 Congratulations to Portland Surgical President (and FSIE innovations team member) Dr. Valerie Halpin and the committee for creating another outstanding program for the annual Portland Surgical Scientific Session held at Good Samaritan Hospital. This year marks the first time in history that all four society executives were women surgeons since the society's inception in 1948. While appreciating this nod toward gender equality, we were reminded that as a surgical community, we may still have work to do. Dr Heather Hoops and colleagues from OHSU presented their findings demonstrating gender-based differences in surgical resident training. Their study showed that mid-level male trainees were given more autonomy than their female counterparts despite similar objective technical aptitude. This difference disappeared by their chief years. This timely and thought provoking work lead to a discussion of potential etiologies. Are gender-based "differences" necessarily discriminatory on the part of the instructors? Or perhaps they reveal gender-based differences in learning styles and/or perceptions of confidence (possibly over confidence) that impact the instructors willingness to let go of the reigns. This type of work and discussion signifies an inspiring willingness to investigate important issues citywide among Portland surgeons. During the conference, the society also tackled quality and performance improvement issues in a lecture by invited guest professor Dr Vance Sohn. His lecture was flanked by a multitude of scientific presentations highlighting the important work done by surgical investigators throughout the city. Here are the FSIE highlights:
  The Annual Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) meeting in Seattle was a resounding success. Congratulations to the multiple FSIE Team members who presented their work! The meeting was held at the Seattle Convention Center with the end of the week celebration at the Museum of Flight. But the highlight was certainly getting together for the Annual Swanstrom/FSIE reunion! Great to see everyone!
 2017 summer intern Matthew Glasgow presented his work on esophageal pH-impedance testing at the Annual Mount David Summit: A celebration of student achievement at Bates College today. Along with his co-authors, including lead author Marc Ward, Matt plans on publishing the full study this year in a peer-reviewed journal. Matt was recently awarded a competitive Summer Research Fellowship grant from Bates college with plans to return to FSIE in June where he will continue his work in clinical esophageal physiology as well as serve as Assistant Program Coordinator for the 2018 summer students. We are excited to have him back with the team! Congratulations Matt!
 Congrats to the fellows for their upcoming DDW presentations June 4th:
Dr Ahmed Zhini SSAT Plenary Session Laparoscopic Heller Myotomy VS POEM: Evolving Criteria for Treatment Selection Dr Walaa Abdelmoaty SSAT Poster presentation Laparoscopic Transhiatal Esophagectomy for Invasive Adenocarcinoma More updates to follow- see you in DC!  Members of the FSIE team enjoyed a week of intensive CME in Maui attending the 33rd annual Hawaii esophageal course (Medical and Surgical Aspects of Esophageal and Foregut Disorders: Pathophysiology and Treatment). Class began every morning before sunrise at 6 am lasting until 12:45. The course featured renowned speakers from around the world and the latest technology. Afternoons were free to explore the island or network by the pool.
 photo art by Ron Fleishman FSIE ACTIVITIES SO FAR: watch for details about the Sing off/ Portland Endofreaks and the Annual FSIE/Swanstrom Fellow Reunion! Great job everyone! Wednesday April 11 ROBOTIC-ASSISTED VERSUS LAPAROSCOPIC UNILATERAL INGUINAL HERNIA REPAIR: A COMPREHENSIVE COST ANALYSIS Research Podium Presentation by Walaa Abdelmoaty Co-authors: Neighorn C, Dunst CM, Swanstrom LL, Hammill CW Session Name: Hernia Session Session Date & Time: Wednesday, April 11, 2018, 7:30 AM - 9:00 AM HELP! I CANNOT CLOSE THE HIATUS Video Podium Presentation by Walaa Abdelmoaty Co-Authors: Dunst CM, Zihni AM, Filicori F, Davila Bradley D, Reavis KM, Swanstrom LL, DeMeester SR. Session Name: Foregut Videos Session Session Date & Time: Wednesday, April 11, 2018, 3:00 PM - 5:00 PM Thursday April 12 ESOPHAGEAL DIVERTICULUM AFTER INCOMPLETE POEM Video Podium Presentation by Filippo Filicori Co-authors: Dunst CM, Zihni AM, Abdelmoaty WF, Demeester SR, Swanstrom LL Session Name: Foregut session Session Date & Time: Thursday, April 12, 2018, 7:30 AM - 9:00 AM Long Term Outcomes After POEM for Achalasia- Is it still experimental? Invited Lecture: Christy M Dunst Session Name: POEM Coming of Age: What Have We Learned and What Are We Still Learning? Session Date & Time: 10-11am Thursday April 12 Endoscopic Alternatives to Fundoplication Case Presentation Kevin Reavis Session Name: Endoscopic Alternatives to Fundoplication Session Date & Time: April 12 11:00-12:00pm Getting and Keeping Referral Patterns Invited Lecture: Valerie Halpin Session Name: Shining in Your Practice Right from the Start- Tools for Success Session Date & Time: April 12 1:30-4:30pm LONG TERM OUTCOMES FOLLOWING POEM FOR NON-ACHALASIA MOTILITY DISORDERS OF THE ESOPHAGUS. Research Podium Presentation by Filippo Filicori Co-authors: Dunst CM, Sharata A, Abdelmoaty WF, Zihni AM, Demeester SR, Swanstrom LL Session Name: Flexible endoscopy session Session Date & Time: Thursday, April 12, 2018, 1:30 PM - 3:00 PM Real-time Diagnosis of Barrett’s Esophagus: A Prospective, Multicenter Trial Comparing Confocal Laser Endomicroscopy with Conventional Histology for the Identification of Intestinal Metaplasia in Novice Users Research Podium presentation by Cory Richardson Co-Authors: Colavita P, Severson P, Dunst CM. Session Name: Flexible endoscopy session Session Date & Time: Thursday, April 12, 2018, 1:30 PM - 3:00 PM Management of gastroparesis-Medications/Endoscope/Laparoscope? Invited Lecture: Christy M Dunst Session Name: MIS Approaches to Complications of Esophagogastric Surgery Session Date & Time: April 12 1:30-3:00 pm LAPAROSCOPIC TRANSGASTRIC SUBMUCOSAL DISSECTION Video Podium Presentation by Walaa Abdelmoaty Co-Authors: Dunst CM, Filicori F, Zihni AM, Davila Bradley D, Reavis KM, DeMeester SR, Swanstrom LL Session Name: Thursday Exhibit Hall Theater Session Date & Time: Thursday, April 12, 2018, 1:30 PM - 4:00 PM PARAESOPHAGEAL HERNIA ASSOCIATED WITH POSTERIOR SLIPPAGE OF GASTRIC BAND Video presented by William Reid Shepard Co-authors: Emily Speer, Valerie Halpin, Christy M Dunst, Lee L Swanstrom, Kevin M Reavis Session Name: Thursday Exhibit Hall Theater (Non CME) Session date and time: Thursday, April 12, 2018, 1:30 PM - 4:00 PM Friday April 13 Why Diversity Matters Invited Lecture: Lee Swanstrom Session Name: We R SAGES-Celebrating Diveristy Session Date & Time: Friday April 13 10-12 Laparoscopic Fundoplication: Technical Lessons Learned from 5000 operations Invited Lecture: Lee Swanstrom Session Name: MASTERS Foregut Session: Mastering GERD-Christy Dunst Chair, Steven P Bowers and Gerald Fried Co-chairs Session Date & Time: April 13 3:00-5:00 pm Esophageal Adenocarcinoma: Does ARS have an Impact? Invited Lecture: Steve DeMeester Session Name: MASTERS Foregut Session: Mastering GERD-Christy Dunst Chair, Steven P Bowers and Gerald Fried Co-chairs Session Date & Time: April 13 3:00-5:00 pm Minimally Invasive Pancreatic Resection: Present and Future Case Presentation Moderator Pippa Newell Session Name: Minimally Invasive Pancreatic Resection: Present and Future Session Date & Time: Friday April 13 3:30-5:30 Saturday April 14 Percutaneous Image Guided Treatments- The New MIS Chair Eran Shlomovitz & Co-chair Lee Swanstrom Session Date and Time: Saturday April 14 9:30-11:00 Percutaneous Intervention: Hybrid OR Why Do We Need It? Invited Lecture: Lee Swanstrom Session Name: Percutaneous Image Guided Treatments- The New MIS Session Date and Time: Saturday April 14 9:30-11:00 When Bad Things Happen to Good People: Endoscopy-Being FLEXible Chair Jeffrey M Marks Co-Chair Kevin Reavis Session Date and Time: Saturday April 14 9:30-11:00am The Symptomatic Patient After Antireflux Surgery: Causes, Work-Up and Management Strategies Chair Anne Lidor Co-chair Steve DeMeester Session Date and Time: Saturday April 14 12:30-1:30 RESEARCH POSTER PRESENTATIONS: LAPAROSCOPIC REPAIR OF RECURRENT PARAESOPHAGEAL HERNIA IS SAFE AND EFFECTIVE Zihni AM, Dunst CM, Abdelmoaty WF, Filicori F, Ilchev R, Davila-Bradley D, Reavis KM, Swanstrom LL SUBJECTIVE AND OBJECTIVE EVALUATION OF HIATAL CLOSURE TENSION DURING PARA-ESOPHAGEAL HERNIA REPAIR Abdelmoaty WF, Dunst CM, Sharata AM, Fisher M, Zihni AM, Filicori F, Davila Bradley D, Reavis KM, Swanstrom LL, DeMeester SR PATIENT CHARACTERISTICS ASSOCIATED WITH SUCCESSFUL CESSATION OF TUBE FEEDS IN MALNOURISHED PATIENTS WITH GASTROPARESIS Filicori F, Dunst CM, Zihni AM, Abdelmoaty WF, Davila-Bradley D, Halpin V, Demeester SR, Swanstrom LL TEN-YEAR OUTCOMES OF PYLOROPLASTY IN ADULT GASTROPARESIS Abdelmoaty WF, Dunst CM, Zihni AM, Filicori F, Davila Bradley D, Reavis KM, DeMeester SR, Swanstrom LL USE OF FULLY BIORESORBABLE POLY-4-HYDROXYBUTYRATE MESH FOR REINFORCEMENT OF CRURAL CLOSURE DURING PARA-ESOPHAGEAL HERNIA REPAIR Abdelmoaty WF, Dunst CM, Filicori F, Zihni AM, Davila Bradley D, Reavis KM, Swanstrom LL, DeMeester SR TECHNIQUE FOR LAPAROSCOPIC JEJUNOJEJUNOSTOMY Zihni AM, Filicori F, Abdelmoaty WF, Reavis KM COMBINED ENDOSCOPIC AND LAPAROSCOPIC RECONSTRUCTION OPTIMIZES OPERATIVE EFFICACY, EFFICIENCY, AND SAFETY Zihni AM, Abdelmoaty WF, Filicori F, Schneider A, Wolf R, Reavis KM The first POEM course of 2018 was extra special as the live operations portion was held in the newly integrated conference room of the Providence Surgical Simulation Institute (PSSI). For months, the PSSI has been diligently working on installing the highest technology transmission system for live case projection into the comfort of the center. The new state of the art imaging system with crystal clear live video and audio was great- no delays, no glitches! Participants could physically go to the operating room for live important demonstrations but also spread out comfortably in the conference room with live surgeon audio and extra large high definition monitors showing room view, endoscopic view and endoflip views simultaneously for a comprehensive experience. As an added bonus, between cases, participants enjoyed taking advantage of dry lab activities in the lab such as the overstitch practice station and the ENDOFLIP demonstrations. Great job PSSI! We look forward to many more!
 Innovations team members just returned from a fantastic experience at the annual American College of Surgeons Clinical Congress in sunny San Diego where they networked and caught up on all the latest and greatest in the world of endocrine, hepatobiliary, colorectal and foregut surgery. Some highlights include:
 Beloved Innovations Team member Dr Roy Breen has retired from clinical practice after >30 years (7 years with FSIE)
Roy Eugene Breen, III, MD was born in Bethesda Navy Hospital in Maryland to Captain Roy Eugene Breen, II and Winifred Breen, the only son with five sisters. Since his father was a navy man, he moved every two years and attended three high schools. He was a lifeguard in high school and college. He was a dedicated surgical trainee known for going the extra mile literally. Rumor has it that he once walked 6 miles from Nonna Emilia’s Restaurant in Aloha to St. Vincent hospital, spent the night at the hospital only to walk 5 miles through the hills of Portland to Good Samaritan Hospital the next day. Those were the days! After completing his surgical residency at OHSU in 1985, Roy stayed in Portland Oregon as he transitioned from general surgeon to colorectal specialist while in private practice. He joined The Oregon Clinic in 2008 and retires as one of the city's best known and loved colorectal surgeons. Dr. Breen would always keep his patients “entertained” by talking to them about movies, books, actors, places he visited, countries, cities, restaurants, family, etc., etc., while performing their hemorrhoid treatments and exams. Many of Dr. Breen’s patients enjoyed the picture of the ponies hanging on the wall and always got to hear the famous story of the Chincoteague Pony Run, the story of his wife’s grandfather taking that picture and its history. One of the most endearing qualities about Roy is his sense of humor. While colorectal surgeons are generally known for being pretty funny, Roy’s ability to make patients laugh despite the often awkwardness of their predicament is appreciated and will definitely be missed. For example, Roy would commonly suggest that the patient get comfortable and “just lay on your left side so you can fall asleep” as if that were really possible. Once in position, Roy would carefully inspect their hemorrhoids and if the patient had been there before, he would excitedly exclaim “Oh, now I remember you!”. Occasionally, the use of cautery was necessary which would produce a distinct burning smell. Once a patient commented that it smelled like something was burning and Dr. Breen replied, “burnt rump roast”. Ba da da. Despite being called “Dr. Bean”, “Dr. Brem” and “Dr. Green”, Roy’s patients loved him dearly. One even asked to “send the FBI” to find him one day when he was out. His partners too will miss his energy, many techniques, knowledge and wisdom on the daily! But they will always be reminded of him whenever they ask for “Roy’s special bug juice” or use the famous “Breen-O-Scope” (a special unlighted anoscope) that lives on. Congratulations on a fabulous career, Roy! We wish you a long and relaxing retirement with Nancy, the kids and the grandkids! You deserve it! Even though it is August, we can’t help but say “Happy New Rear!”   The phrase "best yet!" was heard several times last night by party goers at the 6th Annual FSIE Summer Celebration Fundraiser held at Ecotrust Rooftop in downtown Portland. The guests enjoyed delicious food from local, organic and sustainable catering by Artemis as well as wine from our Innovation Team owned vineyards Z'IVO and WAHLE Vineyards and Cellars. The party is a wonderful way to celebrate the collaboration of FSIE with industry and private supporters and friends. The silent auction and raffle were the hit of the night thanks to generous personal donations from the Swanstrom, Dunst, DeMeester, Wolf, and O'Brien families as well as an exceptional gift of 2 opportunities to participate in educational courses at the famous IRCAD (Strasbourg University, France) donated by IRCAD President Jacques Marescaux. It was an extra special night as we celebrated the graduation of the students who participated in our Summer Undergraduate Surgical Internship Program, said good bye to departing fellows and welcomed in the new. We thank all our guests and donors for helping FSIE continue its mission of promoting quality in research and education in the field of minimally invasive surgery.  The highly competitive FSIE Summer Surgical Internship program has grown substantially over the past several years attracting pre-medical students from across the country. Our aim is to provide aspiring young doctors exposure to a wide range of experiences in GI surgical practice including foregut, colorectal and hepatobiliary surgery and clinical research. We are thrilled to have 7 fantastic new interns (from left to right in photo): Huy Doan from Portland State University in Portland, Max Fisher from Washington University in St Louis, Rosen Illchev from Longwood University in Virginia, Matt Glasgow from Bates College in Maine, Simran Handa from Lewis and Clark College in Portland, Malcolm Asher from Cleaveland High School in Portland, and Matalynn Shealy from Berea College in Kentucky). The interns are already highly productive actively participating in research projects and learning surgical skills in the hands-on lab. The curriculum includes ample clinic shadowing and operating room observation as well as weekly lectures about surgical anatomy and physiology from the Innovations Team Surgeons. Next week begins their esophageal diagnostic and physiologic testing session where they will learn about high resolution manometry, pH testing, endoscopic optical biopsy and more! President elect and FSIE member Dr. Valerie Halpin and the committee created a great program for the annual Portland Surgical Scientific Session at Good Samaritan Hospital. FSIE had a great time attending and contributing! Here are the FSIE highlights:
PORTLAND SURGICAL SOCIETY: A Portland Institution Since 1948 The Portland Surgical Society is the only professional organization of its type in the Portland area. The society is an important educational forum for surgeons as well as a showcase for the achievements of many of our trainees. Perhaps most importantly, it provides a wonderful opportunity to renew the camaraderie and unique sense of fellowship that unites us within our community of surgeons. The FSIE crew gathered at Breakside Brewery in NW Portland on May 23 to celebrate Dr Ahmed Sharata who is leaving Oregon to start his US surgical internship at Maricopa Medical Center in Phoenix Arizona. Dr Sharata grew up on an olive farm in Libya with a large but close knit family. After completing medical school and surgical training in Tripoli he came to the US in 2010 with the intention of gaining additional surgical education and experience to bring back to his homeland through a grant sponsored by the Libyan embassy. However, this plan was quickly derailed as the Libyan war commenced at home. With his funding cut off and his medical school closed so he could not access his credentials, Dr Sharata joined FSIE as a post-graduate research intern in 2011. He quickly became an integral member of the Innovations Team working tirelessly on numerous projects and running the lab. Dr Sharata has become one of the world's leading experts in per-oral endoscopic myotomy (POEM) surgery for achalasia and non-achalasia. He has published more than 2 dozen peer reviewed publications and produced countless surgical videos during his time here. Perhaps the most impressive accomplishment has been his multiple local and national podium presentations in English! Dr Sharata is a kind and loyal friend and co-worker always willing to go the extra mile to help out. His generosity and dedication will be missed tremendously at FSIE! We wish him the best as he starts this new chapter in his journey! Thank you for everything Dr Ahmed! You deserve it!
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