Dr. Sara Nogueira

Let's Wrap 2022 Up

1. Welcome and Introduction - Dr. Luis Felipe Cabrera Vargas (Colombia) 2. Residents Worldwide - Testimonials and perspectives  3. The RR: Highlights - Dr. Luis Felipe Cabrera Vargas (Colombia) 4. Industry Perspective- Mr. Rich Merklinger (USA) 5. The Resilient Chain - Dr. Barham Abu Dayyeh (USA), Dr. Julia Coleman (USA), Dr. Zoe Garoufalia (USA), Dr. James Glasbey (UK), Dr. Geeta Lal (USA), Dr. Emanuele Lo Menzo (USA), Dr. Winnie Mathur (India), Dr. Violeta Moizé (Argentina), Dr. Sara Tavares Nogueira (Spain), Dr. Daniel Tomey (USA) 6. Closing remarks - Dr. Luis Felipe Cabrera Vargas (Colombia)

With Johnson & Johnson MedTech

5 Things you Should Know about Sacral Nerve Stimulation for Fecal Incontinence

Sacral Nerve Stimulation (SNS) is a minimally invasive technique used for the treatment of fecal incontinence. From the first description in the 90s to this day, the technique has been evolving and establishing its role as a central option for patients with and without anal sphincter injury presenting with this condition. In this SOC we will go through the 5 things you should know about SNS for the treatment of fecal incontinence.

ECCO Guidelines on Therapeutics in Crohn's Disease: Surgical Treatment

Crohn’s Disease Crohn’s disease is a chronic, relapsing inflammatory bowel disease, that can affect the GI tract in all his extension. The most common portion affected is the terminal ileum and proximal colon. Epidemiologically, Crohn has no specific gender distribution. Onset usually occurs in the 2nd to 4th decade of life, with a smaller peak from the ages of 50 to 60. Incidence is growing and is higher in developed countries. Prevalence is higher in Europe. Crohn’s disease is believed to result of a combination of genetic and environmental factors such as intestinal microflora, resulting in abnormal mucosal immune response and epithelial function. Treatment requires a multidisciplinary team of experts of various of gastroenterologists, surgeons, radiologists, pathologists, infectologists, as well as nutritionists and social workers. Clinical Presentation, Classification and Diagnosis Clinical presentation is variable and depends on the level of involvement and the type of disease. Symptoms can be of 3 distinct types: 1) Gastrointestinal: nausea, vomiting, diarrhea, abdominal pain; 2) Perineal: perianal abscess, complex perianal fistula 3) or Systemic: fever, fatigue, weight loss. The Montreal classification of IBD was developed in 2005 to accurately classify the phenotype (physical characteristics) of all subtypes of IBD, encompassing disease location (L; L1-4 for CD), behavior (B; B1-B3 for CD), severity (S), and age of onset (A; A1 for diagnosis <17), thus allowing coverage of features at diagnosis and during evolution with time that had not been covered in the previous Vienna classification. The Paris classification, published in 2011, extended the classification of Crohn’s disease to the pediatric population, which was overlooked in the former ones. Crohn’s disease diagnosis relies on a combination of symptoms and complementary exams. Endoscopy, radiology and pathology all contribute to differential and definitive diagnosis. Laboratory tests are not diagnostic, but help guide treatment and evaluate the basal status of the patient. Management Management of Crohn’s patients is best achieved in a ultidisciplinary setting, always focusing on the patient, and involves medical and surgical strategies. Medical therapy is used for symptomatic control and progression blocking. The commonly used agents are corticosteroids, immunosuppressants, anti-TNF agents and the new biological drugs. Surgery is left for patients with refractory disease or complications. The ECCO Guidelines, created by the European Crohn’s and Colitis Organisation, are evidence-based guidelines designed to guide professionals in the treatment of patients with Crohn’s disease. The new edition was published in November and is composed of 2 segments: one for Medical treatment and another for Surgical treatment. We will focus on the latter.

The surgeon’s burnout

Burnout is a response to overwhelming job stressors, leading to exhaustion, dissatisfaction, depersonalization, and more serious issues (depression, suicidal ideation). In this first episode, Dr. Pena and Dr. Nogueira discuss burnout among surgeons and surgical trainees.

Science of Energy - The Resilient Residents

Program Welcome and faculty introduction. - Dr. Sara Nogueira (Spain). Why is this Important? - Dr. Jänes (Sweden) & Dr. Sehat (USA). Principles of electricity, tissue & vessel sealing - Dr. Jänes (Sweden). Bipolar devices - Dr. Jänes (Sweden). Ultrasonic devices - Dr. Jänes (Sweden). Advanced energy – what’s that? - Dr. Jänes (Sweden). Optimizing patient outcomes: Choosing the right device for the procedural task - Dr. Jänes (Sweden). Optimizing patient outcomes: Tips, tricks and avoiding accidents - Dr. Jänes (Sweden). Leadership Skills: Managing Surgical Burnout - Dr. Sharon Ben-Or (USA). Panel discussion - All faculty moderated by Dr. Freund (USA).

With Johnson & Johnson MedTech

5 Things You Should Know about Anal Cancer

Anal cancer refers to all cancer arising in the anal canal. It comprises less than 4% of low gastrointestinal tumors and it is many times overlooked or misdiagnosed. Knowledge of the anatomy and histology are crucial to understand the different types of malignancy that may occur in the anal canal. A comprehensive clinical history and detailed physical examination are essential in the diagnostic process of anal malignancies. In today’s Surgical Open Classroom, I will make a short and comprehensive overview of anal cancer and highlight the latest recommendations on diagnosis, treatment and follow-up of the ESMO/ESSO Guidelines. Further readings: https://doi.org/10.1016/j.annonc.2021.06.015 https://doi.org/10.1016/S1470-2045(17)30456-4 http://dx.doi.org/10.1007/s00330-016-4337-z https://doi.org/10.1259/bjr.20170370 http://dx.doi.org/10.1016/S1470-2045(17)30071-2