THANK YOU TO EVERYONE WHO MADE THE 2020 COURSE A SUCCESS!
Course Overview
This is the 35th year of the course, “Medical and Surgical Aspects of Esophageal and Foregut Disorders: Pathophysiology and Treatment”. This year we are pleased to again bring together outstanding leaders in the field of Esophageal Disease as faculty. The faculty brings broad experience in benign and malignant esophageal disease and includes a mixture of gastroenterologists and surgeons from diverse locations to ensure a comprehensive, state-of-the-art, yet balanced approach to the diagnosis and management of patients with esophageal and foregut disorders.
The course is co-directed by Steve DeMeester, MD and Philip Katz, MD. Steve DeMeester is a Thoracic surgeon specializing in foregut disease and is currently at the Oregon Clinic in Portland, OR. Prior to moving to Portland he was Professor of Surgery and Clinical Scholar at the University of Southern California. Philip Katz is a gastroenterologist specializing in esophageal diagnostics and therapy and is a Professor of Medicine at Weill Cornell Medicine, NYC. Prior to moving to Cornell, Phil was Chief of Gastroenterogy and Nutrition at the Albert Einstein Medical Center, Jefferson Medical College in Philadelphia, PA. He is a past president of the American College of Gastroenterology.
Emeritus directors Tom DeMeester MD, Don Castell MD, and Jeff Peters MD, are part of the core faculty along with Stu Spechler MD, Felice Schnoll-Sussman MD, and Para Chandrasoma MD.
Tom DeMeester was Professor of Surgery and Chairman of the Department of Surgery at the University of Southern California. He is world-renown for his numerous contributions in the field of esophageal disease, including the development of the DeMeester score of assessment of esophageal acid exposure during pH testing.
Don Castell was Professor of Medicine and Director of Esophageal Function Laboratory at the Medical University of South Carolina, Charleston SC. He is internationally renown for his contributions to esophageal function testing as well as diagnosis and therapy of gastroesophageal reflux disease. He is currently Emeritus professor of Medicine.
Jeff Peters was Professor of Surgery and Chairman of the Department of Surgery at The University of Rochester, and then his most recent position was Chief Operating Officer for University Hospitals Healthcare System in Cleveland, OH.
Stu Spechler is Chief, Division of Gastroenterology and Co-Director, Center for Esophageal Diseases at Baylor University Medical Center at Dallas and Co-Director, Center for Esophageal Research at Baylor Scott & White Research Institute. He has is a recognized leader and has published extensively on topics in esophageal disease including GERD and Barrett’s esophagus.
Felice Schnoll-Sussman is Professor of Clinical Medicine and Director of the Jay Monahan Center for Gastrointestinal Health and Director of Endoscopy, Division of Gastroenterology and Hepatology, Weill Cornell Medicine. She is known for her skills in advanced esophageal endoscopy including management of complex strictures and Barrett’s esophagus.
Para Chandrasoma is one of the world’s leading experts in esophageal pathology and has proposed ground-breaking concepts related to the histology of the normal and the reflux-damaged gastroesophageal junction.
In addition to the core faculty each year there are special surgical and medical guests, from national or international locations, to highlight the specific topics that are focused on at each year’s meeting. These topics include esophageal diagnostics, endoscopic imaging and interventions, the pathology of GERD and Barrett’s esophagus, esophageal motility abnormalities and diverticula, hiatal hernia, laryngopharyngeal reflux, medical, surgical and endoscopic therapies for GERD and motility disorders, esophageal perforation and caustic injury, eosinophilic esophagitis, benign tumors of the esophagus and stomach, and the diagnosis, staging and therapy for esophageal and gastric cancer.
For those that have not attended previously, the course is specifically designed to have the feel and interaction of a small-group classroom environment where questions, comments and discussion are encouraged. The course is open to all physicians and allied health personnel with an interest in esophageal and foregut disorders and is particularly appreciated by gastroenterologists and gastrointestinal surgeons who focus on the diagnosis and treatment of patients with esophageal disorders, and for those who have or an interest in developing a swallowing center and who function as a team to collaboratively approach esophageal problems. The lectures are detailed and supported by existing literature and on-going research to provide cutting-edge information that can be immediately applied to patient care. Each lecture is followed by ample time for often vigorous discussion and interaction between the faculty and attendees as areas of controversy are further explored and debated.
In addition, there is an interactive audience response session that allows participants to test out their knowledge on esophageal disease with great prizes given to the winners. There is also an “Interactive New Technology” break-out session to provide participants with the opportunity to gain insight into new and evolving technologies that impact esophageal diagnostics and therapy. Further, there is the option of more in-depth experience with fundamental and novel esophageal diagnostic tools and therapies in the form of Hands-on Certificate Sessions where participants will get added exposure to valuable new technologies or procedures and be provided instruction, assistance and information exchange from the faculty, along with a certificate of completion at the end of the advanced session.
The course is intense, but we also encourage socialization among the participants and faculty. This is aided by a course reception Thursday night and a wonderful evening social event on Monday night. The course starts Thursday and ends Tuesday, with Sunday a free day for everyone to unwind and recharge.
Special Guests
The 2020 annual course “Medical and Surgical Aspects of Esophageal and Foregut Disorders: Pathophysiology and Treatment” will feature a fantastic group of special guest faculty on both the medical and surgical side.
Featured this year on the medicine side are:
C. Prakash Gyawali, MD, MRCP
Professor of Medicine / Director of Neurogastroenterology and Motility / Washington University School of Medicine, St. Louis, MO
Dr. Gyawali went to medical school in Calicut, South India, and after residencies in internal medicine in South India, the United Kingdom, and Washington University in St. Louis, he completed gastroenterology fellowship training at Washington University in St. Louis. He was recruited to join the academic faculty of the Division of Gastroenterology, Washington University in St. Louis in 1999, where he has remained to the present.
Dr. Gyawali's academic interests include gastrointestinal motility, gastroesophageal reflux disease, and functional bowel disorders. He is part of several working groups and consensus committees involving esophageal physiologic testing, and has over 175 original publications. He has an extensive academic practice in esophagology and functional bowel disorders, and is actively involved in clinical research involving neurogastroenterology and motility.
John M. Inadomi, MD
Head, Division of Gastroenterology and Cyrus E. Rubin Chair / Department of Medicine / School of Medicine / University of Washington
Dr. Inadomi received a mechanical engineering degree from the Massachusetts Institute of Technology and a medical degree from the University of California, San Francisco (UCSF) where he also completed his internal medicine residency and gastroenterology fellowship.
Dr. Inadomi is the principal investigator or co-investigator on several NIH grants to conduct health services and outcomes research to optimize the management of Barrett’s esophagus. He has published 180 papers in peer-reviewed journals including the New England Journal of Medicine, Annals of Internal Medicine, JAMA, Gastroenterology, Clinical Gastroenterology and Hepatology, Hepatology and Gut. He is currently an associate editor for the AGA journal Gastroenterology.
He is currently the vice president for the AGA Institute Governing Board and will be AGA president in 2021.
Stavros N. Stavropoulos, MD, FASGE, AGAF
Director, GI Endoscopy / Director, Program in Advanced GI Endoscopy (P.A.G.E.). / NYU-Winthrop University Hospital, Division of Gastroenterology, Hepatology & Nutrition. Associate Professor of Clinical Medicine, New York University / Adjunct Professor of Clinical Medicine, Columbia University, College of Physicians and Surgeons.
Dr. Stavropoulos earned his undergraduate degree from Yale University summa cum laude and his medical degree with AOA distinction from Columbia University, where he also completed his internship, residency, fellowship, and advanced endoscopy fellowship. He stayed at Columbia University Medical Center as Director of Endoscopic Ultrasound (EUS) for 6 years. In October 2007 he was recruited to Winthrop University Hospital as Director of Endoscopy. He continues to serve as Adjunct Professor of Clinical Medicine at Columbia University.
Dr. Stavropoulos has gained international recognition for his pioneering work in the revolutionary per-oral endoscopic myotomy (POEM) procedure which has rapidly evolved as the first line treatment of achalasia within a few years of its inception. Dr. Stavropoulos has been a pioneer of ESD (Endoscopic Submucosal Dissection) and EFTR (Endoscopic Full Thickness Resection) and STER (Submucosal Tunneled Endoscopic Resection) in the United States.
Dr. Stavropoulos has been elected fellow of the American Society of Gastrointestinal Endoscopy (ASGE) and fellow of the American Gastroenterology Association. He is a member of the American College of Gastroenterology and the New York Society of Gastrointestinal Endoscopy, with board certification in Internal Medicine and Gastroenterology. In addition to his work at Winthrop, Dr. Stavropoulos also currently serves as Adjunct Professor of Clinical Medicine at Columbia University, and is active in clinical research, with multiple active trials, over 100 publications and over 100 national and international faculty and lecture invitations.
Featured this year on the surgical side are:
Ralph Aye, MD
Thoracic Surgery / Swedish Medical Center, Seattle, WA
Dr. Ralph Aye is a thoracic and esophageal surgeon at Swedish Medical Center in Seattle, and has been on the clinical faculty of the general surgery residency there since starting practice in 1984. He is currently the associate program director for the department’s thoracic and esophageal fellowships and chairs the Cancer Committee as well as the Quality Committee for the Swedish Cancer Institute. He is past Chief of Surgery at Swedish and past president of the Seattle Surgical Society. He has served as secretary/treasurer and executive committee member for the national Fellowship Council.
Dr. Aye did his general surgery training at New York University and Swedish Medical Center followed by a thoracic and esophageal fellowship under Dr. K. Jeyasingham at Frenchay Hospital in Bristol England. Upon returning to Seattle he studied under and subsequently practiced with Dr. Lucius Hill for over 12 years. His thoracic surgical practice and research interests have focused on lung cancer screening and failure and repair of the anti-reflux barrier. He led a randomized multi-institution study comparing Nissen and Hill repairs and used the findings from that study to address causes for failure with a hybrid procedure. In 2016 he co-edited a textbook on optimizing the results of fundoplication surgery. He resides in the Seattle area with his wife of 40 years and enjoys music as well as his 3 adult children and his 2 grandchildren.
Reginald Bell, MD
General Surgery / Englewood, CO
Dr Bell is a general surgeon in Denver Colorado who specializes in foregut disorders. His primary clinical and research focus is the diagnosis and minimally invasive treatment of GERD and esophageal motility disorders.
Dr Bell earned his medical degree from the Medical College of Virginia where he was elected to the Alpha Omega Alpha honor society. He subsequently completed his general surgery training at the University of Colorado in 1990. Since then, in private practice, he has specialized in foregut disease and been a lead investigator in clinical trials involving minimally invasive treatment of GERD. In 2018 he was a founding member and is currently chairman of the board of the American Foregut Society, a collaborative effort between GI and Surgeons to further research and patient care in this arena.
David Watson, MD
Professor and Head of Surgery / Flinders University / Adelaide, Australia
Professor Watson is an esophagogastric surgeon at Flinders Medical Centre in Adelaide. His interests include gastroesophageal reflux, and esophagogastric cancer. For nearly 3 decades he has led research addressing outcomes following fundoplication, including 8 RCTs which aimed to improve outcomes following surgery for reflux and hiatus hernia. Professor Watson has published more than 400 papers and book chapters, led the development of Australian national guidelines for the management of esophageal and gastric cancer, and contributed to national guidelines for the management of Barrett’s esophagus.
Professor Watson led the establishment of the Australia and New Zealand Gastric and Oesophageal Surgery Association (ANZGOSA) as its foundation President from 2006-10. He has served on Council for the Australian Academy of Health and Medical Sciences (AAHMS). He is the current Vice-President of the International Society for Diseases of the Esophagus (ISDE), and a Board member for Cancer Council SA. In 2018 he was appointed Clinical Director for the Clinical Trials Network Australia and New Zealand (CTANZ), an initiative of the Royal Australasian College of Surgeons (RACS) to enhance surgical research capacity by supporting trainee led multicenter clinical trials.
Professor Watson has been a recipient of the John Mitchell Crouch Fellowship from the RACS, a James IV Travelling Fellowship, Honorary Fellowship of the Royal College of Surgeons of Edinburgh, election to Fellowship of the Australian Academy of Health and Medical Sciences, and appointment to a Matthew Flinders Distinguished Professorship at Flinders University.
ACCREDITATION
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of HCA-HealthONE and Foregut Foundation.
HCA-HealthONE is accredited by the ACCME to provide continuing medical education for physicians.
AMA PRA Category 1 Credit™: HCA-HealthONE designates this live activity for a maximum of 30.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
ABIM MOC Statement
Successful completion of this CME activity enables the participant to earn up to 30.5 MOC points in the AmericanBoard of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC points. Upon successful completion of this course, HCA-HealthONE will submit your completion data to ABIM via ACCME’s Program and Activity ReportingSystem (PARS) for MOC points. Please allow 7-10 business days after claiming for points to appear on your ABIM record.
DISCLOSURE
HCA-HealthONE is committed to providing CME that is balanced, objective, and evidence-based. In accordance with the ACCME Essentials and Standards, all parties involved in content development are required to disclose any relevant conflicts of interest (i.e. any entity producing, marketing, re-selling, or distributing health care goods or services consumed by or used on patients) relating to the topics of this education activity. HCA-HealthONE has established mechanisms to resolve conflicts of interest should they arise. The course director, speakers and members of the planning committee have nothing to disclose.
CORE COMPETENCIES
This activity has been developed with consideration given to the ACGME/ABMS Competencies, Institute of Medicine Core Competencies, and/or Inter professional Education Collaborative Competencies. This activity will increase your competency in the areas of: patient care and procedural skills, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, provide patient-centered care, working in interdisciplinary teams, employ evidence-based practice, apply quality improvements, values/ethics for inter-professional practice, roles/responsibilities, inter-professional communication, and teams and teamwork.
Agenda
THURSDAY, FEBRUARY 6
6:00 A.M. Continental Breakfast/Welcome (S. DeMeester and P. Katz)
Session 1: Esophageal Diagnostics
6:30 A.M. Adjuvant endoscopic techniques in the diagnosis of foregut disease (F. Schnoll-Sussman) 1.0
7:30 A.M. How to best use your pathologist in the diagnosis of foregut disease (P. Chandrasoma) 0.75
8:15 A.M. Maximizing HRM in Practice: core principles and important adjuncts (P. Gyawali) 1.0
9:15 A.M. Reflux Monitoring: What, When, For How Long? (S. DeMeester) 1.0
10:45 A.M. Endolumenal Functional Lumenal Imaging Probe; FLIP 2020 (P. Katz) 1.0
11:45 A.M. Superbowl of Superbowl of Esophageal Diagnostics (S. Spechler, T. DeMeester) 1.0
12:45 P.M. Lunch deep dive: Changes in our understanding of the GEJ and LES over 4 decades (T. DeMeester) 1.25
2:30 P.M. Hands-on Sessions :
Motility in MAUI Suite 1
Stents and Clips in MAUI Suite 2
4:00 P.M. Adjourn for the day
5:30 P.M. WELCOME RECEPTION at the Halona Kai Lawn
FRIDAY, FEBRUARY 7
6:00 A.M. Case Presentation: Hill Procedure (R. Aye) 0.5
6:30 A.M. Continental Breakfast/PEH case presentation (Portland) 0.5
Session 2: GERD and LPR
7:00 A.M. LPR: Pathophysiology, Diagnosis and Medical Management (P. Katz) 1.0
8:00 A.M. TIF and LINX for LPR (R. Bell) 0.75
8:45 A.M. Endoscopic Therapies for Gastroparesis (S. Stavropoulos) 0.75
10:15 A.M. Hill procedure: history and current indications in GERD and PEH (R. Aye) 1.0
11:15 A.M. The Australian PEH trial: lessons and insights (D. Watson) 1.0
12:15 P.M. Lunch Deep Dive: Issues and controversies in PEH repair (Panel: S. DeMeester, R. Aye, R. Bell, D. Watson) 1.75
2:30 P.M. Hands-on Sessions :
Endoflip/Esoflip in MAUI Suite 1
EMR & ESD in MAUI Suite 2
4:00 P.M. Adjourn for the day
SATURDAY, FEBRUARY 8
6:00 A.M. Insurance authorizations: a view from the inside (L. Soot) 0.5
Session 3: GERD and PEH
6:30 A.M. Continental Breakfast/Diagnosis, implications and indications for PEH repair (S. DeMeester) 0.75
7:15 A.M. Pathology of GERD (P. Chandrasoma) 1.0
8:15 A.M. Break-out Sessions: Seven 20-minute Sessions will be presented :
Endo-Surgical Tools in MAUI Suite 1 (F. Schnoll-Sussman, P. Katz)
Endotherapeutics in MAUI Suite 2 (J. Peter, S. Stavroploulos)
A Fresh Option in Biologic Tissues in MAUI Suite 3 (T. DeMeester)
Enhanced Esophageal Biopsy Sampling with AI-Enabled Tissue Analysis in MAUI Suite 3 (S. Spechler, J. Inadomi)
What’s New in Robotic-Assisted Foregut Surgery in MAUI Suite 4 (R. Bell, R. Aye)
Mucosal Integrity: Objective Evidence in GERD and Eosinophilic Esophagitis in MAUI Suite 5 (P. Gyawli)
Partnership Between Surgical Technique and Phasix-ST Mesh in PEH Repair; 2-year Objective Outcomes (S. DeMeester)
10:45 A.M. Balancing cost, benefit and risk in the eval. and long-term management of patients with reflux symptoms (J. Inadomi) 1.0
11:45 A.M. The anterior fundoplication for GERD: technique and outcomes (D. Watson) 0.75
12:30 P.M. Long-term outcomes with TIF and current indications (R. Bell) 0.75
1:15 P.M. Case presentations (Panel)
2:15 P.M. Adjourn for the day
SUNDAY, FEBRUARY 9 – FREE DAY
MONDAY, FEBRUARY 10
6:00 A.M. Early Risers Video Session (P. Katz) 0.5
6:30 A.M. Continental Breakfast/Case presentation (K. Hajifathalian, New York)
Session 4: Eosinophils and Motility Disorders
7:00 A.M. Esophageal Eosinophils: A Cause of Achalasia and Other Esophageal Motility Disorders? (S. Spechler) 1.0
8:00 A.M. Modern management for EOE (P. Gyawali) 0.75
8:45 A.M. Is POEM the answer for achalasia and other esophageal motility abnormalities? (S. Stavropoulos) 0.75
Session 5: Management of Refractory GERD 2020
9:30 A.M. Work Up, optimal medical management and when is it time for surgery? (F. Schnoll-Sussman) 1.0
11:15 A.M. Side effects of surgical therapy for GERD: significance and influence of procedure type (R. Aye) 1.0
12:00 P.M. Ineffective Esophageal Motility: Concepts and Implications for GERD Management and Antireflux Surgery (P. Gyawali) 0.75
12:45 P.M. Adjourn for the day
6:00 P.M. FAREWELL RECEPTION in the Lahaina 1 and 2 rooms
TUESDAY, FEBRUARY 11
6:00 A.M. Early Risers Video Session (A. Sharata, Portland) 0.5
6:30 A.M. Continental Breakfast/Case Presentation (R. Fletcher, Portland)
Session 6: Mucosal Disease and Tumors of the esophagus and stomach
7:00 A.M. Principles, technique and limits of endoscopic resection for esophageal and gastric lesions (S. Stavropoulos) 1.0
8:00 A.M. Cost-effectiveness and role for Barrett’s surveillance (J. Inadomi) 1.0
9:00 A.M. Obstacles to Stemming the Rising Tide of Esophageal Adenocarcinoma (S. Spechler) 1.0
Session 7: Esophageal perforation: new concepts for an old problem
10:30 A.M. Iatrogenic esophageal perforations: principles of management (J. Peters) 0.75
11:15 A.M. Modern endoscopic options for management of esophageal perforation (S. DeMeester) 0.75
12:00 P.M. Management of caustic esophageal injury (S. DeMeester) 0.75
12:45 P.M. Adjourn for the day