Table of Contents                                                                                                         ...
General Information                                                                           Illustrate­the­principles­o...
General Information Review­the­current­evaluation,­treatment­and­follow­up                                   Accreditatio...
General Information                                                                 CLICK H                               ...
Saturday, April 27                    Transanal Endoscopic Surgery Workshop                                               ...
Saturday, April 27                     Transanal Endoscopic Surgery Workshop (Continued)                                  ...
Saturday, April 27                    Transanal Endoscopic Surgery Workshop (Continued)                                   ...
Saturday, April 27             Anorectal Ultrasound and Physiology Workshop                                               ...
Saturday, April 27               Anorectal Ultrasound and Physiology Workshop (Continued)              Anorectal Ultrasoun...
Saturday, April 27          Advanced Laparoscopic Symposium and Workshop:                        Pearls from the Pro’s    ...
Saturday, April 27             Advanced Laparoscopic Symposium and Workshop (Continued)10:45­am SILS: When, How?          ...
Saturday, April 27Luncheon Symposium                                “Surgeon as a Leader” –                          Profe...
Saturday, April 27Symposium                  Treatment of Common Anorectal Disorders                                      ...
Saturday, April 27                  Treatment of Common Anorectal Disorders (Continued)1:15­pm   Current Treatment of Hemo...
Saturday, April 27Symposium                  How to Get Paid: Colon and Rectal Surgery                         Coding and ...
Saturday, April 27EBRS Symposium            Time to Change the Treatment of Rectal Cancer:                             Rol...
Saturday, April 27Symposium              AIN and HRA: What a Surgeon Needs to Know                                        ...
Saturday, April 27Symposium                            Advanced Endoscopic Techniques                                     ...
Saturday, April 27                           Advanced Endoscopic Techniques (Continued)5:00­pm   Enhanced Visualization: L...
Sunday, April 28                                                                                                          ...
Sunday, April 28Symposium                                                                                              Par...
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting
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2013 American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting

  1. 1. Table of Contents CLICK H Reg ist O ERE T er Onlin e General Information Monday Program (continued)­ ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­. 3-5 Presidential­Address ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.42 Abstract Session Neoplasia­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.43 Symposium Update­on­the­Treatment­of­Inflammatory­ Bowel­Disease ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.44 Saturday Program­ Research­Forum­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.45Transanal­Endoscopic­Surgery­Workshop ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.6-8 Parviz­Kamangar­Humanities­in­Surgery­Lectureship­.­.­.­.­.­.­.­.­.­.­.­.46Anorectal­Ultrasound­and­Physiology­Workshop ­.­.­.­.­.­.­.­.­.­.­.­.­.­.9-10 Masters­in­Colorectal­Surgery­Lectureship­Honoring­ Victor­W.­Fazio,­MD­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.46Advanced­Laparoscopic­Symposium­and­Workshop:­Pearls­from­the­Pro’s ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.11-12 Abstract Session Rectal­Cancer ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.47Luncheon Symposium “Surgeon­as­a­Leader”­–­ Symposium 2013­Ten­Minute­Updates:­What­You­Really­Professionalism­and­Communication ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.13 Need­to­Know ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.48Symposium Treatment­of­Common­Anorectal­Disorders­.­.­.­.­.­.14-15 General­Surgery­Forum ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.49Symposium How­to­Get­Paid:­Colon­and­Rectal­Surgery­ Abstract Session Inflammatory­Bowel­Disease ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.50Coding­and­Reimbursement ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.16 Symposium Treatment­of­Fecal­Incontinence­and­EBRS Symposium Time­to­Change­the­Treatment­of­Rectal­Cancer: Obstructed­Defecation ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.51-52Role­of­MRI ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.17 Residents’­Reception ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.52Symposium AIN­and­HRA:­What­a­Surgeon­Needs­to­Know ­.­.­.­.­.­.18Symposium Advanced­Endoscopic­Techniques ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.19-20 Tuesday Program ­ Sunday Program Tuesday­Meet­the­Professor­Breakfasts ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.53­ Memorial­Lectureship­Honoring­James­F.­Guthrie,­MD ­.­.­.­.­.­.­.­.­.­.53Core­Subject­Update ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.21 Abstract Session Anorectal­and­Colonoscopy ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.54Symposium The­Surgeon’s­Toolbox:­Using­Staplers­and­ Symposium Improving­Colon­and­Rectal­Outcomes­in­2013 ­.­.­.­.­.55Energy­Wisely­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.22-23 Abstract Session Pelvic­Floor­and­Complex­Fistula ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.56AIN­and­HRA:­What­the­Colorectal­Surgeon­Needs­to­ ASCRS/SAGES Symposium What­are­the­Outcomes­of­Know­Hands-on­Workshop ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.24 Minimally­Invasive­Surgery? ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.57Advanced­Endoscopy­Hands-on­Workshop ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.25 Ernestine­Hambrick,­MD,­Lectureship ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.58Symposium Practical­Solutions­to­Improve­Your­Colon­ Norman­D.­Nigro,­MD,­Research­Lectureship ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.58and­Rectal­Surgery­Practice ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.26-27 Abstract Session Rectal­Cancer­II ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.59Laparoscopic­Nuts­and­Bolts­and­Robotic­Rivets ­.­.­.­.­.­.­.­.­.­.­.­.­.28-29 Symposium Anastomotic­Techniques­and­Leaks­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.60Lunch Symposium Stomas­and­their­Complications ­.­.­.­.­.­.­.­.­.­.30-31 Symposium Nightmare­at­the­Movies:­The­Remake ­.­.­.­.­.­.­.­.­.­.61-62Lunch Symposium Evaluation­and­Management­of­Inherited ASCRS­Annual­Reception­and­Dinner­Dance ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.62Colorectal­Cancer ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.32Welcome­and­Opening­Announcements ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.33Abstract Session Outcomes­I ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.34Symposium How­to­Treat­Rectal­Cancer­in­2013­.­.­.­.­.­.­.­.­.­.­.­.­.­.35-36 Wednesday Program ­Harry­E.­Bacon,­MD,­Lectureship ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.36 Wednesday­Meet­the­Professor­Breakfasts ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.63Symposium Healthcare­Economics­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.37-38 Symposium Worst­Cases:­A­Global­Perspective ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.64Welcome­Reception­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.38 Abstract Session Videos ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.65Abstract Session Outcomes­II ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.39 Symposium Challenges­in­Wound­Healing­and­Hernias ­.­.­.­.­.­.66-67 ASCRS­Annual­Business­Meeting­and­State­of­the­ Society­Address ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.67 Monday Program­ Poster­Presentations ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.68Monday­Meet­the­Professor­Breakfasts ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.40 Featured­Lecturers­and­Faculty ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.85Residents’­Breakfast ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.40Symposium Multidisciplinary­Approach­to­Colon­and­Rectal­Cancer ­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.­.41-42 2 Return to Table of Contents
  2. 2. General Information  Illustrate­the­principles­of­rectal­cancer­surgery­and techniques­required­for­optimum­oncologic­outcome. Discuss­such­techniques­as­TME,­APR,­laparoscopic­and robotic­surgery­and­well­as­use­of­other­multimodality treatment­options.  Review­the­current­status­of­rectal­cancer­treatment principles­including­the­evaluation­process,­surgicalStephen Sentovich, MD Jennifer Beaty, MD R. Scott Nelson, DO technique­and­lymph­node­harvest,­oncologic­treatment, Program­Chair Program­Vice-Chair Program­Vice-Chair and­current­recommendations­for­the­treatment­of metastatic­disease.Video Message from Dr. Sentovich  Discuss­important­aspects­of­developing­perioperative strategies­to­improve­surgical­outcomes­including­an Overview and Objectives enhanced­recovery­program,­pain­control,­as­well­as understanding­the­maintenance­of­certificationThis­scientific­program­is­designed­to­provide­surgeons requirements­and­process.with­in-depth­and­up-to-date­knowledge­relative­tosurgery­for­diseases­of­the­colon,­rectum­and­anus­with  Discuss­changes­in­healthcare­economics,­and­structureemphasis­on­patient­care,­teaching­and­research. including­ACO’s,­pay­for­performance,­meaningful­usePresentation­formats­include­podium­presentations and­bundled­payments.­Describe­impacts­of­thesefollowed­by­audience­questions­and­critiques,­panel changes­on­reimbursement,­and­practice­type.discussions,­poster­presentations,­video­presentations­and  Review­the­management­strategies­of­complicatedsymposia­focusing­on­specific­state-of-the-art­diagnostic clinical­scenarios­in­IBD,­and­functional­disorders­withand­treatment­modalities.­The­purpose­of­all­sessions­is­to perspectives­from­surgeons­around­the­globe.improve­the­quality­of­care­of­patients­with­diseases­of­the  Describe­the­treatment­options­for­fecal­incontinence,colon­and­rectum.­At­the­conclusion­of­this­meeting, and­obstructed­defecation.­Discuss­the­technique­ofparticipants­should­be­able­to: sacral­nerve­stimulation,­injectables,­and Review­the­indications­and­techniques­for­TEM­including sphincteroplasty,­as­well­as­the­role­of­surgery­for patient­preparation­and­positioning,­equipment­set-up obstructed­defecation. and­postoperative­management­of­complications.  Review­the­different­techniques­of­anastomotic­creation, Review­the­technical­aspects­of­laparoscopic­colectomy with­either­hand-sewn,­stapled­or­compression with­an­emphasis­on­retroperitoneal­anatomy,­step-by- techniques­and­the­role­of­temporary­fecal­diversion. step­demonstration­on­how­to­perform­the­procedure Discuss­the­biology­of­anastomotic­healing,­and­current safely,­and­techniques­for­single-site­laparoscopic­colon management­of­anastomotic­leak,­stenosis,­or resection. hemorrhage. Understand­the­role­of­advanced­endoscopic­procedures  Discuss­the­current­surgical­and­medical­management­of including­extended­submucosal­resection,­laparoscopic- inflammatory­bowel­disease­including­the­timing­and assisted­colonoscopic­polypectomy,­colonic­stent­and role­of­biologics­or­surgery.­Review­surgical clip­placement,­new­methods­of­sedation,­and complications­including­pouchitits,­fistula,­stenosis,­and reimbursement. poor­function. Discuss­the­role­of­the­surgeon­as­the­leader­with  Describe­the­evaluation­and­treatment­options­for­rectal emphasis­on­communication,­professionalism,­and prolapse,­intussusception,­and­solitary­rectal­ulcer. overcoming­dysfunctional­momentum.­Learn­how­to Understand­the­management­of­benign­and­malignant lead­changes­in­your­health­care­environment,­and­in anal­and­retrorectal­tumors. other­venues­such­as­professional­societies.  Understand­the­tools­utilized­to­measure­quality­and Review­the­technique­of­stoma­creation­as­well­as­how performance­in­colon­and­rectal­surgery­as­well­as­its to­avoid­and­care­for­complications­related­to­parastomal impact­on­current­practice­and­how­improvement­is hernia,­retraction­and­poor­position.­Discuss­the accomplished. treatment­options­available­for­such­complications.  Illustrate­the­techniques­and­tricks­used­to­handle Illustrate­the­nuts­and­bolts­principles­of­laparoscopic various­complications­encountered­in­laparoscopic­and colon­resection­for­benign­and­malignant­disease­with open­colorectal­surgical­procedures. an­emphasis­on­techniques­for­handling­routine­and complex­cases. 3 Return to Table of Contents
  3. 3. General Information Review­the­current­evaluation,­treatment­and­follow­up Accreditation of­familial­colorectal­cancer­syndromes­and­understand the­surgical­management­of­the­different­syndromes­and The­American­Society­of­Colon­and­Rectal­Surgeons associated­complications. (ASCRS)­is­accredited­by­the­Accreditation­Council­for Continuing­Medical­Education­to­provide­continuing Describe­the­basic­use­of­the­ultrasound­machine­and medical­education­for­physicians.­ASCRS­takes probes,­pertinent­anatomy­related­to­the­specific responsibility­for­the­content,­quality­and­scientific­integrity examination,­and­interpretation­of­the­images­obtained. of­this­CME­activity. Appreciate­their­role­in­the­evaluation­of­patients suffering­from­complex­pelvic­floor­disorders. Discuss­the­treatment­strategies­for­complex­open­or Continuing Medical Education Credit non-healing­wounds,­and­utilizing­the­latest­techniques The­American­Society­of­Colon­and­Rectal­Surgeons for­optimizing­wound­healing.­Review­techniques­for d ­ esignates­this­live­activity­for­a­maximum­of­44.5­AMA PRA laparoscopic­and­open­ventral­hernia­repair,­and Category 1 Credit(s)™.­Physicians­should­claim­only­the temporary­abdominal­wall­closure. credit­commensurate­with­the­extent­of­their­participation Understand­diagnosis­coding­and­billing­changes in­the­activity. including­modifiers­to­E&M­and­CPT­codes.­Be­able­to appropriately­apply­these­codes­for­clinic­visits,­inpatient Self Assessment Credit and­outpatient­procedures. A­few­of­the­sessions­offered­will­be­designated­as­self Describe­the­current­treatment­options­and assessment­CME­credit,­applicable­to­Part­2­of­the­ABS recommendations­for­common­anorectal­disorders MOC­program.­In­order­to­claim­self­assessment­credit, including:­hemorrhoids,­fissures,­fistulas,­condyloma,­ attendees­must­have­their­badges­scanned­prior­to and­AIN.­ attending­the­session­and­take­a­test­at­the­conclusion­of Discuss­maintaining­and­growing­a­surgical­practice­with the­session.­A­passing­score­of­75­is­required. emphasis­on­marketing,­clinical­and­revenue­cycle efficiency,­EMR­use,­and­contracts­with­payers­and hospitals. Disclosure and Conflict of Interest Discuss­the­outcomes­and­economic­impact­of­the In­compliance­with­the­standards­of­the­Accreditation various­minimally­invasive­surgical­techniques­including: Council­for­Continuing­Medical­Education­and­the­ASCRS, laparoscopic­colectomy­and­proctectomy,­SILS,­NOTES, faculty­have­been­requested­to­complete­the­Disclosure of and­robotic­surgery. Significant Financial Relationships. Disclosures­will­be­made Review­the­science­behind­and­become­familiar­with­the at­the­time­of­presentation,­as­well­as­included­in­the available­stapling­and­energy­devices­on­the­market. Program­Guide.­All­perceived­conflicts­of­interest­will­be Understand­the­risks­and­benefits­of­this­equipment­in resolved­prior­to­presentation­and,­if­not­resolved,­the various­surgical­and­endoscopic­settings. presentation­will­be­denied. GoalsThe­goals­of­these­programs­are­to­improve­the­prevention,diagnosis­and­treatment­of­patients­with­diseases­anddisorders­affecting­the­colon­and­rectum;­and­improve­thequality­of­patient­care­by­maintaining,­developing­andenhancing­the­knowledge,­skills,­professional­performanceand­multidisciplinary­relationships­necessary­to­provide Join ASCRSservices­for­patients,­the­public­and­the­profession. Non-members­who­submit­their­membership application­prior­to­the­meeting­will­receive­ Target Audience the­discounted­“member”­rate.­The­program­is­intended­for­the­education­of­colon­and Please­click here for­benefits­of­joining­ASCRS.rectal­surgeons­as­well­as­general­surgeons­and­othersinvolved­in­the­treatment­of­diseases­affecting­the­colon, Click here for­application­form.rectum­and­anus. 4 Return to Table of Contents
  4. 4. General Information CLICK H Reg ist O ERE T er Onlin e Accommodations Official ASCRS Travel AgencyThe­meeting­will­be­held­at­the­Phoenix­Convention­Center To­book­your­airline­reservation,­call­ASCRS’s­official­traveland­Sheraton­Phoenix­Hotel. agency,­Uniglobe­Preferred­Travel,­at­1-800-626-0359­and after­the­prompt­dial­“0”­(M-F­8:30­am­–­5:30­pm­CST).­IfThe­convention­center­and­hotel­are­approximately­10 you­prefer­you­may:minutes­from­Phoenix­Sky­Harbor­International­Airport.  Book­your­travel­online­at­www.uniglobepreferred.com.Hotel­reservations­must­be­made­via­the­internet­or­by Scroll­down­and­click­on­Rapid-Rez­links.­When­thephone.­A­credit­card­will­be­required­to­guarantee­your booking­page­comes­up,­click­on­“Create­New­User”.reservation. Enter­personal­information,­click­“done”;­the­next­page­isFor­best­availability,­click here to­make­your­reservation­via for­more­detailed­personal­information­–­here­you­mustthe­internet­or­at­www.fascrs.org.­ enter­a­credit­card­number­and­billing­address­to­make­aIf­making­reservation­by­phone,­call­(866)­837-4213­and­ reservation.­Scroll­down­and­click­“Save”.­Click­on­theask­for­the­American­Society­of­Colon­and­Rectal­Surgeons “Travel­Planner”­tab­to­make­a­reservation­and­selectroom­block. ASCRS­for­the­“Trip­Reason”.­Please­record­your­User­ID and­your­Password­for­future­use.­Booking­on­this­siteSheraton Phoenix Hotel Room Rate: will­have­a­reduced­agency­service­fee­of­$15.$259­Single­/­Double­(+13.27%­tax)The deadline for hotel reservations is Wednesday, Places to See in PhoenixMarch 27, 2013. For­a­list­of­suggested­things­to­do­in­Phoenix,­please­Hotel­reservations­/­rate­availability­are­not­guaranteed click here.­You­may­also­check­with­your­hotel­conciergeafter­the­room­block­is­full­or­after­March 27, 2013.­Please for­specific­information­and­reservations.register­early­–­only­a­limited­number­of­rooms­areavailable­at­the­hotel. Temperature The­average­April­/­May­temperature­in­Phoenix­ranges Social Events from­a­low­of­65°F­to­a­high­of­90°F.The Annual Reception / Dinner Dance is­scheduled­forTuesday,­April­30.­The­reception­will­begin­at­7:00­pm­and Arizona Diamondbacks Baseballthe­dinner­dance­at­8:00­pm.­There­is­no­additional­cost­for­a The­Arizonaticket­for­full-paying­Members­and­Fellows.­Members/Fellows Diamondbacks­will­ Photo Credit: Greater Phoenix CVBmust­indicate­whether­they­want­to­attend­the­dinner­dance take­on­the­San­either­online,­or­on­the­registration­form,­and­then­obtain Francisco­Giants­at­their­seating­ticket­on-site­prior­to­the­dinner­dance.­The­cost 6:40­pm,­Monday,­for­all­others­is­$75­per­ticket. April­29th­at­nearby Chase­Field.­ For­tickets,­call­ (602)­514-8400. Spouse/Guest Program Child Care Services Please review the following and indicate your choices on the registration form. Please­contact­the­concierge­at­the­hotel­at­which­you­are staying­for­a­list­of­bonded­independent­babysitters­and Package #1 ($100)­Includes­items­A­thru­D babysitting­agencies. Package #2 ($55)­Includes­items­A­and­B­only A. Welcome Reception, 6:30­–­8:30­pm,­ Dining in Phoenix Sunday,­April­28 There­are­many­fine­establishments­in­Phoenix­for­dining. B. Admission to­scientific­sessions­and­the­ Click here for­a­list­of­restaurants­in­the­area.­ e ­ xhibit­area C. Annual Reception, 7:00­–­8:00­pm,­ Free WiFi Available Tuesday,­April­30 New­this­year,­ASCRS­will­offer­free­WiFi­throughout­the D. Annual Dinner Dance, 8:00­–­10:00­pm,­ Convention­Center. Tuesday,­April­30 5 Return to Table of Contents
  5. 5. Saturday, April 27 Transanal Endoscopic Surgery Workshop 7:00 am – 5:00 pm Fee: $495 • Limit: 48 participants • Lunch Included Registration Required • No refunds after April 8Transanal­excision­of­tumors­of­the­rectum­has­been­limited­by­the­technical­difficulties­of­operating­in­a­confined­spacewith­inadequate­instrumentation.­Access­to­lesions­higher­than­6­cm­from­the­anal­verge­is­not­feasible­with­standardtransanal­techniques.­Transanal­endoscopic­microsurgery­was­designed­to­overcome­these­limitations­and­has­proven­to­bean­invaluable­endoscopic­tool­in­treating­rectal­lesions­which­might­otherwise­require­proctectomy.­Radical­resection­of­the­rectum­for­benign­and­malignant­neoplasms­is­associated­with­rates­of­perioperative­complicationsand­functional­disorders­that­largely­exceed­the­morbidity­associated­with­other­types­of­bowel­resections.­This­has­ledsurgeons­to­attempt­less­invasive­surgical­alternatives­including­transanal­excision­and­traditional­endoscopic­approaches.Standard­transanal­excisional­techniques­are­limited­by­instrumentation­and­anatomy­to­the­distal­6-12­cm­of­the­rectumand­are­associated­with­substantial­recurrence­rates­for­benign­and­malignant­disease.­In­the­early­1980’s­transanalendoscopic­microsurgery­(TES)­was­described.­In­the­past­decade­its­acceptance­has­increased­and­several­authors­havedemonstrated­decreased­recurrence­rates­for­benign­and­early­stage­malignant­neoplasms­when­compared­to­standardtransanal­excision.­Morbidity­for­TES­has­been­low­and­similar­to­transanal­excision.­With­the­recent­introduction­of­newdevices­to­perform­transanal­endoscopic­resections,­surgeons­now­have­more­flexibility­in­terms­of­equipment­andoperative­set-up.­Surgeons­experienced­in­transanal­endoscopic­excisions­have­learned­valuable­lessons­in­patientselection,­operative­set-up­available,­technical­pearls­and­troubleshooting,­and­postoperative­management­that­canaccelerate­learning­for­those­interested­in­adopting­this­technique.­Existing GapsWhat Is: Despite­increased­acceptance­of­TES­and­reported­decreased­rates­of­recurrence­compared­to­standard­transanalexcision,­many­colorectal­surgeons­have­not­adopted­TES­into­their­practices.What Should Be: Comprehensive­review­of­indications­for­transanal­endoscopic­microsurgery­and­of­all­devices­currentlyavailable,­and­hands-on­practice­in­an­inanimate­lab­training­session­under­the­guidance­of­experts,­will­allow­for­moresurgeons­to­adopt­TES­and­offer­it­to­patients­as­an­alternative­to­radical­resection­when­clinically­indicated. Director: Patricia Sylla, MD, Boston, MA Assistant Director: Elisabeth McLemore, MD, La Jolla, CA7:00­am Introduction to TES: Past and Future 8:15­am TES: Postoperative Considerations and Patricia­Sylla,­MD,­Boston,­MA Complications Elisabeth­McLemore,­MD,­La­Jolla,­CA7:15­am Indications for TES: Benign Disease Mark­Whiteford,­MD,­Portland,­OR­ 8:30­am Billing and Coding Theodore­Saclarides,­MD,­Maywood,­IL7:30­am Indications for TES: Malignant Disease Peter­Cataldo,­MD,­Burlington,­VT 8:45­am Introduction to the Lab Patricia­Sylla,­MD,­Boston,­MA7:45­am Preoperative Assessment and Preparation Steve­Hunt,­MD,­St.­Louis,­MO8:00­am TES: Procedural Overview Alessio­Pigazzi,­MD,­PhD,­Orange,­CA Continued next page 6 Return to Table of Contents
  6. 6. Saturday, April 27 Transanal Endoscopic Surgery Workshop (Continued) Lab Sessions 9:00 am – 1:45 pm (24 participants) 9:00 am – 1:00 pm (24 participants) Group A – Hands-on Lab Group B – Workshop Elisabeth McLemore, MD, Lab Director Patricia Sylla, MD, Workshop Director9:00­am TEM 9:00­am Cases Drs.­Liliana­Bordeianou,­Boston,­MA;­Peter Drs.­Matthew­Albert,­Orlando,­FL;­Alessandro Cataldo,­Burlington,­VT;­and­Sanghyun­Kim,­ Fichera,­Seattle,­WA;­Jorge­Marcet,­Tampa,­FL; New­York,­NY and­Theodore­Saclarides,­Maywood,­IL10:00­am TEO 10:00­am Complications Drs.­Steve­Hunt,­St.­Louis,­MO;­and­Rudolph Drs.­Alessandro­Fichera,­Seattle,­WA;­Jorge Rustin,­Mount­Pleasant,­SC Marcet,­Tampa,­FL;­Patricia­Sylla,­Boston,­MA; and­Mark­Whiteford,­Portland,­OR11:00­am SILS Drs.­Eric­Haas,­Houston,­TX;­Alessio­Pigazzi, 11:00­am New Applications Orange,­CA;­and­Jaime­Sanchez,­Tampa,­FL­ Drs.­Matthew­Albert,­Orlando,­FL;­Antonio­Lacy, Barcelona,­Spain;­and­Patricia­Sylla,­Boston,­MA­Noon­ Gelpoint Drs.­Matthew­Isho,­San­Diego,­CA;­Elisabeth 11:45­am Panel Discussion/Questions McLemore,­La­Jolla,­CA;­and­Theodoros Noon­ Lunch Voloyiannis,­Houston,­TX­1:00­pm­ Lunch Continued next page Views­of Greater Phoenix, ± Photo Credit: Greater Phoenix CVB including golf,­hiking, shopping restaurants Destination:­Phoenix­ and­more. CVB­Video 7 Return to Table of Contents
  7. 7. Saturday, April 27 Transanal Endoscopic Surgery Workshop (Continued) Lab Sessions 1:45 – 5:00 pm (24 participants) 1:00 – 5:00 pm (24 participants) Group A – Workshop Group B – Hands-on Lab Patricia Sylla, MD, Workshop Director Elisabeth McLemore, MD, Lab Director1:45­pm Cases 1:00­pm TEM Drs.­Liliana­Bordeianou,­Boston,­MA;­Eric­Haas, Drs.­Theodore­Saclarides,­Maywood,­IL;­and Houston,­TX;­Sanghyun­Kim,­New­York,­NY;­and Mark­Whiteford,­Portland,­OR Elisabeth­McLemore,­La­Jolla,­CA 2:00­pm TEO2:45­pm Complications Drs.­Alessandro­Fichera,­Seattle,­WA;­Rudolph Drs.­Peter­Cataldo,­Burlington,­VT;­Eric­Haas, Rustin,­Mount­Pleasant,­SC;­and­Patricia­Sylla, Houston,­TX;­Steve­Hunt,­St.­Louis,­MO;­and Boston,­MA Alessio­Pigazzi,­Orange,­CA 3:00­pm SILS3:45­pm New Applications Drs.­Jorge­Marcet,­Tampa,­FL;­and­Jaime Drs.­Steve­Hunt,­St.­Louis,­MO;­Antonio­Lacy, Sanchez,­Tampa,­FL Barcelona,­Spain;­and­Elisabeth­McLemore,­ 4:00­pm­ Gelpoint La­Jolla,­CA Drs.­Matthew­Albert,­Orlando,­FL;­Matthew­Isho,4:45­pm Panel Discussion/Questions San­Diego,­CA;­and­Theodoros­Voloyiannis, Houston,­TX Objectives: At­the­conclusion­of­this­session,­participants­should­be­able­to:­a)­understand­the­surgical indications­and­preoperative­preparation­for­TES;­b)­learn­the­operative­set-up,­transanal­devices­and­equipment currently­used­to­perform­TES;­c)­learn­to­troubleshoot­technical­difficulties­during­TES;­d)­discuss­intraoperative complications­and­postoperative­management­of­patients­undergoing­TES;­and­e)­develop­technical­skills necessary­to­perform­TES­and­become­familiar­with­all­the­available­transanal­devices. 8 Return to Table of Contents
  8. 8. Saturday, April 27 Anorectal Ultrasound and Physiology Workshop 7:15 am – 5:00 pm Fee: $295 • Limit 80 • Lunch Included • Registration Required • No refunds after April 8Endorectal­ultrasound­plays­a­central­role­in­the­clinical­decision-making­in­the­evaluation­and­management­of­benign­andmalignant­anorectal­disorders.­With­technological­advances,­the­application­of­ultrasound­has­expanded­into­the­evaluationof­pelvic­floor­abnormalities.­Endoanal­ultrasound­is­the­best­modality­to­document­sphincter­injuries­and­it­is­frequentlyused­in­conjunction­with­other­evaluation­modalities,­such­as­manometry,­to­optimize­outcomes.­Preoperative­staging­ofrectal­cancer­is­essential­to­determine­the­need­for­possible­neoadjuvant­therapy.­Ultrasound­offers­excellent­stagingaccuracy.­The­technique­is­cost­effective­and­enables­surgeons­to­assess­their­own­patients.­The­advances­of­high­resolution3D-ultrasound­enables­studies­of­pelvic­floor­abnormalities­and­the­technique­is­also­applied­in­evaluating­dynamicdisorders­such­as­obstructed­defecation.Patients­with­fecal­incontinence­or­severe­constipation­can­benefit­from­specialized­assessment­with­additional­modalities,such­as­manometry,­defecography­or­MRI,­and­motility­testing.­Most­surgeons­will­not­attempt­a­sphincter­repair­unless­adefect­can­be­demonstrated­at­ultrasound.­Manometry­and­other­tests­may­clarify­the­underlying­problem­and­this­isespecially­important­after­the­introduction­of­new­treatment­modalities,­such­as­sacral­nerve­stimulation­and­injectables­forfecal­incontinence.This­full-day­workshop­highlights­the­current­clinical­uses­of­anorectal­and­pelvic­floor­ultrasound­with­2D­and­3Dtechniques.­The­course­will­also­discuss­and­demonstrate­modern­evaluation­techniques­used­in­the­assessment­of­patientswith­fecal­incontinence­and­severe­constipation.­The­course­will­provide­the­colorectal­surgeon­with­training­on­the­basicuse­of­the­ultrasound­machine­and­probes,­pertinent­anatomy­to­the­specific­examination,­and­interpretation­of­the­imagesobtained.­The­course­will­discuss­the­clinical­value­of­using­ultrasound­and­physiology­testing.Existing GapsWhat Is: Anorectal­and­physiology­testing­play­an­important­role­in­the­assessment­of­patients­with­anorectal­and­pelvicfloor­disorders.­The­accuracy­of­these­examinations­depends­upon­the­operator’s­ability­to­perform­the­exam­and­properlyinterpret­the­results­that­are­obtained.What Should Be: It­is­important­that­colorectal­surgeons­develop­hands-on­expertise­in­the­use­of­anorectal­ultrasound­inorder­to­effectively­manage­benign­and­malignant­disorders­in­these­areas. Director: Anders Mellgren, MD, PhD, Minneapolis, MN Co-Director: Amy Thorsen, MD, Minneapolis, MN Continued next page 9 Return to Table of Contents
  9. 9. Saturday, April 27 Anorectal Ultrasound and Physiology Workshop (Continued) Anorectal Ultrasound Clinical Applications7:15­am Introduction and Course Objectives 11:00­am Practical Applications of Testing for Constipation Anders­Mellgren,­MD,­PhD,­Minneapolis,­MN Tracy­Hull,­MD,­Cleveland,­OH Amy­Thorsen,­MD,­Minneapolis,­MN 11:20­am Practical Applications of Testing for Fecal7:30­am Ultrasound Technique & Image Interpretation Incontinence Johan­Nordenstam,­MD,­PhD,­Minneapolis,­MN Liliana­Bordeianou,­MD,­Boston,­MA7:45­am Normal Anorectal Ultrasound Anatomy 11:40­am Practical Applications of Testing for Prolapse Robert­Akbari,­MD,­Towson,­MD Ian­Lindsey,­MD,­Oxford,­United­Kingdom8:00­am Ultrasound Evaluation of Fistula & Abscess Noon Lunch Juan­Poggio,­MD,­Philadelphia,­PA8:15­am Ultrasound Evaluation of Fecal Incontinence Hands-on Training Mitchell­Bernstein,­MD,­New­York,­NY8:30­am Ultrasound Staging of Rectal Tumors 1:00 – 3:00 pm P.­Terry­Phang,­MD,­Vancouver,­BC,­Canada Groups­1­– 4: Hands-on Sessions (with live models) • Anal Ultrasound8:45­am The Role of Ultrasound in Staging of Rectal Juan­Poggio,­MD,­Philadelphia,­PA Tumors • Rectal Ultrasound Juan­Nogueras,­MD,­Weston,­FL Johan­Nordenstam,­MD,­PhD,­9:00­am Refreshment Break in Foyer Minneapolis,­MN • Pelvic Floor Ultrasound Giulio­Santoro,­MD,­PhD,­Treviso,­Italy Pelvic Floor and Motility Testing • Pelvic Floor Testing Massarat­Zutshi,­MD,­Cleveland,­OH9:30­am Normal Pelvic Floor Ultrasound Anatomy Groups­5­– 8: Case Discussions Giulio­Santoro,­MD,­PhD,­Treviso,­Italy Drs. Mellgren and Thorsen9:45­am Ultrasound Evaluation of Posterior 3:00 – 5:00 pm Compartment Pelvic Floor Disorders Groups­1­– 4:­ Case Discussions Elizabeth­Mueller,­MD,­Maywood,­IL Drs. Mellgren and Thorsen10:00­am Radiologic Evaluation of Pelvic Floor Problems Groups­5­– 8: Hands-on Sessions (with live models) Sarah­Vogler,­MD,­Salt­Lake­City,­UT • Anal Ultrasound10:15­am Anorectal Manometry Juan­Poggio,­MD,­Philadelphia,­PA Massarat­Zutshi,­MD,­Cleveland,­OH • Rectal Ultrasound Johan­Nordenstam,­MD,­PhD,­10:30­am Motility Testing from a GI Perspective Minneapolis,­MN Adil­E.­Bharucha,­MD,­Rochester,­MN • Pelvic Floor Ultrasound10:45­am Discussion Giulio­Santoro,­MD,­PhD,­Treviso,­Italy • Pelvic Floor Testing Massarat­Zutshi,­MD,­Cleveland,­OH Objectives: At­the­conclusion­of­this­session,­participants­should­be­able­to:­a)­understand­the­set-up­and operation­of­the­ultrasound­machine­and­probes;­b)­understand­the­indications­and­limitations­of­the­ultrasound for­the­evaluation­of­diseases­of­the­colon,­rectum­and­anus;­c)­understand­the­pertinent­anatomy­associated with­each­examination;­d)­interpret­the­images­obtained­for­each­examination;­e)­have­knowledge­about different­modalities­of­pelvic­physiology­testing;­and­f )­interpret­results­of­pelvic­floor­physiology­testing­in­a clinical­context. 10 Return to Table of Contents
  10. 10. Saturday, April 27 Advanced Laparoscopic Symposium and Workshop: Pearls from the Pro’s Didactic Session: 7:30 – Noon • Didactic is open to all meeting registrants (Complimentary) Hands-on Lab Session: Noon – 5:00 pm • Limit 20 • Fee: $595 Lunch Included for Hands-on Lab Participants: • Registration Required • No refunds after April 8 Location for Hands-on Lab: Science­Care,­Inc.­•­2020­W.­Melinda­Lane •­Phoenix,­AZ Transportation will be providedDidactic SessionLaparoscopic­and­minimally­invasive­techniques­have­permeated­the­field­of­colon­and­rectal­surgery.­New­technology­andnew­techniques­are­constantly­being­developed­to­improve­the­safety­and­feasibility­of­these­approaches.­This­didacticsession­will­feature­lectures­with­multiple­videos­demonstrating­the­anatomy­of­the­colon,­vasculature,­andretroperitoneum­associated­with­the­various­approaches­to­mobilization­of­the­right­colon,­transverse­colon,­splenic­flexure,left­colon,­and­rectum.­Pearls­and­tricks­of­the­trade­will­be­highlighted­that­will­help­to­facilitate­the­learning­curve­andadoption­of­laparoscopic­techniques.­Existing GapsWhat Is: Despite­its­widespread­acceptance­as­a­standard­of­care,­many­colon­and­rectal­surgeons­still­have­not­adoptedthe­laparoscopic­approach­to­colon­resections­into­their­practices.­What Should Be: Several­studies­have­demonstrated­the­effectiveness­of­the­cadaver­model­for­the­teaching­and­facilitationof­adoption­of­laparoscopic­colectomy.­We­have­progressed­through­the­majority­of­the­learning­curve­for­most­colon­andrectal­surgeons­and­attempt­to­close­the­gap­with­the­population­who­remains­reluctant­to­implement­it­on­a­routine­basis. Director: Bradley Champagne, MD, Cleveland, OH Co-Director: Jamie Cannon, MD, Birmingham, AL7:30­am Right Colectomy, When it is Not So Easy! 9:00­am Laparoscopic TME: Technical Problems and Karim­Alavi,­MD,­Worcester,­MA Solutions John­Marks,­MD,­Wynnewood,­PA7:45­am Straight Lx Sigmoid Colectomy: A Case for General Surgery Residents 9:15­am Panel Discussion/Questions Edward­Lee,­MD,­Albany,­NY 9:30­am Break8:00­am Complicated Diverticulitis 9:45­am Laparoscopic Recto-pexy: How and When Jason­Hall,­MD,­Burlington,­MA Scott­Steele,­MD,­Fort­Lewis,­WA8:15­am Laparoscopic Colectomy in the Morbidly 10:00­am Complex Crohn’s: Reoperative and Fistulas Obese Sharon­Stein,­MD,­Cleveland,­OH Mark­Manwaring,­MD,­Greenville,­NC 10:15­am Pouch Pearls8:30­am HALS Colectomy: Tool or Trade Matthew­Mutch,­MD,­St.­Louis,­MO H.­David­Vargas,­MD,­New­Orleans,­LA 10:30­am Conversions: When Enough is Enough8:45­am Laparoscopic Proctectomy: Reconstruction Jonathan­Efron,­MD,­Baltimore,­MD (Stapled vs Sewn) vs APR Martin­Weiser,­MD,­New­York,­NY Continued next page 11 Return to Table of Contents
  11. 11. Saturday, April 27 Advanced Laparoscopic Symposium and Workshop (Continued)10:45­am SILS: When, How? 11:30­am Panel Discussion/Questions Daniel­Geisler,­MD,­Columbus,­OH Noon Adjourn11:00­am Robotic Approaches to Colorectal Disease Alessio­Pigazzi,­MD,­Orange,­CA11:15­am Learning Past the Learning Curve Antonio­Lacy,­MD,­PhD,­Barcelona,­Spain Advanced Laparoscopic Colorectal Surgery Hands-on Lab Session For Course Registrants Only (Tickets Required) Noon – 5:00 pm Fee: $595 • Limit 20 • Lunch Included Hands-on Session for Course Registrants Only Tranportation­to­Science­Care,­Inc.­ProvidedParticipants­will­perform­either­a­straight­laparoscopic,­single-site­laparoscopic­colectomy,­or­hand-assistedproctocolectomy­under­the­close­supervision­of­an­expert­faculty­member.­This­course­is­aimed­at­two­populations­ofsurgeons:­1)­practicing­colorectal­or­general­surgeons­who­wish­to­incorporate­minimally­invasive­techniques­into­theirpractice;­and­2)­general­surgery­residents­who­are­interested­in­colon­and­rectal­surgery.­ Director: Bradley Champagne, MD, Cleveland, OH Co-Director: Jamie Cannon, MD, Birmingham, ALFaculty for hands-on session includes:Drs.­Karim­Alavi,­Worcester,­MA;­Joanne­Favuzza,­Chicago,­IL;­Todd­Francone,­Rochester,­NY;­Jason­Hall,­Burlington,­MA;­EricJohnson,­Fort­Lewis,­WA;­Edward­Lee,­Albany,­NY;­Mark­Manwaring,­Greenville,­NC;­Alessio­Pigazzi,­Orange,­CA;­Scott­Steele,Fort­Lewis,­WA;­and­Sharon­Stein,­Cleveland,­OH Objectives: At­the­conclusion­of­this­session,­participants­should­be­able­to:­a)­understand­the­basic­techniques of­laparoscopic­intestinal­surgery;­b)­understand­the­anatomy­of­the­colon,­its­vasculature­and­retroperitoneum from­a­laparoscopic­perspective;­c)­understand­the­sequence­of­steps­necessary­to­perform­these­procedures safely;­and­d)­understand­the­sequence­of­steps­necessary­to­perform­a­single-site­laparoscopic­right­colectomy.­ 12 Return to Table of Contents
  12. 12. Saturday, April 27Luncheon Symposium “Surgeon as a Leader” – Professionalism and Communication 11:45 am – 1:00 pmLeadership­may­be­the­most­important­skill­for­a­surgeon.­Many­surgeons­have­received­no­formal­training­in­leadershipand­some­surgeons­have­never­had­the­benefit­of­a­senior­mentor­figure.Leadership­can­take­many­forms.­It­can­be­clinical­in­the­operating­room­leading­the­operating­room­team­or­in­the­cliniccoordinating­the­outpatient­care­of­patients.­A­system­approach­to­improving­care­is­critical­for­quality.­Surgeons­need­toknow­how­to­lead­multidisciplinary­teams­to­improve­hospital­care.­Understanding­clinical­microsystems­is­key­to­qualityand­efficiency­improvement­in­health­care.­Clinical­microsystems­and­how­a­surgeon­leader­can­effect­change­within­aclinical­microsystem­will­be­discussed­in­detail­by­one­of­the­nation’s­experts.­Among­their­many­functions,­professional­societies­provide­both­education­and­a­means­for­advocacy.­Many­surgeons­donot­participate­in­these­activities­because­they­may­not­realize­its­purpose­and­benefits.­In­this­symposium,­insights­intoparticipation­in­professional­society­activities­and­how­to­lead­them­will­be­highlighted­by­the­current­ASCRS­President.This­symposium­will­focus­on­practical­framework­to­use­when­approaching­leadership­endeavors.­Existing GapsWhat Is: Many­surgeons­have­had­no­formal­training­in­leadership.­Surgeons­do­not­know­how­they­can­improve­theirpatient’s­experience.­What Should Be: Surgeons­should­know­how­to­lead­clinical­teams­designed­to­improve­inpatient­care.­Surgeons­also­needto­know­how­professional­societies­can­assist­them­in­education­as­well­as­advocacy­with­the­ultimate­goal­of­improvingpatient­education­and­care. Director: Michael Stamos, MD, Orange, CA Assistant Director: Terry Hicks, MD, New Orleans, LA11:45­am Leading a Care Improvement Project: Making Microsystems Work Matthew­A.­Facktor,­MD,­Danville,­PA12:20­pm Leading Professional Societies: Education and Advocacy Alan­G.­Thorson,­MD,­Omaha,­NE1:00­pm Adjourn Objectives: At­the­conclusion­of­this­session,­participants­should­be­able­to:­a)­learn­how­to­lead multidisciplinary­patient­care­improvement­teams;­and­b)­learn­about­the­ways­professional­societies­assist individual­surgeons­in­education­and­advocacy. 13 Return to Table of Contents
  13. 13. Saturday, April 27Symposium Treatment of Common Anorectal Disorders 1:15 – 3:00 pmHemorrhoids are­extremely­common­and­may­be­treated­by­a­wide­variety­of­in-office­and­operating­room­methods.­Manysurgeons­are­unaware­of­the­variety­of­treatments,­the­indications­for­these­treatments­and­the­results­of­the­treatments.When­surgery­is­indicated,­treatments­range­from­rubber-band­ligation­and­infrared­coagulation­to­doppler-guidedhemorrhoid­artery­ligation,­stapled­hemorrhoidopexy­and­conventional­hemorrhoidectomy.­In­any­given­patient­one­ofthese­treatment­options­may­be­superior­to­the­other­in­terms­of­effectiveness,­potential­complications,­disability­andpatient­satisfaction.Anal fissure is­a­common­cause­of­rectal­pain­and­bleeding.­Management­of­anal­fissures­includes­medical­treatment­withstool­softeners­and­topical­sphincter­relaxants.­Surgical­intervention­includes­sphincterotomy­and­advancement­flaps.Although­it­is­estimated­that­roughly­half­of­patients­with­anal­fissure­will­heal­with­sitz­baths­and­fiber­supplementation,recurrence­rates­are­high­and­many­patients­will­develop­chronic­fissures­that­require­surgical­intervention.­Choice­oftherapy­is­dependent­on­patient­factors­and­the­risks­and­benefits­of­each­therapy.Anal fistula represents­one­of­the­most­common­and­challenging­anorectal­diseases­encountered­by­surgeons.­Theprinciples­of­successful­treatment­include­destruction­of­the­internal­opening­with­preservation­of­sphincter­function.Primary­lay-open­fistulotomy­has­a­high­success­rate­in­treating­fistulas,­however­most­surgeons­are­reluctant­to­performthis­procedure­in­instances­where­substantial­impairment­of­continence­may­result.­As­a­result,­several­alternativetreatments­have­been­pursued­which­do­not­involve­anal­sphincter­division.­Fibrin­glue,­collagen­plug,­rectal­mucosaladvancement­flap,­and­ligation­of­the­intersphincteric­fistula­tract­(LIFT)­are­all­sphincter-sparing­fistula­treatments­thathave­been­used­with­varying­degrees­of­success.­Understanding­the­indications,­limitations,­and­success­rates­of­the­varioustreatment­modalities­would­allow­for­more­effective­and­efficient­treatment­of­anal­fistula.Anal condyloma are­treated­using­destruction­or­excision­in­the­office­or­operating­room.­Follow-up­of­these­patients­iscritical­because­of­the­high­rate­of­recurrence­and­increased­risk­for­anal­cancer.­While­surgeons­are­aware­of­standardsurgical­treatment­methods­for­anal­condyloma,­treatment­of­anal­intraepithelial­neoplasia­(AIN)­is­varied­and­controversial.Finally,­new­methods­to­prevent­disease­as­well­as­recurrence­are­now­available,­and­many­surgeons­may­be­unaware­ofthese­prevention­options.­Existing GapsWhat Is: There­are­many­treatment­options­for­the­treatment­of­hemorrhoids,­anal­fissure,­and­anal­fistula.­New­means­toprevent­anal­condyloma­are­now­available.­Many­surgeons­are­unaware­of­all­of­these­treatment­and­prevention­options.Surgeons­may­also­be­unaware­of­how­many­of­these­treatment­options­can­be­efficiently­and­effectively­performed­in­theoffice­setting­rather­than­the­operating­room.What Should Be: Surgeons­should­understand­the­indications,­success­rates,­and­complications­of­the­treatments­availablefor­these­common­anorectal­disorders.­Surgeons­should­know­how­to­efficiently­treat­patients­with­anorectal­disorders­inthe­office­setting. Director: Richard Billingham, MD, Seattle, WA Assistant Director: Cary B. Aarons, MD, Philadelphia, PA Continued next page 14 Return to Table of Contents
  14. 14. Saturday, April 27 Treatment of Common Anorectal Disorders (Continued)1:15­pm Current Treatment of Hemorrhoids: Options 2:00­pm Anal Condyloma and AIN: Treatment and and Results Prevention William­Cirocco,­MD,­Grosse­Point­Woods,­MI Bard­Cosman,­MD,­San­Diego,­CA1:30­pm Anal Fissure and Stenosis: Medical and 2:15­pm Office-Based Treatments: How to Avoid the OR Surgical Options Sergio­Larach,­MD,­Orlando,­FL Peter­Cataldo,­MD,­Burlington,­VT 2:30­pm Panel Discussion/Questions1:45­pm Anal Fistula: Glue, Plug or LIFT to Success? 3:00­pm Adjourn Amir­Bastawrous,­MD,­Seattle,­WA Objectives: At­the­conclusion­of­this­session­participants­should­be­able­to:­a)­understand­the­indications, methods­and­results­of­treatments­currently­available­for­hemorrhoids;­b)­learn­about­the­medical­and­surgical options­to­treat­patients­with­anal­fissures;­c)­understand­the­different­treatment­modalities­available­for­anal fistula;­d)­develop­an­algorithm­for­the­management­of­different­types­of­anal­fistula;­e)­learn­about­treatment and­prevention­strategies­for­patients­with­anal­condyloma;­and­f )­learn­about­how­to­effectively­and­efficiently treat­patients­with­common­anorectal­disorders­in­the­outpatient­office. The­Phoenix­Convention­ &­Visitors­Bureau­Mobile­ Site­contains­maps,­ ratings­and­reviews,­ pictures,­phone­numbers, websites­and­a­place­ to­ask­the­Visitors­ Center­questions Phoenix­CVB­­Mobile­Site www.visitphoenix.com/ mobile-phoenix/index.aspx 15 Return to Table of Contents
  15. 15. Saturday, April 27Symposium How to Get Paid: Colon and Rectal Surgery Coding and Reimbursement 1:15 – 5:00 pmWith­their­focus­dedicated­to­the­delivery­of­safe­and­high­quality­care,­most­surgeons­have­little­time­left­to­develop­acomprehensive­understanding­of­coding­and­reimbursement­policies­and­procedures­that­drive­reimbursement.­This­gap­ismade­worse­by­the­ever­increasing­complexity­and­changes­that­frequently­accompany­coding­and­reimbursement­policiesin­the­United­States.There­are­also­significant­changes­that­will­occur­with­the­transition­from­ICD-9­codes,­to­the­new­ICD-10­codes.Understanding­what­these­changes­are­and­how­they­will­impact­practices­is­essential­for­surgeons.Other­opportunities­exist­for­surgeons­to­understand­coding­levels,­what­elevates­certain­patient­interactions­to­a­higherbilling­level,­and­how­modifiers­change­billing­practices.­Finally,­billing­errors,­even­made­unintentionally,­can­have­a­significant­impact­on­physicians­and­hospitals.­Understandingcommon­errors,­pitfalls,­and­how­payers­and­CMS­monitor­and­audit­these­errors­is­essential­for­the­practicing­surgeon.The­purpose­of­this­symposium­is­to­provide­a­basic­foundation­of­key­elements­of­coding­and­billing­that­affect­thepractice­of­our­members.­We­hope­to­illustrate­some­of­the­more­difficult­coding­scenarios­utilizing­actual­case­studies,where­we­will­walk­the­audience­through­a­complicated­procedure­and­explain­the­logic­of­how­it­was­coded­and­why.This­symposium­is­for­educational­purposes.­It­is­important­for­attendees­to­recognize­that­coding­and­billing­proceduresmay­vary­by­hospital­and­practice,­and­they­should­confer­with­their­local­coding­resources­when­making­coding­decisions.Existing GapsWhat Is: Surgeons­have­a­poor­understanding­of­how­codes­are­created­and­assigned­value­and­a­limited­understanding­ofbasic­coding­principles.­There­is­confusion­regarding­coding­of­complicated­procedures;­poor­understanding­of­how­to­usecoding­tactics­such­as­modifiers;­and­lack­of­basic­understanding­of­coding­compliance­risk.What Should Be: Surgeons­need­to­have­a­basic­understanding­of­how­codes­are­created­and­valued,­and­how­to­uniformlyapply­coding­and­billing­strategies­to­be­appropriately­paid­for­their­work,­and­remain­in­compliance. Director: James Merlino, MD, Cleveland, OH Co-Directors: David Margolin, MD, New Orleans, LA; David O’Brien, MD, Portland, OR; Guy Orangio, MD, New Orleans, LA1:15­pm Introduction – The Challenges We All Face 3:30­pm Break James­Merlino,­MD,­Cleveland,­OH 3:45­pm Compliance and Billing Pitfalls1:30­pm How Providers are Reimbursed for Medical David­O’Brien,­MD,­Portland,­OR Services in the United States 4:15­pm Case Vignettes/Discussion Guy­Orangio,­MD,­New­Orleans,­LA 5:00­pm Adjourn2:30­pm Important Tactics to Ensure Appropriate Coding and Billing David­Margolin,­MD,­New­Orleans,­LA Objectives: At­the­conclusion­of­this­session,­participants­should­be­able­to:­a)­understand­ICD-9­and­ICD-10 diagnosis­coding;­b)­learn­how­to­appropriately­code­E&M­visits­in­colorectal­surgery;­c)­understand­modifiers related­to­E&M­visits;­d)­learn­how­to­appropriately­code­surgical­and­endoscopic­procedures;­e)­describe­add-on codes­and­modifiers­for­procedures;­and­f )­understand­billing­reconciliation­and­how­to­deal­with­payer­denials. 16 Return to Table of Contents
  16. 16. Saturday, April 27EBRS Symposium Time to Change the Treatment of Rectal Cancer: Role of MRI 3:00 – 4:30 pmEvidence­Based­Reviews­in­Surgery­(EBRS),­a­joint­program­of­the­Canadian­Association­of­General­Surgeons­and­the­ACS,­isan­internet-based­journal­club.­The­aim­of­the­program­is­for­participants­to­evaluate­the­clinical­article,­further­theirknowledge­about­the­topic­and­to­learn­critical­appraisal­skills­that­can­be­used­to­evaluate­future­articles.­Each­monthlypackage­includes:­methodological­and­clinical­articles,­reviews­completed­by­methodological­and­clinical­experts­and­alistserv­discussion.In­this­symposium,­the­audience­will­actively­participate­in­a­“typical”­EBRS­monthly­package.­Participants­will­hear­what­theevidence­is,­what­the­experts­say,­learn­how­to­navigate­through­the­EBRS­website,­and­have­an­opportunity­to­discuss­theissues­with­a­panel­of­experts.­The­specific­topic­reviewed­will­be­“Time­to­Change­the­Treatment­of­Rectal­Cancer:­The­Roleof­MRI”.Existing GapsWhat Is: General­and­colorectal­surgeons­and­residents­are­faced­with­a­large­amount­of­literature­and­in­order­toincorporate­the­data­into­clinical­practice,­critical­appraisal­skills­are­paramount.­What Should Be: EBRS­is­an­effective­method­to­review­the­current­literature­and­give­a­better­understanding­tomethodological­issues­to­facilitate­the­decision­to­incorporate­the­literature­into­practice.­ Director: Larissa Temple, MD, New York, NY Assistant Director: Robin McLeod, MD, Toronto, ON, Canada3:00­pm Introduction and Overview of EBRS 4:00­pm Expert Panel with Audience Discussion Larissa­Temple,­MD,­New­York,­NY Marc­Gollub,­MD,­New­York,­NY­ Erin­Kennedy,­MD,­PhD,­Toronto,­ON,­Canada­3:10­pm Overview of EBRS Website David­Rothenberger,­MD,­Minneapolis,­MN Marg­McKenzie,­RN,­Toronto,­ON,­Canada 4:20­pm Summary of Experts’ Remarks and Listserv3:30­pm Poll the Audience on their Practices Discussion Larissa­Temple,­MD,­New­York,­NY Carl­Brown,­MD,­Vancouver,­BC,­Canada3:35­pm Presentation of Salient Points of Article 4:25­pm Concluding Remarks Nancy­Baxter,­MD,­PhD,­Toronto,­ON,­Canada Larissa­Temple,­MD,­New­York,­NY3:40­pm Methodological Critique 4:30­pm Adjourn Nancy­Baxter,­MD,­PhD,­Toronto,­ON,­Canada3:50­pm Discussion re Methodology and Validity and Generalizability Robin­McLeod,­MD,­Toronto,­ON,­Canada Objectives: At­the­conclusion­of­this­session,­participants­should­be­able­to:­a)­describe­what­is­Evidence­Based Reviews­in­Surgery;­b)­describe­the­use­of­EBRS­for­continuing­medical­education­and­journal­club­activities;­ c)­navigate­the­EBRS­website;­and­d)­discuss­the­potential­role­of­MRI­in­treating­patients­with­rectal­cancer. EBRS Article for Discussion: Preoperative High-resolution Magnetic Resonance Imaging Can Identify Good Prognosis Stage I, II and III Rectal Cancer Best Managed by Surgery Alone. Taylor FGM, Quirke P, Heald RJ et al. Ann Surg, 2011; 253: 711-19. 17 Return to Table of Contents
  17. 17. Saturday, April 27Symposium AIN and HRA: What a Surgeon Needs to Know 4:30 – 6:30 pmThe­incidence­of­anal­cancer­is­increasing­due­to­rising­rates­of­human­papilloma­virus­(HPV)­infection.­HPV­infection­canlead­to­anal­intraepithelial­neoplasia­(AIN)­that­can­be­identified­with­high­resolution­anoscopy­(HRA).­While­colon­andrectal­surgeons­are­very­familiar­with­the­evaluation­and­treatment­of­anal­cancer,­many­do­not­know­how­to­identify­theanal­cancer­precursor,­AIN­with­HRA.­In­the­United­States­anal­cancer­rates­are­rising­at­approximately­2%­per­year­and­theage­of­diagnosis­is­falling.­Certain­populations­including­men­who­have­sex­with­men,­women­with­gynecologic­HPV-related­disease­and­immune­compromised­individuals­are­disproportionately­affected.­The­anal­cancer­precursor­lesion,high-grade­anal­intraepithelial­neoplasia­(HGAIN),­is­histologically­and­etiologically­identical­to­the­high-grade­cervicaldysplasia.­Cervical­cancer­rates­have­fallen­dramatically­because­clinicians­diagnose­and­treat­high-grade­cervical­dysplasiathereby­preventing­progression­to­cancer.­All­colon­and­rectal­surgeons­will­no­doubt­identify­patients­with­anal­cancer,­butmost­do­not­know­how­to­diagnose­and­treat­HGAIN.­A­growing­number­of­clinicians­have­adapted­cervical­cancerscreening­techniques­to­the­anal­canal.­High-resolution­anoscopy­(HRA)­requires­special­skill­sets­most­surgeons­have­not,as­yet,­been­trained­in.This­symposium­will­present­the­epidemiology­of­anal­HPV­infection­with­a­particular­focus­on­prevalence­and­at­riskpopulations.­Screening­techniques­will­be­discussed­including­benefits­and­limitations­of­anal­cytology,­as­well­as­howhigh-resolution­anoscopy­(HRA)­is­performed­and­precancerous­and­cancerous­lesions­identified.­Treatment­options­both­inoffice­and­in­the­operating­room­will­be­presented­with­a­strong­focus­on­how­the­colon­and­rectal­surgeon­fits­into­thispicture.­Lastly,­we­will­discuss­the­efficacy­of­HPV­vaccines­as­related­to­anal­cancer­and­dysplasia­prevention.Existing GapsWhat Is: While­colon­and­rectal­surgeons­understand­the­evaluation­and­treatment­of­anal­cancer,­many­are­not­skilled­atthe­evaluation­and­treatment­of­AIN­and­use­of­HRA.What Should Be: Colon­and­rectal­surgeons­should­have­a­thorough­understanding­of­the­biology­of­AIN.­In­addition­colonand­rectal­surgeons­should­have­an­understanding­of­how­to­use­HRA­to­evaluate­and­treat­AIN.­Finally,­surgeons­shouldknow­all­of­the­treatment­options­available­for­patients­with­AIN. Director: Stephen Goldstone, MD, New York, NY4:30­pm Welcome and Overview 5:20­pm High-Resolution Anoscopy: What is HRA? Stephen­Goldstone,­MD,­New­York,­NY Naomi­Jay,­RN,­NP,­PhD,­San­Francisco,­CA4:35­pm Background on HPV: Epidemiology, Natural 5:45­pm The Role of the Surgeon in HRA History and Screening Stephen­Goldstone,­MD,­New­York,­NY Joel­Palefsky,­MD,­San­Francisco,­CA Mark­Welton,­MD,­Stanford,­CA5:05­pm Pathology of HPV: Understanding Cytology 6:30­pm Adjourn and Histology J.­Michael­Berry,­MD,­San­Francisco,­CA Objectives: At­the­conclusion­of­this­session,­participants­should­be­able­to:­a)­understand­the­prevalence­of anal­HPV­infection;­b)­understand­how­to­best­diagnose­AIN;­c)­learn­how­to­perform­high­resolution­anoscopy; and­d)­understand­treatment­options­available­for­AIN.­ 18 Return to Table of Contents
  18. 18. Saturday, April 27Symposium Advanced Endoscopic Techniques 5:00 – 6:45 pmThe­adoption­of­new­technology­and­techniques­for­surgeons­in­practice­is­challenging.­There­is­often­insufficientopportunity­for­the­practicing­surgeon­to­be­exposed­to­the­most­state­of­the­art­methods.­In­addition,­it­can­be­difficultfor­physicians­to­incorporate­these­techniques­into­their­practice.­In­order­to­surmount­these­obstacles,­it­is­necessary­forthe­surgeon­to­acquire­an­in­depth­understanding­of­the­available­technology,­the­indications­for­its­use­and­the­potentialbenefits­to­the­intended­patient­population.­A­number­of­new,­advanced­endoscopic­techniques­have­been­developed­over­the­past­few­years.­These­techniques­havenot­only­broadened­the­ability­of­the­endoscopist­to­successfully­scope­all­patients­but­they­also­allow­identification­andtreatment­of­colonic­pathology­such­as­polyps,­cancer,­and­inflammatory­bowel­disease.­New­endoscopic­techniques­haveresulted­in­higher­cecal­intubation­rates­and­lesion­identification.­Enhanced­imaging­technology­increases­polyp­detection.Endoscopic­clipping­can­control­bleeding­and­treat­colonic­perforation.­Colonic­stenting­is­a­non-operative­means­oftreating­colonic­obstruction­and­can­convert­a­two-stage­operation­into­a­one-stage­procedure.­Extended­submucosaldissection­and­the­use­of­both­CO2­and­laparoscopic­assistance­have­allowed­surgeons­to­resect­more­complex­coloniclesions­without­major­surgery.This­symposium­will­also­address­recent­advances­in­sedation­during­colonoscopy­and­how­surgeons­are­reimbursed­forcolonoscopy.Existing GapsWhat Is: Colorectal­surgeons­may­be­unfamiliar­with­several­new­techniques­to­improve­the­success­rate­of­colonoscopy­aswell­as­new­imaging­techniques­for­lesion­identification.­A­significant­number­of­surgeons­are­not­performing­endoscopicsubmucosal­resection­of­colorectal­neoplasia­or­combined­laparo-endoscopic­resection.­With­the­continued­advances­oftechnology­in­endoluminal­therapy,­surgeons­will­need­training­to­incorporate­these­methods­into­their­practice.What Should Be: Surgeons­need­to­have­a­comprehensive­understanding­of­the­newer­visualization­techniques­as­well­asthe­indications­and­uses­for­endoscopic­submucosal­resection,­colonic­stenting,­and­endoscopic­clipping.­This­importantlearning­session­will­provide­the­basis­for­the­meaningful­implementation­of­these­newer­endoluminal­techniques­andimprove­their­patients’­colorectal­care. Director: Peter Marcello, MD, Burlington, MA Assistant Director: Richard L. Whelan, MD, New York, NY Continued next page 19 Return to Table of Contents
  19. 19. Saturday, April 27 Advanced Endoscopic Techniques (Continued)5:00­pm Enhanced Visualization: Light, Dyes and 5:48­pm Colonic Stenting: When and How? Microscopy Maher­Abbas,­MD,­Los­Angeles,­CA Toshiaki­Watanabe,­MD,­Toyko,­Japan 6:00­pm Laparoscopic-Assisted Polypectomy5:12­pm Beyond Polypectomy: ESD Sang­Lee,­MD,­New­York,­NY Richard­L.­Whelan,­MD,­New­York,­NY 6:12­pm The Pain and Gain: Sedation and5:24­pm ESD: Another Point of View Reimbursement I.­Emre­Gorgun,­MD,­Cleveland,­OH­ Charles­Whitlow,­MD,­New­Orleans,­LA5:36­pm Endoscopic Clipping and Other Tools 101: 6:24­pm Panel Discussion/Questions Indications and Use 6:45­pm Adjourn Eric­Weiss,­MD,­Weston,­FL Objectives: At­the­conclusion­of­this­session,­participants­should­be­able­to:­a)­understand­methods­to­improve cecal­intubation­rates­and­lesion­detection;­b)­become­familiar­with­the­available­enhanced­endoscopic visualization­techniques;­c)­understand­the­indications­and­uses­for­endoscopic­submucosal­resection­for colorectal­neoplasia;­d)­understand­the­indications­and­technical­aspects­of­combined­laparoscopic­and endoscopic­resection­of­colorectal­neoplasia;­e)­understand­the­indication­and­utility­of­colonic­stent­placement; f )­learn­how­and­when­to­use­the­endoscopic­clip;­g)­learn­about­the­benefits,­risks­and­costs­of­new­methods of­sedation­for­colonoscopy;­and­h)­understand­how­colonoscopy­is­reimbursed. Photo Credit: Greater Phoenix CVB Inspired by the colors and textures of the Grand Canyon, the Phoenix Convention Center will serve as the venue for the Annual Meeting. 20 Return to Table of Contents
  20. 20. Sunday, April 28 Parallel Session 1-A Core Subject Update 7:00 – 9:30 amThe­core­subject­update­was­developed­to­assist­in­the­education­and­recertification­of­colon­and­rectal­surgeons.­Twenty-four­core­subjects­have­been­chosen­and­are­presented­in­a­rotating­four-year­cycle.­Presenters­are­experts­on­theirselected­topics­and­present­evidence­based­reviews­on­the­current­diagnosis,­treatment­and­controversies­of­thesediseases.­Following­each­20-minute­presentation,­a­brief­question­period­is­moderated­by­the­course­director.­A­writtensummary­of­each­talk­will­be­available­on­the­ASCRS­website­prior­to­the­meeting,­and­questions­developed­from­eachpresentation­will­be­included­in­the­American­Board­of­Colon­and­Rectal­Surgery’s­recertification­question­bank. Director: Steve Hunt, MD, St. Louis, MO7:00­am Colon Cancer 8:15­am Fecal Incontinence Luca­Stocchi,­MD,­Cleveland,­OH Tracy­Hull,­MD,­Cleveland,­OH7:20­am Discussion 8:35­am Discussion7:25­am Diverticulilitis 8:40­am Fistula/Abscess Andreas­Kaiser,­MD,­Los­Angeles,­CA Peter­Cataldo,­MD,­Burlington,­VT7:45­am Discussion 9:00­am Discussion7:50­am Other Colidites 9:05­am Perioperative Management Brian­Kann,­MD,­Philadelphia,­PA Alan­Herline,­MD,­Nashville,­TN8:10­am Discussion 9:25­am Discussion 9:30­am Adjourn Objectives: Upon­completion­of­this­session,­participants­should­be­able­to:­a)­discuss­the­medical­and­surgical treatment­of­anal­fissures­and­hemorrhoids;­b)­demonstrate­an­understanding­of­intussusception­and­solitary rectal­ulcer­and­discuss­optimal­treatment­of­rectal­prolapse;­c)­discuss­the­evaluation­and­medical­and­surgical treatment­of­ulcerative­colitis;­d)­discuss­the­management­of­patients­with­colonic­injuries­due­to­trauma­and­the surgical­treatment­of­colonic­volvulus;­e)­demonstrate­an­understanding­of­the­diagnosis­and­surgical­treatment­of anal­and­retrorectal­tumors;­and­f )­demonstrate­an­understanding­of­hereditary­colon­cancer­syndromes­and­the role­of­genetic­testing. 21 Return to Table of Contents
  21. 21. Sunday, April 28Symposium Parallel Session 1-B The Surgeon’s Toolbox: Using Staplers and Energy Wisely 7:00 – 9:30 amWhile­commonly­used­by­colon­and­rectal­surgeons,­the­science­of­stapling­and­energy­sources­is­a­topic­that­mostsurgeons­know­very­little­about.­Surgeons­need­to­know­the­mechanics­of­these­devices­in­order­to­use­them­properly.­Inaddition,­surgeons­need­to­know­about­the­various­ways­staplers­and­energy­sources­can­be­used­to­optimize­the­care­oftheir­patients.­The­mechanics­and­uses­of­all­stapler­types­will­be­reviewed.­In­addition,­the­complications­such­as­misfire,­stuck­andanastomotic­leak­will­be­discussed.­A­number­of­new­stapling­devices­have­become­available­over­the­past­few­years,including:­compression­anastomosis,­powered­staplers,­biologic­reinforcement­of­staple­lines,­and­more­minimally­invasivestapling­options.­This­symposium­will­review­these­newer­devices­and­techniques­as­well­as­compare­them­to­deviceswhich­have­been­in­use­for­some­time.­Final­emphasis­will­be­on­outcomes­based­on­methods­of­anastomosis­andtechnique­as­dictated­by­the­stapler­mechanics.Commonly­used­energy­sources­will­be­discussed­in­detail.­The­types­of­energy,­spread,­and­potential­for­injury­will­all­beaddressed.­This­symposium­will­also­address­recent­advances­in­energy­sources­available­for­colon­and­rectal­surgeons.Finally,­how­to­manage­a­fire/burn­in­the­operating­room­will­be­presented.Energy­of­various­kinds­is­also­used­by­colorectal­surgeons­in­the­endoscopy­suite.­This­symposium­will­address­the­types­ofenergy­and­optimal­use­of­that­energy­during­endoscopic­procedures.It­is­imperative­that­members­of­the­American­Society­of­Colon­and­Rectal­Surgeons­are­familiar­with­and­understand­thenew­techniques­and­technology­associated­with­staplers­and­energy­devices­in­order­to­provide­their­patients­with­the­bestpossible­colorectal­care.­Existing GapsWhat Is: Surgeons­currently­use­several­modalities­and­types­of­energy­and­stapling­devices­routinely­in­clinical­practice.There­is­a­generalized­lack­of­understanding­of­the­science­behind­and­proper­use­of­energy­devices­and­tissue­staplers.What Should Be: Surgeons­should­have­a­clear­understanding­of­the­science­and­biology­regarding­the­various­modalitiesof­energy­(advanced­bipolar,­monopolar,­ultrasonic)­and­tissue­management­(linear­and­circular­stapling)­in­order­tooptimize­outcomes­and­minimize­complications.­ Director: Scott Steele, MD, Fort Lewis, WA Assistant Director: Joshua Bleier, MD, Philadelphia, PA Continued next page 22 Return to Table of Contents

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