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The FSIE POEM course remains a popular destination for physicians to learn the skills of submucosal endosurgery. This week the team hosted a new crop of surgeons and gastroenterologists to a 2 day course including an intensive hands on skills lab and observation of live cases. Participants were able to complete multiple POEM procedures throughout the day in the lab and relax with a fabulous course dinner at Portland's Noble Rot restaurant. Cases began bright and early the following morning where they observed the endoscopic removal of a large submucosal esophageal mass and two endoscopic myotomies for achalasia.
Thank you to our industry sponsors who always make sure participants have access to trial all the latest and greatest endosurgery tools and technology with a collaborative attitude.    Great time had by all at the 7th Annual FSIE Summer Celebration at Ecotrust in downtown Portland! The Innovations team and friends happily cleaned up and exchanged their daily scrubs for an elegant night on the town. Money was raised for programs such as the FSIE Summer Internships, research scholarships and educational travel awards. Thank you to all who made the party such a success and to everyone who contributes to the mission of FSIE to inspire, innovate and educate! See you next summer!  The students ended the academic portion of the FSIE Summer Internship program with a special hands on didactic in the lab. The team headed out to the off-site FSIE partner lab facility for an outstanding session on electrosurgery. We started off with an introductory didactic where they got to hear how all their physics classes do actually pay off in real surgical applications (V=IR, Ohm's law anyone?). Then they performed flexible endoscopic surgery on live and explant human simulation models. The day concluded with an absolutely mind blowing and inspiring lecture about the future of medicine by Dr Lee Swanstrom (TED talks ain't got nothin' on our FSIE President!). A huge thanks goes to John Day and ERBE for supporting this lab! It was a perfect way to end the summer student program!  Congratulations to the FSIE Undergraduate Summer Surgical Interns! This year the formal 6 week program received a record number of applicants from around the country. The committee made final selections in the fall and the lucky winners are (top left clockwise in photo): Anthony Jones Cal State East Bay Hannah Creasey Lewis and Clark Naly Setthavongsack Portland State University Natalie Bolton Creighton University Roshini Mudunuru Purdue University It has been a pleasure getting to know this group of bright and motivated students as they head into the last few weeks of the program. The interns have been busy! In addition to ample hands on labs in the PSSI, operating room experiences and clinical shadowing they have been productive researchers working on a variety of projects. They also learned about sterile technique, anesthesia and robotic surgery from our Providence Portland Medical Center Operating Room partners and have had weekly lectures from expert surgeons in the fields of foregut, colorectal, endocrine, hernia, thoracic and hepatobiliary surgery. We look forward to the upcoming hands-on electrosurgery laboratory and “Future of Surgery” lecture by Founder and President Dr Lee Swanstrom followed that night by the certificate ceremony at the 7th Annual FSIE Summer Celebration! Thanks to Co-Direcor Walaa Abdelmoaty, SIM lab coordinator Rosen Ilchev, student coordinator Matt Glasgow, administrator Lisa Leeth and the entire Innovations Team for making this internship program such a success!   Digestive diseases week (DDW) was held in Washington, DC over the past several days. FSIE had a strong showing! Special congratulations goes to Dr Ahmed Zihni for presenting "Laparoscopic Heller Myotomy VS POEM: Evolving Criteria for Treatment Selection" which took a critical look at not only the clinical outcomes of the two procedures but also the role insurance plays in the once doctor-patient decision for treatment. The work was also given the prestigious honor of being highlighted in the "Best of DDW" all society session. Great job team! Some other FSIE DDW highlights include:
  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:
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