Clinical Congress ACS Strong for Jacobson Promising 3 in San Diego 7 Surgery 11 Investigator Award CLINICAL CONGRESSNEWS

THURSDAY, OCTOBER 20, 2016 INSIDE THIS ISSUE

2017 Clinical Congress ACS Strong for Jacobson Promising 3 in San Diego 7 Surgery 11 Investigator Award CLINICAL CONGRESSNEWS

Surgeon workforce BARBARA LEE BASS, MD, shortage requires innovative solutions FACS, IS 2016−2017 ACS “Simply producing more surgeons is an unwise response to the PRESIDENT-ELECT workforce crisis,” said Samuel R. G. Finlayson, MD, MPH, FACS, at arbara Lee Bass, MD, FACS, the executive director, Houston Methodist a Tuesday afternoon Panel Session John F. and Carolyn Bookout Institute for Technology, Innovation and titled Who’s on Call: Surgical Distinguished Endowed Chair Education (MITIE), a state-of-the-art Workforce Needs for the Next 25 and chair, department of surgery, education and research facility developed Years. “Addressing geographic BHouston Methodist Hospital, TX, was elected to safely train practicing health care distribution, specialty mix, and care Barbara Lee Bass, MD, FACS, President-Elect of the American College professionals in new technologies and 2016−2017 ACS President-Elect delivery models are the main chal- of Surgeons (ACS) procedures. She is lenges,” noted Dr. Finlayson, chair, at Wednesday’s professor of surgery, department of surgery, University of department of surgery, University Annual Business Weill Cornell Maryland, Baltimore (1999−2005). In of Utah Health Care, Salt Lake City. Meeting of the Medical College, 1997, she was interim chair, department A review of surgical workforce Members. The First New York, NY, and of surgery. While at the University data provided by KMarie Reid, and Second Vice- senior member of Maryland, Dr. Bass also served as MD, MS, FACS, a gastrointestinal Presidents-Elect also of the Houston chief, gastrointestinal surgical research surgeon, indicates that the U.S. were also elected. Methodist Hospital (1994−2005) at the Veterans Affairs population is projected to in- Dr. Bass is highly Research Institute. (VA) Medical Center, Baltimore. Earlier crease from 314 million in 2012 to respected for Before taking appointments included faculty positions 420 million in 2060. General sur- MD, FACS, her outstanding Left to right: Charles D. Mabry, on her roles at at the George Washington University First Vice-President-Elect; Basil A. Pruitt, Jr., geon workforce data from 2011 clinical and MD, FACS, FCCM, MCCM, Second Vice- Methodist Hospital School of Medicine, the Uniformed suggest that there are 5.8 general academic President-Elect in 2005, Dr. Bass was Services University of Health Sciences surgeons per 100,000 population, contributions professor of surgery (USUHS), the Veterans Affairs Medical although the ideal ratio is 7 per to the field of general surgery and (1994−2005), associate chair for research Center, and the Walter Reed Army 100,000, according to Dr. Reid. her commitment to teaching the next and academic affairs, and general Institute of Research. “Demand for physicians con- generation of surgeons. Dr. Bass is the surgery residency program director, tinues to grow faster than supply, PRESIDENT-ELECT continued on page 12 leading to a projected shortfall of between 46,100 and 90,400 physicians by 2025,” said Dr. Reid, New Regents, Board of Governors noting that the surgical workforce shortage is linked to an expanding Executive Committee members elected number of Medicare recipients and caps on training. The Board of Governors (B/G) of the Governor (2008−2014) and Chair, Advisory “General surgery training slots can American College of Surgeons (ACS) has Council for Urology (2011−2015). Prior to be changed by the U.S. Congress elected two new members to the Board of chairing the Advisory Council, Dr. Atala alone. The COGME [Council on Regents: Anthony Atala, MD, FACS, and was a member of the panel (2001−2011). Graduate Medical Education] has Fabrizio Michelassi, MD, FACS. In addition, He also has served on the Program recommended an increase in slots new B/G Executive Committee members Committee (2007−2011), the Surgical and funding over the last several have been elected. Research Committee (member, 2006−2011; decades, in disagreement with the Executive Committee, 2011−2014), the IOM [Institute of Medicine],” she Regents Scientific Forum Committee (2002−2007), said. COGME does not share the Dr. Atala is director of the Wake Forest the Advisory Council Chairs (2011−2015), Left to right: Anthony Atala, MD, FACS; IOM Committee’s conviction that Fabrizio Michelassi, MD, FACS Institute for Regenerative Medicine, and the and the B/G Committee to Study the Fiscal current funding levels and residency W. Boyce Professor and Chair, department Affairs of the College (2009−2014). positions are adequate to meet of urology, Wake Forest University, Winston- Dr. Michelassi is the Lewis Atterbury An ACS Fellow since 1987, Dr. Michelassi future health care needs and has Salem, NC. He is a practicing surgeon and Stimson Professor and Chair, Weill Cornell has held several leadership positions in the concluded that a physician shortage researcher in regenerative medicine. His Medical Center, and surgeon-in-chief, organization. Most recently, he was Chair of is likely in specific general and spe- groundbreaking, award-winning work has New York-Presbyterian/Weill Cornell the B/G (2014−2016; member, 2010−2014), cialty areas, according to Dr. Reid. focused on growing human cells, tissues, and Medical Center, New York, NY. He is a and, at present, he is a member of the Focusing solely on “expanding organs, as well as advances in 3-D printing. world-renowned gastrointestinal surgeon Ethics Committee. As a Governor, he has surgery training programs ignores A Fellow of the College since 1996, with expertise in the surgical treatment of served on the B/G Committee on Surgical the problem of maldistribution,” Dr. Atala has served in several leadership gastrointestinal and pancreatic cancers as Infections (2011−2013), Committee on positions in the ACS, including ACS well as inflammatory bowel disease. WORKFORCE continued on page 6 REGENTS continued on page 14

CLINICAL CONGRESS 2016 Stay Connected #ACSCC16 #CC16SELFIE

http://www.seeklogo.net

THURSDAY, OCTOBER 20, 2016 3

SESSION EXAMINES TODAY’S BURNING SURGICAL ISSUES uring Tuesday’s Ethics Colloquium: many production decisions that go into doc- without the patient’s knowledge or informed INSIDE Burning Issues in Surgical Ethics, umentary filmmaking. These programs tend consent—an echo of today’s itinerant surgery. THIS ISSUE surgeons explored challenges in to objectify the patient” and reduce them to Finally, session panelists focused on contemporary surgical practice. By their ailment, he added. “Reality TV can be concurrent surgery. Panelists noted that the Ddesign, the panel focused more on raising very misleading. A straightforward encounter ACS Statements on Principles now contain a 4 Oweida Scholar at ethical issues than on answering them. can become quite inflammatory,” he said. section on concurrent surgery—the practice Clinical Congress Anne C. Mosenthal, MD, FACS, chair, In addition, the panel focused on surgeons of dividing attention between two operating department of surgery, and professor, taking after-hours calls in rural or under- rooms. The panel examined the essence of 4 Question of the day department of surgery, Rutgers New Jersey served settings. Basic ethical questions often the issue, the surgeon’s obligation to the 4 #ACSCC16 on social Medical School, Newark, addressed the issues emerge. Panelist Dhiresh R. Jeyarajah, MD, unconscious patient. In December 2015, the surrounding surgery and television—“when FACS, Methodist Dallas Medical Center, TX, Boston Globe’s Spotlight team drew attention media entertainment, reality, and ethics collide at offered both an academic and private practice to the subject in a report, Clash in the Name 6 John J. Conley Ethics the bedside,” when the operating room be- perspective and said he always tries to act in of Care, which investigated concurrent surgery and Philosophy Lecture comes the setting for reality emergency room the best interest of the patient. “I always ask at Massachusetts General Hospital. Panelists television programming, “what are the ethical myself, ‘Am I the best person to take on this noted that concurrent surgery may occur from 11 2017 Jacobson Promising issues here?” Dr. Mosenthal asked. patient?’” he said. time to time, but represents a small portion of Investigator Award call “Filming what happens in the emergency The panel also explored itinerant surgery— all operations performed. for applications room has no benefit for the patient,” she when surgeons operate at a distance from The patient has the reasonable assumption 11 SESAP ® 16 mobile apps said. Does it harm the patient? “Concerns for their primary location. Itinerant surgery was that the attending surgeon is making the surgeons are related to ethics,” she said. “They long considered unethical, but surgical care is decisions, said Alexander Langerman, MD, ask themselves, ‘Can I be sued for this?’” It is evolving. Today, for example, much postop- SM, FACS, an otolaryngologist at Vanderbilt vital to obtain the patient’s explicit consent to erative care takes place outside the hospital. University Medical Center, but patients need be filmed, she said. Resident Kristy K. Broman, MD, MPH, Vander- to be assured that resident involvement will THURSDAY, OCTOBER 20, 2016 Ryan M. Antiel, MD, department of general bilt University Medical Center, Nashville, TN, not harm the quality of their care. CLINICAL surgery, Mayo Clinic, Rochester, MN, reported noted that surgical missions provide itinerant The patient has to trust the surgeon, who CONGRESSNEWS on a six-part documentary, Hopkins, which care that saves lives. In addition, postopera- still bears responsibility for the outcome, said aired on ABC in 2008, putting the Johns Hop- tive care is often provided by non-surgeons. Griffith Harsh, MD, MA, MBA, FACS, professor kins Hospital, Baltimore, MD, before a national “Times change, but people don’t,” said pan- of neurosurgery and associate dean, postgrad- TV audience. The program, which followed elist Tyler G. Hughes, MD, FACS, Chair of the uate medical education, Stanford University, Clinical Congress News the lives of caregivers and their patients, was American College of Surgeons (ACS) Advisory CA. If we violate that trust, he added, we’re in VOLUME 67, NO. 4 intended to be a reality-based adjunct to the Council for Rural Surgery. In 1913, the College’s trouble. Panelists called for continued explo- Editor popular drama, Grey’s Anatomy. burning ethical issues were fee-splitting and ration of the question and a tracking of the Diane Schneidman “The editing in these reality shows is highly “ghost surgery”—the practice of performing risks of concurrent surgery. More data-driven Senior Editor manipulative,” Dr. Antiel said. “There are an operation on another physician’s patient regulations are needed, they said. Tony Peregrin Contributing Editors Alison Boggs Matt Fox Plan to attend Clinical Congress 2017 in scenic San Diego Jeannie Glickson Director, Division of Integrated With Clinical Congress 2016 winding down, the members and staff Other sites of historic, cultural, and aesthetic note to see while in Communications of the American College of Surgeons can begin looking forward to San Diego include the Cabrillo National Monument, which commem- Lynn Kahn next year’s meeting. For the first time, Clinical Congress will take orates the first European expedition on the West Coast, and the San Photography Editor place in San Diego, CA, October 22–26. As always, the conference Diego Presidio fort, which is the first permanent European establish- Tina Woelke will provide the best surgical education and training opportunities for ment on the Pacific Coast. Hotel del Coronado, a historic beachfront Photography surgeons, residents, medical students, and allied health care profes- hotel located across San Diego Bay, is the second-largest wooden Oscar & Associates sionals. But the scenic host city also offers several points of interest structure in the U.S. Published daily Oct. 16-20, 2016 to keep in mind while planning your trip. Old Town and the Gaslamp Quarter offer a look into the city’s Office: Walter E. Washington San Diego is celebrated for its year-round beautiful weather. With history, alongside newer shopping and recreation areas. Seaport Convention Center, Hall B Phone: 202-249-4006 an average October temperature of 73 degrees Fahrenheit, the Village, a popular outdoor, waterfront shopping area, is less than Published by TriStar Publishing, Inc. many family-friendly attractions and sites around the city should a 15-minute walk from the San Diego Convention Center. And, of Items of interest or information must be available for your enjoyment after a busy day of meetings and course, one of the first images that comes to mind when thinking of be reported to the office of the Clinical educational programs. the San Diego area is its 70-plus miles of temperate beaches, includ- Congress News by 1:00 pm on the day preceding the desired day of publication. One the city’s most popular destinations is the world-renowned San ing Mission Bay, Pacific Beach, and La Jolla Shores. Diego Zoo, and especially the associated San Diego Zoo Safari Park. Clinical Congress 2017 in San Diego will offer many opportunities TriStar Publishing, Inc. 7285 W. 132nd St., Suite 300 The zoo is part of Balboa Park, which features a variety of museums to learn, teach, and network with colleagues from around the world, Overland Park, KS 66213 and gardens. Other popular sites include Sea World and Legoland— and the city promises a beautiful, unique setting to enjoy when it’s www.tristarpub.com and Disneyland is just a two-hour drive north in Anaheim. time to relax. International Guest Scholars International Guest Scholars and Travelers met with members of the International Relations Committee and posed for a group photo on Tuesday afternoon. Front row, from left: Christopher C. K. Ho, MD, MS, Kuala Lumpur, Malaysia; Manabu Kawai, MD, PhD, Wakayama, Japan; Guiseppe R. Nigri, MD, FACS, Chair, Scholarships Subcommittee; George Velmahos, Chair, IRC; Waddah Badir Al-Refaie, MB, BCh, FACS, Chair, Designated Scholarship Subcommittee; and Hiba Ezzeddine, MD, Beirut, Lebanon, Resident Exchange Fellow. Also pictured on the far right is Omar Khalaf, MD, Beirut. Middle row: Dimitrios Tsamis, MD, MSc, PhD, Athens, Greece, Stavros Niarchos Foundation Scholar; Adewale Oluseye Adisa, MB, BCh, FACS, Ile-Ife, Nigeria, International Surgical Education Scholar I; Takeo Toshima, MD, PhD, Matsuyama, Ehime, Japan, Japan Exchange Fellow; Joseph Martin Plummer, MB, BS, Kingston, Jamaica; Vivek Bindal, MB, BS, FACS, New Delhi, India, International Surgical Education Scholar II; Mauricio A. Pontillo, MD, FACS, Montevideo, Uruguay, Murray F. Brennan Scholar; Tanveer Ahmed, MB, BS, Dhaka, Bangladesh; Gustavo Kohan, MD, Buenos Aires, Argentina, Dr. Abdol Islami & Mrs. Joan Islami Scholar II; Yi Chen, MB, BS, PhD, FRACS, Melbourne, Australia, ANZ Exchange Fellow; and Wan Mohammed Aldohuky, MB, BCh, FACS, Duhok, Iraq, Community Surgeons Travel Awardee. Back row: Anubhav Vindal, MB, BS, FACS, New Delhi, India; Goran Santak, MD, Pozega, Croatia; Mohammed Kamal, MD, Kabul, Afghanistan, Baxiram S. and Kankuben B. Gelot Community Surgeons Travel Awardee; Nai- Chen Cheng, MD, PhD, Taipe, Taiwan, Elias Hanna Scholar; Marcello Donati, MD, PhD, Catania, Italy; Joseph S. Butler, MB, BCh, BOA, London, United Kingdom, Dr. Abdol Islami & Mrs. Joan Islami Scholar I; and Anthony Yuen Bun Teoh, MB, BCh, FRCSEd, PHKAM, PCSHK, Hong Kong, SAR, China, Carlos Pellegrini Traveling Fellow. Not pictured: Thilo Welsch, MD, MBA, Dresden, Germany, Germany Exchange Fellow.

CLINICAL CONGRESS NEWS Stay Connected #ACSCC16 #CC16SELFIE 4 4 CLINICAL CONGRESS NEWS

Join the OWEIDA SCHOLAR REFLECTS ON conversation CLINICAL CONGRESS BY CHAYANIN MUSIKASINTHORN, MD, FACS underrepresented by women. Their pres- During the Rural Surgeons Open Forum Follow @AmCollSurgeons General/trauma and critical care surgeon, ence, experience, and generous contri- Tuesday, I was able to interact with fellow Gallup Indian Medical Center, NM and let your colleagues know butions to the ACS Foundation exemplify rural surgeons, some of whom are affiliat- how surgeons can offer continued sup- ed with the Indian Health Service. Receiv- about Clinical Congress using In October 2013, I arrived in Washington, port for programs that provide funding for ing the Oweida Award from 2015–2016 #ACSCC16 DC, and stood among hundreds of my scholarships that allow talented surgical ACS President J. David Richardson, MD, The renowned Dr. Carlos Pellegrini. peers and colleagues from across the residents and ACS Fellows to conduct FACS, was truly a great honor. Hearing Blessed to hear his wisdom on the role of globe at the 99th Annual Clinical Con- research. I had the pleasure of hearing the challenges of a dwindling surgical trust in the patient-physician relationship. gress Convocation Ceremony reciting many of these scholars give their reports workforce with increased workload, #ACSCC16 the Fellowship Pledge of the American at the Scholarships Committee meeting. combined with additional administrative @webthethird College of Surgeons (ACS). I still remem- Participating onstage at the Opening duties, I am even more honored to be ber vividly the anticipation as I was about Ceremony Monday was an exhilarating ex- among the likes of Tyler G. Hughes, MD, Resident giving handoff think they are to step in the footprints of renowned perience. Being in the presence of the elite FACS, and other rural surgical colleagues, doing great. Resident receiving handoff surgeons in a league way above my own. group of ACS leaders disagree. Important area to improve I truly felt a sense of belonging and honor on the stage who have #patientsafety #ACSCC16 to be a part of such a respected organiza- dedicated years of @JustinBtheMD tion that has always sought to do what is sacrifice, leadership, Ohio--are you ready to #StoptheBleed? best for the patient. Being a Fellow of the and accomplishments I am! #ACSCC16 Let’s take this statewide. ACS has been one of the proudest times to keep surgical @nganttmd of my career, and the Clinical Congress traditions alive while has been one of the events that I look progressively ushering Dr Rebecca Britt presenting speed forward to each year. the field of surgery mentoring program - great way to address Having matriculated at the Uniformed into the 21st century multiple issues and potentially meet a Services University of the Health Sci- in these challenging mentor! #ACSCC16 ences in Bethesda, MD, being here is times of electronic @mcwhmd like coming home. Now living in a small health records and From left: Tyler G. Hughes, MD, FACS; Chayanin Musikasinthorn, MD, Dr. Pellegrini giving an amazing and rural community of 23,000 people that payment reforms FACS; J. David Richardson, MD, FACS inspiring talk on patient trust and otherwise serves more than 300,000 reinforced not only my communication. #wisdom #necessary mainly Navajo patients, I often feel a passion for medical knowledge and surgi- knowing the sacrifices they often make #notinbooks #ACSCC16 pang of nostalgia being back in the city cal expertise, but also for the optimization due to the limited resources available. I @SantosMDsurg of many ethnicities. The diversity is similar of patient care. This message was reflected am honored and truly humbled to have at Clinical Congress, with the represen- in the ACS President’s video address by been selected to receive the 2016 Nizar Dr Bass re: #surgmentoring “Be astonished by the generosity of your colleagues.” tation of national and foreign surgeons, Courtney M. Townsend, Jr., MD, FACS, N. Oweida, MD, FACS, Scholarship. The Definitely impressed by the support young and experienced, all with the same 2016–2017 ACS President, who empha- generous award in memory of Dr. Owei- available at #ACSCC16 goals—to obtain new information, learn sized that we should “Do What’s Right for da has enabled me attend the Clinical @sadiailyasmd from experts, and bring updated surgical the Patient.” Congress and take advantage of its many information on how to better care for The Martin Memorial Lecture by Delos educational opportunities. Should surgeon-scientists accept a lower patients back home. M. Cosgrove III, MD, FACS, highlighted The worst part about being a physician salary for the “luxury” of doing research? As the 2016 Nizar N. Oweida Scholar, the epidemic of burnout facing physi- is that sometimes it isn't possible to help @CapriceGreenber says “no” #ACSCC16 I was given a great honor to personally cians, especially general surgeons. The someone. The worst cases are those where @drewshirleymd meet several talented and experienced ACS’ acknowledgement of the forces I have nothing to offer, like so many of my Goodbye DC! Had a wonderful time at surgeons from different backgrounds, affecting surgeon’s well-being and work- young alcohol cirrhotic patients facing #ACSCC16 and #AWS2016. Until next time! including the remarkable Amilu Stewart, force shortages nationwide reassured me end-of-life palliative care. Being a Fellow of @AmCollSurgeons @WomenSurgeons MD, FACS, and Mary H. McGrath, MD, that the College is committed to quality the ACS means I have access to the tools @PMartinezMD MPH, FACS, who have inspired me and care with the emphasis on doing what is not only to help me provide quality care other young women to pursue a career in right, not only for the patient, but for the to my patients, but also to cope when I Excellent slide set and great pearls surgery, which, to this day, continues to be physician as well. am unable to provide such care. on social media, intellectual property, data acquisition & academic meetings. #ACSCC16 #AAO2016 @RaviDGoel QUESTION OF THE DAY What has been the highlight of this year’s Clinical Congress? CLINICAL CONGRESS REGISTRATION

Zachary Andrew Taylor, Martina de Sienna, Eric Alan Wiebke, Isabella Jade Kuo, DO, Resident Member Medical Student Member MD, FACS MD, FACS Bethesda, MD Rome, Italy Hampton, VA Irvine, CA

“The global and “General surgery is the “Connecting with people “The highlight for me humanitarian effort highlight for me. I’m from we haven’t seen in a was the session for new As of Wednesday afternoon, total sessions and activities Italy and this is a huge and few years is always the Fellows because I was an registration for Clinical Congress 2016 were a big highlight this interesting conference highlight of the meeting— Initiate this year.” was 12,865; 8,769 were physicians, and the year. They reflected this for me to learn and meet seeing old friends and rest were exhibitors, guests, spouses, and year’s theme of identifying others.” meeting new ones.” convention personnel. the challenges we face going forward.”

Stay Connected #ACSCC16 #CC16SELFIE THURSDAY, OCTOBER 20, 2016 APPROVED

TO LEARN MORE… VISIT US AT BOOTH 801

John J. Conley Ethics and Philosophy Lecture TRUSTING RELATIONSHIPS ADD CONTEXT AND MEANING TO SURGEONS’ PROFESSIONAL LIVES “I did not embrace the study of philosophy the arch, the so-called keystone, because commitment to trust, they must protect Another potential barrier to fostering or ethics in any formal way during my the stability and the integrity of the arch rather than exploit that vulnerability. To do physician-patient communication is formative years or during my early are dependent on the keystone,” he said. so, the physician must place the medical physician burnout. “There are many professional life. But as the years went “It is my theory that communication is good in the context of the patient’s assess- reasons that account for burnout, by, I found that the power of healing, the the most effective vehicle to engender ment of what is good,” he said. including the increasing regulations under influence that I have over my patients to that trust,” added Dr. Pellegrini, referring The physician must recognize that which we work, the long hours most alleviate pain, suffering, and discomfort specifically to non-verbal communication. although he or she is the medical expert, physicians have to put into their work, and could be substantially enhanced by the “The way we ‘walk the talk’ of life is the “the patient is the expert when it comes the emotional rollercoaster physicians kind of relationship I established with single most powerful way to communi- to determining what is ‘good’ for him face as they witness firsthand the effects them,” said Carlos A. Pellegrini, MD, FACS, cate. I am convinced that in order to main- or her given his or her values, beliefs, of their illnesses,” Dr. Pellegrini noted. “To FRCSI(Hon), FRCS(Hon), FRCSEd(Hon), in tain trust, we must use communication in and aspirations.” In other words, Dr. deal with the latter, some have suggested his opening remarks during Wednesday’s every form that allows us to establish a re- Pellegrini said, the physician is obligated that physicians should not become John J. Conley Ethics and Philosophy lationship with another human being, with to present clinical data as free as possible personally or emotionally involved with Lecture, TRUST: The Keystone of the ourselves as we reflect on our own lives, of personal or professional bias. the fate of their patients. But how can we Patient-Physician Relationship. and with other members of the team. A perceived barrier to establishing not do that? How can one person become Dr. Pellegrini, Past-President of the “Medicine brings a few twists to the communication and trust in the physician- immutable when a patient’s husband is American College of Surgeons (ACS) general understanding of trust,” Dr. patient relationship is technology. shedding some tears because his wife and professor of surgery and chair, Pellegrini said. In the physician-patient “Some argue that modern and advanced has just been diagnosed with advanced department of surgery, University of relationship, trust results from a number of technologies have led us astray by breast cancer? While some have tried to Washington, Seattle, said he visualizes interactions and dimensions that include emphasizing technology over emotional disconnect themselves from patients or the patient-physician relationship and the patient’s perception of the physician’s care,” Dr. Pellegrini said. “I personally the community they serve, I submit to you the connection surgeons develop with technical competence, the physician’s view modern technological medicine that establishing a meaningful connection members of the surgical team as an values, and their overall impression of as a wonderful thing—for you, for me, with the patients and the colleagues in arch—the curved structure that spans the how the system works, including the and for the patients—and I would never the organization is probably one of the space between two points. reputation of the institution. advocate the suppression of technological most powerful deterrents to physician “The surgeon represents one pillar and Dr. Pellegrini underscored the relevance advances. The solution to our problem is burnout. These relationships provide the other party represents the other pillar. of vulnerability when building trust with pa- not to deny technology or to pretend that context, meaning, and purpose to the I envision trust as the stone on the top of tients. “In order for physicians to fulfill their it is unnecessary.” physician’s life.”

WORKFORCE continued from page 1

Dr. Finlayson said. “Flooding the market said Dr. VanDerHeyden, adding that “the with surgeons will likely lead to oversupply breakpoint for considering an [acute care] STOP Neck Pain in high-supply areas with little effect on service seems to be about two to three low-supply areas. Improving the way we general surgery operative admits per day, deliver surgical care will directly address the per group.” with Ergonomic Loupes workforce problem.” When approaching hospital adminis- Dr. Finlayson cited a physician workforce trators with an acute care general surgery study conducted by the Dartmouth Center service proposal, Dr. VanDerHeyden sug- for the Evaluative Clinical Sciences (now gested highlighting improved emergency the Dartmouth Institute for Health Policy department (ED) and operating room flow and Clinical Practice), Lebanon, NH, which and a decrease in ED general surgery call suggests that patients in U.S. regions with a coverage expense. greater physician supply do not necessarily “Coding and billing are more complex get better care. than elective surgery,” she added. “[But] “Physicians in high-supply regions are resources applied to coding assistance and more likely to report problems with continuity documentation pay for themselves.” of care, poor communication, and difficulty Addressing the needs of the rural surgery providing good quality care,” Dr. Finlayson workforce, Alexander D. Wade, MD, FACS, Traditional SurgiTel’s noted. “There is no evidence that patient a general surgeon with the Gundersen Loupe Designs Ergonomic Design outcomes are better in high-supply regions.” Health System, La Crosse, WI, noted that He suggested channeling resources “rural hospitals will be in competition with toward the provision of higher quality care, urban hospitals for hiring from a limited which would result in physicians taking less pool of surgeons. As urban hospitals have “The SurgiTel loupes have essentially time to address complications. [an advantage], surgical care in rural areas eliminated all of the neck and back Nicole VanDerHeyden, MD, PhD, DVM, may be at risk.” He said that “based on rec- FACS, director of trauma, acute care ognized workforce models, rural hospitals pain that I previously endured while surgery and surgical critical care, Salem will need to recruit two general surgeons performing surgery. Simply put, the Regional Medical Center, OR, addressed each by 2030.” SurgiTel loupes have saved my career.” acute care general surgery service and its Dr. Wade offered a number of solutions potential to solve workforce needs and on- to address the rural surgeon workforce Raymond Singer call issues. “You should consider a trauma shortage, including employing the “frac- MD, MMM, CPE, FACS, FACC, FCCP and acute care surgery program if surgeons tional surgeons” model (two full-time and complain that call is too burdensome at one part-time surgeon); surgeon job shar- night or if hospital [staff and administrators] ing; and “surgical relief,” as exemplified ® feel that quality of care afterhours is hit or by the University of North Dakota School miss,” Dr. VanDerHeyden suggested. of Medicine and Health Sciences Rural Booth Another sign that adding an acute care Surgery Support Program, Grand Forks, program would be beneficial is an uptick in which provides practice coverage for rural SurgiTel the number of surgeons who “complain of surgeons and helps in the recruitment of a 1-800-959-0153 www.SurgiTel.com #512 interference with elective cases or clinic,” permanent surgeon for the community.

Stay Connected #ACSCC16 #CC16SELFIE THURSDAY, OCTOBER 20, 2016 THURSDAY, OCTOBER 20, 2016 7

Special Session introduces attendees to ACS Strong for Surgery initiative dverse surgical event prevention have on postoperative outcomes and is that an effective checklist is a remarkable including the ACS; as well as the program now at the hospital occurs too little, complications. He reviewed data from tool for standardization, a remarkable tool for being used in 50 Pacific Northwest hospitals too late, said Thomas K. around the world and across surgical education; but it’s also a communication tool,” as examples of the program’s success. Varghese, Jr., MD, MS, FACS, specialties that show an increased risk of said Dr. Varghese, noting that if a step on a Concluding the session, Clifford Y. Ko, duringA a Tuesday Special Session, American postoperative infections if a patient has checklist is missed, it provides an opportunity MD, MS, MSHS, FACS, Director, ACS College of Surgeons (ACS) Strong for Sur- hyperglycemia the day preceding surgery to discuss why the omission occurred. Division of Research Optimal Patient Care, gery. The Strong for Surgery initiative, which or within two days after surgery. Dr. Varghese explained that the Strong for discussed how Strong for Surgery aligns started in select Washington State hospitals “The exact correct level of glucose prior Surgery initiative has defined four modifi- with the College’s longstanding goal of in 2012 and will operate under the ACS aegis to operation is unknown, but high glucose able factors—smoking cessation, optimizing improving patient care. A significant por- as a nationwide model in the near future, is unequivocally increases the risk of surgical medication usage, optimizing nutrition, and tion of the ACS workforce and spending is aimed at improving surgical outcomes by site infection and other perioperative blood sugar control—that can affect patient dedicated to its various Quality Programs, bettering the patient’s health before surgery. infection,” Dr. Dellinger said. He also spoke outcomes. “These were chosen because all aimed at providing better care for Waiting until the day of surgery to focus of preoperative carbohydrate loading with they had the most robust data available,” patients, he noted. The tenets of Strong for on a patient’s health is a missed opportunity, associated insulin administration and its he said. After data and content experts Surgery are a natural fit, and the College is said Dr. Varghese, head of general thoracic positive impact on blood sugar control. were consulted, the methods for controlling always looking to partner with people and surgery, University of Utah, adding that “if Dr. Varghese returned to the podium to these factors were formed into checklists for organizations that are doing good work. instead of waiting for the patient to come discuss how Strong for Surgery has worked use at six diverse pilot hospitals. “We’re going to take the good work all of to the hospital we shift that spotlight to in the Pacific Northwest. He explained So what was the measurable impact of these people are doing, and we’re going to engaging patients from the first time they that the program was founded on two Strong for Surgery on these hospitals? Dr. expand it,” said Dr. Ko, explaining that the walk in a physician’s office, it gives us a principles: raising awareness and changing Varghese discussed the reach, effectiveness, ultimate goal is to take Strong for Surgery unique opportunity to optimize their health practice. One significant change that Dr. adoption, implementation, and maintenance and tie it together with the College’s other in the perioperative environment.” Varghese emphasized as important to of the program, which included significant perioperative improvement initiatives E. Patchen Dellinger, MD, FACS, general effective practice change was the use of social media and print publication interest; a and program, such as the ACS National surgeon, University of Washington Medical checklists, which he said are sometimes drop in serious adverse event rates following Surgical Quality Improvement Program Center, Seattle, spoke on the impact that misunderstood. preoperative immunonutrition support and Risk Calculator and the continuing work on preoperative blood sugar control, which “One of the myths about checklists is a decrease in smoking rates, both based on preparing elderly patients for surgery, to is one of four preoperative areas of focus sometimes people think of them as passive Strong for Surgery recommendations; and make the ACS a unified resource base to in the Strong for Surgery initiative, can documents that hang on the wall. The reality support from many professional organizations, best prepare patients for surgery.

JOIN THE HEALTH CARE TEAM THAT MAKES A DIFFERENCE.

There are few experiences more rewarding than serving as a surgeon and ofﬁ cer on the U.S. Army or Army Reserve health care team. You will work with professionals at the top of their ﬁ elds, be exposed to new innovative technologies and points of view, and even have the opportunity to take part in humanitarian missions.

Visit the Army Medical Recruiting Booth #205 or go to healthcare.goarmy.com/fx25 to learn more.

CLINICAL CONGRESS NEWS Stay Connected #ACSCC16 #CC16SELFIE I ENEREG AC For Patients Undergoing Partial Bowel Resections With Primary Anastomosis ER AC Addn ETERE to an Acceeated otoeate Cae atay oed ean Te to Recoeya y to 1 Day Phase 4 Radical Phase 3 Bowel Cystectomy Study ACCELERATE GI RECOVERY Resection Studies The ACP used in E E E HOURS clinical trials included: NGT FASTER HOURS HOURS FASTER HOURS FASTER FASTER HOURS ENEREG HOURS FASTER FASTER ndcaton and Uae ENTEREG is indicated to accelerate the time to upper and lower gastrointestinal recovery following surgeries that include partial bowel resection with primary anastomosis. otant Saety noaton Time vs Placebo, Hours

WARNING: POTENTIAL RISK OF MYOCARDIAL INFARCTION WITH LONG-TERM USE: FOR SHORT-TERM HOSPITAL USE ONLY in GI Recovery Mean Improvements tudy tudy tudy tudy tudy tudy EEE n EEE n EEE n EEE n EEE n EEE n haard ratio Placeo n Placeo n Placeo n Placeo n Placeo n Placeo n C conidence Increased incidence of myocardial infarction was seen in a clinical trial of patients taking . C .. . C .. . C .. . C .. . C .. . C .. interal alvimopan for long-term use. No increased risk was observed in short-term trials. aGI recovery was de ned as the time to toleration of solid food and rst bowel movement. Because of the potential risk of myocardial infarction, ENTEREG is available only Median time to GI recovery was improved with use of ENTEREG by 17 hours (Study 1, Study 2), 15 hours (Study 3), 12 hours (Study 4), and 3 hours (Study 5) in the phase 3 3 through a restricted program for short-term use (15 doses) called the ENTEREG Access bowel resection studies and 29 hours in the phase 4 radical cystectomy study (Study 6). Patient numbers are for modi ed ITT; dose of ENTEREG used was 12 mg. Support and Education (E.A.S.E.) Program. S bladder cancer) were administered ENTEREG 12 mg The ef cacy of ENTEREG following Data are from 5 multicenter, randomized, double-blind, or placebo 30 minutes to 5 hours prior to surgery total abdominal hysterectomy has not parallel-group, placebo-controlled studies in patients and twice daily after surgery until discharge, for a been established. C undergoing bowel resection and 1 randomized, maximum of 7 days. double-blind, placebo-controlled study in patients There were no limitations on the types of general S E ENTEREG Capsules are contraindicated in patients who have taken undergoing radical cystectomy (5 US studies and 1 anesthesia used. Patients who received more than 3 doses therapeutic doses of opioids for more than 7 consecutive days non-US bowel resection study; ENTEREG: n=1096; The primary endpoint for all studies was time to of an opioid (regardless of route) during the immediately prior to taking ENTEREG. placebo: n=1058; 54% male; 89% Caucasian). achieve resolution of postoperative ileus, a clinically 7 days prior to surgery and patients with complete Patients 18 years of age or older (average age: 62 de ned composite measure of both upper and lower bowel obstruction or who were scheduled for a years) who underwent bowel resection surgeries that GI recovery. GI2 (toleration of solid food and rst total colectomy, colostomy, or ileostomy were W included primary anastomosis (partial large or small bowel movement) represents the most objective and excluded. Intrathecal or epidural opioids or bowel resection surgery or radical cystectomy for clinically relevant measure of treatment response. anesthetics were prohibited. There were more reports of myocardial infarctions in patients treated with alvimopan 0.5 mg twice daily compared with placebo-treated patients in a 12-month otant Saety noaton study of patients treated with opioids for chronic W (continued) pain. In this study, the majority of myocardial prior to surgery. These patients may be more sensitive infarctions occurred between 1 and 4 months E.A.S.E. Program for ENTEREG: ENTEREG is available to ENTEREG and may experience GI side effects (eg, after initiation of treatment. This imbalance only to hospitals that enroll in the E.A.S.E. ENTEREG abdominal pain, nausea and vomiting, diarrhea). has not been observed in other studies REMS Program. To enroll in the E.A.S.E. Program, the ENTEREG is not recommended for use in patients with of alvimopan, including studies hospital must acknowledge that: severe hepatic impairment, end-stage renal disease, of patients undergoing bowel – Hospital staff who prescribe, dispense, or administer complete gastrointestinal obstruction, or pancreatic or resection surgery who received ENTEREG have been provided the educational gastric anastomosis, or in patients who have had surgery alvimopan 12 mg twice materials on the need to limit use of ENTEREG for correction of complete bowel obstruction. daily for up to 7 days. A to short-term, inpatient use A R causal relationship with – Patients will not receive more than 15 doses of ENTEREG The most common adverse reaction (incidence ≥1.5%) alvimopan has not – ENTEREG will not be dispensed to patients after they occurring with a higher frequency than placebo among been established. have been discharged from the hospital ENTEREG-treated patients undergoing surgeries that ENTEREG should be administered with caution to patients included a bowel resection was dyspepsia (ENTEREG, receiving more than 3 doses of an opioid within the week 1.5%; placebo, 0.8%). S I W

U S T I B R A ae ETERE at o Yo e and otca otoco

R Berger NG, Ridol TJ, Ludwig KA. Delayed gastrointestinal recovery after abdominal operation—role of alvimopan. Clin Exp Gastroenterol. 2015;8:231- 235. Melnyk M, Casey RG, Black P, Koupparis AJ. Enhanced recovery after surgery (ERAS) protocols: time to change practice? Can Urol Assoc J. 2011;5(5):342-348. Data available on request from Merck & Co., Inc., Professional Services-DAP, WP1-27, PO Box 4, West Point, PA 19486-0004. Please specify information package ANES-1149074-0001.

81777me_b.indd 1-2 8/9/16 5:13 PM I ENEREG AC For Patients Undergoing Partial Bowel Resections With Primary Anastomosis ER AC Addn ETERE to an Acceeated otoeate Cae atay oed ean Te to Recoeya y to 1 Day Phase 4 Radical Phase 3 Bowel Cystectomy Study ACCELERATE GI RECOVERY Resection Studies The ACP used in E E E HOURS clinical trials included: NGT FASTER HOURS HOURS FASTER HOURS FASTER FASTER HOURS ENEREG HOURS FASTER FASTER ndcaton and Uae ENTEREG is indicated to accelerate the time to upper and lower gastrointestinal recovery following surgeries that include partial bowel resection with primary anastomosis. otant Saety noaton Time vs Placebo, Hours

U S T I B R A ae ETERE at o Yo e and otca otoco

81777me_b.indd 1-2 8/9/16 5:13 PM ENTEREG® (alvimopan) capsules 12 mg, for oral use Effects of Alvimopan on Intravenous Morphine Coadministration of alvimopan does not appear to alter the pharmacokinetics of morphine and its metabolite, BRIEF SUMMARY OF PRESCRIBING INFORMATION morphine-6-glucuronide, to a clinically significant degree when morphine is administered intravenously. Dosage WARNING: POTENTIAL RISK OF MYOCARDIAL INFARCTION WITH LONG-TERM USE: adjustment for intravenously administered morphine is not necessary when it is coadministered with alvimopan. FOR SHORT-TERM HOSPITAL USE ONLY Effects of Concomitant Acid Blockers or Antibiotics There was a greater incidence of myocardial infarction in alvimopan-treated patients compared A population pharmacokinetic analysis suggests that the pharmacokinetics of alvimopan were not affected by to placebo-treated patients in a 12-month clinical trial, although a causal relationship has not concomitant administration of acid blockers or antibiotics. No dosage adjustments are necessary in patients been established. In short-term trials with ENTEREG, no increased risk of myocardial infarction taking acid blockers or antibiotics. was observed. USE IN SPECIFIC POPULATIONS Because of the potential risk of myocardial infarction with long-term use, ENTEREG is available Pregnancy only through a restricted program for short-term use (15 doses) under a Risk Evaluation and Pregnancy Category B Mitigation Strategy (REMS) called the ENTEREG Access Support and Education (E.A.S.E.®) Program. Risk Summary: There are no adequate and/or well-controlled studies with ENTEREG in pregnant women. No fetal harm was observed in animal reproduction studies with oral administration of alvimopan to rats at doses 68 to DOSAGE AND ADMINISTRATION 136 times the recommended human oral dose, or with intravenous administration to rats and rabbits at doses For hospital use only. The recommended adult dosage of ENTEREG is 12 mg administered 30 minutes to 5 hours 3.4 to 6.8 times, and 5 to 10 times, respectively, the recommended human oral dose. Because animal prior to surgery followed by 12 mg twice daily beginning the day after surgery until discharge for a maximum of 7 reproduction studies are not always predictive of human response, ENTEREG should be used during pregnancy days. Patients should not receive more than 15 doses of ENTEREG. only if clearly needed. CONTRAINDICATIONS Animal Data: Reproduction studies were performed in pregnant rats at oral doses up to 200 mg/kg/day (about ENTEREG is contraindicated in patients who have taken therapeutic doses of opioids for more than 7 consecutive 68 to 136 times the recommended human oral dose based on body surface area) and at intravenous doses up days immediately prior to taking ENTEREG. to 10 mg/kg/day (about 3.4 to 6.8 times the recommended human oral dose based on body surface area) and WARNINGS AND PRECAUTIONS in pregnant rabbits at intravenous doses up to 15 mg/kg/day (about 5 to 10 times the recommended human Potential Risk of Myocardial Infarction with Long-term Use oral dose based on body surface area), and revealed no evidence of impaired fertility or harm to the fetus due There were more reports of myocardial infarctions in patients treated with alvimopan 0.5 mg twice daily to alvimopan. compared with placebo-treated patients in a 12-month study of patients treated with opioids for chronic non- Nursing Mothers cancer pain (alvimopan 0.5 mg, n = 538; placebo, n = 267). In this study, the majority of myocardial infarctions It is not known whether ENTEREG is present in human milk. Alvimopan and its ‘metabolite’ are detected in the occurred between 1 and 4 months after initiation of treatment. This imbalance has not been observed in other milk of lactating rats. Exercise caution when administering ENTEREG to a nursing woman. studies of ENTEREG in patients treated with opioids for chronic pain, nor in patients treated within the surgical Pediatric Use setting, including patients undergoing surgeries that included bowel resection who received ENTEREG 12 mg Safety and effectiveness in pediatric patients have not been established. twice daily for up to 7 days (the indicated dose and patient population; ENTEREG 12 mg, n = 1,142; placebo, n = 1,120). A causal relationship with alvimopan with long-term use has not been established. Geriatric Use ENTEREG is available only through a program under a REMS that restricts use to enrolled hospitals. Of the total number of patients in 6 clinical efficacy studies treated with ENTEREG 12 mg or placebo, 46% were 65 years of age and over, while 18% were 75 years of age and over. No overall differences in safety or E.A.S.E. ENTEREG REMS Program effectiveness were observed between these patients and younger patients, and other reported clinical experience ENTEREG is available only through a program called the ENTEREG Access Support and Education (E.A.S.E.) has not identified differences in responses between the elderly and younger patients, but greater sensitivity of ENTEREG REMS Program that restricts use to enrolled hospitals because of the potential risk of myocardial some older individuals cannot be ruled out. No dosage adjustment based on increased age is required. infarction with long-term use of ENTEREG. Notable requirements of the E.A.S.E. Program include the following: Hepatic Impairment ENTEREG is available only for short-term (15 doses) use in hospitalized patients. Only hospitals that ENTEREG is not recommended for use in patients with severe hepatic impairment. have enrolled in and met all of the requirements for the E.A.S.E. program may use ENTEREG. Dosage adjustment is not required for patients with mild-to-moderate hepatic impairment. Patients with To enroll in the E.A.S.E. Program, an authorized hospital representative must acknowledge that: mild-to-moderate hepatic impairment should be closely monitored for possible adverse effects (e.g., diarrhea, • hospital staff who prescribe, dispense, or administer ENTEREG have been provided the educational gastrointestinal pain, cramping) that could indicate high drug or ‘metabolite’ levels, and ENTEREG should be materials on the need to limit use of ENTEREG to short-term, inpatient use; discontinued if adverse events occur. • patients will not receive more than 15 doses of ENTEREG; and Renal Impairment • ENTEREG will not be dispensed to patients after they have been discharged from the hospital. ENTEREG is not recommended for use in patients with end-stage renal disease. Dosage adjustment is not Further information is available at www.ENTEREGREMS.com or 1-800-278-0340. required for patients with mild-to-severe renal impairment, but they should be monitored for adverse effects. Gastrointestinal-Related Adverse Reactions in Opioid-Tolerant Patients Patients with severe renal impairment should be closely monitored for possible adverse effects (e.g., diarrhea, Patients recently exposed to opioids are expected to be more sensitive to the effects of μ-opioid receptor gastrointestinal pain, cramping) that could indicate high drug or ‘metabolite’ levels, and ENTEREG should be antagonists, such as ENTEREG. Since ENTEREG acts peripherally, clinical signs and symptoms of increased discontinued if adverse events occur. sensitivity would be related to the gastrointestinal tract (e.g., abdominal pain, nausea and vomiting, diarrhea). Race Patients receiving more than 3 doses of an opioid within the week prior to surgery were not studied in the No dosage adjustment is necessary in Black, Hispanic, and Japanese patients. However, the exposure to postoperative ileus clinical trials. Therefore, if ENTEREG is administered to these patients, they should be ENTEREG in Japanese healthy male volunteers was approximately 2-fold greater than in Caucasian subjects. monitored for gastrointestinal adverse reactions. ENTEREG is contraindicated in patients who have taken Japanese patients should be closely monitored for possible adverse effects (e.g., diarrhea, gastrointestinal pain, therapeutic doses of opioids for more than 7 consecutive days immediately prior to taking ENTEREG. cramping) that could indicate high drug or ‘metabolite’ levels, and ENTEREG should be discontinued if adverse Risk of Serious Adverse Reactions in Patients with Severe Hepatic Impairment events occur. Patients with severe hepatic impairment may be at higher risk of serious adverse reactions (including dose- NONCLINICAL TOXICOLOGY related serious adverse reactions) because up to 10-fold higher plasma levels of drug have been observed Carcinogenesis, Mutagenesis, Impairment of Fertility in such patients compared with patients with normal hepatic function. Therefore, the use of ENTEREG is not Carcinogenesis: Two-year carcinogenicity studies were conducted with alvimopan in CD-1 mice at oral doses recommended in this population. up to 4000 mg/kg/day and in Sprague-Dawley rats at oral doses up to 500 mg/kg/day. Oral administration of End-Stage Renal Disease alvimopan for 104 weeks produced significant increases in the incidences of fibroma, fibrosarcoma, and sarcoma No studies have been conducted in patients with end-stage renal disease. ENTEREG is not recommended for use in the skin/subcutis, and of osteoma/osteosarcoma in bones of female mice at 4000 mg/kg/day (about 674 in these patients. times the recommended human dose based on body surface area). In rats, oral administration of alvimopan for Risk of Serious Adverse Reactions in Patients with Complete Gastrointestinal Obstruction 104 weeks did not produce any tumor up to 500 mg/kg/day (about 166 times the recommended human dose No studies have been conducted in patients with complete gastrointestinal obstruction or in patients who have based on body surface area). surgery for correction of complete bowel obstruction. ENTEREG is not recommended for use in these patients. Mutagenesis: Alvimopan was not genotoxic in the Ames test, the mouse lymphoma cell (L5178Y/TK+/−) forward Risk of Serious Adverse Reactions in Pancreatic and Gastric Anastomoses mutation test, the Chinese Hamster Ovary (CHO) cell chromosome aberration test, or the mouse micronucleus ENTEREG has not been studied in patients having pancreatic or gastric anastomosis. Therefore, ENTEREG is not test. The pharmacologically active ‘metabolite’ ADL 08-0011 was negative in the Ames test, chromosome recommended for use in these patients. aberration test in CHO cells, and mouse micronucleus test. ADVERSE REACTIONS Impairment of Fertility: Alvimopan at intravenous doses up to 10 mg/kg/day (about 3.4 to 6.8 times the Clinical Trials Experience recommended human oral dose based on body surface area) was found to have no adverse effect on fertility Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the and reproductive performance of male or female rats. clinical trials of a drug cannot be compared directly with rates in the clinical trials of another drug and may not PATIENT COUNSELING INFORMATION reflect the rates observed in clinical practice. The adverse event information from clinical trials does, however, Recent Use of Opioids provide a basis for identifying the adverse events that appear to be related to drug use and for approximating Patients should be informed that they must disclose long-term or intermittent opioid pain therapy, including any rates. The data described below reflect exposure to ENTEREG 12 mg in 1,793 patients in 10 placebo-controlled use of opioids in the week prior to receiving ENTEREG. They should understand that recent use of opioids may studies. The population was 19 to 97 years old, 64% were female, and 84% were Caucasian; 64% were make them more susceptible to adverse reactions to ENTEREG, primarily those limited to the gastrointestinal tract undergoing a surgery that included bowel resection. The first dose of ENTEREG was administered 30 minutes to (e.g., abdominal pain, nausea and vomiting, diarrhea). 5 hours before the scheduled start of surgery and then twice daily until hospital discharge (or for a maximum of 7 Hospital Use Only days of postoperative treatment). ENTEREG is available only through a program called the ENTEREG Access Support and Education (E.A.S.E.) Among ENTEREG-treated patients undergoing surgeries that included a bowel resection, the most common Program under a REMS that restricts use to enrolled hospitals because of the potential risk of myocardial adverse reaction (incidence ≥1.5%) occurring with a higher frequency than placebo was dyspepsia (ENTEREG, infarction with long-term use of ENTEREG. Patients should be informed that ENTEREG is for hospital use only for 1.5%; placebo, 0.8%). Adverse reactions are events that occurred after the first dose of study medication no more than 7 days after their bowel resection surgery. treatment and within 7 days of the last dose of study medication or events present at baseline that increased in Most Common Side Effect severity after the start of study medication treatment. Patients should be informed that the most common side effect with ENTEREG in patients undergoing surgeries DRUG INTERACTIONS that include bowel resection is dyspepsia. Potential for Drugs to Affect Alvimopan Pharmacokinetics An in vitro study indicates that alvimopan is not a substrate of CYP enzymes. Therefore, concomitant For more detailed information, please read the Prescribing Information. USPI-MK3753-C-1508R000 administration of ENTEREG with inducers or inhibitors of CYP enzymes is unlikely to alter the metabolism Revised: 08/2015 of alvimopan. Potential for Alvimopan to Affect the Pharmacokinetics of Other Drugs Based on in vitro data, ENTEREG is unlikely to alter the pharmacokinetics of coadministered drugs through Copyright © 2016 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. inhibition of CYP isoforms such as 1A2, 2C9, 2C19, 3A4, 2D6, and 2E1 or induction of CYP isoforms such as All rights reserved. ANES-1187831-0001 07/16 1A2, 2B6, 2C9, 2C19, and 3A4. In vitro, ENTEREG did not inhibit p-glycoprotein.

81777me_b.indd 3 8/9/16 5:13 PM THURSDAY, OCTOBER 20, 2016 11

Ankit Bharat, MD, FACS, receives 2016 Joan L. and Julius H. Jacobson II Promising Investigator Award ACS ACCEPTING APPLICATIONS FOR 2017 nkit Bharat, MD, FACS, recruitment in the transplanted lung, assistant professor of leading to its injury. Recently, Dr. Bharat JACOBSON PROMISING thoracic surgery and made an important discovery that INVESTIGATOR AWARD pulmonary and critical a donor-derived intracellular patho- careA medicine, Feinberg School of gen, ureaplasma species, previously The American College of Surgeons (ACS) is Medicine, Northwestern University, unknown to cause fatal infections, is the accepting nominations for the 13th Joan L. and Chicago, IL, received the 12th Joan cause of hyperammonemia following Julius H. Jacobson II Promising Investigator Award L. and Julius H. Jacobson II Prom- lung transplantation, which kills at least (JPIA), which will be conferred in 2017. The award ising Investigator Award during the 4 percent of lung recipients. He further was established to recognize outstanding surgeons Annual Business Meeting of Members showed that this organism leads to who are engaged in research that advances the art Wednesday. Courtney M. Townsend, other significant complications in lung and science of surgery and who demonstrate early Jr., MD, FACS, 2016−2017 President recipients and can be easily treated by Left to right: Ankit Bharat, MD, FACS; Kamal M.F. Itani, MD, FACS promise of significant contribution to the practice of the American College of Surgeons antimicrobial therapy. of surgery and the safety of surgical patients. The (ACS) presented the award. Dr. Bharat’s second line of investiga- of Respiratory Cell and Molecular award is funded through a generous endowed fund Dr. Bharat completed his surgical tion focuses on lung repair/regenera- Biology and as a reviewer for several established by the donors and administered by the residency, postdoctoral fellowship, tion. He recently developed a technol- other journals. He is also a mentor to ACS Surgical Research Committee (SRC). and cardiothoracic surgery training at ogy for accurate assessment in lung surgical residents in his laboratory, Award Criteria Washington University, St. Louis, MO, healing following thoracic resections both of whom have been awarded 1. Candidates must be Fellows or Associate Fellows in July 2013 before joining the faculty based on the analysis of intrapleural institutional T32 awards, as well as a of the ACS. at Northwestern University, where he gas milieu. He further demonstrated postdoctoral research fellow. 2. Candidates must be board certified in a surgical serves as program director for the ad- that intrapleural carbon dioxide is det- Melina R. Kibbe, chair, department specialty and must have completed surgical vanced lung failure fellowship and the rimental to lung repair and reduction of surgery and the Zach D. Owens Dis- training, including fellowship, in the last six thoracic surgery clerkship director. He in carbon dioxide can achieve a three- tinguished Professor of Surgery, Uni- years. This does not include military, medical, also serves as director of the inaugural fold improvement in lung healing. versity of North Carolina at Chapel Hill, or family leave. lung transplantation program at North- Basic investigation in his laboratory and past Edward G. Elcock Professor 3. Candidates must hold a faculty appointment at a western Medicine. has shown that mammalian airway and of Surgical Research, and vice-chair of research-based academic medical center or hold Upon joining Northwestern, Dr. alveolar epithelial cells as well as mac- research, department of surgery, and a military service position. Bharat started the school’s lung rophages sense carbon dioxide. He professor, division of vascular surgery, 4. Candidates must have received peer-reviewed transplant and respiratory extracorpo- has found that carbon dioxide impairs Northwestern University, said, “I can- funding such as a K-series award from the real membrane oxygenation (ECMO) the ability of macrophages to clear not think of anyone more deserving National Institutes of Health (NIH), Veterans programs. His clinical practice involves cellular debris at the site of injury (effe- of the Joan L. and Julius H. Jacobson Administration, National Science Foundation, treating complex thoracic diseases and rocytosis) and impairs cell proliferation II Promising Investigator Award than or U.S. Department of Defense merit review to providing advanced therapies such as and migration independently through Dr. Ankit Bharat. Dr. Bharat represents support their research. Surgeon-scientists who ECMO and lung transplantation oper- inhibition of Kreb’s cycle in mitochon- the epitome of a surgeon scientist. In are well established (for example, recipients of ations to patients with end-stage lung dria and Rac1-GTPase, respectively. the process of delivering outstanding NIH R01 grants or equivalent grants from other failure. He also provides minimally inva- His work introduces the possibility that patient care, what is unique about Dr. agencies) are not eligible. sive treatment to patients with thoracic strategies to counter carbon dioxide Bharat is that he asks the important 5. Only one application per surgical department will malignancies, including robotic and signaling can improve lung healing. question: ‘How can we do this better?’ be accepted. video-assisted thoracoscopic surgery. Dr. Bharat has received a K08 re- He then takes the key clinical ques- i. Nomination documentation must include Dr. Bharat’s research interests include search award from the National Heart tions to the laboratory and determines a one-page essay to the committee lung immunobiology and repair. He Lung and Blood Institute. He has also a better way to care for patients explaining why the candidate should be is investigating the pathogenesis and received grants from the American through innovation and discovery re- considered for the award and describing importance of lung-restricted autoim- Lung Association, American Associa- search. In the short time since starting the importance of their past and current munity in allograft rejection and has tion of Thoracic Surgery, Thoracic Sur- his academic career, he has already research. described a novel two-hit mechanism gery Research Foundation, LUNGevity contributed fundamentally to improv- ii. Nomination documentation must include for the development of autoimmunity, Foundation, Dixon Foundation, Soci- ing the care of transplant patients copies of the candidates’ three most showing that it plays a dominant role in ety of University Surgeons, and Gift of suffering from hyperammonemia, and significant publications from their current lung allograft rejection. Upon comple- Hope – Chicago Foundation. His work has determined a better way to treat faculty position. tion, this work will challenge the current has resulted in a number of manu- pulmonary air leaks. These extraordi- iii. Nomination documentation must include paradigm that only looks at histocom- scripts as well as awards from national nary initiatives demonstrate the true a letter of recommendation from the patibility antigens in allotransplantation. organizations. The Royal Australasian potential for Dr. Bharat to contribute candidates’ department chairs. Up to three Related to his work in immunology, College of Surgeons recently invited substantially to our understanding and additional letters of recommendation will Dr. Bharat has identified the presence Dr. Bharat for a visiting professorship treatment of surgical diseases in the be accepted. of a novel subset of intravascular pul- at their annual meeting. future. I strongly believe that Dr. Bharat iv. Nomination documentation includes a NIH- monary monocytes that are responsi- Dr. Bharat serves on the editori- has a unique vision and is a rising star formatted biographical sketch though the ble for the initial signals of neutrophil al board of the American Journal in the world of academic surgery.” electronic application system. ® New edition of SESAP offers apps to go anywhere Special consideration will be given to surgeons who are at the “tipping point” of their research careers The new edition of Surgical Education convenience of being able to exit the ing each category, or all at once. The with a track record indicative of early promise and and Self-Assessment Program (SESAP®) program without completing a section iterative model used for Continuing potential (for example, degree program in research offers a variety of mobile applications and, upon re-entering, will be returned Medical Education (CME) credits rein- or K-award). that will allow participants to use to the same point in the program. forces learning and supports mastery SESAP without a continuous Internet SESAP 16 features 850 newly of the content. How to Apply connection. SESAP 16, developed by constructed, multiple-choice ques- SESAP 16 is available in a variety of To be considered for the 2017 award, applications the American College of Surgeons tions with discussions and references CME and NonCME formats. To earn must be submitted on or before February 24, 2017. Division of Education, upholds the to the current literature in 14 major CME credit, the CME Web version Please visit the JPIA website at www.facs.org/ program’s 45-year tradition of providing areas of general surgery consistent or corresponding applications must quality-programs/about/cqi/jacobson to submit the highest-quality, peer-reviewed, evi- with the American Board of Surgery be used. The print syllabus books are documentation and nomination materials. dence-based content to promote surgi- (ABS) outline for topics addressed in available as an optional supplement. For additional information, please contact Carla cal expertise, and now offers expanded ABS examinations. Participants can A NonCME Web version and NonCME Manosalvas at [email protected]. access. Users can move seamlessly be- earn up to 90 AMA PRA Category 1 print version are also available. All tween mobile applications on tablets or Credits™, all of which can be used for options include access to mobile smartphones and the online versions. Self-Assessment purposes and can be applications for iPads, Android tablets, For the first time, users have the added claimed immediately after complet- iPhones, and Android phones.

CLINICAL CONGRESS NEWS Stay Connected #ACSCC16 #CC16SELFIE 1212 CLINICAL CONGRESS NEWS

PRESIDENT-ELECT continued from page 1

A Fellow of the College since 1988 changes in surgical training. As Chair Dr. Bass graduated summa cum laude Board of Regents (2002−2011). As a and the 2013 recipient of the College’s of the Program Committee, she led the with a bachelor of science degree from Regent, he was a member of the Finance highest honor—the Distinguished Clinical Congress strategic planning Tufts University, Medford, MA, (1975). She Committee (2003−2011), the Executive Service Award—Dr. Bass served as an process in 2006. As a result, the annual earned her doctor of medicine (MD) de- Committee (2010−2011), and the Advisory ACS Regent (2001−2010) and on the meeting was restructured progressively in gree (1979) from the University of Virginia, Council for Pediatric Surgery (2002−2003); Executive Committee of the Board of 2007−2010 to facilitate access to high- Charlottesville, where she was elected to he chaired the Member Services Liaison Regents (2005−2009). As a Regent, she quality specialty and program-specific the Alpha Omega Alpha Honorary Soci- Committee (2008−2011) and the Health was a member of the Finance Committee content tracks. Programmatic review, ety. She completed her surgical internship Policy Steering Committee (2006−2009). (2005−2010), Member Services Liaison targeted expansion, a review course for and general surgery residency at George Dr. Mabry also has served on the Board of Committee (2004−2008), Central Judiciary board examination preparation, Meet- Washington University, Washington, DC Governors Committee on Socioeconomic Committee (2002−2005), and the Schol- the-Expert Luncheons, and Town Hall (1986), while completing a gastrointestinal Issues (2007−2009, 2011−2013) and the arship Committee. She is a Past-Chair of meetings were added to the Clinical surgical research fellowship and serving Health Policy and Advocacy Workgroup both the ACS Committee on Education Congress during this process. Dr. Bass as Captain, U.S. Army Medical Corps (2013−2014), the Program Committee (2003−2006) and the Clinical Congress continued to serve as a consultant to the (1982−1984). (2006−2009, 2011−2014), and the Com- Program Committee (2005−2011). Program Committee until 2014. munications Committee (1991−1995, Prior to becoming a Regent, Dr. Bass She was recently appointed to Co- First Vice-President-Elect 2002−2003). At present, he is a member served on the ACS Board of Governors Chair the Committee on Skills Training for The First Vice-President-Elect is Charles of the ACS Health Policy Advisory Group (1995−2001), as a member of the Gover- Surgeons in Practice with Ajit K. Sachdeva, D. Mabry, MD, FACS, a general surgeon and Chair of the Health Policy Advisory nors Executive Committee (1998−2001), MD, FACS, FRCSC, Director, ACS Division from Pine Bluff, AR, and associate Council. He is Past-President of the Arkan- and ultimately as Chair (1999−2001). She of Education. This committee will address professor of surgery and practice sas Chapter, Past-Chair of the Arkansas chaired the Governors Committee on retooling needs and strategies for prac- management advisor to chair, department Committee on Trauma, and a member of Surgical Practice (1997−1998) and was a ticing surgeons who need to acquire new of surgery, University of Arkansas for the Arkansas Committee on Applicants. member of the Governors Committees on skills. To launch this effort, she hosted the Medical Sciences, Little Rock. Dr. Mabry Dr. Mabry is a 1971 graduate of the Socioeconomic Issues (1996−1998) and “Retooling Reimagined” symposium at also is medical director of quality, Jefferson University of Central Arkansas, Conway. Physician Competence (1999−2001). In MITIE earlier this year. Regional Medical Center, Pine Bluff. He earned his MD and completed his addition, she served on the ACS Health Dr. Bass has held leadership roles in many Dr. Mabry serves on the Governor’s general surgery residency at the University Policy Advisory Committee (2008−2010) other professional organizations, including Trauma Advisory Committee for the of Arkansas for Medical Sciences (1975 and the Transition to Practice workgroup chair, ABS; president, Society for Surgery of State of Arkansas and is Chair of the and 1979, respectively). (2012). She served on the ACS Women the Alimentary Tract; and president, Society Committee’s Quality Improvement in Surgery Committee for many years as of Surgical Chairs. She has inspired other Subcommittee. He is Chairman of the Second Vice-President-Elect a member and then as a consultant until women in surgery and as a result is a recipi- Board of the Arkansas Preferred Provider The Second Vice-President-Elect is former 2014. She delivered the Olga M. Jonasson, ent of the Association of Women Surgeons Organization. He previously served on the ACS Governor Basil A. Pruitt, Jr., MD, FACS, MD, Lecture at Clinical Congress 2014. Nina Starr Braunwald Award and the Olga Continuing Medical Education Committee FCCM, MCCM, the Dr. Ferdinand P. Herff Dr. Bass has been a champion of the Jonasson Distinguished Member Award. and as Vice-Chair of the Board of the Chair in Surgery, clinical professor of surgery, National Surgical Quality Improvement A mentor to more than 30 pre- and Arkansas Foundation for Medical Care. In department of surgery, trauma division, Program (NSQIP) since its inception at the postdoctoral fellows, Dr. Bass has authored addition, he has served on the Governor’s University of Texas Health Science Center, VA. While at VA Medical Center in Balti- or co-authored 145 peer-reviewed papers, Advisory Council for Emergency Medical San Antonio, and professor of surgery at more, she helped to launch the program, delivered 52 named lectureships, and Service Training Committee. ® USUHS. Dr. Pruitt is an esteemed leader® in and served as a principal investigator at a presented 109 invited talks. Her research AMarginMarker Fellow of the College since 1988, Dr. &four CorrectClips broad areas: burns, trauma, injury, and participating institution in the Agency for programs in gastrointestinal cell biology, Mabry has been a tireless and committed critical care surgery; biomedical research Healthcare Research and Quality’s testing computational surgery, surgical outcomes volunteer since THEhe joined STANDARD the Young SurFOR- TISSUEand scholarship; ORIENTATION organizational® leadership of the program (1994−2002). She went sciences, and clinical research have been geons Committee in 1989. He was a mem- and development; and mentorship. on to serve on the ACS NSQIP® Steering funded by the National Institutes of Health ber of the committee until 1993 and then From 1967 to 1968, Dr. Pruitt was chief Committee (2004−2010). (NIH), the VA Research program, the went on to serve as Vice-Chair through of surgeryExhibit and chief 940 of professional A contributor to a number of ACS National Science Foundation, and other 1995. His command of analytical data and services at the busiest evacuation educational initiatives, Dr. Bass was an groups. Her first grant was an ACS Faculty effective communication skills led to his hospitalSterile in Vietnam Ink (400−500and major author of the Surgical Education and Research Award (1987). She has served appointment to represent the ACS on the operationsRadiographic per month) Clips and then chief Self-Assessment Program (1996−2002). As as a member of the NIH Surgery and American Medical Association Relative of the trauma research team, studying an ACS Regent and chair of the American Bioengineering Section and has served Value Update Committee (1995−present). the cardiopulmonaryImprove Outcomes responses to Board of Surgery (ABS), she served on on the editorial boards or as associate In a related activity, he serves on the ACS injury in combat casualties. He served the American Surgical Association’s Blue editor of many surgical journals, including General Surgery Coding and Reimburse- as Commander and Director of the U.S. Ribbon Committee, cosponsored by the Journal of the American College of ment Committee (1992−present). Army Institute of Surgical Research for the ACS, to evaluate and recommend Surgeons, Annals of Surgery, and Surgery. Dr. Mabry served three terms on the continued on next page MMCC Showcase 9 2016 MMCC Showcase

EXHIBITOR SPOTLIGHT

MarginMarker® & CorrectClips® SilversteinWrap™

THE STANDARD FOR TISSUE ORIENTATION® Exhibit 940 Post-Surgical Post-Biopsy Exhibit 940 Compression Wrap Sterile Ink and Fewer Seromas and Radiographic Clips Hematomas Improve Outcomes Improve Outcomes MMCC Showcase 9 2016 MMCC Showcase SW Showcase 9 2016 Showcase SW

Stay Connected #ACSCC16 #CC16SELFIE THURSDAY, OCTOBER 20, 2016 SilversteinWrap™

Exhibit 940 Post-Surgical Post-Biopsy Compression Wrap Fewer Seromas and Hematomas Improve Outcomes SW Showcase 9 2016 Showcase SW THURSDAY, OCTOBER 20, 2016 13

PRESIDENT-ELECT continued from page 1 DR. CIOFFI HOSTS 27 years and became a trailblazer in Care Medicine, the Whitaker International ATLS instructor (1981−present), on SESAP MEET AND GREET the management of trauma, burns, and Burns Prize, the Tanner-Vandeput-Boswick development committees, as a Scudder critical care patients worldwide. Burn Prize, the Lifetime Achievement Orator (1984), and as an Excelsior Surgical ON TTP PROGRAM Dr. Pruitt has been recognized with Award of the Society of University Sur- Society/Edward D. Churchill Lecturer (1988). appointments to NIH study sections, the geons, the Roswell Park Medal, and the He served on the Executive Committee VA Merit Review Board for Surgery, and the King Faisal International Prize in Medicine. (1974−1980) and as a Councilor (1981−1984) Shriners Hospitals Research Advisory Board A Fellow of the College since 1966, of the South Texas Chapter of the ACS. and Clinical Outcomes Studies Advisory Dr. Pruitt has been an ACS Governor In addition to his many years of service Board. He has served as a reviewer and (1973−1979), serving on the B/G Nominating to the College, Dr. Pruitt has served referee for the Hong Kong Research Grants Committee (1977−1979; Chair, 1978−1979). as president of 12 surgical societies, Council; the BC (British Columbia) Health He has served on what is now known as including the American Burn Association, Research Foundation and Alberta Heritage the Committee on Perioperative Care American Association for the Surgery of Foundation, Canada; the U.S. VA, and the (1969−1975; Vice-Chair, 1973−1975; Senior Trauma, American Surgical Association, NIH. Perhaps Dr. Pruitt’s most enduring Member, 1975−1979). He remained on Halsted Society, International Society legacy is his mentorship of a cadre of the Editorial Committee of that body for Burn Injuries, Southern Surgical leading physicians and scientists, including (1979−1984) and was a contributing Association, and the Western Surgical 46 directors of burn centers, more than 20 author or co-editor of Manual of Surgical Association. He is an Honorary Fellow of department chairs, and 11 past-presidents Nutrition; Manual on Control of Surgical the Society of Black Academic Surgeons of the American Burn Association. Infections, 1st edition; Manual of Surgical and an honorary member of the Japanese Dr. Pruitt has received national and Critical Care; Manual of Preoperative and Association for Acute Medicine. He served international commendations for his con- Postoperative Care; and Manual on Control for 20 years as the associate editor and 17 William G. Cioffi, Jr., MD, FACS (right), tributions to patient care. A few examples of Infection in Surgical Patients, 2nd edition. years as the editor-in-chief of the Journal American College of Surgeons (ACS) include the National Safety Council’s Sur- He also has played an active role on the of Trauma. Treasurer, met with Clinical Congress guests in an informal Meet and Greet geons Award for Distinguished Service to Committee on Trauma (1974−1980; Senior Dr. Pruitt graduated from Harvard Col- hosted by the ACS Transition to Practice Safety, the Robert Danis Prize of the Socíeté Member, 1980−1984), the International lege, Boston, MA (1952), and Tufts Medical (TTP) Program on Tuesday afternoon. Internationale de Chirurgie, the Medallion Relations Committee (1982−1989; Chair, School (1957). He completed his initial Dr. Cioffi and other program participants were available to speak with anyone for Scientific Achievement of the American 1987−1989), and the Surgical History Group surgical training at Boston City Hospital interested in the program. Surgical Association, the Distinguished (2013−present; Chair, Program Committee, (1962) and his surgical residency at Brooke Investigator Award of the Society of Critical 2014−present). He also has served as an General Hospital, San Antonio (1964).

EXHIBITOR SPOTLIGHT

TM TM

Anchor_ACS_2016_NEW_ShowcaseAdsTrio_PRINTr1.indd 5 9/12/16 3:25 PM Anchor_ACS_2016_NEW_ShowcaseAdsTrio_PRINTr1.indd 6 9/12/16 3:25 PM

TM How close is your ideal surgery job? Depends on how close you are to this:

Booth 1344

Visit the locums experts.

Anchor_ACS_2016_NEW_ShowcaseAdsTrio_PRINTr1.indd 4 9/12/16 3:25 PM CLINICAL CONGRESS NEWS Stay Connected #ACSCC16 #CC16SELFIE 1414 CLINICAL CONGRESS NEWS

REGENTS continued from page 1 Socioeconomic Issues (2011), and the and assistant dean of governmental Cheryl L. Olson, MD, FACS, San Diego; Ad Hoc Committee to Restructure the affairs, University of Nebraska College James M. Nottingham, MD, FACS, South B/G Committees (2012−2013). He also of Medicine, Omaha (second term) Carolina; Peter A. Andreone, MD, FACS, has served on the International Relations • Michael J. Zinner, MD, FACS, founding South Dakota; Stephan Baker, MD, FACS, Committee (2003−2009; Vice-Chair, chief executive officer and executive South Florida; Mary L. Brandt, MD, FACS, 2007−2009; Chair, 2009−2011; Consultant, medical director of the Miami Cancer Daniel L. Dent, MD, FACS, South Texas; 2011−2013); Committee on Chapter Institute at Baptist Health South Oscar J. Hines, MD, FACS, Vincent L. Rowe, Relations (2007−2011); Advisory Council Florida, Coral Gables, FL (third term) MD, FACS, Brian R. Smith, MD, FACS; Shirin Program Representatives (Co-Chair, Towfigh, MD, FACS,Southern California; 2007−2013); Committee on Video-Based B/G Executive Committee Left to right: S. Rob Todd, MD, FACS, Alan M. Buchele, MD, FACS, Southwest Education (1992−2002); Advisory Council The B/G elected the following Officers FCCM; Nicole S. Gibran, MD, FACS Missouri; Sopon Jirasiritham, MD, FACS, for General Surgery (2003−2013; Vice- to the Board of Governors Executive Thailand; Safwan Abdul-Rahman Taha, MB, Chair, 2013−2014); Program Committee Committee: critical care residency, Baylor College of BCh, FACS, United Arab Emirates, and Brian (2007−2013; Consultant, 2013−2014); • Chair: Diana L. Farmer, MD, FACS, Medicine; and chief, general surgery, and J. Kaplan, MD, FACS, Virginia. Committee on Research and Optimal a pediatric surgeon, Pearl Stamps director, Ginni and Richard Mithoff Trauma Patient Care (2014−2015); Bylaws Stewart Professor of Surgery, and chair, Center, Ben Taub Hospital, Houston, TX. 2016 Specialty Society Governors Committee (2014−2015); Advisory department of surgery, University of Cali- Elected to an initial two-year term on The following individuals were selected Council Chairs (2013−2014); and Member fornia Davis Health System Sacramento the B/G Executive Committee is Nicole to represent their specialty societies: Services Liaison Committee (2013−2016). • Vice-Chair: Steven C. Stain, MD, FACS, S. Gibran, MD, FACS, David and Nancy Philip R. Wolinsky, MD, FACS, American He also has played a leadership role a general surgeon and Henry and Auth-Washington Research Foundation Academy of Orthopaedic Surgeons; in the Manhattan Chapter of the ACS Sally Schaffer Chair and Professor, Endowed Chair for Restorative Burn Jeffrey M. Schwartz, MD, FACS, American as a Governor and as member of the department of surgery, Albany Medical Surgery, professor, department of surgery, Academy of Orthopaedic Surgeons; Credentials Committee (2013−present). Center, NY director, UW Medicine Regional Burn George W. Holcomb III, MD, FACS, In addition, the following individuals have • Secretary: Susan K. Mosier, MD, MBA, Center at Harborview Medical Center, American Academy of Pediatrics (Surgical been reappointed to the Board of Regents: FACS, an ophthalmologist, Secretary, and adjunct professor, department Section); Kimberly A. Davis, MD, MBA, • Margaret M. Dunn, MD, MBA, FACS, Kansas Department of Health and of medicine, division of dermatology, FACS, American Association for the Surgery dean of medicine and professor Environment, and State Health Officer University of Washington, Seattle. of Trauma; William M. Kuzon Jr., MD, PhD, of surgery, Wright State University for Kansas, Topeka FACS, American Association of Plastic Boonshoft School of Medicine, In addition, S. Rob Todd, MD, FACS, Governors-at-Large Surgeons; Nicole S. Gibran, MD, FACS, Dayton, OH (third term) FCCM, has been selected to serve an initial The members elected the following American Burn Association; Gady Har- • James W. Gigantelli, MD, FACS, pro- one-year term on the Executive Committee Governors representing the chapters of El, MD, FACS, American Laryngological fessor and interim chair, department of the B/G. Dr. Todd is professor and chief, the College and the surgical specialty Association; Brad W. Warner, MD, FACS, of ophthalmology and visual sciences, section of acute care surgery, department societies to fill pending vacancies for an American Pediatric Surgical Association; University of Nebraska Medical Center, of surgery, and program director, surgical initial, three-year term: Helen A. Pass, MD, FACS, American Society Alberto Raul Ferreres, MD, PhD, of Breast Surgeons; Thomas E. Read, MD, FACS(Hon), Argentina; Jorge E. Foianini, FACS, American Society of Colon and MD, FACS, Bolivia; Savino Gasparini, MD, Rectal Surgeons; Scot B. Glasberg, MD, FACS, Brazil; John M. Cosgrove, MD, FACS, FACS, American Society of Plastic Surgeons; CLINICAL CONGRESS 2017 Brooklyn-Long Island; O. N. M. Panton, Arun K. Gosain, MD, FACS, American OCTOBER 22–26 | SAN DIEGO, CA MB, BS, FACS, British Columbia (Canada); Society of Maxillofacial Surgeons; Ginny L. Juan Hepp, MD, FACS, Chile; Gilberto Bumgardner, MD, PhD, FACS, American Ka Kit Leung, MB, BS, FACS, China-Hong Society of Transplant Surgeons; Russell Kong; Larry D. Dillon, MD, FACS, Colorado; J. Nauta, MD, FACS, American Surgical Edward M. Timmins, DO, FACS, Eastern Association; Arthur I. Sagalowsky, MD, Long Island; Luis O. Carrion, MD, FACS, FACS, American Urological Association; Ecuador; Deepak G. Nair, MD, FACS, Florida; Peter B. Greenspan, DO, FACS, Central James D. Colquitt, MD, FACS, Harold L. Association of Obstetricians and SAVE THE DATE Kent, MD, FACS, Christopher K. Senkowski, Gynecologists; Jamie S. Ullman, MD, FACS, MD, FACS, Georgia; Dimitrios A. Linos, MD, Congress of Neurological Surgeons; Eric OCT 22–26 • SAN DIEGO, CA FACS, Greece; Brian E. O’Byrne, MD, FACS, A. Elster, MD, FACS, Department of the Idaho; Mark Kuhnke, MD, FACS, Illinois; Navy; Oscar D. Guillamondegui, MD, FACS, David J. Welsh, MD, FACS, Indiana; Iradj Eastern Association for the Surgery of Fazel, MD, FACS, Iran; Thomas F. Gorey, MB, Trauma; Francis D. Ferdinand, MD, FACS, BCh, FACS, Ireland; Antonio Di Cataldo, International Society for Minimally Invasive The Best Surgical Education MD, FACS, Italy; Michael S. Nussbaum, MD, Cardiothoracic Surgery; David L. Berger, FACS, Jacksonville; Katsuhiko Yanaga, MD, MD, FACS, New England Surgical Society; All in One Place PhD, FACS, Japan; William S. Richardson, Gaetan Brochu, MD, FACS, Royal College of MD, FACS, Louisiana; Terry Buchmiller, MD, Physicians and Surgeons of Canada; James FACS, Massachusetts; H. David Reines, MD, W. L. Wilson, MD, FACS, Royal College of FACS, Metropolitan DC; Ronald L. Ernst, Physicians and Surgeons of Canada; Andrea MD, FACS, Nebraska; Patrick A. Mahon, MD, A. Hayes-Jordan, MD, FACS, Society of Black FACS, New Hampshire; Michael L. Arvanitis, Academic Surgeons; Steven C. Stain, MD, MD, FACS, Anne C. Mosenthal, MD, FACS, FACS, Society for Surgery of the Alimentary Michael J. Spedick, MD, FACS, New Jersey; Tract; Steven D. Schwaitzberg, MD, FACS, David W. Wormuth, MD, FACS, New York; Society of American Gastrointestinal and Roberto Anaya-Prado, MD, FACS, Nor- Endoscopic Surgeons; Robert P. Edwards, Occidental (Mexico); Terry Sarantou, MD, MD, FACS, Society of Gynecologic FACS, North Carolina; Michael S. Truitt, MD, Oncologists; Ronald J. Weigel, MD, PhD, FACS, Northeast Texas; Carlos A. Gutierrez- FACS, Society of Surgical Oncology; Flores, MD, FACS, Northeast Mexico; Walter Kelli Bullard Dunn, MD, FACS, Society of S. Cha, MD, FACS, Randy J. Woods, MD, University Surgeons; Eric W. Sherburn, FACS, Ohio; Ronald A. Squires, MD, FACS, MD, FACS, Southern Neurological Oklahoma; Camilo A. Rodriguez Zambrano, Society; Joseph B. Zwischenberger, MD, FACS, Panama; Jaime Herrera-Matta, MD, FACS, Southern Thoracic Surgical facs.org MD, FACS, Peru; Christopher M. Pezzi, MD, Association; Soumitra R. Eachempati, FACS, Metropolitan Philadelphia; Carlos MD, FACS, Surgical Infection Society; and M. Ramirez, MD, FACS, Puerto Rico; Tarek Mark F. Conrad, MD, FACS, Vascular and S. A. Razek, MD, FACS, Quebec (Canada); Endovascular Surgery Society. CCNews_CC2017_7.5x10in_v7.indd 1 8/25/2016 2:11:49 PM

Stay Connected #ACSCC16 #CC16SELFIE THURSDAY, OCTOBER 20, 2016 Are You Ready for Value-Based Purchasing?

OPERATE IN A 3D ENVIRONMENT FOR A FRACTION OF THE COST OF ROBOTICS

ENDOEYE FLEX 3D improves surgical skill by providing views that cannot be achieved with traditional 2D surgical imaging systems. Learn how ENDOEYE FLEX 3D can allow you to:

Ⅲ Provide a cost-effective alternative to robotic surgery Ⅲ Help deﬁ ne your role as a low-cost, high-value provider Ⅲ Maintain tactile feedback while viewing in a 3D advanced imaging environment

Download your free case study, “How 3D Imaging Helped Secure My Role as a Low-Cost, High-Value Provider” www.medical.olympusamerica.com/3D

OAISE0916AD19640_ACSDailyNewsAd_REV092016.indd 1 9/23/16 10:43 AM XENMATRIX AB Surgical Graft

ALLOMAX Surgical Graft

PHASIX Mesh Biologically Derives Resorbable Scaffold XENMATRIX AB Surgical Graft

PHASIX ST Mesh Features a hydrogel barrier Featuring a Hydrogel Barrier ALLOMAX Surgical Graft

ARISTA AH PHASIX Mesh Absorbable Hemostatic Particles Biologically Derives Resorbable Scaffold

PHASIX ST Mesh Features a hydrogel barrier FLEXITIP XL-R Featuring a Hydrogel Barrier FLEXITIP XL-R Applicator Applicator ARISTA AH Absorbable Hemostatic Particles

FLEXITIP XL-R FLEXITIP XL-R Applicator Pleural Air Leak Sealant Applicator

AVITENE Pleural Air Leak Sealant Microfibrillar Collagen Hemostat AVITENE Microfibrillar Collagen Hemostat VENTRIO ST Hernia Patch VENTRIO ST Hernia Patch

VENTRALEX ST Hernia Patch VENTRALEX ST Hernia Patch

VENTRALIGHT ST Mesh VENTRALIGHT ST Mesh ECHO PS Positioning System

OPTIFIX ECHO PS PositioningAbsorbable S Fixationystem CAPSURE Permanent Fixation OPTIFIX AbsorbableXEN FixationMATRIX AB Surgical Graft XENMATRIX AB Surgical Graft CAPSURE Permanent Fixation ALLOMAX Surgical Graft ALLOMAX Surgical Graft BIORESORBABLES PHASIX Mesh PHASIX Mesh Biologically Derives Resorbable Scaffold XENMATRIX AB Surgical Graft Biologically Derives Resorbable Scaffold PHASIX ST XMeshENMATRIX AB Surgical Graft Features a hydrogel barrier Featuring a Hydrogel Barrier ALLOMAX Surgical Graft PHASIX ST Mesh Features a hydrogel barrier Featuring a Hydrogel Barrier ALLOMAX Surgical Graft ARISTA AH HASIX Mesh Absorbable Hemostatic Particles P ARISTA AH Biologically Derives Resorbable Scaffold Absorbable Hemostatic Particles HASIX HASIX P Mesh P ST Mesh Features a hydrogel barrier FLEXITIP XLBiolog-Rically Derives Resorbable Scaffold Featuring a Hydrogel Barrier FLEXITIP XL-R Applicator FLEXITIP XL-R Applicator FLEXITIP XL-R Applicator PHASIX ST Mesh RISTA Features a hydrogel barrier Featuring a Hydrogel Barrier A AH Applicator Absorbable Hemostatic Particles ARISTA AH Absorbable Hemostatic Particles FLEXITIP XL-R FLEXITIP XL-R Applicator Pleural Air Leak Sealant Applicator Pleural Air Leak Sealant FLEXITIP XL-R FLEXITIP XL-R Applicator AVITENE Applicator Microfibrillar Collagen Hemostat Pleural Air Leak Sealant AVITENE Microfibrillar Collagen Hemostat AVITENE Pleural Air Leak Sealant VENTRIO ST Hernia Patch Microfibrillar Collagen Hemostat ENTRIO V ST Hernia Patch AVITENE VENTRIO ST Hernia Patch Microfibrillar Collagen Hemostat

VENTRALEX VSTENTR HerniaIO ST Hernia Patch Patch VENTRALEX ST Hernia Patch VENTRALEX ST Hernia Patch DAV-2477 ACS Daily Ad-fnl3-OL.indd 1 9/26/16 11:22 AM VENTRALEX ST Hernia Patch VENTRALIGHT ST Mesh VENTRALIGHT ST Mesh VENTRALIGHT ST Mesh VENTRALIGHT ST Mesh ECHO PS Positioning System ECHO PS Positioning System ECHO PS Positioning SystemECHO PS Positioning System OPTIFIX Absorbable Fixation

OPTIFIX OPTIFIX CAPSURE Absorbable Fixation OPTIFIX Absorbable Fixation Permanent Fixation Absorbable Fixation CAPSURE CAPSURE Permanent Fixation CAPSURE Permanent Fixation Permanent Fixation