal surgeries for left-side colorectal pathologies including cancer. 

More importantly, NOSE does not unnecessarily traumatize other 

normal organs. 

P010 

SINGLE-INCISION LAPAROSCOPIC COLECTOMY FOR COLON CANCER: 

EXPERIENCE OF 35 CASES Bac H Nguyen, PhD, Thinh H Nguyen, MD, Viet 

V Ung, MD University Medical Center at Ho Chi Minh City 

Objective: Single-port trans-umbilical laparoscopy has emerged as an 

attempt to further enhance cosmetic benefits and reduce morbidity 

of minimally invasive surgery. There were some reports about singleport 

laparoscopic colectomy in the world. However, this technique 

requires a specialized multichannel port for introducing laparoscope 

and articulating instruments. We present our preliminary experience of 

using conventional ports and straight instruments for performing singleincision 

laparoscopic colectomy (SILC). 

Methods: We inserted 3 ports (one 10-mm port and two 5-mm ports) at 

different places in midline through the 4cm umbilical incision. Using 450 

scope and conventional straight laparoscopic instruments, the dissection 

was performed in a medial-to-lateral fashion with extracorporeal 

anastomosis. This is a prospective study of consecutive 35 colon cancer 

patients who underwent SILC between May and September 2009. 

Results: There were 35 patients (16 males, 19 females); median age 59.1 

years. Right hemicolectomy was performed in 11 patients (31%), left 

hemicolectomy in 9 (26%), sigmoidectomy in 12 (34%), right and left 

colectomy for synchronous colon cancer in 2 (6%), left hemicolectomy 

and cholecystectomy in 1 (3%). The median operative time was 115 min 

(80-145). There was no conversion, no intraoperative complications or 

postoperative complications. The mean estimated blood loss was 10ml. 

All of patients had safe margin of resection. Overall morbidity rate was 

6.2%, with no significant difference between right hemicolectomy and left 

hemicolectomy or sigmoidectomy. The length of hospital stay was 5 days. 

Conclusions: Single-incision laparoscopic colectomy is technically feasible 

and safe. This technique may be an alternative for current specialized port 

and instruments. Greater numbers and a randomized controlled trial will 

be necessary to access the true benefit of this approach. 

P011 

SAFETY AND USEFULNESS OF LAPAROSCOPIC METHOD FOR 

TREATMENT OF PERITONITIS DUE TO ANASTOMOSIS SITE LEAKAGE 

AFTER RECTAL CANCER RESECTION Gyu-Seog Choi, MD, Kyoung- 

Hoon Lim, MD, Jun Seok Park, MD, You Seok Jang, MD, Soo-Han Jun, 

MD Department of Surgery, School of Medicine, Kyungpook National 

University, Daegu, Korea 

Introduction:In cases of peritonitis due to anastomosis site leakage 

after rectal cancer resection where surgical management was necessary, 

patients who have undergone open laparotomy and patients with 

laparoscopic exploration have been compared to determine safety and 

usefulness of laparoscopic method. 

Methods:Out of 1146 patients who have undergone rectal cancer 

resection excluding patients with AP, double primary maliganancy, 

preoerative ileostomy, and FAP, 97 patients who suffered anastomosis 

sited leakage have been compared and analyzed for peritonitis sx, 

operation method, operation time for second op, complication after 

operation, hospitalization time after second operation, and location of 

anastomosis. In case of open laparotomy, previous op wound was used, 

and in case of laparoscopy, only previous trocar sites were used, not mini 

laparotomy site. In reoperation, intra peritoneum irrigation was done in 

all patients, ileostomy was done in 47 patients, and 4 patients only did a 

simple closure without ileostomy. Of the 47 patients who had ileostomy, 

39 patients had only ileostomy, 6 patients had simple closure with 

ileostomy, and remaining 2 patients had reanastomosis with ileostomy. 

Results: Of the total 1146 patients, 97 patients had anastomosis site 

leakage, and 51 patients had peritonitis symptom requiring intra 

peritoneal irrigation. Patients who previously had open surgery 

done open laparotomy for reoperation, patients who previously had 

laparoscopic surgery done laparoscopy for reoperation. 21 patients 

had laparoscopy, 30 patients had open laparotomy. There were no 

difference in age, sex ration, or anastomosis location between two 

groups. Hospitalization time after reoperation in laparoscopy group 

was noticeably shorter than that of open laparotomy group (16.3±10.9 

days vs. 33.4 ± 19.7 days, p



P012 

INDICATIONS, COMPLICATIONS AND LONG TERM OUTCOMES OF 

REMNANT GASTRECTOMY FOR GASTRO-GASTRIC FISTULA AFTER 

DIVIDED ROUX-EN-Y GASTRIC BYPASS FOR MORBID OBESITY Emeka 

Acholonu, Jeremy Eckstein, Sheetal Patel, Wasef Abu-Jaish, Samuel 

Szomstein, Raul Rosenthal Cleveland Clinic Florida 

Background: GGF is a rare complication after divided RYGBP for morbid 

obesity. Medical management has proved grossly ineffective. Less 

invasive methods like fibrin glue and sealants via an endoscopic approach 

have been reported with recurrence rates as high as 75 %. 

Method: After IRB approval and following HIPAA guidelines, we 

retrospectively analyzed our prospectively collected database for 2226 

patients that underwent LRG for GGF after divided RYGBP between April 

2001 and September 2008. RYGB divided were completed over this period 

as well as referred cases from outside institutions. The procedure entails 

dissecting out the pouch and remnant stomach, stapling off the GGF and 

transecting the remnant stomach at the antrum. A total of 60 cases were 

completed. Our patients were followed up 10 days, 2 months, 6 months 

and yearly after discharge. 

Results: There were 51 females (85%) and 9 males (15%). The age range 

was between 25 and 68 (average 45), the BMI ranged between 20 and 

58.7 (average 36.3).The most common indication for the procedure was 

pain, other indications include recurrent or persistent ulcers, weight 

regain, upper gastrointestinal bleed, intractable nausea and vomiting. 

10 (17%) of the procedures were converted to open. We did not regard 

conversion as a complication but as a judgment call, opting for safer 

treatment. There was a 15% complication rate (9 patients) and the most 

common complication was leakage from staple lines. Our cumulative long 

term outcome suggests most patients were satisfied with the results. 4 

patients (7%) complained of persistent unexplained pain. There has been 

no recurrence and there has been no mortality. 

Conclusions: LRG seems to be a safe, feasible and reliable option to 

treat GGF after divided RYGB, with significant relief of symptoms and 

acceptable perioperative morbidity. 

P013 

NEEDLESCOPIC SURGERY: THE COSMETIC ALTERNATIVE TO SILS Morris 

E Franklin, MD, Karla Russek, MD, Jojy George, MD Texas Endosurgery 

Institute 

Introduction: Minimally invasive procedures have revolutionized the 

art of surgical practice. Laparoscopic cholecystectomy (LC) is the gold 

standard for management of gall bladder disease. In an attempt to further 

improve on the benefits of the standard multiple incision LC, less invasive 

methods have been described, including smaller incisions, fewer incisions, 

and use of single incisions. Needlescopic cholecystectomy (NC) utilizes 2 

or 3 mm instruments and has been shown to provide improved cosmesis. 

Single incision is a newer approach to cholecystectomy, with theoretical 

advantage of improved cosmesis and reduced postoperative wound 

complications. 

Methods: All 404 operations at TEI were done by a single surgeon from 

1995-2008. 86% of subjects were female, and average age of all subjects 

was 41.9 years (range 14-82). Average BMI was 25.7 (range 16.4 -39.2). 

19.6 % of patients had previous abdominal surgery. Ultrasound findings 

most commonly was cholelithiasis; no patients had preoperative imaging 

indicating common duct stones, and only one patient was found to 

have a dilated (>1cm) CBD on preoperative ultrasound. We performed 

intraoperative cholangiograms on all patients regardless of preoperative 

diagnosis, laboratory values or ultrasound findings. 

Results: Only once was a CBD stone found on cholangiogram, and a 

CBDE, stone extraction and T-Tube placement was performed. Average 

operating time was 59.3 minutes (range 30- 200). One 200 minute 

operation required laparoscopic CBDE, accounting for the extended time. 

Average estimated intraoperative blood loss (EBL) was < 15 cc ( range 

0-50cc). 2% of cases required conversion to standard 5 mm LC and was 

completed without incident. Since 1995, only one patient presented with 

a hernia at the umbilical site. Otherwise, no wound, bile duct, bile leaks, 

bleeding complications or hernias have been identified. 


Conclusion: We propose that NC currently provides a better cosmetic 

result over standard LC and SILS cholecystectomy, with fewer theoretical 

and actual wound and hernia complications. 

P014 

ROLE OF INTERLEUKIN-6 (IL-6) IN THE GROWTH OF CT26 COLORECTAL 

CANCER IN A MURINE MODEL Melissa A Donigan, BS, Heidi Bahna, 

MD, Bryan D Loh, MD, Laurie S Norcross, MD, John Aversa, DO, Paul 

R Williamson, MD, Samuel DeJesus, MD, Andrea Ferrara, MD, Joseph 

T Gallagher, MD, Cheryl H Baker, PhD M. D. Anderson Cancer Center 

Orlando, University of Central Florida, Colon and Rectal Clinic of Orlando, 

Orlando Regional Medical Center 

PURPOSE: This study is designed to investigate the role of surgeryinduced 

levels of cytokines in affecting proliferation and migration of 

colon cancer cells. Clinical standards in the management of colon cancer 

and surgery-related differences in various cytokines have been predicted 

to correlate with the degree of trauma afflicted during surgery, ultimately 

impacting tumor growth and metastasis. Laparoscopic surgery is thought 

to stimulate less of an acute cytokine (IL-1β, TNF-α, IL-6) response 

than open surgery, thereby preserving normal immune function. The 

significance of the surgery-related differences in these cytokines may 

correlate with the degree of anterior abdominal wall trauma. 

METHODS: Murine colon cancer CT26 cells were incubated in the 

absence or presence of 1-10 uM recombinant mouse IL-6. Protein 

expression of IL-6 and its receptor (IL-6R) was measured and the cell 

proliferation/cell viability and migration was monitored by in vitro 

biological assays. In the first set of in vivo studies, non-tumor bearing 

Balb/c mice and Balb/c mice injected subcutaneously with CT26 cells 

received an open or laparoscopic surgery (LAS). Serum levels of IL-6 

were measured at 30 minutes, 2 hrs, 4 hrs, 6 hrs, 12 hrs, 24 hrs, and 48 

hrs following surgery. In a second set of murine studies, 10 Balb/c mice 

received either an intraperitoneal (i.p.) or a subcutaneous (s.c.) injection of 

1500 ng of recombinant mouse IL-6 immediately following s.c. injections 

of CT26 cells. Tumor growth was monitored by caliper measurements 

every three days for twenty-one days. Tumor-bearing mice that did not 

receive IL-6 injections served as controls. 

RESULTS: Colon cancer CT26 cells growing in vitro express low levels of 

IL-6 and IL-6R. CT26 cell proliferation and migration was not significantly 

increased in the presence of recombinant IL-6. There is a significant 

decrease in tumor take, size and volume of subcutaneously growing CT26 

cells in mice which received LAS surgery as compared to mice which 

received an open surgery, and control mice (no surgery). IL-6 levels in the 

open group peaked at 8 hours; in sharp contrast, IL-6 peaked in the LAS 

group at 4 hours. Interestingly, the peak (at their respective hours) in the 

open surgery group was significantly greater as compared to the LAS 

group. By 48 hours, the IL-6 levels for both groups normalized to baseline 

levels. Additionally, i.p. injection (and not the s.c. injection) of IL-6 into 

mice caused the most significant increase in tumor growth. 

CONCLUSION: These data suggest that surgery-induced (and not tumorderived) 

serum levels of IL-6 may play a crucial role in the in vivo growth 

of colon cancer. Understanding the differential effects of open versus 

laparoscopic surgery on the growth of colon cancer may significantly 

impact the immediate and long-term prognosis of colon cancer patients. 

P015 

LAPAROSCOPIC LIVER SURGERY IN CANCER PATIENTS-EXPERIENCE AT 

A NATIONAL CANCER INSTITUTE Ronald Matteotti, MD, John Hoffman, 

MD, Elie Chouillard, MD, Veeraiah Siripurapu, MD, Andrew Gumbs, MD 

FOX CHASE CANCER CENTER, Philadelphia-PA, USA 

Introduction: The oncological adequacy and safety of major liver 

resections is still uncertain. The aim of this retrospective analysis was to 

compare intraoperative data with final pathology and short-term clinical 

outcome. 

Methods:Patients undergoing laparoscopic liver surgery were 

retrospectively analysed using our tumor registry. Surgical and 

postsurgical outcomes were compared with final pathology. The data 

were statistically analyzed using ANOVA and Fisher’s Exact test. 

Results: Forty-nine consecutive liver procedures by a single surgeon


were analyzed, of which 47 were attempted and 45 (96%) completed 

laparoscopically. Mean age was 62, mean BMI 27, average ASA was 

2. Fifteen underwent major resections (31%), 27 minor resections 

(56%) 7 (13%) underwent either an ablation or liver biopsy. The major 

hepatectomy group constituted of 5 laparoscopic left hepatectomies 

(33%), 10 right hepatectomies of which 8 were completed 

laparoscopically (80%). 95% of patients underwent additional procedures 

such as adhesiolysis, ablation or an additional wedge resection. In 4 

(9%) patients we encountered intraoperative complications, 2 required 

conversion. Our overall conversion rate was 4% and the reason for 

conversion was major bleeding from the parenchyma in one case, an 

IVC injury in another case, requiring a staged procedure. Two patients 

had diaphragm injuries that were repaired laparoscopically, the second 

patient also had an injury to the IVC that was repaired laparoscopcally. 

Twenty-two percent had a postoperative complication, mainly DVT, 

one pulmonary embolism, and ileus. We only encountered one postoperative 

bile leak. Lymph node dissection in the hepatoduodenal 

ligament was only necessary in 19% of the patients (n=9). We never used 

portal clamping and a drain was only placed in 19% of the patients (n=9). 

Preoperative embolization before major resections was done in 4% of the 

patients. Mean EBL was 403 cc, Mean operative time was 259 min. 

n Mean EBL Mean OR time 

Major resection 15 1000 cc 383 min 

Minor resection 27 90 cc 120 min 

Intraoperative obtained frozen sections were positive in 27% requiring 

re-resection during the same surgery. Thirty-six patients were given a 

diagnosis of malignancy upon final pathology. Margins were positive in 

1 (2%) patient. In 29 patients we were dealing with stage 4 disease, n=21 

being colorectal cancer metastatic to the liver. 

Size (mm) Volume (cc) Weight (gr) Distance tumor to margin (mm) 

111 925 605 14 

The mean hospital stay was 4.8 days. Thirty-day mortality was 0%. Four 

patients required intraoperative blood transfusion of 2 units of pRBCs. 

Infectious complications during hospital stay was only seen in n=1, an 

intra-abdominal abscess, requiring drainage by interventional radiology. 

Conclusions: Laparoscopic liver surgery at a major cancer center is safe, 

feasible and does not translate into more complications intraoperatively 

or postoperatively. Mean hospital stay, short term mortality are 

comparable to similar series in the literature, reporting open procedures. 

Most important, a laparoscopic approach does not violate oncological 

principles intraoperatively, tumor visualization is excellent and adequate 

margins can be obtained. Long-term follow up data will be needed to 

compare laparoscopy to an open approach in terms of survival and 

quality of life. 

P016 

IS SURGERY A BETTER OPTION AS FIRST LINE TREATMENT 

FOR ACHALASIA?: A COMPARISON OF LAPAROSCOPIC 

ESOPHAGOMYOTOMY WITH FUNDOPLICATION AND ENDOSCOPIC 

DILATION Jason F Reynoso, MD, Manish M Tiwari, MD PhD MPH, Albert 

W Tsang, MD, Dmitry Oleynikov, MD Department of Surgery, University of 

Nebraska Medical Center 

INTRODUCTION: Recent studies have shown laparoscopic 

esophagomyotomy with fundoplication (LM) to have superior long-term 

symptom relief and low rates of post-operative gastroesophageal reflux 

when compared to endoscopic dilation (ED). This study evaluates the 

morbidity, mortality and cost of treating achalasia with LM versus ED. 

METHODS: The University HealthSystem Consortium (UHC) is an alliance 

of more than 100 academic medical centers and nearly 200 affiliate 

hospitals. UHC’s Clinical Data Base / Resource Manager (CDB/RM) allows 

member hospitals to compare patient-level risk-adjusted outcomes for 

performance improvement purposes. The CDB/RM was queried using 

ICD-9 diagnosis and procedural codes for patients with achalasia who 

underwent LM (N=1,390) or ED (N=492) during a 37 month period 

between January 2006 and January 2009. Overall comorbidity, mortality, 

readmission rates, hospital cost and specific complications are assessed in 

this multicenter, retrospective study. 

RESULTS: Overall esophageal perforation rates for LM and ED were 0.4% 

and 2.4% (p



laparoscopic study task as well as the more expert groups because of 

prior specific training on this task as part of their curriculum. However, 

their performance declined dramatically when confronted with the 

challenges of the single port task. These results strongly suggest a role for 

systematic lab-based single port training prior to clinical application, as is 

now done for conventional laparoscopy. 

P018 

ONCOLOGIC AND PERIOPERATIVE OUTCOMES OF LAPAROSCOPIC 

ASSISTED VS HAND-ASSISSTED VS OPEN RESECTIONS FOR 

RECTAL CANCER RESECTION: A CASE MATCH STUDY. PORNTHAPE 

PRATHANVANICH, JIRAWAT Pattana_arun, CHUCHEEP Sahakitrungruang, 

PUTTARAT Atithansakul, ARUN Rojanasakul CHULALONGKORN 

UNIVERSITY 

Purpose: Advances in surgical techniques and improvements in 

laparoscopic instruments have enabled most colorectal procedures to be 

performed by using the laparoscopic approach.Laparoscopic surgery of 

colon cancer has been accepted to be oncologically adequate compared 

with open resection.However,the situation in rectal cancer remains 

unclear,because anatomy and complex surgical procedures.There have 

been only a few reports compare Laparoscopic assisted vs Hand-Assissted 

vs Open resections for rectal cancer resection. 

This study is designed to analyze oncologic and perioperative outcomes 

for selected patients;match by staging who undergoing in these three 

access of surgery. 

Methods: A total of 114 patients with rectal cancer,who underwent 

surgery by the same surgical team(2006-2008) are prospectively 

analyzed;by select the same staging.38 patients are choosen in each 

group. 

One-way ANOVA,Pearson’s chi-square and Fisher’sExact test are used to 

compare differences in demographics and perioperative parameters. 

Results: Each groups are comparable regarding age,gender,tumor 

localization,and complications.Each groups have 2/upper,6/middle,30/ 

low rectal cancer and 5/stage 0,3/stage I,13/stage IIA,3/stage IIIA,9/stage 

IIIB, 4/stage IIIC,1/stage IV. No mortality occurred in either group.Mean 

operative times are not difference significantly between open and HALS 

group(276 min/open vs 263 min/HALS, p = 0.546).But difference are found 

in these both groups with laparoscopic surgery(344 min/lap , p=0.002 

and 0.000 respectively).Not difference significantly are found in first 

bowel movement between minimal invasive surgery(2.5 day/lap vs 1.9 

day/ HALS , p = 0.128),but difference with open group(3.5 day/ open , p = 

0.02 and 0.00 respectively).The mean tumor size is 4.5 cm/open, 3.6 cm/ 

lap and 4.2 cm/HALS.The mean tumor-free margin is 1.6 cm/open,1.8 cm/ 

lap and 2.3 cm/HALS group. And the mean number of harvested lymph 

nodes is 19.4 /open, 17.5 /lap and 17.6 /HALS group. No wound recurrene 

is observed. 

Conclusions: Minimal invasive surgery is equivalent with conventional 

surgery in the treatment of rectal cancer and shows advantages of faster 

recovery. Especially in patients with low rectal cancer,minimally invasive 

surgery with exact preparation of the total mesorectal excision seems to 

be favorable compared with open access surgery. 

P019 

“INCISIONLESS” LAPAROSCOPIC PROCTECTOMY: AN IDEAL NATURAL 

ORIFICE AND LAPAROSCOPIC SURGERY HYBRID John Marks, MD, Radu 

Nedelcoviciu, MD, Eileen Larkin, BA, Albert DeNittis, MD, Gerald Marks, 

MD Lankenau Hospital and Institute for Medical Research: Section of 


Introduction: To evaluate the safety and efficacy of laparoscopic 

proctectomy with per-anal delivery of the specimen for rectal cancer, 

avoiding an incision for specimen extraction while accomplishing 

sphincter preservation we review our experience. 

Methods: Between 2001 and 2009, in a prospective database, 51 patients 

with invasive adenocarcinoma of the rectum underwent laparoscopic 

total mesorectal excision (TME) with delivery of the specimen transanally 

without the need for an additional incision to remove the specimen. 

Patients undergoing APR were excluded. Demographics were as follows: 

men=33, women=18, mean level in the rectum=1.5 cm (-0.5-5.0 cm). 

Pretreatment T stage was T1=1, T2=11, T3=39. Mean size of cancer was 4.2 

cm (2-10 cm). Fixity of the tumor was: mobile=33, tethered=15, fixed=2. 

Patients receiving chemotherapy: N=44. Mean radiation dose was 5385 

(4500-8040cGy). Mean BMI=26.2 (17.4-47.5). 

Results: Mean follow up was 21.2 months (1.4-80.3 months). There were 

no perioperative mortalities. There were no laparoscopic conversions. 

Mean EBL was 302 cc (75-1900cc). Transfusion rate was 2.0%. The mean 

size for the largest incision was 1.9cm (1.2-3cm). The mean total length 

of all incisions was 4.6cm (1.8-8cm). All patients were protected with 

a temporary stoma. Overall morbidity rate was 31%, major morbidity 

rate was 5.8% and included pelvic abscess N=2, fistula N=1. Pathology 

was complete response = 21%. ypT stage : T0=11, T1=8, T2=17, T3=15. 

ypN positive=15; ypN negative=36. Local Recurrence rate (LR) was 2.0%. 

One patient had a positive margin, undergoing subsequently an APR. 

Permanent 5 year stoma rate was 86%. 

Conclusion: For distal rectal cancer in need of a coloanal anastomosis, 

“incisionless” laparoscopic TME using the natural orifice, per-anal route for 

specimen delivery is a safe and accomplishable technique with good early 

oncologic results. Long term follow up and multi-institutional studies will 

be required to establish the widespread applicability of this promising 

technique. 

P020 

COLORECTAL CANCER RISK REDUCTION IN INFLAMMATORY BOWEL 

DISEASE WITH AMINOSALICYLATE THERAPY: A META-ANALYSIS 

AND COMPARISON TO COLORECTAL CANCER RISK IN THE GENERAL 

POPULATION Omer Nasir, MD, Amit Kaul, MD, Tejwant Datta, MD, 

Maryanne Franco, M Gilson, MD, Michael Marohn, DO, Hien Nguyen, MD 

Johns Hopkins University School of Medicine 

Background: Worldwide, the incidence rates for inflammatory bowel 

disease (IBD) vary from 0.5 to 24.5 per 100,000 people (0.012%). It has 

been estimated that the risk of CRC in IBD patients increases by 0.5% 

per year after eight years of the disease. Many recent studies proposed 

aminosalicylates as chemopreventive agents for colorectal cancer (CRC) 

development in IBD. 

Objectives: The aim of the present study is to conduct a meta-analysis to 

evaluate CRC incidence rate reduction with the use of aminosalicylates 

in patients with IBD, and to compare it to CRC incidence in the general 

population. 

Methods: The PUBMED engine was utilized to search for relevant 

literature by use of specific search criteria and experts consult was sought 

where appropriate. All papers were scrutinized for 1) total sample size, 2) 

defined exposure to aminosalicylates, 3) total number of exposed and unexposed 

groups, and 4) CRC outcomes. 

Results: Three case-control studies from Europe satisfied our inclusion 

criteria, containing 236 cases of CRC and a total of 775 subjects 

(performed between the years 1965 and 2001). CRC incidence in patients 

not on aminosalicylates therapy was averaged to be 1.89%, while patients 

on aminosalicylates therapy had an average incidence of 0.67%. The 

European, age-adjusted CRC incidence rate was estimated to be 0.05%. 

Conclusion: Collective analysis showed a significant link between 

aminosalicylates and CRC incidence rates among IBD patients treated 

with aminosalicylates, compared to non-exposed IBD population. Pooled 

results of these studies support a three-fold reduction in CRC incidence 

in the treated IBD population. This reduction continues to approach a 

general population CRC incidence rate. 

However, these studies presented pre-immunomodulator therapy data. 

Moreover, publications continue to report varying degrees of benefit. 

Further studies, particularly in the United States, including prospective 

trials and cost-effectiveness analyses, need to be performed to develop 

an optimal strategy for the reduction of cancer risk in patients with IBD, as 

well as clarifying the synergistic role of immunomodulator therapy with 

anti-inflammatory treatment in reducing CRC risk. 



P021 

CONVENTIONAL 4-PORT LAPAROSCOPIC CHOLECYSTECTOMY 

VERSUS SILS PORT LAPAROSCOPIC CHOLECYSTECTOMY- EARLY 

RESULTS OF THE FIRST PROSPECTIVE RANDOMIZED SHAM 

CONTROLLED TRIAL Jeffrey Marks, MD, Raymond Onders, MD, George 

DeNoto, MD, Berry Paraskeva, PhD, Homero Rivas, MD, Kurt Roberts, MD, 

Alexander Rosemurgy, MD, Sajani Shah, MD, Nathaniel Soper, MD, Roberto 

Tacchino, MD University Hospitals Case Medical Center, North Shore 

University Hospital, Imperial College of London, UT Southwestern Medical 

Center, Yale New Haven Medical Center, Tampa General Hospital, Tufts 

Medical Center, Northwestern Memorial Hospital, Catholic U 

Introduction: Laparoscopic surgery through a single incision (SILS) 

aims to enhance the benefits of conventional minimally invasive surgery 

by reducing the number of required surgical incisions. To date, SILS 

has been utilized to accomplish cholecystectomy, gastric banding, 

Nissen fundoplication, appendectomy, nephrectomy, tubal ligation, 

gastric bypass, right colectomy, sleeve gastrectomy, and numerous 

other procedures. The initial experience with SILS suggests that it 

is technically feasible and safe and may offer select advantages over 

standard laparoscopic approaches. This is a preliminary report of an ongoing 

multi-institutional study which we believe is the first prospective 

randomized sham controlled trial, aimed at objectively analyzing the 

safety and efficacy of SILS Cholecystectomy. 

Methods: The study is designed to randomize 200 patients in a 3:2 SILS 

cholecystectomy vs conventional 4 port laparoscopic cholecystectomy 

(“4PLC”) ratio at 9 centers. All patients, regardless of randomized 

procedure, receive 4 bandages at conventional locations to achieve a 

sham design. Patients are blinded until the bandages are removed after 

completion of the 1 week pain evaluation. Patients are contacted by 

phone on days 1,3, and 5. Patients are seen in follow up at 1,2, 4, 12, and 

52 weeks post-operatively. Pain intensity numerical rating scale(PI-NRS), 

SF-8, and body image scoring are performed at each followup. In addition, 

analgesic usage, surgical complications, hernia development, and 

wound complications are recorded. Primary endpoints include feasibility, 

operative time, and EBL. Secondary endpoints include pain, cosmesis, 

and quality of life. 

Preliminary Results: Between April 2009 and September 2009 twenty 

five (25) patients, 15 SILS and 10 4PLC, have been enrolled and have 

completed their 1 month follow-up visit. No significant adverse events 

have occurred. One SILS case was converted to a 4PLC secondary 

to adhesions. The mean operative time (54.9 minutes for SILS vs. 51.5 

minutes for 4PLC) and mean intra-operative blood loss (16.2 ml vs. 

13.8 ml) have trended similar between groups. The postoperative Pain 

Intensity Numerical scores at various time points are trending similar 

between groups at all time points. Cosmesis was evaluated utilizing three 

questionnaires at 1 month follow-up. Patient derived body image data 

indicates a positive trend for SILS versus 4PLC. 68% of the total patient 

population would have SILS if they had to have the procedure again. 

Conclusion: In this prospective randomized sham controlled trial, early 

results are trending towards showing that SILS is a safe and effective 

procedure with select cosmetic advantages over conventional 4-port 

laparoscopic cholecystectomy. It is understood that the these are early 

results of a small patient population. On-going enrollment and follow-up 

will permit a more robust scientific analysis. 

P022 

COLON RESECTIONS IN AN ERA OF NONAGENARIANS: NSQIP 

PREDICTORS OF MORTALITY Dan Ruiz, MD, Alexander Kraev, MD, 

Darshak Shah, MD, Allapagan W Annamalai, MD, James W Turner, MD, 

Howard Tiszenkel, MD New York Hospital Queens 

BACKGROUND: Nonagenarians are a growing population often viewed 

as high-risk surgical candidates. This study aims to review mortality and 

predictors of adverse outcome in nonagenarians undergoing colon 

resection.The National Surgical Quality Improvement Project (NSQIP) 

database was used for the analysis. 

METHODS: The 2005-2008 NSQIP databases were reviewed for all 

patients over ninety years old who underwent colon resection. Logistic 

regression and then multi-iteration logistic regression analysis was used 

to identify univariate and multivariate predictors of mortality. 

RESULTS: The study evaluated 766 patients over ninety years old who 

underwent colon resection between years of 2005 and 2008. Overall 

mortality was 11.6%. Significant univariate predictors of mortality 

were: dyspnea at rest (p-value 0.014), having DNR order (p-value .005), 

history of angina (p-value 0.032), history of peripheral vascular disease 

(p-value .006), impaired sensorium (p-value .018), sepsis (p-value .008), 

septic shock (p-value .032), SIRS (p-value .022), and BUN (p-value .027). 

Risk adjusted multivariable predictors of mortality were dyspnea at rest 

(p-value .0205), having DNR order (p-value of .0091), history of peripheral 

vascular disease (p-value .0317), sepsis (p-value


2010 Poster Listing 


P023 LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS WITH PRIMARY 

REPAIR FOR SYMPTOMATIC GIANT PARAESOPHAGEAL HERNIA IN 

MORBID OBESITY: KILLING TWO BIRDS WITH ONE STONE George 

Kasotakis, MD, Ranjan Sudan, MD, Sumeet Mittal, MD, Creighton 

University Medical Center, Omaha, NE; Duke Health Center, Durham, NC 

P024 WANDERING SPLEEN AFTER ROUX-EN-Y GASTRIC BYPASS Ziad y 

Fayad, MD, Ryan Hashem, Piotr Gorecki, MD, New York Methodist Hospital 

P025 LAPAROSCOPIC APPROACH TO REVISIONAL BARIATRIC 

SURGERY David M Lauter, MD, Troy P Houseworth, MD, Karen Baumann, 

RN, Institute for Laparoscopic Surgery, Overlake Hospital Medical Center 

P026 COMPUTED TOMOGRAPHY GUIDED PERCUTANEOUS 

GASTROSTOMY FOR MANAGEMENT OF ACUTE GASTRIC REMNANT 

LEAK FOLLOWING ROUX EN Y GASTRIC BYPASS Shahzeer Karmali, 

MD FRCSC, Daniel W Birch, MD FRCSC FACS, Vadim Sherman, MD FRCSC 

FACS, University of Alberta, Baylor College of Medicine 

P027 LAPAROSCOPIC GASTRIC BYPASS IN 1,692 PATIENTS. 

Constantine T Frantzides, MD PhD FACS, Atul Madan, MD, George 

Ayiomamitis, MD, Jennifer R Glover, MD, John Zografakis, MD FACS, 

Chicago Institute of Minimally Invasive Surgery 

P028 NINE STEPS TO FOLLOW FOR SAFE AND STANDARD APPROACH 

FOR LAPROSCOPIC PARAESOPHAGEAL HERNIA REPAIR. Ismael 

Court, Omar Bellorin, Samuel Szomstein, Raul Rosenthal, Cleveland 


P029 IS THERE AN OPTIMAL GASTRIC BAND STOMA SIZE? John O’Dea, 

BE MED PhD CEng FIEI, Robert G Snow, FACOS, Crospon, Galway, Ireland; 

Specialty Surgery Center of Fort Worth, TX 

P030 ANCHORLESS, SUTURELESS PLACEMENT OF ADJUSTABLE 

GASTRIC BAND PORT FOR CONSISTENT, RELIABLE EASY PER- 

CUTANEOUS ACCESS. Philippe J Quilici, MD FACS, Alexander Tovar, MD, 

Carie McVay, MD, Providence St. Joseph Medical Center, Burbank. Cedars 

Sinai Medical Center, Los Angeles 

P031 SCLEROTHERAPY TREATMENT FOR WEIGHT GAIN WITH DILATED 

GASTRO-JEJUNOSTOMY FOLLOWING ROUX EN Y GASTRIC BYPASS: 

HOW MANY TREATMENTS? Mario P Morales, MD, J Stephen Scott, MD, 

Roger A de la Torre, MD, SSM DePaul Weight Loss Institute 

P032 IMPROVEMENTS IN OBESITY-RELATED CO-MORBIDITIES 

FOLLOWING BARIATRIC PROCEDURES IN CHINESE POPULATION 

Dennis Wong, FRACS, Kenneth Chau, MBBS, Cliff Chung, FRCS, Michael 

Li, FRCS, PAMELA YOUDE NETHERSOLE EASTERN HOSPITAL 

P033 GASTRIC POUCH DILATION VERSUS SLIPPED BAND: AN 

IMPORTANT DISTINCTION Daniel W Birch, MSc MD, Farzan Ali, MD, 

Shahzeer Karmali, MD, CAMIS, Royal Alexandra Hospital, University of 

Alberta 

P034 BARIATRIC SURGERY SIGNIFICANTLY IMPROVES BODY 

PROPORTION James B Wooldridge, MD, Khoi Du, MD, Laura Periou, RD, 

William S Richardson, MD, Ochsner Medical Center 

P035 COULD EARLY STRICTURE AFTER LAPAROSCOPIC GASTRIC 

BYPASS BE A RESULT OF SURGICAL TECHNIQUE, ANALYSIS OF 1760 

PATIENTS? I Hamdallah, MD, C David, MD, M Singh, MD, A Averbach, 

MD, K Singh, MD, Saint Agnes Hospital 

P036 MICROLAPAROSCOPIC GASTRIC BYPASS IS AS SAFE A 

TRADITIONAL LAPAROSCOPIC GASTRIC BYPASS Keith A Zuccala, 

MD, Laura H Choi, MD, Pierre F Saldinger, MD, Department of surgery, 

Danbury Hospital, Danbury, CT 06810 

P037 THE USE OF ONDANSETRON (ZOFRAN®) TO RELIEVE 

POSTOPERATIVE NAUSEA AND VOMITING AFTER INTRAGASTRIC 

BALLOON PLACEMENT: A RANDOMIZED CONTROLLED TRIAL Simon 

K.H. Wong, Dr, Wilfred LM Mui, Dr, Enders KW Ng, Dr, Prince of Wales 

Hosiptal, The Chinese University of Hong Kong 

P038 LAPAROSCOPIC SLEEVE GASTRECTOMY IN TYPE II DIABETIC 

PATIENTS; PROMISING EARLY RESULTS S N Wiebe, MD, D Klassen, MD, 

J Bonjer, MD, D Lawlor, RN, J Plowman, BSc, T Ransom, MD, M Vallis, PhD, 

J Ellsmere, MD, Departments of General Surgery and Medicine, Queen 

Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada 

P039 RESULTS OF LAPAROSCOPIC SLEEVE GASTRECTOMY Shahram 

Nazari, Dr, Semira Mousavi Khosroshahi, Dr, Hosain Khedmat, Dr, Erfan 

Hospital, Department of General and Laparoscopic surgery 

P040 LAPAROSCOPIC ROUX-EN- Y GASTRIC BYPASS(LRYGB) AND 

ADJUSTABLE GASTRIC BANDING(LAGB) FOR MORBIDLY OBESE 

PATIENTS IN KOREA : A SERIES OF 204 CASES Hong Lee, MD, Ho Youn, 

MD, Jun Lee, Eung Kim, MD, St. Mary’s Hospital, The Catholic University 

of Korea 

P041 IS THE SUB-LINGUAL ANALGESIC ROUTE OVERLOOKED IN THE 

POST-OPERATIVE BARIATRIC PATIENT Susannah M Wyles, MBBS MSc 

MRCS, M Harry Thompson, MBBS, Catherine Bradshaw, MBBS, Ahmed 

R Ahmed, BSc FRCS, Jonathan Cousins, BSc FRCA, Imperial College 

Healthcare London 

P042 BODY COMPOSITION: EARLY CHANGES AFTER WEIGHT LOSS 

INDUCED BY LAPAROSCOPIC GASTRIC BYPASS. R H Clements, MD, 

N Saraf, MPH, M Kakade, MPH, M White, RN, J Hackett, RN, Division 

of Gastrointestinal Surgery, University of Alabama at Birmingham, 

Birmingham, AL 

P043 SAGB TUBE INFECTION MIMICING ACUTE APPENDICITIS AFTER 

TUBE DECONECTION DUE TO INJECTION PORTE INFECTION – A CASE 

REPORT Toni Kolak, MD PhD, Josip Bakovic, MD, Igor Stipancic, MD PhD, 

Marijan Kolovrat, MD, Antonela Radic, MD, University hospital Dubrava; 

Department of colorectal surgery 

P044 A PROPOSED CLASSIFICATION SYSTEM FOR GASTRIC POUCH 

ENLARGEMENT ASSOCIATED WITH LAPAROSCOPICALLY PLACED 

ADJUSTABLE GASTRIC BANDS Bradley F Schwack, MD, Jeffrey q Allen, 

MD, Norton Healthcare 

P045 INTEGRATED BIOABSORBABLE TISSUE REINFORCEMENT IN 

LAPAROSCOPIC SLEEVE GASTRECTOMY Joshua B Alley, MD, Richard 

M Peterson, MD MPH, Michael Harnisch, MD, Stephen J Fenton, MD, San 

Antonio Military Medical Center, Lackland AFB / Fort Sam Houston, TX 

P046 LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS USING 3 PORTS 

TECHNIQUE FOR TREATMENT OF MORBID OBESITY Haider A Al- 

Shurafa, MD, Abdullah Al-Masood, MD, Ali S Al-Mutairi, MD, Riyadh 

Military Hospiatl 

P047 TECHNIQUES FOR CLOSURE OF COMMON ENTEROTOMY OF 

THE JEJUNOJEJUNOSTOMY DURING GASTRIC BYPASS DETERMINES 

DEGREE OF ALIMENTARY LIMB NARROWING. Meena Theva, BS, 

Donald T Hess, MD, Brian Carmine, MD, Miguel Burch, MD, Boston 

University School of Medicine 

P048 COMPARISON OF STAPLE-LINE LEAKAGE AND HEMORRHAGE 

IN PATIENTS UNDERGOING LAPAROSCOPIC SLEEVE GASTRECTOMY 

WITH OR WITHOUT THE USE OF BIOABSORBABLE SEAMGUARD ® 

Todd E Simon, DO, Joshua A Scott, MD, Joel R Brockmeyer, MD, Farah A 

Husain, MD, Jim D Frizzi, MD, Yong U Choi, MD, Department of General 

Surgery, D.D. Eisenhower Army Medical Center, Ft. Gordon, GA 

P049 CO-MORBIDITIES RECUR WITH WEIGHT REGAIN AFTER INITIAL 

RESOLUTION POST-GASTRIC BYPASS Mohammed R Salabat, MD, 

Woody Denham, MD, Steven Haggerty, MD, Michael B Ujiki, NorthShore 

University Health System 

P050 OUTCOME ANALYSIS OF 100 PATIENTS UNDERGOING SINGLE- 

INCISION LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING Gary S 

Schwartz, MD, Scott B Gmora, MD, Kevin McGill, MD, Deva Boone, MD, 

Justin D Blasberg, MD, Steven J Binenbaum, MD, Glenn J Forrester, MD, 

Scott J Belsley, MD, Julio A Teixeira, MD, St. Luke’s-Roosevelt Hospital 

Center, Columbia University College of Physicians and Surgeons 

P051 THE METABOLIC IMPACT OF BARIATRIC SURGERY: LESSONS 

LEARNED Gary S Schwartz, MD, Scott B Gmora, MD, Kevin McGill, 

MD, James J McGinty, MD, Scott J Belsley, MD, Laferrere B, MD, Julio A 

Teixeira, MD, St. Luke’s-Roosevelt Hospital Center, Columbia University 

College of Physicians and Surgeons 

P052 THE UTILITY OF LAPAROSCOPIC TRANSGASTRIC ACCESS IN THE 

ASSESSMENT AND TREATMENT OF THE GASTRIC BYPASS PATIENT 

Ursula D McMillian, MD, Keith Zuccala, MD, Danbury Hospital 




P053 IS EXTENDED POST-OPERATIVE MONITORING NECESSARY FOR 

MORBIDLY OBESE PATIENTS WITH OBSTRUCTIVE SLEEP APNEA 

UNDERGOING BARIATRIC SURGERY? Racquel S Bueno, MD FACS, Chan 

Park, MD, Edward Lam, Kenric Murayama, MD FACS, Cedric Lorenzo, MD, 

University of Hawaii, Queen’s Medical Center 

P054 PROGRESSIVE RESISTANCE TRAINING TO IMPROVE STRENGTH, 

FITNESS AND METABOLIC HEALTH IN WEIGHT LOSS SURGERY 

PATIENTS Jamie D Adair, MD, Samuel B Wollner, BA, Daniel B Jones, MD, 

Renee Miciek, MS, Benjamin Schneider, MD, George L Blackburn, MD 

PhD, Beth Israel Deaconess Hospital, Harvard Medical School 

P055 LAPAROSCOPIC SLEEVE GASTRECTOMY (SG) IMPROVES 

INSULIN SECRETION AND SENSITIVITY IN TYPE 2 DIABETIC OBESE 

PATIENTS Frida Leonetti, Danila Capoccia, Federica Coccia, Cristina 

Maglio, Francesca Abbatini, Paola Mariani, Nicola Basso, Policlinico 

“Umberto I”, University “Sapienza” 

P056 LAPAROSCOPIC PLICATION OF A GASTROJEJUNOSTOMY WITH 

ENDOSCOPIC GUIDANCE IN THE PORCINE MODEL Connie J Rossini, 

MD, Viriato M Fiallo, MD, Burritt L Haag, MD, Department of Surgery, 

Baystate Medical Center / Tufts University School of Medicine 

P057 DOES GENDER AFFECT EXCESS WEIGHT LOSS AFTER WEIGHT 

LOSS SURGERY? Maher El Chaar, MD, TImothy Kuwada, MD, Dimitrios 

Stefanidis, MD PhD, Keith Gersin, MD, Carolinas Medical Center 

P058 SILS PORT BARIATRIC SURGERY Ali Fardoun, MD, Fawaz Torab, Phd 

Associate Professor, Tawam Hospital 

P059 SILS, DILS AND THRILLS: AN EVALUATION OF SINGLE INCISION 

SURGERY IN LAPAROSCOPIC GASTRIC BANDING. P Ayoung-Chee, 

MD, H Hoang, MD, F Colonna, RN, C Magallanes, RN, G Rosario, RNP, A 

Finger, RPA, C Ren-Fielding, MD, G Fielding, MD, M Kurian, MD, NYU 

P060 DIAPHRAGMATIC HERNIATION OF GASTRIC REMNANT: RARE 

COMPLICATION Mohamed I Dahman, MD, Peter T Hallowell, MD, 

Bruce D Schirmer, MD, Department of Surgery, University of Virginia, 

Charlottesville, VA, USA 

P061 T2DM AND SLEEVE GASTRECTOMY : DIABETES DURATION AS 

PROGNOSTIC FACTOR OF CURE Giovanni Casella, Giorgio Alessandri, 

Francesca Abbatini, Mario Rizzello, Emanuele Soricelli, Danila Capoccia, 

Nicola Basso, Policlinico “Umberto I”, Università “Sapienza” 

P062 UNBUCKLING: A NEW TWO-STAGED APPROACH TO 

SYMPTOMATIC SLIPPAGE OF LAPAROSCOPIC ADJUSTABLE GASTRIC 

BANDS (LAGB) Eric A Sommer, MD, Amit Trivedi, MD, Douglas Ewing, 

MD, Garth Ballantyne, MD, Hans Schmidt, MD, Hackensack University 


P063 LAPAROSCOPIC SLEEVE GASTRECTOMY (LSG) IN MORBIDLY 

OBESE – AN EARLY ASSESSMENT OF SAFETY AND EFFICACY Manish 

Singh, MD, Riny Karras, MD, Javeed Khan, MD, Kuldeep Singh, FACS, 

Andrew Averbach, FACS, Steve C David, MD, Saint Agnes Hospital , 

Baltimore, MD 

P064 ROUTINE DRAIN PLACEMENT IN ROUX-EN-Y GASTRIC BYPASS: 

AN EXPANDED RETROSPECTIVE COMPARATIVE STUDY OF 755 

PATIENTS. Srinivas Kavuturu, MD, Daniel C Williams, MD, Randy s 

Haluck, MD, Timothy R Shope, MD, Ann M Rogers, MD, Penn State Milton 

S Hershey Medical Center 

P065 BARIATRIC SURGERY OUTCOMES FOR PATIENTS UNDERGOING 

PREOPERATIVE IVC FILTER PLACEMENT Tejwant S Datta, MD, 

Kimberley Steele, MD, Andrew D Shore, PhD, Thomas Magnuson, MD, 

Anne O Lidor, MD, Hien Nguyen, MD, Martin Makary, MD, Michael 

Schweitzer, MD, Johns Hopkins University School of Medicine 

P066 SUTURE LINE LEAKS AFTER LAPAROSCOPIC SLEEVE 

GASTRECTOMY : DIFFICULTIES OF MANAGEMENT MIGHT BE 

UNDERESTIMATED. Manish Singh, MD, Javeed Khan, MD, Nicholas c 

Tapazoglou, MD, Kuldeep Singh, FACS, Andrew Averbach, FACS, Steve c 

David, MD, Saint Agnes Hospital , Baltimore, MD 

P067 IS LAPAROSCOPIC SLEEVE GASTRECTOMY MORE SAFE AND 

EFFICACIOUS THAN LAPAROSCOPIC GASTRIC BANDING ? : A 

SHORT TERM REVIEW Manish Singh, MD, Nicholas s Tapazoglou, MD, 

Javeed Khan, MD, Steve c David, MD, Kuldeep Singh, FACS, Andrew 

Averbach, FACS, Saint Agnes Hospital , Baltimore, MD 

P068 REVIEW OF RYGB VERSUS FUNDOPLICATION FOR GERD IN 

OBESE PATIENTS M Cavaretta, MD, K Chinnappan, MD, J Gabrielsen, 

title, A Petrick, MD, Geisinger Medical Center 

P069 A NOVEL APPROACH TO FAILED VERTICAL BANDED 

GASTROPLASTY: LAPAROSCOPIC CONVERSION TO SLEEVE 

GASTRECTOMY John A Primomo, MD, Candace Y Williams-Covington, 

MD, Shazeer Karmali, MD, Vadim Sherman, MD, Baylor College of 

Medicine 

P070 GEOGRAPHICAL VARIATION IN INPATIENT MORTALITY AND 

LENGTH OF STAY AFTER LAPAROSCOPIC GASTRIC BYPASS Jennifer 

E Foster, MD, Sharon E Phillips, MSPH, D. Brandon Williams, MD, Michael 

D Holzman, MD MPH, Willie V Melvin, MD, Kristy L Kummerow, BS, 

Julia Shelton, MD, Benjamin K Poulose, MD MPH, Vanderbilt University 


P071 FORCED GASTRIC WALL EROSION AND STAGED REMOVAL OF 

NONADJUSTABLE GASTRIC BANDS – A CASE SERIES Kanayochukwu 

J Aluka, MD, Todd D Wilson, MD, Brad E Snyder, MD, Sherman Yu, MD, 

Erik B Wilson, MD, University of Texas Health Science Center Houston, 

Houston, Texas 

P072 FEASIBILITY OF SIMULTANEOUS HIATAL HERNIA (HH) REPAIR 

AND LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING (LAGB): 

CASE-IN-POINT PRESENTATION FOR PREVENTION OF DELAYED 

COMPLICATIONS. Gustavo Franco, MD, Murad Bani Hani, MD, Andrew 

Averbach, MD FACS, Saint Agnes Hospital. Baltimore, MD. USA. 

P073 DOES THE PATIENT CHOICE OF THE TYPE WEIGHT LOSS 

SURGERY AFFECT THE AMOUNT OF WEIGHT LOSS ACHIEVED 

PREOPERATIVELY ? Maher El Chaar, MD, Dimitrios Stefanidis, MD PhD, 

Keith Gersin, MD, Gray Hughes, MD, Timothy Kuwada, MD, Carolinas 

Medical Center, Division of Minimally Invasive Surgery and Bariatrics 

P074 CREATION OF A UNIVERSAL HEALTH SCORE Todd A Worley, MD, 

Brad E Snyder, MD, Kanayochukwu J Aluka, MD, Todd D Wilson, MD, Erik 

B Wilson, MD, University of Texas Health Science Center at Houston 

P075 DOES GASTRIC BYPASS RESOLVE CARDIAC COMORBIDITIES 

EQUALLY FOR THE OBESE VS SUPER OBESE? Eric Changchieng, MD, 

Gavitt A Woodard, BS, Sarah Miri, MD, Tina H Boussard, PhD, John M 

Morton, MD MPH, Stanford University 

P076 A SMALL POUCH LAPAROSCOPIC ADJUSTABLE GASTRIC 

BAND (HIGH BAND) IS ASSOCIATED WITH A LOWER INCIDENCE OF 

COMPLICATIONS. MIDTERM ANALYSIS OF 132 PATIENTS. Niazy M 

Selim, MD MBChB PhD FACS, Iris Dupanovic, University of Kansas 

P077 THE IMPACT OF PREVIOUS FUNDOPLICATION ON 

LAPAROSCOPIC GASTRIC BYPASS OUTCOMES Anna Ibele, MD, 

Michael Garren, MD, Jon Gould, MD, University of Wisconsin School of 

Medicine and Public Health, Department of Surgery 

P078 SINGLE PORT ACCESS FOR LAPAROSCOPIC ADJUSTABLE 

GASTRIC BANDING WITH REGULAR LAPAROSCOPIC INSTRUMENTS 

IS FEASIBLE AND ECONOMIC. Niazy M Selim, MD MBChB PhD FACS, 

University of Kansas 

P079 A COMBINED LAPRASCOPIC AND ENDOSCOPIC TECHNIQUE TO 

EVALUATE GASTRIC REMNANT AFTER GASTRIC BYPASS Neeraj Singh, 

MD, Artun Aksade, MD FACS, Easton Hospital, EAston,PA-18042 

P080 THE ASSOCIATION BETWEEN GERD AND LAPAROSCOPIC SLEEVE 

GASTRECTOMY Patrice R Carter, MD, Karl A LeBlanc, MD FACS, Mark 

G Hausmann, MD FACS, Kenneth P Kleinpeter, MD, Minimally Invasive 

Surgery Institute - The Surgeon’s Group of Baton Rouge 

P081 PATIENT PERCEPTIONS OF BAND ADJUSTMENTS AFTER 

LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING Atul K Madan, 

MD, David S Tichansky, MD, Beverly Hills Surgery Center and Thomas 

Jefferson University 






P082 LAPAROSCOPIC CHOLECYSTECTOMY ASSOCIATED WITH 

GASTRIC BYPASS SURGERY: A SAFE APPROACH FOR MORBID 

OBESITY PATIENTS? Carlos Alberto Lopera Ramírez, Jesús Vásquez 

Arango, Jean Pierre Vergnaud Córdoba, Sergio Díaz Rodríguez, Carmelo 

Díaz Pájaro, Universidad de Antioquia 

P083 GANGLIONEUROMA OF THE ADRENAL GLAND AND 

RETROPERITONEUM. A REPORT OF UNUSUAL CASE AND REVIEW 

OF THE LITERATURE Iswanto Sucandy, MD, Yasir M Akmal, MD, Joseph 

A Blansfield, MD, David G Sheldon, MD, William E Strodel, Geisinger 

Health System 

P084 THERMAL TISSUE FUSION: INTERACTION OF CONTROL 

PARAMETERS AND TISSUE EFFECTS Deogracias A Reyes, MD MMAS, 

Luisa Motta, MD, Lynda Cochrane, PhD, Chengli I Song, PhD, Stuart I 

Brown, PhD, Alfred Cuschieri, Prof, University of Dundee 

P085 THORACOSCOPIC SYMPATHETIC NERVE BLOCKING UNDER 

LOCAL ANESTHESIA WITH MAC: 114 CASES REPORT Shaohong Guo, 

MD, Jingjing Wang, Department of General Surgery,BenQHospital, 

Nanjing Medical University 

P086 CHOLECYSTECTOMY BY MICROLAPAROTOMY-AS THE 

PRECURSOR OF SINGLE INCISION LAPAROSCOPIC SURGERY- 

COMPARING TO STANDARD LAPAROSCOPIC CHOLECYSTECTOMY 

(IN HONOUR OF TWO HUNGARIAN SURGEONS) Istvan Gal, MD PhD, 

Zoltan Szabo, PhD, Miklos Czobel, MD, Gyorgy Weber, MD PhD, Telki 

International Private Hospital, Budapest-Telki,Hungary, M.O.E.T. Institute 

San Francisco, CA, USA, University of Szeged,Faculty of Medicine, 

Department of Surgery, Department of Surgical Research and Technique 

University Medical School of Pécs 

P087 CREATION OF A SLEEVE GASTRECTOMY MOUSE MODEL: A NEW 

TOOL IN THE EVALUATION OF THE BETA CELL PROLIFERATION AND 

GLUCOSE TOLERANCE EFFECTS OF BARIATRIC SURGERY Avraham 

Schlager, MD, Abed Khalaileh, MD, Seth Salpeter, Yuval Dor, PhD, Gideon 

Zamir, MD, New York University Medical Center, Hadassah-Hebrew 


P088 HUMAN VITAL AMNIOTIC MEMBRANE REDUCES ADHESIONS TO 

A POLYPROPYLENE MESH AND SUTURE FIXATION IN EXPERIMENTAL 

IPOM REPAIR IN RATS Alexander H Petter-Puchner, MD, René H 

Fortelny, MD, Simone Gruber-Blum, MD, Kathrin Mika, MD, Simone 

Hennerbichler, PhD, Heinz Redl, Prof, Ludwig Boltzmann Institute for 

Experimental and Clinical Traumatology, Vienna, Austria 

P089 ANALYSIS OF TISSUE DAMAGE CAUSED BY ULTRASONICALLY 

ACTIVATED DEVICE FOR LAPAROSCOPIC SURGERIES Hideki Hayashi, 

MD, Naomi Hioki, BA, Masaru Oya, MA, Tadashi Yamaguchi, PhD, 

Hiroyuki Hachiya, MD PhD, Toshiyuki Natsume, MD, Hiroshi Kawahira, 

MD, Hisahiro Matsubara, MD, Research Center for Frontier Medical 

Engineering, Chiba University, Chiba, Japan. 

P090 EMERGENCY SURGERY FOR COLONIC DIVERTICULITIS: 

DIFFERENCES BETWEEN RIGHT-SIDED AND LEFT-SIDED DISEASE IN 

AN ASIAN POPULATION Ker-Kan Tan, Jody Z Liu, Richard Sim, Tan Tock 

Seng Hospital, Singapore 

P091 INCISIONLESS LAPAROSCOPIC SURGERY FOR COLORECTAL 

CANCER ~HYBRID NOTES TECHNIQUE APPLIED TO TRADITIONAL 

LAPAROSCOPIC COLORECTAL RESECTION~ Goutaro Katsuno, MD 

PhD, Masaki Fukunaga, MD PhD, Hidenori Tsumura, MD PhD, Kunihiko 

Nagakari, MD PhD, Masahiko Sugano, MD PhD, Yoshifumi Lee, MD PhD, 

Shuichi Sakamoto, MD PhD, Masaru Suda, MD PhD, Yoshito Iida, MD 

PhD, Seiichiro Yoshikawa, MD PhD, Department of Surgery Juntendo 

Urayasu Hospital/Juntendo University 

P092 POST COLONOSCOPY COLONIC INTUSSUSCEPTION REDUCED 

VIA A LAPAROSCOPIC APPROACH: A CASE REPORT Mindy M Ho, MD, 

John J Park, MD, Leela M Prasad, MD, Metropolitan Group Hospitals 

General Surgery Residency, Lutheran General Hospital 

P093 LAPAROSCOPIC-ASSISTED RECTAL SURGERY USING THE SIMPLE 

RECTUM CATCHER DEVICE Akiyo Matsumoto, Kaida Arita, Masaki 

Tashiro, Hidenori Takahashi, Masaru Sugimoto, Junichi Kuramochi, 

Shinsuke Usui, Koji Ito, Noriaki Takiguchi, Susumu Hiranuma, Katsuhiro 

Sanada, Department of Surgery, Tsuchiura Kyodo General Hospital 

P094 LESS INVASIVE SURGERY ON THE PATIENTS WITH SEVERE 

CONSTIPATION INCLUDIING THE SPLENIC FLEXURE TYPE 

Hirotsugu Ohara, Yasuhiko Masuda, Fujieda Heisei Memorial Hospital 

P095 WHEN STAPLERS MISFIRE: ENDOSCOPIC RESCUE OF THE LOW 

PELVIC ANASTOMOSIS Rebecca A Levine, MD, Omar Kadro, MD, William 

Beaumont Hospital 

P096 TOTAL LAPAROSCOPIC REPAIR OF FOREIGN BODY 

PERFORATION OF JEJUNUM Floyd Herman, MD MSc, Nimitt Patel, MD, 

Marco Yung, MD MPH, Derick Christian, MD, St. Francis Medical Center, 

Seton Hall University School of Graduate Medical Education 

P097 3DCT NAVIGATION FOR SINGLE UMBILICAL INCISION 

LAPAROSCOPIC APPENDECTOMY Keiichi Fujino, MD PhD, Minoru 

Kakihara, MD PhD, Tamio Yamasaki, MD PhD, Hidekazu Yano, MD, 

Tonami Sato, MD, Hironori Tsujimoto, MD PhD, Takemaru Tanimizu, MD 

PhD, Nobuo Kugai, MD PhD, Department of General Medicine, National 

Defense Medical College Hospital, Japan 

P098 DOES THE RATIO OF LYMPH NODE HAS A NOTABLE 

PROGNOSTIC FACTOR ON THE SURVIVAL OF PATIENTS WITH STAGE 

III COLORECTAL CANCER Sezai Demirbas, MD, Nail Ersöz, MD, Ismail 

H Ozerhan, MD, Gokhan Yagci, MD, Mustafa T Ozer, MD, Ali Harlak, MD, 

Saadettin Cetiner, Prof Dr, Gulhane Mil. Medical Academy (GMMA) 

P099 CIRCULAR STAPLED TRANSANAL RECTAL RESECTION, A 

USEFUL TECHNIQUE IN TREATING RECTAL INTUSSUSCEPTION AND 

RECTOCELE. OUR EXPERIENCE OF A SINGLE CENTER WITH 23 CASES. 

Shahram Nazari, Dr, Semira Mousavi Khosroshahi, Dr, Omid Tahbaz, Dr, 

M. Towliat kashani, Dr, Ahmad Fanaie, Dr, Erfan Hospital, Department of 

General and Laparoscopic surgery 

P100 GASTROINTESTINAL BLEEDING IN HIV PATIENTS (5 YR STUDY) 

- A PARADIGM SHIFT IN THE ETIOLOGY Srinivas Kavuturu, MD, 

Anterpreet Singh, Daniel Farkas, MD, Vellore Parithivel, MD, John 

M Cosgrove, MD, Bronx Lebanon Hospital Center, Bronx, New York 

NY10457 

P101 SYNCHRONOUS APPENDICITIS AND UMBILICAL HERNIAL 

METASTASIS FROM CECAL ADENOCARCINOMA Shankar R Raman, 

MD MRCS, V Vattipally, MD, Daniel Farkas, MD FACS, John Cosgrove, MD 

FACS, Bronx-Lebanon Hospital Center 

P102 MINIMALLY INVASIVE MANAGEMENT OF JEJUNAL 

PERFORATION DUE TO ACCIDENTAL INGESTION OF KEBAB STICK IN 

INTOXICATED MORBIDLY OBESE PERSON Bala Thatigotla, MD, Vikram 

Vattipally, MD, Daniel Farkas, MDFACS, John M Cosgrove, MDFACS, Bronx 

Lebanon Hospital Center,Bronx,NY 10457,USA 

P103 SINGLE INCISION LAPAROSCOPIC COLECTOMY FOR NEOPLASMS 

OF THE COLON Michiya Kobayashi, MD PhD, Ken Dabanaka, MD, Ken 

Okamoto, MD PhD, Tsutomu Namikawa, MD PhD, Kazuhiro Hanazaki, 

MD PhD, Department of Human Health and Medical Sciences, Hospital 

Administration Section, Kochi Medical School 

P104 LAPAROSCOPIC COLECTOMY WITH RADICAL LYMPH NODE 

DISSECTION FOR TRANSVERSE COLON CANCER Yosuke Fukunaga, 

MD, Masao Kameyama, MD, Masayasu Kawasaki, MD, Hiroshi Sonoo, 

MD, Masashi Takemura, MD, Yushi Fujiwara, MD, Nagahisa Fjujio, MD, 

Masao Ogawa, MD, Koichi Demura, MD, Keiichi Yamazaki, MD, Tsuyoshi 

Ichikawa, MD, Tomoyuki Ueki, MD, Atsuo Ima, Bell-land General Hospital 

P105 FULL THICKNESS ENDOSCOPIC EXCISION OF A 3 CM 

LEIOMYOMA WITH ENDOCLIP REPAIR: A CASE REPORT. Amy L Levin, 

MD, Christine M Bouchard, MD, John J Park, MD, Advocate Lutheran 

General Hospital, Park Ridge, Illinois 




P106 MANTLE CELL LYMPHOMA OF THE GASTROINTESTINAL TRACT 

PRESENTING WITH MULTIPLE INTUSSUSCEPTIONS – CASE REPORT 

AND REVIEW OF LITERATURE Venkata K Kella, Radu Constantine, John 

M Cosgrove, Department of Surgery and Oncology, Bronx-Lebanon 

Hospital Center, Bronx, New York, USA 

P107 AN UNUSUAL CASE OF INTUSSUSCEPTION MASQUERADING AS 

RECTAL PROLAPSE. Phil V Bach, BSc, Daniel W Birch, MD, University of 

Alberta 

P108 UPDATED RESULTS OF DOUBLE TA TRANSECTION METHOD 

IN THE LAPAROSCOPE-ASSISTED ANTERIOR RESECTION OF THE 

RECTUM Fumihiro Uchikoshi, MD PhD, Yuko Yamagami, MD, Takahiko 

Tatsumi, MD PhD, Department of Surgery, Tatsumi clinic & Hospital 

P109 DOES AN ENLARGED EXTRACTION SITE AFFECT 

POSTOPERATIVE OUTCOMES AFTER LAPAROSCOPICALLY 

COMPLETED INTESTINAL RESECTION FOR CROHN’S DISEASE? 

Matteo Rottoli, MD, Luca Stocchi, MD, Daniel P Geisler, MD, Cleveland 

Clinic Foundation 

P110 PREOPERATIVE CHEMORADIATION FOLLOWED BY 

LAPAROSCOPIC INTERSPHINCTERIC RESECTION FOR LOW RECTAL 

CANCER Masanori Nishioka, Mitsuo Shimada, Nobuhiro Kurita, 

Takashi Iwata, Shinya Morimoto, Kozo Yoshikawa, Jun Higashijima, The 

University of Tokushima 

P111 COMPARISON OF SHORT TERM & LONG TERM FUNCTIONAL 

OUTCOMES AFTER LAPAROSCOPIC VS OPEN SURGERY FOR 

ULCERATIVE COLITIS – RESTORATIVE PROCTOCOLECTOMY ILEAL 

POUCH ANAL ANASTOMOSIS Haribhakti S P, MS DNB MCh, Soni H N, M 

S, Nagpal A P, MS, Haribhakti Surgical Hospital, Ahmedabad, India 

P112 A NEW STRATEGY FOR ADHESIVE BOWEL OBSTRUCTON USING 

LAPAROSCOPIC SURGERY AND BIOABSORBABLE MEMBRANE 

Hiroyuki Nagayama, MD, Yasuo Ishida, MD, Sumito Satou, MD, 

Junichi Ooga, MD, Toshiyuki Hatakeyama, MD, Department of 

surgery,Yokohama Asahi Central General Hospital 

P113 DGHAL WITH RECTO-ANAL-REPAIR MODIFICATION: 

FUNCTIONAL EVALUATION AND SAFETY ASSESSMENT OF A NEW 

MINIMALLY-INVASIVE METHOD OF TREATMENT OF ADVANCED 

HEMORRHOIDAL DISEASE. Piotr Walega, MD PhD, Michal Romaniszyn, 

MD, Jakub Kenig, MD PhD, Piotr Richter, MD PhD, Roman Herman, Prof, 

Wojciech Nowak, Prof, 3 rd Department of General Surgery, Jagiellonian 

University School of Medicine, Krakow, Poland 

P114 DEFINING MEASUREMENTS OF THE ILEOCOLIC AND INFERIOR 

MESENTERIC VESSELS BY CONTRAST-ENHANCED CT: IMPLICATIONS 

FOR VASCULAR PEDICLE LIGATION DURING COLECTOMY Jennifer D 

Rea, MD, Brent J Bose, MD, Nora Dobos, MD, Molly M Cone, MD, Karen 

E Deveney, MD, Kim C Lu, MD, Daniel O Herzig, MD, Oregon Health & 

Science University 

P115 DOES THE PRESENCE OF LAPAROSCOPIC COLORECTAL SURGERY 

CAPABILITY REFLECT GREATER PRESENCE OF OTHER HOSPITAL- 

LEVEL STRUCTURES OF CARE? Rahima N Nenshi, MD MSc, Binu Jacob, 

MSc, Kennedy Erin, MD PhD, Nancy Baxter, MD PhD, Rinku Sutradhar, 

PhD, David R Urbach, MD MSc, Department of Surgery, University Health 

Network 

P116 RISK FACTORS FOR ANASTOMOTIC LEAKAGAE AFTER 

LAPAROSCOPIC SURGERY FOR RECTOSIGMOIDAL AND RECTAL 

CANCER USING STAPLING TECHNIQUE Shin Fujita, MD, Takayuki 

Akasu, MD, Tomoya Funada, MD, Yoshihiro Moriya, MD, Seiichiro 

Yamamoto, MD PhD, National Cancer Center Hospital 

P117 LAPAROSCOPIC SURGERY IN COLORECTAL CANCERS: 

EXPERIENCE WITH 118 PATIENTS AT SINGLE INSTITUTION Shigeoki 

Hayashi, MD PhD, Minoru Matsuda, MD FACS, Motoo Yamagata, MD 

PhD, Ken Hagiwara, MD, Junko Sugiyama, MD, Tomoaki Takasugi, MD, 

Tadatoshi Takayama, MD PhD, Department of Digestive Surgery, Nihon 

University School of Medicine, Tokyo, Japan 

P118 FULL THICKNESS LAPAROENDOSCOPIC EXCISION (FLEX) 

PROCEDURE FOR LESIONS OF THE COLON AND STOMACH- A NOVEL 

TECHNIQUE Robin H Kennedy, MD, Ronan A Cahill, MD, Paul D Sibbons, 

FIBMS PhD, Chris Fraser, MD, St Marks Hospital, Harrow, UK; Oxford 

Radcliffe Hospitals, Oxford, UK, Northwick Park Biomedical Institution, 

Harrow UK. 

P119 LAPAROSCOPIC ANTERIOR RESECTION FOR RECTAL CANCER; A 

PROSPECTIVE FEASIBILITY STUDY Masafumi Inomata, MD, Yoshitake 

Ueda, MD, Manabu Togigamori, MD, Tsuyoshi Etoh, MD, Kazuhiro 

Yasuda, MD, Tsuyoshi Noguchi, MD, Norio Shiraishi,, MD, Seigo Kitano, 

Oita University Faculty of Medicine 

P120 LAPAROSCOPIC SURGERY FOR DUKES C COLORECTAL CANCER 

Takeshi Naitoh, MD, Atsushi Oyama, MD, Takashi Tsuchiya, MD, Hiroshi 

Honda, MD, Masaya Oikawa, MD, Tetsuya Kakita, MD, Department of 

Surgery, Sendai City Medical Center 

P121 TOTALLY LAPAROSCOPIC RIGHT HEMICOLECTOMY FOR CANCER 

Jordan B Lazarevic, MD, Vladimir Stajic, MD, Ivan Popovic, MD, City 

Hospital Valjevo 

P122 LAPAROSCOPIC HARTMAN’S COLOSTOMY REVERSAL Mohan 

Narasimhan, Kumar Palaniappan, Ramesh Ardhanari, Department of 

Surgery and Gastroenterology, Meenakshi Mission Hospital & Research 

Center, Madurai 

P123 STAPLED TRANSANAL RECTAL RESECTION (STARR) FOR 

OBSTRUCTIVE DEFECATION SYNDROME – A PROSPECTIVE STUDY 

WITH 6 MONTHS FOLLOW UP Brij B Agarwal, MS, Kumar Manish, 

MBBS, Rathindra Sarangi, MS, Krishan C Mahajan, FRCS, Dr. Agarwal’s 

Surgery & Yoga and Sir Ganga Ram Hospital, New Delhi, India 

P124 OUR EXPERIENCE OF TRANS UMBILICAL LAPAROSCOPIC 

APPENDECTOMY. Ibrahim Ahmed, FRCSI, Ibraheem Tunau, FRCSI, 

Elnazier Ibrahim, FRCSI, Alexander Lockley, MBCh, Thomas McEnery, 

Mohamed Salama, FRCSI, Vijaya Selvaraju, Our Lady’s Hospital, Navan, 

Ireland 

P125 SINGLE INCISION LAPAROSCOPIC COLECTOMY (SILC) FOR 

COLON CANCER Jun-ichi Tanaka, MD PhD, Gumpei Yoshimatsu, MD, 

Shunpei Mukai, MD, Kuniyasu Horikoshi, MD, Tomokatsu Omoto, 

MD, Shungo Endo, MD, Fumio Ishida, MD, Shin-ei Kudo, MD, Showa 

University Northern Yokohama Hospital 

P126 – Withdrawn. 

P127 EFFECT OF PRE-OPERATIVE RECTAL PREPARATION BY 

DIFFERENT METHODS ON OPERATIVE AND CLINICAL OUTCOMES 

OF STAPLED HEMORRHOIDOPEXY – A RANDOMIZED CONTROLLED 

STUDY Brij B Agarwal, MS, Kumar Manish, MBBS, Tapish Sahu, MBBS, 

Rathindra Sarangi, MS, Krishan C Mahajan, FRCS, Dr. Agarwal’s Surgery & 

Yoga and Sir Ganga Ram Hospital, New Delhi, India 

P128 IS MECHANICAL BOWEL PREPARATION NECESSARY FOR 

LAPAROSCOPIC COLON SURGERY Alex J Ky, MD, Ray Wong, MD, Erin 

Ly, BA, Mt Sinai Hospital 

P129 LAPAROSCOPIC SURGERY FOR COLONIC PERFORATION. 

ANALYSIS OF THREE CASES. Miguel J Garcia-Oria, MD PhD, Jose A 

Gazo, MD, Eduardo San Pio, MD, Jesus Merello, MD, Hospital Sanitas La 

Moraleja 

P130 SINGLE INCISION LAPAROSCOPIC SURGERY FOR RIGHT 

COLON PROCEDURES: A PROSPECTIVE ANALYSIS OF OUR INITIAL 

EXPERIENCE Maher El Chaar, MD, Gray Hughes, MD, Timothy Kuwada, 

MD, carolinas Medical Center, Division of Minimally Invasive Surgery 

P131 LAPAROSCOPIC TOTAL MESORECTAL EXCISION FOR MIDDLE 

AND LOW RECTAL ADENOCARCINOMA WITH OR WITHOUT 

SPHINCTER PRESERVATION: A PROSPECTIVE STUDY Elie K Chouillard, 

MD, Aziz Karaa, MD, Ziad Elrassi, MD, Andrew A Gumbs, Poissy Medical 

Center (France), Clinique de l’Yvette (France) and Fox Chase Cancer 

Center (USA) 






P132 COMPARISON OF SHORT-TERM AND LONG-TERM OUTCOMES 

OF THE COLON-LIFTING METHOD AND STANDARD 5-PORTS 

LAPAROSCOPIC COLECTOMY FOR COLORECTAL CANCER: A CASE- 

MATCHED CONTROL STUDY Shoichi Fujii, MD PhD, Shigeru Yamagishi, 

MD PhD, Mitsuyoshi Ota, MD PhD, Yasushi Ichikawa, MD PhD, Shunichi 

Osada, MD PhD, Kazuteru Watanabe, MD PhD, Hirokazu Suwa, MD, Kenji 

Tatsumi, MD PhD, Yasuhiko Nagano, MD PhD, Takashi Oshima, MD PhD, 

Chikara Kunisaki, Prof, Department of Surgery, Gastroenterological 

Center, Yokohama City University 

P133 ONCOLOGICAL OUTCOME OF STAGE II/III COLON CANCER 

TREATED VIA MINILAPAROTOMY APPROACH Hideyuki Ishida, PhD, 

Toru Ishiguro, MD, Tomonori Ohsawa, MD, Norimichi Okada, PhD, 

Keiichiro Ishibashi, PhD, Norihiro Haga, PhD, Department of Digestive 

Tract and General Surgery, Saitama Medical Center, Saitama Medical 

School 

P134 PATTERN OF ARTERIAL BRANCHES CROSSING THE SUPERIOR 

MESENTERIC VEIN: ITS RELEVANCE TO LAPAROSCOPIC RIGHT 

HEMICOLECTOMY Tomonori Ohsawa, MD, Toru Ishiguro, MD, Keiichiro 

Ishibashi, PhD, Hideyuki Ishida, phD, Department of Digestive Tract and 

General Surgery, Saitama Medical Center, Saitama Medical School 

P135 ONE HEM-O-LOK CLIP IS ENOUGH TO SECURE THE BASE OF 

APPENDIX DURING LAPAROSCOPIC APPENDECTOMY. Samir 

Delibegovic, Ass Prof PhD, Department of surgery, University Clinci 

Center Tuzla 

P136 PELVIC PERITONIZATION AFTER LAPAROSCOPIC 

ABDOMINOPERINEAL RESECTION FOR LOW-RECTAL CARCINOMA 

Nikica Druzijanic, MD PhD, Zdravko Perko, MD PhD, Zenon Pogorelic, MD 

PhD, Damir Kraljevic, MD, Josko Juricic, MD, Kanito Bilan, MD, Dragan 

Krnic, MD, Department of surgery, University Hospital Split, Spinciceva 1, 

21000 Split, Croatia 

P137 SHORT-TERM RESULTS OF LAPAROSCOPIC INTERSPHINCTERIC 

RESECTION FOR VERY LOW RECTAL CANCER Masaaki Ito, MD, Yusuke 

Nishizawa, MD, Akihiro Kobayashi, Masanori Sugito, MD, Norio Saito, 

MD, Ntional Cancer Center Hospital East 

P138 EMERGENCY LAPAROSCOPIC COLORECTAL SURGERY— IS THE 

PAIN WORTH THE GAIN? Jim Khan, FRCS, Karim Muhammad, FRCS, Anil 

Hemandas, FRCS, Emma McGlone, Karen Flashman, BSc, Amjad Parvaiz, 

FRCS, Queen ALexandra Hospital, Portsmouth, UK 

P139 PROSPECTIVE COMPARISON OF SHORT-TERM OUTCOMES 

FOLLOWING LAPAROSCOPIC AND OPEN TOTAL MESORECTAL 

EXCISION FOR RECTAL CANCER Anil Hemandas, FRCS, Karim 

Muhammad, FRCS, Karen Flashman, BSc, Jim Khan, FRCS, Asha Senapati, 

FRCS, Daniel O’Leary, FRCS, Amjad Parvaiz, FRCS, Queen Alexandra 

Hospital, Portsmouth, UK. 

P140 EXPERIENCE OF SINGLE-INCISION LAPAROSCOPIC RECTAL 

ANTERIOR RESECTION Nobuhiro Ito, MD PhD, Hiroshi Nagata, MD 

PhD, Noiku Nakao, MD PhD, Hitoshi Inagaki, MD PhD, Toshiaki Nonami, 

MD PhD, Department of Gastroenterological Surgery, Aichi Medical 

University 

P141 OBESITY IS ASSOCIATED WITH INADEQUATE LYMPH NODE 

HARVEST IN LAPAROSCOPIC RIGHT HEMICOLECTOMY Matthew L 

Silviera, MD, Brian P Smith, MD, John Migaly, MD, Temple University 

Hospital, Philadelphia, PA, USA 

P142 PLASMA SOLUBLE VASCULAR ADHESION MOLECULE-1 LEVELS 

ARE PERSISTENTLY ELEVATED DURING THE FIRST MONTH AFTER 

COLORECTAL CANCER RESECTION HMC Shantha Kumara, PhD, X Yan, 

PhD, Sonali A C Herath, BS, A Nasar, MS, A Senagore, MD, R Baxter, BS, 

M Kalady, MD, RL Whelan, MD, Department of Surgery,Colon &Rectal 

Division,St.Luke Roosevelt Hospital Center, New York, NY,USA ,Colon & 

Rectal Surgery, Ferguson Clinic, Grand Rapids, MI, USA, Colon & Rectal 

Surgery,Cleveland Clinic, Cleveland,OH, USA 

P143 NUCLEOTIDE-GUIDED MESORECTAL EXCISION (NGME) DURING 

TEM FOR RECTAL CANCER: PRELIMINARY RESULTS Emanuele 

Lezoche, MD FACS, Giancarlo D’Ambrosio, MD, Alessandro M Paganini, 

MD PhD FACS, Mario Guerrieri, MD, Giovanni Lezoche, MD, Luciana 

Barchetti, MD, Bernardina Fabiani, MD, Pietro Ursi, MD, Daniele Scoglio, 

MD, Department of General Surgery, II Clinica Chirurgica, Università “La 

Sapienza”, Rome. *Azienda Ospedaliera Universitaria Ospedali Riuniti, 

Ancona, Italy. 

P144 ELEVATED LEVELS OF SOLUBLE VASCULAR ADHESION 

MOLECULE -1 IS ASSOCIATED WITH COLORECTAL CANCER HMC 

Shantha Kumara, PhD, Sonali A C Herath, BS, X Yan, PhD, V Cekic, RN, N 

Dujovny, MD, RL Whelan, MD, Department of Surgery, Colon & rectal 

Division, St.Lukes- Roosevelt Hospital Center,New York,NY,USA,Colon & 

Rectal Surgery,Ferguson Clinic, Grand Rapids, MI, USA. 

P145 TRANSANAL ENDOSCOPIC MICROSURGERY: A SINGLE 

INSTITUTION EXPERIENCE Joshua A Waters, MD, Jeffery S Browne, MD, 

Eric A Wiebke, MD, Bruce W Robb, MD, Virgilio V George, MD, Indiana 

University Department of Surgery 


P147 LAPAROSCOPIC MANAGEMENT OF GENERALIZED PERITONITIS 

Jorge Fernandez-Alvarez, MD, Omar Pichardo, MD, Armando Baqueiro- 

Cendon, MD, Jose Manuel Gomez, MD, Francisco Terrazas, MD, Iker Leon, 

MD, Gonzalo Vargas, MD, Hospital Español De Mexico 

P148 SELF-EXPANDABLE METALLIC STENT IS A GOOD ALTERNATIVE 

TO SURGERY IN COLONIC OBSTRUCTION Maria Bergstrom, MD PhD, 

Eva Angenete, MD PhD, Dan Asplund, MD, Helena Lindegren, MD, Per- 

Ola Park, MD PhD, Dept of Surgery, Sahlgrenska University Hospital, 

Gothenburg, Sweden 

P149 TEACHING RESIDENTS LAPAROSCOPIC COLECTOMY; 

EXPERIENCE WITH 1069 CASES Candy K Anim, PGY, Vanessa Malit, PGY, 

Eben Strobos, PGY, Steve Fassler, Attending, Mark Zebley, Attending, 

Abington Memorial Hospital 

P150 LAPAROSCOPY-ASSISTED SURGERY FOR RECTO-SIGMOID 

TUMOR: A COMPARISON OF THE MEDIAL APPROACH AND LATERAL 

APPROACH. H Matsuoka, MD, T Mori, MD, T Masaki, MD, T Kobayashi, 

MD, K Sato, M Sugiyama, MD, Y Atomi, MD, Kyorin University 

P151 LAPAROSCOPIC TREATMENT OF CROHN’S DISEASE: A RESIDENT 

CASE? Nora Meenaghan, MD, Tiffany Stoddard, MD, Yassar Youssef, MD, 

Stephen M Kavic, MD, University of Maryland 

P152 PLASMA LEVELS OF PLACENTA GROWTH FACTOR (PLGF), A 

PROANGIOGENIC PROTEIN, ARE ELEVATED FOR 3 WEEKS AFTER 

MINIMALLY INVASIVE COLORECTAL CANCER RESECTION HMC 

Shantha Kumara, PhD, X Yan, PhD, D Feingold, MD, M Kalady, MD, N 

Dujovny, MD, RL Whelan, MD, Department of Surgery,Colon&Rectal 

Division,St.Lukes-Roosevelt Hospital,New York,NY,USA,Department 

of Surgery,Columbia University,New York,USA,Colon&Rectal 

Surgery,Cleveland Clinic,Cleveland,OH,USA,Colon&Rectal 

Surgery,Ferguson Clinic,Grand Rapid,MI,USA 

P153 ADULT INCIDENTAL INTUSSUSCEPTION – SINGLE INSTITUTE 

EXPERIENCE Venkata K Kella, SivaKumar Mahalingam, Ajay K Shah, 

Department of Surgery, Bronx Lebanon Hospital Center, Bronx New York 

10457 

P154 IS BODY MASS INDEX A FACTOR AFFECTING PEROPERATIVE 

AND EARLY POSTOPERATIVE COMPLICATIONS IN LAPAROSCOPIC 

RECTAL CANCER SURGERY? Erman Aytac, MD, Tayfun Karahasanoglu, 

MD, Ismail Hamzaoglu, MD, Bilgi Baca, MD, Istanbul University 

Cerrahpasa Medical School, Department of General Surgery, Istanbul, 

Turkey 

P155 WHAT ABOUT MINIMALLY INVASIVE SURGERY IN SENIOR 

COLORECTAL PATIENTS? Sandrine Ostermann, MD PhD, Pascal Bucher, 

MD, Pascal Gervaz, MD PD, Isabelle Neyroud, MD, Philippe Morel, Prof, 

Department of Surgery, University Hospital of Geneva (HUG); Geneva 

Cancer Registry, Geneva, Switzerland 




P156 COLONIC VOLVULUS: NOT ONLY A DISEASE OF THE ELDERLY 

Sebastian V Demyttenaere, MD, Jean-Michel Lavoie, BSc, Gabriella 

Ghitulescu, MD, Shannon Fraser, MD, Issie Weissglas, MD, Simon 

Bergman, MD, Department of Surgery, Saint Mary’s Hospital and Sir 

Mortimer B. Davis Jewish General Hospital, McGill University 

P157 SINGLE INCISION LAPAROSCOPIC COLECTOMY FOR NEOPLASIA: 

INITIAL OPERATIVE EXPERIENCE Kelly A Garrett, MD, Daniel Geisler, 

MD, Feza H Remzi, MD, Cleveland Clinic 

P158 ONCOLOGICAL OUTCOMES OF LAPAROSCOPIC COLON 

RESECTION FOR CANCER AFTER IMPLEMENTATION OF A FULL-TIME 

PRECEPTORSHIP Yasir M Akmal, MD, Carissa Bailey, Jeong-Heum Baek, 

MD PhD, Michelle Metchikian, Alessio Pigazzi, MD PhD, City of Hope 

National Medical Center, Department of General and Oncologic Surgery 

P159 LAPAROSCOPIC PRIMARY REPAIR OF COLONOSCOPIC 

PERFORATIONS J. R Salameh, MD, J. T Mayes, MD, Department 

of Surgery, Georgetown University, Washington, DC and Surgical 

Associates at Virginia Hospital Center, Arlington, VA 

P160 HAND ASSISTED LAPAROSCOPIC COLECTOMY: LOW 

CONVERSION RATE AND SHORT HOSPITAL STAY Constantinos 

Constantinou, MD, Paul Meade, MD, Jane Miller, RN, Geisinger Health 

System 

P161 WHAT IS THE COMPLIANCE WITH RECOMMENDED GUIDELINES 

FOR ENDOSCOPIC SURVEILLANCE AFTER COLON CANCER 

RESECTION? Rita A Brintzenhoff, MD, Amy E Lincourt, PhD, Dimitrios 

Stefanidis, MD PhD, B Todd Heniford, MD, Carolinas Medical Center 

P162 LONG-TERM OUTCOMES AFTER LAPAROSCOPIC VERSUS OPEN 

TOTAL MESORECTAL EXCISION FOR MID AND LOW RECTAL CANCER: 

A COMPARATIVE STUDY OF 259 CONSECUTIVE RESECTION BY A 

SINGLE SURGEON Taek-Gu Lee, MD, Duck-Woo Kim, phD, Sung-Bum 

Kang, phD, Department of Surgery Seoul National University Bundang 

Hospital, Seoul, Korea 

P163 USE OF A CLINICAL PATHWAY COMBINED WITH LAPAROSCOPY 

AS THE STANDARD OF CARE IN ACUTE APPENDICITIS Wijaya G 

Premaratne, Dr, Chatika Premaratne, Dr, Stephen Strahan, Dr, Thushara 

Dissanayake, Dr, Rohana Wanasinghe, Dr, Department of Surgery and 

Gastrointestinal Endoscopy Caboolture Hospital, Queensland Australia. 

P164 LAPAROSCOPIC RESECTION FOLLOWING STENT INSERTION FOR 

OBSTRUCTING COLORECTAL CANCER Wai Lun Law, MD, Joe Fan, MD, 

Jensen Poon, MD, Department of Surgery, The University of Hong Kong 

P165 ALVIMOPAN CAN REDUCE POSTOPERATIVE ILEUS AND 

HOSPITAL LENGTH STAY IN LAPAROSCOPIC COLON SURGERY 

Alia Abdulla, DO MPH, Gretchen Aquilina, DO, Roy Sandau, DO, John 

D’Emilia, MD, David Berg, MD, Larry Cohen, DO, Marc Neff, MD, UMDNJ, 


P166 LAPAROSCOPIC GASTRECTOMY WITH COMPLETE D2 

LYMPH NODE DISSECTION CAN BE SAFELY PERFORMED IN OUR 

INSTITUTION Kohei Nakata, PhD, Eishi Nagai, PhD, Kenoki Ohuchida, 

Takao Ohtsuka, Hiroki Toma, Masao Tanaka, Department of Surgery and 

Oncology, Graduate School of Medical Sciences, Kyushu University 

P167 COMBINED LAPAROSCOPIC AND INTRAOPERATIVE 

ENTEROSCOPIC MANAGEMENT OF BENIGN INTESTINAL POLYPOSIS 

IN PEUTZ-JEGHERS SYNDROME – A CASE SERIES Eugenius J Harvey, 

MBBS, Kervin Arroyo, MD, Blair S Lewis, MD, Anthony J Vine, MD, Lester B 

Katz, MD, Mount Sinai School of Medicine 

P168 OUTCOME OF LAPAROSCOPIC RECTOPEXY VERSUS PERINEAL 

RECTOSIGMOIDECTOMY FOR FULL-THICKNESS RECTAL PROLAPSE 

IN ELDERLY Seung-Hyun Lee, Paryush Lakhtaria, Hong-Jae Jo, Steven D 

Wexner, Cleveland Clinic Florida 

P169 Assessment of the Outcomes of Hand-Assisted 

Laparoscopy vs. Laparoscopy in Elective Colorectal 

Surgery in Obese Patients – Are There Advantages? 

Kazuhiro Narita, Cesar Reategui, Sherief Shawki, Eric G Weiss, Juan G 

Nogueras, Steven D Wexner, Cleveland Clinic Florida 

P170 LAPAROSCOPIC REMOVAL OF AN INTRAABDOMINAL 

INTRAUTERINE DEVICE: CASE AND SYSTEMATIC REVIEW Derek Mok, 

MD, Daniel W Birch, MD FRCSC FACS, Christopher DeGara, MD FRCSC, 

Shahzeer Karmali, MD FRCSC, University of Alberta 

P171 HOSPITALIZATION COSTS OF LAPAROSCOPIC VS OPEN 

APPENDECTOMY: 5 YEAR EXPERIENCE. Jorge Cervantes, Carlos M 

Cardenas, Enrique R Jean, Sergio A Toledo, Adrian Murillo, Jose A Posada, 

Raul Lopez - Infante, Pablo D Murakami, Department Of Surgery, The 

American British Cowdray Medical Center, Mexico City. 

P172 LAPAROSCOPIC PRIMARY COMMON DUCT REPAIR: 

MANAGEMENT OF AN UNUSUAL COMPLICATION OF ERCP Alfred 

B Johnson, MD, Teresa Klainer, MD, Highland Community Hospital, 

Picayune, MS 

P173 PREOPERATIVE EVALUATION OF THE MAJOR BRANCHES OF 

THE MID HEPATIC VEIN AND PORTAL VEIN AT THE LIVER BED 

WITH THE DYNAMIC FLOW INVESTIGATION BY THE DOPPLER 

ULTRASONOGRAPHY TO AVOID THE BLEEDING FROM THE LIVER 

BED AT LAPAROSCOPIC CHOLECYSTECTOMY. Minoru Kakihara, 

MD PhD, Eiichi Sugasawa, MD PhD, Yoshiki Kajiwara, MD, Toshimichi 

Takigawa Phd, MD, Taichi Satou, MD, Nobuaki Kawarabayashi, MD PhD, 

Kazuo Hatsuse, MD PhD, Junji Yamamoto, MD PhD, Department of 

Surgery, National Defense Medical College, Japan. 

P174 DOES AN INCREASED BODY MASS INDEX (BMI) LEAD TO 

INCREASED RATES OF CONVERSION DURING LAPAROSCOPIC 

CHOLECYSTECTOMY? Daniel T Farkas, MD, Dovid S Moradi, BA, John M 

Cosgrove, MD, Bronx-Lebanon Hospital Center, Albert Einstein College 

of Medicine, Bronx, NY, USA. 

P175 MAJOR COMPLICATIONS OF LAPAROSCOPIC 

CHOLECYSTECTOMY ARE NOT NECESSARILY MEDICAL NEGLIGENCE 

– THE EVIDENCE IN SURGICAL LITERATURE. Manmohan Varma, MS, 

Kushal Varma, Medical Student, Private, Kanpur, India 

P176 THE ROLE OF BODY MASS INDEX AND VISCERAL FAT AREA IN 

COLORECTAL CANCER PATIENTS TREATED WITH LAPAROSCOPIC- 

ASSISTED SURGERY. Noriko Matsumoto, MD, Mitsuo Shimada, Prof, 

Nobuhiro Kurita, MD PhD, Takashi Iwata, MD PhD, Masanori Nishioka, 

MD PhD, Shinya Morimoto, MD PhD, Jun Higashijima, MD PhD, 

Tomohiko Miyatani, MD PhD, Toshihiro Nakao, MD, Oura Ryoko, MD, 

Masato Komatsu, MD, Hi, Department of Surgery, The University of 

Tokushima, Japan 

P177 THE CLINICAL RESERCH OF PREVENTION OF PANCREATIC 

LEAKAGE AND THE USEFULNESS OF FIBRIN GLUE AND POLYGLYCOL 

ACID FELT AFTER LAPAROSCOPIC ASSISTED GASTRECTOMY FOR 

GASTRIC CANCER Yuichiro Hiura, MD, Shuji Takiguchi, MD PhD, Makoto 

Yamasaki, MD PhD, Kiyokazu Nakajima, MD PhD, Hiroshi Miyata, MD 

PhD, Yoshiyuki Fujiwara, MD PhD, Masaki Mori, MD PhD, Yuichiro Doki, 

MD PhD, Osaka University, Graduate School of Medicine, Department of 

Gastroenterological Surgery 

P178 CAN CASE SELECTION MINIMISE CONVERSION RATE IN 

LAPAROSCOPIC COLORECTAL SURGERY? Susannah M Wyles, MBBS 

MSc MRCS, Danilo Miskovic, MD FRCS, Zhifang Ni, MSc, Ara W Darzi, 

FMedSci HonFREng KBE, George B Hanna, PhD FRCS, Biosurgery and 

Surgical Technology, Imperial College London 

P179 ACUTE PANCREATITIS AFTER ELECTIVE LAPAROSCOPIC 

CHOLECYSTECTOMY: RETROSPECTIVE STUDY JR Ramirez Gavidia, 

MD, P Raj, Cleveland Clinic Foundation 

P180 SPONTANEOUS RETROPERITONEAL HAEMATOMA CAUSED BY 

LUMBAR ARTERY BLEED. JR Ramirez Gavidia, P Raj, Clevelan Clinic 

Foundation 

P181 PREVENTION OF STOMAL COMPLICATIONS Madhav V Phadke, 

MD FACS, Lewis H Stocks, MD PhD FACS, Yeshwant G Phadke, MD FACS, 

WakeMed, Raleigh, NC affiliated with UNC Chapel Hill, NC, USA 






P182 SURGEON-CONTROLLED FACTORS THAT REDUCE MONOPOLAR 

ELECTROSURGERY CAPACITIVE COUPLING DURING LAPAROSCOPY 

Thomas N Robinson, MD FACS, Katherine R Pavlovsky, MS, Heidi Looney, 

MS, Greg V Stiegmann, MD FACS, Francis T McGreevy, BS, University of 

Colorado School of Medicine, Denver, CO, USA. 

P183 COMPLICATIONS OF BARIATRIC SURGERY AND SOLUTION Dr Ali 

Fardoun, MD, Fawaz Torab, Phd associated prof, tawam UAE affiliated 

with John’s Hopkins 

P184 SAFETY OF OPEN TECHNIQUE FOR FIRST TROCAR PLACEMENT 

IN LAPAROSCOPIC SURGERY – A SERIES OF 6000 CASES Pawanindra 

Lal, MD, Rajeev Sharma, MD, Jagdish Chander, MD, Vinod K Ramteke, 

MD, Maulana Azad Medical College, New Delhi, India & Government 

Medical College, Chandigarh. 

P185 ESOPHAGEAL-PLEURAL FISTULA AFTER LAPAROSCOPIC SLEEVE 

GASTRECTOMY (LSG): SUCCESSFUL ENDOSCOPIC MANAGEMENT. 

Juan D Hernandez, MD, Hector Cardona, MD, Natan Zundel, Hospital 

Central de la Policía, Universidad de los Andes, Miami International 

University 

P186 COMMUNICATION PROBLEMS ACROSS SURGICAL PATIENTS’ 

CARE PATHWAYS Kamal Nagpal, MD, Sonal Arora, MRCS, Helen Wong, 

MSc, Nick Sevdalis, PhD, Amit Vats, MRCS, Charles Vincent, PhD, Krishna 

Moorthy, FRCS, Department of Biosurgery and Surgical Technology, 

Imperial College, St Mary’s Hospital, Praed Street, London W21NY, 

United Kingdom. 

P187 PULMONARY EMBOLISM IN LAPAROSCOPIC 

CHOLECYSTECTOMY Prasanta Raj, MD MS FACS, Neilendu Kundu, MD, 

Andrew Smith, MD, Fairview Hospital / Cleveland Clinic Health Systems 

P188 EYE TRACKING AS A TOOL TO EVALUATE COLONOSCOPY SKILL 

Kazuhiko Shinohara, MD PhD, Yasushi Yamauchi, PhD, Tokyo University 

of Technology 

P189 HIGH FIDELITY RECONSTRUCTION OF HUMAN ANATOMY USING 

3 DIMENSIONAL PRINTING: PROOF OF CONCEPT Robert A Andrews, 

MD, Justin W Kung, MD, Theodore Korelitz, Scott R Johnson, MD, Daniel 

B Jones, MD, Beth Israel Deaconess Medical Center, Carl J Shapiro 

Simulation and Skills Center, Harvard Medical School 

P190 TRAINING MODEL FOR LAPAROSCOPIC COMMON BILE DUCT 

EXPLORATION. IMPACT IN THE IMPROVEMENT OF SURGICAL SKILLS. 

Alexis Sanchez, MD, Omaira Rodriguez, MD, Renata Sanchez, MD, 

Gustavo Benitez, MD, Omar Bellorin-Marin, MD, Samuel Szomstein, MD 

FACS, Universitary Hospital of Caracas, Central University of Venezuela, 

Caracas-Venezuela. Cleveland Clinic Florida, Weston-Florida 

P191 CROSS-PLATFORM ADAPTATION AND VALIDATION OF 

LAPAROSCOPIC SKILLS TASKS: SOME TASKS ARE ROBUST ACROSS 

PLATFORMS Daniel Box, BS, Rollin Nagel, PhD, David Way, MS, Alan E 

Harzman, MD, The Ohio State University, Columbus, Ohio, USA 

P192 RESULTS AND PERSPECTIVE TO THE FUTURE IN THE FIELD OF 

LAPAROSCOPIC CHOLECYSTECTOMY OF JAPANESE ENDOSCOPIC 

SURGICAL SKILL QUALIFICATION SYSTEM Sumio Matsumoto, PhD, 

Hiromi Tokumura, PhD, Yuichi Yamashita, PhD, Toshiyuki Mori, PhD, 

Masaki Kitajima, PhD, 1ESSQS Committee of the Japan Society for 

Endoscopic Surgery, Tokyo, Japan 

P193 FIVE YEAR EXPERIENCE OF THE LAPAROSCOPIC SKILL 

ACCREDITATION SYSTEM IN JAPAN Toshiyuki Mori, MD PhD, Yutaka 

Atomiu, MD PhD, Taizo Kimura, MD PhD, Masaki Kitazima, MD PhD, 

Department of Surgery, Kyorin University, Japan 

P194 ASSESSING THE VALIDITY OF SIMULATING THE FUNDAMENTALS 

OF LAPAROSCOPY (FLS) TASKS IN VIRTUAL REALITY Vanessa N Palter, 

MD, Neil Orzech, MD, Teodor P Grantcharov, MD PhD, The Wilson Centre 

and St Michael’s Hospital, Toronto, Canada 

P195 A NOVEL SENSORIZED INSTRUMENT-BASED MINIMALLY 

INVASIVE SURGERY (SIMIS) TOOL: INITIAL CONSTRUCT VALIDATION 

OF POSITION SENSING Shiva Jayaraman, MD MESc, Ana Luisa 

Trejos, MASc, Andrew C Lyle, Michael D Naish, PhD, Rajni V Patel, PhD, 

Christopher M Schlachta, MD, CSTAR (Canadian Surgical Technologies & 

Advanced Robotics), Lawson Health Research Institute and Department 

of Surgery, Schulich School of Medicine and Dentistry, The University of 

Western Ontario, London, Ontario, Canada 

P196 TELEMENTORING OF ENDOSCOPIC SUTURING USING THE 

ANNOTATION SYSTEM BETWEEN JAPAN AND THAILAND Kazuo 

Tanoue, MD PhD FACS, Satoshi Ieiri, MD PhD, Kozo Konishi, MD PhD, 

Kenoki Ohuchida, MD PhD, Manabu Onimaru, MD, Morimasa Tomikawa, 

MD PhD, Makoto Hashizume, MD PhD FACS, Department of Advanced 

Medicie and Innovative Technology 

P197 MENTORSHIP FOR PARTICIPANTS IN A LAPAROSCOPIC 

COLECTOMY COURSE Vanessa P Ho, MD, Koiana Trencheva, MS BSN, 

Sharon L Stein, MD, Jeffrey W Milsom, MD, Weill Cornell Medical College- 

NewYork Presbyterian Hospital 

P198 PORTABLE, SELF-PRACTICE LAPAROSCOPIC BOX TRAINERS 

UNDERUTILIZED BY SURGICAL TRAINEES Michael A Russo, MD, Shawn 

Tsuda, MD, University of Nevada School of Medicine 

P199 HOW DO WE MAKE DECSIONS REGARDING CANCER 

MANAGEMENT? Zhifang Ni, Miss, Kamran Ahmed, Mr, Laura 

Zimmermann, Miss, George Hanna, Prof, Imperial College London 

P200 SINGLE INCISION LAPAROSCOPIC SURGERY TRAINING COURSE: 

THE NEXT STEP IN SURGICAL EDUCATION Avraham Schlager, MD, 

Ram Elazary, MD, Abed Khalaileh, MD, Noam Shussman, MD, Gideon 

Zamir, MD, Avraham I Rivkind, MD, Yoav Mintz, MD, Hadassah-Hebrew 

University Center, New York University Medical Center 

P201 PLAYING NINTENDO® WII IMPROVES VIRTUAL REALITY 

LAPAROSCOPIC SIMULATOR PERFORMANCE Kellie K Middleton, MPH, 

John L Falcone, MD, Giselle G Hamad, MD FACS, Dana B Middleton, 

Travis M Hamilton, BS, University of Pittsburgh School of Medicine, 

University of Pittsburgh Medical Center 

P202 USE OF IMAGES TO ILLUSTRATE THE MEDICAL CONDITIONS IN 

THE OUTPATIENT CLINIC. R Vilallonga, PhD, Jm Fort, PhD, O Gonzalez, 

PhD, Ja Baena, PhD, M Armengol, PhD, Universitary Hospital Vall 

d’Hebron. Barcelona. 

P203 THE IMPACT OF A MENTOR ON THE EARLY LEARNING CURVE 

IN LAPAROSCOPIC COLORECTAL SURGERY Susannah M Wyles, MBBS 

MSc MRCS, Danilo Miskovic, MD FRCS, Zhifang Ni, MSc, Ara W Darzi, 

FMedSci HonFREng KBE, George B Hanna, PhD FRCS, Department of 

Biosurgery and Surgical Technology, Imperial College London 

P204 MEASURING PERFORMANCE USING THE GOALS-INCISIONAL 

HERNIA MODULE (GOALS-IH) Marilou Vaillancourt, MD, Iman Ghaderi, 

MD, Pepa Kaneva, MSc, Melina Vassiliou, MD, Nicole Koloszvari, MD, 

Gerald M Fried, MD, Liane S Feldman, MD, Steinberg-Bernstein Centre 

for Minimally Invasive Surgery & Innovation, McGill University, Montreal, 

Quebec, Canada 

P205 LAPAROSCOPIC APPENDECTOMY IS FEASIBLE AND SAFE IN 

SURGICAL TRAINING Ramon A Saade-Cardenas, MD, Maria E Aponte- 

Rueda, PhD MD, Miguel J Saade-Aure, PhD MD FACS, Gustavo A Benitez, 

MD, Salvador Navarrete-Aulestia, MD, Caracas University Hospital. 

Central University of Venezuela.Service of Surgery II-III 

P206 WEB BASED TELE-SIMULATION TRAINING Danny A Sherwinter, 

MD, Maimonides Simulation Center, Maimonides Medical Center, 

Brooklyn NY, USA 

P207 THE IMPACT OF VERBAL GUIDANCE ON LAPAROSCOPIC SKILLS 

TRAINING AND MULTI-TASKING PERFORMANCE Jamie Poolton, PhD, 

Joe Fan, MD, Rich S Master, PhD, Niv G Patil, MD Professor, Wai Lun Law, 

MD Professor, The University of Hong Kong 




P208 VIRTUAL REALITY SIMULATOR FOR THE TRAINING OF OPTICAL 

TROCAR ACCESS Michitaka Fujiwara, MD, Norifumi Ohashi, MD, 

Akimasa Nakao, MD, Masamichi Sakaguchi, PhD, Hiroki Hidaka, PhD, 

Hideo Fujimoto, PhD, Department of Surgery II, Graduate School of 

Medicine, Nagoya University, Graduate School of Engineering, Nagoya 

Institute of Technology 

P209 PROFICIENCY-BASED VIRTUAL REALITY LAPAROSCOPIC SKILLS 

TRAINING: A 7-YEAR EXPERIENCE Peter S Wu, MD, Ron W Bush, BS, 

Neal E Seymour, MD, Department of Surgery, Baystate Medical Center. 

Springfield, MA 

P210 THE FUNDAMENTALS OF LAPAROSCOPIC SURGERY (FLS) 

SIMULATOR AS A PLATFORM FOR EVALUATING SINGLE PORT 

LAPAROSCOPIC SURGERY AND ENABLING INSTRUMENTATION S. 

Al-Sabah, MD MBA, LS Feldman, MD, MC Vassiliou, MD MEd, PA Kaneva, 

MSc, GM Fried, MD, Steinberg- Bernstein Centre for Minimally Invasive 

Surgery and Innovation, McGill University Health Centre, Montreal, 

Canada 

P211 LAPAROSCOPE POSITION IMPACTS SURGEON EFFICIENCY AND 

WORKLOAD Paul N Montero, MD, Christina Acker, Dimitrios Stefanidis, 

MD PhD, B T Heniford, MD, Carolinas Laparoscopic and Advanced 

Surgery Program, Carolinas Medical Center 

P212 LAPAROSCOPIC FELLOWSHIP DOES NOT AFFECT GENERAL 

SURGERY RESIDENT EXPERIENCE Mohamed I Dahman, MD, Bruce D 

Schirmer, MD, Peter T Hallowell, MD, Department of Surgery, University 

of Virginia, Charlottesville, VA, USA 

P213 ENDOSCOPIC HARVESTING OF THE GRACILIS MUSCLE - 

EXPERIMENTAL STUDY IN A SWINE MODEL Alexandru I Blidisel, MD 

Phd, Lucian p Jiga, MD Phd, Laurentiu Sima, MD Phd, Octavian Cretu, 

MD Phd, Mihai Ionac, MD Phd, University Of Medicine and Pharmacy 

from Timisoara, Romania 

P214 LIVE CADAVERIC LAPAROSCOPY WITH LAPAROSCOPIC VIDEOS 

IN GROSS ANATOMY: INFLUENCE ON LEARNING AND CAREER 

CHOICE Sean B Orenstein, MD, Ean R Saberski, BS, Yuri W Novitsky, MD, 

University of Connecticut School of Medicine, Farmington, Connecticut 

P215 GILDING THE GOLDEN HOUR: USING M&M CONFERENCE DATA 

TO REFINE RESIDENT EDUCATION AND PATIENT SAFETY Stephen M 

Kavic, MD, Adrian Park, MD, University of Maryland 

P216 DOES A FELLOW’S INVOLVEMENT IN ADVANCED LAPAROSCOPIC 

PROCEDURES IMPROVE OUTCOMES? Jeffrey J Wannares, Timothy 

D Jackson, MD MPH, Robert T Lancaster, MD MPH, Matthew M Hutter, 

MD MPH FACS, The Codman Center for Clinical Effectiveness in Surgery, 

Massachusetts General Hospital 

P217 DOES A LAPAROSCOPIC SKILLS TRAINING CURRICULUM ON 

A VIRTUAL TRAINER IN A BUSY SURGICAL RESIDENCY PROGRAM 

NEED TO BE OPTIMIZED? Ben Selvan, MS, N. N Williams, MB BCh 

MCh FRCSI FRCSGen, Andrew S Resnick, MD, Jon B Morris, MD, 

Mayank Mittal, MRCS, K. R Dumon, MD, The Penn Medicine Clinical 

Simulation Center, Department of surgery, Hospital of University of 

Pennsylvania,Philedelphia.PA 19130 

P218 INCREASED VIDEO GAME EXPERIENCE RESULTS IN 

IMPROVED LAPAROSCOPY SKILLS: A PROSPECTIVE STUDY OF 

LAPAROSCOPICALLY NAIVE SUBJECTS Mark A Vitale, Wesley B 

Jones, MD, Jeff W Allen, MD, Gary C Vitale, MD, Department of Surgery, 

University of Louisville School of Medicine, Louisville, KY, USA 

P219 A RETROSPECTIVE STUDY CHALLENGES THE CONSTRUCT 

VALIDITY OF COLONOSCOPIC VIRTUAL TRAINING Ben Selvan, MS, 

K. R Dumon, MD, Jon B Morris, MD, Andrew S Resnick, MD, Mayank 

Mittal, MRCS, N. N Williams, MB BCh MCh FRCSI FRCSGen, The Penn 

Medicine Clinical Simulation Center , Department of Surgery, Hospital 

Of University of Pennsylvania, Philedelphia, PA 19130 

P220 TRAINING THE SURGEONS FOR COMPLEX SURGICAL UPPER 

GASTRO INTESTINAL AND COLORECTAL PROCEDURES IN UNITED 

KINGDOM Amir Nisar, FRCS, Glasg FRCSI FRCS, H Ali, J Gossage, Umerto 

Bracale, Oesophago Gastric Regional Unit, Maidstone and Tunbridge 

Wells Trust, Maidstone, Kent, England, United Kingdom 

P221 OBJECTIVE ASSESSMENT OF LAPAROSCOPIC SURGICAL SKILL 

USING THE DUAL-TASK APPROACH Adam T Meneghetti, MD, George 

Pachev, Valentyna Koval, Bin Zheng, MD, Karim Qayumi, MD, Ormond N 

Panton, MD, University of British Columbia 

P222 VALIDATION OF A NEW TRAINING CURRICULUM FOR BASIC 

LAPAROSCOPIC SKILLS Christian I Villeda-Sandoval, MD, David 

Velázquez-Fernández, MD PhD, Juan Pantoja, MD, Patricio Santillán- 

Doherty, MD, Miguel F Herrera, MD, Mauricio Sierra, MD, National 

Institute of Medical Sciences and nutrition “Salvador Zubirán” 

P223 INVESTIGATION OF THE RELATIONSHIP RISK FACTOR OF 

LAPAROSCOPIC ASSISTED GASTRECTOMY AND THE SKILL OF 

THE ASSISTANT OF OPERATION TEAM. Takashi Iwata, MD, Mitsuo 

Shimada, MD PhD FACS, Hideya Kashihara, MD, Jun Higanshijima, MD, 

Kozo Yoshikawa, MD, Shinaya Morimoto, MD, Masanori Nishioka, MD, 

Nobuhiro Kurita, MD, Department of Surgery, The Tokushima University 

P224 SURGICAL RESIDENT RETENTION OF FUNDAMENTALS OF 

LAPAROSCOPY (FLS) SKILLS Don J Selzer, MD, Daniel McKenna, MD, 

Jennifer Choi, MD, Laura Torbeck, PhD, Department of Surgery, Indiana 

University School of Medicine, Indianapolis, IN, USA 

P225 A MULTI-CENTER, SIMULATION-BASED SKILLS TRAINING 

COLLABORATIVE USING SHARED GI MENTOR II SYSTEMS: 

RESULTS FROM THE TEXAS ASSOCIATION OF SURGICAL SKILLS 

LABORATORIES (TASSL) FLEXIBLE ENDOSCOPY CURRICULUM Kent 

Van Sickle, MD, Lauren Buck, MD, Ross Willis, PhD, Alicia Mangram, MD, 

Michael S Truitt, MD, Mohsen Shabahang, MD PhD, Scott Thomas, MD, 

Lee Trombetta, MD, Brian Dunkin, MD, Daniel Scott, MD, UT Health 

Science Center San Antonio (UTHSCSA), Methodist Hospital, Dallas,TX 

(MHD), Texas A&M University, Temple, TX (TAMU), Brooke Army Medical 

Center, San Antonio, TX (BAMC), Methodist Hospital, Houston, TX, UT 

Southwestern, Dallas,TX (UTSW) 

P226 INDIVIDUALIZED SIMULATION USING 3D VIRTUAL REALITY 

IMAGE FACILITATES LEFT COLON CANCER SURGERY Norifumi Òhashi, 

MD, Michitaka Fujiwara, MD, Chie Tanaka, MD, Naoki Iwata, MD, Kensaku 

Mori, PhD, Goro Nakayama, MD, Masahiko Koike, MD, Yasuhiro Kodera, 

MD, Akimasa Nakao, MD, Department of Surgery II, Graduate School of 

Medicine, Nagoya University, Graduate School of Information Science, 

Nagoya University 

P227 VALIDATION OF A HIGH-FIDELITY NOTES SIMULATOR FOR 

TEAM TRAINING Shawn Tsuda, MD, Kai Matthes, MD, Charles St. Hill, 

MD, Alexandre Derevianko, MD, Tori Derevianko, Adnan Mohsin, Daniel 

Hashimoto, James Lau, MD, University of Nevada School of Medicine, 

Las Vegas, NV, USA; Beth Israel Deacones Medical Center, Boston, MA, 

USA, Boston University School of Medicine, Boston, MA, USA 

P228 IMPACT OF LEARNING STYLE IN NOVICES’ ACQUISITION OF 

MINIMALLY INVASIVE SURGICAL (MIS) BASIC SKILLS J Paige, MD, T 

Yang, MD, R Suleman, MD, S Chauvin, Ph D, J Alleyn, MD, M Brewer, MD, 

R Hoxsey, MD, Louisiana State University Health Sciences Center 

P229 EVALUATION OF NOTES® HANDS-ON COURSES BY SURGEONS AT 

THE SAGES ANNUAL MEETING LEARNING CENTER Mark A Gromski, 

BA, Fuad Alkhoury, MD, Suck-Ho Lee, MD PhD, Kai Matthes, MD PhD, 

Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, 

MA and Hospital of Saint Raphael, Yale School of Medicine, New Haven, 

CT 

P230 PROGRAM OF BASIC TRAINING IN ENDOSCOPY FOR SURGEONS 

TO PERFORM NOTES Kiyoshi Hashiba, MD PhD, Sergio Roll, MD PhD, 

Pablo R Siqueira, MD, Marco A DÀssunção, MD, Jarbas M Farraco, MD, 

Institute of Teaching and Research of the Lebanese Syrian Hospital 

P231 THE USE OF REMOTE COMPUTER AUDIO-VIDEO PROCESSING 

TO CONDUCT SURGICAL FELLOWSHIP INTERVIEWS OF DEPLOYED 

PHYSICIANS. C V Chukwumah, MD, C Shega, M J Rosen, MD, L Khaitan, 

MD, J L Ponsky, MD, J M Marks, MD, University Hospitals Case Medical 

Center, Cleveland, Ohio,USA 






P232 SURGICAL TECHNOLOGISTS DEMONSTRATE INITIAL 

PROFICIENCY AND POSITIVE IMPRESSIONS OF LAPAROSCOPIC 

AND ENDOSCOPIC SKILLS TRAINING Shawn Tsuda, MD, Samaan 

Sattarzadeh, Adnan Mohsin, Charles St. Hill, MD, Wright Jones, MD, 

James Lau, MD, University of Nevada School of Medicine, Las Vegas, NV, 

USA 

P233 CURRENT STATUS OF PERI-OPERATIVE TECHNICAL SKILL 

FEEDBACK – A NEEDS ASSESSMENT Don J Selzer, MD, Rahul Reddy, BS, 

Jennifer Choi, MD, Laura Torbeck, PhD, Department of Surgery, Indiana 

University School of Medicine, Indianapolis, IN, USA 

P234 VR TO OR PART II: THE EFFECT OF WARMUP ON OPERATIVE SKILLS 

IN THE OR Aaron Ashby, Kanav Kahol, PhD, Sumeet Kadakia, MD, John J 

Ferrara, MD FACS, Marshall L Smith, MD PhD, Richard M Satava, *Human 

Machine Symbiosis Laboratory, Department of Biomedical informatics, 

Arizona State University, Phoenix Arizona, +Banner Good Samaritan 

Medical Center, Phoenix, Arizona, ^Department of Surgery, University of 

Washington, Seattle Washington 

P235 NOTES IN EMERGENCY José F Noguera, MD PhD, Angel Cuadrado, 

MD PhD, Carlos Dolz, MD PhD, José M Olea, MD, Rafael Morales, MD, 

José C Vicens, MD, Luis Lozano, MD, Hospital Son Llàtzer 

P236 NOTES® STAPLED CYSTGASTROSTOMY –A NOVEL APPROACH 

FOR SURGICAL MANAGEMENT OF PANCREATIC PESUDOCYSTS 

Ratnakishore Pallapothu, MD, John Romanelli, MD, David Desilets, 

MDPhD, David Earle, MD, Baystate Medical Center, Tufts University 

School of Medicine, Springfield, MA 

P237 SINGLE INCISION PROCEDURE WITH CONVENTIONAL PORTS 

AND INSTRUMENTS Shailesh Puntambekar, MS, Galaxy-Care 

Laparoscopy Institute 

P238 HYBRID TRANSVAGINAL CHOLECYSTECTOMY Sanjeev K Singla, 

Dr, Sushil Budhiraja, Ravinder P Babra, Dayanand Medical College & 

Hospital, Ludhiana, India 

P239 FIRST CROATIAN TRANSVAGINAL LAPAROSCOPICALLY 

ASSISTED CHOLECYSTECTOMIES Zdravko Perko, Prof PhD, Radoslav 

Stipic, MD, Zoran Cala, Prof PhD, Zeljko Mimica, Prof PhD, Jasenka 

Kraljevic, MD, University Hospital and Medical School, Split, Croatia 

P240 NOTES PERITONEOSCOPY WITH CO2 INSUFFLATION SHOWS 

SIMILAR PHYSIOLOGIC STRESS AS STANDARD LAPAROSCOPY IN A 

SWINE MODEL. Erica A Moran, MD, Christopher J Gostout, MD, Juliane 

Bingener, MD, Department of Surgery, Mayo Clinic College of Medicine, 

Rochester, MN; Department of Medicine, Division of Gastroenterology 

and Hepatology, Developmental Endoscopy Unit, Mayo Clinic College of 

Medicine, Rochester, MN, United States. 

P241 TRANSORAL ENDOSCOPIC THYROIDECTOMY Nobumi Tagaya, 

PhD, Hiroyuki Oyama, MD, Keiichi Kubota, PhD, Second Department of 

Surgery, Dokkyo Medical University, Tochigi, Japan 

P242 NATURAL ORIFICE TRANSLUMENAL ENDOSCOPIC SURGERY 

(NOTES): A TECHNICAL REVIEW Edward D Auyang, MD, Daniel H Enter, 

BA, Byron F Santos, MD, Eric S Hungness, MD, Nathaniel J Soper, MD, 

Northwestern University, Department of Surgery 

P243 SURGEONS’ ATTITUDES TOWARDS NATURAL ORIFICE 

TRANSLUMENAL ENDOSCOPIC SURGERY Joe KM Fan, MD, Christine 

SY Lo, MD, Wai Lun Law, MD Professor, The University of Hong Kong, 

Hong KOng 

P244 TEMS USING SINGLE PORT INSTRUMENTS HJ Kim, MD, HM Cho, 

MD, SC Lee, MD, JK Shim, MD, IK Lee, MD, YS Lee, MD, ST Oh, MD, JG Kim, 

MD, Deparment of Surgery, The Catholic University of Korea 

P245 A NOVEL DEVICE FOR ENDOSCOPIC TRANSMURAL TISSUE 

FIXATION Kenneth Binmoeller, MD, Janak Shah, MD, California Pacific 



P246 MAGNETIC CAUTERY DISSECTOR SUITABILITY FOR 

TRADITIONAL OR SINGLE SITE LAPAROSCOPIC CHOLECYSTECTOMY 

IN HUMAN CADAVER MODELS Lauren B Mashaud, MD, Emmanuel 

Eisenstein, BS, Deborah C Hogg, BS, Angel Caban, MD, Sara Best, MD, Jeff 

Cadedu, MD, Richard Bergs, MS, Heather Beardsley, PhD, Juan Paramo, 

Raul Fernandez, PhD, Daniel J Scott, MD, UT Southwestern Center for 

Minimally Invasive Surgery 

P247 SINGLE ACCESS TRANSVAGINAL NOTES LYMPHATIC MAPPING 

WITH COLONIC SENTINEL NODE BIOPSY IN A PORCINE MODEL Susan 

H Whang, MD, Jason Loewen, MD, Brent W Miedema, MD, Klaus Thaler, 

MD, University of Missouri, Department of General Surgery 

P248 INITIAL EXPERIENCE IN ECORES (ENDOSCOPIC COLORECTAL 

SURGERY) Ifesegun D Ayodeji, MD, Bas Govaert, MD, Nicole D Bouvy, 

MD PhD, Cor G Baeten, MD PhD, Marjolein L Smidt, MD PhD, Maastricht 

University Medical Center, Department of General surgery 

P249 SINGLE INCISION LAPAROSCOPIC COLORECTAL SURGERY: A 

PRELIMINARY EXPERIENCE Elie K Chouillard, MD, Andrew A Gumbs, 

MD, Poissy Medical Center (FRANCE) and Fox Chase Cancer Center (USA) 

P250 HYBRID NOTES SLEEVE GASTRECTOMY FOR MORBID OBESITY 

Elie K Chouillard, MD, Ziad Elrassi, MD, Poissy Medical Center (France) 

and Saint-Georges Hospital (Lebanon) 

P251 TWO HANDED ENDOSCOPIC ROBOT FOR USE IN NATURAL 

ORIFICE TRANSLUMENAL ENDOSCOPIC SURGERY (NOTES) 

TRANSABDOMINAL PRE-PERITONEAL (TAPP) INGUINAL 

HERNIORRHAPHY Danny A Sherwinter, MD, Department of minimally 

invasive Surgery, Maimonides Medical Center, Brooklyn N.Y. 

P252 CIRCUMFERENTIAL PERIUMBILICAL INCISION APPROACH FOR 

THE RESECTION OF T1N0 AND TIS COLON CANCER: RELEVANCE TO 

SINGLE PORT LAPAROSCOPIC SURGERY (SILS) Tomonori Ohsawa, MD, 

Hideyuki Ishida, PhD, Daijo Hashimoto*, PhD, Department of Digestive 

Tract and General Surgery and Hepatobiliary and Pancreatic and 

Pediatric Surgery*, Saitama Medical Center, Saitama Medical School 

P253 TRANSGASTRIC DIAGNOSTIC PERITONEOSCOPY WITH 

LAPAROSCOPIC ASSISTANCE USING A NOVEL FLEXIBLE TOOLBOX 

FOR ADVANCED MINIMALLY INVASIVE PROCEDURES: AN INITIAL 

EVALUATION Vanchad R Memark, MD, Nilay R Shah, MD, Peter N Nau, 

MD, Clinton R Hall, MD, Eric T Volckmann, MD, Rebecca R Dettorre, BA 

CCRC, Bradley J Needleman, MD, W. Scott Melvin, MD, Jeffrey W Hazey, 

MD, Center for Minimally Invasive Surgery, Division of Gastrointestinal 

Surgery, The Ohio State University Medical Center, Columbus, Ohio, USA 

P254 TRANSLUMENAL TRANSPARENT NAVIGATION BY OSIRIX GPS 

SYSTEM IN SINGLE INCISION LAPAROSCOPIC SURGERY AND NOTES 

Maki Sugimoto, MD PhD, Yoshinori Morita, MD PhD, Takeshi Azuma, MD 

PhD, Gastroenterology Kobe University, Veterans Affairs Palo Alto Health 

Care System, Stanford University 

P255 TOTAL TRANSVAGINAL APPENDECTOMY: LESS PAIN AND 

FASTER RECOVERY Kurt E Roberts, MD, Andrew J Duffy, MD, Dan Silasi, 

MD, Tom Rutherford, MD, Jeuse Saint Fleur, NP, Priya Jamidar, MD, Robert 

L Bell, MD, Department of Surgery, Yale School of Medicine. 

P256 PATIENTS AND SURGEONS PERCEPTIONS OF NATURAL 

ORIFICE TRANSLUMINAL ENDOSCOPIC SURGERY (NOTES), A 

SOUTHAMERICAN POINT OF VIEW. María Francisca Navarrete, MD, 

Alex Escalona, MD, Francisco Riquelme, Intern, Ignacio Cifuentes, MD, 

Pontificia Universidad Católica de Chile 

P257 SURGICAL ENTEROSCOPY: THE POTENTIAL FOR LESS INVASIVE 

SURGICAL INTERACTIONS BETWEEN LAPAROSCOPES AND 

INTRALUMENAL ENTEROSCOPES Per-Ola Park, MD PhD, Maria 

Bergstrom, MD PhD, Margherita Cadeddu, MD, Paul Swain, MD, Dept of 

Surgery, South Alvsborg Hospital, Boras, Sweden and Department of 

Surgical Oncology and Technology, Imperial College, London, United 

Kingdom 

P258 TRANSVAGINAL MA-NOS. CLINICAL EXPERIENCE IN MORBID 

OBESITY AND COLON CANCER S. Delgado, A. Ibarzabal, R. Corcelles, F. 

Higuera, N. Salgado, A.M. Lacy, Gastrointestinal Surgery Unit. Hospital 

Clínic. ICMDM. Barcelona.



P259 SELF EXPANDING METAL STENTS FOR COMPLICATIONS OF 

RYGB: DO THE BENEFITS JUSTIFY THE RISKS? K Chinnappan, MD, M 

S Jean, MD, M Cavaretta, MD, J D Gabrielsen, MD FACS, A T Petrick, MD 

FACS, Geisinger Medical Center, Danville, PA, USA 

P260 AN EXPERIMENTAL STUDY OF THE EFFICACY OF NEW FLEXIBLE 

BIPOLAR FORCEPS (BELA) FOR HEMOSTASIS AND CYSTIC DUCT 

CLOSURE DURING CHOLECYSECTOMY Per-Ola Park, MD PhD, Asghar 

Azadani, MD, Henrik Jonsson, MD, Paul Swain, MD, Maria Bergstrom, 

MD PhD, Dept of Surgery, South Alvsborg Hospital, Boras, Sweden and 

Department of Surgery, Sahlgrenska University Hospital, Gothenburg, 

Sweden, and Department of Surgical Oncology and Technology, 

Imperial College, London, United Kingdom 

P261 RANDOMIZED STUDY COMPARING HEMODYNAMIC AND 

PULMONARY EFFECTS OF TRANSGASTRIC ENDOSCOPIC SURGERY 

WITH THE INSUFLATION OF CO2 AND AIR. A. Ibarzabal, B. Escobar, P. 

Taura, S. Delgado, N. Salgado, J. Mercadal, A. Alzaga, J. Rojas, A.M. Lacy, 

Gastrointestinal Surgery Unit. ICMDM. Hospital Clinic. Barcelona 

P262 RADICAL TRANSANAL ENDOSCOPIC MICROSURGEY (TEM): 

ENDOLUMINAL SURGERY FOR COMPLEX RECTAL LESIONS John 

Marks, MD, Rahila Essani, MD, Yusef Kudsi, MD, Eileen Larkin, BA, 

Lankenau Hospital and Institute for Medical Research: Section of 


P263 SLEEVE GASTRECTOMY: COMPARISON BETWEEN NOTES, SINGLE 

PORT AND LAPAROSCOPIC APPROACH. INITIAL EXPERIENCE. A. 

Ibarzabal, S. Delgado, R. Corcelles, A.M. Lacy, Gastrointestinal Surgery 

Unit. ICMDM. Hospital Clinic. Barcelona. 

P264 ANTIREFLUX TRANSORAL INCISIONLESS FUNDOPLICATION 

USING ESOPHYX: THE NEW YORK EVIDENCE Shankar R Raman, MD 

MRCS, V Kella, Shawn Garber, MD FACS, Spencer Holover, MD FACS, 

John M Cosgrove, MD FACS, Bronx-Lebanon Hospital Center and Mercy 


P265 LAPAROENDOSCOPIC SINGLE-SITE (LESS) CHOLECYSTECTOMY: 

RESULTS OF A PILOT RANDOMIZED TRIAL Marco Maria Lirici, MD, 

Francesco Corcione, MD, Andrea Domenico Califano, MD, B-M-M 

Hospital dpt. General and Thoracic Suregery - Reggio Calabria - Italy 

P266 NATURAL ORIFICE SURGERY: INITIAL BRAZILIAN EXPERIENCE 

UTILIZING THE STOMAPHYXTM DEVICE TO REDUCE GASTRIC 

POUCHES AND GASTROJEJUNOSTOMY ANASTOMOSIS (STOMA) 

AFTER ROUX-EN-Y GASTRIC BYPASS Sergio Roll, MD PhD, Marco A 

DÀssunção, MD, Bariatric Center Germany Hospital Oswaldo Cruz 

P267 EXPANDABLE GASTRIC PORT (EGP) FOR NOTES Kiyoshi Hashiba, 

MD PhD, Pablo R Siqueira, MD, Sergio Roll, MD PhD, Marco A D’Assunção, 

MD, Hospital Sírio Libanês Endoscopic Unit. S.Paulo Brazil. 

P268 ENDOLUMINAL FUNDOPLICATION (EFL) FOR THE TREATMENT 

OF GERD – FEASIBILITY STUDY OF A NEW TECHNIQUE IN PIGS. 

Sergio Roll, MD PhD, kiyoshi Hashiba, MD PhD, Pablo R Siqueira, MD, 

Marco A DÀssunção, MD, Hospital Sírio Libanês Endoscopic Unit. 

S.Paulo Brazil 

P269 NEW PLATFORM FOR A HYBRID N.O.T.E.S.TRANS-VAGINAL 

SLEEVE GASTRECTOMY Stephan R Myers, MD FACS, Riverside 

Methodist Hospital 

P270 COMBINING SINGLE INCISION LAPAROSCOPY AND NOTES 

TO MINIMIZE TRAUMA FOR ADVANCED PROCEDURES: GASTRIC 

BYPASS IN A PORCINE MODEL Monika E Hagen, MD MBA, Oliver 

J Wagner, Philippe Morel, MD PhD, Kari J Thompson, MD, Santiago 

Horgan, MD, Paul C Swain, Center for the Future of Surgery, Department 

of Surgery, University of California San Diego & Division of Digestive 

Surgery, University Hospital Geneva & Imperial College London 

P271 AN EX VIVO BACTERIOLOGIC STUDY COMPARING ANTISEPTIC 

TECHNIQUES FOR NATURAL ORIFICE TRANSLUMENAL ENDOSCOPIC 

SURGERY (NOTES) VIA THE GASTROINTESTINAL TRACT Marvin Ryou, 

MD, Ronen Hazan, PhD, Laurence Rahme, PhD, Christopher C Thompson, 

MD MSc FACG FASGE, Brigham and Women’s Hospital, Boston, MA, USA 

and Massachusetts General Hospital, Boston, MA, USA 

P272 EVALUATION OF COMMERCIALLY AVAILABLE PORT ACCESS 

DEVICES FOR SINGLE INCISION LAPAROSCOPIC SURGERY Daniel 

A Cusati, MD, Michael L Kendrick, MD, James M Swain, MD, Juliane 

Bingener, MD, Mayo Clinic Rochester 

P273 GALLBLADDER RETRACTION WITHOUT TRANSCUTANEOUS 

SUTURES DURING SINGLE-INCISION LAPAROSCOPIC 

CHOLECYSTECTOMY Eugene Rubach, MD FACS, Joanne McDevitt, 

RPAC, George DeNoto, MD FACS, Gary R Gecelter, MD FACS, St. Francis 

Hospital, Roslyn, NY; North Shore University Hospital, Manhasset, NY 

P274 OPTIMAL DESIGN OF INSTRUMENTS FOR SINGLE PORT 

LAPAROSCOPIC SURGERY USING MOTION ANALYSIS Yogesh V 

Kolwadkar, MD MCh Orth, Stuart I Brown, PhD, Rami J Abboud, Prof, 

Alfred Cuschieri, Prof Sir, Weijie Wang, PhD, University of Dundee 

P275 ERGONOMIC PERFORMANCE WITH CROSSED AND UNCROSSED 

INSTRUMENTS IN SINGLE PORT LAPAROSCOPIC SURGERY Roberto 

Rimonda, MD, Benjie Tang, MD, Stuart I Brown, PhD, Alfred Cuschieri, 

Prof, University of Dundee 

P276 GOING BACK TO OPEN TECHNIQUE ( FUNDUS FIRST ) SINGLE 

INCISION LAPAROSCOPIC CHOLECYSTECTOMY Shailesh P 

Puntambekar, MS, Galaxy-CARE Laparoscopy Institute 

P277 MANAGEMENT OF THE ULTRASONICALLY ACTIVATED SCALPEL 

HANDPIECE WITH SELF-CHECK “BME MODE”. Minoru Ishida(1), BA, 

Keisuke Kimura(1), Takashi Saitoh(1), Yuma Ebihara(2), MD PhD, Shunichi 

Okushiba(2), MD PhD, Hiroyuki Katoh(2), MD PhD, Tsukasa Iwakura(3), 

BA, (1)Department of Clinical Engineering KKR Sappro Medical Center 

Tonan Hospital Japan (2)Department of Surgery KKR Sappro Medical 

Center Tonan Hospital Japan (3)Department of Clinical Engineering 

Nikko kinen Hospital Japan 

P278 SINGLE-INCISION LAPAROSCOPIC CHOLECYSTECTOMY IN 

MODIFIED LITHOTOMY POSITION – IMPROVED ERGONOMICS FOR 

SURGEONS AND SURGICAL ASSISTANTS Eugene Rubach, MD FACS, 

Joanne McDevitt, RPAC, Vikraman Gunabushanam, MD, Nitin Mishra, 

MD, George DeNoto, MD FACS, Gary R Gecelter, MD FACS, St. Francis 

Hospital, Roslyn, NY; North Shore University Hospital, Manhasset, NY 

P279 SINGLE PORT ACCESS SURGERY: PERFORMANCE DIFFICULTY 

AND A POSSIBLE SOLUTION Zheng Bin, MD PhD, Thamer Al-Tayeb, MD, 

Young Sang Sohn, MD, Karim A Qayumi, MD PhD, Adam T Meneghetti, 

MD, Neely M Panton, MD, University of British Columbia 

P280 A NEW MULTI-VIEW (MV) RIGID LAPAROSCOPE Harmik J 

Soukiasian, MD, Edward H Phillips, MD FACS, Aydin H Pooli, MD, Toshiko 

Nobuto, MD, George Berci, MD FACS FRCS, Department of Surgery, 

Cedars-Sinai Medical Center, Los Angeles, CA 

P281 A COMPARISON OF INDEPENDENCE OF MOTION IN SINGLE PORT 

ACCESS TECHNIQUES Erica R Podolsky, MD, Paul G Curcillo, II MD FACS, 

Drexel University, College of Medicine, Department of Surgery 

P282 EFFECTS OF DIFFERENT TYPES OF STAPLE LINE 

REINFORCEMENT ON TISSUE HANDLING AND SLIPPAGE DURING 

LAPAROSCOPIC STAPLING Eric T Volckmann, MD, Ozgur Firat, MD, Nilay 

R Shah, MD, Dean J Mikami, MD, Clinton R Hall, MD, Vanchad R Memark, 

Bradley J Needleman, MD, Center for Minimally Invasive Surgery, 

Division of Gastrointestinal Surgery, The Ohio State University Medical 

Center, Columbus, Ohio, USA 

P283 APPLICATION OF HEM-O-LOK CLIP IN BASIC LAPAROSCOPIC 

PROCEDURES: A SINGLE CENTER EXPERIENCE ON 856 CASES AND 

REVIEW OF DATA FROM FOOD AND DRUG ADMINISTRATION Ali 

Aminian, MD, Faramarz Karimian, MD, Karamollah Toolabi, MD, Rasoul 

Mirsharifi, MD, Department of Surgery, Tehran University of Medical 

Sciences, Tehran, Iran 

P284 FIRST HUMAN EXPERIENCE WITH A NOVEL LAPAROSCOPIC 

PORT SITE CLOSURE DEVICE Bilal M Shafi, MD MSE, Scott Perryman, 

MD, Eric Thorsell, MSE, Gabriel Sanchez, MSE, Carlos Mery, MD MPH, 

Thomas Krummel, MD, John Morton, MD, Department of Surgery, 

Stanford University, Stanford, CA, Department of Surgery, University of 

Pennsylvania, Philadelphia, PA 






P285 ESOPHAGECTOMY FOR ADENOCARCINOMA: COMPARISON OF 

MINIMALLY INVASIVE, TRANSHIATAL AND EN BLOC RESECTION 

TECHNIQUES Joerg Zehetner, MD, Steven R DeMeester, MD, Shahin 

Ayazi, MD, Patrick Kilday, MS, Florian Augustin, MD, Helen J Sohn, 

MD, John C Lipham, MD, Jeffrey A Hagen, MD, Tom R DeMeester, MD, 

Department of Surgery, University of Southern California 

P286 ENDOSCOPIC CLOSURE OF AN ESOPHAGOCUTANEOUS FISTULA 

USING A BIOABSORBABLE MATERIAL AND TISSUE GLUE Lonnie W 

Frei, MD, University of Mississippi Medical Center 

P287 OBESITY DOES NOT INCREASE OPERATIVE MORBIDITY FOR 

ESOPHAGEAL RESECTION Brittany L Willer, Stephanie G Worrell, MD, 

Sumeet K Mittal, MD, Seemal Mumtaz, MD, Creighton University Medical 

Center 

P288 TREATMENT CHOICES AND OUTCOMES OF PATIENTS WITH 

MANOMETRICALLY DIAGNOSED ACHALASIA Christian J Finley, MD 

MPH, Linda Miller, RN, Urbach David, MD MSc, Lorenzo Ferri, MD PhD, 

Gail Darling, MD, Division of Thoracic Surgery, Toronto General Hospital 

P289 COMPARISON OF THE EFFECT OF OBESITY ON LAPAROSCOPY- 

ASSISTED DISTAL GASTRECTOMY WITH THAT ON OPEN DISTAL 

GASTRECTOMY Hideki Kawamura, MD, Ryoichi Yokota, MD, 

Department of Surgery, JA Sapporo Kosei Hospital 

P290 A NOVEL LAPAROSCOPIC COMPRESSION ANASTOMOSIS CLIP 

(LAPCAC) FOR LAPAROSCOPIC GASTROENTEROANASTOMOSIS: 

Xinxiang Li, MD, Chengzhu Zheng, MD, Raul J Rosenthal, MD, Kai 

Yin, MD, Department of Colorectal Surgery, Fudan University Cancer 

Hospital 

P291 LAPAROSCOPIC SLEEVE RESECTION FOR NON-CANCEROUS 

GASTRIC TUMORS Gadiyaram Srikanth, MCh, Neel Shetty, MS, TLVD 

Prasad Babu, MCh, Sadiq S Sikora, MS, Manipal Institute of Liver and 

Digestive Diseases 

P292 POSTERIOR VAGUS NERVE WITHIN OR OUTSIDE NISSEN 

FUNDOPLICATION: DOES IT MATTER? Kazuto Tsuboi, MD, András 

Legner, MD, Tommy H Lee, MD, Fumiaki Yano, MD, Sumeet K Mittal, MD, 

Department of Surgery, Creighton University Medical Center, Omaha, 

Nebraska 

P293 DOES METASTATIC LYMPH NODE RATIO ACCEPT AS 

A PROGNOSTIC FACTOR IN THE PATIENTS UNDERWENT 

LYMPHADENECTOMY WITH LESS THAN 15 LYMPH NODES FOR 

GASTRIC CANCER? Sezai Demirbas, MD, Ilker Sucullu, MD, Ali I Filiz, MD, 

Mustafa T Ozer, MD, Kagan Coskun, MD, Nail Ersoz, MD, Gulhane Mil. 

Medical Academy (GMMA) 

P294 OUTCOMES OF LAPAROSCOPIC SURGERY FOR ESOPHAGEAL 

ACHALASIA IN 200 PATIENTS Fumiaki Yano, MD PhD, Nobuo Omura, 

MD PhD, Kazuto Tsuboi, MD, Masato Hoshino, MD, Seryon Yamamoto, 

MD, Syunsuke Akimoto, MD, Hideyuki Kashiwagi, MD PhD, Katsuhiko 

Yanaga, MD PhD, Department of Surgery, Jikei University School of 

Medicine, Tokyo, Japan 

P295 LAPAROSCOPIC TREATMENT OF A UNIQUE CASE OF LARGE 

SLIDING PARAESOPHAGEAL HIATAL HERNIA WITH INTRATHORACIC 

STOMACH AND ACHALASIA M R Jaber, MD, Ata Mazahiri, MD, Loma 

Linda University Medical Center 

P296 A PRELIMINARY STUDY ON PREOPERATIVE THREE- 

DIMENSIONAL SIMULATION USING MDCT FOR SINGLE PORT ACCESS 

SURGERY ON GIST Toshiyuki Natsume, MD PhD, Kiyohiko Shuto, MD 

PhD, Tsuguaki Kohno, MD PhD, Gaku Ohira, MD PhD, Takayuki Tohma, 

MD PhD, Asami Sato, MD PhD, Hiroshige Saito, MD, Takumi Ohta, MD, 

Hiroshi Kawahira, MD PhD, Takashi Akai, MD PhD, Yoshihiro Nabeya, MD 

PhD, Hide, Department of Frontier Surgery, Chiba University Graduate 

School of Medicine, Research Center for Frontier Medical Engineering, 

Chiba University 

P297 THORACOSCOPIC TOTAL OESOPHAGECTOMY Shailesh 

Puntambekar, MS, Galaxy-Care Laparoscopy Institute 

P298 MINIMALLY INVASIVE ESOPHAGECTOMY FOR CLINICAL 

EARLY STAGE ESOPHAGEAL SQUAMOUS CELL CARCINOMA: 

THORACOSCOPY COMPARED WITH MEDIASTINOSCOPY ASSISTED 

Lijie Tan, MD, Mingxiang Feng, MD, Qun Wang, MD, Division of Thoracic 

Surgery, Zhong Shan Hospital, Fu Dan University 

P299 MINIMALLY INVASIVE ESOPHAGECTOMY FOR ESOPHAGEAL 

CANCER VERSUS OPEN THORACOABDOMINAL ESOPHAGECTOMY 

Hiroyuki Kitagawa, Michiya Kobayashi, Tsutomu Namikawa, Kochi 

Medical School 

P300 INITIAL OUTCOME OF LAPAROSCOPIC NISSEN 

FUNDOPLICATION: THAILAND EXPERIENCE Chadin Tharavej, 

MD, Patpong Navicharoen, MD, Poochong Timratana, MD, Suppa-at 

Pungpapong, MD, Suthep Udomsaweangsup, MD, Department of 

Surgery, Chulalongkorn University, Bangkok THAILAND 

P301 Withdrawn. 

P302 THE IMPACFT OF OBESITY AND HIATAL HERNIA ON THE LONG 

TERM RESULT OF LAPAROSCOPIC HELLER MYOTOMY Fawzi S Khayat, 

MD, Patricia Sylla, MD, David W Rattner, MD, Massachusetts General 

Hospital 

P303 TRANSORAL ESOPHAGO-GASTRIC PARTIAL FUNDOPLICATION 

FOR THE TREATMENT OF GASTROESOPHAGEAL REFLUX DISEASE 

(GERD): OPERATIVE FINDINGS AND SAFETY Reginald Bell, MD, Kate 

Freeman, NP MSN, Swedish Medical Center, Englewood CO 

P304 PERIOPERATIVE OUTCOMES OF SURGICAL PROCEDURES FOR 

RECURRENT GERD FOLLOWING NISSEN FUNDOPLICATION Sandeepa 

Musunuru, MD, Jon Gould, MD, University of Wisconsin School of 

Medicine and Public Health 

P305 OUTCOMES FOLLOWING LAPAROSCOPIC VS. ROBOTIC HELLER 

MYOTOMY Sandeepa Musunuru, MD, Jon Gould, MD, University of 

Wisconsin School of Medicine and Public Health 

P306 IDENTIFICATION OF RISK FACTORS FOR POST-OPERATIVE 

DYSPHAGIA AFTER LAPAROSCOPIC PRIMARY ANTI-REFLUX 

SURGERY Kazuto Tsuboi, MD, András Legner, MD, Tommy H Lee, MD, 

Fumiaki Yano, MD, Xiang Fang, PhD, Sumeet K Mittal, MD, Department 

of Surgery, Creighton University Medical Center, Omaha, Nebraska, 

Research and Compliance, Creighton University, Omaha, Nebraska 

P307 INTERSTITIAL LUNG DISEASE AND GASTROESOPHAGEAL 

REFLUX DISEASE: KEY ROLE OF ESOPHAGEAL FUNCTION TESTS 

IN THE DIAGNOSIS AND TREATMENT. Renato V Soares, MD, Anne 

Forsythe, RN, Kyle Hogarth, MD, Nadera Sweiss, MD, Irme Noth, MD, 

Marco G Patti, MD, University of Chicago 

P308 THE TRAINING OF OPERATING SURGEON IN LAPAROSCOPIC 

ASSISTED DISATAL GASTRECTOMY Kazuyoshi Yamamoto, MD, 

Shuji Takiguchi, MD PhD, Yuichiro Hiura, MD, Makoto Yamasaki, MD 

PhD, Hiroshi Miyata, MD PhD, Kiyokazu Nakajima, MD PhD, Yoshiyuki 

Fujiwara, MD PhD, Masaki Mori, MD PhD, Yuichiro Doki, MD PhD, 

Division of Gastroenterological Surgery, Department of Surgery, 

Graduate School of Medicine, Osaka University, Osaka, Japan 

P309 FEASIBILITY OF LAPAROSCOPIC DISTAL GASTRECTOMY FOR 

NON-CURATIVE GASTRIC CANCER FOLLOWING ENDOSCOPIC 

SUBMUCOSAL DISSECTION Yuma Ebihara, PhD, Shunichi Okushiba, 

PhD, Daisuke Miyasaka, PhD, Takeshi Sasaki, PhD, You Kawarada, PhD, 

Shuji Kitashiro, PhD, Hiroyuki Katoh, PhD, Department of Surgery, Tonan 

Hospital 

P310 CORRELATION BETWEEN INTRAOPERATIVE AND 

POSTOPERATIVE EVALUATION OF THE GASTRIC TUBE VIABLITY IN 

ESOPHAGECTOMY Katsunori Nishikawa, MD, Nobuyoshi Hanyuu, MD, 

Yujirou Tanaka, MD, Akira Matsumoto, MD, Yuichiro Tanishima, MD, 

Fumiaki Yano, MD, Hideyuki Kashiwagi, MD, Katsuhiko Yanaga, MD, Jikei 





P311 LAPAROSCOPIC GASTRECTOMY WITH D2 LYMPHADECTOMY 

FOR GASTRIC CANCER: IS IT STILL TIME-CONSUMING? Jun Yan, 

MD, Changhua Zhuo, MD, Yu Yao, MD, Hui Yu, MD, Weidong Zang, MD, 

Mingang Ying, MD, Fujian Provincial Tumor Hospital, Fuzhou, 350014, 

China 

P312 THE M,ANAGEMENT OF GASTROESOPHAGEAL REFLUX 

DISEASE-RELATED PULMONARY SYMPTOMS BY LAPAROSCOPIC 

FUNDOPLICATION Zhong-Gao Wang, MD, Ji Feng, MD, Ji-min Wu, MD, 

Yun-Gang Lai, MD, Xiang Gao, MD, Xiu Chen, MD, Herbert Dardik, MD, 

Ibrahim M Ibrahim, MD, Center for GERD of Er Pao General Hospital, 

Beijing, China and Englewood Hospital & Medical Center, Englewood, NJ 

P313 LUNG TRANSPLANT CANDIDATES MAY BENEFIT FROM ANTI- 

REFLUX SURGERY; DEMONSTRATON OF GASTROESOPHAGEAL 

REFLUX (GERD), ESOPHAGEAL MOTILITY DISORDERS AND 

ANATOMIC ABNORMALITIES IN THIS POPULATION Harmik J 

Soukiasian, MD, Jaclyn T Parker, MD, Edward H Phillips, MD FACS, Robert 

Tabrizi, MD, Sinan A Simsir, MD, Jeffrey L Conklin, MD, Esophageal And 

Thoracic/Foregut Surgery Program, Cedars – Sinai Medical Center. Los 

Angeles, CA 

P314 OVERCOMING BARRIERS TO DEVELOPMENT OF A MINIMALLY 

INVASIVE ESOPHAGECTOMY PROGRAM Kfir Ben-David, MD, Nicole A 

Kissane, MD, Georgios Rossidis, MD, Stephen R Grobmyer, MD, Juan C 

Cendan, MD, George A Sarosi, MD, Steven N Hochwald, MD, University of 

Florida College of Medicine. Gainesville, Florida. 

P315 HYBRID ESOPHAGECTOMY FOR ESOPHAGEAL CANCER: 

COMBINED THORACOSCOPIC AND MEDIASTINOSCOPIC 

ESOPHAGECTOMY. Y Izumi, PhD, A Miura, PhD, T Kato, MD, T Ryotokuji, 

MD, Tokyo Metropolitan Cancer and Infectious Disease Center, 

Komagome Hospital, Tokyo, Japan 

P316 LAPAROSCOPIC MANAGEMENT OF GASTROINTESTINAL 

STROMAL TUMOURS AT A CANADIAN INSTITUTION Jasmine C Lam, 

MD, Adam T Meneghetti, MD, Ormond N Panton, MD, University of 

British Columbia 

P317 LOWER LEVELS OF OCCASIONAL BLOOD GLUCOSE IN PATIENTS 

WITH BILLROTH I RECONSTRUCTION AFTER NOT VAGUS NERVE- 

SPARED LAPAROSCOY-ASSISTED DISTAL GASTRECTOMY. Hiroshi 

Kawahira, MD, Hideki Hayashi, MD, Toshiyuki Natsume, MD, Yoshihiro 

Nabeya, MD, Takashi Akai, MD, Hisahiro Matsubara, MD, Department of 

Frontier Surgery, Chiba University Graduate School of Medicine 

P318 EFFECTS OF EARLY ORAL FEEDING ON SURGICAL OUTCOMES 

AND RECOVERY AFTER LAPAROSCOPY-ASSISTED DISTAL 

GASTRECTOMY FOR EARLY GASTRIC CANCER: A NONRANDOMIZED 

STUDY. Shinya Asami, Hitoshi Idani, Hiroshi Sasaki, Kenjirou Kumano, 

Youhei Kurose, Shinichirou Kubo, Hiroki Nojima, Kanyu Nakano, Takashi 

Yoshioka, Masahiko Muro, Hitoshi Kin, Norihisa Takakura, Department of 

surgery, Fukuyama city hospital, Hiroshima, Japan 

P319 ESOPHAGO-GASTROSTOMY USING NARROW GASTRIC TUBE 

AFTER LAPAROSCOPY-ASSISTED PROXIMAL GASTRECTOMY Kenoki 

Ohuchida, MD PhD, Eishi Nagai, MD PhD, Kohei Nakata, MD PhD, Hideki 

Takanami, MD, Takao Ohtsuka, MD PhD, Hiroki Toma, MD PhD, Masao 

Tanaka, MD PhD FACS, Department of Surgery and Oncology, Kyushu 

University 

P320 LAPAROSCOPIC MANAGEMENT OF GASTRIC GIST Mohan 

Narasimhan, Kumar Palaniappan, Ramesh Ardhanari, Department of 

Surgery and Gastroenterology, Meenakshi Mission Hospital & Research 

Center, Madurai 

P321 COST COMPARISON OF LAPAROSCOPIC V/S OPEN 

GASTRECTOMY IN THE TREATMENT OF GASTRIC CANCER Pablo 

Becerra, MD, Ricardo Yañez, MD, Sergio Guzman, MD, Luis Ibanez, MD, 

Ricardo Funke, MD, Cristian Alvear, Alex Escalona, MD, Department of 

Digestive Surgery. Pontificia Universidad Católica de Chile 

P322 THE ROLE OF ENDOSCOPIC ULTRASOUND IN ASSESSING TUMOR 

RESPONSE AND STAGING POST NEOADJUVANT CHEMOTHERAPY IN 

ESOPHAGEAL CANCER Subhasis Misra, MD MS, Mark W Choi, BS, Alan 

S Livingstone, MD, Dido Franceschi, MD, Division of Surgical Oncology, 

Sylvester Comprehensive Cancer Center, University of Miami 

P323 SINGLE PORT ACCESS PARTIAL GASTRECTOMY FOR GASTRIC 

GIST. Ken Hagiwara, MD, Minoru Matsuda, MD FACS, Motoo Yamagata, 

MD, Shigeoki Hayashi, MD, Tadatoshi Takayama, MD, Division of 

digestive surgery, Nihon University School of medicine 

P324 ESOPHAGEAL RECONSTRUCTION USING BIOLOGICAL 

SCAFFOLDS IN A CLINICAL SETTING. Toshitaka Hoppo, MD PhD, Bart 

Witteman, MD, Adolfo E Badaloni, MD, Ricardo Casella, MD, Alejandro F 

Sanz, MD, Stephen F Badylak, DVM PhD MD, Blair A Jobe, MD, Alejandro 

Nieponice, MD, 1) Esophageal Surgery Institute, Fundacion Favaloro, 

Buenos Aires, Argentina. 2) The Heart, Lung and Esophageal Institute 3) 

McGowan Institute for Regenerative Medicine, University of Pittsburgh 

Medical Center, Pittsburgh, PA USA 

P325 ESD-ASSISTED LAPAROSCOPIC PARTIAL GASTRECTOMY 

FOR GASTRIC SUBMUCOSAL TUMOR Takashi Ogata, Hidenori 

Tomioka, Yusuke Murakoshi, So Katayanagi, Motohide Shimazu, 

Gastroenterological Surgery, Hachioji Medical Center, Tokyo Medical 

University, Tokyo, Japan 

P326 PARAESOPHAGEAL HIATAL HERNIA REPAIR USING GORE 

BIO-A TISSUE REINFORCEMENT, ONE YEAR FOLLOW UP DATA 

James M Massullo, MD, Tejinder P Singh, MD, Brian Binetti, MD, Ward 

Dunnican, MD, Albany Medical Center 

P327 LAPAROSCOPIC PARAESOPHAGEAL HERNIA REPAIR WITH 

HUMAN ACELLULAR DERMAL MATRIX CRUROPLASTY Dennis F Diaz, 

MD, John Scott Roth, MD, University of Kentucky Chandler Medical 

Center 

P328 LAPAROSCOPIC GASTROJEJUNOSTOMY FOR MALIGNANT 

GASTRIC OUTLET OBSTRUCTION. Norihito Wada, MD PhD, Yoshiro 

Saikawa, MD PhD, Rieko Nakamura, MD PhD, Takashi Ohyama, MD, 

Tsunehiro Takahashi, MD PhD, Hiroya Takeuchi, MD PhD, Yuko Kitagawa, 

MD PhD, Department of Surgery, School of Medicine, Keio University 

P329 STANDARDIZATION OF VIDEO-ASSISTED ESOPHAGECTOMY: 

HAND-ASSISTED THORACOSCOPIC SURGERY AS A SAFETY 

PROCEDURE Toshiaki Shichinohe, MD PhD, Shunichi Okushiba, MD PhD, 

You Kawarada, MD PhD, Shuji Kitashiro, MD PhD, Hiroto Manase, MD PhD, 

Kentaro Kato, MD PhD, Takahiro Tsuchikawa, MD PhD, Joe Matsumoto, MD 

PhD, Ryosuke Kawasaki, MD PhD, Eiichi Tanaka, MD PhD, Satosh, Surgical 

Oncology, Hokkaido University Graduate School of Medicine, Tonan 

Hospital, Asahikawa Redcross Hospital, Hokkaido, Japan 

P330 MEDIASTINOSCOPIC TRANSHIATAL ESOPHAGECTOMY FOR 

AN AGED PERSON WITH TYPE 4 THORACIC ESOPHAGEAL CANCER: 

REPORT OF A CASE T Ryotokuji, MD, Y Izumi, PhD, A Miura, PhD, T Kato, 

MD, K Ogawa, MD, okyo Metropolitan Cancer and Infectious Diseases 

Center, Komagome Hospital, Tokyo, JAPAN 

P331 COMPARATION BETWEEN LAPAROSCOPY ASSISTED 

GASTRECTOMY D2 LYMHP NODE DISSECTION AND OPEN 

PROCEDURE FOR GASTRIC CANCER IN COLOMBIA Jorge Alberto 

Bernal Mesa, Dr, Evelyn Astrid Dorado Alban, Dr Fellowship, Mario 

muñoz, Dr, Las Americas Oncology Institute 

P332 TRANASVAGINAL SPECIMEN EXTRACTION AFTER TOTALLY 

LAPAROSCOPIC SUBTOTAL GASTRECTOMY IN EARLY GASTRIC 

CANCER Young-Joon Lee, PhD, Sang-Ho Jeong, MD, Won-Joon Choi, 

PhD, Soon-Tae Park, PhD, Sang-Kyung Choi, PhD, Soon-Chan Hong, PhD, 

Young-tae Joo, PhD, Chi-Young Jeong, MD, Hyeong-Gon Moon, MD, 

Woo-Song Ha, PhD, Department of Surgery, Department of Obstetrics 

and Gynecology, Gyeongsang National University Hospital, Gyeongnam 

Regional Cancer Center,Gyeongsang Institute of Health Sciences, Jinju, 

South Korea. 






P333 THE SAFETY OF BIOLOGIC MESH FOR LAPAROSCOPIC REPAIR 

OF LARGE, COMPLICATED HIATAL HERNIA Eelco Wassenaar, MD, Saad 

Shebrain, MD, Huseyin Sinan, MD, Valeria Martin, MD, Carlos Pellegrini, 

MD, Brant Oelschlager, MD, Center for Videoendoscopic Surgery, 

Department of Surgery, University of Washington 

P334 THE RISK OF COMBINED ORGAN RESECTION IN RADICAL 

GASTRECTOMY Sang-Ho Jeong, MD, Young-Joon Lee, PhD, Soon-Tae 

Park, PhD, Sang-Kyung Choi, PhD, Soon-Chan Hong, PhD, Young-tae 

Joo, PhD, Chi-Young Jeong, MD, Hyeong-Gon Moon, MD, Woo-Song Ha, 

PhD, Department Surgery of Gyeongsang National University Hospital, 

Gyeongnam Regional Cancer Center, Gyeongsang Institue of Health 

Sciences, Jinju, South Korea 

P335 DISTAL GASTRECTOMY WITH LAPAROSCOPIC ASSISTANCE FOR 

NON-OVERWEIGHT PATIENTS WITH T1N0 GASTRIC CANCER Hideyuki 

Ishida, PhD, Toru Ishiguro, MD, Norimichi Okada, PhD, Keiichiro Ishibashi, 

PhD, Norihiro Haga, PhD, Department of Digestive Tract and General 

Surgery, Saitama Medical Center, Saitama Medical School 

P336 FACTORS OF INCREASING BLOOD LOSS AND OPERATION TIME 

IN LAPAROSCOPIC ASSISTED DISTAL GASTRECTOMY Hisae Aoki, MD, 

Osamu Yanagida, MD PhD, Gen Nagao, MD, Nobutsugu Abe, MD PhD, 

Tadahiko Masaki, MD PhD, Toshiyuki Mori, MD PhD, Masanori Sugiyama, 

MD PhD, Yutaka Atomi, MD PhD, Kyorin University, School of Medicine 

P337 TOTALLY LAPAROSCOPIC TOTAL GASTRECTOMY WITH 

ESOPHAGOJEJUNOSTOMY USING LINER STAPLING DEVICES. Eishi 

nagai, MD PhD, Hiroki Toma, MD PhD, Kenoki Ouchida, MD PhD, Kohei 

Nakata, MD, Takao Otsuka, MD PhD, Shuji Shimizu, MD PhD, Masao 

Tanaka, MD PhD, Department of Surgery and Oncology, Graduate 

School of Medical Sciences, Kyushu University 

P338 LAPAROSCOPIC TRANSHIATAL APPROACH FOR SQUAMOUS 

CELL CARCINOMA OF THE LOWER THIRD OF THE ESOPHAGUS 

A Miura, PhD, Y Izumi, PhD, T Kato, MD, T Ryotokuji, MD, Tokyo 

Metropolitan Cancer and Infectious Disease Center, Komagome 

Hospital, Tokyo, Japan 

P339 TECHNIQUES OF ROUX-EN Y RECONSTRUCTION USING 

REVERSED RHO-SHAPED SIDE-TO-SIDE ESOPHAGO-JEJUNOSTOMY 

IN LAPAROSCOPY-ASSISTED TOTAL GASTRECTOMY (LATG) Norio 

Shiraishi, MD, Tyuyoshi Etoh, MD, Kazuhiro Yasuda, MD, Masafumi 

Inomata, MD, Seigo Kitano, MD, Department of Surgery I, Oita University 

Faculty of Medicine, 

P340 THE TOTAL NUMBER OF RESECTED LYMPH NODES HAS AN 

IMPACT ON SURVIVAL IN NODE-NEGATIVE ESOPHAGEAL CANCER 

Jacqui C. Zhu, MBBS, Guillemo Becerril, MBBS, Gregory L. Falk, MBBS, 

Deptartment of Upper Gastrointestinal Surgery and Endosurgery, 

Concord Hospital 

P341 LAPAROSCOPIC FUNDOPLICATION FOR GERD; EXPERIENCE 

FROM A TERTIARY CARE HOSPITAL IN INDIA. Pawanindra Lal, MD 

DNBFRCSEd FRCSGlasg, Nitin Leekha, MD, Rakesh Saini, MD, Jagdish 

Chander, MD, Vinod K Ramteke, MD, Department of Surgery, Maulana 

Azad Medical College, New Delhi, India 

P342 LAPAROSCOPIC FUNDOPLICATION FOR GASTRO-ESOPHAGEAL 

REFLUX DISEASE: A 10 YEAR EXPERIENCE Konstantinos Tsalis, Prof, 

Stavros Kalfadis, PhD, Konstantinos Blouhos, MD, Theofanis Maris, MD, 

Kyriakos Christodoulou, MD, Foteini Kordits, MD, Charalampos Lazaridis, 

Prof, D’ Surgical Department Aristotle University of Thessaloniki Greece 

P343 FEASIBILITY AND POST OPERATIVE OUTCOME OF MINIMALLY 

INVASIVE ESOPHAGECTOMY IN PATIENTS WHO RECEIVED 

NEOADJUVANT CHEMOTHERAPY FOR LOCALLY ADVANCED 

ESOPHAGEAL CANCER C Palanivelu, P Senthilnathan, MS DNB MRCS, 

V Vaithiswaran, MS MRCS, N Anand Vijai, MS, K.V Jaiganesh, MS, GEM 

Hospital 

P344 LYMPH NODE HARVEST IN MINIMALLY INVASIVE 

ESOPHAGECTOMY FOR ESOPHAGEAL CANCER C Palanivelu, MCh 

FACS FRCS, P S Rajan, MS FACS, S Rajapandian, MSFRCS, P Senthilnathan, 

MS DNB MRCS, R Rohit, MS, A.P Manoj Kumar, MS, V Vaithiswaran, MS 

MRCS, P Praveen Raj, MS, GEM Hospital 

P345 A NEW SYNTHETIC BIOABSORBABLE PROSTHETIC AND METHOD 

OF FIXATION FOR MESH REINFORCEMENT OF CRURAL CLOSURE 

DURING HIATAL HERNIA REPAIR Dan Wandrey, MD, Benjamin Powell, 

MD, Guy Voeller, MD, University of Tennessee Health Science Center, 

Memphis, TN 

P346 LAPAROSCOPIC GASTRECTOMY FOR CANCER Theodore Liakakos, 

MD, Evangelos P Misiakos, MD, Anastasios Macheras, MD, Dimitrios 

Bistarakis, MD, Paul Patapis, MD, Gabriel Karatzas, MD FACS, 3rd 

Department of Surgery-University of Athens School of Medicine 

P347 GASTRODUODENAL INTUSSUSCEPTION WITHOUT UNDERLYING 

MASS Matthew M Philp, MD, Daniel T Dempsey, MD, Colleen Gaughan, 

MD, Temple University Hospital 

P348 MINIMALLY INVASIVE ESOPHAGECTOMY IN A PATIENT WITH 

PORTAL HYPERTENSION. Scott J Keckler, MD, Colleen S Hupp, DO, Amit 

K Taggar, MD, Mazin F Al-kasspooles, MD, Niazy M Selim, MD MBChB 

PhD, University of Kansas Medical Center, Department of Surgery 

P349 ONCOLOGICAL ‘HOLY PLANE’ IN CHEST FOR OESOPHAGEAL 

CANCER RESECTION Amir Nisar, FRCSGlasg FRCSI FRCS, H Ali, John 

B Schofield, Regional Oesophago Gastric Cancer Unit, Maidstone and 

Tunbridge Wells Trust, Maidstone, Kent, England, United Kingdom 

P350 THREE “5MM” PORTS LAPAROSCOPIC NISSEN FUNDOPLICATION 

- THE LEAST INVASIVE SO FAR. Amir Nisar, FRCSGlag FRCSI FRCS, H Ali, 

U Bracale, Y Abdulaal, Oesophago Gastric Regional Unit, Maidstone and 

Tunbridge Wells Trust, Maidstone, Kent, England, United Kingdom 

P351 IMPACT OF A VISITING PRECEPTOR ON THE INSTITUTIONAL 

SURGICAL RESULTS OF LADG Shuji Takiguchi, MD, Yoshiyuki Fujiwara, 

MD, Makoto Yamasaki, MD, Hiroshi Miyata, MD, Kiyokazu Nakajima, MD, 

Mitsugu Sekimoto, MD, Masaki Mori, MD, Yuichiro Doki, MD, Osaka Univ. 

Dept. of Gastroenterological Surgery 

P352 HELLER’S MYOTOMY WITH RECONSTRUCTION OF THE 

ANGLE OF HIS IN ACHALASIA. IMPACT ON POSTOPERATIVE 

GASTROESOPHAGEAL REFLUX AND LES PRESSURE Juan F Molina, 

MD, Mauricio Sierra, MD, Federico López, MD, David Velázquez, MD PhD, 

Juan P Pantoja, MD, Miguel A Valdovinos, MD, Miguel F Herrera, MD PhD, 

Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 

Mexico City, Mexico 

P353 TOTALLY SUPINE LAPAROSCOPIC/THORACOSCOPIC IVOR LEWIS 

OESOPHAGECTOMY - A NOVEL TECHNIQUE Amir Nisar, FRCSGlasg 

FRCSI FRCS, Umberto Bracale, H Ali, Y Abdulaal, Oesophago Gastric 

Regional Unit, Maidstone and Tunbridge Wells Trust, Maidstone, Kent, 

England, United Kingdom 

P354 LAPAROSCOPIC REPAIR OF RECURRENT PARAESOPHAGEAL 

HERNIA: A RARE BUT SAFE PROCEDURE Marianne Franco, MD, 

Ariel Spencer, MD, Hien Nguyen, MD, Kimberley Steele, MD, Michael 

Schweitzer, MD, Michael Marohn, DO, Anne Lidor, MD MPH, Johns 

Hopkins Medical Institutions 

P355 LONG AND SHORT TERM RESULTS OF LESS INVASIVE SURGERY 

FOR STOMACH CANCER: LAPAROSCOPIC-ASSISTED DISTAL 

GASTRECTOMY WITH “SLIDING WINDOW METHOD (SWM)”. 

Takanobu Hoshino, MD PhD, Takashi Ishida, MD, Narihiro Cho, MD, 

Akio Odaka, MD PhD, Hashi Daijo, MD PhD, Saitama Medical University, 

Saitama Medical Center 

P356 GASTRIC DUPLICATION TREATED BY LAPAROSCOPIC GASTRIC 

PARTIAL RESECTION Yoo Shin Choi, MD, Beom Gyu Kim, MD, In Taik 

Chang, MD, Department of Surgery, College of Medicine, Chung-Ang 

University, Seoul, Korea 

P357 IMPROVEMENT AFTER LAPAROSCOPIC AND ENDOSCOPIC 

PYLOROPLASTY FOR GASTROPARESIS Michael L Hibbard, MD, Lee L 

Swanström, MD, Christy M Dunst, MD, The Oregon Clinic 

P358 TRANSORAL INCISIONLESS FUNDOPLICATION IMPROVES 

REFLUX SYMPTOMS IN LONG-TIME PPI USERS: A RETROSPECTIVE 

STUDY IN LIVINGSTON COUNTY, KENTUCKY William E Barnes, MD 

MBAFACS, Michael P Gavin, MD, Stephanie Mundy, RN, Livingston 

Hospital and Healthcare Services, Inc., Salem, KY 




P359 CLINICAL SIGNIFICANCE OF ENDOSCOPIC SURGERY FOR 

THORACIC ESOPHAGEAL CANCER AFTER NEOADJUVANT 

CHEMOTHERAPY Hiroki Toma, MD, Eishi Nagai, MD, Kenoki Ohuchida, 

MD, Takao Ohtsuka, MD, Shuji Shimizu, MD, Masao Tanaka, MD, 

Department of Surgery and Oncology 

P360 MINIMALLY INVASIVE ESOPHAGO- GASTRECTOMY (IVOR- 

LEWIS) A SERIES OF 13 PATIENTS C Palanivelu, MCh FRCS FACS, P 

Senthilnathan, MS DNB MRCS, V Vaithiswaran, MS MRCS, P Praveen Raj, 

MS, GEM hospital 

P361 MINIMALLY INVASIVE OESOPHAGECTOMY IN ENGLAND: 

TRENDS OF UTILISATION Kamal Nagpal, MD, Antonio Ivan Lazzarino, 

MD, Alex Bottle, PhD, Omar Faiz, FRCS, Krishna Moorthy, FRCS, Paul 

Aylin, FFPH, Department of Biosurgery and Surgical Technology, 

Imperial College, St Mary’s Hospital, Praed Street, London W21NY, 

United Kingdom. 

P362 LAPAROSCOPIC REVISIONAL FUNDOPLICATION WITH PRIMARY 

SUTURED CLOSURE AND PROSTHETIC REINFORCEMENT: A 

RETROSPECTIVE STUDY Sergio Roll, MD PhD, CEITEL - Center for 

Education, Inovation and Technology in EndoSurgery- Laparoscopy of 

Sao Paulo, Brazil. 

P363 LAPAROSCOPIC ANTI-REFLUX SURGERY AS A DEFINITIVE 

TREATMENT IN REFRACTORY UPPER AND LOWER RESPIRATORY 

TRACT DISEASES. A A Warsi, C P Armstrong, Bristol, U.K. 

P364 ESOPHAGEAL STENTING FOR IMMEDIATE PALLIATION OF 

SYMPTOMATIC THORACIC MALIGNANCIES Natasha M Rueth, MD, 

Darcy Shaw, MD, Shawn S Groth, MD, Jennifer Swanson, MD, Jonathan 

D’Cunha, MD PhD, Michael A Maddaus, MD, Rafael S Andrade, MD, 

University of Minnesota Department of Surgery, Division of Thoracic and 

Foregut Surgery, Minneapolis MN USA 

P365 ARE RURAL GENERAL SURGEONS PERFORMING VALID 

COLONOSCOPIES? Truman M Sasaki, MD FACS, Solo Practitioner 

P366 ENDOSCOPIC MANAGEMENT OF A RARE RIGHT COLON 

PERFORATION FROM A MIGRATED BILIARY STENT Logan Rawlins, 

MD, Linda Barney, MD, Wright State University, Dept of Surgery 

P367 FIRST REPORT OF SPRAY CRYOSURGERY DEPTH OF INJURY TO 

THE HUMAN ESOPHAGUS Afonso Ribeiro, MD, Dido Francerschi, MD, 

Pablo Bejarano, MD, Lynne Sparling, RN, Alan Livingstone, MD, Bach 

Ardalan, MD, University of Miami 

P368 SAFETY AND QUALITY OF COLONOSCOPY PERFORMED BY 

GENERAL SURGEONS Ibrahim Ahmed, FRCSI, Elnazier Ibrahim, FRCSI, 

Edrian Iskandar, MRCSI, Alexander Lockley, MBCh, Ibraheem Tunau, 

FRCSI, Mohamed Salama, FRCSI, Olumide Fagbeja, FRCSI, Our Lady’s 

Hospital, Navan, Ireland 

P369 SMALL-DOSE INDIA INK TATTOOING FOR PREOPERATIVE 

LOCALIZATION OF COLORECTAL TUMOR: A PILOT STUDY Mi Ri 

Hwang, MD, Dae Kyung Sohn, MD, Ji Won Park, MD, Byung Chang Kim, 

MD, Chang Won Hong, MD, Kyung Su Han, MD, Hee Jin Chang, MD, 

Jae Hwan Oh, MD, Center for Colorectal Cancer, Research Institute & 

Hospital, National Cancer Center 

P370 EARLY US EXPERIENCE WITH ENDOSCOPIC REMOVAL OF THE 

ORBERA SYSTEM® INTRAGASTRIC BALLOON. Mark A Fusco, MD, 

LifeShape Advanced Bariatrics Center of Florida, and Melbourne 

Internal Medicine Associates 

P371 ENDOSCOPIC STENT MANAGEMENT OF LEAKS AND 

ANASTOMOTIC STRICTURES AFTER FOREGUT SURGERY Panot 

Yimcharoen, MD, Fady Moustarah, MD MPH, Nabil Tarek, MD, Joseph 

Talarico, MD, Kibwe Weaver, MD, Fahed Sabagh, MD, Stacy Brethauer, 

MD, Philip Schauer, MD, Matthew Kroh, MD, Bipan Chand, MD, Bariatric 

& Metabolic Institute, Cleveland Clinic Foundation, Cleveland, OH 

P372 OUTCOME COMPLICATIONS OF PERCUTANEOUS ENDOSCOPIC 

GASTROSTOMY TUBE PLACEMENT IN SEVERLY MALNOURISHED 

PATIENTS Sammy D Eghbalieh, MD, Navid Eghbalieh, MD, Robert 

Brenes, MD, Michael S Ajemian, MD FACS, Saint Mary’s Healthcare 

Hospital System 

P373 A CASE SERIES OF TRANSMURAL PRESSURE NECROSIS FROM 

PROLONGED USE OF PEG TUBES Hamed Taheri, MD, Vijay Rastogi, MD 

FACS, Hani mourad, MD, Harjit Kohli, MD FACS, Easton Hospital 

P374 THE RELATIONSHIP BETWEEN POST-OPERATIVE ANATOMY AND 

ENDOSCOPIC STENT MIGRATION Gary S Schwartz, MD, Koji Park, MD, 

Scott B Gmora, MD, Kevin McGill, MD, Deva Boone, MD, Shahzad S Razi, 

MD, James J McGinty, MD, Faiz Y Bhora, MD, Scott J Belsley, MD, Julio A 

Teixeira, MD, St. Luke’s-Roosevelt Hospital Center, Columbia University 

College of Physicians and Surgeons 

P375 FLEXIBLE ENDOLOOP “ HAND MADE” Mohamed Seleem, PhD, 

Cairo University Faculty Of Medicine 

P376 EFFICACY OF A PROTOTYPE ENDOSCOPE WITH TWO 

DEFLECTING WORKING CHANNELS FOR ENDOSCOPIC SUBMUCOSAL 

DISSECTION (ESD): A PROSPECTIVE COMPARATIVE EX-VIVO STUDY 

Suck-Ho Lee, MD PhD, Mark A Gromski, BA, Alexandre Derevianko, 

MD, Daniel B Jones, MD MS FACS, Douglas K Pleskow, MD, Mandeep 

Sawhney, MD, Ram Chuttani, MD, Kai Matthes, MD PhD, Beth Israel 

Deaconess Medical Center and Harvard Medical School, Boston, MA 

P377 ONE STEP MANAGEMENT OF COMMON BILE DUCT STONES 

Matthew Johnson, MD, Charles R St. Hill, MD, Nabeel Arain, BA MSIV, 

Nathan Ozobia, MD FACS, University of Nevada School of Medicine, 


P378 PNEUMATOSIS COLI FROM ENDOSCOPY: A CASE REPORT Kayla J 

Foertsch, MD, De Tran, MD, VA Fargo, ND 

P379 CONCURRNET USE OF SELF-EXPANDABLE BILIARY AND ENTERIC 

METAL STENTS FOR OBSTRUCTING INOPERABLE DUODENAL 

CANCER Diya I Alaedeen, MD, Jose M Martinez, MD, Cleveland Clinic 

Foundation, Fairview Hospital Department of Surgery, and * University 

of Miami School of Medicine, Department of Surgery, Division of 

Laparoendoscopic Surgery 

P380 ARE COLONOSCOPIES BY COLORECTAL SURGEONS ADEQUATE? 

Vincent Obias, MD, Grace Montenegro, MD, Bruce Orkin, MD, George 

Washington University 

P381 ENDOSCOPIC TREATMENT OF LARGE CHRONIC 

GASTROCUTANEOUS FISTULA AFTER BARIATRIC SURGERY USING 

A PARTIALLY COVERED METALLIC ESOPHAGEAL STENT Javier 

E Andrade, MD, Alberto R Iglesias, MD, Decio Carvalho, MD, Jose M 

Martinez, MD, University of Miami. Miller School of Medicine. DeWitt 

Daughtry Family Department of Surgery. Division of Laparoendoscopic 

and Bariatric Surgery. Miami, FL, USA. 

P382 THE VALUE OF ERCP IN THE MANAGEMENT OF COMPLEX LIVER 

INJURIES Charles R St. Hill, MD, Matthew Johnson, MD, Nabeel Arain, 

BA MSIV, Nathan Ozobia, MD FACS, University of Nevada School of 

Medicine, Department of Surgery, Las Vegas, Nevada 

P383 BARRETT’S ESOPHAGITIS IN PATIENTS UNDERGOING 

PREOPERATIVE SCREENING ENDOSCOPY FOR BARIATRIC SURGERY 

Atul K Madan, MD, Jose M Martinez, Alberto R Iglesias, MD, Scott T 

Hartnett, DO, Javier Andrade, MD, Beverly Hills Surgery Center and 

University of Miami 

P384 LAPAROSCOPIC SUBTOTAL CHOLECYSTECTOMY. A SAFE 

ALTERNATIVE! Gadiyaram Srikanth, MCh, Neel Shetty, MS, TLVD Prasad 

Babu, MCh, Sadiq S Sikora, MS, Manipa Institute of Liver and Digestive 

Surgery 

P385 SINGLE-STAGE LAPAROSCOPIC CBD EXPLORATION IMPROVES 

THE OUTCOME OF LC IN CURRENT LAPAROSCOPIC ERA. Shahram 

Nazari, Dr, Semira Mousavi Khosroshahi, Dr, Hosain Khedmat, Dr, 

Shahram Agah, Dr, Erfan Hospital, Department of General and 

Laparoscopic surgery 

P386 MINIMALLY INVASIVE CHOLECYSTECTOMY PROCEDURES – A 

REVIEW OF THE LITERATURE. Manmohan Varma, Ms, Kushal Varma, 

MedicalStudent, Private, Kanpur, India 

P387 LAP MANAGEMENT OF VARIOUS PANCREATIC TUMORS Shailseh 

Puntambekar, Galaxy Care Laparoscopy 






P388 LAPAROSCOPIC CHOLECYSTECTOMY IN HIV POSITIVE PATIENTS: 

A CASE SERIES Daniel T Farkas, MD, Dovid S Moradi, BA, John M 

Cosgrove, MD, Bronx-Lebanon Hospital Center, Albert Einstein College 

of Medicine 

P389 TRANS-UMBILICAL SINGLE INCISION LAPAROSCOPIC 

CHOLECYSTECTOMY CONSIDERED ABOUT ECONOMIC EFFICIENCY 

Hidenori Fujii, MD PhD, Yosiyuki Kawakami, MD PhD, Toshiharu Aotake, 

MD PhD, Koiji Doi, MD PhD, Kei Hirose, MD, Hisaya Shirai, MD, Naoki 

Nagayoshi, MD, Atushi Ikeda, MD, Fumie Tanak, MD, Yuki Hirose, MD 

PhD, Fukui Red Cross Hospital 

P390 CLINICAL OUTCOMES COMPARED BETWEEN LAPAROSCOPIC 

AND OPEN DISTAL PANCREATECTOMY FOR BENIGN TUMORS Jun 

Chul Chung, MD PhD, Hyung Chul Kim, MD PhD, Chong Woo Chu, MD 

PhD, Department of Surgery, Soonchunhyang University College of 

Medicine,Soonchunhyang University Bucheon Hospital, Bucheon, Korea. 

P391 IN LAPAROSCOPIC DISTAL PANCREATECTOMY, PANCREATIC 

RESECTION USING HARMONIC SCALPEL Jun Chul Chung, MD PhD, 

Hyung Chul Kim, MD PhD, Chong Woo Chu, MD PhD, Department 

of Surgery, Soonchunhyang University College of Medicine, 

Soonchunhyang University Bucheon Hospital, Bucheon, Korea. 

P392 GASLESS SINGLE PORT LAPAROSCOPIC CHOLECYSTECTOMY 

Nobumi Tagaya, PhD, Akihito Abe, PhD, Keiichi Kubota, PhD, Second 

Department of Surgery, Dokkyo Medical University, Tochigi, Japan 

P393 MINIMALLY INVASIVE PANCREATIC NECROSECTOMY – HOW 

TO CHOOSE THE BEST APPROACH? Sanjiv P Haribhakti, Harshad 

Soni, Anish P Nagpal, Nitin Patel, Rahul Naik, Department of Surgical 

Gastroenterology and Advanced Laparoscopic Surgery, Haribhakti 

Surgical Hospital 

P394 FEASIBILITY OF LAPAROSCOPIC PORTAL VEIN LIGATION PRIOR 

TO MAJOR LIVER RESECTION Hitoshi Inagaki, MD, Tsuyoshi Kurokawa, 

MD, Tadashi Yokoyama, MD, Nobuhiro Ito, MD, Manabu Kikuchi, MD, 

Yasuhisa Yokoyama, MD, Toshiaki Nonami, MD, Department of Surgery, 

Yokoyama Hospital for Gastroenterological Diseases 

P395 LAPAROSCOPIC PANCREATIC SURGERY Nobumi Tagaya, PhD, 

Aya Nakagawa, PhD, Yukihiro Iso, PhD, Yoshimi Iwasaki, phD, Mitsugi 

Shimoda, PhD, Keiichi Kugota, PhD, Second Department of Surgery, 

Dokkyo Medical University, Tochigi, Japan 

P396 A PROSPECTIVE COHORT STUDY FOR SIMPLE NEW TECHNIQUE 

TWO-INCISION LAPAROSCOPIC CHOLECYSTECTOMY Pornthape 

Prathanvanich, Patpong Navicharern, Chadin Tharavej, Suthep 

Udomsawaengsup, Suppa-ut Suppa-ut, Chulalongkorn University 

P397 SINGLE PORT LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT 

THE INDUCTION OF PNEUMOPERITONEUM Masashi Ihikawa, PhD, 

Takako Furukawa, Dr, Ayumi Kihara, Dr, Yutaka Matsuoka, Dr, Yoko 

Yamamura, Dr, Takuya Minato, Dr, Yasuhiro Yuasa, Dr, Toshihiro Ichimori, 

Dr, Suguru Kimura, PhD, Akihiro Sakata, PhD, Tokushima Red Cross 

Hospital 

P398 LAPAROSCOPIC LIVER RESECTION FOR HEPATOCELLULAR 

CARCINOMA IN PATIENTS WITH LIVER CIRRHOSIS Chung-Wei Lin, 

MD, Tzu-June Tsai, MD, Tsung-Yen Cheng, MD, Chii-Ming Chen, MD, 

Department of Surgery, Koo-Foundation Sun Yat-Sen Cancer Center, 

Taipei, Taiwan 

P399 LAPAROSCOPIC SURGERY FOR BILIARY TRACT CANCER Osamu 

Itano, MD PhD, Shingo Maeda, MD PhD, Naokazu Chiba, MD PhD, 

Takeyuki Wada, MD, Takashi Nakayama, MD, Hideki Ishikawa, MD PhD, 

Yasumasa Koyama, MD, Yuko Kitagawa, MD PhD, Endoscopic Surgery 

Center, Eiju General Hospital, Tokyo, Japan, Department of Surgery, Keio 

University, School of Medicine, Tokyo, Japan 

P400 BOUVERET’S SYNDROME: GALLSTONE ILEUS OF THE 

DUODENUM Katie Love, MD, Zachary P Englert, DO, Stephan Barrientos, 

MD, Mark D Marilley, MD, Curtis E Bower, MD FACS, ECU Department of 

Surgery, Brody School of Medicine 

P401 SINGLE INCISION LAPAROSCOPIC CHOLECYSTECTOMY WITH 

ROUTINE CHOLANGIOGRAM: REPORT OF 30 CASES Brendan G 

O’Connell, MD, Bruce Bernstein, PhD, Ibrahim M Daoud, MD, University 

of Connecticut, St. Francis Hospital and Medical Center, Hartford, CT 

P402 UMBILICAL SINGLE INCISION LAPAROSCOPIC 

CHOLECYSTECTOMY Alberto R Ferreres, MD PhD MPH FACS, Anibal 

Rondán, MD, Julieta Paleari, MD, Mariano E Giménez, MD, Vicente P 

Gutiérrez, MD FACS, Department of Surgery, University of Buenos Aires 

P403 LAPAROSCOPIC RESECTION OF THE LEFT LIVER: TECHNICAL 

REFINEMENTS FOR STANDARDIZATION Satoru Imura, MD, Mitsuo 

Shimada, MD PhD, Toru Utsunomiya, MD PhD, Yuji Morine, MD, Tetsuya 

Ikemoto, MD, Jun Hanaoka, MD, Shuichi Iwahashi, MD, Yu Saito, MD, 

Nobuhiro Kurita, MD, Hidenori Miyake, MD PhD, Department of Surgery, 

The University of Tokushima 

P404 LAPAROSOCPIC MANAGEMENT OF CYSTIC NEOPLASM OF 

PANCREAS Mohan Narasimhan, Sourav Kalia, Kumar Palaniappan, 

Ramesh Ardhanari, Department Of Surgery And Gastroenterology, 

Meenakshi Mission Hospital And Research Centre, Madurai 

P405 EMERGENCY LAPAROSCOPIC COMMON BILE DUCT 

EXPLORATION IN ACUTE CHOLANGITIS WITH COMMON BILE DUCT 

STONE PATIENTS. Koo Yong Hahn, MD, Jeong Hwan Keum, MD, 

Department of Surgery, Seongnam Central Hospital 

P406 THE CRITICAL VIEW OF SAFETY DURING SINGLE INCISION 

LAPAROSCOPIC CHOLECYSTECTOMY Hitoshi Idani, MD, Takashi 

Yoshioka, MD, Kenjiro Kumano, MD, Yohei Kurose, MD, Hiroki Nojima, 

MD, Shinichiro Kubo, MD, Hiroshi Sasaki, MD, Shinya Asami, MD, Nakano 

Kanyu, MD, Tetsumasa Yamashita, MD, Masahiko Muro, MD, Hitoshi Kin, 

MD, Norihisa Takakura,, Department of Surgery, Fukuyama City Hospital/ 

Okayama University Graduate School of Medicne, Dentistry and 

pharmaceutical Sciences 

P407 CLINICAL OUTCOMES OF LAPAROSCOPIC CHOLECYSTECTOMY 

(WITHOUT ENERGISED DISSECTION) PERFORMED BY A BASIC 

SURGICAL TRAINEE OR A CONSULTANT-DOUBLE BLIND 

RANDOMIZED CONTROL STUDY Brij B Agarwal, MS, Lakshmi 

Jayaraman, MD, Ashish Mishra, MS, Rathindra Sarangi, MS, Krishan 

C Mahajan, FRCS, Dr. Agarwal’s Surgery & Yoga and Sir Ganga Ram 

Hospital, New Delhi, India 

P408 SYNCHRONOUS LAPAROSCOPIC TREATMENT OF LIVER HYDATID 

CYSTS AND CHOLELITHIASIS AFTER OBSTRUCTIVE ICTERUS Toni 

Kolak, MD PhD, Josip Bakovic, MD, Igor Stipancic, MD PhD, Mario Tadic, 

MD, Antonela Radic, MD, University hospital Dubrava; Department of 

colorectal surgery 

P409 INTRADUCTAL PAPILLARY MUCINOUS CARCINOMA WITH A 

RARE ATYPICAL FISTULIZATION TO ADJACENT STRUCTURES HN 

Aydin, MD, K Singh, MD, A Shiyab, MD, M Arregui, Department of MIS 

and Advanced Endoscopy, St. Vincent Hospital, Indianapolis IN USA 

P410 LAPAROSCOPIC LIVER RESECTION FOR HEPATOCELLULAR 

CARCINOMA Yang-Seok Koh, MD PhD, Jin Shick Seoung, MD, Young Hoi 

Hur, MD, Jung Chul Kim, MD PhD, Chol-Kyoon Cho, MD PhD, Hyun Jong 

Kim, MD PhD, Department of Surgery, Chonnam National University 

Hwasun Hospital 

P411 NOT JUST LITTLE STONES IN LITTLE ADULTS: BILIARY 

MICROLITHIASIS IN CHILDREN IS SUCCESSFULLY MANAGED 

WITH ENDOSCOPIC ULTRASOUND AND LAPAROSCOPIC 

CHOLECYSTECTOMY Lucas P Neff, MD, Girish Mishra, MD, John E 

Fortunato, MD, John K Petty, MD, Brenner Children’s Hospital/ Wake 

Forest University School of Medicine 

P412 LAPAROSCOPIC LIVER RESECTION: A SINGLE CENTER 

EXPERIENCE Kim Hohyun, MD, Park Eunkyu, MD, Seoung Jinshick, 

MD, Hur Younghoe, MD, Koh Yangseok, MD, Kim Jungchul, MD, Cho 

Cholkyoon, MD, Kim Hyunjong, MD, Department of surgery, Chonnam 

National University Hospital 




P413 CONVERSION FACTORS IN LAPAROSCOPIC CHOLECYSTECTOMY 

Tae Han Kim, Dr, Yoo Shin Choi, MD, Beom Gyu Kim, MD, Jun Seok Park, 

MD, Seong Jae Cha, MD, Sung Jun Park, MD, In Taik Chang, MD, Chungang 

university hospital 

P414 EFFECT OF YOGA ON THE SPEED OF CONVALESCENCE 

AFTER UNCOMPLICATED OUTPATIENT LAPAROSCOPIC 

CHOLECYSTECTOMY--A CASE CONTROLLED STUDY Brij B Agarwal, 

MS, Rathindra Sarangi, MS, Krishan C Mahajan, FRCS, Dr. Agarwal’s 

Surgery & Yoga and Sir Ganga Ram Hospital, New Delhi, India 

P415 UTILITIES OF PREOPERATIVE ASSESSMENT OF ABDOMINAL 

ADHESIONS USING ULTRASOUND SCANS IN THE LAPAROSCOPIC 

HEPATECTOMY Yuichiro Otsuka, MD, Masaru Tsuchiya, MD, Tetsuya 

Maeda, MD, Satoshi Yajima, MD, Takashi Suzuki, MD, Yorichika Kubota, 

MD, Masashi Watanabe, MD, Yoko Oshima, MD, Satoru Kagami, MD, 

Hironori Kaneko, PhD, Department of surgery (Omori), Toho university 

faculty of medicine, Tokyo, Japan 

P416 NECESSITY OF INTRAOPERATIVE CHOLANGIOGRAPHY DURING 

LAPAROSCOPIC CHOLECYSTECTOMY BASED ON ANALYSIS OF 

CASES OF PANCREATICOBILIARY DUCTAL MALJUNCTION WITHOUT 

COMMON BILE DUCT DILATATION Shoji Fukuyama, MD PhD, Hiromi 

Tokumura, MD PhD, Takashi Tsuchiya, MD PhD, Sendai Open Hospital, 

Department Of Surgery 

P417 PRELIMINARY EXPERIENCE OF LAPAROSCOPIC HEPATECTOMY 

IN HEPATOCELLULAR CARCINOMA Choon Hyuck D Kwon, MD, Gwan 

Chul Lee, MD, Jae Won Joh, MD PhD, Jin Seok Heo, MD PhD, Gum O 

Jung, MD, Ju Ik Moon, MD, Jong Man Kim, MD, Department of Surgery, 

Samsung Medical Center, Sungkyunkwan University 

P418 LONG TERM FOLLOW UP AFTER LAPAROSCOPIC NON- 

MALIGNANT PANCREATIC TUMOR SURGERY Emanuele Lezoche, 

MD FACS, Alessandro M Paganini, MD PhD FACS, Mario Guerrieri, 

MD, Giancarlo D’Ambrosio, MD, Maddalena Baldarelli, MD, Giovanni 

Lezoche, MD, Luciana Barchetti, MD, Massimiliano Rimini, MD, Daniele 

Scoglio, MD, Clinica Chirurgica e Tecnologie Avanzate, Department of 

Surgery “Paride Stefanini”, University of Rome “La Sapienza”, Rome, Italy. 

*Department of General Surgery, Università Politecnica delle Marche, 

“Umberto I” Hospital, Via Conca, Ancona, Italy 

P419 IMPACT OF HEALTH INSURANCE ON COMPLICATED 

CHOLEDOCHOLITHIASIS AND SAME-ADMISSION INTERVENTIONS 

K Kummerow, BS, J Shelton, MD, J Foster, MD, S Phillips, MSPH, M 

Holzman, MD MPH, K Sharp, MD, B Poulose, MD MPH, Vanderbilt 


P420 CARBON FOOTPRINT OF LAPAROSCOPIC CHOLECYSTECTOMY 

PERFORMED WITH OR WITHOUT ENERGIZED DISSECTION-A CASE 

CONTROLLED STUDY Krishna A Agarwal, Brij B Agarwal, Krishan C 

Mahajan, VMMC & Safdarjung Hospital, Dr. Agarwal’s Surgery & Yoga 

and Sir Ganga Ram Hospital, New Delhi, India 

P421 COMPARATIVE PATEINT REPORTED WELL BEING AFTER 

LAPAROSCOPIC CHOLECYSTECTOMY PERFORMED WITH OR 

WITHOUT ENERGISED DISSECTION-A CASE CONTROLLED STUDY Brij 

B Agarwal, MS, Krishan C Mahajan, FRCS, Dr. Agarwal’s Surgery & Yoga 

and Sir Ganga Ram Hospital, New Delhi, India 

P422 HAND-ASSISTED LAPAROSCOPIC AND TOTAL LAPAROSCOPIC 

PARTIAL HEPATECTOMY FOR HEPATOCELLULAR CARCINOMA – A 

COMPARATIVE STUDY Eric C.H. Lai, Chung Ngai Tang, George P.C. Yang, 

Oliver C.Y. Chan, Michael K.W. Li, Department of Surgery, Pamela Youde 

Nethersole Eastern Hospital, Hong Kong SAR, China 

P423 LAPAROSCOPIC LIVER RESECTION USING VASCULAR STAPLERS 

IN THE PORCINE MODEL Konstantinos G Tsalis*, Prof, Konstantinos 

Blouhos*, MD, George Vrakas*, MD, Ioannis Savvas×, Assist Prof, 

Timoleon Ralis×, Prof, Staavros Kalfadis*, PhD, Charalampos Lazaridis*, 

Prof, *D’ Surgical Department Medical School Aristotle University of 

Thessaloniki Greece 

P424 HOW RELIABLE IS LAPAROSCOPIC CHOLECYSTECTOMY IN 

ELDERLY PATIENTS? A RETROSPECTIVE ANALYSIS OF OUTCOMES. 

A. Ziya Anadol, MD FACS, Ekmel Tezel, MD PhD, Emin Ersoy, MD, Gazi 


P425 ON DEMAND TROCAR INSERTION FOR LAPAROSCOPIC 

CHOLECYSTECTOMY: TWO, THREE OR FOUR? A. Ziya Anadol, MD PhD, 

Gazi University School of Medicine 

P426 LAPAROSCOPIC LIVER RESECTIONS INCLUDING MAJOR 

HEPATECTOMIES- A TERTIARY CENTRE EXPERIENCE C Palanivelu, 

MCh FACS FRCS, P Senthilnathan, MS DNB MRCS, P S Rajan, MS FACS, R 

Rohit, MS, P Praveen Raj, MS, Atul Kumar Gupta, MS, Pinak Das Gupta, 

MS, GEM Hospital 

P427 SHORT TERM OUTCOME AFTER LAPAROSCOPIC RADICAL 

CHOLECYSTECTOMY FOR CARCINOMA OF THE GALL BLADDER 

C Palanivelu, MCh FACS FRCS, P Senthilnathan, MS DNB MRCS, V 

Vaithiswaran, MS MRCS, Charles William, MS, Pinak Das Gupta, MS, Atul 

Das Gupta, MS, C Chandramaliteeswaran, MS, GEM Hospital 

P428 SINGLE INCISION LAPAROSCOPIC CHOLECYSTECTOMY: THE 

FIRST 100 OUTPATIENTS Jose Erbella, MD, Gary Bunch, MD, Manatee 

Memorial Hospital 

P429 STAPLE LINE REINFORCEMENT IN LAPAROSCOPIC DISTAL 

PANCREATECTOMY Ezra N Teitelbaum, MD, Khashayar Vaziri, MD, Fred 

Brody, MD, Paul P Lin, MD, The George Washington University Medical 

Center 

P430 LAPAROSCOPIC VS OPEN LEFT (DISTAL) PANCREATECTOMY- A 

CASE-MATCHED COMPARATIVE STUDY. Srinivas Kavuturu, MD, Dustin 

Morrow, MD, Isabelle Deshaies, MD, Eric T Kimchi, MD, Kevin F Staveley- 

O’Carroll, MD PhD, Niraj J Gusani, MD MS, Penn State Milton S Hershey 


P431 GALLBLADDER PERFORATION: INCREASED RISK IN A VA 

POPULATION ASSOCIATED WITH LOWER BODY MASS INDEX (BMI) 

Amit Parikh, DO, Kshitij Kakar, MD, Salvador Sordo, MD, Helenmari 

Merritt, DO, Kishore Malireddy, MD, Michelle K Savu, MD, The University 

of Texas Health Science Center at San Antonio 

P432 PREOPERATIVE PANCREATIC STENTING PRIOR TO 

PANCREATECTOMY FOR CHRONIC PANCREATITIS: A COMBINED 

ENDOSCOPIC AND SURGICAL APPROACH Wesley B Jones, MD, Mark 

A Vitale, Brian R Davis, MD, Roger M Galindo, MD, Daniel Makela, Gary 

C Vitale, MD, Department of Surgery, University of Louisville School of 

Medicine, Louisville, KY, USA 

P433 TOTALLY LAPAROSCOPIC HEPATECTOMY FOR HEPATOLITHIASIS 

Kuo-Hsin Chen, MD, Hsin-An Chen, MD, Jain-Ming Wu, MD, Chao-Chiang 

Tu, MD, Kuo- Hsiang Cheng, MD, Shin-Horng Huang, MD PhD, Division of 

General Surgery, Department of Surgery, Far-Eastern Memorial Hospital 


P435 TOTALLY LAPAROSCOPIC ISOLATED CAUDATE HEPATECTOMY 

WITH SELECTIVE INFLOW CONTROL – CASE REPORT Shiu-Dong 

Chung, MD, Kuo-Hsin Chen, MD, Hsin-An Chen, MD, Jain-Ming Wu, MD, 

Chao-Chiang Tu, MD, Kuo- Hsiang Cheng, MD, Shin-Horng Huang, MD 

PhD, Department of Surgery, Far-Eastern Memorial Hospital, Taipei, 

Taiwan 

P436 LAPAROSOCPIC DISTAL PANCREATIC RESECTION Furuta kauznori, 

MD PhD, Ishii Kenichiro, MD PhD, Katagiri Hiroyuki, MD PhD, Takahashi 

Yoshihito, MD PhD, Watanabe Masahiko, MD PhD, Kitasato University 

P437 ROLE OF LAPAROSCOPIC HEPATECTOMY FOR HEPATOCELLULAR 

CARCINOMA Hironori Kaneko, MD, Yuichiro Otsuka, MD, Masaru 

Tsuchiya, MD, Akira Tamura, MD, Takayuki Suzuki, MD, Takashi 

Suzuki, MD, Yoko Oshima, MD, Yorichika Kubota, MD, Jun Ishii, MD, 

Shigeki Imamura, MD, Masashi Watanabe, MD, Hideaki Shimada, MD, 

Department of Surgery(Omori), , Toho university school of Medicine, 

Tokyo, Japan 






P438 REPEATED LAPAROSCOPIC HEPATECTOMY FOR THE RECURRENT 

HEPATOCELLULAR CARCINOMA Hironori Kaneko, PhD, Masaru 

Tsuchiya, MD, Yuichiro Otsuka, MD, Akira Tamura, MD, Kunihiro 

Yamazaki, MD, Toshio Katagiri, MD, Tetsuya Maeda, MD, Satoru Kagami, 

MD, Yoshihisa Kubota, MD, Satoshi Matsuda, MD, Shigeki Imamura, MD, 

Yasuo Nagashima, MD, Department of Surgery(Omori), Toho University 

School of Medicine, Tokyo, Japan 

P439 USE OF COVERED METALLIC STENTS IN THE MANAGEMENT OF 

BENIGN BILIARY STRICTURES Javier E Andrade, MD, Decio Carvalho, 

MD, Alberto R Iglesias, MD, Jose M Martinez, MD, University of Miami 

Miller School of Medicine. DeWitt Daughtry Family Department of 

Surgery. Division of Laparoendoscopic and Bariatric Surgery. Miami, FL, 

USA. 

P440 LAPAROSCOPIC TRANSGASTRIC CYST GASTROSTOMY FOR AN 

UNRESECTABLE MUCINOUS CYST ADENOMA OF THE PANCREAS 

Venkata Kanthimathinathan, MD, J Andres Astudillo, MD, Ata Mazaheri, 

MD, Loma Linda University, Department of Surgery 

P441 LAPAROSCOPIC MANAGEMENT OF SYMPTOMATIC CYSTIC 

DISEASE OF THE LIVER Fumiki Kushihata, MD, Jota Watanabe, MD, 

Tetsuya Mizumoto, MD, Yoshikuni Nonenaga, MD, Akifumi Miyoshi, MD, 

Taiji Toyama, MD, Kazuo Honda, MD, Yasutsugu Takada, MD, Surgery, 

Ehime University School of medicine 

P442 A NEW APPLICATION OF BILIARY TRACT IDENTIFICATION 

BASED ON INDOCYANINE GREEN FLUORESCENT IMAGING AT 

LAPAROSCOPIC SURGERY Jota Watanabe, MD, Fumiki Kushihata, MD, 

Tetsuya Mizumoto, MD, Yoshikuni Yonenaga, MD, Akifumi Miyoshi, MD, 

Taiji Toyama, MD, Kazuo Honda, MD, Yasutsugu Takada, MD, Dept. of 

Surgery, Ehime University School of Medicine 

P443 SINGLE INCISION VENTRAL HERNIA REPAIR: THE INITIAL 

EXPERIENCE Katie M Love, MD, Curtis E Bower, MD FACS, ECU Brody 


P444 PHYSICOMECHANICAL EVALUATION OF ABSORBABLE 

AND NONABSORBABLE BARRIER COMPOSITE MESHES FOR 

LAPAROSCOPIC VENTRAL HERNIA REPAIR Corey R Deeken, PhD, 

Michael S Abdo, Margaret M Frisella, RN, Brent D Matthews, MD, 

Washington University School of Medicine 

P445 RESULTS OF LAPAROSCOPIC REPAIR OF PRIMARY AND 

RECURRENT INCISIONAL HERNIAS AT A SINGLE UK INSTITUTION 

Julian Sturt, MD FRCS, Christopher Liao, MD MRCS, Shivani 

Arulanandam, MD, Jyoti Sidhu, MD, Donald Menzies, MD FRCS, Roger 

Motson, MD FRCS, ICENI Centre, Colchester, United Kingdom 

P446 RARE CASE OF LAPAROSCOPIC REPAIR OF A STRANGULATED 

OBTURATOR HERNIA Ashraf A Sabe, MD, Mustapha Daoadi, MD, Sang 

Lee, MD, Praneetha Narahari, MD, Saint Vincent Hospital, Beth Israel 

Deaconess Medical Center, Harvard School of Medicine 

P447 LAPAROSCOPIC VENTRAL HERNIA IN THE ELDERLY: A SAFE 

OPTION Ashwin Kurian, MD, Sidhbh Gallagher, MD, Abhiman 

Cheeyandira, MD, Mary Hofmann, MD, Robert Josloff, MD, Abington 


P448 SIMULTANEOUS LAPAROSCOPIC HERNIOPLASTY AND 

LAPAROSCOPIC CHOLECYSTECTOMY Nobuhiro Ito, MD PhD, Noiku 

Nakao, MD PhD, Hiroshi Nagata, MD PhD, Hitoshi Inagaki, MD PhD, 

Toshiaki Nonami, MD PhD, Department of Gastroenterological Surgery, 

Aichi Medical University 

P449 PREDICTORS OF IN HOSPITAL LENGTH OF STAY AFTER 

LAPAROSCOPIC VENTRAL HERNIA REPAIR: A MULTI VARIATE 

LOGISTIC REGRESSION ANALYSIS. Ashwin A Kurian, MD, Sidhbh 

Gallagher, MD, Abhiman Cheeyandira, MD, Robert Josloff, MD, Abington 


P450 LAPAROSCOPIC REPAIR OF INCIDENTALLY FOUND SPIGELIAN 

HERNIAS: A CASE SERIES AND REVIEW OF LITERATURE Khanjan H 

Nagarsheth, MD, Henry S Nelson, MD, Todd Nickloes, DO, Greg Mancini, 

MD, Julio A Solla, MD, University of Tennessee Medical Center 

P451 MEANDERING EXTERNAL ILIAC ARTERY: A FREQUENT 

VASCULAR VARIANT FOUND DURING LAPAROSCOPIC INGUINAL 

HERNIA REPAIR Tiffany C Cox, MD, Jonathan P Pearl, MD, E. Matthew 

Ritter, MD, Departments of Surgery, National Naval Medical Center and 

the Uniformed Services University, Bethesda, Maryland 

P452 SINGLE-INCISION TOTALLY EXTRAPERITONEAL INGUINAL 

HERNIA REPAIR IS A USEFUL PRECURSOR TO MORE COMPLEX 

SINGLE-INCISION LAPAROSCOPIC OPERATIONS Jonathan P Pearl, MD, 

Uniformed Services University and National Naval Medical Center 

P453 LAPAROSCOPIC INCISIONAL HERNIA REPAIR: A RETROSPECTIVE 

REVIEW OF A MODIFIED TECHNIQUE Eugenia Kang, MD, Jonathan 

Svahn, MD, Kaiser Hospital- Oakland 

P454 USE OF LIGHT, PARTIALLY ABSORBABLE MESH IN OPEN 

INGUINAL HERNIA REPAIR REDUCES POST-OPERATIVE PAIN AND 

COMPLICATIONS: PRELIMINARY DATA WITH COUSIN 4D-DOME 

Andrew Morfesis, MD, Brian P Rose, Owen Drive Surgical Clinic of 

Fayetteville 

P455 POST-OPERATIVE CHRONIC PAIN AND RECURRENCE 

FOLLOWING LAPAROSCOPIC INGUINAL HERNIA REPAIR: TO STAPLE 

OR NOT TO STAPLE? Ibrahim M Daoud, MD, Vladimir P Daoud, MSc, St. 

Francis Hospital and Medical Center, Hartford, CT 

P456 LAPAROSCOPIC INGUINAL HERNIA REPAIR: A RETROSPECTIVE 

STUDY BASED ON THE 17-YEAR EXPERIENCE OF A SINGLE 

SURGEON. Ibrahim M Daoud, Vladimir P Daoud, MSc, St. Francis 

Hospital and Medical Center, Hartford, CT 

P457 PRECLINICAL EVALUATION OF NOVEL DESIGN FOR A 

RESORBABLE MESH FIXATION DEVICE Pullen Shnoda, DVM, Thomas 

Divilio, MD FACS, James W Oldham, PhD DABT, Timothy Muench, DVM 

PhD, Ethicon, Inc. 

P458 A PROSPECTIVE RANDOMIZED STUDY COMPARING 

LAPAROSCOPIC TOTALLY EXTRA PERITONEAL (TEP) REPAIR 

VERSUS TRANS ABDOMINAL PRE-PERITONEAL (TAPP) REPAIR FOR 

INGUINAL HERNIA REPAIR Mahesh C Misra, MS FRCS, Virinder K Bansal, 

MS, Subodh Kumar, MS, Asuri Krishna, MBBS, Department of Surgical 

Disciplines, All India Institute of Medical Sciences, New Delhi, India 


P460 A COMPARATIVE BIOMECHANICAL EVALUATION OF HERNIA 

MESH FIXATION WITH FIBRIN SEALANT (FS) CONTAINING 4 

VS. 500 IU THROMBIN IN PIGS René H Fortelny, MD, A.H. Petter 

Puchner, MD, S. Blum, MD, J Ferguson, VD, J Brand, K Mika, MD, H Redl, 

PhD, II. Department of General Surgery, Wilhelminenspital, Vienna, 

Austria;Ludwig Boltzmann Institute for Experimental and Clinical 

Traumatology, Research Center of AUVA, Austrian Cluster for Tissue 

Regeneration, Vienna, Austria 

P461 THE IMPACT OF ATRAUMATIC FIBRIN SEALANT VS. STAPLE 

MESH FIXATION IN TAPP HERNIA REPAIR ON CHRONIC PAIN AND 

QUALITY OF LIFE – RESULTS OF A RANDOMIZED CONTROLLED 

STUDY René H Fortelny, MD, A.H. Petter Puchner, MD, Z. Khakpour, DI, 

C. May, MD, K. Mika, MD, K.S. Glaser, MD, H. Redl, PhD, II. Department of 

General Surgery, Wilhelminenspital, Vienna, Austria;Ludwig Boltzmann 

Institute for Experimental and Clinical Traumatology, Research Center 

of AUVA, Austrian Cluster for Tissue Regeneration, Vienna, Austria 

P462 POLYESTER COMPOSITE VERSUS PTFE IN LAPAROSCOPIC 

VENTRAL HERNIA REPAIR Modesto J Colon, MD, Dana Telem, MD, Scott 

Nguyen, MD, Edward Chin, MD FACS, Weber J Kaare, MD, Celia M Divino, 

MD FACS, The Mount Sinai Hospital, New York 

P463 EXPERIENCE OF SINGLE-SITE LAPAROSCOPIC HERNIOPLASTY 

Nobuhiro Ito, MD PhD, Hiroshi Nagata, MD PhD, Noiku Nakao, MD PhD, 

Hitoshi Inagaki, MD PhD, Toshiaki Nonami, MD PhD, Department of 

Gastroenterological Surgery, Aichi Medical University 

P464 COMPARISON OF LAPAROSCOPIC PRIMARY REPAIR AND OPEN 

REPAIR TECHNIQUES FOR SMALL VENTRAL HERNIAS. A. Ziya Anadol, 

MD FACS, Ekmel Tezel, MD PhD, Emin Ersoy, MD, Gazi University School 

of Medicine 




P465 LAPAROSCOPIC MANAGEMENT OF VARIOUS TYPES OF 

DIAPHRAGMATIC HERNIAS – A FIFTEEN YEARS EXPERIENCE FROM 

AN ADVANCE LAPAROSCOPIC CENTRE C Palanivelu, MCh FACS FRCS, 

S Rajapandian, MS FRCS, P Praveen Raj, MS, P Senthilnathan, MS DNB 

MRCS, R Kumaravel, MS, S Saravana Kumar, MS, GEM Hospital 

P466 LAPAROSCOPIC TRANSABDOMINAL PREPERITONEAL MESH 

REPAIR WITH SUTURED CLOSURE OF LOWER ABDOMINAL 

INCISIONAL HERNIA - A SINGLE CENTRE EXPERIENCE OF 15 CASES 

C Palanivelu, MCh FACS FRCS, P Senthilnathan, MS DNB MRCS, P S 

Rajan, MS FACS, V Vaithiswaran, MS MRCS, P Praveen Raj, MS, Alwar 

Ramanujam, MS, Atul Kumar Gupta, MS, GEM Hospital 

P467 LAPAROSCOPIC REPAIR OF LOSS OF DOMAIN INCISIONAL 

HERNIA COMBINING ENDOSCOPIC MYOFASCIAL ADVANCEMENT 

FLAPS, MEDIALIZATION OF THE RECTUS SHEATH, AND MESH 

REINFORCEMENT: A CASE SERIES Scott R Philipp, MD, Archana 

Ramaswamy, MD, University of Missouri - Columbia, Columbia, Missouri, 

USA 

P468 TOTALLY EXTRAPERITONEAL (TEP) SURGERY FOR INGUINAL 

HERNIA: SINGLE PORT ENDO-LAPAROSCOPIC SURGERY (SPES) 

VS STANDARD LAPAROSCOPIC SURGERY Michael M Lawenko, 

MD, Alembert Lee-Ong, MD, Javier Lopez-Gutierrez, MD, Sarah Chian, 

Davide Lomanto, MD, Minimally Invasive Surgical Centre, Department 

of Surgery, Yong Loo Lin School of Medicine, National University Health 

System - Singapore; Department of Sociology, Singapore Management 

University, Singapore 

P469 LAPAROSCOPIC TOTALLY EXTRAPERITONEAL PREPERITONEAL 

(TEPP) INGUINAL HERNIA REPAIR USING FETAL BOVINE DERMAL 

TISSUE (SURGIMEND). Joseph J Pietrafitta, MD, Fairview Northland 


P470 LAPAROSCOPIC REPAIR OF ABDOMINAL WALL HERNIAS USING 

FETAL BOVINE DERMAL TISSUE (SURGIMEND). Joseph J Pietrafitta, 

MD, Fairview Northland Medical Center, Princeton, MN 

P471 TOTAL EXTRAPERITONEAL INGUINAL (TEP) HERNIORRHAPHY 

FOR PRIMARY INGUINAL HERNA: 3-YEAR EXPERIENCE OF A 

MINIMALLY INVASIVE FELLOWSHIP TRAINED SURGEON Beau 

Aldridge, Medical Student, Tejaswi Belavadi, Michael A Edwards, MD, 

Department of Surgery Gastrointestinal Section, Medical College of 

Georgia, Augusta, GA, USA 

P472 COMPARATIVE PATIENT REPORTED OUTCOMES IN 

LAPAROSCOPIC INTRAPERITONEAL ONLAY MESH REPAIR FOR 

VENTRAL HERNIA WITH OR WITHOUT DEFECT CLOSURE - A 9-YEAR 

FOLLOW UP CASE CONTROLLED STUDY Brij B Agarwal, MS, Sneh 

Agarwal, MS, Krishan C Mahajan, FRCS, Dr. Agarwal’s Surgery & Yoga, Sir 

Ganga Ram Hospital and Lady Hardinge Medical College, New Delhi, 

India 


P474 SINGLE INCISION INTRACOPORAL LAPAROSCOPIC 

APPENDECTOMY: AN EARLY EXPERIENCE Elyssa J Feinberg, MD, David 

J O’Connor, MD, Prathiba Vemulapalli, MD, Diego Camacho, MD, Albert 

Einstein College of Medicine, Montefiore Medical Center 

P475 ANATOMIC THORACOSCOPIC LUNG SEGMENTECTOMY 

SIMULATED BY THREE-DIMENSIONAL COMPUTED TOMOGRAPHY 

ANGIOGRAPHY Hiroyuki Oizumi, PhD, Makoto Endoh, PhD, Jun 

Suzuki, MD, Ken Fukaya, MD, Mitsuaki Sadahiro, PhD, Department of 

Cardiovascular, Thoracic and Pediatric Surgery, , Yamagata University 

P476 LAPAROSCOPIC GASTROJEJUNOSTOMY FOR THE TREATMENT 

OF GASTRIC OUTLET OBSTRUCTION Linda P Zhang, MD, Parissa 

Tabrizian, MD, Dana Telem, MD, Scott Q Nguyen, MD, Celia Divino, MD, 

Mount Sinai School of Medicine 

P477 A SIMPLE ‘FUNDAL TRACTION SUTURE’ IN SINGLE INCISION 

LAPAROSCOPIC CHOLECYSTECTOMY Srikanth Gadiyaram, Dr, Neel 

Shetty, Dr, Manipal Institute of Liver and Digestive Diseases 

P478 THE FASHION OF INCISION AND TROCAR PLACEMENT FOR 

SINGLE PORT LAPAROSCOPIC CHOLECYSTECTOMY Atsushi Iida, MD 

PhD FACS, Kenji Koneri, MD, Kei Honda, MD, Takanori Goi, MD, Kanji 

Katayama, MD, Akio Yamaguchi, MD PhD, Gastroenterological surgery, 

University of Fukui, Fukui, Japan 

P479 THE FEASIBILITY OF LESS USING CONVENTIONAL 

LAPAROSCOPIC INSTRUMENTS. Modesto J Colon, MD, Dana Telem, 

MD, Scott Nguyen, MD FACS, Celia M Divino, MD FACS, Edward Chin, MD 

FACS, Mount Sinai Hospital 

P480 SILS USING STANDARD LAPAROSCOPIC INSTRUMENTS Shahram 

Nazari, Dr, Semira Mousavi Khosroshahi, Dr, Afshin Amini, Dr, Hosain 

Khedmat, Dr, Ahmad Fanaii, Dr, Erfan Hospital, Department of General 

and Laparoscopic surgery 

P481 LAPAROSCOPIC INFERIOR MESENTERIC ARTERY LIGATION 

PRIOR TO ENDOVASCULAR ABDOMINAL AORTIC ANEURYSM REPAIR 

Robert A Brenes, MD, Lucian Panait, MD, Jaime S Strachan, MD, Guiseppe 

Tripodi, MD FACS, Michael S Ajemian, MD FACS, Shady H Macaron, MD, 

Saint Mary’s Hospital, The Stanley J. Dudrick Department of Surgery, 

Waterbury, Connecticut 

P482 INITIAL EXPERIENCE IN SINGLE INCISION LAPAROSCOPIC 

SURGERY LEAD TO MODIFICATIONS AND DEDICATED TOOLS 

FOR COMPARABLE SAFETY TO STNADARD LAPAROSCOPY Noam 

Shussman, MD, Ram Elazary, MD, Abed Khalaileh, MD, Andrei Keidar, MD, 

Avraham I Rivkind, MD FACS, Yoav Mintz, MD, Department of Surgery, 

Hadassah-Hebrew University Medical Center, Jerusalem, Israel 

P483 ROBOTIC VERSUS LAPAROSCOPIC ADRENALECTOMY Hizir Y 

Akyildiz, MD, Allan Siperstein, MD, Mira Milas, MD, Jaime Mitchell, MD, 

Eren Berber, Cleveland Clinic 

P484 DAY CASE LAPAROSCOPIC SURGERY: HOW CAN WE IMPROVE 

? Ibrahim Ahmed, FRCSI, Elnazier Ibrahim, FRCSI, Mohamed Salama, 

FRCSI, Michelle Nolan, Alexander Lockley, MBCh, Noreen Kinsella, MSc, 

Our Lady’s Hospital, Navan, Ireland 

P485 OPINION SURVEY ON OPERATIVE MANAGEMENT OF 

ADHESIVE SMALL BOWEL OBSTRUCTION: LAPAROSCOPY VERSUS 

LAPAROTOMY IN THE STATE OF CONNECTICUT Tolutope O Oyasiji, 

MD, Scott W Helton, MD FACS, Hospital of Saint Raphael,1450 Chapel 

Street, New Haven, CT 06511 

P486 MINI-INCISION LAPARATOMY AS A ONE STAGE APPROACH IN 

MANAGEMENT OF COMPLICATED GALLSTONE DISEASE Abdulkadir 

Yakubu, MD, Viktor N Chernov, Professor, Rostov State Medical University 

P487 NEW EQUIPMENTS AND TECHNIQUES FOR VIDEO-ASSISTED 

THYROIDECTOMY USING LIFTING METHOD BY NEW RETRACTOR VIA 

AXILLARY APPROACH Koichi Kayano, MD PhD, Junichi Kohmoto, MD 

PhD, Hisao Mizutani, MD PhD, Motohisa Kojo, MD PhD, Satoshi Nishioka, 

MD PhD, Ako Central Hospital, Ako city, Japan 

P488 SINGLE PORT ACCESS CHOLECYSTECTOMY: SHORT-TERM 

OUTCOMES Shuji Kitashiro, Shunnichi Okushiba, Yo Kawarada, Yuma 

Ebihara, Tuyoshi Sasaki, Daisuke Miyasaka, Hiroyuki Katoh, tonan 

hospital 

P489 HYBRID NEEDLESCOPIC – SILS CHOLECYSTECTOMY VS 

LAPAROSCOPIC CHOLECYSTECTOMY: A PRELIMINARY COMPARISON 

IN ACUTE CHOLECYSTITIS Andreas Kiriakopoulos, MD, Dimitrios 

Tsakayannis, MD, Dimitrios Linos, MD, Hygeia Hospital, Athens, Greece 

P490 SINGLE PORT ACCESS SURGERY: EVALUATION OF ACCESS 

PLATFORMS, VERSATILITY AND FASCIAL DEFECTS Erica R Podolsky, 

MD, Paul G Curcillo, II MD FACS, Drexel University, College of Medicine, 


P491 SINGLE-INCISION VERSUS CONVENTIONAL LAPAROSCOPIC 

APPENDICECTOMY: A COMPARATIVE STUDY Dennis Wong, FRACS, 

C N Shum, MRCS, H H Wong, MRCS, Kevin Yau, FRCS, Cliff Chung, FRCS, 

Michael Li, FRCS, Pamela Youde Nethersole Eastern Hospital 






P492 TRANSUMBILICAL LAPAROSCOPIC ASSISTED APPENDECTOMY 

(TULAA) VERSUS CONVENTIONAL LAPAROSCOPIC APPENDECTOMY 

– PRELIMINARY RESULTS FROM A CASE CONTROL STUDY Robert 

Bergholz, MD, Ines Klein, Katharina Wenke, MD, Thomas Krebs, MD, 

Altona Children’s Hospital: Department of Pediatric Surgery, UKE - 

Medical School, Hamburg, Germany 

P493 LAPAROSCOPIC CHOLECYSTECTOMY FOR ASA III PATIENT’S 

IN DAY SURGERY. WHY NOT? Jonas Andriuškevicius, PhD, Zigmantas 

Urniežius, Dr, Tadas Pranckevicius, Dr, Martynas Jonkus, Dr, Department 

of Day Surgery, Kaunas district hospital, Kaunas, Lithuania 

P494 SINGLE PORT LAPAROSCOPIC SURGERY UNDER ABDOMINAL 

WALL LIFTING (LIFT-SPS) FOR APPENDECTOMY, HERNIA REPAIR, 

CHOLECYSTECTOMY Takashi Urushihara, PhD, Toshiyuki Itamoto, 

PhD, Hideki Nakahara, PhD, Yasuhiro Matugu, PhD, Toshihiko Kohashi, 

PhD, Takayuki Kadoya, PhD, Hiroyuki Egi, PhD, Ichiro Oomori, PhD, 

Department of General Surgery,Hiroshima Prefectural Hospital 

P495 DEVELOPMENT OF A NEW SURGICAL PROCEDURE, TWO- 

STEP TOTAL LAPAROSCOPIC HYSTERECTOMY COMBINED 

MYOMECTOMY(TTLH-CM), FOR DIFFICULT CASES OF LH Eiji Nishio, 

Yutaka Hirota, Akira Yasue, Haruki Nishizawa, Kazuhiko Tsukada, Yasuhiro 

Udagawa, Fujita Health UNIVERSITY SCHOOL OF MEDCINE 

P496 DIAGNOSTIC EFFICACY OF LAPAROSCOPIC BIOPSY FOR INTRA- 

ABDOMINAL LYMPHADENOPATHY S Wiebe, MD, D Klassen, MD, 

Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada 

P497 MEASURING ESOPHAGOGASTRIC JUNCTION DISTENSIBILITY 

PERIOPERATIVELY AT HELLER MYOTOMY FOR ACHALASIA USING 

ENDOFLIP® Silvana Perretta, MD, Barry P McMahon, MSc PhD, Bernard 

Dallemagne, MD, 1. IRCAD-EITS,Department of Gastrointestinal and 

Endocrine Surgery, University of Strasborg, France 2. Dept of Medical 

Physics & Clinical Engineering, AMNCH, Dublin 24, Ireland 

P498 FINDING OF BRANCHES OF THE RECURRENT LARYNGEAL NERVE 

IN ENDOSCOPIC THYROIDECTOMY Yoshifumi Ikeda, MD, Junichi 

Takayama, MD, Naomi Morita, MD, Hiroshi Takami, MD, Department of 

Surgery, Teikyo University School of Medicine 

P499 SUPERIOR MESENTERIC ARTERY SYNDROME FOLLOWING 

LAPAROSCOPIC-ASSISTED PROCTOCOLECTOMY AND ILEAL 

J-POUCH-ANAL ANASTOMOSIS IN A PEDIATRIC PATIENT. Hamed 

Taheri, MD, Peter A Mattei, MD, The Children’s Hospital Of Philadelphia 

P500 LAPAROSCOPIC APPROACH FOR PHEOCROMOCYTOMA LARGER 

THEN 6 CM Roxana Ganescu, MD, Sorin Paun, MD PhD, Mircea Beuran, 

MD PhD, Mihaela Vartic, MD PhD, Diana Paun *, MD PhD, Constantin 

Dumitrache *, MD Phd, Emergency Hospital Bucharest Romania, * 

National Institute of Endocrinology C.I. Parhon 

P501 A DEVICE OF OPERATIVE METHOD FOR LAPAROSCOPIC 

SUBTOTAL HYSTERECTOMY. Akira Yasue, Eiji Nishio, Haruki Nishizawa, 

Kazuhiko Tsukada, Yutaka Hirota, Yasuhiro Udagawa, Dept. Obstetrics 

and Gynecology, Fujita Health University School of Medicine 

P502 THE INITIAL CANADIAN EXPERIENCE WITH SINGLE INCISION 

LAPAROSCOPIC SURGERY Benjamin D Teague, MBBS BA, Matthew 

S Butler, MD BSc, Pierre Y Garneau, MD, Clifford B Sample, MD, Anil 

Kapoor, MD, Margherita O Cadeddu, MD, Mehran Anvari, PhD, Centre 

for Minimal Access Surgery, St Josephs Healthcare ,McMaster University. 

Service de Chirurgie Générale, Hôpital du Sacré-Coeur de Montreal, 

Université de Montréal. Centre for Advancement of Minimally Invasive 

Surgery, University of Alberta. Canada. 

P503 LAPAROSCOPIC “SUDECK” SUTURE RECTOPEXY FOR ELDERLY 

PATIENTS Kengo Kanetaka, PhD MD, Yujo Kawashita, PhD MD, 

Shinichiro Ono, MD, Toru Iwata, PhD MD, Takashi Kanematsu, MD 

PhD, Department of Surgery, Nagasaki University, Graduate School of 

Biomedical Sciences 

P504 A NOVEL MINIMALLY INVASIVE TECHNIQUE FOR FORMING 

COMPRESSION GASTROJEJUNOSTOMY WITH IMMEDIATE 

DRAINAGE Benjamin D Teague, MBBS BA, Margherita O Cadeddu, MD, 

William D Fox, BSMT, Mehran Anvari, PhD, Paul Swain, MD, Centre for 

Minimal Access Surgery, St Joseph’s Healthcare, McMaster University, 

Hamilton, Ontario, Canada. Ethicon Endosurgery, Cincinnati, USA. 

Imperial College, London, UK. 

P505 INTRODUCER PEG (IPEG): THE TECHNIQUE FOR ENTERAL 

ACCESSING IN ADVANCED OROPHARYNGEAL CANCER PATIENT 

Suthep Udomsawaengsup, MD, Amarit Tansawet, MD, Suppa-ut 

Pungpapong, MD, Chadin Tharavej, MD, Patpong Navicharern, MD, 

Chula Minimally Invasive Surgery Center, Department of Surgery, 

Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. 

P506 MANAGEMENT OF RETAINED GALLBLADDER/ CYSTIC DUCT 

REMNANT POST-CHOLECYSTECTOMY Sanjeev Singla, Dr, Varun Gupta, 

Dr, Sushil Budhiraja, Dr, Dayanand Medical College & Hospital, Ludhiana, 

India 

P507 LAPAROSCOPIC OMENTOPLASTY FOR BRONCHIAL STUMP 

REINFORCEMENT IN PNEUMONECTOMY PATIENT. Masanobu Hagiike, 

MD PhD, Tatsushi Inoe, MD, Minoru Ohshima, MD, Yasuyuki Suzuki, MD, 

Department of Gastroenterological surgery, Kagawa University, Japan 

P508 ENDOSCOPIC MANAGEMENT OF POST TRAUMATIC HEPATIC 

ARTERY ANEURYSM Varun Gupta, Sanjeev Singla, Sushil Budhiraja, 

Dayanand Medical College & Hospital, Ludhiana, India 

P509 USEFULNESS OF COAGULATING SHEARS IN SUBFASCIAL 

ENDOSCOPIC PERFORATOR VEIN SURGERY Akihito Abe, PhD, Nobumi 

Tagaya, PhD, Yuki Sakuraoka, MD, Masatsugu Tachibana, PhD, Kubota 

Keiichi, PhD, Second Department of Surgery, Dokkyo Medical University, 

Tochigi, Japan 

P510 SIMULTANOUS EMERGENCY AND ELECTIVE SURGERY IN A 

SINGLE LAPAROSCOPIC SESSION: IS IT SAFE ? Ibrahim Ahmed, FRCSI, 

Elnazier Ibrahim, FRCSI, Alexander Lockley, MBCh, Olumide Fagbeja, 

FRCSI, Saeed Khan, FRCSI, Our Lady’s Hospital, Navan, Ireland 

P511 CAMERA-LESS PERITONEAL ENTRY FOR UROLOGIC (C-PET) 

LAPAROSCOPY: DESCRIPTION OF A NOVEL TECHNIQUE Ricardo A 

Rendon, MD, Amit Rajguru, MD, William Carlson, MD, Griffeth W Tully, 

MD, Queen Elizabeth II Health Sciences Centre 

P512 A SCARLESS CHOLECYSTECTOMY MADE EASY BY THE HIDDEN 

SUPRAPUBIC APPROACH Angel Martinez-Munive, MD, Fernando 

Quijano-Orvananos, MD FACS, Rafael Padilla-Longoria, MD DSc FRCSC, 

ABC Medical Center IAP 

P513 DEVELOPMENT OF NEW METHODS AND DEVICES FOR FORMING 

MINIMALLY INVASIVE ANASTOMOSES - TOWARDS A COMPRESSION 

ENTERAL ANASTOMOSIS WITH IMMEDIATE DRAINAGE Margherita 

O Cadeddu, MD, Benjamin D Teague, MBBS BA, William D Fox, BSMT, 

Charles A Mosse, MD, Mehran Anvari, PhD, Paul Swain, MD, Centre for 

Minimal Access Surgery, St Joseph’s Healthcare, McMaster University, 

Hamilton, Canada. Ethicon Endosurgery, Cincinatti, USA. Imperial 

College, London, UK. 

P514 SCARLESS LAPAROSCOPIC APPENDECTOMY BY HIDDEN 

SUPRAPUBIC APPROACH Angel Martinez-Munive, MD, Fernando 

Quijano-Orvananos, MD FACS, Rafael Padilla-Longoria, MD DSc FRCSC, 

ABC Medical Center IAP 

P515 SINGLE INCISION ENDO-LAPAROSCOPIC SURGERY A 

PROSPECTIVE STUDY Michael M Lawenko, MD, Alembert Lee-Ong, 

MD, Javier Lopez-Gutierrez, MD, Charles Tan, MD, Yoke Fai Fong, MD, 

Jimmy So, MD, Cheah Wei Kit, MD, Davide Lomanto, MD, Minimally 

Invasive Surgical Centre, Department of Surgery, Yong Loo Lin School of 

Medicine, National University Health System - Singapore 

P516 PROSPECTIVE COMPARATIVE THERAPIES FOR PORTAL 

HYPERTENSION USING LAPAROSCOPY AND OPEN AZYGOPORTAL 

DISCONNECTION Yangwen Zhu, MD, Yuedong Wang, MD FACS, Zhijie 

Xie, MD, Xiaoli Zhan, MD, Zaiyuan Ye, MD, Department of General Surgery, 

Zhejiang Provincial People’s Hospital, Hangzhou 310014, China 




P517 SUMMARY OF FIVE CASES HALS-NEPHRECTOMY AND DISTAL 

PANCREATECTOMY: MINIMALLY INVASIVE APPROACH FOR 

DONOR OPERATION OF SIMULTANEOUS PANCREAS AND KIDNEY 

TRANSPLANT Naotake Akutsu, MD, Michihiro Maruyama, MD, Kenichi 

Saigo, MD, Chikara Iwashita, MD, Kazunori Otsuki, MD, Taihei Ito, MD, 

Takashi Kenmochi, MD, Department of Surgery, Chiba-East National 

Hospital, National Hospital Organization, Japan 

P518 COST SAVINGS ANALYSIS OF REUSABLE VERSUS DISPOSABLE 

TROCARS Tejwant S Datta, MD, Richard Lee, Marianne Franco, MD, Zaki 

Busbaih, MD, Amit Kaul, MD, Omer Nasir, MD, Anne O Lidor, MD, Hien 

Nguyen, MD, Michael R Marohn, DO, The Johns Hopkins University 

P519 LAPAROSCOPIC HYSTERECTOMY OF INTRALIGAMENTOUS 

FIBROIDS IN OUR HOSPITAL Haruki Nishizawa, Yutaka Hirota, Akira 

Yasue, Eiji Nishio, Kazuhiko Tsukada, Yasuhiro Udagawa, Department of 

Obstetrics and Gynecology, Fujita Health University School of Medicine 

P520 OUTCOMES OF SINGLE INCISION CHOLECYSTECTOMIES IN 

A NON-SELECT PATIENT GROUP Jacqueline J Wu, MD, Anthony L 

McCluney, MD, Anaeze C Offodile, MD, Ali Tavakkoli-zadeh, MD, Brigham 

and Women’s Hospital 

P521 SLEEVE GASTRECTOMY FOR THE TREATMENT OF DIABETIC 

GASTROPARESIS Melissa B Bagloo, MD, Aku Ude, MD, Marc Bessler, MD, 

New York Presbyterian Hospital 

P522 COMPUTER GUIDED SINGLE INCISION LAPAROSCOPIC 

SURGERY AND NOTES USING INTRAOPERATIVE MAGNETIC 3D GPS 

NAVIGATION SYSTEM Maki Sugimoto, MD PhD, Yoshinori Morita, MD 

PhD, Yuichiro Matsuoka, PhD, Hayato Yoshinaka, MD, Kagayaki Kuroda, 

PhD, Takeshi Azuma, MD Prof, Gastroenterology, Kobe University, Kobe, 

Hyogo, Japan, Veterans Affairs Palo Alto Health Care System, Stanford 

University, Palo Alto, CA, USA Molecular Imaging Research, Institute of 

Biomedical Research and Innovation, Kobe, Hyogo, Japan 

P523 LAPAROSCOPIC COMMON BILE DUCT EXPLORATION AND 

CURRENT MANAGEMENT OF COMMON BILE DUCT STONES. 

EXPERIENCE AT THE UNIVERSITARY HOSPITAL OF CARACAS- 

VENEZUELA Alexis Sanchez, MD, Omaira Rodriguez, MD, Renata 

Sanchez, MD, Gustavo Benitez, MD, Omar Bellorin-Marin, MD, 

Universitary Hospital of Caracas, Caracas-Venezuela. Central University 

of Venezuela 

P524 DIAGNOSTIC LAPAROSCOPY IS HELPFUL IN PERITONEAL 

DIALYSIS PATIENTS WITH ACUTE SCROTAL EDEMA Stephen Haggerty, 

MD, Jay Jorge, MD, NorthShore University Healthsystem, Evanston, 

Illinois, USA 

P525 A NEW APPROACH FOR LAPAROSCOPIC RESECTION OF 

SUBMUCOSAL TUMOR ON UPPER PORTION OF THE STOMACH Hun- 

Jin Kim, MD, Hoi-Won Kim, MD, Mi-Ran Jung, MD, Ho-Kun Kim, MD, 

Oh Cheong, MD, Young-Kyu Park, MD, Seong-Yeob Ryu, MD, Dong-Yi 

Kim, MD, Young-Jin Kim, MD, Division of Gastroenterologic Surgery, 

Department of Surgery, Chonnam National University Medical School. 

Gwangju, South Korea 

P526 FIRST EXPERIENCE OF SINGLE PORT ACCESSORY SPLENECTOMY 

IN PATIENT WITH AUTOIMMUNE HEMOLYTIC ANEMIA. Roman V 

Petrov, MD, Nikolaos Chandolias, MD, Paul T Singh, MD, Department of 

Surgery, Albany MedicalCenter 

P527 MULTICENTER EXPERIENCE WITH NON-ISCHEMIC 

LAPAROSCOPIC NEPHRON SPARING SURGERY UTILIZING HABIB 

4X BIPOLAR RADIOFREQUENCY ABLATION COAGULATOR Wassim 

M Bazzi, MD, Sijo Parekattil, MD, Mohamad Allaf, MD, Jared Berkowitz, 

MD, Hany Atalah, MD, Ithaar H Derweesh, MD, University of California 

San Diego, University of Florida, Gainesville and the Brady Urological 

Institute, Johns Hopkins University 

P528 PROSPECTIVE COMPARISON OF SINGLE SITE AND TRADITIONAL 

LAPAROSCOPY FOR UPPER URINARY TRACT SURGERY: INITIAL 

OUTCOMES Wassim M Bazzi, MD, Elana Godebu, MD, Jonathan 

Silberstein, MD, Ronald Im, MD, Kyoko Sakamoto, MD, Tracy M Downs, 

MD, Christopher J Kane, MD, Ithaar H Derweesh, MD, University of 

California San Diego, San Diego, CA, USA 

P529 SINGLE PORT LAPAROSCOPIC SURGERY FOR GASTRIC 

SUBMUCOSAL TUMOR USING OCTO(TM) PORT Seong-Yeob Ryu, MD, 

Hun-Jin Kim, MD, Hoi-Won Kim, MD, Mi-Ran Jung, MD, Ho-Kun Kim, 

MD, Oh Cheong, MD, Young-Kyu Park, MD, Jai-Kyun Joo, MD, Dong-Yi 

Kim, MD, Young-Jin Kim, MD, Division of Gastroenterologic Surgery, 

Department of Surgery, Chonnam National University Medical School. 

Gwangju, South Korea 

P530 LAPAROENDOSCOPIC SINGLE SITE SURGERY: A SINGLE 

INSTITUTION EXPERIENCE Michael J Guzman, MD, Joshua A Waters, 

MD, Don J Selzer, MD, Bruce W Robb, MD, Eric A Wiebke, MD MBA, 

Virgilio V George, MD, Indiana University School of Medicine 

P531 SINGLE INCISION LAPAROSCOPIC SURGERY: ONE SURGEON’S 

EXPERIENCE Kristine O’Hara, MD, Balaji Jangam, MD, Bruce Bernstein, 

PhD, Ibrahim M Daoud, MD, St. Francis Hospital and Medical Center, 

Hartford, CT 

P532 SINGLE INCISION LAPAROSCOPIC COLORECTAL SURGERY - 

INITIAL EXPERIENCES AND LEARNING CURVE Matthew S Butler, 

MD, Benjamin D Teague, MBBS BA, Federico Pampaloni, MD, Mehran 

Anvari, PhD, Centre for Minimal Access Surgery, St Joseph’s Healthcare, 

McMaster University, Hamilton, Ontario, Canada 

P533 SINGLE INCISION ACCESS CHOLECYSTECTOMY VS 

LAPAROSCOPIC Ali Fardoun, MD, Fawaz Torab, phd, Tawam 

P534 MIS TRAINING IN CANADA: THE STAFF SURGEONS’ 

PERSPECTIVE. Alia P Qureshi, MD, Ashley Vergis, MD, Carolina M 

Jimenez C.M, Jessica Green, medical student, Aurora D Pryor, MD, 

Christopher Schlachta, MD, Allan Okrainec, MD, 1. University of Toronto, 

Department of Surgery, 2. University Health Network, Toronto Western 

Hospital 3. Duke Minimally Invasive Surgery at Durham Regional 

Hospital 4. University of Western Ontario 

P535 PAEDIATRIC LAPAROSCOPIC APPENDICECTOMY IN AN ADULT 

UNIT- A TEN YEAR EXPERIENCE Nikhil Pawa, MD, Justin K Lawrence, 

MD, Matthew G Tutton, MD, Tan Arulampalam, MD, Roger W Motson, 

MD, ICENI Centre, Colchester University Hospital, Colchester, UK 

P536 ENDOCRINE COMORBIDITIES AND LAPAROSCOPIC SURGERY 

FOR ADRENAL PATHOLOGY – OUR EXPERIENCE Roxana Ganescu, MD, 

Sorin Paun, MD PhD, Mircea Beuran, MD PhD, Mihaela Vartic, MD PhD, 

Diana Paun *, MD PhD, Constantin Dumitrache *, MD PhD, Emergency 

Hopsital Bucharest Romania. * National Institute of Endocrinology C. I. 

Parhon. Bucharest. Romania 

P537 SINGLE-INCISION LAPAROSCOPIC RIGHT HEMICOLECTOMY: 

SAFETY AND FEASIBILITY IN A SERIES OF 10 CONSECUTIVE CASES 

Diego I Ramos-Valadez, MD, Chirag B Patel, MSE, Madhu Ragupathi, 

MD, T. Bartley Pickron, MD, Eric M Haas, MD FACS, Division of Minimally 

Invasive Colon and Rectal Surgery, Department of Surgery, University of 

Texas Medical School at Houston, Houston, Texas 

P538 ADVANCED LAPAROENDOSCOPIC SINGLE SITE PROCEDURES 

Fernando Arias, MD FACS, Monica Rodriguez, Adolfo Torres, Jairo 

Dussan, Carlos Aguilar, MD, Daniel Carrillo, MD, Beatriz Angulo, Isabel 

Cañon, MD, Fundación SantaFe de Bogotá 

P539 SINGLE PORT CHOLECYSTECTOMY: SMALL SCAR, SHORT 

LEARNING CURVE Daniel Solomon, MD, Robert Bell, MD, Andrew Duffy, 

MD, Kurt Roberts, MD, Yale University School of Medicine 

P540 TRANSUMBILICAL MINIMALLY INVASIVE SURGERY (TUMIS): THE 

EARLY EXPERIENCE IN A TERTIARY CARE CENTER Candace Y Williams- 

Covington, MD, John A Primomo, MD, Vadim Sherman, MD, Baylor 

College of Medicine 

P541 SINGLE SITE WIRELESS LAPAROSCOPY IN ANIMAL MODEL 

Fernando Arias, MD FACS, Adolfo Torres, Jairo Dussan, Carlos Aguilar, 

MD, Beatriz Angulo, Pedro Merlano, Sara Vergara, Miguel Sarmiento, 

Fundación SantaFe de Bogotá 

P542 SINGLE INCISION LAPAROSCOPIC SPLENECTOMY: A CASE 

SERIES COMPARISON TO LAPAROSCOPIC SPLENECTOMY Michael 

G Doorly, MD, Brian Binetti, MD, Tejinder P Singh, MD, Albany Medical 

Center 






P543 SINGLE PORT ENDO-LAPAROSCOPIC SURGERY (SPES) FOR 

MULTIPLE PROCEDURES Michael M Lawenko, MD, Javier Lopez- 

Gutierrez, MD, Alembert Lee-Ong, MD, Asim Shabbir, MD, James Mok, 

MD, Sarah Chian, Jimmy So, MD, Davide Lomanto, MD PhD, Minimally 

Invasive Surgical Centre, Department of Surgery, Yong Loo Lin School of 

Medicine, National University Health System - Singapore 

P544 DEFLECTABLE TIP LAPAROSCOPE DECREASES OPERATION 

TIME AND BLOOD LOSS DURING SINGLE INCISION LAPAROSCOPIC 

CHOLECYSTECTOMY. Mohammed R Salabat, MD, Woody Denham, MD, 

Jin Zhao, MD, Michael B Ujiki, NorthShore University Health System 

P545 BENEFITS OF LAPAROSCOPY FOR VENTRICULOPERITONEAL 

SHUNT PLACEMENT Yu Liang, MD, Anne Roberts, BS, Julie 

Monteagudo, BS, Sean B Orenstein, MD, Patrick B Senatus, MD, Hillary 

Onyiuke, MD, Yuri W Novitsky, MD, University of Connecticut Healh 

Center, Farmington, CT 

P546 CHOOSING THE COSMETICALLY SUPERIOR LAPAROSCOPIC 

ACCESSS TO THE ABDOMEN: THE IMPORTANCE OF THE NAVEL 

Monika E Hagen, MD MBA, Pouya Iranmanesh, MS, Oliver J Wagner, 

MG, Kari J Thompson, MD, Santiago Horgan, MD, Philippe Morel, PhD, 

Division of Digetsive Surgery, University Hospital Geneva & Center for 

the Future of Surgery, Department of Surgery, University of California 

San Diego 

P547 MENTORING FACILITATES ONCOLOGICALLY SOUND 

LAPAROSCOPIC COLON RESECTION A R Beaulieu, G K Kaban, MD 

FRCSC, Regina General Hospital, Regina Qu’Appelle Health District, 

University of Saskatchewan 

P548 CASE REPORT: GASTROINTESTINAL TRACT DUPLICATIONS 

TREATEMENT WITH LAPAROSCOPIC SURGERY Sergio Roll, MD PhD, 

German Hospital Oswaldo Cruz 

P549 INITIAL EXPERIENCE WITH SINGLE INCISION LAPAROSCOPIC 

SURGERY Emanuel Sporn, MD, Sebastian Roka, MD, Erwin Rieder, MD, 

Johannes Zacherl, MD, Gerhard Prager, MD, Department of Surgery - 

Medical University of Vienna 

P550 ACCEPTANCE OF SINGLE PORT ENDOSCOPIC SURGERY (SPES), 

NOTES AND LAPAROSCOPIC SURGERY IN A COHORT OF SURGICAL 

PATIENTS Javier Lopez Gutierrez, MD, Michael Lawenko, MD, Alembert 

Lee Ong, MD, Sarah Chian, Davide Lomanto, MD PhD, Minimally Invasive 

Surgical Centre, Dept.Surgery, National University Health System, 

National University of Singapore. Singapore Management University, 

Department of Sociology, Singapore. CMN 20 de Noviembre, ISSSTE, 

Mexico. 

P551 PICTORIAL DOCUMENTATION OF LAPAROSCOPIC 

CHOLECYSTECTOMY Prasanta Raj, MD MS FACS, Neilendu Kundu, MD, 

Fairview Hospital / Cleveland Clinic Health Systems 

P552 THE CURRENT STATUS OF LAPARO-ENDOSCOPIC SINGLE- 

SITE SURGERY (LESS) ACROSS SURGICAL DISCIPLINES, A SINGLE 

INSTITUTION’S EXPERIENCE. J Taylor, N Hubbard, R Atkins, N Mishra, 

V Gunabushanam, M Schwartz, N Wainganker, M Ostrowitz, D Eschete, 

E Rubach, L Richstone, L Kavoussi, L Gellman, D Gadaleta, H Zemon, M 

Nimaroff, G DeNoto, Northshore/LIJ Health System 

P553 ROBOTIC POSTERIOR RETROPERITONEAL ADRENALECTOMY: 

INITIAL REPORT Eren Berber, MD, Hizir Akyildiz, MD, Jamie Mitchell, MD, 

Mira Milas, MD, Allan E Siperstein, Cleveland Clinic 

P554 ROBOTIC-ASSISTED THYROIDECTOMY USING A GASLESS 

TRANSAXILLARY APPROACH: A PRELIMINARY EXPERIENCE Dimitrios 

Linos, MD, Andreas Kiriakopoulos, MD, Efthimios Poulios, MD, Hygeia 

Hospital, Athens, Greece 

P555 LAPAROSCOPIC SPLENECTOMY: CONVENTIONAL VERSUS 

ROBOTIC APPROACH: A COMPARATIVE STUDY Roberta Gelmini (1), 

MD PhD, Chiara Franzoni (1), MD, Alessandro Spaziani (2), MD, Alberto 

Patriti (2), MD, Luciano Casciola (2), MD, Massimo Saviano (1), MD PhD, 

University of Modena and RE - Dept. of Surgery(1) S. Matteo degli 

Infermi Hospital Spoleto - Dept of Surgery (2) ITALY 

P556 ENHANCING ROBOT-ASSISTED FUNDAMENTAL SURGICAL 

PROFICIENCY USING PORTABLE VIRTUAL SIMULATOR Jung H 

Chien, Irene H Suh, Mukul Mukherjee, PhD, Shi-Hyun Park, PhD, Dmitry 

Oleynikov, MD, Ka-Chun Siu, PhD, University of Nebraska Medical Center 

P557 ROBOTIC FOREGUT SURGERY: ONE SURGEON’S EXPERIENCE 

WITH NISSEN FUNDOPLICTION, ESOPHAGOMYOTOMY, AND HIATAL 

HERNIA REPAIR Robin A Alley, MD, Franziska Huettner, MD PhD, Jamie 

Doubet, RN, Michael J Ryan, MS, Danuta I Dynda, MD, David L Crawford, 

MD, University of Illinois College of Medicine, Peoria, IL 

P558 COMPARISON BETWEEN ROBOTIC AND LAPAROSCOPIC 

GASTRECTOMY WITH EXTRAPERIGASTRIC LYMPHNODE 

DISSECTION FOR ADVANCED GASTRIC CANCER Kazuki Inaba, MD, 

Geon-Ung Heo, MD, Woo Jin Hyung, MD PhD, Sung Hoon Noh, MD PhD, 

Department of Surgery, Yonsei University College of Medicine 

P559 ROBOTIC VERSUS LAPAROSCOPIC TOTAL MESORECTAL 

EXCISION OF RECTAL CANCER. A COMPARATIVE STUDY OF 

ONCOLOGICAL SAFETY AND SHORT-TERM OUTCOMES PP Bianchi, 

MD, C Ceriani, MD, A Locatelli, MD, B Andreoni, MD, Unit of Minimally- 

Invasive Surgery. European Institute of Oncology. Milano. Italy 

P560 FEASIBILITY OF TRANSVAGINAL PERITONEOSCOPY USING 

NOVEL ARTICULATED STEREO-LAPAROSCOPE ROBOT. Mikael 

Sodergren, MRCS, James Clark, MRCS, David Noonan, MSc, Jianzhong 

Shang, PhD, Christopher Payne, MSc, David James, MRCS, Thanos 

Athanasiou, PhD, Teare Julian, MD, Ara Darzi, FRCS KBE, Yang Guang- 

Zhong, PhD, Department of Biosurgery and Surgical Technology and the 

Institute of Biomedical Engineering; Imperial College London, UK. 

P561 A NOVEL ARTICULATED ROBOTIC LAPAROSCOPE FOR SINGLE 

INCISION AND NATURAL ORIFICE SURGICAL APPLICATIONS; 

PRELIMINARY USABILITY TRIALS IN A LIVE PORCINE MODEL. James 

Clark, MRCS, Mikael Sodergren, MRCS, David Noonan, MSc, Shang 

Jianzhong, PhD, Christopher Payne, MSc, David James, MRCS, Julian 

Teare, MD, Thanos Athanasiou, PhD, Ara Darzi, FRCS KBE, Yang Guang- 

Zhong, PhD, Department of Biosurgery and Surgical Technology and the 

Institute of Biomedical Engineering; Imperial College London, UK. 

P562 LAPAROBOTIC APPROACH TO ADRENALECTOMY Emil Shakov, 

MD, Anusak Yiengpruksawan, MD, Atthaphorn Trakarnsanga, MD, 

Shankar Raman, MD, The Valley Hospital 

P563 ROBOTIC-ASSISTED LAPAROSCOPIC SURGERY FOR 

DIVERTICULITIS: EXPERIENCE IN 19 CONSECUTIVE CASES AND A 

REVIEW OF THE LITERATURE Madhu Ragupathi, MD, Diego I Ramos- 

Valadez, MD, Chirag B Patel, MSE, Eric M Haas, MD FACS, Division of 

Minimally Invasive Colon and Rectal Surgery, Department of Surgery, 

University of Texas Medical School at Houston, Houston, Texas 

P564 STEPWISE PROGRESSION TO TOTALLY ROBOTIC BYPASS 

Arundathi Rao, MD, Erik B Wilson, MD, Brad Snyder, MD, Eduardo Parra- 

Davila, MD FACS FACCRS, Keith C Kim, MD, Department of Bariatric 

Surgery at Florida Hospital Celebration Health 

P565 ROBOTIC NISSEN FUNDOPLICATION REVISION Niazy m Selim, MD 

MBChB PhD FACS, Tamer Dabous, MD, University of Kansas 

P566 LEARNING CURVE FOR ROBOTIC-ASSISTED LAPAROSCOPIC 

COLORECTAL SURGERY OF THE PELVIS: ANALYSIS OF 50 

CONSECUTIVE CASES Chirag B Patel, MSE, Diego I Ramos-Valadez, 

MD, Madhu Ragupathi, MD, Malak Bokhari, MD, Eric M Haas, MD FACS, 

Division of Minimally Invasive Colon and Rectal Surgery, Department of 

Surgery, University of Texas Medical School at Houston, Houston, Texas 

P567 CASE REPORT: LAPAROSCOPIC ADRENALECTOMY FOR 

BILATERAL METACHRONOUS ALDOSTERONOMAS Piotr Gorecki, MD, 

Philippe Rizek, MSc, Aristid Lindenmayer, MD, Sabita Moktan, MD, New 

York Methodist Hospital, Brooklyn, NY 

P568 COMBINED ANTERIOR AND POSTERIOR APPROACH FOR 

STAPLESS LAPAROSCOPIC SPLENECTOMY; TOWARDS SAFE 

AND ECONOMIC LAPAROSCOPIC SPLENECTOMY Ahmed A Nada, 

AProfessor, Ayman El Samadoni, AProfessor, Amr Mohsen, Professor, 

Department of surgery, Faculty of Medicine, Cairo University, Egypt 




P569 A REVIEW OF PERIOPERATIVE COMPLICATIONS IN 120 

CONSECUTIVE COMMUNITY BASED LAPAROSCOPIC DONOR 

NEPHRECTOMIES John F Lazar, MD, Harold Yang, MD PhD, Harrisburg 

Hospital 

P570 LAPAROSCOPIC MANAGEMENT OF CYSTIC LESIONS OF SPLEEN 

Mohan Narasimhan, Kumar Palaniappan, Sourav Kalia, Ramesh 

Ardhanari, Department of surgery and Gastroenterology, Meenakshi 

Mission Hospital & Research Center, Madurai 

P571 A LARGE SINGLE INSTITUTION CASE SERIES OF LAPAROSCOPIC 

SPLENECTOMY FOR BENIGN AND MALIGNANT SPLENIC MASSES 

Haris Khwaja, MD DPhil, Fady Moustarah, MD MPH, Joseph Talarico, MD, 

Tamara Kindelan, MD, Nabil Tariq, MD, Vikram Attaluri, MD, Bipan Chand, 

MD, Matthew Kroh, MD, Stacy Brethauer, MD, Tomasz Rogula, MD, Philip 

Schauer, MD, Steven Rosenblatt, MD, Surgery Institute, Cleveland Clinic 

Foundation, Cleveland, Ohio 

P572 LAPAROSCOPIC SPLENECTOMY IN TRAUMA: BENEFIT OR 

BURDEN? Lucian Panait, MD, Tifany T Fancher, MD, Stanley J Dudrick, 

MD, Michael S Ajemian, MD, Saint Mary’s Hospital, Waterbury, CT 

P573 MINIMALLY INVASIVE DONOR NEPHRECTOMY USING A SUPRA- 

PUBIC APPROACH: INITIAL CLINICAL EXPERIENCE Ajai Khanna, MD 

PhD, Monika E Hagen, Santiago Horgan, MD, Section of Transplant 

Surgery, Center for the Future of Surgery, Department of Surgery, 

University of California San Diego 

P574 STANDARDIZED TRANS-ABDOMINAL SUTURING WITH THE 

IMESH STITCHER DEVICE Daniel R Marcus MD, Bruce Ramshaw MD, 

Yoav Mintz MD, Izhak Fabian, Nir Altman, Ofir Rimer, St Johns Health 

Center, Santa Monica CA, University Of Missouri, Columbia , Missouri, 

Hadassah Medical Center, Jerusalem, Israel 




Emerging Technology Oral Abstracts 

ET01 

NOVEL HANDHELD PET PROBES PROVIDE INTRAOPERATIVE 

LOCALIZATION OF MALIGNANT LYMPH NODES Segundo J Gonzalez, 

MD, Joyce Wong, MD, Lorena Gonzalez, MD, Peter Brader, MD, Mithat 

Gönen, Maureen Zakowski, MD, Yuman Fong, MD, Vivian Strong, MD 

Departments of Surgery,1 Radiology,2 Pathology,3 and Epidemiology and 

Biostatistics,4; Memorial Sloan-Kettering Cancer Center, New York, NY, 

10065 USA 

Introduction: Positron emission tomography (PET) scanning is a helpful 

preoperative modality to detect sites of malignancy, however, for 

identification of smaller deposits such as suspicious lymph nodes it is 

not as reliable. A tool to identify such nodes intraoperatively may aid in 

improving sampling quality, provide better staging, and decrease overall 

intraoperative time. We investigated the ability of a novel, minimally 

invasive tool to localize these suspicious nodes intraoperatively. 

Methods: Ten female rats were inoculated with a lymphogenic tumor line 

and followed weekly with PET scan studies using 18F-2-fluoro-2-deoxy- 

D-glucose (18F-FDG) radiotracer. When suspicious nodes were found, 

animals were sacrificed for tissue harvesting, intraoperative radiotracer 

uptake counts, and later pathological analysis of these nodal tissues. The 

amount of radiation uptake was analyzed as tumor to background ratio 

(TBR) for its correction with the background uptake within each animal. 

Results: The intraoperative probe was used to guide dissections and 

select high risk nodes based on their specific radiotracer uptake. A total of 

52 nodes were harvested, eight of these being suspicious on preoperative 

PET scan studies. Using a TBR of 2.5, the intraoperative probes were 

able to localize all suspicious nodes previously seen on PET scan. Both 

gamma (sensitivity: 100%; specificity: 86%; positive predictive value (PPV): 

57%; negative predictive value (NPV): 100%) and beta (sensitivity: 88%; 

specificity: 91%; positive predictive value (PPV): 64%; negative predictive 

value (NPV): 98%) probes showed an excellent area under the curve (AUC) 

in the receiver operating characteristic analysis (ROC). Gamma probe had 

an AUC of 0.911 (95% C.I.:0.83-0.99), and beta had an AUC of 0.98 (95% 

C.I.: 0.94-1.0). Furthermore, its ability to specifically detect malignant 

nodes was also analyzed, with comparable statistical results. 

Conclusion: This novel tool reliably localized suspicious nodes identified 

on PET scan, which were subsequently confirmed malignant on histology. 

This device may be used synergistically with the PET scan exam to 

maximize intraoperative nodal selection and sampling. 

ET02 

SINGLE CENTER EXPERIENCE WITH A NOVEL PURELY ENDOLUMINAL 

FUNDOPLICATION DEVICE Ozanan R Meireles, MD, Julietta Paleari, 

MD, Noam Belkind, MD, Kari Thompson, MD, Michael Sedrak, MD, Garth 

Jacobsen, MD, Mark A Talamini, MD, Santiago Horgan, MD University of 

California-San Diego 

Background: Gastroesophageal reflux disease (GERD) has a high 

prevalence in the Western World. The surgical treatment of GERD has 

evolved from open surgery to robotic assisted anti-reflux operations, 

offering patients less invasive treatment options while improving 

outcomes. In trying to deliver the similar outcomes of laparoscopic 

surgery with less invasive approaches, endoluminal techniques have 

emerged as promising alternatives. This study aims to assess the safety 

and efficacy of a novel, computer monitored flexible endoluminal 

stapling system for the treatment of GERD. Methods: Under IRB approval, 

patients with history of GERD for at least 2 years, confirmed with 24h 

pH acid exposure test, and currently taking PPIs with significant relief of 

symptoms are being enrolled in our clinical trial. The exclusion criteria 

includes presence of hiatal hernia greater than 3 cm, Type III hiatal hernia 

of any size, presence of Barrett’s esophagus or grade IV esophagitis, 

esophageal stricture and any anatomical abnormality of the esophagus. 

A flexible endoscopic stapling system placed through the mouth was 

used under general anesthesia. Using a computer monitored system for 

stapling, an endoscopic fundoplications was created. 

Results: Four patients underwent endoscopic fundoplication. The 

average operative time was 78.75 minutes. The length of hospital stay 

was 1 day for all patients. No peri-operative complication occurred. All 

patients experienced relief of symptoms immediately after surgery. 

Conclusion: Our preliminary data demonstrates that purely endoluminal 

fundoplication is feasible, and that this novel flexible endoluminal 

stapling device is safe for human use. This system has the advantage 

of recreating key steps of conventional fundoplications with the 

unquestionable benefit of being much less invasive. Endoluminal 

therapies for GERD are promising, yet challenging, alternatives 

to laparoscopic fundoplications. Although our preliminary data 

demonstrates favorable results, a larger sample size is being gathered in 

coordination with other institutions in order to power a multi-centered 

study. Furthermore, long term outcomes must be obtained before 

considering this approach as the procedure of choice for the treatment of 

GERD. 

ET03 

CLEANOSCOPE: A CLEAR IMAGE AT ALL TIMES Barry Salky, MD, Daniel 

Sherwin, Mr, Ori Nesher, Mr, Noam Danenberg, Mr, Gadi Lotan, MD 

Cleanoscope, Ltd; The Mount Sinai Hospital, New York 

Objective: This device is designed to keep the view through a 

laparoscope or flexible endoscope clear at all times. 

Description: A rapidly spining optical disc(3000/minute) has been 

developed which does not allow liquids or solid particles to adhere to it. 

At present, it is designed to fit as an overtube. The overtube is made of a 

type of stainless steel that has FDA approval for medical procedures. The 

device can be incorporated into a laparoscope or flexible endoscope at 

the factory level, which, of course, would obviate an overtube. The optical 

disc spins rapidly, but this can not be detected by the hman ey or the 

image on the LCD/CRT. The device is patented. 

Results: Blood, iodine, fat, stool or other solid debris does not adhere 

to it. When the laparoscope passes through the trocar, the visual field 

remains clear at all times. Because of the heat generated by the motor/ 

disc, fogging is no longer an issue. 

Conclusions: A completely clear video field is important in the 

performance of both basic and advanced laparoscopic and endoscopic 

surgery. This device keeps the video field clear at all times, and it will 

obviate taking the laparoscope out to clean it. In terms of flexible 

endoscopy, the channel now used for irrigation to clean the lens could be 

redesigned and made larger. That could benefit NOTES procedures. 



ET04 

LAPAROSCOPIC INFRARED IMAGING - THE FUTURE VASCULAR MAP 

Noam Shussman, MD, Mahmoud Abu Gazala, MD, Avraham Schlager, 

MD, Ram Elazary, MD, Abed Khalaileh, MD, Gideon Zamir, MD, Avraham 

I Rivkind, MD FACS, Yoav Mintz, MD Department of General Surgery, 

Hadassah Hebrew University Medical Center, Jerusalem, Israel 

OBJECTIVE: one of the major disadvantages of minimally invasive surgery 

(MIS) is the lack of palpation. Surgeons spend much time during surgery 

in order to locate the blood vessels, either to secure them or divide them 

safely. Recently due to the introduction of Single Port Access Surgery 

and NOTES this is further accentuated. Infrared (IR) detection has already 

shown promise in its ability to map out vascular structures during open 

surgery. The aim of this study, however, was to evaluate the performance 

of IR detectors inside the peritoneal cavity to localize blood vessels during 

laparoscopic procedures. 

DESCRIPTION OF TECHNOLOGY: IR radiation is composed of 

electromagnetic waves with a lower frequency and longer wavelength 

than that of visible light. Measurement of the IR emissions is a highly 

sensitive method of detecting discrepancies in thermal energy, or 

temperature. Because blood vessels are naturally warmer than their 

surroundings, IR detection can be highly effective in identifying and 

mapping out their course. In recent years, IR detection has been 

used successfully for this purpose in open surgery. Nevertheless, this 

technology has yet to be employed in laparoscopic surgery, where 

its contribution would be greatest, for a number of reasons: Firstly, IR 

detectors at present are too large to be introduced into the abdomen 

via a standard trocar and IR radiation cannot be transmitted through 

standard laparoscopic lenses. Secondly, because the closed insufflated 

abdomen does not allow heat loss, there has been concern that there 

would not be sufficient temperature discrepancy between blood vessels 

and their surrounding tissue to allow sensitive discrimination of the 

vasculature. We have developed a method to introduce detectors into 

a closed abdomen and test the sensitivity of their detection in the 

laparoscopic environment. 

PRELIMINARY RESULTS: We performed a feasibility study using this 

technology on live porcine models. After insertion of IR detectors into the 

insufflated abdomen we performed a series of laparoscopic procedures. 

During these operations we evaluated the ability of the IR detector to 

identify blood vessels as well as the effects of local and systemic changes 

in temperature. The IR detector successfully identified concealed blood 

vessels as well as acute bleeding. While cool lavage as well as insufflation 

of the peritoneal cavity with room temperature CO 2 

accentuated IR 

detection of blood vessels, warm CO 2 

and systemic temperature changes 

did not affect IR detection. Additionally, localized heating of tissue on the 

operative field using electro-cautery did not interfere with IR sensitivity. 

CONCLUSIONS AND FUTURE DIRECTIONS: Laparoscopic IR imaging is 

a feasible method of blood vessel detection in laparoscopic procedures. 

Use of IR blood vessel detection in laparoscopy has a potential to enable 

safer surgery and reduced operative times. The technique and video clips 

will be demonstrated. Fusion of IR imaging with the standard laparoscopic 

view is currently being developed to allow real time vessel mapping 

during laparoscopic surgery. 

ET05 

TRANSGASTRIC SMALL BOWEL RESECTION WITH A NEW 

MULTITASKING PLATFORM ENDOSAMURAI(TM) Karl H Fuchs, title, 

Wolfram Breithaupt, title Markus-Krankenhaus, Dept of Surgery 

Introduction: Recently NOTES-techniques in gastro-intestinal endoscopy 

and surgery are carefully introduced in clinical practice. It emerges that 

future therapeutic endoscopes should enable the operator to perform 

surgical task like suturing with a steerable stabile platform. A new 

prototype of a multitasking platform (EndoSAMURAI, Olympus Medical 

Systems Corporation, Tokyo, Japan) could fulfil these criteria and was 

tested by our team. 

Aim: The purpose of this study was the evaluation of this new prototype 

in an animal model using transgastric small bowel resection with 

laparoscopic assistance. 

Methods: In a porcine model small bowel resection was performed via 

the transgastric route using a needle knife gastrotomy and laparoscopic 

port assistance for stapler application. After resection an end-to-end 

interrupted sutured small bowel anastomosis were performed. After 

completion of the hand-sutured anastomosis with the EndoSAMURAI 

platform the experiment was terminated. The segment of small bowel, 

carrying the anastomosis, was again resected and air leak pressure and 

bursting pressure were measured in the laboratory using perfusion 

manometry. The bowel segment with the anastomosis was kept in 

a water bath and air was insufflated at 1ml/sec via an independent 

channel into the bowel lumen. Pressure values were recorded when an 

air leak occurred during rising intraluminal pressure. The experiment 

was terminated, after the bursting pressure was recorded, when air was 

abruptly insufflated with 50 ml/sec. 

Results: in total 7 animals were operated with a median body weight 

of 30 kg. All end-to-end anastomsis were completed. Total time of the 

procedure from skin incision for the assisting trocard until completion 

of the anastomosis was median 100 min (70-125). The median time for 

anstomosis was 90 min. Leak pressures: 50 mmHg (19-68). The results 

show that end-to-end small bowel anastomosis can be sutured in 

sufficient quality. 

Conclusion: The new prototype can be used for anastomotic suturing 

with a sufficient quality. These results and the technical experience are 

very promising to use this tool in the future for safe surgical endoscopic 

performance. 

ET06 

A NOVEL FLEXIBLE BIPOLAR HEMOSTASIS FORCEPS (BELA, ETHICON 

ENDO-SURGERY, NOTES TOOLBOX) OVERCOMES THE CURRENT 

SHORTCOMINGS OF ENDOSCOPIC ZENKER’S DIVERTICULOTOMIES: 

AN EXPERIMENTAL MODEL. Erwin Rieder, MD, Danny V Martinec, BS, 

Christy M Dunst, MD, Lee L Swanstrom, MD Dept. of Minimally Invasive 

Surgery, Legacy Health, Portland, OR 

Objective: Zenker´s diverticulum (ZD) is the most common type of 

diverticulum in the upper gastrointestinal tract. Treatment is indicated for 

symptomatic patients as complications such as carcinoma, aspiration or 

stenosis of the upper esophagus can occur. Common treatments are open 

surgical diverticulectomy and rigid endoscopic myotomy, using an endo- 

GIA stapler. This endoscopic alternative is relatively minimally invasive 

but is not applicable to all patients due to anatomic reasons. It also may 

have a higher failure rate due to the incomplete division of the stapleline. 

Flexible endoscopy has been described for diverticulotomy, and may 

have advantages over the rigid approach as it can be performed without 

general-anesthesia or the need for hyperextension of the neck. Different 

techniques such as needle-knife incision or argon plasma coagulation 

have been used for division of the septum between the diverticulum and 

the esophagus. These techniques are associated with a longer learning 

curve, which is difficult to achieve given the overall rarity of this condition. 

The danger inherent in the flexible approach is that division of the septum 

is not accompanied by sealing of the pouch and esophageal mucosa. 

This can lead either to clinical recurrence, mediastinal emphysema 

and infection or bleeding. We hypothesized that recent developments 

evolving from natural orifice transluminal endoscopic surgery (NOTES) 

techniques might strongly facilitate and simultaneously assure precise 

and safe endoscopic diverticulotomy. 

Methods: As the pig has a normal pharyngeal diverticulum (PD) that is 

identical to a human ZD from the endoscopic perspective, this model 

was used to perform diverticulotomy. A double-channel endoscope was 

inserted into the pharyngeal diverticulum of an intubated pig, which 

permits excellent viewing of the septum along with the esophageal 

lumen. The PD septum was dissected to the inferior border using a 

Flexible Bipolar Hemostasis Forceps (BELA, prototype instrument, 

Ethicon Endo-Surgery) providing intermittent coagulation and cutting. 

The septum can simultaneously be stabilized with a standard flexible 

endoscopic grasper, if necessary. 

Results: The PD could be easily visualized. Due to the small size of the 

BELA, the septum could be precisely dissected to the end of the inferior 

border, which is often not possible with the current standard endoscopic 





procedure such as the use of a rigid endo-GIA stapler. In contrast to 

needle knife dissection, the BELA can easily be readjusted prior to any 

tissue dissection. As otherwise inevitable movements or tension while 

dissecting are not necessary and additionally energy is only applied on 

the tissue to be divided due to isolated branches, dissection is much more 

precise. The coapting or “tissue welding” characteristics of the bipolar 

technology were also valuable to fuse the esophageal and pouch-mucosa 

together and prevent leaks. Although no esophageal protection was used 

no complication occurred. The whole dissection of the septum took 16 

minutes. 

Conclusion: The use of the flexible bipolar hemostasis forceps (“BELA”) 

for endoscopic Zenker´s diverticulotomy could be a quicker and safer 

approach compared to needle knife dissection. This novel tool can 

significantly facilitate performance of endoscopists and may make flexible 

endoscopy the preferred method of Zenkers ablation. 

ET07 

INSERTABLE ROBOTIC EFFECTOR PLATFORM Dennis L Fowler, MD MPH, 

Peter Allen, PhD, Jayson Ding, PhD, Roger Goldman, BA, Austin Reiter, BA, 

Nabil Simaan, PhD Columbia University 

Objective of Device: The objectives of developing this technology are 

1) to reduce the invasiveness of surgery by converting access to either a 

single incision or a natural orifice, 2) to make it easier for surgeons to learn 

minimally invasive techniques with a manageable, computer-assisted 

platform, and 3) to reduce the overall cost and size of a robotic platform 

for minimally invasive surgery. 

Description of the Technology: The device includes robotic and 

control hardware, software, and a standard PC for operator interface. 

The hardware is a 15 mm diameter device that is inserted into the body 

cavity through a single site. When inserted into a body cavity, the device 

uses its 21 degrees of freedom to deploy a camera module containing 

two cameras for stereoscopic imaging and two dexterous snake-like 

robotic arms. The camera module and dexterous arms are motor-driven 

and are controlled by a surgeon using a telemanipulation interface or 

by the software itself using sensory information from the cameras. The 

controller software includes modules for moving the cameras and tools; 

advanced, novel, image processing software for optimally displaying 

and using the images from the cameras; and software to integrate the 

sensory information from the cameras with the controller software so as 

to manage the overall functionality of the device. 

Preliminary Results: We have measured and video-recorded the 

performance of the prototype in an inanimate model for study and 

presentation. In initial testing the system effectively controls the 

movement of the camera module by tracking the movement of the tool 

controlled by the surgeon’s dominant hand. The surgeon effectively 

controls the tools using the master manipulator. 

Conclusions/Future Directions: The camera module will autonomously 

follow one of the instruments, enabling the surgeon to be free to control 

only the tools. Future activities include refining the software; enhancing 

instrument performance by adding new functionality to existing tools as 

well as adding new instruments; and proceeding with animal trials. 

ET08 

INTRA-LUMINAL INJECTION OF FERROMAGNETIC GLUE-BASED MEDIA 

FOR BOWEL RETRACTION IN LAPAROSCOPIC SURGERY Z Wang, PhD, 

A W Brown, S I Brown, PhD, D Liu, L Wang, PhD MD, A Cuschieri, Professor 

Institute for Medical Science and Technology, University of Dundee, UK 

Objective Safe and effective manipulation of soft tissue during 

laparoscopic and other minimal access surgical procedures can be 

enabled by use of electromagnetic force. Previously we reported 

two approaches for tissue ferro-magnetisation, e.g. mucosal surface 

magnetisation using adhesives and sub-mucosal injection of magnetic 

media. This presentation describes a new method of ferro-magnetisation 

of a bowel segment for its magnetic retraction which overcomes the low 

retraction force limitation of the previously reported approaches. 

Method stainless steel microparticles were dispersed in cyanoacrylate 

liquid and injected intra-lumenally to form a coagulum attached to 

the inner (mucosal) aspect of the bowel wall using an ex-vivo porcine 

bowel model. The coagulum was then retracted towards a magnetic 

probe which was located external to the bowel wall. The probe was 

made of small magnet discs, and the magnetic force could be varied by 

changing the number of the stacked discs. Finite element method (FEM) 

was used to analyze the magnetic field and force exerted by the intralumenal 

magnetic coagulum for optimization of the probe design. The 

characteristics of the magnetic glue were investigated to ensure that the 

maximal retraction force could be delivered reliably and that the media 

could be injected without difficulty. Biocompatibility of the implanted 

ferromagnetic coagulum was preliminarily assessed by in-vitro cell culture 

toxicity studies. 

Results Using the ex-vivo porcine bowel loops, a large volume of 

magnetic media with a microparticle concentration of up to 2 g/mL was 

injected into the bowel lumen, and a range of magnetic retraction force 

was generated for manipulating the bowel. This was compared to grip 

retraction by forceps which resulted in significantly higher stress on the 

grasped bowel tissue. A low bond force between the coagulum and 

mucosal layer was found to facilitate removal of the coagulum from the 

bowel wall after surgical procedure. In-vivo, any residual ferromagnetic 

material from the intraluminal coagulum would be eliminated following 

the return of bowel function after surgery. The tendency for the 

microparticles to aggregate within the syringe was investigated by 

varying the viscosity of the cyanoacrylate liquid and concentration of the 

magnetic media. The cell culture tests indicated that the magnetic media 

based on medical grade cyanoacrylate were not cytotoxic. 

Conclusions Glue based intra-lumenal ferromagnetic coagula for 

magnetic retraction of bowel were realized in this ex-vivo porcine bowel 

model. The optimal magnet probe design and ferromagnetic implanted 

materials were investigated and identified using both FEM analysis and 

simulated surgical procedures. We previously reported mucosal retraction 

using glued media on the tissue surface and found that there was a low 

bond-strength between the mucosal and the magnetic coagulum. The 

present development based on use of intra-lumenal ferromagnetic gluebased 

media overcomes this problem and utilizes the maximal magnetic 

attraction potential by holding the bowel wall segment and retracting 

it towards a magnetic probe external to the bowel wall. Intra-luminal 

injection of ferromagnetic coagula appears to be a promising method for 

safe and effective magnetic bowel retraction. 

ET09 

“THE DUNDEE ENDOCONE”: A NEW REUSABLE SILS DEVICE Andrea 

Pietrabissa, MD, Mario Alessiani, MD, Andrea Peri, MD, Sandro Zonta, MD, 

Lorenzo Cobianchi, MD, Paolo Dionigi, MD, SI Brown, MD, TG Frank, MD, 

Alfred Cuschieri, MD Department of Surgical Science, University of Pavia; 

Institute for Medical Science and Technology - Dundee U.K 

Objective of the technology or device: Dundee EndoCone is a new 

device for SILS (Single Incision Laparoscopic Surgery) created at the 

Institute for Medical Science and Technology in Dundee U.K. with the 

industrial partnership of Karl Storz Gmbh. The challenge was to create 

a low cost SILS device which allows the surgeon to perform advanced 

surgical procedures using up to three instruments and the camera at 

the same time, through a single port of acceptable size. Most currently 

commercially available devices only allow the insertion of 2 operating 

instruments and the optics. 

Description of the technology and method of its use or application: 

The device consists of a waisted metallic cone with an extra-abdominal 

diameter of 45mm which tapers to a cylindrical section (30mm diameter) 

for insertion through the abdominal parieties into the previously 

insufflated peritoneal cavity. The device has a removable cap (bulkhead) 

with 8 valved ports: 6 - 5mm, 1 - 10mm and 1 - 12 mm for use of staplers. 

Insertion into the peritoneal cavity is achieved through a vertical 30mm 

umbilical incision by a clockwise screwing action. The device has a 

dedicated long Hopkins 5mm telescope which enables the camera person 

to manoeuvre the camera without encroaching on the operating space 

of the surgeon. The system enables the use of 4 instruments (including 

optic) at any one time. It overcomes the problem of triangulation, 



typical of SILS by use of specifically designed single and double curved 

instruments. Provided the specimen is small the bulkhead is removed 

for extraction, with the cone in situ, thus providing protection of the 

abdominal wall during the extraction. 

Initial clinical experience: Our initial clinical experience with the 

EndoCone includes SILS cholecystectomies and colectomy. The additional 

grasper of the EndoCone enables the necessary exposure and tension 

during active dissection not possible with current SILS devices. This 

facilitates execution of the procedure and control of any bleeding. 

All gallbladder specimens (n =2) were removed by simple removal 

of the bulkhead with the cone providing complete protection to the 

abdominal walls. For bulky specimens such as colectomy for colon 

cancer, the EndoCone is replaced by a protective circular plastic drape. 

Following extracorporeal reconstruction, the EndoCone is replaced for 

final inspection. All patients had a smooth post-operative course with no 

complications and required minimal analgesic medication in view of their 

low pain scores. 

Conclusions/ Future directions: The initial experience with the first 

generation EndoCone has been entirely favourable in terms of ease of 

execution and operating times. The feedback from these clinical results 

will be used to make fine tuning adjustments to the EndoCone operating 

system for SILS. The changes envisaged included a flexible waist to 

improve manoeuvrability and a range of disposable bulkheads depending 

on the requirements of specific operations. 

ET10 

FLEXIBLE CO2 LASER AND SUBMUCOSAL GEL INJECTION FOR SAFE 

ENDOSCOPIC AND LAPAROSCOPIC SURGERY OF THE INTESTINES 

Joyce T Au, MD, Arjun Mittra, MD, Joyce Wong, MD, Iain Nixon, MD, Paula 

Ezell, DVM, Snehal Patel, MD, Yuman Fong, MD Memorial Sloan Kettering 

Cancer Center 

OBJECTIVE: The CO2 laser’s unique wavelength of 10.6 μm has the 

advantage of being readily absorbed by water but historically limited 

it to line-of-sight procedures. Through recent technological advances, 

a flexible CO2 laser fiber has been developed and holds promise for 

endoluminal and laparoscopic surgery. In this study, we examined 

whether injection of a water-based gel in the submucosal space will allow 

safe dissection of the intestines using the flexible CO2 laser and enhance 

potential of this tool for endoluminal and laparoscopic surgery. 

METHODS: Using an ex vivo model with porcine intestines, spot and 

linear burning was performed with the flexible CO2 laser fiber at different 

power settings until transmural perforation. Additionally, excisions of 

mucosal patches were performed by submucosal dissection with and 

without submucosal injections of a water-based gel. 

RESULTS: With spot burning at 5 W, none of the specimens were 

perforated by 5 minutes which was the maximum recorded time. The time 

to perforation was significantly shorter at 10 W (mean=6 sec, p



Further work is needed to study the effect of curvature of the tissue 

on the signal, the pattern of tissue oxygen saturation associated with 

development of ischemia, and how this influences surgical outcomes, e.g. 

anastomotic leak rate. 

ET12 

LAPAROSCOPIC INTESTINAL ANASTOMOSIS WITH THE CAIMAN 

LEKTRAFUSE DEVICE Dirk W Meijer, MD MSc PhD, H Jaap Bonjer, MD PhD 

BRG, VUMC 

Objective of the technology/device. Laparoscopic Intestinal Anastomosis 

with the Lektrafuse Caiman Device, without sutures or staples. 

Description of the technology and method of its use or application. 

The Aragon Surgical Lektrafuse Caiman laparoscopic instrument is a 

dedicated bipolar electrosurgical instrument intended for use in general 

surgical and gynecologic laparoscopic procedures where ligation 

and division of vessels is desired. The instrument creates a seal by the 

application of bipolar electrosurgical RF energy (coagulation) to vascular 

structure (vessels) and tissue interposed between the jaws of the device. 

A cutting blade is activated for the division of tissue. The device can be 

used on vessels up to 7mm in diameter and non-vascular tissue that fits 

between the jaws of the instrument. 

A challenging application is the creation of an intestinal anastomosis. 

This would be an attractive alternative to a stapled anastomosis. This was 

investigated in a side-to-side intestinal anastomosis in the mid-jejunum in 

2 pigs. The Aragon Lektrafuse system was used for intestinal transection 

and side-to-side intestinal anastomosis. Animals were sacrificed 20 

days postoperatively. The anastomosis and surrounding tissues were 

explanted and preserved in 10% neutral buffered formalin (NBF). Formalin 

fixed tissues were then trimmed, routinely processed in alcohol and 

xylene, embedded in paraffin, sectioned at 4-6 microns, and stained 

with hematoxylin and eosin (H&E) for routine microscopic evaluation. 

Trichrome stain was used on some sections to demonstrate fibrosis. 

Preliminary results. Grossly, a discrete anastomotic site was difficult to 

discern. The degree of fibrous adhesions forming around the anastomotic 

site was considered within normal limits as compared to side-to-side 

anastomosis performed with surgical staples. At the anastomotic site was 

a small discrete zone of fibrosis creating a stable adhesion and fusion 

between the conjoining loops of intestine. Furthermore, there was normal 

regeneration and growth of the mucosal lining over the anastomotic site. 

Conclusions and Future directions. This study demonstrates that small 

bowel anastomosis is feasible with the Caiman instrument. This very 

promising technique is evaluated in further detail to determine suitability 

for use in patients. 

ET13 

NOVEL METHODOLOGY FOR COMPARING TISSUE ANALOGS Jenna 

Turocy, John Hryb, Danyel Racenet, Andrew Miesse, Thomas Wenchell, 

Covidien 

Objective: To compare the compressive properties and penetration 

resistances of various tissue analogs to organic tissue using a powered 

stapling device. 

Technology and Method: An important step in the development of any 

medical device is frequent testing to evaluate device performance. While 

the need for a more realistic, consistent and humane testing material is 

not new, the development of the powered stapling device allows for a 

more accurate analysis our testing material. Current engineering tests 

for surgical staplers are performed in foam, polymeric materials, in vivo 

and ex vivo animal tissue and cadaver tissue. With many different options 

available, it is imperative that standardized tissue analogs be used for 

different physiological tissues. Recently, a synthetic tissue was developed 

to mimic the mechanical, structural, and visco-elastic properties of living 

tissue. To test the mimicry of the tissue analogs, device performance on 

versions of this media will be analyzed using electric current profiles. The 

electric current the powered stapling device draws as it clamps, staples 

and transects the media can be recorded with high resolution. The electric 

current is directly related to the torque in the device motor and can be 


translated into the linear force required to compress and penetrate the 

test media. The compressive force and penetration resistance can be used 

to determine a tissue analog’s similarity to organic tissue. 

Preliminary Results: 

Graph 1. Above are the electric current profiles recorded during firing a 

linear stapling reload with a powered stapling device on synthetic and 

in vivo canine tissue. The peaks in the current profile correspond to the 

formation of a staple. 

Conclusions/Future Directions: In the future, a synthetic tissue promises 

to provide a more realistic testing media than foam and a humane and 

more consistent testing media than live animals. Results from this testing 

will be used to modify the synthetic tissue to more accurately reflect 

the compression and penetration properties seen in organic tissue. 

The media’s relaxation rate and strain under compression will also be 

measured using a material compression testing machine. In the future, 

the testing will be expanded to study different tissue types as well 

introduce more variables such as age, sex, weight and disease state of 

tissue. 

ET14 

BETA TESTING OF A V-BAND SIMULATOR Jamie D Adair, MD, Ganesh 

Sankaranarayanan, PhD, Tansel Halic, MS, Zhonghua Lu, MS, Woojin Ahn, 

PhD, Mark A Gromski, BA, Daniel B Jones, MD, Suvranu De, ScD Beth Israel 

Deaconess Medical Center and Rensselaer Polytechnic Institute 

Background: The Laparoscopic Adjustable Gastric Band (LAGB) is an 

adjustable and reversible surgical weight loss procedure and the second 

most common weight loss procedure in the United States. The objective 

of our study was to evaluate the face, content and construct validity of a 

V-Band simulator that we have developed. 

Methods: Twenty eight subjects participated in the study and were 

categorized into two groups, experts (PGY 5/fellows/faculty) and novice 

(4th year medical students and PGY1-4). There were 13 subjects in the 

expert group and 15 in the novice group. Face and content validity was 

assessed using a 5-point Likert scale questionnaire. The face validity 

questions assessed subjects on the realism of the simulated procedure, 

haptic feedback, and videoendoscopic instrument movement. Content 

validity was evaluated by experts and consisted of a questionnaire on 

the usefulness of the V-Band trainer for training residents/surgeons 

and for potential LAGB certification. Construct validity was assessed by 

computing normalized individual scores for dissection of structures using 

electrocautery and band placement. An average score based on these 

two tasks was also calculated to determine a total score for the entire 

simulator procedure. Penalties were accorded to the number of times the 

band was dropped and the size of the perforations made in the stomach 

and esophagus. 

Results: Face validity results revealed an average rating of more than 3.0 

for realism. Visual display and tools/interface obtained a higher average 

rating of 4.0 and 4.07, respectively. Mann-Whitney U test between the two 

groups showed no significant difference indicating a general agreement 

between experts and novices. 

Content validity results show that the experts overwhelmingly agree that 

the V-Band simulator will be a useful trainer for residents/surgeons before 

their operating room experience (mean score of 4.5). They also agreed


that it could potentially be used for certification of the procedure (mean 

score of 3.4). Construct validity (Table 1) was tested by using the Mann- 

Whitney U test between the two groups. The results show that the virtual 

LAGB simulator was able to differentiate between expert and novice 

groups. 

Table 1. 

Scoring Parameter Experts Experts Novice Novice 

Mann-Whitney 

U Test 

Lap-Band Placement 85.06 12.01 51.18 27.30 0.0003 

Electrocautery 81.49 24.26 62.41 17.74 0.0061 

Total Score 81.93 17.02 51.13 25.35 0.0002 

Conclusion: The V-Band simulator demonstrated excellent face, content 

and construct validity. We plan to add additional tasks of the procedure 

such as securing the band using gastro-gastric imbrications. To our 

knowledge, this is the first virtual reality simulator with haptic feedback 

developed for training surgeons and surgical residents in the LAGB 

procedure. 

ET15 

WIRELESS ENDOLUMINAL APPLICATION OF A MAGNETIC DRIVEN 

CAMERA Nicola Di Lorenzo, MD Phd, Arianna Menciassi, Prof, Pietro 

Valdastri, Eng Phd, Livia Cenci, MD, Luca Iezzi, Eng Phd, Achille Lucio 

Gaspari, Prof, Paolo Dario, Prof Scuola superiore Sant’ Anna Pisa - 

Department of surgey-University of Rome Tor Vergata 

Objective of technology or device. The use of magnetic fields to control 

and steer assistive and operative devices is increasing in endoluminal and 

transluminal surgical operations. 

The single port access is the future of surgery, thus allowing surgical 

procedures through a single incision. 

A promising technology is the Magnetic Internal Mechanism (MIM) control 

of diagnostic or surgical instruments deployed inside the patient’s body. 

A wireless controllable endoscopic capsule was developed as a proof 

of concept equipped with one electromagnetic motor moving two 

permanent magnets, coupled with an external sources of magnetic field 

for coarse positioning and stabilization of the device. 

The objective of our study was to assess the feasibility and functionality of 

a wireless miniaturized mechanism based on magnetic forces for precise 

camera steering and orientation. 

Description of technology and method of its use or application. MIM 

works jointly with an external static magnetic field source both for the 

coarse positioning and for stabilization. 

MIM capsule’s body has a cylindrical shape with a diameter of 15 mm and 

length of 48 mm and it incorporates one electromagnetic direct current 

brushless motor, two small permanent magnets diametrically magnetized 

and an electronic circuit for wireless motor control. 

In order to prove the concept of on line control of vision, a real time wired 

camera was incorporated in the device. 

The overall capsule weight is 14,4 g. 

This mechanism would allow to maximize the number of tools with respect 

of access port while in endoscopic practice magnetized camera system can 

be introduced by natural orifices and oriented by magnetic means. 

By adding an internal degree of freedom it would be possible to move the 

device relatively to the surrounding tissue more effectively and reliably. 

We performed 3 sets of test with MIM: a bench test in free space, a 

phantom with porcine gastrointestinal tract inserted, and two in vivo 

experiments with a 30 kg female domestic pig. 

Preliminary results. A fine navigation and rotation was achieved in all 

tests keeping an external magnet approximately 10 cm distant from the 

capsule. 

MIM allowed the capsule to identify several marks previously placed 

inside the cavity. 

Once the operative location has been reached, fine orientation and 

steering of the visual field can be obtained by actuating the in board 

motor without any further modification of the external magnetic field. 

Conclusion. We report the feasibility and effectiveness of the synergic 

use of the external static magnetic field and single internal wireless 

actuator to move small permanent magnets on board the capsule in 

order to achieve wirelessly controllable and precise camera steering 

intrabdominally. 

The concept is applicable to wireless capsule endoscopy as to other 

instrumentation for laparoscopy or endoluminal and transluminal 

procedures. 

ET16 

AUGMENTED REALITY SYSTEM FOR ENDOSCOPIC AND NOTES 

PROCEDURES Luc Soler, PhD, Vincent Agnus, PhD, Stephane Nicolau, PhD, 

Julien Waechter, Eng, Oliver Burckhardt, MD, Silvana Perretta, MD, Bernard 

Dallemagne, MD, Didier Mutter, MD PhD, Jacques Marescaux, MD IRCAD 

Objective: Endoluminal and Transluminal surgeries are known as 

complex procedures due to long articulated instruments on which no 

direct view is obtainable. Instrument direction, location and shape are 

thus difficult to estimate. Currently available systems can only overcome 

the shape obstacle by providing a 3D virtual view of the scope. To add 

direction and location, we have developed a new system named METRIS 

that provides a real-time 3D view of the flexible endoscope mixed to the 

patient’s real image. METRIS can also add the preoperative 3D modelling 

of patient organs to this augmented reality view. 

Material and methods: Based on the NDI Aurora© device, we have 

designed a 1.20m long and 2.2mm wide flexible tube containing eight 

8mm by 1mm 5 degree of freedom electromagnetic coils placed all along 

its length. This electromagnetic Aurora 5DOF shaped tool© developed by 

NDI can be sterilized in autoclave and is small enough to be introduced 

in the operative channels of almost all flexible endoscopes. From 

the spatial position and direction provided by Aurora©, our software 

computes the 3D shape of the tool by using a spline modelling. It can 

also provide the distance between two locations of the tool’s tip. To add 

the patient’s direction and location data linked to his position, we use an 

optical tracking of a fiducial tag stuck on the Aurora device by using an 

Augmented Reality Library (ARL) that we have developed. A conventional 

OP-room camera (scialitic or external camera) is linked through a Firewire 

port to a laptop integrating an OpenGL Graphic card. ARL calibration, 

registration and tracking algorithms then allow to fuse patient video 

view provided by the camera to the 3D shape virtual view of the flexible 

catheter. When available, a preoperative 3D modelling of the patient 

performed from a CT-scan or MRI using the VR-Anat© software developed 

by IRCAD, can be superimposed on the same video providing the patient’s 

virtual transparent view. 

Validation: Our preclinical validation was performed on pigs using 

Karl Storz flexible endoscopic devices. In colonoscopy, the endoscope 

loop can be avoided by 3D representation, thus reducing colonic 

perforation risks. We also demonstrated that METRIS provides a 

1mm accuracy of polyp sizes. Additionally, METRIS was evaluated to 

estimate the best NOTES path and gastrotomy position for transgastric 

cholecystectomy. Combined with Augmented Reality, it simplifies the 

NOTES scope navigation through anatomical structures and endoscope 

3D visualization. 

Conclusion: The METRIS system is a reusable sterizable system adjustable 

to any endoscopic system with an operative channel larger than 2.3mm. 

The 3D shape of an endoscope along with its direction and position 

are provided. It can also be passed through the endoscope’s tip to 

measure tumor sizes accurately. In this way, typical NOTES difficulties 

are diminished when combined to augmented reality. The next step will 

consist in validating these first preclinical tests clinically. 

ET17 

360° IMMERSIVE PANOMORPH ENDOSCOPIC DEVICE: A NEW 

ADVANCED VISION SYSTEM CONCEPT Pierre Garneau, MD, Patrice 

Roulet, Pierre Konen, Mathieu Villegas, Simon Thibault, MSc PhD ing 

Sacré-Coeur Hospital of Montreal, ImmerVision, Université Laval 

Minimally-invasive surgical procedures and medical examination 

procedures now require increasingly sophisticated devices to help 

explore a patient’s internal organs. Fortunately, recent advances in 

optic miniaturization and improvements in sensor size and resolution 

have led to the development of superior and smaller videoscopes for 





certain medical imaging procedures. In fact, these ultra-modern visual 

instruments benefit from sensor miniaturization with an increased 

resolution of up to 1.3 megapixels (HD). 

Even with such high-resolution capacity, though, endoscopic vision 

is quite different from human vision in the context of open surgery, 

especially as regards field-of-view (Fig. 1). Existing endoscopic devices 

don’t address common limitations, including the afore-mentioned poor 

field-of-view, a limited range of motion, loss of depth perception and the 

need for counter-intuitive camera manipulation. 

This paper presents an innovative approach using a wide-angle 180° 

field-of-view panomorph lens and corresponding visualization software, 

designed specifically for endoscopy procedures. 

The new panomorph endoscopy application is based on replicating as 

closely as possible the parameters of human vision. As an example, it 

features a wide field-of-view (>140°) and the ability to increase angular 

resolution when and where required. This allows video capture of the full 

body cavity (Fig. 2). 

The device’s visualization software processes 360° panomorph endoscopic 

images from various distortion-free points of view, mimicking real-world 

proportions and actual geometrical information. With this visualization 

software, it is possible for a surgeon to customize views best suited 

to his/her psychomotor skills, physical position, and any extenuating 

circumstances, without having to physically manipulate the endoscope. 

In addition, the surgeon can arrange different points of view on several 

screens, to enable a global overview of the complete procedure. 

To further illustrate this advantage, we cite a possible scenario from a 

typical cholecystectomy procedure. Using our new device, the video feed 

from a panomorph laparoscope would allow the insertion of laparoscopic 

tools into the patient’s abdominal cavity without any camera movement 

and without losing the images of the surgical procedure underway. 

This is a considerable benefit during any unforeseen difficulties, such as 

intraoperative bleeding. Without adjusting the panomorph endoscope, 

the surgeon can simultaneously oversee any active bleeding and continue 

monitoring his/her surgical instruments, simply by using different views 

from the same immersive panomorph endoscopic video. 

In summary, the use of the new panomorph endoscopy device for both 

diagnostic and minimally-invasive surgical applications has the potential 

to: 

- enhance depth perception; 

- reduce procedure time; 

- decrease manipulation of tools and endoscope; and 

- provide more intuitive viewing and a superior user interface. 

Just as importantly, though, it will help the surgeon see more, and see it 

all simultaneously, for a true “big picture”. 

Just as advancements in minimally-invasive surgery, such as singleincision 

laparoscopic surgery (SILS), are forcing the progression of 

imaging technology, this newly developed “panomorph” device may 

make these procedures more efficient, with the added potential to 

increase procedural safety and cost-effectiveness. 

ET18 

ROBOTIC TRANSAXILLARY THYROIDECTOMY: REPORT OF TWO CASES 

AND DESCRIPTION OF THE TECHNIQUE Katherine B Heiden, MD, Allan 

Siperstein, MD, Mira Milas, MD, Joyce Shin, MD, Jamie Mitchell, MD, Eren 

Berber, MD Cleveland Clinic 

Objective: Various techniques for minimally invasive thyroid surgery 

have been described over the last decade. These techniques have 

significant limitations due to two-dimensional view and awkward 

endoscopic instrumentation. Robotic surgical technology was developed 

to overcome these limitations. In this case report and submitted video, 

we are describing and demonstrating the operative technique for robotic 

transaxillary thyroid lobectomy. 

Description: The procedure is performed by creating a subcutaneous 

flap from the axilla to the thyroid bed. The operative field is established 

using a specially designed retractor to lift the strap muscles anteriorly, 

exposing the thyroid. The entire procedure is completed using a robotic 

grasper, camera, and Harmonic scalpel inserted from the axillary incision, 

in addition to a robotic grasper inserted through a separate 8 mm 

parasternal incision. 

Results: In our initial two cases, we demonstrate that robotic transaxillary 

surgery is technically feasible, avoids a neck scar, and offers quality threedimensional 

vision of the recurrent laryngeal nerve and parathyroid 

glands. 

ET19 

TRANS-ORAL ENDOSCOPIC RESTRICTIVE IMPLANT SYSTEM (TERIS) 

FOR THE TREATMENT OF MORBID OBESITY: A 12 MONTHS REVIEW 

OF SAFETY AND RESULTANT WEIGHT LOSS Fady Moustarah, MD MPH, 

Stéfane Lebel, MD, Laurent Beirtho, MD, Frédéric-Simon Hould, MD, Simon 

Biron, MD Institut Universitaire de Cardiologie et de Pneumologie de 

Québec, Université Laval 

Introduction: An endoluminal natural orifice approach designed to 

produce gastric restriction and weight loss is currently under investigation 

at our Centre. A 12 month review of the safety profile, device tolerance, 

and resultant weight loss observed with the use of the Trans-oral 

Endoscopic Restrictive Implant System (TERIS) is presented. 

Methods: The TERIS procedure consists of two stages: 1) Endoscopic 

placement of 5 silicone anchors in the proximal stomach forming 

gastric plications, and 2) implantation of a restrictive silicone membrane 

(restrictor device) held in place by the previously inserted anchors. A 

registered randomized study is ongoing and compares a single stage 

procedure with simultaneous placement of the anchors and restrictor 

element (group 1) to a two stage procedure, where the anchors are placed 

6weeks before the restrictor is implanted (group 2). Each patient is then 

followed for a minimum of six months, at which time the device is either 

removed or kept in place as requested and tolerated by the patient. 

Results: The last patient in our randomized series of 12 patients (6 per 

group) was recruited and treated with TERIS in February 2009. There is no 

difference in initial pretreatment BMI between groups. In our total sample, 

male to female ratio is 1:3, and mean initial weight is 120±5 Kg. Mean 

initial age and BMI are 39 yrs (range: 29-52 yrs) and 43.7 Kg/m2 (range: 

38-48 Kg/m2), respectively. One year follow up data will be available for 

8 patients by February 2010. Four patients exited the study before 12 

months. There is no statistically significant difference in weight or BMI 

between groups 1 and 2 at 6 or 12 months (p>0.05). Mean weight and 

BMI are, however, significantly less at both 6 and 12 months compared 

to values at the time of restrictor implantation (p


Conclusion: Using TERIS for the treatment of morbid obesity will 

be described and presented by video. Early results demonstrate 

the feasibility of using TERIS clinically to promote significant weight 

loss in our sample at 12 months. Moreover, while there appears to be 

no difference in weight loss after one or two stage implantation of the 

system, simultaneously implanting the device components (anchors and 

restrictor) under general anesthesia in one endoscopic session is well 

tolerated by patients. 

ET20 

HEMORRHOIDAL LASER PROCEDURE (HELP) IN THE TREATMENT OF 

SYMPTOMATIC HEMORRHOIDS Paolo Giamundo, MD, Maria Geraci, 

MD, Livio Tibaldi, MD, Marco Valente, MD Department of General Surgery 

-Hospital S. Spirito - Bra (CN) - ITALY 

INTRODUCTION: Doppler-guided hemorrhoidal artery ligation, also 

known as THD or HAL-Doppler, represents an innovative approach that 

has captured the interest of many surgeons. It is based on the selective 

suture of the terminal branches of the superior rectal artery arteries that 

feed the hemorrhoidal plexus through a Doppler-guided identification. 

The technique seems to be successful and less painful than traditional 

surgery for hemorrhoids. The HeLP Laser procedure,described by the 

Authors follows the same rationale of THD/HAL Doppler procedure. 

980 nm Diode Laser has several different applications in the medical field. 

When used on the mucosa of the anal canal it causes shrinkage of tissue. 

The depth and width of tissue shrinkage can be regulated by the power 

and duration of Laser beam. 

Through a 600 micron conic fiber, five laser pulsed shots generated at 

a power of 13 Watt with a duration of 1.2 seconds each and a pause of 

0.6 seconds, causes shrinkage of mucosa and submucosa to a depth of 

approximately 5 mm and a width of 4 mm . 

Terminal branches of superior hemorrhoidal arteries in the anal canal, if 

precisely identified through a Doppler signal, can be consequently closed 

with the use of this Laser. 

PATIENTS and METHODS: A special proctoscope has been specifically 

designed for this nonexcisional technique. 

The proctoscope has a small window that allows introducing a Doppler 

probe whose function is to identify terminal branches of hemorrhoidal 

arteries. 

Approximately 4 cm above the dentate line, all branches of the superior 

hemorrhoidal arteries (usually 8-12) are recognized through a clockwise 

rotation of the proctoscope. Once identified, all arteries are progressively 

fulgurated through a Laser fiber which replaces the Doppler probe in 

the small window of the proctoscope. Effective closure of arterial flow is 

confirmed by the absence of Doppler-signal after the Laser shots. 

The procedure does not require anesthesia and can be performed as 

ambulatory treatment. 

Twenty Patients (12 males) with 2nd- 3rd degree symptomatic 

hemorrhoids have been treated with the described technique. 

RESULTS: Necrosis of the terminal hemorrhoidal arteries caused a 

progressive shrinkage of haemorrhoidal cushions and also a partial 

reduction of mucosal internal prolapse through shrinkage of mucosal/ 

submucosal tissue. 

The procedure resulted to be successful in terms of improved symptoms 

in 95% of cases at a median follow-up of 6 months. No major adverse 

effects or complications were reported. 

Bleeding was observed intraoperatively in two cases. In one case surgical 

hemostasis was necessary. Minor pain requiring medication was reported 

in three cases(two intraoperatively). 

CONCLUSIONS: Doppler-guided closure of terminal branches of superior 

haemorrhoidal arteries with Diode-Laser represents a new proposal of 

mini-invasive treatment for patients suffering from 2nd and 3rd degree 

haemorrhoids without severe mucosal prolapse. 

This technique, if compared with previously described procedures, has 

several potential advantages: it is almost painless, it does not need 

anaesthesia, is technically easy to perform, has low morbidity rate and can 

be performed in a outpatients environment. 

ET21 

TRANSCOLONIC NOTES- PRELIMINARY HUMAN EXPERIENCE: NOTES 

TRANSRECTAL RECTOSIGMOID RESECTION AND TME Ricardo Zorron, 

Djalma Coelho, Luciana Flach, Fabiano Lemos, Moacyr Moreira, Priscila 

Oliveira, Alain Barbosa Department of Surgery - University Hospital 

Teresópolis HCTCO-FESO;Hospital Municipal Lourenco Jorge, Rio de 

Janeiro, Brazil 

Objectives: Clinical natural orifice surgery has been applied for 

abdominal surgery in recent years, using either a transvaginal or a 

transgastric access to perform the procedures. Despite potential 

advantages of using transcolonic NOTES to treat colorectal diseases, it 

was since now not yet clinically applied. The study describes the first 

successful series of human application of transcolonic NOTES access in the 

literature, in a new oncologic transrectal TME procedure for rectal cancer. 

Methods: Curative oncologic resection was indicated for 3 patients 

with diagnosed rectal adenocarcinoma at middle third of the rectum. 

IRB approval was obtained at the institution for the study, and the 

patients signed informed consent. Total mesorectal resection and 

rectosigmoidectomy with lymphadenectomy was performed using a 

posterior transcolonic access 3cm from the anal verge (Perirectal NOTES 

Access-PNA), and mesorectal dissection was achieved using flexible 

colonoscope and endoscopic instrumentation. In two cases, single port 

access was directly inserted in the rectum, and dissection was progressed 

proximally using LESS visualization. Laparoscopic assistance was used 

for IMA ligation and left colon mobilization. The specimen was extracted 

transanally, and stappled transorificial anastomosis was performed. 

Results: 3 patients were submitted to Transcolonic NOTES. Operative time 

was a mean of 350 min, no intraoperative complications occurred. The 

postoperative course at 15 days was uneventful, with resumption of oral 

diet on the second or third postoperative day. Pain scores were low for 

this initial casuistic. 

Conclusion: Successful first human series report on Transcolonic NOTES 

potentially brings new fronteers and future wider applications for 

minimally invasive surgery. The treatment of colorectal diseases through 

a flexible Perirectal NOTES Access (PNA) is a promising new approach 

besides existing laparoscopic and open surgery to improve patient care. 

ET22 

DUAL CONSOLE ROBOTIC SURGERY ENHANCES OPERATIVE TASK 

EFFICIENCY Michael M Awad, MD PhD, Eric Jenkins, MD, Lora Melman, 

MD, Brent Matthews, MD Washington University in St. Louis - School of 

Medicine 

OBJECTIVE - Robotic surgery has transformed the way in which 

laparoscopic surgery is conducted. However, it is still largely performed 

by a surgeon operating independently with little or no assistance. This 

potentially detracts from the efficiency that a skilled assistant may 

provide during complex procedures. The dual console for the da Vinci 

Si robot (Intuitive Surgical, Inc.) is an emerging technology that allows a 

second operator to provide real-time robotic assistance, possibly resulting 

in improved intra-operative efficiency. The potential benefits of the dual 

console have not been evaluated to date. 

METHODS - Surgeons with varying levels of laparoscopic and robotic 

experience were asked to perform four tasks using the single console or 

the dual console of the da Vinci Si robot. Surgeons who performed more 

than 100 laparoscopic procedures a year were considered ‘advanced’ 

and all others were considered ‘novice.” Surgeons who performed more 

than 50 robotic procedures a year were considered ‘advanced’ and all 

others were considered ‘novice.’ The four timed tasks were: (1) FLS-style 

pattern cutting, (2) tension suturing, (3) hand-sewn bowel anastomosis, 

and (4) crural closure with mesh. Study subjects were asked to rate on a 

Likert scale the ease of performing each task using the single vs the dual 

console. 

RESULTS - Task performance was significantly improved when the 

dual console was employed compared to the single console. Surgeons 

universally rated the dual console as easier to use than the single console 





for all tasks. Differences in task performance were particularly pronounced 

for novice laparoscopic surgeons compared to advanced surgeons. There 

was an improvement in task performance even for advanced robotic 

surgeons when using the dual console. 

CONCLUSIONS / FUTURE STUDIES - The use of the dual console 

provided significant advantages in operative task efficiency for novice and 

advanced laparoscopic and robotic surgeons alike. The dual console adds 

significant costs to the institution. These costs may be partially recouped 

by reduced operative procedure times. Future studies will be needed to 

see if this advantage is realized in patient procedures. 


Emerging Technology Poster Listings 


ETP01 TRANSUMBILICAL CHOLECYSTECTOMY WITH FLEXIBLE 

ENDOSCOPE (NOTES–SILS), PRELIMINARY CLINICAL EXPERIENCE. 

José F Noguera, MD PhD, Angel Cuadrado, MD PhD, José M Olea, MD, 

Rafael Morales, MD, José C Vicens, MD, Hospital Son Llàtzer 

ETP02 NOVEL SIMULATOR FOR LAPAROSCOPIC INGUINAL HERNIA 

Yo Kurashima, MD PhD, Salman Al-Sabah, MD, Pepa Kaneva, MSc, 

Liane Feldman, MD, Gerald Fried, MD, Melina Vassiliou, MD, Steinberg- 

Bernstein Center for Minimally Invasive Surgery & Innovation, McGill 

University 

ETP03 FEASIBILITY OF A 3-D IMAGE-GUIDANCE SYSTEM FOR 

LAPAROSCOPIC LIVER RESECTION Shiva Jayaraman, MD MESc, Logan 

W Clements, PhD, James D Stefansic, PhD, Robert L Galloway, PhD, 

William R Jarnagin, MD, Hepatopancreatobiliary Service, Department 

of Surgery, Memorial Sloan-Kettering Cancer Center; Pathfinder 

Therapeutics Inc; Department of Biomedical Engineering, Vanderbilt 

University 

ETP04 A NOVEL RETRACTION INSTRUMENT IMPROVES THE SAFETY 

OF SINGLE INCISION LAPAROSCOPIC CHOLECYSTECTOMY Danny A 

Sherwinter, MD, Department of Minimally Invasive Surgery, Maimonides 


ETP05 A NOVEL INSUFFLATING GUIDE-WIRE FOR TRANSGASTRIC 

NOTES Kiyokazu Nakajima, MD, Toshirou Nishida, MD, Tsuyoshi 

Takahashi, MD, Yoshihito Souma, MD, Masaki Mori, MD, Yuichiro Doki, 

MD, Osaka University Graduate School of Medicine, Osaka, Japan 

ETP06 SINGLE INCISION LAPAROSCOPIC SURGERY WITH A NOVEL 

PORT CAMERA SYSTEM Jonathan Schoen, MD, Benjamin S Terry, 

Zachary Mills, Aditya Bhave, Mark E Rentschler, PhD PE, University of 

Colorado at Boulder, University of Colorado at Denver 

ETP07 EFFECTS OF INCREASED LAPAROSCOPE COMPLEXITY ON 

MANEUVERABILITY AND PROFICIENCY Eric D Jenkins, MD, Michael 

Yip, BS, Lora Melman, MD, Margaret M Frisella, RN, Brent D Matthews, 

MD, Department of Surgery, Washington University, St Louis, Missouri 

ETP08 MINIATURE CAMERA FOR ENHANCED VISUALIZATION FOR 

SIMIS AND NOTES Mahmoud Abu Gazala, MD, Noam Shussman, MD, 

Avraham Schlager, MD, Ram Elazary, MD, Oleg Ponomarenko, MD, Abed 

Khalaileh, MD, Avraham I Rivkind, MD FACS, Yoav Mintz, MD, Hadassah 

Ein Kerem Medical Center 

ETP09 SIMULATING OPEN ABDOMINAL AORTIC ANEURYSM REPAIR: 

HIGH FIDELITY TEAM TRAINING AND EVALUATION FOR RESIDENTS 

Daniel A Hashimoto, BA, Ben Selvan, MD, Peter R McCombs, MD, 

Kristoffel Dumon, MD, Joseph Palmieri, MSEd, Josef Luba, Andrew S 

Resnick, MD, Noel N Williams, MD FRCSI, University of Pennsylvania 

School of Medicine, Penn Surgery Simulation, Philadelphia VAMC 

ETP10 A NEW METHOD FOR BOWEL ANASTOMOSIS BY SEALING Dirk 

W Meijer, MD MSc PhD, Jaap H Bonjer, MD PhD, BRG VUMC 

ETP11 CO2 LASER ENERGY FLEXIBLE TOOLS FOR MIS, NOTES 

AND SINGLE PORT SURGERY Oleg Ponomarenko, MD, Mahmoud 

Mahmoud Abu-Gazale, MD, Abed Khalaileh, MD, Ram Elazary, MD, Noam 

Shussman, MD, Avraham I Rivkind, MD, Yoav Mintz, MD, Department of 

Surgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel 

ETP12 USE OF FLOSHIELD TO PREVENT LENS REMOVAL DURING 

SURGERY Wayne Poll, MD, Riverside Methodist Hospital 

ETP13 ENDOSCOPIC TRANSGASTRIC SUTURE CLOSURE Farid Kehdy, 

MD, Kenny King, Lindsay Strotman, Erica Wells, Guruprasad Giridharan, 

PhD, University of Louisville 

ETP14 A NEW METHOD FOR DETECTING COLORECTAL CANCER 

David Nasralla, MD MRCS, C Ferrett, MD FRCR, B George, MD FRCS, A 

Loktionov, PhD, Lywood H, MD, John Radcliffe Hospital, Oxford, UK; 

Colonix Medical, Cambridge, UK 

ETP15 MINIMALLY INVASIVE TUMOR ABLATION: A NEW ENDOSCOPIC 

APPROACH WITH THE ENDOVE DEVICE Declan M Soden, PhD, Patrick 

Forde, PhD, Gerald C O’Sullivan, MD, Cork Cancer Research Centre, UCC 

ETP16 OUTCOMES OF THORACOSCOPY FOR MYASTHENIA GRAVIS 

Vladimir N Nikishov, MD PhD, Eugeny I Sigal, MD PhD, Albert M Sigal, 

MD, Azat G Latipov, MD PhD, Tom L Sharapov, MD, Clinical Cancer 

Center, Kazan, Russia 

ETP17 THE LEARNING CURVE FOR SINGLE PORT INTRACORPOREAL 

SUTURE IN A MODIFIED FLS SIMULATOR S. Al-Sabah, MD MBA, MC. 

Vassiliou, MD, PA. Kaneva, MSc, R. Ribeiro, MD, Y. Kurashima, MD, GM 

Fried, MD, LS Feldman, MD, Steinberg-Bernstein Centre for Minimally 

Invasive Surgery and Innovation, McGill University Health Centre, 

Montreal, Canada 

ETP18 ENDOSCOPIC INFRARED COAGULATION: BROAD RANGE 

OF NOVEL AND PRACTICAL UTILITY RANGING FROM INTERNAL 

HEMORRHOIDS TO NOTES Elisabeth C McLemore, MD, Sonia 

Ramamoorthy, MD, Mark A Talamini, MD, University of California San 

Diego 

ETP19 TECHNIQUES OF RADIOFREQUENCY-ASSISTED PRE- 

COAGULATION IN LAPAROSCOPIC LIVER RESECTION Hizir Y Akyildiz, 

MD, Morris Stiff, MD, Frederico Aucejo, MD, John Fung, MD, Eren Berber, 

MD, Cleveland Clinic General Surgery Department 

ETP20 TOWARDS SPHINCTER OF ODDI-PRESERVING AND T-TUBE FREE 

LAPAROSCOPIC COMMON BILE DUCT EXPLORATION Shuo-Dong Wu, 

MD PhD, Chun-Chih Chen, MD, Ying Fan, MD MS, Ernest A Siwo, MD, The 

Department of Biliary and Vascular Surgery, Shengjing Hospital of China 

Medical University 

ETP21 ROBOTIC SINGLE PORT LAPAROSCOPIC CHOLECYSTECTOMY 

Sherry M Wren, MD, Myriam J Curet, MD, Stanford University School of 

Medicine and Palo Alto Veterans Health Care System 

ETP22 SUTURE RETRACTION TECHNIQUES: ELIMINATING PORTS TO 

FACILITATE BASIC AND COMPLEX SINGLE INCISION LAPAROSCOPIC 

SURGERY Daniel J Rosen, MD, Jenny Choi, MD, Marc Bessler, MD, 

Columbia University Medical Center, Beth Israel Medical Center 

ETP23 AN INSTRUMENTED SURGICAL TOOL FOR RELIABLE ISCHEMIA 

DETECTION Philip Roan, Andrew S Wright, MD, Mika Sinanan, MD 

PhD, Blake Hannaford, PhD, University of Washington: Department of 

Electrical Engineering, Department of Surgery 

ETP24 A VIRTUAL REALITY SIMULATOR FOR THE LAPAROSCOPIC 

EXAMINATION OF THE SMALL INTESTINES Matthew Johnson, MD, 

Tony Rubin, Anders Larsson, Shawn Tsuda, MD, University of Nevada 


ETP25 NEW TRANSVAGINAL PORT SYSTEM FOR RIGID AND FLEXIBLE 

NOTES CHOLECYSTECTOMY- HUMAN EXPERIENCE Ricardo Zorron, 

Marcos Filgueiras, Daniel Leal, Eduardo Kanaan, Priscila Oliveira, Gustavo 

Lessa, Henrique Phillips, Department of Surgery – University Hospital 

Teresópolis HCTCO-FESO;Hospital Municipal Lourenco Jorge, Rio de 

Janeiro, Brazil 

ETP26 IMPULSIVE HEAT DEPOSITION (IHD) LASER AND ITS POTENTIAL 

USE IN SURGERY AND ENDOSCOPY E Dubcenco, MD, T Grantcharov, 

MD, C J Streutker, MD, D Kraemer, M L Cowan, N N Baxter, MD, O D 

Rotstein, MD, RJ D Miller, J P Baker, St. Michael’s Hospital; Keenan 

Research Centre in the Li Ka Shing Knowledge Institute; University of 

Toronto; Toronto, Ontario, Canada 

ETP27 SINGLE INCISION LAPAROSCOPIC COMBINED PARTIAL 

GASTRECTOMY ,DISTAL PANCRECTOMY AND PARTIAL COLECTOMY 

: THE FIRST ONE CASE Shuo-Dong Wu, MD PhD, Ying Fan, MD MS, Yang 

Su, MD PhD, The Department of Biliary and Vascular Surgery, Shengjing 

Hospital of China Medical University 

ETP28 SINGLE PORT SURGERY ON PROMIS SIMULATOR Donncha Ryan, 

Fiona Slevin, Nicolas Sezille, Derek Cassidy, Haptica Inc., Boston 

ETP29 BETWEEN LAP AND LESS: THE EVOLUTION OF 

MICROLAPAROSCOPY Ralf Kleemann, PhD, Thomas Aue, Philippe Hall, 

MD PhD, Olympus Winter & Ibe 






ETP30 MULTI-SCREEN, HANDS-FREE POINTER SYSTEM FOR TRAINING 

IN MINIMALLY INVASIVE SURGERY C D Ward, MESc, A L Trejos, MASc, 

M D Naish, PhD, R V Patel, PhD PEng, C M Schlachta, MD, Canadian 

Surgical Technologies and Advanced Robotics (CSTAR) 

ETP31 SINGLE PORT ACESS SURGERY 2.0 Paul G Curcillo II, MD, Erica 

R Podolsky, MD, Stephanie A King, MD, Drexel University College of 

Medicine 

ETP32 ASSESSMENT OF MULTI-SPECTRAL IMAGING FOR ENHANCED 

VISUALIZATION IN MINIMALLY INVASIVE SURGERY Matthew Field, 

Duncan Clarke, PhD, W B Seales, PhD, University of Kentucky 

ETP33 A RANDOMIZED CONTROL STUDY TO COMPARE A NEW 

VALVELESS TROCAR WITH A CONVENTIONAL TROCAR IN MORBIDLY 

OBESE PATIENTS Clinton Hall, MD, Nilay Shah, MD, Eric Volckmann, MD, 

Vanchad Memark, MD, Alexandar Haas, BS, W. Scott Melvin, MD, Dean 

Mikami, MD, Bradley Needleman, MD, Center for Minimally Invasive 

Surgery, Department of Surgery, The Ohio State University Medical 

Center, Columbus, Ohio 

ETP34 NITINOL COMPRESSION ANASTOMOSIS RING FOR 

RESTORATION OF INTESTINAL CONTINUITY AFTER RECTO-SIGMOID 

RESECTIONS. Dan Shteinberg, MD, Gideon Sroka, MD MSc, Foad 

Misharky, RN, Ibrahim Matter, MD, Department of General Surgery,Bnai- 

Zion Medical Center, Haifa, Israel. 

ETP35 NOTES CADAVERIC HYBRID SMALL BOWEL RESECTION: 

IMPROVED TECHNIQUE USING A NOVEL STEERABLE TROCAR, 

FLEXIBLE POWERED STAPLER, MAGNETIC CAMERA, AND 

INTERNALLY-ASSEMBLED PERCUTANEOUS INSTRUMENTS Byron F 

Santos, MD, Eric S Hungness, MD, Northwestern University, Department 

of Surgery 

ETP36 CADAVERIC SINGLE-SITE LAPAROSCOPIC CHOLECYSTECTOMY 

USING NOVEL ARTICULATING INSTRUMENTS, MAGNETIC 

ELECTROCAUTERY, AND INTERNALLY-ASSEMBLED PERCUTANEOUS 

INSTRUMENTS Byron F Santos, MD, Eric S Hungness, Northwestern 

University, Department of Surgery 

ETP37 COMPARISON OF N.O.T.E.S. AND LAPAROSCOPIC SURGICAL 

MOTION CHARACTERISTICS Balazs I Lengyel, MD, Dan E Azagury, MD, 

Marvin Ryou, MD, Sohail N Shaikh, MD, Raul E San Jose, PhD, Michele B 

Ryan, MS, Keith Obstein, MD, Vaibhav D Patil, MD, Jayender Jagadeesan, 

PhD, Christopher C Thompson, MD MHES, Kirby G Vosburgh, PhD, 

Brigham and Women’s Hospital / Harvard Medical School 

ETP38 VIRTUAL MEASURING OF ANATOMICAL STRUCTURES IN 3D 

DIGITAL MEDICAL IMAGE DATA FOR LAPAROSCOPIC SURGICAL 

PLANNING Marisol Martinez Escobar, MS, Catherine Peloquin, MS, 

Kenneth Kopecky, MS, Jung-Leng Foo, PhD, Eliot Winer, PhD, Thom Lobe, 

MD, Iowa State University & Blank Children’s Hospital 

ETP39 UTILITY OF MAGNETIC RESONANCE ENTEROGRAPHY IN 

SURGICAL DECISION-MAKING FOR CROHN’S DISEASE Anjali S 

Kumar, MD MPH, Raman Battish, MD, Duncan P Yoder, MD, Reena 

Chhitwal, MD, Kevin Olden, MD, James D McFadden, MD, Thomas Stahl, 

MD, Washington Hospital Center - Departments of Gastroenterology, 

Radiology, and Colon & Rectal Surgery 

ETP40 A NOVEL LAPAROSCOPIC BOX TRAINER WITH INTEGRATED 

FORCE AND POSITIONING SENSORS Timothy Kowalewski, Andrew 

S Wright, MD, Jacob Rosen, PhD, Blake Hannaford, PhD, University of 

Washington 

ETP41 OSIRIX SURGICAL NAVIGATION SYSTEM USING IMAGE 

OVERLAY IN NOTES AND SINGLE PORT ENDOSCOPIC SURGERY 

Maki Sugimoto, MD PhD, Takeshi Azuma, Prof, Gastroenterology Kobe 

University Graduate School of Medicine 

ETP42 EVALUATION OF THE EFFICACY OF LIGASURETM DEVICES IN 

SEALING OF LUNG PARENCHYMA Rebecca Coulson, Ms, Kimberly 

Martin, BS, Kimberly Krugman, MS, Ned Cosgriff, MD, Covidien Energy 

Based Devices Boulder, Co 

ETP43 THE SELF-APPROXIMATING TRANSLUMENAL ACCESS 

TECHNIQUE (STAT) FOR NOTES HELLER MYOTOMY IN A HUMAN 

CADAVER Jegan Gopal, MD, Eric M Pauli, MD, Randy S Haluck, MD, 

Matthew M Moyer, MD, Sami S Tannouri, MS, Brooke B Ancrile, PhD, 

Ann M Rogers, MD, Abraham Mathew, MD, Penn State Hershey Medical 

Center, Hershey, PA 

ETP44 OPTIMIZED ABLATION AND PROBE PLACEMENT VIA 

MATHEMATICAL MORPHOLOGY Brady King, Luke Reisner, Madhu 

Prasad, MD, Abhilash Pandya, PhD, Electrical and Computer Engineering, 

Wayne State University, Detroit, MI; Department of Surgery, Henry Ford 

Hospital, Detroit, MI 

ETP45 HIGH TEMPERATURE SUPERCONDUCTOR MAGNETIC 

INSTRUMENTATION FOR NATURAL ORIFICE TRANSLUMINAL 

ENDOSCOPIC SURGERY (N.O.T.E.S.) AND OTHER LIMITED ACCESS 

SURGICAL OPERATIONS Ronan A Cahill, MD, Richard P Lewin, PhD, 

Neil J Mortensen, MD, Harry Jones, PhD, Department of Colorectal 

Surgery, Oxford Radcliffe Hospitals, Oxford, UK & Clarendon Laboratory, 

Department of Physics. Oxford University, Oxford, UK. 

ETP46 COST EFFECTIVE SIMULATION BASED ENDOCRINE SURGERY 

TRAINING MODULE Mayank K Mittal, MD MRCS, Ben Selvan, MD MS, 

K R Dumon, MD, A S Resnick, MD, N N Williams, MD, J B Morris, MD, R R 

Kelz, MD MSCE, Penn Medicine Clinical Simulation Center, Philadelphia 

ETP47 A DEVICE SYSTEM FOR EFFICIENT LAPAROSCOPIC AND SILS 

VENTRAL HERNIA REPAIR Bruce Ramshaw, MD, Andrew J Duffy, MD, 

Einat Duvdevany, Daniel Marcus, MD, Yoav Mintz, MD, Guy Voeller, MD, 

Halifax Medical Center 

ETP48 EARLY RESULTS OF LOTUS (LAPAROSCOPIC OPERATING BY 

TORSIONAL ULTRASOUND) IN LAPAROSCOPIC LIVER RESECTION 

Neil W Pearce, DM FRCS, Mohammad Abu Hilal, MD FRCS, *Steven M 

Young, DPhil ARCS, Dept of Surgery, Southampton University Hospitals, 

Southampton, UK. *SRA Developments, Ashburton, Devon, UK 

ETP49 REAL-TIME 3D VISUALIZATION OF ORGAN DEFORMATIONS IN 

MINIMUM INVASIVE SURGERY Dan Wang, Ahmed H Tewfik, PhD, Bruce 

Hammer, PhD, Timothy Kinney, MD, Eric Jensen, MD, Juliane Bingener- 

Casey, MD, Bradley Erickson, MD, University of Minnesota 

ETP50 USE OF THE SUMO PROCEDURE FOR ENDOSCOPIC 

SUBMUCOSAL RESECTION OF SUPERFICIAL ESOPHAGEAL LESIONS 

Richard A Pierce, MD PhD, Danny V Martinec, BS, Christy M Dunst, MD, 

Lee L Swanstrom, MD, Legacy Health System, Division of Minimally 

Invasive Surgery, Portland, OR, USA 

ETP51 LAPAROSCOPIC SINGLE PORT INTRACORPREAL SUTURING: 

TIPS AND TRICKS S. Al-Sabah, MD MBA, R. Ribeiro, MD, Y. Kurashima, 

MD, MC Vassiliou, MD, GM Fried, MD, LS Feldman, MD, Steinberg- 

Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill 

University Health Centre 

ETP52 TRANS-GASTRIC ENDO-ORGAN RESECTION OF GASTRO- 

ESOPHAGEAL JUNCTION ADENOCARCINOMA. Aru Panwar, MD, 

Tommy H Lee, MD, Charles Filipi, MD, Sumeet Mittal, MD, Division of 

esophageal surgery, Department of surgery, Creighton University, 

Omaha, Nebraska, USA 

ETP53 ACCELERATED WOUND HEALING WITH TOPICALLY DELIVERED 

DISSOVED OXYGEN Andrew Slemp, MD, Alan Dine, BSN, Bruce Gibbins, 

PhD, Carillion Wound Care Clinic, Acrymed Inc. 

ETP54 CURVED INSTRUMENTS FOR SINGLE PORT LAPAROSCOPY: THE 

WAY TO GO? Nicole Bouvy, Rob Strijkers, Sofie Fransen, Sanne Botden, 

MD PhD, LAurents Stassen, MD PhD, Maastricht University Medical 

Center 

ETP55 DEVELOPMENT OF A MODIFIED SKILLS TRAINER FOR SINGLE 

INCISION LAPAROSCOPY Andrew S Wright, MD, Saurabh Khandelwal, 

MD, Brant K Oelschlager, MD, University of Washington 




ETP56 NATURAL ORIFICE TRANSLUMINAL ENDOSCOPIC SURGERY 

(NOTES) DISTAL PANCREATECTOMY IN A PORCINE SURVIVAL 

MODEL USING A TRANSVAGINAL APPROACH. Linda Barry, MD, 

Seaborn A Roddenbery, MD, Alexander Rosemurgy, MD, Sujat Dahal, 

MD, Sharona B Ross, MD, Leo Ondrovic, PhD, University of South Florida 


ETP57 USE OF TYLE PRO SYSTEM FOR INTRAOPERATIVE NAVIGATION 

DURING ROBOTIC SURGERY Savvas Hiridis, MD, Konstantinos 

Kostantinidis, MD PhD, Pericles J Chrysoheris, MD, Athens Medical 

Center 

ETP58 TRACKING LAPAROSCOPIC ULTRASOUND PROBE IMPROVES 

SURGEON PERFORMANCE: EARLY CLINICAL EXPERIENCE James 

Ellsmere, MD, Jeffery Stoll, PhD, Raúl San José Estépar, PhD, Kirby 

Vosburgh, PhD, Dalhousie University, Halifax NS and Massachusetts 

General Hospital and Brigham and Women’s Hospitals, Boston MA 

ETP59 CLOSURE OF A FULL THICKNESS GASTRIC MUCOSAL 

DEFECT WITH THE APOLLO ENDOSURGERY, INC. OVERSTITCHTM 

ENDOSCOPIC SUTURING SYSTEM (ESS). Chike V Chukwumah, MD, 

Jeffrey M Marks, MD, University Hospitals Case Medical Center 

ETP60 TRANSORAL INCISIONLESS FUNDOPLICATION IS EFFECTIVE 

FOR THE TREATMENT OF CHRONIC GERD PATIENTS WITH THERAPY- 

RESISTANT SYMPTOMS Kevin M Hoddinott, MD, Madeline Williams, 

CRNFA, Monroe Regional Medical Center, Ocala, Florida 




Notes 


Exhibit Hall Floor Plan 

CONCESSIONS 

20' 

20' 

20' 

848 

748 749 

648 649 

548 549 

449 

20' 

349 

20' 

20' 

847 

846 

746 747 

646 647 

546 547 

447 

446 

347 

147 247 

LEARNING 

CENTER 

ENTRANCE 

20' 

842 843 

742 743 

20' 

642 

543 

542 

20' 

20' 

342 

243 

143 

840 841 

740 741 

641 

640 

541 

540 

441 

341 

340 

241 

141 

839 

139 

20' 

20' 

837 

20' 

736 

20' 

20' 20' 

20' 

237 336 337 436 

20' 

835 

735 

734 

635 

634 

535 

435 

235 334 335 434 

20' 

20' 

40' 

20' 

333 

233 

131 

ENTRANCE 

831 

20' 

730 

20' 

430 

331 

40' 

829 

727 

728 

629 

40' 

30' 

827 

726 

20' 

20' 

40' 

30' 

825 

20' 

724 

625 

425 

823 

723 

C 

323 

123 

60' 

30' 

50' 

20' 

819 

20' 

20' 

817 

717 

60' 

117 

50' 

20' 

30' 

20' 

813 

20' 

20' 

811 

711 

411 

213 

111 


Inventory as of 03/10/201 

Size 

100 

200 

400 

600 

900 

1,600 

2,500 

3,600 

Dimension 

10'x10' 

10'x20' 

20'x20' 

20'x30' 

30'x30' 

40'x40' 

50'x50' 

60'x60' 

40' 

706 

20' 

606 

507 

506 

20' 

406 

306 307 

20' 20' 

40' 

20' 

605 

604 

505 

504 

405 

20' 20' 20' 

205 

204 

702 

603 

602 

503 

502 

402 403 

302 303 

203 

202 

Totals: 

700 

**174 DOUBLE SIDED 

9900 Business Parkway 

Lanham, Md 20706 


03.10.2010 

SAGES & CAGS 12TH WORLD CONGRESS OF ENDOSCOPIC SURGERY 

APRIL 14-17, 2010 

GAYLORD NATIONAL RESORT & CONVENTION CENTER - PRINCE GEORGE'S BALLROOMS A-D 

NATIONAL HARBOR, MD 

EVERY EFFORT HAS BEEN MADE TO ENSURE THE ACCURACY OF ALL INFORMATION CONTAINED ON THIS FLOORPLAN. HOWEVER, NO WARRANTIES, EITHER EXPRESSED OF IMPLIED, ARE MADE WITH RESPECT TO THIS FLOORPLAN. IF THE LOCATION OF BUILDING COLUMNS, UTILITIES 

OR OTHER ARCHITECTURAL COMPONENTS OF THE FACILITY IS A CONSIDERATION IN THE CONSTRUCTION OR USAGE OF AN EXHIBIT, IT IS THE SOLE RESPONSIBILITY OF THE EXHIBITOR TO PHYSICALLY INSPECT THE FACILITY TO VERIFY ALL DIMENSION AND LOCATIONS. 

COPYRIGHT 2000, FREEMAN DECORATING CO., ALL RIGHTS RESERVED.


Exhibitor Profiles 

3-Dmed #604 

255 Industrial Drive 

Franklin, OH 45005 

Tel: 937-746-2901 

Fax: 937-746-5071 

Website: www.3-dmed.com 

3-Dmed is the innovator and manufacturer 

of the Minimally Invasive Training System 

(MITS) that provides a creative environment 

to practice and teach laparoscopic skills, 

procedures, camera navigation, and instrument 

demonstration. 3-Dmed MITS is a complete and 

portable system that is the best value for your 

budget. 

Residents can practice on the MITS to acquire 

the FLS skills. Try the New FLS Practice Board 

and other models. 

AESCULAP, INC. #111 

3773 Corporate Parkway, Center Valley, PA 

18034 

Tel: (800)258-1946 ext. 5247 

Fax: (610)791-6884 

Website: www.aesculapusa.com 

Aesculap is a leading manufacturer and supplier 

of handheld instruments for minimally invasive 

surgery. These laparoscopic instruments 

combine precision craftsmanship with modern 

materials and design. Precise performance 

makes Aesculap laparoscopic instruments the 

instrument of choice for today’s and tomorrow’s 

surgery. 

AGENCY FOR MEDICAL 

INNOVATIONS, INC. #648 

20 Main Street, Suite 205 

Natick, MA 01760 

Tel: 508-655-1200 

Fax: 508-655-0012 

Website: www.amisurgical.com 

The (DG)HAL/RAR Doppler guided Hemorrhoid 

Arterial Ligation/Recto Anal Repair System is the 

first system to utilize minimally invasive surgical 

techniques to treat the source of hemorrhoidal 

disease without surgical excision, stapling or 

banding. Additional products include Facia 

cutter and gastric band cutter. 

ALACE-SOBRACIL 2010 #829 

Rua do Carmo, 6 – 601 Centro 

Rio de Janeiro 20011-020 - Brazil 

Tel: 55-21-2215-4476 

Website: www.alacesobracil2010.com 

ALLERGAN #723 

2525 Dupont Drive 

Irvine, CA 92612 

Tel: 714-246-4500 

Fax: 714-246-4971 

Website: www.allergan.com 

Allergan has joined the effort to fight the 

growing obesity epidemic with the LAP-BAND® 

Adjustable Gastric Banding System, the first 

minimally invasive surgical approach approved 

in the United States by the FDA, to help patients 

achieve sustained weight loss, realize their goals 

for healthy living, and reduce obesity-related 

risks. 

ALOKA ULTRASOUND #605 

10 Fairfield Boulevard 

Wallingford, CT 06942 

Tel: (203) 269-5088 

Toll Free: (800) 872-5652 

Fax: (203) 269-6075 

Website: www.aloka.com 

Aloka’s commitment to ultrasound offers a 

range of consoles and transducers to meet 

surgeons needs. Recognized for our image 

quality, system reliability and intuitive use of 

cutting edge technology, Aloka remains the 

standard in the field of ultrasound for surgeons. 

AMERICAN COLLEGE OF 

SURGEONS #549 

Bariatric Surgery Center 

Network (ACS BSCN) Accreditation Program 

633 North Saint Clair Street 

Chicago, IL 60611 

Tel: 312-202-5000 

Fax: 312-202-5063 

Website: www.acsbscn.org 

The American College of Surgeons continues its 

dedication to quality improvement through the 

Bariatric Surgery Center Network Accreditation 

Program. The ACS BSCN accredits facilities that 

have undergone an independent, rigorous 

peer evaluation in accordance with nationally 

recognized bariatric standards and participate 

in the program’s longitudinal outcomes 

database. Please visit booth 549 for information 

regarding program standards and enrollment. 

APOLLO ENDOSURGERY # 634 

7000 Bee Caves Rd, Suite 250, Austin, TX 78746 

Phone: 512-328-9990 

Fax: 512-328-9994 

Website: www.apolloendo.com 

Apollo Endosurgery is...Revolutionizing 

Patient Care through the Evolution of Flexible 

Surgery through the development of flexible 

endoscopic surgical tools. Our collaboration 

with physicians, providers, and the healthcare 

community is critical to delivering the future of 

advanced minimally invasive care. 

ARAGON SURGICAL #730 

1810 Embarcadero Road, Suite B 

Palo Alto, CA 94303 

Tel: 650-543-3100 

Fax: 650-318-1857 

Website: www.aragonsurgical.com 

Aragon Surgical is dedicated to pioneering 

utilization of its proprietary Lektrafuse 

technology in applications unmet by current 

RF tissue and vessel sealing devices. Aragon 

Surgical’s unique instruments are designed 

to help general and gynecologic surgeons in 

laparoscopic and open procedures. 

ARMY MEDICAL RECRUITING 

#717 

Munoz Building #206 - 9th Cavalry Reg. Ave. 

Ft Knox, KY 40121 

Tel: 502-626-0856; 502-626-1981 

Fax: 502-626-0854 

Website: www.healthcare.goarmy.com 

ARROW MARKET RESEARCh 

#347 

One Meridian Boulevard 

Wyomissing, PA 19610 

Arrow Market Research is a market research 

firm gathering qualitative and quantitative 

information for use within the medical device 

surgical market. Incentives will be provided for 

your valued opinion. 

ASCENT HEALTHCARE 

SOLUTIONS #117 

10232 S. 51st Street 

Phoenix, AZ 85044 

Tel: 800-887-9073 

Fax: 480-763-5320 

Website: www.ascenths.com 

Ascent is a medical device company leading 

the industry’s pursuit of more sustainable and 

responsible use of resources in healthcare 

through reprocessing and other programs. 

ATRIUM MEDICAL 

CORPORATION #446 

5 Wentworth Drive 

Hudson, NH 03051 

Tel: 603-880-1433 

Fax: 603-386-6266 

Website: www.atriummedical.com 

Atrium’s C-QUR Mesh family of hernia 

products combine our industry-leading 

ProLite polypropylene with a proprietary 

Omega 3 fatty acid absorbable coating. 

Pre-clinical studies demonstrate minimized 

tissue attachment and significant reduction 

in inflammation, resulting in a well healed, 

reinforced repair. 



AUTOMATED MEDICAL 

PRODUCTS CORPORATion 

#502 

P.O. Box 2508 

Edison, NJ 08818 

Tel: 732-602-7717 

Fax: 732-602-7706 

Website: www.ironintern.com 

Automated Medical Products Corp offers the 

Iron Intern® Available for use in laparoscopic 

and open surgery. The Iron Intern® Stieber 

Rib Grip Kit provides superior exposure in the 

abdomen and serves liver transplants. 

BARIATRIC TIMES #827 

Matrix Medical Communications 

1595 Paoli Pike, Suite 103 

West Chester, PA 19380 

Tel: 866-325-9907 

Fax: 484-266-0726 Fax 

Website: www.Bariatrictimes.com 

Please stop by Booth 827 to pick up the recent 

issue of Bariatric Times and receive discounts 

on our educational textbooks, including 

the recently published Weight Loss Surgery: 

A Multidisciplinary Approach, edited by Drs. 

Raul Rosenthal and Dan Jones. New for 2010: 

International attendees can register to receive a 

complimentary subscription to Bariatric Times 

International Edition, published exclusively in 

digital format. 

BÂRRX MEDICAL, INC. #702 

540 Oakmead Parkway 

Sunnyvale, CA 94085 

Tel: 408-328-7300 

Fax. 408-328-7395 

Website: www.barrx.com 

Developed by BÂRRX Medical, Inc. the HALO 

System provides a uniform and controlled 

ablation effect, removing the diseased tissue 

and allowing regrowth of normal cells for the 

treatment of Barrett’s esophagus, radiation 

proctitis and gastric antral vascular ectasia 

(GAVE). 

B-K MEDICAL SYSTEMS, INC. 

#436 

8 Centennial Drive 

Peabody, MA 01960 

Tel: 978-326-1300 

Fax: 978-326-1399 

Website: www.bkmed.com 

Designed for surgeons and to suit the OR, 

the Pro Focus UltraView has a wide range 

of specialized surgical transducers for 

percutaneous, laparoscopic and intraoperative 

scanning. With the mobile Flex Focus for breast 

scanning, you can afford to see everything. 

B-LINE MEDICAL #233 

1300 19th Street. NW, Suite 100 

Washington, DC 20036 

Tel: 301-768-4461 

Fax: 202-223-1171 

Website: www.blinemedical.com/ 

B-Line Medical is a software firm specializing 

in web-based solutions for recording and 

assessment of simulation-based medical 

training. B-Line Medical’s SimCapture® and 

SimBridge® products are currently used in over 

100 top hospitals, medical schools and nursing 

programs in 6 different countries. 

BOSTON SCIENTIFIC, INC. #405 

100 Boston Scientific Way 

Marlboro, MA 01752 

Tel: 508 683 4000 

Website: www.bostonscientific.com 

BSC Endoscopy develops a broad spectrum of 

diagnostic and therapeutic devices for a variety 

of digestive diseases throughout the GI tract. 

We are committed to innovation, collaboration 

and less invasive, more efficient procedures that 

contribute to better patient outcomes. 

BUFFALO FILTER #547 

595 Commerce Drive 

Buffalo, NY 14228 

Tel: 716-835-7000 

Fax: 716-835-3414 

Website: www.buffalofilter.com 

Buffalo Filter® is a medical device manufacturer 

with a primary focus on manufacturing and 

engineering products for the evacuation and 

filtration of hazardous smoke plume generated 

during laser/electrosurgical procedures. 

Products include: surgical smoke evacuators, 

ULPA/HEPA replacement filters. 

CAE HEALTHCARE #842 

8585 Cote de Liesse 

Montreal, Quebec H4T 1G6 – Canada 

Tel: 514-341-6780 

Website: www.cae.com 

CALMOSEPTINE, INC. #307 

16602 Burke Lane 

Huntington Beach, CA 92647-4536 

Tel: (714) 840 - 3405 

Fax: (714) 840 – 9810 

Website: www.calmoseptine.com 

Calmoseptine Ointment is a multi-purpose 

moisture barrier that protects and helps 

heal skin irritations from moisture, such as 

urinary and fecal incontinence. Calmoseptine 

Ointment temporarily relieves discomfort and 

itching. Free samples at our booth! 

CANADIAN ASSOCIATION OF 

GENERAL SURGEONS (CAGS) 

#823 

774 Echo Drive 

Ottawa, ON K1S 5N8 - Canada 

Tel: 613-730-6280 

Fax: 613-730-1116 

Website: www.cags-accg.ca 

The Canadian Association of General Surgeons 

strives to be the voice of General Surgery across 

Canada by promoting the training, education, 

continuing professional development, 

thoughtful practice and research essential to 

exemplary surgical care. 

CAREFUSION #247 

3750 Torrey View Court 

San Diego, CA 92130 

Phone: 888-876-4287 

Website: www.carefusion.com 

CareFusion brings technology and 

intelligence together to help make the care 

process easier for caregivers and safer for 

patients. Our clinically proven products and 

services help reduce medication errors and 

healthcare-associated infections. Our portfolio 

encompasses some of the most trusted brands 

in healthcare, including Alaris®, ChloraPrep®, 

Nicolet, Pyxis® and V. Mueller®. 

CINE-MED, INC. #303 

127 Main Street N 

Woodbury, CT 06798 

Tel: 203-263-0006 

Fax: 203-263-4839 

Website: www.cine-med.com 

Ciné-Med partners with SAGES to produce and 

distribute the SAGES video library, including 

SAGES Grand Rounds, Postgraduate Courses, 

Top 14, and the SAGES Pearls series. Stop by 

booth #303 for more information and to view 

samples of these videos and more. 

CONMED CORPORATION #441 

525 French Road, Utica NY 13502 

Tel: 800-448-6506 

Fax: 800-438-3051 

Website: www.conmed.com 

CONMED specializes in Arthroscopy, 

Electrosurgery, Endoscopy, Imaging, Integrated 

Systems, Patient Care and Powered Instruments 

that are sold worldwide through its family of 

companies (CONMED & Linvatec). 





COOK MEDICAL #402 

750 Daniels Way 

Bloomington, IN 47404 

Tel: 800-457-4500 

Fax: 800-554-8335 

Website: www.cookmedical.com 

Cook Medical was one of the first companies 

to help popularize interventional medicine, 

pioneering many of the devices now commonly 

used worldwide to perform minimally invasive 

medical procedures. 

COOPER SURGICAL #746 

95 Corporate Drive 

Trumbull, CT 06611 

Tel: 203-601-5200 

Fax 203-601-4741 

www.coopersurgical.com 

CooperSurgical is the leading provider of 

medical devices and procedure oriented 

solutions that result in improved health care 

delivery to women regardless of clinical 

setting. The company targets products that aid 

clinicians in the management and treatment 

of the broad spectrum of women’s health care 

issues that occur throughout her life. 

COVIDIEN #411 

150 Glover Avenue 

Norwalk, CT 06850 

Tel: 800-722-8772 

Fax: 888-636-1002 

Website: www.covidien.com 

Covidien is a leading global healthcare 

company that creates innovative solutions for 

better patient outcomes and delivers value 

through clinical leadership and excellence. 

Covidien manufactures a range of industryleading 

products in five segments including 

Surgical and Energy-based Devices. 

CROSPON INC. #505 

3rd Floor, 701 Palomar Airport Road 

Carlsbad, CA 92011 

Tel: 760-931-4801 

Fax: 760-931-4804 

Website: www.crospon.com 

The Crospon EndoFLIP imaging system is used 

intra-operatively and/or during endoscopy 

to assess stoma diameter for the purpose of 

optimizing the adjustment of all gastric bands. 

The company has CE Mark approval in Europe 

for the use of EndoFLIP for diameter, pressure 

and volume measurements in the upper 

gastrointestinal tract. 

DalimSurgNET CORP. #202 

B-708 Woolim Blue Nine 

240-21 Yeomchang-dong, Gangseo-gu 

Seoul, 157779 Korea 

Tel: +82-2-335-1651 

Fax: +82-2-323-1651 

Website: www.dalimsurg.net 

www.octo-port.com 

The DalimSurgNET aims to be the most 

innovative medical device company, and our 

vision is to be the global medical solution 

provider for sincere patient care. The OCTOTM 

Port is intended to use multiple instruments 

and endoscope through a single incision during 

the advanced minimally invasive laparoscopic 

surgery. 

DAVOL INC., 

A BARD COMPANY #435 

100 Crossings Boulevard 

Warwick, RI 02886 

Tel: 800-556-6275 

Fax: 401-825-8759 

Website: www.davol.com 

Davol, a BARD Company, is the market leader in 

hernia repair, offering a broad range of unique 

synthetic and biologic implants for laparoscopic 

and open approaches. Additionally, the NEW 

PermaFix and SorbaFix Fixation Systems 

provides strong, consistent, and reliable fixation 

with both permanent and fully absorbable 

fasteners. 

EASY-LAP LTD. #205 

POB 128 

Kfar Truman, Israel, 73150 

Tel: +972-52-6717051 

Fax: +972-77-6201003 

Website: www.easy-lap.com 

Easy-Lap’s vision is to enable widespread use of 

laparoscopy through devices that shorten the 

learning curve, reduce laparoscopic procedure 

time, optimize technique, and minimize 

complications. Easy-Lap’s *iMESH Hernia Kit 

* offers an intelligent path to laparoscopic 

success in hernia repair. 

ELSEVIER/SAUNDERS/MOSBy 

#602 

8701 Ivyberry Way 

Gaithersburg, MD 20886 

Tel: 240-277-3081 

Fax: 301-527-9248 

Website: www.elsevierhealth.com 

Elsevier is one of the world’s leading publisher 

of medical books and periodicals. Please stop by 

our booth during The World Congress to see the 

latest titles on display. 

ENCISION INC. #337 

6797 Winchester Circle 

Boulder, CO 80301 

Tel: 303-444-2600 

Fax: 303-444-2693 

Website: www.encision.com 

Encision’s ACTIVE ELECTRODE MONITORING 

system is a laparoscopic safety system that 

continuously monitors Encision’s monopolar 

laparoscopic instruments during surgery to 

eliminate the risk of stray energy burn injury to 

patients during laparoscopy. 

ENDOCHOICE #334 

11800 Wills Road, Suite 100 

Alpharetta, GA 30009 

Tel: 888-682-3636 

Fax: 866-567-8218 

Website: www.endochoice.com 

Welcome to EndoChoice - delivering a 

diverse portfolio of GI supplies, diagnostics, 

equipment and devices. Launching at SAGES 

are: the revolutionary BONASTENT® - the most 

advanced GI stenting platform; and Exagen® IBD 

and IBS genomic tests. 

The company strives to exceed expectations 

through its exemplary customer care, superior 

products and easy online ordering. For more 

information, call 888-682-ENDO (3636) or visit 

www.EndoChoice.com. 

ENDOCONTROL #540 

5, Avenue du Grand Sablon 

38700 La Tronche 

+33 (0) 4 76 63 75 82 

+33 (0) 4 76 54 95 61 

Website: www.endocontrol-medical.com 

EndoControl is an innovative company 

specializing in the development of robotic 

surgical solutions for endoscopic surgery. It 

markets a range of products including ViKY®, a 

robotic assistant for laparoscopic, pelviscopic 

and thoracoscopic surgery. 

ENDOGASTRIC SOLUTIONS 

#629 

555 Twin Dolphin Drive, Suite 620 

Redwood City, CA 94065 

Tel: 650-226-2225 

Fax: 650-226-2201 

Website: www.endogastricsolutions.com 

EndoGastric Solutions, (EGS) is the pioneer 

in incisionless surgical procedures for the 

treatment of upper gastrointestinal diseases. 

TIF (Transoral Incisionless Fundoplication) with 

EGS’ EsophyX device creates a valve between 

the stomach and esophagus, reduces hiatal 

hernia, and restores the anatomy to reduce/ 

prevent gastroesophageal reflux. 




#213 

4545 Creek Road 

Cincinnati, Ohio 45242 

Tel: 800-USE-ENDO 

Fax: 800-873-3636 

Website: www.ethiconendo.com 

Ethicon Endo-Surgery, Inc. develops 

and markets advanced medical devices 

for minimally invasive and open surgical 

procedures. The company focuses on 

procedure-enabling devices for the 

interventional diagnosis and treatment of 

conditions in general and bariatric surgery, 

as well as gastrointestinal health, plastic 

surgery, orthopedics, gynecology, and surgical 

oncology. 

ETHOS SURGICAL #546 

2065 NW Miller Road, Suite 301 

Portland, OR 92779 

Tel: 440-289-9788 

Website: www.ethos-surgical.com 

GENERAL SURGERY NEWS #507 

545 West 45th Street 

New York, NY 10036 

Tel: 212-957-5300 

Fax: 212-957-7230 

Website: www.generalsurgerynews.com 

General Surgery News is a monthly newspaper 

designed to keep general surgeons abreast 

of the latest developments in the field. The 

publication features extensive meeting 

coverage, analysis of journal articles, 

educational reviews, and information on new 

drugs and products. 

GORE & ASSOCIATES, INC. #711 

Medical Products Division 

301 Airport Road / P. O. Box 1408 

Elkton, MD 21922 

Tel: 410-506-8283 

FAX: 410-506-8221 

Website: www.davol.com 

Gore Medical Products Division has provided 

creative therapeutic solutions to complex 

medical problems for three decades. The 

extensive Gore Medical family of products 

includes vascular grafts, endovascular and 

interventional devices, surgical materials for 

hernia repair, soft tissue reconstruction, staple 

line reinforcement, and sutures for use in 

vascular, cardiac and general surgery. 

H & H SURGICAL 

TECHNOLOGIES #504 

4437 Robertson Road 

Madison, WI 53714 

Tel: 608-222-2776 

Fax: 608-222-2604 

Website: www.hhsurgical.com 

H+H Surgical Technologies is a leader in preowned 

medical equipment sales. We specialize 

in flexible endoscopy, laparoscopy and related 

instrumentation. We are dedicated to providing 

high quality and customer satisfaction. We feel 

that our prices are unbeatable and we stand 

behind every piece. 

HAPTICA INC #606 

101 Federal Street, Suite 1900 

Boston, MA, 02110 

Tel: +1 617 342 7270 

Fax: +1 617 342 7080 

Website: www.haptica.com 

Haptica’s award-winning ProMIST Surgical 

Simulator is the best validated simulator for 

training in laparoscopic skills and procedures. 

ProMIS’ ‘mixed reality’ approach has been 

shown to be better than VR and preferred by 

users. Haptica also develops custom simulation 

solutions to accelerate uptake of new surgical 

devices 

HCA - HOSPITAL CORPORATION 

OF AMERICA #447 

2 Maryland Farms, Suite 200 

Brentwood, TN 37027 

Tel: 615.372.5196 

Fax: 866.789.2288 

Website: www.hcahealthcare.com 

HCA owns and operates 163 healthcare 

facilities in 20 states with opportunities 

coast to coast. HCA was one of the nation’s 

first hospital companies. We strive to deliver 

quality healthcare that meets the needs of the 

communities we serve. 

HRA RESEARCH #724 

400 Lanidex Plaza 

Parsippany, N J 07054 

Tel: 973-240-1200 

Website: www.hraresearch.com 

Our team of experienced interviewers will be 

distributing carefully developed questionnaires. 

We’ll be gathering the answers to vital 

marketing and clinical questions- answers that 

can affect the introduction of new products 

or the continuation of existing healthcare 

products and services. 

INTEGRA SURGICAL #406 

311 Enterprise Drive, Plainsboro, NJ 08536 

Tel: 609-275-0500 

Fax: 609-799-3297 

Website: www.integra-ls.com 

Integra Surgical is a leader in quality surgical 

instrumentation for laparoscopic, general, 

cardiovascular, neurosurgery, orthopedic, 

plastic and reconstructive surgery. Products 

include surgical instrumentation from Jarit® , 

Ruggles-Redmond and Padgett Instruments®, 

CIMS® Consulting Services, Luxtec® Xenon 

illumination and digital video recording 

systems, fiber optic cables, surgical loupes, and 

Omni-Tract® table-mounted retractor systems. 

INTERNATIONAL CONGRESS OF 

ENDOSCOPY (ICE 2011) #839 

C/O Hanser Service GmbH 

PaulsBorner Str. 44 

Berlin 14133 – Germany 

Tel: +4913033006690 

Fax: +4913013057391 

Website: www.ICE2011.org 

IFSES - INTERNATIONAL #740 

FEDERATION OF SOCIETIES OF 

ENDOSCOPIC SURGEONS 

Providencia # 1043, Col. 

Del Valle, Mexico City 03100 

Tel: + 52 + 55 + 5559-5332 

Fax: + 52 + 55 + 5559-6468 

Website: www.ifses.org 

IFSES, the International Federation of Societies 

of Endoscopic Surgeons will host in 2012 the 

13th World Congress of Endoscopic Surgery 

in Mexico. We will be pleased to welcome you 

in this wonderful country, cradle of ancient 

civilizations, full of beautiful places, cultural 

heritage, typical gastronomy and charming 

people. 

INTUITIVE SURGICAL, INC. #123 

1266 Kifer Road 

Sunnyvale, CA 94086 

Tel: 408-523-2100 

Fax: 408-523-1390 

Website: www.intuitivesurgical.com 

Intuitive Surgical, Inc., is the global technology 

leader in robotic-assisted, minimally invasive 

surgery. The Company’s da Vinci® Surgical 

System enables general surgeons to offer a new, 

minimally invasive approach to patients. 





KARL STORZ ENDOSCOPY- 

AMERICA #323 

2151 E Grand Ave 

El Segundo, CA 90245 

Phone: 424- 218-8100 

Website: www.ksea.com 

KARL STORZ provides minimally invasive 

solutions for virtually every surgical specialty. . 

Among these innovative products is our Image 

1® FULL HD platform, which acquires and 

displays wide 16:9 1080p60 images, providing 

the optimal viewing experience necessary for 

minimally invasive surgery. 

KIMBERLY-CLARK HEALTHCARE 

#541 

1400 Holcomb Bridge Road 

Rosswell, GA 30076 

Tel: 770-587-8000 

Website: www.kchealthcare.com 

LEXION MEDICAL, INC. #635 

5000 Township Parkway 

St. Paul, MN 55110-5865 

Tel: 877-9LEXION 

Fax: 651-635-0090 

Website: www.lexionmedical.com 

LEXION Medical, a leader of innovative medical 

technologies improving patient safety, offers 

the Insuflow® Laparoscopic Gas Conditioning 

Systems for minimally invasive surgery, 

including thoracoscopic, laparoscopic and 

endoscopic vein harvesting surgical procedures 

and PneuVIEW® XE Laparoscopic Smoke 

Elimination System. 

LIFECELL #302 

1 Millennium Way 

Branchburg, NJ 08876 

Telephone; 908-947-1100 

Fax: 908-947-1200 

Website: www.lifecell.com 

LifeCell engineers both AlloDerm® 

Regenerative Tissue Matrix and Strattice 

Reconstructive Tissue Matrix used in hernia 

repair, breast reconstruction and breast plastic 

surgery revisions. They support regeneration 

through rapid revascularization, cell 

repopulation and white cell migration. 

LIMBS & THINGS, INC. #542 

PO Box 15669 

Savannah, GA 31416 

Tel: 912-629-0357 

Fax: 912- 629-0358 

Website: www.GOLIMBS.com 

Limbs & Things works hard to be your sole 

source for medical training models and medical 

simulators, providing medical education task 

training models for critical care, diagnostic skills, 

venipuncture, surgical simulation, Ob/Gyn, 

suturing, minor surgery, soft tissue injection, 

vascular surgery and many other medical 

simulation subjects. 

LIPPINCOTT WILLIAMS & 

WILKINS #837 

202 9th Street SE 

Washington, DC 20003 

Tel./Fax: 202-543-8710 

Website: www.lww.com 

Lippincott Williams & Wilkins publishes medical 

books, journals and software. 

MARKET ACCESS PARTNERS 

#641 

3236 Meadowview Road 

Evergreen, CO 80439 

Tel: 303-526-1900 

Fax: 303-526-7920 

Website: www.marketaccesspartners.com 

Market Access Partners provides market 

research consulting to the medical device and 

pharmaceutical industries. We use innovative 

qualitative and quantitative methodologies 

to research opinions of physicians, nurses and 

patients. We offer a management-oriented 

approach to product development and 

marketing. 

MARY ANN LIEBERT, INC., 

PUBLISHERS #434 

140 Huguenot Street 

New Rochelle, NY 10801 

Tel: 914-740-2100 

Fax: 914-740-2101 

Website: www.liebertpub.com 

Mary Ann Liebert, Inc., publishes authoritative, 

peer-reviewed journals in new and promising 

areas of science and biomedical research 

including Bariatric Nursing and Surgical Patient 

Care. With bariatric surgical procedures 

increasing, this is the must-have journal for 

optimal patient care. 

MASIMO CORPORATION #333 

40 Parker 

Irvine, CA 

Tel: (949) 297-7534 

Website: www.masimo.com 

MEDERI THERAPEUTICS INC. 

#331 

8 Sound Shore Drive, Suite 304 

Tel: 203-930-9900 

Fax: 203-869-1013 

Website: www.mederitherapeutics.com 

Mederi Therapeutics manufactures and 

markets innovative medical devices that 

deliver radiofrequency energy to treat diseases 

affecting the human digestive system. The first 

two products — Secca, for bowel incontinence 

and Stretta, for GERD — have demonstrated 

clinical effectiveness in numerous studies. All 

Mederi therapies are outpatient, minimally 

invasive and promote rapid recovery for 

patients. 

MEDIFLEX SURGICAL 

PRODUCTS #603 

250 Gibbs Road 

Islandia, NY 11749 

Tel: 800-879-7575 

Fax: 631-582-8487 

Website: www.mediflex.com 

Visit Mediflex (Booth 603) to see the newest 

Holders/Positioners for Laparoscopy, the 

largest selection of Nathanson Hooks and our 

complete line of Laparoscopic Instruments and 

Disposables. And, if you do Bariatrics, come see 

how the AWEL device can help you. 

MEDTRONIC, INC. #403 

8200 Coral Sea Street NE 

Mounds View, MN 55112 

Tel: 763-528-9970 

Fax: 651-367-2476 

Website: www.medtronic.com 

At Medtronic, we’re committed to Innovating 

for Life by pushing the boundaries of medical 

technology and actually changing the way 

the world treats chronic disease. Medtronic’s 

U-CLIP® Device simplifies suturing by 

eliminating knot-tying and suture management 

in open, robotic and endoscopic procedures. 

MICROLINE SURGICAL #341 

800 Cummings Center, #166T 

800 Cummings Center #157X 

Beverly, MA 01915 

Tel: 978-922-9810 

Fax: 978-922-9209 

Website: www.microlinesurgical.com 

Microline Surgical develops and manufactures 

precision laparoscopic reposable instruments 

unsurpassed in precision, performance and 

reliability. Starion Instruments employs the 

direct transfer of thermal energy and pressure 

to simultaneously seal and divide tissue. Starion 

is a wholly owned subsidiary of Microline 

MINNESOTA MEDICAL 

DEVELOPMENT, INC. #449 

14305 21ST Avenue North, Suite 100 

Plymouth, MN 55447 

Tel: 763-354-7100 

Fax: 765-354-7101 

Website: www.2mdinc.com 

Minnesota Medical Development will feature 

the innovative Rebound HRD and Rebound 

HRD-V, a family of self-expanding Nitinol 

framed hernia repair devices designed for 

laparoscopic and open repair of inguinal and 

ventral hernias. The Rebound HRD ushers in a 

new era for surgical hernia repair. 



NASHVILLE SURGICAL 

INSTRUMENTS #506 

2005 Kumar Lane 

Springfield, TN 37172 

Tel: 615-382-4996 

Fax: 615-382-4199 

Website: www.NashvilleSurg.com 

Kumar PRE-VIEW* Cholangiography Clamp and 

Kumar PRE-VIEW* Cholangiography Catheters 

allow Cystic Duct Marking to Prevent Common 

Bile Duct Injury. There is No Cystic Duct 

Cannulation! Kumar T-ANCHORS* Hernia Set 

allows easy laparoscopic Hernia Mesh Fixation 

by eliminating the need to grasp and feed 

sutures with Suture Passer. May be used with 

any brand of mesh. 

* Trademark and Patent 

NEATSTITCH #734 

800 East Leigh Street 

Richmond, VA 23219 

Tel: (804) 828-6884 

Website: www.neatstitch.com 

NeatStitch has developed the NeatClose 

system, which is the first fully automated 

port closure device for laparoscopic surgery. 

This system combines safety, ease of use and 

significantly reduced port closure time. 

NEW DIRECTION SYSTEM #819 

821 East Gate Drive 

Mount Laurel, NJ 08054 

Telephone: 866-494-1216 

Fax: 856-778-4439 

Website: www.newdirectionsystem.com 

Robard Corporation provides best-in-class 

nutritional solutions for successful weight 

management to surgeons and physicians 

nationwide. Partner your surgical technique 

with our turnkey medically-supervised system 

(New Direction) to provide patients with 

preoperative preparation, decreased surgical 

complications, and enhanced post-op weight 

loss. 

NEW WAVE SURGICAL Corp 

#342 

3700 NW 124th Avenue, Ste. 135 

Coral Springs, Florida 33065 

Tel: 866-346-8883 

Fax: 866-586-6793 

Website: www.newwavesurgical.com 

New Wave Surgical offers cutting-edge devices 

that increase the safety and efficiency of 

laparoscopic surgery. 

NOVARE SURGICAL SYSTEMS, 

INC. #535 

10440 Bubb Road, Suite A 

Cupertino, CA 95014 

Phone: 877-668-2730 

Fax: 408-873-3168 

Website: www.novaresurgical.com 

RealHand® High Dexterity (HD) Instruments 

continue to advance minimally invasive 

surgery including applications in Single Port 

Surgery and NOTES. RealHand delivers greater 

dexterity and surgical control with 7 degrees of 

freedom of movement and tactile feedback in 

convenient hand-held instruments. 

NOVUS INSURANCE COMpany 

#335 

Risk Retention Group 

3000 Bayport Drive, Suite 300 

Tampa, FL 33607 

Tel. 888-490-5185 

Fax 866-955-9831 

Website: www.NovusMD.com 

Novus Insurance Company is the medical 

malpractice solution for bariatric and general 

surgeons! Novus was created by surgeons 

for surgeons. Our goal is to provide stable 

insurance premiums while reducing your 

liability risk. Visit Booth #335 or our website: 

www.NovusMD.com. 

NOVUS SCIENTIFIC, INC. #649 

1030 Turnpike Street 

Canton, MA 02021 

Tel: 877- 211-4339 

Fax: 781- 713-4717 

Website: www.novusscientific.com 

OASYS HEALTHCARE 

CORPORATION #741 

191 Main Street North 

Uxbridge, Ontario L9P 1C3 - Canada 

Tel: 905-852-3399 

Fax: 905-852-3323 

Website: www.oasyshealthcare.com 

OASYS Healthcare integrates audio, video and 

control systems for the medical marketplace. 

Our solutions include OR Control, Telemedicine, 

digital signage and video monitoring 

systems. All OASYS systems are designed using 

the latest open platform, non-proprietary 

technology. 

OLYMPUS #425 

3500 Corporate Parkway 

Center Valley, PA 18034 

Tel: 484-896-5000 

Fax: 484-896-5133 

Website: www.olympusamerica.com 

Olympus, which incorporates surgical market 

leader Gyrus ACMI, develops solutions for 

healthcare professionals that help improve 

outcomes and enhance quality of life for their 

patients. By enabling less invasive procedures, 

innovative diagnostic and therapeutic 

endoscopy and early stage cancer evaluation 

and treatments, Olympus is transforming the 

future of healthcare. 

OVESCO ENDOSCOPY AG #235 

Dorfackerstr. 26 

72074 Tuebingen - Germany 

Mailing address: service@ovesco.com 

Tel: +49 (0)7071 98979-160 

Fax: +49 (0)7071 98979-260 

Website: www.ovesco.com 

Ovesco Endoscopy AG develops, manufactures 

and markets innovative products for the 

treatment of gastrointestinal disease: The 

OTSC® Over-The-Scope-Clip for gastrointestinal 

hemostasis and endoscopic digestive organ 

wall closure and application aids such as the 

OTSC® Anchor and the OTSC® Twin Grasper®. 

PARÉ SURGICAL INC. #706 

7332 S. Alton Way, Suite H 

Centennial, CO 80112 

Tel: 303-689-0187 

Fax: 303-689-0579 

Website: www.PareSurgical.com 

Innovative suturing technology for 

advanced Laparoscopic, Single Port and Flexible 

Endoscopic procedures. Disposable or reusable 

system delivers a pre-tied locking Roeder knot 

for secure tissue approximation, ligation or 

fixation. Quik-Stitch is ideal for gastric band 

placement and gastric bypass, especially for 

over-sewing staple lines. Quik-Stitch does not 

require triangulation. Perfect for all Single Port 

Procedures. 

During Flexible Endoscopic Procedures, 

gi-Stitch readily achieves serosa to serosa tissue 

penetration to tighten the dilated stoma of a 

gastric bypass. Delivered through the 2.8mm 

operating channel, the 2.6mm gi-Loop provides 

the capability to ligate vessels or ducts utilizing 

suture with the pre-tied locking Roeder knot. 





PATTON SURGICAL #340 

6300 Bridgepoint Parkway 

Building Two, Suite 420 

Austin, TX 78730 

Tel: 512-329-0469 

Fax: 512-328-9113 

Website: www.pattonsurgical.com 

Patton Surgical improves patient care through 

advancements in surgical instrumentation. The 

PassPort® Double-Shielded Trocar, endorsed by 

renowned laparoscopic surgeons worldwide, 

provides superior protection and control and 

drastically reduces the risk of catastrophic vessel 

and organ injury associated with laparoscopic 

procedures. 

PERKINS HEALTHCARE 

TECHNOLOGIES #835 

700 International Parkway Suite 100 

Richardson, TX 75081 

Tel: 214.828.4545 

Fax: 214.827.6319 

Website: www.Perkins-HT.com 

Perkins Healthcare Technologies has earned the 

reputation of developing and manufacturing 

high quality medical products and solutions 

to meet the growing demand for video 

distribution and advanced visualization 

products in the clinical environment. 

RICHARD WOLF MEDICAL 

INSTRUMENTS #727 & #825 

353 Corporate Woods Parkway 

Vernon Hills, IL 60061 

Phone: 847.913.1113 

Fax: 847.913.6959 

Website: www.richardwolfusa.com 

Richard Wolf Medical Instruments (RWMIC) 

manufactures and distributes laparoscopic 

and thoracoscopic instruments. RWMIC 

also manufactures scopes, insufflators and 

a complete line of instruments and optics 

designed specifically for bariatric and colorectal 

surgery. RWMIC offers the only stereoscope on 

the market, designed specifically for Transanal 

Endoscopic Microsurgery. 

SAINT VINCENT HEALTH 

SYSTEM #728 

232 West 25th Street 

Erie, PA 16544 

Tel: (814) 452-7822 

Website: www.svhs.org 

SIERRA SCIENTIFIC 

INSTRUMENTS # 811 

5757 W. Century Blvd., Ste 660 

Los Angeles, CA 90045 

Tel: 310-641-8492 

Fax: 310-872-5558 

Website: www.sierrainst.com 

SSI produces high-resolution solid-state 

manometry systems for gastrointestinal motility 

studies. Our ManoScan 360T High-Resolution 

Manometry System has advanced diagnostic 

technology that makes manometry simple, 

accurate and complete. An average esophageal 

study can be done in 10 minutes or less. 

SIMBIONIX USA CORPORATion 

#430 

7100 Euclid Avenue, Suite 180 

Cleveland, OH 44103 

Tel: +216 229 2040 

Fax: +216 229 2070 

Website: www.simbionix.com 

Simbionix is a global leader in medical 

simulation and education technologies. 

Simbionix LAP Mentor and GI Mentor 

provide advanced simulation experience of 

complete MIS procedures. Simbionix was 

selected by SAGES to develop web-based 

didactic material and hands-on exam for the 

FES Program. 

SONY ELECTRONICS, INC. #131 

1 Sony Drive 

Park Ridge, NJ 07656 

Tel: 201-930-1000 

Website: www.sony.com/medical 

Sony Electronics is a leading provider of 

innovative medical imaging products. Our 

offerings include High Definition cameras, 

displays, capture systems and printers. Sony’s 

medical group is recognized for its commitment 

to fine-tuning its products to meet the 

demands for healthcare professionals. 

SPECIALTY SURGICAL 

INSTRUMENTATION #813 

200 River Hills Drive 

Nashville, TN 37210 

Tel: 615-883-9090 

Fax: 615-883-9107 

Website: www.specsurg.com 

SSI Ultra surgical instruments are handcrafted 

by the finest surgical instrument makers in 

Germany, individually inspected to maintain 

the highest standards of quality. SSI Ultra 

serves the surgical specialties of Neuro/Spine 

Orthopedics, Eye, ENT, Plastics Cardio/Peripheral 

Vascular, General GYN, Laparoscopic surgeries. 

SPRINGER #503 

233 Spring Street 

New York, NY 10013 

Tel: 212-460-1600 

Fax: 212-460-1575 

Website: www.springer.com 

Springer offers an increasing number of cuttingedge 

Surgery titles written by highly qualified 

experts. Visit our booth and browse books 

and journals on the newest developments 

in Surgery, including Surgical Endoscopy, the 

Official Journal of SAGES and EAES. 

STRYKER ENDOSCOPY #700 

5900 Optical Court 

San Jose, CA 95138 

Tel: 800-624-4422 

Fax: 800-729-2917 

Website: www.stryker.com 

Stryker Corporation is one of the world’s 

leading medical technology companies with 

the most broadly based range of products in 

orthopaedics and a significant presence in 

other medical specialties. 

SUPER BRUSH, LLC #843 

800 Worcester Street 

Springfield, MA 01151 

Tel: 413-543-1442 

Fax: 413- 543-1523 

Website: www.superbrush.com 

SURGICAL PRODUCTS 

MAGAZINE #726 

199 East Badger Road, Suite 201 

Madison, WI 53713 

Tel: 973-920-7789 

Fax: 608-274-6454 

Website: www.surgicalproductsmag.com 

Surgical Products, a monthly product news 

magazine, is the leading source for cuttingedge 

surgical product information to 60,000 

surgeons and other medical and purchasing 

professionals in hospitals and surgi-centers 

across the country. Surgical Products is 

available in both hard and digital editions. The 

publication is complemented by a stable of 

online offerings including a weekly Surgical 

Focus On enewsletter, e-product showcase 

and custom-designed, audience-directed 

E-Marketing blasts. 

SURGICAL SCIENCE, INC. #306 

7760 France Ave South, Suite 1100 

Minneapolis, MN 55435 

Tel: 612-810-1474 

Fax: 888-737-1648 

Website: www.surgical-science.com 

Surgical Science has been a market leader 

in Virtual Reality Laparoscopic Simulation 

since 2001. With a strong focus on usability, 

applicability in clinical education, and 

advanced technology, the LapSim® System 

continues to be in high demand among surgical 

professionals worldwide. 



SURGIQUEST #847 

12 Cascade Blvd. – Suite 2B 

Orange, CT 06477 

Tel: 203-799-2400 

Website: www.surgiquest.com 

SurgiQuest, founded May 2006, creates 

innovative technology for minimally invasive 

surgery. SurgiQuest’s AirSeal access 

system presents significant technological 

breakthroughs in minimally invasive surgery. 

The AirSeal system provides unobstructed 

access to abdominal cavity and reduces 

variations of intra-abdominal pressure. 

SurgiQuest’s unique approach to MIS enables 

improved single incision surgery and many new 

instrument platforms. 

SYNAPSE BIOMEDICAL, INC. 

#336 

300 Artino Street 

Oberlin, OH 44074 

Tel: 440-774-2488 

Fax: 440-774-2572 

Website: www.synapsebiomedical.com 

Synapse Biomedical Inc., a neurostimulation 

company, markets the NeuRx Diaphragm 

Pacing System (DPS). The system is designed 

for laparoscopic implantation to address 

respiratory insufficiency or chronic ventilator 

dependency in high spinal cord injury and ALS 

(Lou Gehrig’s disease) patients. 

SYNOVIS SURGICAL 

INNOVATIONS #625 

2575 University Avenue W 

St Paul, MN 55114 

Tel: 1-800-255-4018 

Fax: 1-651-642-9018 

Website: www.synovissurgical.com 

Synovis Surgical Innovations, a division of 

Synovis Life Technologies, Inc., will feature 

Veritas® Collagen Matrix, a biomaterial for soft 

tissue repair that is rapidly revascularized and 

repopulated by surrounding host tissue. Synovis 

will also display Peri-Strips Dry® with Veritas® 

Collagen Matrix, its biologic circular and linear 

staple line reinforcement, for gastric, small 

bowel and mesentery applications. 

TEI BIOSCIENCES INC. #647 

7 Elkins St., Boston, MA 02127 USA 

Tel: Toll Free 800-524-0022; or 617-268-1616 

Fax: 617-268-3282 

Website: www.teibio.com 

TEI Biosciences is a leading, privatelyheld 

biomedical company with expertise 

in regenerative medicine that develops 

biologic products for soft tissue repair and 

reinforcement applications - from plastic 

and reconstructive surgery, abdominal wall 

reconstruction and hernia repair, and wound 

management. 

TUEBINGEN SCIENTIFIC 

MEDICAL GMBH #237 

Dorfackerstr. 26 

72074 Tuebingen - Germany 

Tel: +49 (0)7071 98979-140 

Fax: +49 (0)7071 97979-240 

Website: www.tuebingen-scientific.com 

Tuebingen Scientific Medical GmbH develops, 

produces and markets instruments 

and accessories for minimally invasive 

surgery. Our mission is to create products that 

significantly improve endoscopic surgery and 

match up with today’s economic reality in the 

hospital industry. 

ULTIMATE ESCAPES LUXURY 

DESTINATION CLUBS #742 

3501 W. Vine Street, Ste. 225 

Kissimmee, FL 34741 

Telephone: 1-877-955-1900 

Fax: 407-483-1936 

Website – www.UltimateEscapes.com 

Ultimate Escapes is a private club that gives you 

and your family a lifetime of “once-in-a-lifetime” 

vacation experiences. Similar to a traditional 

country club, Ultimate Escapes members pay 

a onetime membership fee and annual dues 

for access to over 130 private multi-milliondollar 

vacation residences and more than 140 

luxury resort hotels in over 150 destinations 

worldwide! Our Escape Planners assist you 

with complete pre-trip planning and at your 

destination, a Local Private Host offers 5-star 

concierge service and helps you feel completely 

at home. Memberships start at $70,000. 

UNIVERSITY OF MISSOURI 

HEALTH CARE #831 

One Hospital Drive; MC414 McHaney Hall 

Columbia, MO 65212 

Tel: 573-882-5609 

Fax: 573-884-4611 

The Department of Surgery at the University 

of Missouri is currently recruiting for excellent 

surgeons with fellowship or advanced training 

in minimally invasive surgery, laparoscopic 

techniques, and robotic procedures. 

THE UNIVERSITY OF 

TENNESSEE #548 

PHYSICIAN EXECUTIVE MBA PROGRAM 

916 Volunteer Boulevard 

608 Stokely Management Center 

Knoxville, TN 37996-0562 

Tel: (865) 974-1772 

Fax: (864) 974-0929 

Website: www.pemba.utk.edu 

The Physician Executive MBA at The University 

of Tennessee is the #1 preferred program 

exclusively for physicians. It is an internationally 

accredited one-year-long MBA, delivered via 

distance education and campus residency 

periods, offered exclusively for physicians 

seeking leadership skills 

VIRTUAL PORTS, LTD. #203 

800 E. Leigh Stree 

Richmond, VA 23219 

Tel: 804-827-8231 

Fax: 804-828-8566 

Website: www.virtual-ports.com 

Virtual Ports’ products are designed to reduce 

the number of “ports” needed for a surgery and 

medical staff required for a procedure. These 

products reduce the risk of complications, 

recovery time, scarring andoverall cost while 

allowing the surgeon more control. 




Index of Faculty and Presenters 

Jamie D. Adair ..................................... 58 

Gina L. Adrales ................................... 33 

Brij B Agarwal ..................................... 69 

Krishna A.Agarwal ............................ 50 

Frances Allocco .............................56,67 

S. Al-Sabah ........................................... 68 

Luigi Angrisani ................................... 20 

Mehran Anvari .......................41, 66, 70 

Maurice E. Arregui ............................ 67 

Horacio J. Asbun ......................... 19, 52 

Theodor Asgeirsson ......................... 69 

Vikram Attaluri ................................... 50 

Joyce T. Au ........................................... 58 

Michael M. Awad ............................... 59 

Shahin Ayazi ........................................ 68 

Asghar Azadani .................................. 57 

Heidi Bahna ......................................... 46 

Fady Kamal Balaa .............................. 51 

Virinder K. Bansal .............................. 55 

Linda Barry .......................................... 68 

Katherine A. Barsness ...................... 28 

Nicola Basso ........................................ 67 

Bruce Behn .......................................... 40 

Estuardo J. Behrens .......................... 68 

Richard Bell ......................................... 48 

Simon Bergman .......................... 51, 55 

Ramon Berguer .................................. 52 

Marc Bessler ...........................20, 40, 55 

Jai Bikhchandani ............................... 68 

Daniel W. Birch ............................ 27, 65 

Desmond H. Birkett .......................... 53 

S. Biron .................................................. 20 

Raghid S. Bitar .................................... 54 

Jeffrey A. Blatnik ................................ 56 

Victor Bochkarev ............................... 54 

Alexandre Bouchard ........................ 35 

Steven P. Bowers ...................33, 52, 62 

E. Boyle .................................................. 54 

Fredrick J. Brody ......................... 35, 40 

Shaun R. Brown ........................... 46, 67 

L. Michael Brunt .......................... 35, 65 

Matias Bruzoni ................................... 28 

Luis E. Burbano .................................. 33 

Jo Buyske ...................................... 63, 65 

Angel M. Caban ................................. 69 

Ronan A. Cahill ................................... 55 

Guilherme M. Campos .................... 69 

Alfredo M. Carbonell ................. 33, 67 

Antonio O. Castellvi .......................... 56 

Bipan Chand ................................ 40, 52 

Ryan A. Chandhoke .......................... 68 

George Chang .................................... 18 

Eric Changchien ................................ 66 

Hester Cheung ................................... 68 

Gyu-Seog Choi ............................ 46, 66 

Elie K. Chouillard ........................ 55, 68 

Elie Chouilliard ............................ 55, 68 

Alberto Chousleb ....................... 63, 70 

Elias Chousleb .................................... 27 

Pradeep K. Chowbey ...........27, 33, 70 

W. Y. Chung .......................................... 19 

Tatyan Clarke ...................................... 67 

Ronald Hanson Clements ....... 51, 66 

Ricardo V. Cohen ............................... 20 

Tran Cong Duy Long ........................ 55 

Nathan E. Conway ............................. 46 

Manolo Cortez .................................... 20 

Federico Costantino ......................... 57 

Ismael Court ........................................ 57 

Daniel R. Cox ....................................... 56 

Peter Crookes ..................................... 53 

Angel Cuadrado ................................ 57 

David Cummings .............................. 41 

Paul G. Curcillo II ............33, 39, 51, 55 

Alfred Cuschieri ....................41, 53, 70 

Allan Dackiw ....................................... 19 

Gregory F. Dakin ......................... 54, 74 

Bernard Dallemagne ........................ 41 

Abhay N. Dalvi .................................... 50 

Donald Davis ...................................... 54 

Aureo L. De Paula .............................. 27 

Edmundo Dedios Orozco ............... 52 

Conor P. Delaney ........................ 18, 36 

Nicolas Demartines .......................... 19 

Ithaar H. Derweesh ........................... 50 

Ashwin L. deSouza ............................ 47 

Daniel J. Deziel ................................... 53 

Ushast Dhir .......................................... 68 

Andre Dhoore ..................................... 36 

Nicola Di Lorenzo .............................. 58 

Robert DiRaddo ................................. 63 

John Dixon .......................................... 20 

Quan-Yang Duh ................................. 19 

Brian J. Dunkin ......................40, 66, 74 

Sanjeev Dutta ..................................... 28 

David Bryan Earle .............................. 65 

Kristen R. Earle .................................... 66 

Paula K. Edelson ................................. 66 

Steven Edmundowicz ...................... 40 

Claire Edwards .................................... 50 

Michael B. Edye .................................. 33 

Jonathan E. Efron .............................. 18 

Ahmed R. El-Geidie ........................... 55 

Steve Eubanks ............................. 54, 70 

Liane S. Feldman ........................ 35, 65 

Edward L. Felix ................................... 27 

John J. Feng ........................................ 32 

Alberto R. Ferreres ............................ 57 

David Field ........................................... 40 

Abe L. Fingerhut ......................... 33, 53 

Aaron S. Fink ....................................... 67 

Heidi L. Fitzgerald ............................. 54 

Jean Bernard Flament ..................... 62 

James W. Fleshman .......................... 68 

Roberto Fogel ..................................... 20 

Kenneth A. Forde .............................. 53 

Dennis L. Fowler ......................... 36, 58 

Morris E. Franklin, Jr. ...........46, 65, 68 

Gerald M. Fried ...............34, 54, 66, 75 

Karl H Fuchs ................................. 41, 58 

Daniel J. Gagne .................................. 35 

Michel Gagner .................................... 20 

Roberto Gallardo ............................... 69 

Alex Gandsas ...................................... 58 

Pierre Garneau ................................... 58 

Brice Gayet .............................19, 33, 55 

Denise W. Gee ..................................... 57 

Daniel P. Geisler ....................18, 36, 68 

Keith E. Georgeson ........................... 36 

Iman Ghaderi ...................................... 56 

Saber Ghiassi ...................................... 63 

Paolo Giamundo ............................... 58 

Joshua Glenn ...................................... 76 

Alec Glover .......................................... 40 

Matthew Randall Goede .......... 32, 75 

Trudie A. Goers ................................... 69 

Ke Gong ................................................ 56 

Segundo J. Gonzalez ........................ 58 

Christopher J. Gostout ............. 40, 63 

Jon Gould ............................................. 67 

Teodor P. Grantcharov .............. 56, 65 

Casey J. Graybeal ............................... 39 

John C. Graybill .................................. 50 

Frederick L. Greene .................... 50, 54 

Andrew A. Gumbs ................19, 39, 55 

Prateek K. Gupta ................................ 67 

Peter T. Hallowell ............................... 51 

M. Hamada .......................................... 69 

Erik N. Hansen .................................... 28 

Paul Hansen ........................................ 24 

Carroll M. Harmon ............................. 28 

Kristi Lee Harold ................................ 33 

Vincent L. Harrison ........................... 55 

Karem C. Harth ............................ 56, 67 

Eugenius J. Harvey ............................ 69 

Jeffrey W. Hazey ................................. 40 

David Hazzan ...................................... 56 

Katherine B. Heiden ......................... 58 

B. Todd Heniford ................................ 33 

Miguel Herrera ................................... 19 

Kelvin D. Higa ..................................... 27 

Jacques M. Himpens ........................ 20 

Vanessa P. Ho ...................................... 56 

Michael D. Holzman ......................... 54 

Elizabeth Honigsberg ...................... 56 

William W. Hope ................................ 50 

Santiago Horgan ............................... 40 

Franziska Huettner ........................... 46 

Eric Steven Hungness ............... 39, 51 

John Hunter ................................. 41, 67 

Matthew M. Hutter ........................... 20 

Sayeed Ikramuddin .......................... 19 

William Barry Inabnet III .......... 19, 54 

Haruhiro Inoue ............................ 19, 41 

Takeaki Ishizawa ................................ 35 

Eran Itzkowitz ..................................... 68 

Gretchen Purcell Jackson ............... 76 

Timothy D. Jackson ......................... 54 

Brian P. Jacob ............................... 68, 74 

Samuel Jacob ..................................... 55 

Garth R. Jacobsen ............................. 40 

David James ................................. 58, 66 

Christopher Jamieson .............. 47, 54 

Balaji Jangam ..................................... 67 

Shiva Jayaraman ......................... 50, 57 

Eric D. Jenkins ..................................... 55 

Blair A. Jobe ......................................... 41 

Daniel Bougere Jones ...................... 65 

Rohan A. Joseph ................................ 67 

David J. Kaczorowski ........................ 67 

Matthew F. Kalady ............................. 18 

Jawaid Kalim ....................................... 18 

Timothy D. Kane ................................ 28 

Sergey V. Kantsevoy ......................... 32 

Kazunori Kasama ........................ 27, 52 

Zachary Kastenberg ......................... 28 

Namir Katkhouda ....................... 55, 67 

L. Brian Katz ......................................... 75 

Nilton Kawahara ................................ 27 

Chuck Kennedy .................................. 64 

Michael J. Kim ..................................... 67 

Subhash U. Kini .................................. 46 

Sue Kirkman ........................................ 41 

Seigo Kitano ................................. 19, 70 

Shuji Kitashiro .................................... 39 

Bastiaan R. Klarenbeek ............. 24, 68 

Nicoleta O. Kolozsvari ...................... 56 

Shanu N. Kothari ........................ 32, 75 

Amanda J. Kravetz ............................ 54 

Sachin S. Kukreja ............................... 66 

Birte Kulemann .................................. 69 

Yo Kurashima ...................................... 75 

Marina Kurian .............................. 27, 74 

Antonio M. Lacy ................................. 20 

Pawanindra Lal ................................... 55 

Jacob C. Langer .................................. 28 

Antonio D. Lassaletta ....................... 69 

Wai Lun Law ........................................ 56 

William Laycock ................................. 55 

Gyusung Lee ................................ 57, 68 

James Lee ............................................ 19 

Andras Legner .................................... 68 

Joel Leroy ...................................... 19, 55 

Emanuele Lezoche ........................... 68 

Michael K.W. Li ................................... 70 

Isadore Lieberman ............................ 40 

Song Liang .......................................... 46 

Demetrius E.M. Litwin ..................... 40 

Thom E. Lobe ...................................... 28 

Katie Love ............................................ 54 

Kirk Allen Ludwig .............................. 36 

Markham C. Luke .............................. 36 

James D. Luketich ............................. 62 

Bruce V. MacFadyen Jr. .................... 54 

Joseph Mamazza ............................... 51 

Jacques Marescaux .................... 25, 41 

Gerald Marks ................................ 21, 70 

Jeffrey M. Marks ......35, 40, 47, 51, 66 

John H. Marks ..................................... 36 

Michael R. Marohn ............................ 40 

Ian Martin ............................................. 33 

Pamela Martin .................................... 64 

Jose M. Martinez ................................ 40 

Abraham Mathew ............................ 40 

Samer G. Mattar ................................. 64 

Ronald Matteotti ............................... 46 

Kai Matthes ......................................... 74 

Brent D. Matthews ............................ 33 

Dirk W. Meijer ...................................... 58 

Ozanan R. Meireles ........................... 58 

John D. Mellinger .............................. 66 

W. Scott Melvin ........................... 51, 57 

Adam T. Meneghetti ......................... 27 

Carlos A. Menezes ............................. 56 

Dean J. Mikami ............................ 51, 57 

Bertrend Millat ................................... 33 

Karl A. Miller ........................................ 20 

Rebecca Manget Minter ................. 51 

Yoav Mintz .................................... 40, 51 

Danilo Miskovic ................................. 56 

John R.T. Monson .............................. 36 

Derek E. Moore ................................... 50 

John M. Morton ................................. 75 

Fady Moustarah ................................. 58 

Erica Moran ......................................... 22 

Kenric M. Murayama ........................ 69 

Didier Mutter ...................................... 35 

Omer Nasir 

Radu Nedelcoviciu ............................ 47 

Adrian Marius Nedelcub ................. 69 

Ninh Tuan Nguyen ............................ 20 

Thinh H Nguyen ................................ 46 


Index of Faculty and Presenters 

Gregg K. Nishi ..................................... 74 

Yuri W. Novitsky ....................33, 67, 75 

Michael S. Nussbaum ...................... 56 

David O’Brien ...................................... 18 

Kathleen O’Connell .......................... 68 

Tomonori Ohsawa ............................ 63 

Allan E. Okrainec ....34, 52, 56, 65, 74 

Dmitry Oleynikov .................32, 66, 75 

Sarah C. Oltmann .............................. 46 

Pablo E. Omelanczuk ....................... 69 

Raymond P. Onders .......................... 36 

Sean B. Orenstein .............................. 56 

Ismail H. Ozerhan .............................. 68 

Chinnasamy Palanivelu ............ 27, 35 

Juan P. Pantoja ................................... 19 

Neely Panton ...................................... 54 

Adrian E. Park ............................... 64, 75 

Chan W. Park ....................................... 66 

John J. Park .......................................... 18 

Michael Parker ............................. 35, 63 

Eric M. Pauli ......................................... 67 

Nikhil Pawa .......................................... 56 

Suraj B. Pawar ..................................... 35 

Jonathan Pearl ................................... 34 

Carlos A. Pellegrini ............................ 65 

Jacques J. Perissat ............................. 70 

Silvana Perretta .....................35, 57, 63 

Jeffrey H. Peters ....................41, 53, 62 

Edward H. Phillips ...................... 52, 62 

Andrea Pietrabissa ............................ 58 

Alessio Pigazzi .................................... 66 

Rodrigo A. Pinto ................................ 54 

Tim Pitney ............................................ 40 

Mun Jye Poi ......................................... 56 

Alfons Pomp ................................ 20, 66 

Jeffrey L. Ponsky ................................ 28 

Benjamin K. Poulose ................. 66, 75 

Pornthape Prathanvanich .............. 47 

Rhonda J. Prewitt .............................. 32 

Jose Manuel Prince ........................... 28 

Aurora Dawn Pryor ........................... 67 

Shailesh Puntambekar .................... 35 

Karim Qayumi ..................................... 65 

Sonia L. Ramamoorthy .................... 18 

Bruce J. Ramshaw ............................. 62 

Abhay Rane ......................................... 39 

G. V. Rao ................................................ 51 

Prashanth Prabhakar Rao ........ 39, 55 

David W. Rattner ......................... 51, 53 

Arthur Rawlings ................................. 63 

Petachia Reissman ............................ 36 

Feza Remzi ........................................... 55 

Jason F. Reynoso ................................ 46 

J. Ribamar ............................................. 27 

William O. Richards ........................... 66 

Erwin Rieder ........................................ 58 

E. Matt Ritter ....................................... 34 

Homero Rivas ..................................... 39 

Sergio Roll ............................................ 51 

John R. Romanelli ...................... 32, 65 

Michael J. Rosen ......................... 33, 62 

Raul J. Rosenthal ....20, 46, 52, 56, 68 

James B. Rosser Jr. ............................. 75 

Steven S. Rothenberg ...................... 28 

Francesco Rubino .............................. 41 

Dan Ruiz ............................................... 47 

Eric Rullier ............................................ 19 

Mohamad D Saad ............................. 47 

Adheesh A. Sabnis ..................... 54, 75 

Yoshihisa Saida .................................. 69 

Barry A. Salky ............................... 58, 69 

Bryan J. Sandler ................................. 57 

Byron F. Santos ............................ 46, 54 

Aviva Sapers ........................................ 40 

Abeezar I. Sarela ................................ 19 

Richard M. Satava .................19, 41, 62 

Philip R. Schauer ................................ 41 

Bruce D. Schirmer .................51, 54, 64 

Steven D. Schwaitzberg ........... 19, 58 

Daniel J. Scott .............................. 39, 64 

Carol E. Scott-Conner ....................... 24 

Donna See ........................................... 36 

Don J. Selzer ........................................ 35 

P Senthilnathan ................................. 55 

Elliot L. Servais ................................... 50 

Neal E. Seymour ................................. 75 

Baiju R. Shah ....................................... 36 

Nilay R. Shah ....................................... 56 

Paresh C. Shah .................................... 27 

Scott A. Shikora .................................. 20 

Samuel Shuchleib ............................. 70 

Noam Shussman ............................... 58 

Gerd R. Silberhumer ......................... 67 

Allan E. Siperstein ...................... 19, 50 

David E. Skarda .................................. 50 

C. Daniel Smith .................................. 47 

Brad E. Snyder .................................... 46 

Luc Soler ........................................ 41, 58 

Toyooki Sonoda ................................. 36 

Nathaniel J. Soper ................25, 34, 53 

Mike Stahl ............................................ 40 

Steven C. Stain ................................... 50 

Greg V. Stiegmann ............................ 53 

Sharon Stein ........................................ 18 

Vivian E.M. Strong ...................... 19, 22 

Erica Sutton ......................................... 35 

Lee L. Swanstrom ..........28, 34, 52, 53 

Patricia Sylla ........................................ 40 

Zoltan Szabo ....................................... 75 

Amir Szold .................................... 20, 50 

Nobumi Tagaya .................................. 55 

Mark A. Talamini ......................... 53, 67 

Eduardo Targarona ..............35, 55, 69 

Craig J. Taylor ...................................... 62 

Julio A. Teixeira ......................20, 39, 74 

Christopher C. Thompson ....... 20, 40 

Jonathan R. Thompson ................... 47 

Kari Thompson ................................... 35 

Michael H. Thompson ...................... 28 

Sarah K. Thompson .......................... 67 

Augusto Almeida Tinoco ......... 33, 67 

Manish M. Tiwari ................................ 63 

Philippe A. Topart .............................. 46 

Alfonso Torquati ......................... 20, 41 

Shirin Towfigh ............................. 33, 62 

Tung T. Tran ......................................... 67 

L. William Traverso ..................... 33, 54 

Thadeus L. Trus .................................. 74 

Albert W. Tsang .................................. 68 

Shawn T. Tsuda ............................ 34, 76 

Jenna Turocy ....................................... 58 

Tehemton Udwadia .......................... 67 

Surendra M. Ugale ..................... 27, 33 

David R. Urbach ................................. 65 

Oliver A. Varban ................................. 46 

Esteban Varela .................................... 55 

Melina C. Vassiliou ........34, 46, 66, 74 

Khashayar Vaziri ................................. 66 

Ashley Vernon .................................... 34 

Leonardo Villegas .............................. 75 

Anthony J. Vine .................................. 27 

Guy R. Voeller ...................................... 62 

Daniel Von Renteln ........................... 51 

Go Wakabayashi ................................ 52 

Martin Walz ......................................... 19 

Z. Wang ................................................. 58 

Eric Glenn Weiss ................................. 36 

Steven D. Wexner .................52, 53, 68 

R. Larry Whelan ........................... 19, 54 

Mark H. Whiteford ............................. 18 

Yanghee Woo ..................................... 66 

Tatsuo Yamakawa .............................. 52 

Manabu Yamamoto .......................... 52 

Jun Yan .................................................. 50 

Han-Kwang Yang ............................... 19 

Laurence Yee ....................................... 18 

Tonia M. Young-Fadok ..................... 36 

Yassar Youssef ..................................... 67 

Basil Yurcisin II .................................... 22 

Minhua Zheng ................................... 55 

Jacqui C. Zhu ...................................... 68 

Ricardo Zorron ................................... 59 

Natan Zundel ............................... 56, 70 




Notes

2010 SAGES Final Program

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