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Contributors
Jacqueline Blank, MD Department of Surgery, Medical College of Wisconsin,
Milwaukee, WI, USA
StephanieBollenbach, MD Department of Surgery, Maricopa Integrated Health
System, Phoenix, AZ, USA
P. Bennett Brock, MD Department of Surgery, Emory University School of
Medicine, Atlanta, GA, USA
Charles E. Butler, MD, FACS
Department of Plastic Surgery, MD Anderson
Cancer Center, University of Texas, Houston, TX, USA
Diego Camacho, MD Department of Surgery, Minimally Invasive and
Laparoscopic General Surgery, Monteore Medical Center, Bronx, NY, USA
AlfredoM.Carbonell, DO, FACOS, FACS Department of Surgery, University of
South Carolina School of Medicine Greenville, Greenville, SC, USA
SamuelP. Carmichael II, MD Department of Surgery, University of Kentucky
School of Medicine, Lexington, KY, USA
GustavoCarvalho, MD, MSc, MBA, PhD Department of Surgery—University
of Pernambuco, Hospital Universitario Oswaldo Cruz, Recife, PE, Brazil
LeandroTottiCavazzola, MD, MSc, PhD, FACS Hospital de Clínicas de Porto
Alegre, Porto Alegre, RS, Brazil
Department of Surgery, Anne Arundel Medical Center, Annapolis, MD, USA
DavidC. Chen, MD Section of Minimally Invasive Surgery, UCLA Division of
General Surgery, Lichtenstein Amid Hernia Clinic at UCLA, Los Angeles, CA,
USA
Michael Choi, MD Department of Surgery, Weill Cornell Medical College,
New York, NY, USA
Mark W. Clemens, MD, FACS Department of Plastic Surgery, MD Anderson
Cancer Center, University of Texas, Houston, TX, USA
NatashaL.Clingempeel, RN, MSN, FNP Division of Bariatric and Gastrointestinal
Surgery, Department of Surgery, Virginia Commonwealth University Medical
Center, Richmond, VA, USA
Alisa M. Coker, MD Division of Minimally Invasive Surgery, Department of
Surgery, Johns Hopkins Hospital, Baltimore, MD, USA
Jorge Daes, MD Minimally Invasive Surgery, Clínica Portoazul, Barranquilla,
Atlantico, Colombia
Gregory Dakin, MD, FACS Division of GI, Metabolic, and Bariatric Surgery,
Department of Surgery, Weill Cornell Medicine, New York, NY, USA
Contributors
xi
S. Scott Davis Jr, MD Department of Surgery, Emory University School of
Medicine, Atlanta, GA, USA
CoreyR.Deeken, PhD Covalent Bio, LLC, St. Louis, MO, USA
Salvatore Docimo Jr, DO Division of Bariatric, Foregut, and Advanced GI
Surgery, Department of Surgery, Stony Brook University Hospital, Stony Brook,
NY, USA
Patrick Dolan, MD Department of Surgery, Weill Cornell Medical College,
NewYork Presbyterian Hospital, New York, NY, USA
Gregory A. Dumanian, MD, FACS Division of Plastic Surgery, Northwestern
Feinberg School of Medicine, Northwestern Memorial Hospital, Chicago, IL, USA
David Earle, MD, FACS Tufts University School of Medicine, Boston,
MA, USA
New England Hernia Center, North Chelmsford, MA, USA
MorrisE. Franklin Jr., MD, FACS Department of Minimally Invasive Surgery,
Texas Endosurgery Institute, San Antonio, TX, USA
Paul Frydenlund, MD Department of Surgery, University of Minnesota,
Minneapolis VA Medical Center, Minneapolis, MN, USA
FernandoGarcía, MD, FACS John Peter Smith Hospital, Fort Worth, TX, USA
Marco Alban Garcia, MD Hernia Unit of RedSalud Clínica Bicentenario y
Clínica Tabancura, Department of Surgery, Los Andes University, Santiago, Chile
OmarM.Ghanem, MD Department of Surgery (Minimally Invasive and Bariatric
Surgery Division), Mosaic Life Care, Saint Joseph, MO, USA
MatthewI.Goldblatt, MD Department of Surgery, Medical College of Wisconsin,
Milwaukee, WI, USA
JonC.Gould, MD
Department of Surgery, Froedtert and the Medical College of
Wisconsin, Milwaukee, WI, USA
JacobA.Greenberg, MD, EdM Department of Surgery, University of Wisconsin,
Madison, WI, USA
Philip Mason Hamby, MD Department of Minimally Invasive Surgery,
Texas Endosurgery Institute, San Antonio, TX, USA
Miguel A. Hernández, MD Department of Minimally Invasive Surgery, Texas
Endosurgery Institute, San Antonio, TX, USA
RanaM.Higgins, MD Department of Surgery, Froedtert and the Medical College
of Wisconsin, Milwaukee, WI, USA
xii
Contributors
WilliamW.Hope, MD Department of Surgery, New Hanover Regional Medical
Center, Wilmington, NC, USA
Charlotte Horne, MD Department of General Surgery, Cleveland Clinic,
Cleveland, OH, USA
DesmondT.K.Huynh, MD Department of Surgery, Cedars-Sinai Medical Center,
Los Angeles, CA, USA
EdmundoInga-Zapata, MD, MSc, FACS
Surgical Andean Group, Lima, Peru
BrianJacob Department of Surgery, Icahn School of Medicine at Mount Sinai,
New York, NY, USA
DanielB.Jones, MD, MS, FACS Harvard Medical School, Ofce of Technology
and Innovation, Beth Israel Deaconess Medical Center, Boston, MA, USA
Ryan M. Juza, MD Division of Minimally Invasive and Bariatric Surgery,
Department of Surgery, Penn State Hershey Medical Center, Hershey, PA, USA
AngelaM.Kao, MD Division of Gastrointestinal and Minimally Invasive Surgery,
Department of Surgery, Carolinas Medical Center, Charlotte, NC, USA
Omar Yusef Kudsi, MD Department of Surgery, Tufts University School of
Medicine, Boston, MA, USA
Department of General Surgery, Good Samaritan Medical Center, Brockton, MA,
USA
Spencer P. Lake, PhD Department of Mechanical Engineering and Materials
Science, Washington University, St. Louis, MO, USA
StevenT.Lanier, MD Division of Plastic Surgery, Northwestern Feinberg School
of Medicine, Northwestern Memorial Hospital, Chicago, IL, USA
GraceLassiter, MD Texas A&M College of Medicine, Bryan, TX, USA
MikeK.Liang, MD Department of General Surgery, McGovern Medical School,
University of Texas Health Science Center, Houston, TX, USA
Edward Lin, DO, MBA Department of Surgery, Emory University School of
Medicine, Atlanta, GA, USA
Marcelo Loureiro, MD, PhD Department of General Surgery, INC Curitiba
Positivo University, Curitiba, Parana, Brazil
FlavioMalcher, MD, MSc, FACS Department of Surgery, Monteore Medical
Center, Bronx, NY, USA
ShahidM. Malik, MD Division of Gastroenterology, Hepatology and Nutrition,
Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh,
PA, USA
Department of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh
Medical Center, Pittsburgh, PA, USA
Contributors
xiii
LuisA.Martin-del-Campo, MD Unviersity Hospitals Cleveland Medical Center,
Cleveland, OH, USA
Abraham J. Matar, MD Department of Surgery, Emory University School of
Medicine, Emory University Hospital, Atlanta, GA, USA
Craig S. Mauro, MD Department of Orthopaedic Surgery, Burke and Bradley
Orthopedics, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
MichaelP.Meara, MD, MBA
Division of General and Gastrointestinal Surgery,
Department of Surgery, The Ohio State University Wexner Medical Center,
Columbus, OH, USA
Eduardo Moreno Paquentin, MD Department of General and Laparoscopic
Surgery, Hospital Centro Medico ABC Santa Fe, Mexico City, Mexico
SaraP.Myers, MD Division of Trauma and Acute Care Surgery, Department of
Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
MiguelNacul, MD, MSc Institute of Education and Research, Moinhos de Vento
Hospital, Porto Alegre, Rio Grande do Sul, Brazil
MauriceY.Nahabedian, MD Virginia Commonwealth University - Inova Branch
Falls Church, McLean, VA, USA
Matthew D. Neal, MD, FACS Division of Trauma and Acute Care Surgery,
Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA,
USA
David K. Nguyen, MD Department of Surgery, Kaiser Permanente Northern
California, Oakland, CA, USA
Yuri W. Novitsky, MD Department of Surgery, Columbia University Medical
Center, New York, NY, USA
Sean B. Orenstein, MD Division of Gastrointestinal and General Surgery,
Department of Surgery, Oregon Health and Science University, Portland, OR, USA
RajaviS.Parikh, DO Department of Surgery, New Hanover Regional Medical
Center, Wilmington, NC, USA
AnkitD.Patel, MD, FACS Division of General and GI Surgery, Emory University
School of Medicine, Emory Bariatric Center, Emory Saint Joseph Hospital, Atlanta,
GA, USA
EricM.Pauli, MD, FACS, FASGE Division of Minimally Invasive and Bariatric
Surgery, Department of Surgery, Penn State Hershey Medical Center, Hershey, PA,
USA
RebeccaP.Petersen, MD University of Washington Medical Center, Seattle, WA,
USA
ThomasPomposelli, MD St. Elizabeth’s Medical Center, Brighton, MA, USA
xiv
Contributors
ToddA.Ponsky, MD Division of Pediatric Surgery, Akron Children’s Hospital,
Akron, OH, USA
AjitaPrabhu, MD Department of General Surgery, Cleveland Clinic, Cleveland,
OH, USA
Archana Ramaswamy, MD, MBA Department of Surgery, University of
Minnesota, Minneapolis VA Medical Center, Minneapolis, MN, USA
J.ScottRoth, MD Division of General Surgery, Department of Surgery, College
of Medicine, University of Kentucky, Lexington, KY, USA
Zachary Sanford, MD Department of Surgery, Anne Arundel Medical Center,
Annapolis, MD, USA
Linda Schultz Society of American Gastrointestinal and Endoscopic Surgeons,
Los Angeles, CA, USA
PhillipShadduck, MD Department of Surgery, Duke University Medical Center,
Durham, NC, USA
NathanielStoikes, MD Department of Surgery, University of Tennessee Health
Science Center, Memphis, TN, USA
T.J.Swope, MD Center for Minimally Invasive Surgery, Mercy Medical Center,
Baltimore, MD, USA
Talar Tejirian, MD Department of Surgery, Kaiser Permanente Los Angeles
Medical Center, Los Angeles, CA, USA
Amit D. Tevar, MD Division of Transplant Surgery, Department of Surgery,
University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
ShirinTowgh, MD, FACS Beverly Hills Hernia Center, Beverly Hills, CA, USA
Kara A. Vande Walle, MD
Department of Surgery, University of Wisconsin,
Madison, WI, USA
GuyVoeller, MD Department of Surgery, University of Tennessee Health Science
Center, Memphis, TN, USA
Jeremy A. Warren, MD Department of Surgery, University of South Carolina
School of Medicine Greenville, Greenville, SC, USA
DavidWebb, MD Department of Surgery, University of Tennessee Health Science
Center, Memphis, TN, USA
Adam S. Weltz, MD Department of Surgery, Anne Arundel Medical Center,
Annapolis, MD, USA
AndrewS.Wright, MD University of Washington Medical Center, Seattle, WA,
USA
Louise Yeung, MD Department of Surgery, Kaiser Permanente Los Angeles
Medical Center, Los Angeles, CA, USA
Contributors
xv
ChristopherYheulon, MD Division of General and GI Surgery, Department of
Surgery, Emory University School of Medicine, Atlanta, GA, USA
BrianS.Zuckerbraun, MD Division of General and Trauma Surgery, Department
of Surgery, University of Pittsburgh Medical Center and VA Pittsburgh Healthcare
System, Pittsburgh, PA, USA
SAGES University MASTERS PROGRAM:
Hernia Pathway
DanielB.Jones, LindaSchultz, andBrianJacob
The MASTERS Program organizes educational materials along clinical pathways
into discrete blocks of content which could be accessed by a surgeon attending the
SAGES annual meeting or by logging into the online SAGES University (Fig.1.1)
[1]. The SAGES MASTERS Program currently has eight pathways including:
Acute Care, Biliary, Bariatrics, Colon, Foregut, Hernia, Flex Endoscopy, and
Robotic Surgery (Fig.1.2). Each pathway is divided into three levels of targeted
performance: Competency, prociency, and mastery (Fig.1.3). The levels originate
from the Dreyfus model of skill acquisition [2], which has ve stages: novice,
advanced beginner, competency, prociency, and expertise. The SAGES MASTERS
Program is based on the three more advanced stages of skill acquisition: competency, prociency, and expertise. Competency is dened as what a graduating general surgery chief resident or MIS fellow should be able to achieve; prociency is
what a surgeon approximately 3years out from training should be able to accomplish; and mastery is what more experienced surgeons should be able to accomplish
after several years in practice. Mastery is applicable to SAGES surgeons seeking
in-depth knowledge in a pathway, including the following: Areas of controversy,
outcomes, best practice, and the ability to mentor colleagues. Over time, with the
1
Adopted from Jones, DB, Stefanidis D, Korndorffer JR, Dimick JB, Jacob BP, Schultz L, Scott DJ,
SAGES University Masters Program: a structured curriculum for deliberate, lifelong learning.
Surg Endoscopy, 2017, in press.
D. B. Jones (*)
Harvard Medical School, Ofce of Technology and Innovation, Beth Israel Deaconess
Medical Center, Boston, MA, USA
e-mail: djones1@bidmc.harvard.edu
L. Schultz
Society of American Gastrointestinal and Endoscopic Surgeons, Los Angeles, CA, USA
e-mail: linda@sages.org
B. Jacob
Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
© Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) 2019
S. S. Davis Jr. et al. (eds.), The SAGES Manual of Hernia Surgery,
https://doi.org/10.1007/978-3-319-78411-3_1
1
2
Fig. 1.1 MASTERS
Program logo
Fig. 1.2 MASTER
Program clinical pathways
D. B. Jones et al.
ACUTE CARE
BARIATRIC
BILIARY
COLORECTAL
FLEX ENDO
FOREGUT
HERNIA
ROBOTICS
Comprtency
Curriculum
Proficiency
Curriculum
Mastery
Curriculum
Fig. 1.3 MASTERS Program progression
utilization of coaching and participation in SAGES courses, this level should be
obtainable by the majority of SAGES members. This edition of the SAGES
Manual—Hernia Surgery aligns with the current version of the new SAGES
University MASTERS Program Hernia Surgery pathway (Table1.1).
1 SAGES University MASTERS PROGRAM: Hernia Pathway
3
Table 1.1 Hernia surgery
curriculum
Curriculum elements Competency
Anchoring Procedure—Competency 2
CORE LECTURE 1
CORE MCE 70% 1
Annual meeting content 2
Guidelines 1
SA CME Hours 6
Sentinel articles 2
Social Media 2
SAGES Top 21 video 1
FLS 12
PEARLS 1
Hernia task force tool 2
Sages manual 2
CREDITS 35
Curriculum elements Prociency
Anchoring Procedure—Prociency 2
CORE LECTURE 1
CORE MCE 70% 1
Annual meeting content 5
FUSE 12
Outcomes database enrollment 2
SA CME Hours (ASMBS electives, SAGES
or SAGES-endorsed)
Sentinel articles 2
Social Media 2
SAGES Top 21 video 1
PEARLS 1
CREDITS 35
6
Curriculum elements Mastery
Anchoring Procedure—Mastery 2
CORE LECTURE 1
CORE MCE 70% 1
Annual meeting content 6
Fundamentals of Surgical Coaching 4
Outcomes database reporting 2
SA CME Credits (ASMBS electives, SAGES
or SAGES-endorsed)
Sentinel articles 2
Serving as video assessment reviewer and
providing feedback (FSC)
Social Media 6
SMART Enhanced Recovery 1
CREDITS 35
6
4
4
D. B. Jones et al.
Hernia Surgery Curriculum
The key elements of the Hernia Surgery curriculum include a core lectures for the
pathway, which provides a 45min general overview including basic anatomy, physiology, diagnostic workup, and surgical management. As of 2018. all lecture content
of the annual SAGES meetings are labeled as follows: Basic (100), intermediate
(200), and advanced (300). This allows attendees to choose lectures that best t their
educational needs. Coding the content additionally facilitates online retrieval of
specic educational material, with varying degrees of surgical complexity, ranging
from introductory to revisional surgery.
SAGES identied the need to develop targeted, complex content for its mastery
level curriculum. The idea was that these 25min lectures would be focused on specic topics. It assumes that the attendee already has a good understanding of diseases and management from attending/watching competency and prociency level
lectures. Ideally, in order to supplement a chosen topic, the mastery lectures would
also identify key prerequisite articles from Surgical Endoscopy and other journals,
in addition to SAGES University videos. Many of these lectures will be forthcoming
at future SAGES annual meetings.
The MASTERS Program has a self-assessment, multiple choice exam for each
module to guide learner progression throughout the curriculum. Questions are submitted by core lecture speakers and SAGES annual meeting faculty. The goal of the
questions is to use assessment for learning, with the assessment being criterionreferenced with the percent correct set at 80%. Learners will be able to review incorrect answers, review educational content, and retake the examination until a passing
score is obtained.
The MASTERS Program Hernia Surgery curriculum taps much of the SAGES
existing educational products including FLS, FUSE, SMART, Top 21 videos, and
Pearls (Fig.1.4). The Curriculum Task Force has placed the aforementioned modules along a continuum of the curriculum pathway. For example, FLS, in general,
occurs during the Competency Curriculum, whereas the Fundamental Use of
Surgical Energy (FUSE) is usually required during the Prociency Curriculum. The
Fundamentals of Laparoscopic Surgery (FLS) is a multiple choice exam and a skills
assessment conducted on a video box trainer. Tasks include peg transfer; cutting;
intracorporeal and extracorporeal suturing; and knot tying. Since 2010, FLS has
been required of all US general surgery residents seeking to sit for the American
Fig. 1.4 SAGES educational content: FLS, FUSE, SMART
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