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SLS Minimally Invasive Surgery Week 2016 Conference Report

SLS’s Minimally Invasive Surgery Week was held August 31-September 3, 2016 at the
WestinCopley Plaza in Boston. SLS is the largest Minimally Invasive or Laparoscopic Society in North America and perhaps worldwide with over 6000 active members This multispecialty conference of a number of MIS Societies, helps increase knowledge of laparoscopic, endoscopic, and minimally invasive surgical techniques. The Meeting has Postgraduate Master’s Classes; Plenary Sessions; Lap Updates of multiple topics; Expert review and discussion of surgical videos showing accidents, mishaps, and surprises as well as exhibits and surgical games.

Always a favorite is the Top Gun Shoot Out. Qualifying for ‘Top Gun’ takes place during the conference and the final is held on Saturday afternoon. Surgeons, interns, fellows and medical students compete to master skills they need to operate in the advanced laparoscopic environment such as suturing and 3D depth perception. All of these are needed attributes of a front line 21st Century Surgeon. It is also a challenge and great fun. This year’s 1st place winner was Dr. Abdelkader Hawasli , 2nd place Dr. Vladimir Tica, and 3rd place Dr. Sam Douglas (photo credit Eliot Griffith)
Top Gun is the brain child of Dr. James ‘Butch’ Rosser, Jr. He, SLS and Florida Hospital now have TOP GUN SURGEON ADVANCED LAPAROSCOPIC SKILLS & SUTURING PROGRAM in a 3 Volume Interactive iBooks format for iPad!

The SLS Experience Session sponsored by the Society of Laparoendoscopic Surgeons covered multiple cases of the treatment of endometriosis and different surgical procedures for treatment, depending on where and how widespread it occurred in the uterus. Speakers discussed per centage of recurrence based on treatment and procedure used and when and how ablation therapy or other procedures are most effective and why. The speakers included Louise King, MD; Flavio Malcher, MD; M. Jean Uy-Kroh; and Michael McDonald to name a few.

The Opening Ceremony included a welcome by Maurice K.Chung, President and the presentation of awards during the Welcome reception for best scientific papers and videos, the Young Educators awards and corporate awards for Innovations presented by Paul Wetter and Maurice Chung.

The Hands on Master Classes provided training in laparoscopic/robotic/endoscopic simulation skills; vertical zone and laparoscopic suturing for gynecologist, urologist, and general and robotic surgeons as well as advanced mini lap suturing. Course directors were Charles H. Koh, MD and co-directors were Luigi Fasolino, MD and Gustavo Stringel, MD, MBA who were ably assisted in each of the courses by different SLS Faculty. Participants could attend four hour morning or afternoon sessions to hone their skills.

Dr. Susan Khalil, SLS Women’s committee, and others discussed the value of surgical mentorship in the Updates session. She talked about the various models to mentor female surgeons, the changing dynamics of mentorship and the role of sponsors.

One of the events that I found most helpful, since there were multiple sessions occurring at the same time was the “Highlights” of the previous day’s session given on Thursday and Friday morning. Presenters were assigned to each of the multispecialty events and gave a synopsis of the highlights of each in the day’s opening plenary.

One outstanding plenary session discussed the economics of minimally invasive surgery and Dr. Neil Finkler of Florida Hospital, presented the two year study conducted at Florida Hospital on the pros and cons of high volume surgeons and low volume surgeons. The high volume surgeons have statistically better outcomes. The predicted variables were measured in terms of time in OR, patient cut-close time in OR, surgical supply cost, blood usage, surgical site infections, mortality, 30 day readmissions and LOS. The predicting variables were age, gender, number of consulting physicians, type of insurance, and severity of illness, risk of mortality, admission type, admission source, principal procedure codes, principal surgeon and SSI. The study included the following specialties; colorectal, general and gynecologic oncology.

Dr. Richard Satava and Dr. Robert Sweet chaired a session on 3-D printing. Dr. Satava started the session by talking about the importance of 3-D printing and the fact that in the future it will be possible for ‘us – patients’ to get new parts just like we do for our cars. Rather than waiting for a donor kidney we will be able to grow our own from stem cells from our bodies and the 3- D printer will produce; doing away with rejection and painful life diminishing drugs.

He stated that with the advance of 3-D printing you now provide and entire scan of the human body and in the future you will be able to provide supplies at the point of use. Dr. Satava was followed by Andrey Suprun an M2 at University of Central Florida (UCF) who talked about the manufacturing of sterile mesh for hernia repair. He said today the duration of their printing process is too long but in the future you will be able to manufacture in the OR. Michael McAlpine from the University of Minnesota worked with Dr. Sweet on the synthetic tissue project and discussed their 4-D tissue engineering project and their nerve regeneration project.

michael-mcalpine-300x225In the future by using the 4-D tissue engineering stem cell capsules they will be able to develop nerve reproduction. (photo credit, Sarah Sherwood)

Mark Finkelstein in one of the paper sessions talked about the study he and Dr. Michael Palese conducted using robotic surgery case data from the state of New York that looked at over 63,000 patients from 2009 – 2014. He stated that all specialties are witnessing an increase in utilization of robotic-assisted surgeries and it is growing more rapidly in other surgical specialties but there appears to be a slight decline in urology and gynecology. This could simply be because of the early adoption by urology and gynecology. There also seemed to be a disparity in the patients being served. The judges cautioned the researchers to not make assumptions based on the data without further research (which they are doing) because some patients simply do not want to go somewhere else for their surgery and may not have access to robotic-assisted surgery.

Dr. Duke Herrell, Director of robotic surgery at Vanderbilt gave the history of the da-Vinci robot and talked about new players in the field of robotic surgery. He said the trends from open to robotic helps the patient and he believes in the future we can be even less invasive, not only with da-Vinci but with the new generation of robots being produced by Titan, Medtronics, and TransEnterix.

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