AGENDA | ACCREDITATION | FACULTY INFORMATION

This is the 39th year of the course, “Medical and Surgical Aspects of Esophageal and Foregut Disorders: Pathophysiology and Treatment”. We are pleased to announce that the venue for the 2024 course will be the Royal Sonesta Kaua'i Resort Lihue. 

COURSE OVERVIEW

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. It 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 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 ongoing 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 are lunch and learn sessions that provide even deeper dives into relevant and often controversial subjects, 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, and optional Hands-on Certificate Sessions. In these sessions, participants have close interaction with faculty and vendors on new technology and procedures to enable the participant to leave with a new level of confidence and experience along with a certificate of completion at the end of the advanced session. These sessions typically include high-resolution motility, advanced endoscopic procedures, and novel diagnostic or therapeutic devices.

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.

THURSDAY, FEBRUARY 1

• 6:00 AM Continental breakfast/introductions and welcome (S. DeMeester and P. Katz)

SESSION 1: Esophageal Diagnostics and GERD (Moderator: Steve DeMeester)

• 6:30 AM HRM in the management of patients with esophageal symptoms (P. Katz) .75

• 7:15 AM EndoFLIP and FLIP topography: When and how to best use (P. Gyawali) .75

• 8:00 AM GERD, LPR, and pulmonary fibrosis (R. Bremner) 1.0

• 9:00 AM Using esophageal diagnostics to individualize treatment of foregut disorders (S. DeMeester) 1.0

• 10:00 AM Coffee Break/Case Presentations

SESSION 2: GERD and Cardiac Mucosa (Moderator: Stu Spechler)

• 10:30 AM Aspiration during upper endoscopy: treatment, prevention and the ASA guidelines (D. Molena) .75

• 11:15 AM GERD management in the UK (S. Attwood) .75

• 12:00 PM Lunch and Learn Roundtable: Cardiac mucosa (15 min each) 2.0

  • History of CLE and Barrett’s esophagus in the USA (J. Peters)

  • History of CLE and Barrett’s esophagus in the UK (S. Attwood)

  • Cardiac mucosa and GERD (P. Chandrasoma)

  • Cardiac mucosa and CIM (C. Marginean)

  • Cardiac mucosa and adenocarcinoma: is IM necessary? (R. Odze)

  • Cardiac mucosa and IM after ablation (N. Shaheen)

• 2:00 PM Break

• 2:30 PM Hands-on Sessions:

  • Motility

  • Overstitch

  • Tracmotion and vision

• 4:00 PM Adjourn

• 5:30 PM Welcome reception in the Ka Mala O Kalapaki Garden - All participants

FRIDAY, FEBRUARY 2

• 6:00 AM Industry Breakfast - Break the Fast with Science 

SESSION 3: GERD Treatment (Moderator: Phil Katz)

• 7:00 AM Optimal medical management of the complex GERD patient (F. Schnoll-Sussman) .75

• 7:45 AM Surgical management of GERD in patients with lung disease (R. Bremner) .75

• 8:30 AM Selecting patients for medical and surgical GERD treatment: Lyon 2, GERD diagnostics and esophageal manometry (P. Gyawali) .75

• 9:15 AM Green, yellow and red lights for TIF, LINX, and fundoplication (S. DeMeester) 1.0

• 10:15 AM Extended Coffee Break/Case Presentations

• 11:00 AM Which patients are more likely to develop Barrett’s and how do we monitor and treat them knowing this? (N. Shaheen) .75

• 11:45 AM GERD and obesity: options and outcomes (R. Bremner) .75

• 12:30 PM Understanding the cause of failure helps us perfect our operations  for GERD and PEH (S. DeMeester) 1.0

• 1:30 PM Adjourn

SATURDAY, FEBRUARY 3

• 5:15 AM Industry Breakfast - Break the Fast with Science

SESSION 4: EOE Roundtable (Moderator: Steve DeMeester)

• 6:00 AM Roundtable topics (20 min each) 2.25

  • Overview and history of EOE (S. Atwood)

  • Lymphocytic esophagitis vs EOE (S. Spechler)

  • Is it GERD or EOE? (S. DeMeester)

  • Traditional management of the disease and the dysphagia (P. Katz)

  • Management of the complex EOE patient (F. Schnoll-Sussman)

• 7:45 AM Panel discussion/audience questions

• 8:15 AM Break Out Rooms with Industry

SESSION 5: Gastric and Esophageal Potpourri (Moderator: Stu Spechler)

• 10:45 AM Stages of dysplasia including crypt dysplasia (R. Odze) .75

• 11:30 AM Gastric pathology and function/dysfunction (P. Gyawali) .75

• 12:15 PM Managing esophageal complications: leaks, perforation, and caustic injury (D. Molena) .75

• 1:00 PM Adjourn

SUNDAY, FEBRUARY 4 - FREE DAY

MONDAY, FEBRUARY 5

• 6:00 AM Early Risers Video Session .5

• 6:30 AM Continental Breakfast/Case Presentations .25

SESSION 6: Achalasia 1 (Moderator: Steve DeMeester)

• 7:00 AM Differential diagnosis, subtypes, and treatment options (S. Spechler) 1.0

• 8:00 AM EJGOO : Can FLIP help guide diagnosis and therapy? (P. Gyawali) .75

• 8:45 AM Pneumatic Dilation, Heller, and POEM: what to choose and what to expect over time? (R. Bremner) .75

• 9:30 AM Management of post-therapy GERD (P. Katz) .75

• 10:15 AM Coffee Break/Case Presentations

SESSION 7: Achalasia 2 (Moderator: Felice Schnoll-Sussman)

• 10:45 AM Evaluation and management of recurrent dysphagia (S. DeMeester) .75

• 11:30 AM Scleroderma and end-stage achalasia: options and recommendations (D. Molena) .75

• 12:15 PM Adjourn

• 6:30 PM Course Reception in the Luau Gardens

TUESDAY, FEBRUARY 6

• 6:30 AM Continental Breakfast/Case Presentations .25

SESSION 8: Barrett’s Esophagus (Moderator: Phil Katz)

• 7:00 AM Gastric pathology: polyps, IM, and tumors (C. Marginean) .75

• 7:45 AM Does BE length matter for disease management, risks, and treatment success? Surgery, GI, and pathology perspectives (20 min each) 1.25

  • Pathology perspective (P. Chandrasoma)

  • GI perspective (N. Shaheen)

  • Surgery perspective (S. DeMeester)

• 9:00 AM Thoughts after two decades of studying BE (S. Spechler) 1.0

• 10:00 AM Coffee Break/Case Presentations

• 10:30 AM Current indications, expectations, and cost/benefit of ablation (N. Shaheen) .75

• 11:15 AM Management of BE in the UK (S. Attwood) .75

• 12:00 PM Management after ablation (F. Schnoll-Sussman) .75

• 12:45 PM Adjourn

Target Audience

This activity is designed for general surgeons and thoracic surgeons with a focus on esophageal and foregut disorders and cancer, as well as gastroenterologists with a focus on esophageal and stomach disorders.

Learning Objectives

At the completion of this activity, learners should be able to:

• Discuss complex esophageal physiologic tests.

• Explain indications for endoscopic evaluation, surveillance, and treatment of benign and premalignant esophageal conditions.

• Identify techniques to maximize effective therapy and reduce the risk of disease progression.

• Describe treatment options for other esophageal and motility disorders.

Activity Goal

This activity is designed to address the following core and team competencies:

Patient Care, Medical Knowledge, Professionalism, Employ evidence-based practice, Value & Ethics, Team & Teamwork, Interprofessional Collaboration, and Interprofessional Communication.

Non-Endorsement

The accredited provider verifies that sound education principles have been demonstrated in the development of this educational offering as evidenced by the review of its objectives, teaching plan, faculty, and activity evaluation process. The accredited provider does not endorse or support the actual opinions or material content as presented by the speaker(s) and/or sponsoring organization.

Disclosures

The accredited provider adheres to accreditation requirements regarding industry support of continuing medical education. Disclosure of the planning committee and faculty's commercial relationships will be made known at the activity. Speakers are required to openly disclose any limitations of data and/or any discussion of any off-label, experimental, or investigational uses of drugs or devices in their presentations. - All employees in control of content have no relevant financial relationships to disclose.

The following participants have No Relevant Financial Relationships to Disclose: Ross Bremner, MD, PhD; Parakrama Chandrasoma, MD; Steve DeMeester, MD; Angi Gill, RN; Lisa Leeth; Celia Marginean, MD; Jeffrey Peters, MD

Accreditation

In support of improving patient care, Cine-Med is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physicians

Cine-Med designates this live activity for a maximum of 28 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Other Healthcare Professionals

All other healthcare professionals will receive a Certificate of Participation. For information on the applicability and acceptance of Certificates of Participation for activities designated for AMA PRA Category 1 Credits™, consult your professional licensing board.

CME Certificates

To claim your CME/CE credits, complete the online Credit and Evaluation form using the following URL: https://cine-med.com/certificate.php?redirect=foregut020124. This is a one-time credit submission. Credits should be tracked at the completion of the activity. Participants will be able to download or print a certificate once the form has been submitted.

ABIM / ABS MOC Self -Assessment Credit and Certificates

For ABIM and ABS MOC credits, participants are required to complete a post activity assessment with a minimum passing score of 70%.  A URL to claim your certificate of credit will be issued after successfully passing the assessment.

American Board of Surgery (ABS) Reporting: Successful completion of this CME activity enables the learner to earn credit toward the CME requirement(s) of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit. Claimed credits will be reported to the ABS one-time, 30 days from the conclusion of this activity. Credits claimed after the 30-day window will not be reported to ABS regardless of circumstances.

Support

This activity is being supported by an educational grant from Fujifilm, Medtronic, and Regeneron

This year we are pleased to again bring together outstanding international leaders in the field of esophageal and pulmonary disease as faculty. The faculty brings broad experience in benign and malignant esophageal disease and this year includes a mixture of gastroenterologists, surgeons, and pathologists from the US and Europe 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 was started by Drs Tom DeMeester and Don Castell. Tom DeMeester was Professor of Surgery and Chairman of the Department of Surgery at the University of Southern California. He is world-renowned for his numerous contributions to the field of esophageal disease, including the development of the DeMeester score to assess esophageal acid exposure during pH testing. He remains a dynamic part of this annual course. Don Castell was Professor of Medicine and Director of Esophageal Function Laboratory at the Medical University of South Carolina, Charleston SC. He was internationally renowned for his contributions to esophageal function testing as well as diagnosis and therapy for gastroesophageal reflux disease. Sadly, Don passed away in 2021 but he will be long remembered for his detailed lectures on esophageal physiology, quick mind, and gregarious spirit while debating Tom and the other surgeons at the annual course. His legacy lives on with the spirited discussions that are a tradition at this course.

Currently, the course is co-directed by Steve DeMeester, MD and Philip Katz, MD. Steve DeMeester is a Thoracic Surgeon specializing in foregut disease and until recently was 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 Gastroenterology 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 director Jeff Peters MD, and core faculty Stu Spechler MD, Felice Schnoll-Sussman MD, and Para Chandrasoma MD remain integral to the outstanding content and discussions each year at the course. 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 in Dallas and Co-Director, Center for Esophageal Research at Baylor Scott & White Research Institute. He 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 groundbreaking 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 guest faculty, 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. Our particular focus this year will be on GERD and its relationship to pulmonary disease, esophageal diagnostics and motility disorders, eosinophilic esophagitis, paraesophageal hernias, and Barrett’s esophagus with international experts on the medical and surgical management of these conditions. In addition, this year we are excited to dive deep into the pathology of GERD and Barrett’s with expert pathologists who each offer varied perspectives and unique insights.

FEATURED ON THE MEDICINE SIDE

Nicholas J. Shaheen, MD, MPH

Dr. Nicholas J. Shaheen is the Bozymski-Heizer Distinguished Professor of Medicine at the University of North Carolina School of Medicine and Chief of the Division of Gastroenterology and Hepatology at UNC. He is the co-PI of UNC’s Clinical and Translational Science Award, and co-director of NC TraCS, the clinical research center that is the home of UNC’s CTSA. Dr. Shaheen’s research interests center on gastroesophageal reflux disease, and pre-cancerous and cancerous conditions of the esophagus, including endoscopic treatment of Barrett’s esophagus. He has authored more than 400 publications in these areas. He is the primary or secondary author on guidelines statements on Barrett’s esophagus, GERD, eosinophilic esophagitis, and the use of endoscopy. He has served as senior associate editor for the American Journal of Gastroenterology, and on multiple other editorial boards. Dr. Shaheen is currently the principal investigator on multiple NIH grants investigating aspects of esophageal disease.

C. Prakash Gyawali, MD, MRCP

Dr. Prakash Gyawali is currently a Professor of Medicine, Director of Neurogastroenterology and Motility, and Program Director of Gastroenterology Fellowship Training at the Division of Gastroenterology, Washington University School of Medicine, St. Louis, USA. Dr. Gyawali’s academic interests include esophageal motility disorders, gastroesophageal reflux disease, and functional disorders. He directs gastrointestinal motility centers affiliated with Washington University and is involved in motility testing using high-resolution manometry, esophageal ambulatory esophageal pH and impedance monitoring, wireless pH monitoring, and endoscopic functional lumen imaging probe (FLIP). He is actively involved in clinical research involving neurogastroenterology and motility and has published over 280 original articles, as well as several invited reviews and book chapters.

FEATURED ON THE SURGICAL SIDE

Ross Bremner, MD, PhD

Dr. Bremner is Professor of Surgery, and Executive Director of the Norton Thoracic Institute at the William Pilcher Chair for Thoracic Disease and Transplantation at Norton Thoracic Institute, Dignity Health St. Joseph’s Hospital and Medical Center.

Dr. Bremner received his medical degree from the University of Witwatersrand in Johannesburg, South Africa. He completed his residency in general surgery and his fellowship in cardiothoracic surgery at the University of Southern California (USC). He inherited a deep interest in esophageal disease from his father, Cedric, and spent many years under the mentorship of Tom DeMeester while at USC. He holds professorships with Creighton Medical School - Phoenix Regional Campus and the University of Arizona College of Medicine, Phoenix. Dr. Bremner’s research interests include lung and esophageal cancer, benign esophageal diseases, chronic rejection in lung transplantation, and he leads a number of initiatives in physician well-being. He enjoys spending time with his wife and two daughters and can sometimes be found hiking and biking in the mountains of Phoenix. He is a member of the International Society of Heart/Lung Transplantation (ISHLT), the Western Thoracic Surgical Association (WTSA), the General Thoracic Surgical Club (GTSC), the Society of Thoracic Surgeons (STS), and the American Association for Thoracic Surgery (AATS).

Stephen Attwood, MD, FRCSI

Dr. Attwood is honorary professor in health services research at Durham University, UK, and an independent consulting advisor on research and clinical practice for oesophageal diseases. Most recently, he was a consultant surgeon at Northumbria Healthcare in Northumberland, UK.

Since identifying Eosinophilic Oesophagitis (EoE) in 1989 and publishing the first description of the disease in 1992, Professor Attwood has spent his career caring for patients with EoE. He has been actively engaged in clinical trials of upper gastrointestinal diseases, including budesonide formulations for EoE; the ASPECT trial of cancer prevention in Barrett’s esophagus; BEST3, a study of Cytosponge screening for Barrett’s esophagus in general practices; Endobarrier, a UK study of endoscopic anti-obesity therapy; the LOTUS trial (surgery vs proton pump inhibitor for reflux therapy); and EndoStim, an electrical neuromodulator of the lower oesophageal sphincter for the treatment of gastroesophageal reflux disease. Recently retired from NHS clinical practice which provided minimally invasive treatment for upper gastrointestinal disorders, including endoscopy and laparoscopic surgery. The author of 200 publications, including many papers and guidelines on EoE and GORD, he is the senior author of the British Society of Gastroenterology Guideline on Therapeutic Dilatation of the Oesophagus and the European Guidelines on Eosinophilic Oesophagitis, and co-author on the BSG Guidelines on EoE.

Daniela Molena, MD

Dr. Daniela Molena is Director of the Esophageal Surgery Program and Professor, Cardiothoracic Surgery at Weill Cornell Medical College, and Associate Attending, Thoracic Service at Memorial Sloan Kettering Cancer Center in New York, NY.

Dr. Daniela Molena is a graduate of the University of Padova Medical School in Italy. She completed residencies in general surgery both at the University of Padova and at the University of Rochester Medical Center in Rochester, NY. She completed a gastrointestinal research fellowship at the University of California in San Francisco and cardiothoracic clinical fellowship at Memorial Sloan Kettering Cancer Center (MSKCC) and Weill Cornell Medical College. She served as Chief of Thoracic Surgery at John Hopkins Bayview Medical Center and was recruited back to Memorial Sloan Kettering Cancer Center in 2015 to serve as the Director of the Esophageal Program within the Thoracic Surgery Division.

Her research focuses on identifying and measuring quality indicators to improve clinical and functional outcomes after surgery, designing clinical pathways to decrease costs and improve results, and identifying racial and socioeconomic disparities that limit access to excellent care. She is also interested in developing and studying new technologies and imaging-guided approaches to direct surgical resection to be more precise, effective, and less invasive.

Dr. Molena has authored over 100 manuscripts and several book chapters. She is Deputy Editor of Annals of Thoracic Surgery, Editor of Diseases of the Esophagus, and on the Editorial Board of Annals of Surgery, Journal of Thoracic and Cardiovascular Surgery, and others. She is a Fellow of the American College of Surgeons, a member of the American Surgical Association, the Society of Thoracic Surgeons, the Society of American Gastrointestinal and Endoscopic Surgeons, the Society for Surgeons of the Alimentary Tract, the American Association for Thoracic Surgery, and International Society for the Diseases of the Esophagus. She holds leadership positions in several of these surgical societies and she is Vice President of the Society Women in Thoracic Surgery.

Featured Faculty in Pathology for 2024

Celia Marginean, MD

Dr. Marginean is Professor of Pathology and Director of GI/Liver fellowship at Baylor College of Medicine in Houston, Texas.

Dr. Marginean completed Anatomic and Clinical Pathology residency training at St. Barnabas Medical Center, Livingston, NJ. Following her residency, she completed fellowships in GI/liver pathology at Yale University, CT and in cytopathology at MD Anderson Cancer Center, Houston, TX. She then joined the faculty at Ottawa Hospital, Ottawa, Canada for 14 years and rose to the rank of Professor of Pathology at Ottawa University. While in Ottawa, she had numerous local, provincial, and national leadership roles:  Head of the GI Pathology Section and Deputy Head of the Cytopathology Section at Ottawa Hospital; President of the Ontario Association of Pathologists, Director of Undergraduate Pathology Education at Ottawa University Medical School.   

She joined Providence Medical Center, Portland, OR in 2019 and then moved to Baylor St Luke’s Hospital, Houston, TX in Oct 2021. Currently, she is a Professor of Pathology at Baylor College of Medicine and Director of ACGME-accredited GI/liver pathology fellowship.

The majority of her research projects are related to biomarkers in GI cancers, and she publishes her findings in high-impact peer-reviewed journals and is an invited speaker at numerous local, national, and international meetings.

Robert Odze, MD

Dr. Odze is Professor of Pathology at Tufts University and president of Robert Odze Pathology LLC.

Dr. Odze was born and raised in Montreal, Quebec, Canada. He completed a DEC degree in Physics from Vanier University in 1977, and then a Bachelor’s Degree in Microbiology and Immunology, with honors, in 1980, from McGill University, Montreal Canada. He then attended medical school at McGill University, Montreal, followed by three years of surgical pathology training at McGill University and a GI pathology fellowship program at Harvard Medical School (New England Deaconess and Beth Israel Hospitals), in Boston.

Dr. Odze began his tenure as a faculty Pathologist at Brigham and Women’s Hospital in 1993 and became Director of the division of GI Pathology in 1997. In 2007, Dr. Odze became a full Professor of Pathology at Harvard Medical School. He currently is a consultant faculty pathologist, and Professor of pathology, at Tufts University Medical School and medical center, and president of Dr. Robert Odze Pathology LLC.

Dr. Odze's research has focused on the pathology, etiology, molecular pathogenesis, and natural history of preneoplastic disorders of the GI tract, particularly Barrett’s Esophagus and Inflammatory Bowel diseases (IBD). Dr. Odze has published over 500 peer-reviewed original research articles, reviews, editorials, and book chapters, and has edited and /or authored 6 textbooks in pathology. He currently serves as the senior editor of "Surgical Pathology of the GI Tract, Liver, Biliary Tract and Pancreas". He has served as an executive committee member and as President, of the United States and Canadian Academy of Pathology GI Pathology Society.