The highlights in the Digestive Disease Institute Week 2017

On Feb. 18, 2017, the Digestive Disease Institute Week (DDI Week) sponsored by Cleveland Clinic annually successfully ended, after a 5-day scientific and compact agenda. The event took place in Boca Raton, a beautiful city located in Palm Beach County, Florida, USA (Figure 1). With a history of 38 years’ development, promotion and efforts, it has been a prestigious excellent meeting in digestive disease, enjoying a rather high reputation in China as well. The meeting is dedicated to providing comprehensive in-depth, detailed overview of new, controversial, challenging, and provocative themes, advances, innovations and inspirations in digestive disease.

Figure 1 Meeting venue, Boca Raton Resort & Club.

Following its previous tradition and features, this year’s DDI Week mainly focused on discussion of colorectal disease, covering surgical treatments, such as, upper digestive tract, hepatobiliary diseases, interventional imaging, pathology, etc. The speakers spoke about up-to-date technologies and concepts, such as, transanal surgery, fluorescent guided imaging surgery, bariatric surgery and metabolic interventions, etc. The meeting provided a comprehensive in-depth, detailed overview of new, controversial, challenging, and provocative themes in the field.

Besides surgical videos demonstrations, the meeting also included surgical practice, and various technique demonstrations moderated by Prof. Steven Wexner (Figure 2), a world-renowned expert, Director, Colorectal Surgery Digestive Disease & Surgery Institute, Cleveland Clinic Florida, with international prestigious experts onsite to guide attendees step by step. Undoubtedly, this meeting has greatly benefited attendees no matter what level they currently hold in their field.

Figure 2 Introductory speech from Prof. Steven Wexner (PhD).

It was an honor to receive an invitation from the committee to attend and witness the various events going on within the meeting. The meeting offered onsite broadcast to provide comprehensive up-to-date contents and highlights for worldwide experts in this field who were unable to be onsite. Here are some highlights from the DDI Conference.

Highlight 1: transanal surgical hands-on workshop

Day one offered live surgery followed by a hands-on transanal surgical workshop (Figure 3). The advanced transanal surgery workshop included a wet lab, TaTME cadaver lab. The afternoon spotlighted scientific paper session, which offered additional non-CME educational opportunities. The Symposium provided attendees with a detailed analysis of the status of all the major colorectal areas. Video demonstrations provided ways to improve competencies and patient outcomes. Multidisciplinary integration amongst surgery, gastroenterology, imaging and pathology were emphasized in combined sessions centered upon the definitions and optimization of patient outcomes.

Figure 3 Sketch of hands-on workshops.

Guided by famous masters, the attendees divided into 4 groups to practice TEM, TAMIS, SILS, and TEO in turns after a short training. With direct communication and hand-by-hand guidance of master’s onsite, attendees had a better understanding in regards to characteristics as well as advantages of different techniques. In addition, there were 2 trainees from every group that were able to attend the most popular surgical training, TaTME, which was chaired and trained by Dr. Matthew Albert (Figure 4) from Florida Hospital, one of the founders and renowned master of this technique.

Figure 4 Sketch of Prof. Matthew Albert’s presentation.

Highlights 2: masters’ debate and analysis

Day 2, the international symposium on colorectal disease invited experts from different centers including Cleveland Clinic, OH, Miami University, Mount Sinai Hospital, University of Pennsylvania-Penn Presbyterian, University of Hong Kong, etc., to provide a detailed analysis and debate on the best technique for rectal cancer: open, laparoscopic, robotic, TaTME, Extralevator APR, or Standard Cylindrical APR? Is there a best technique for patients and what are the advantages and disadvantages (Figure 5)?

Figure 5 Masters’ debate and analysis. (A) Dr. Michael Valente, Cleveland Clinic, OH; (B) Dr.Wai Lun Law, University of Hong Kong; (C) Dr. Alessio Pigazzi, UC Irvine Health; (D) Dr. Antonio Lacy, Hospital Clínic in Spain; (E) Dr. Jorge Marcet, University of South Florida.

In addition, concerning the most popular technique TaTME, there was a comprehensive introduction and discussion on its history, current application, indications, standardization formulation and evaluation, complications, etc., aiming to standardize its promotion and application internationally.

Professor Raul Rosenthal, Chairman, Department of General Surgery from Cleveland Clinic Florida spoke about the field of upper gastrointestinal bariatric surgery, the International Consensus on Revisional Bariatric/Metabolic Interventions (ICC-RBMI) l (Figure 6). Dr. Rosenthal is also Past President, American Society for Metabolic and Bariatric Surgery. Prof. Eric J. Demaria (Figure 7) from Bon Secours Health System, Hampton Roads, Virginia, provided the attendees with in-depth discussion on hot topics, such as, banding and stapling procedures, sleeve gastrectomy or diversion. This part of the conference focused on building a foundation to provide guidance for practicing surgeons as well as to establish the framework to answer questions that will lead to improved quality and consistency of care for our patients. The attendees were inspired, acquired in-depth information, guidance, as well as learned new and improved techniques and lessons from the masters’ experiences. For those who attended these sessions should now have a better understanding in regards to these different diseases and the various surgical techniques available for them to discuss with patients.

Figure 6 Prof. Raul Rosenthal.

Figure 7 Prof. Eric J. Demaria.

Highlight 3: multi-disciplinary treatment (MTD)

The advantage of MTD fully executed and embodied in the meeting. International experts from multiple disciplines presented, debated and discussed on diseases from perspectives of different disciplines, e.g., MTD in postoperative treatment for Gastric cancer, liver metastasis, imaging, pathologic diagnosis and biologic treatment for inflammatory bowel disease, complications of Pouch, etc. This session demonstrated mature operation and management of multiple discipline teams, which will assist and improve quality and consistency of care for our patients.

Highlight 4: introducing a series of novel concepts, technologies and methods

Novel surgery has been a tradition to Cleveland Clinic’s medical system. Innovations were reflected vividly in this meeting. It introduced a series of novel concepts such as, transanal surgery, fluorescence guided surgery, novel technologies like TaTME, endoscopic bariatric surgery, POEM, Transanal Hartmann surgery, Transanal Endoscopic Surgery, as well as new methods and applications of Fluorescence imaging in thyroid, intestines, stomach, VAAFT Fistula Treatment, Anal fistula LIFT, covering the most up-to-date and cutting-edge advances in digestive diseases. We feel the attendees have been greatly inspired and benefited from the meeting.

Highlight 5: teaching the teachers: things we did not learn in medical school

Except for academic communications, the meeting is also a robust platform for medical education. There was a specific session, which focused on young experts to do special reports and discuss issues, such as, time management of surgeons, evaluate attending doctors’ techniques, improve medical quality, and avoid medical malpractice. The session also discussed ways to grasp the laparoscopy, robotic surgery, etc., aiming to provide comprehensive introductions to basic qualifications, competency of a qualified doctor, as well as to encourage young doctors to present their progress and achievements (Figure 8).

Figure 8 Sketch of medical education session. (A). Eric Weiss, MD, Cleveland Clinic, FL; (B) Jaime Sanchez, MD, UCF Health; (C) Vincent Obias, MD, George Washington University School of Medicine; (D) Jeffrey Ponsky, MD, Cleveland Clinic, OH; (E) Juan Nogueras, MD, Cleveland Clinic FL; (F, G) pannel discussion.

Night of fluorescence imaging

Day 3, the evening meeting was additional learning session. At this meeting, the attendees enjoyed a special banquet of food. While enjoying the pleasant aura of ambrosial food, attendees received a special session on prognostic improvement of fluorescence imaging, discussing on its application in gastrointestinal surgery, chaired by Prof. Wexner (Figures 9,10).

Figure 9 Night of fluorescence imaging.

Figure 10 Night of fluorescence imaging. (A) David Jayne, MD Cleveland Clinic, OH; (B) Eric Haas, MD, University of Texas Medical School, Houston, TX; (C) Ronan Cahill, MD, UCD School of Medicine & Medical Science; (D) Danny Sherwinter, MD, Maimonides Medical Cancer; (E) Mariana Berho, MD, Cleveland Clinic, FL; (F) Manish Chand, MD, University College London Hospital; (G) panel discussion.

AME in the meeting

It was a pleasure and honor to witness such a grant and significant meeting onsite, and to extend it to our readers worldwide. To fit with the theme, we not only exhibited our related journals and books but we also brought some for purchase (Figure 11). The books on hand were related to Gastric Cancer edited by Prof. Jiafu Ji, Colorectal Cancer edited by Prof. Minghua Zheng, journals, such as Annals of Laparoscopic and Endoscopic Surgery (ALES), Journal of Visualized Surgery (JOVS), Annals of Translational Medicine (ATM).

Figure 11 AME booth with journals and books.

International meetings are always excellent opportunities for us to meet, communicate and interact with our editorial board members, guest-editors, authors, reviewers, readers, speakers and attendees (Figure 12). On behalf of the AME Publishing Company staff, we would like to express our sincere appreciation for their enthusiastic and vigorous support and contributions.

Figure 12 Sketch of our booth.

During the meeting, we were able to conduct brief interviews with some of the renowned speakers (Figures 13,14), to share their presentations and perspectives on hot topics in their fields. Interviews will be published later in our journals. Stay tuned!

Figure 13 Interview and meet with masters in different fields. (A) Interview with Prof. Steven Wexner; (B) interview with Prof. Antonio Lacy; (C) interview with Prof. Jeffrey Ponsky; (D) interview with Prof. Raul Rosenthal; (E) interview with Prof. Tracy Hull; (F) interview with Prof. Eric De Maria; (G) interview with Prof. Matthew Albert.

Figure 14 Interview and meet with masters in different fields. (A) Interview with Prof. Eric Weiss; (B) interview with Prof. Conor Delaney; (C) interview with Prof. Michael Bouvet; (D) interview with Prof. Bo Shen; (E) interview with Prof. Wai Lun Law; (F) Interview with Prof. Alexander Vahrmeijer.

The 5-day excellent meeting ended successfully on February 18. In our opinion, we believe every expert gathered together with excitement, enjoyment, and returned home with contentment and inspiration. Once a year DDI Week held by Cleveland Clinic Ohio and Florida bright attendees from around the world to discuss up-to-date advances, innovations, inspiration, and academic sparks for our future in surgery and care for our patients. What surprises will the event have for next year (Figure 15)? Stay tuned!

Figure 15 Announcement of the 2018 the Digestive Disease Institute (DDI) Week.

Acknowledgements

We would like to extend our sincere appreciation to Mrs. Arroyo Loretta, MBA from Cleveland Clinic Florida, and Dr. Jun Chen, MD from the Fifth People’s Hospital of Shanghai, Fudan University, for their assistance in editing the news report.

Footnote

Conflicts of Interest: The author has no conflicts of interest to declare.