Session Descriptions
Opening Day
Wednesday, September 22, 2021 | 11:00am – 2:00pm
Honorary Chairs
“Huaxia Minimally Invasive Forum in China”
Jixiang Wu, MD
DR. JIXIANG WU is a chief physician, professor and doctoral supervisor. He graduated from the medical department of Beijing Medical University in 1983 and went on to the University of Pittsburgh as a visiting scholar from 2001 to 2002.
He performed the first kidney transplant, the first allogeneic orthotopic liver transplantation, the first laparoscopic small liver cancer radical surgery and airless abdominal laparoscopic surgery for gastric and colorectal cancer successively in Beijing Anzhen Hospital.
Dr. Wu was previously the Director of General Surgery, Endoscopy Training Center of Beijing Anzhen Hospital, and Director of Beijing Tongren Hospital. Currently, he is the Director of the Surgery Center, General Surgery Department, Minimally Invasive Surgery Training Center of Beijing Tongren Hospital and Director of Gastroesophageal Reflux Disease Diagnosis and Treatment Research Center of Capital Medical University.
During his tenure in Beijing Tongren Hospital, Professor Jixiang Wu innovatively improved the operation mode of laparoscopic Nissen fundoplication surgery, introducing an airless abdomen device, 3D laparoscopic, intraoperative esophageal manometry, and short pine Nissen surgery, etc. reducing the operation time, intraoperative bleeding, postoperative complications and recurrence. Academically, he is Deputy Chief Editor of the Chinese Journal of Gastroesophageal Reflux Disease, Deputy Chief Editor of Chinese Journal of Minimally Invasive Surgery, on the editorial board of Chinese Journal of General Surgery, Clinical Medicine of China, Chinese Journal of Medical Guide and China Medicine.
He has undertaken the research projects of the Capital Medical Development Research Fund, such as “Clinical study of CK20, CD44 and micro metastasis in patients undergoing laparoscopic radical resection of colorectal cancer”, “Clinical Study of Suspension Laparoscopic Radical Resection of Colorectal Cancer”, ” Development and Clinical Research of Airless Abdominal Laparoscopic Device” and the National Natural Science Foundation of China “The study of decoy receptor 3 small interfering RNA inhibits the growth and metastasis of colon cancer cells” . More than 60 papers have been published.
“Wonderful Time to Say Thank You”
Thiers Soares Raymundo, MD, PhD
Dr. Thiers Soares Raymundo is currently Chief of Gynecologic Endoscopy Section, Cardoso Fontes Hospital, Rio de Janeiro, Brazil and Gynecologic Endoscopy Section of Pedro Ernesto University Hospital, State University of Rio de Janeiro, Brazil. He is also Professor of Gynecologic Endoscopy Postgraduate Course, Suprema University/Instituto Crispi, Minas Gerais, Brazil and is in charge of the simulation lab. He is the current President of the Brazilian Society of Videosurgery and Robotic – Rio de Janeiro Section, 2020/21. In 2016 he became a Senior Medical Advisor for Shenzen Luohu Hospital Group, Shenzen, China.
Dr. Thiers Soares Raymundo is a member of the Society of Laparoendoscopic Surgeons (SLS) and Global Society of Endometriosis and Pelvic Pain (GSEPS). He is also a member of the first Team of Robotic Surgery in Gynecology in Rio de Janeiro, Brazil.
Multidisciplinary Plenary Session: Teaching Old Tricks to New Dogs
Wednesday, September 29, 2021 | 11:10am – 12:10pm
Director: John E. Morrison, MD
Co-Director: Jessica Ybanez-Morano, MD, MPH
Faculty: Charles O. Kim, Jr., MD
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DESCRIPTION:
The rising number of laparoscopic procedures performed by surgical residents is associated with a drastic decrease in the number of basic open procedures performed. Resident education has been further reduced as a result of enhanced regulation and work-hour restrictions. . Some traditional open procedures are now unfamiliar to many residents. There is a need to include sufficient open operative experiences to instill confidence and develop necessary technical skill in performing open procedures when indicated.
A recent survey of fellowship directors and practicing surgeons raised concerns regarding the preparedness of general surgeons graduating from residency programs. Open common bile duct exploration cases have decreased substantially over the past 20 years. Graduates prefer nonsurgical approaches and increasingly seek the assistance of senior surgeons to manage unexpected events. A substantial portion of the early experience in tissue handling, suturing, and anatomy that is shifted to the later years of residency. The most dramatic impact of the shortcomings of residency training is the rapid growth of fellowships. Many endovascular, endoscopic, and laparoscopic techniques require extensive and prolonged training to become proficient.
Some recommended solutions include a transition from a time/volume-based curriculum to a proficiency-based system help ensure the residents acquire the necessary surgical skills during training; the use of various simulation methods from reusable models to animal laboratories; incorporating standardized technical and oral evaluations to compensate for the loss of experience with open procedures. Developing a competency-based system incorporating open procedures and a return to fundamental concepts would be beneficial to improve surgical training.
OBJECTIVES:
- Understand changes in residency training program structure that contribute to the gap between needed skills for clinical practice and actual trainee experiences and their effect on clinical preparedness.
- Discuss the implications of the lack of access to and training in open surgical procedures on the ability of surgeons to prevent, recognize and manage complications.
- Discuss recommendations to transition from a time/volume-based curriculum to a proficiency-based system.
- Discuss strategies to ensure that trainees develop adequate skills for open as well as MIS procedures.
- Discuss the role of simulation, anatomy and anatomic models as vehicles to develop skills for traditional open surgical procedures and techniques that are less common in the minimally invasive surgical era.
AGENDA
| 11:10am – 11:25am | Common Bile Duct Exploration John E. Morrison, Jr., MD |
| 11:25am – 11:40am | There Is No Shame In Conversion.Laparoscopic Surgery: When to Convert to Laparotomy? Jessica Ybanez-Morano, MD, MPH |
| 11:40am – 11:55am | The Evolution of Surgical Techniques in Urology from Open, Laparoscopic and Robotic Surgery Charles O. Kim, Jr., MD |
| 11:55am – 12:10pm | Discussion/Q&A |
Multidisciplinary Plenary Session: Telepresence and the Application of Novel Technologies in MIS Training
Thursday, September 30, 2021 | 11:10am – 12:10pm
Director: Justin W. Collins, MBCh, MD, FRCS (UROL)
Co-Director: Richard M. Satava, MD
Faculty: Mehran Anvari OOnt MB BS PhD FRCS FACS, Jacques Marescaux, MD, Yulun Wang PhD
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DESCRIPTION:
The role of telepresence services in healthcare in an increasingly connected world and the rate of adoption has been accelerated during the COVID-19 pandemic. There is growing interest in the potential synergy between telepresence and minimally invasive surgery. The development of digital surgery has resulted in new and efficient ways to train and monitor the surgeon’s performance. Robotic surgery provides an ideal environment for surgical telementoring and telesurgery given its endoscopic optics and mechanized instrument movement.
The first multipurpose teleoperated robotic systems were developed by SRI International and DARPA, driven by the identified need to provide additional expertise and technical skills to help decrease morbidity and mortality in battlefield casualties. The surgeon leading this initiative for DARPA was Professor Rick Satava. The practical application of telesurgery was realised via the first transatlantic operation completed on September 7th 2001 by Professor Jacques Marescaux and his team from IRCAD. Speaking at the time, Professor Marescaux commented: ‘The demonstration of the feasibility of a transatlantic procedure, dubbed ‘Operation Lindbergh’, is a richly symbolic milestone. It lays the foundations for the globalization of surgical procedures, making it possible to imagine that a surgeon could perform an operation on a patient anywhere in the world. Dr Yulun Wang is one of the pioneering engineers in robotic surgery and developed the ZEUS robotic system, used during Operation Lindbergh. Wang also created the first remote-presence robotic system to enable a clinician to be in two places at one time to perform medical triaging, diagnosis, and consultations from a distance. The surgical robotics and telemedicine innovations that Wang helped to develop have now benefited several million patients—and are continuing to help over a million patients every year.
The potential for providing surgical expertise from a remote geographical location is an exciting new frontier of medicine. At the forefront of this research is the development of automated telesurgery for space travel. Professor Mehran Anvari has been Chief Scientific Officer on several joint projects run with McMaster University, the Canadian Space Agency and NASA.
OBJECTIVES:
To discuss the current and future opportunities for telepresence in surgical training and service delivery and to propose protocols for the safe launch and integration of telepresence technologies.
AGENDA
| 11:10am – 11:25am | Utilising an Accelerated Delphi Process to Develop Guidance and Protocols for the Safe Introduction of Telepresence Applications Justin W. Collins, MBCh, MD, FRCS (UROL) |
| 11:25am – 11:40am | From Telerobotic Surgery to Robotic Autonomy: A Personal Journey Mehran Anvari OOnt MB BS PhD FRCS FACS |
| 11:40am – 11:55am | Imaging, Robotics, and Artificial Intelligence: The 3 Weapons of Choice for a Smart Surgical Training Jacques Marescaux, MD |
| 11:55am – 12:10pm | Discussion/Q&A Mehran Anvari OOnt MB BS PhD FRCS FACS, Justin W. Collins, MBCh, MD, FRCS (UROL), Jacques Marescaux, MD, Richard M. Satava, MD and Yulun Wang, PhD |
Future Technology Keynote
Biosphere 2’s Radical Experiment Global Ecology: Ecotechnic Insights for the Paradigm Shift Needed to Regenerate Our World
Thursday, October 7, 2021 | 11:10am – 12:10pm
Mark Nelson, PhD
Chairman, Institute of Ecotechnics
Dr. Mark Nelson is Chairman of the Institute of Ecotechnics, head of Wastewater Gardens International and has worked for several decades in closed ecological system research, bioregenerative space life support, ecological engineering, restoration of damaged ecosystems, desert agriculture and wastewater recycling. Dr. Nelson was a member of the eight person “biospherian” crew for the first two year Biosphere 2 closure experiment, 1991-1993. The project included pioneering regenerative agriculture and waste and water recycling. In the 1970s, he planted an organic fruit orchard at Synergia Ranch, Santa Fe NM and has helped manage its organic fruit and vegetable farm for decades. Associate Editor of Life Sciences in Space Research, his books include “Pushing Our Limits: Insights from Biosphere 2” (2018), “The Wastewater Gardener: Preserving the Planet One Flush at a Time” (2014).and “Life Under Glass: Crucial Lessons in Planetary Stewardship” (2020) by Mark and two fellow biospherians.
DESCRIPTION:
Convinced of the urgency of new approaches to harmonize the worlds of ecology and technology, my Institute of Ecotechnics created real-time eco-projects in challenging biomes starting in the late 1960s. Our core team then launched the Biosphere 2 project, the first mini-biospheric global ecology laboratory. Creating a virtually totally sealed 3.15 acre facility required close cooperation of innovative engineers and world-class ecologists. Biosphere 2 reached a vast worldwide audience in the 1990s since it demonstrated human dependence on our biosphere on a scale that was easily comprehended. The requirements of material closure forced a re-design of the technosphere to support and not pollute its living world, creative ways of ecological management to ensure maintenance of clean air, total recycle of wastewater and soil nutrients and development of highly productive non-chemical regenerative agriculture. Join me to experience living in Biosphere 2 and viscerally understand and feel our connection with our dynamic world. Share this extraordinary adventure – an example of the biospheric paradigm shift that is needed if we are all to become responsible biospherians of planet Earth.
AGENDA
| 11:10am – 11:15am | Introduction Richard M. Satava, MD |
| 11:15am – 12:00pm | Biosphere 2’s Radical Experiment in Global Ecology: Ecotechnic Insights for the Paradigm Shift Needed To Regenerate Our World Mark Nelson, PhD |
| 12:00pm – 12:10pm | Q&A and Discussion with Mark Nelson, PhD Moderators: Raymond J. Lanzafame, MD, MBA and Richard M. Satava, MD |
Multidisciplinary Plenary Session: Artificial Intelligence: Making Surgery Smarter and Safer
Wednesday, October 20, 2021 | 11:10am – 12:10pm
Director: Jay A. Redan, MD
Co-Director: Seda Dzhantukhanova, MD, PhD
Faculty: Daniel A. Hashimoto, MD, MS
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DESCRIPTION:
The field of Surgery is currently going through an amazing Metamorphosis. We have over the last 25 years gone from cutting people open, to operating through 5 mm incisions to now using robots, directed energy, check point inhibitors and augmented reality to take care of people. Information overload makes it very difficult for a physician to “know everything” about caring for a disease process at the same time a patient adding their own diagnosis and treatment found on Google and other search engines.
What is the best way to take care of “this disease,” “this surgical problem?” The answers change almost weekly to the point where it is difficult to give patient’s current, accurate and factual advice. Information systems that are currently in evolution may be an excellent step forward for this to happen.
Alexa, Siri, Google Home (for example) all have the power to integrate current medical and surgical care into their databases, coupled with the patient data input of History and Physical, lab data and radiologic data to give your patient the most accurate diagnosis with the appropriate treatment at the current time. As scary as this may sound these artificial intelligence robots can probably perform these tasks faster more accurate and with less errors than the current average human brained physician. There will be no bullying by the patient who wants antibiotics for their viral illness, no elective surgery until pre-operative risk factors are reduced, and no unnecessary testing such as an MRI for “back pain.” This is the low hanging fruit to reduce expensive medical care.
This is a start. When it comes to surgery Artificial Intelligence is not far behind. A surgeon of the future will become a computer programmer assisting the robot where to place the ports for optimal disease excision or ablation; oversee the surgical procedure as the robot uses image guidance to remove pathology and leave normal organs alone. Additionally, we need to keep our patients and ourselves human; but not get distracted from metrics and death by a thousand computer clicks.
This session will give you insight into what the surgeon of the future may be like using Artificial Intelligence.
AGENDA
| 11:10am – 11:25am | From Driverless Cars to Surgeonless Robots Jay A. Redan, MD |
| 11:25am – 11:40am | Facebook and You Tube…Can a Surgeon Learn Surgery from Social Media? Seda Dzhantukhanova, MD, PhD |
| 11:40am – 11:55am | Decision-Making in Surgery: Natural or Artificial Intelligence? Daniel A. Hashimoto, MD, MS |
| 11:55am – 12:10pm | Discussion/Q&A |
Excel Award Recipient
Thursday, October 21, 2021 | 11:10am – 11:55am
“Surgical Mentoring: Paying It Forward”
William E. Kelley, Jr., MD
Dr. William E. Kelley, Jr. is a graduate of the Boston University School of Medicine, and completed his general surgery internship and residency at the Medical College of Virginia in 1978. He was a Fellow of the American Cancer Society at MCV (1975-1976), and completed a fellowship in surgical oncology at Boston University in 1980. Since that time he was in private practice with the Richmond Surgical Group, Richmond VA until his retirement in October, 2017. He was director of general surgery for the Center for Surgical Innovation at Henrico Doctors’ Hospital.
Dr. Kelley has been active internationally in the field of postgraduate surgeon education in minimally invasive surgery since 1990. He performed the first robot-assisted surgical procedure in the United States following FDA approval. Dr. Kelley has contributed over 200 papers and presentations in the fields of surgical oncology, minimally invasive surgery, image-guided breast surgery, and robot-assisted surgery, and textbook chapters in laparoscopic antireflux, colon and spleen surgery. He has been an editor of the Journal of the Society of Laparoendoscopic Surgeons, a Past President of the Society of Laparoendoscopic Surgeons and 12-year past-member of the Board of Trustees of the SLS.
AGENDA
| 11:10am – 11:20am | Introduction Raymond J. Lanzafame, MD, MBA |
| 11:20am – 11:50am | Presentation by Excel Award Recipient Surgical Mentoring: Paying it forward William E. Kelley, Jr., MD |
| 11:50am – 11:55am | Presentation of Excel Award |