I was excited to recently attend SAGES 2017, the annual meeting of the Society of American Gastrointestinal and Endoscopic Surgeons, with my research colleagues from Lumere. I highlighted some of the most interesting trends and key takeaways below.
Increased Interest in Robotic Surgery
Robotic surgery was the talk of the conference, with discussions generally revolving around whether the da Vinci Surgical System should be routinely utilized for ventral and inguinal hernia repair. While many physicians were bullish on robotic technology adoption in general surgery, there was disagreement on whether the current state of the evidence justifies the high initial acquisition and disposable costs associated with the da Vinci system.
Robotic assistance may be integral to the future of surgical practice, but adoption of this technology will be highly dependent on multiple factors, including:
- Demonstrated improvements in clinical or operational outcomes
- Surgeons achieving proficiency without harm to patients
- Contribution margin relative to other surgical techniques
- Market dynamics
Enhancements in Imaging Technology
While no imaging technologies appeared truly groundbreaking, several notable technological enhancements over standard white light endoscopy were on display. The improved visual clarity associated with 4K Ultra High Definition imaging systems consistently demanded physician attention. 3D endoscopic imaging systems and newer indocyanine green (ICG) fluorescence imaging systems also garnered intrigue, though primarily from physicians without previous exposure to the technology.
Push Toward Absorbable Synthetic Mesh
The pursuit of an ideal hernia repair has resulted in an abundance of mesh products made from a variety of materials. Synthetic meshes constructed out of non-absorbable polymers are the mainstay, but fully absorbable biologic meshes derived from human and animal tissue have been specifically promoted in contaminated and infected fields.
For physicians and patients who wish to utilize a fully absorbable mesh while avoiding tissue-based products, meshes derived from absorbable synthetic polymers (also known as biosynthetic mesh) represent an alternative option. The clinical efficacy of one prominent absorbable synthetic mesh—Bard’s Phasix Mesh—has not yet been evaluated in peer-reviewed literature. However, three abstracts presented at the conference described the short-term outcomes associated with Phasix Mesh in ventral hernia repair.
While the findings are encouraging, the appropriate place in therapy for absorbable synthetic mesh remains unclear. Comparative study with long-term follow-up is needed to justify the use of any absorbable synthetic mesh over other mesh types.
Our research team will keep these topics on our watch list as we continue to review indications and outcomes.