Society of Laparoscopic & Robotic Surgeons | Session Descriptions

Session Descriptions

Global Perspectives in MIS

Wednesday, August 26, 2020 | 7:30 am – 5:00 pm

Director: Maurice K. Chung, RPh, MD
Co-Directors: Megan Kennedy Burns, MD, Michael McDonald, MD, and Phillip P. Shadduck, MD


Hands On Skill Courses

Mastering Tools and Techniques in General Surgery

Wednesday, August 26, 2020 | 7:30am – 11:30am
Course Fee: $395

Description:Surgical thinking and practice continues to evolve as our collective knowledge base and experience increase. Minimally invasive approaches have expanded the surgical armamentarium. Multiple energy modalities are available to the surgeon ranging from the traditional monopolar, bipolar to ultrasound and advanced tissue sealing bipolar devices. The differences between the energy sources will be described and compared. Participants will have an opportunity to use all of the different modalities and observe their effects. Morcellation of tissue has been a recognized technique for removal of specimens for many years. Skill and indications for endoscopic stent placement for fistula and perforation management, the role of ureteral stents, the use of ICG fluorescence technologies, applications of surgical meshes and the use of suture assist devices will be highlighted.
Objectives: Participants will understand the indications, contraindications, benefits and limitations of new techniques and technologies in MIS procedures. Participants will learn the proper technique for tissue extraction and specimen retrieval, the use of energy sources, stents, ICG fluorescence technologies, and more.
 

Vertical Zone Suturing Hands-on Skills Course – Advanced Laparoscopic Suturing – For the Gynecologist, Urologist, and General and Robotic Surgeon

Wednesday, August 26, 2020 | 7:30am – 11:30am
Course Fee: $495

Director: Charles H. Koh, MD

Description: Participants will learn the uses and limitations of laparoscopic suturing with the ‘Triangulation’ algorithm. The ‘Vertical Zone’ technique of suturing with two hands ipsilaterally allows the needle to operate in the sagittal plane, while permitting a restful and relaxed attitude of the elbows, forearms and hands. This course equips all attendees with improved suturing skills and insight into applications during surgery.
Objectives: Course participants will be better able to understand ergonomics, theory and rationale for reproducible and efficient laparoscopic suturing; learn port positions, instruments and tips to minimize fulcrum and maximize efficiency, perform interrupted suturing, continuous suturing, cinch knotting; apply learned skills in relevant surgical situations across specialties; and the prevention and management of bowel, bladder and ureteral complications by appropriate suture repair. A pre-test and post-test will demonstrate improvement in skills.
 

Minilaparoscopy Hands-on Skills Course

Wednesday, August 26, 2020 | 7:30am – 5:00pm
Course Fee: $475

Directors: Gustavo Carvalho, MD, PhD and Eduardo Moreno-Paquentin, MD, FACS

Description:The application of new technologies to minimally invasive abdominal surgery has brought great interest in recent years. A new field of reduced port surgery has come into the surgical scene. Minilaparoscopy (Mini) has stood out as one of the more reproducible techniques amongst the different varieties of reduced port options due to its simplicity, enhanced dexterity, improved visualization, low cost and above all, safety. Less analgesic consumption due to less postoperative pain, early recovery and outstanding cosmesis are features that are hard to be equaled by other techniques. The surgeon must be familiarized with the rationale for this surgical alternative and the equipment needed in order to safely and properly apply the principles of Mini in clinical practice.
Objectives: After this course the student will understand the basic principles and science behind Mini, and will be able to identify the instruments and specific surgical techniques to safely apply Mini in clinical scenarios. Participants will have an opportunity to develop basic skills necessary for incorporating Mini technologies in their surgical repertoire.
 

CO2 Laser MIS Surgery Skills Course By Lumenis (Non-CME)

Wednesday, August 26, 2020 | 7:30am – 5:00pm
Course Fee: Free

Description: This hands-on skills course is designed to give MIS Surgeons a focused educational experience in surgical laser techniques and abetter understanding of the laser’s role within the surgical armamentarium.The course will uniquely focus on different surgical techniques and discuss advantages and limitations for each in various clinical scenarios in multiple disciplines.Faculty will emphasize fundamental anatomy, microsurgical, and robotic dissection techniques. Didactic sessions will focus on minimally invasive approaches in both robotic and laparoscopic applications. Additionally, there will be a hands-on session with the Lumenis CO2 laser system.
Objectives: Participants will learn the basic physics, safety and clinical applications of CO2 laser technology in MIS settings. Hand-on skills will focus on fiberoptic and free-hand applications of laser technology.
 

Mastering Tools and Techniques in Gynecology and Urology

Wednesday, August 26, 2020 | 1:00pm – 5:00pm
Course Fee: $395

Description: Surgical thinking and practice continues to evolve as our collective knowledge base and experience increase. Minimally invasive approaches have expanded the surgical armamentarium. Multiple energy modalities are available for use including the traditional monopolar, bipolar and ultrasound as well as advanced tissue sealing bipolar devices. The differences between the energy sources will be described and compared. Participants will have an opportunity to use all of the different modalities and observe their effects. Morcellation of tissue has been a recognized technique for removal of specimens for many years. Skill and indications for ureteral stent placement, the role of ureteral stents, the use of ICG fluorescence technologies, applications and use of suture assist devices will be highlighted and hysteroscopic techniques will be presented.
Objectives: Participants will understand the indications, contraindications, benefits and limitations of new techniques and technologies in MIS procedures. Participants will learn the proper technique for tissue extraction and specimen retrieval, the use of energy sources, stents, ICG fluorescence technologies, the handling, manipulating and maneuvering of hysteroscopes, and the applications and limitations of these techniques in clinical practice, and more.


Multidisciplinary Plenary Sessions

The Source of Surgical Complications: Man, Machine or Both

Thursday, August 27, 2020 | 7:50am – 8:50am

Director: Paul Toomey, MD
Co-Director: Samay Jain, MD
Faculty:
Justin Collins, MD
Jorge Marcel, MD

Session Description:
What unique complications can occur when operating with a robotic platform? Who or what is to blame? Proponents of robotic operations report the benefits are clear: instruments can be more precisely controlled, patients undergo smaller incisions, and the operations lead to less dissection and blood loss with quicker recoveries. Challenges specific to robot-aided operations may arise from hardware issues, software issues and/or human error.

As surgeons, we take it upon ourselves to be responsible for all complications in the operating room. However, device malfunction, dependency on assistants to exchange instruments, inadvertent motions by the platform and increased strength of instruments may be culpable in certain instances. We will explore common issues for General Surgeons, Colorectal Surgeons, Urologists, Gynecologists and Thoracic Surgeons who depend on these machines to function properly in order to minimize risk to patients.

The debate over the role of technology in medicine will become more and more important as technology evolves. Where do we draw the line with regard to incorporating artificial intelligence into our operating platforms? How can we improve the technology to minimize these unique risks? When will the machine be more responsible than the surgeon? We will take a look at the past, the present and the future technology that we envision.

Robotic-assisted surgery is an important surgical option that is safe and effective when used appropriately and with proper training. We will discuss the current standards of training and how it should continue to evolve alongside the evolution of robotic platforms and techniques.

Artificial Intelligence: Making Surgery Smarter and Safer

Thursday, August 27, 2020 | 8:55am – 9:55am

Director: Jay A. Redan, MD
Co-Director: Seda Dzhantukhanova, MD, PhD

Session 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.

Surgery as a Team Sport: What Makes a Great Team

Friday, August 28, 2020 | 7:50am – 8:50am

Director: Mona Orady, MD
Co-Director: Samay Jain, MD
Faculty:
Lisa Cormier, CST
John E. Morrison, Jr., MD
Lynn Tai, PA

Session Description:
This session will be an interactive session with a panel of experts sharing their pearls for working as a team, optimizing communication and efficiency in order to help support great surgery. The importance of the team and team communication in predicting and preventing complications and optimizing surgical planning, efficiency, and outcomes will be demonstrated. Pre-operative assessment and planning and pre-emptively preparing the team for possible complication will also be demonstrated.

Case vignette will be reviewed from perspectives of different members of the team and audience interaction will be paramount in understanding the importance of forward thinking and the team approach to creating great surgical outcomes.

Vignette:
Complex Multidisciplinary case with potential for complications will be presented.
Case and potential complications will be acted out in a mock OR set-up
Dr. Orady will be commentator and ask questions.
Panel will be involved in discussion and acting out the case
Will have Video to show different aspects of optimization of surgical efficiency and quality as well as tips for predicting and preventing complications with panel commenting and providing tips and knowledge to the audience in the discussion.

Teaching Old Tricks to New Dogs

Friday, August 28, 2020 | 8:55am – 9:55am

Director: John E. Morrison, Jr., MD
Co-Director: Jessica Ybanez-Morano, MD, MPH
Faculty:
Charles Kim, MD

Session 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:

  1. 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.
  2. 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.
  3. Discuss recommendations to transition from a time/volume-based curriculum to a proficiency-based system.
  4. Discuss strategies to ensure that trainees develop adequate skills for open as well as MIS procedures.
  5. 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.

State of the Art Lectures in Robotic Surgery

Thursday, August 27, 2020 | 10:30 am – 12:30 pm

Director: Mona Orady, MD
Co-Directors: Samay Jain, MD and Jay A. Redan, MD


The World Summit

Director: Maurice K. Chung, RPh, MD
Co-Directors: Ian Hodgdon, MD, Ja Hyun Shin, MD, Paul Toomey, MD, and Mireille Truong, MD

Thursday, August 27 | 1:45pm – 5:00pm
Friday, August 28 | 1:45pm – 5:00pm


Best Poster Showcase

Thursday, August 27, 2020 | 1:45pm – 5:00pm

Director: Gustavo Stringel, MD, MBA
Co-Director: William E. Kelley, Jr., MD


Nezhat Distinguished Lecturer at MISWeek

Friday, August 28, 2020 | 10:40am – 11:10am

“The Past, Present, and Future of Surgery and Surgeons and The Role of Endometriosis In It”
Camran Nezhat

The Nezhat brothers, Camran, Ceana, and Farr Nezhat, have a passion for medicine, in particular minimally invasive surgery in gynecology, and are luminaries in their field. Their support of the Society of Laparoendoscopic Surgeon’s mission of education and information can be seen not only through their participation in SLS, but also through their teaching, their practices, and their philanthropic efforts. This generous endowment will allow SLS to continue its efforts into the future. In appreciation and recognition of their support and efforts, the SLS Board of Directors voted to name a lecture in honor of the Nezhat Family, which will take place each year at MISWeek. Join us for this year’s distinguished lecture on The Past, Present, and Future of Surgery and Surgeons and The Role of Endometriosis In It by Camran Nezhat.


Surgical Surprises – When the Unexpected Happens!

Friday, August 28, 2020 | 11:15am – 12:30pm

The Surgical Surprises session has been an enormously popular session since its debut at MISWeek. It aims to highlight unexpected events occurring during the progress of surgery, the decision process of how to remedy the accident/occurrence, and the video demonstration of the even and its correction. Videos will show an unexpected event or complication that occurred during a real surgical case study, followed by the corrective action taken to remedy it. The presentation will be marked by several video pause intervals when the presenter will interact with the expert panel of surgeons, urologists and gynecologists, as well as the audience in a lively discussion of alternative options, etc. This particular strength of the SLS is what distinguishes this program. Join us for another interactive, discussion-filled session at MISWeek this year with new case studies submitted by fellow attendees.


Pediatric Session: Multi-Disciplinary Issues in the Care of Pediatric Patients

Friday, August 28, 2020 | 1:45pm


Future Technology Session

Saturday, August 29, 2020 | 8:50pm – 9:40pm

Director & Moderator: Richard M. Satava, MD
Co-Director & Moderator: Raymond J. Lanzafame, MD, MBA