Division of General Surgery

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Advanced GI & Minimal Invasive Surgery Fellowship

Fellowship Description

The Advanced GI and Minimally Invasive Surgery Fellowship provides the highest level of training in advanced GI and minimally invasive surgical techniques, preparing the fellow for future clinical practice, research, and teaching. The goals of the one-year (July 1 through June 30) program are to:

  • Train the fellow in the application of new techniques in advanced GI and minimally invasive surgery.
  • Prepare the fellow to train others in the application of new technology.
  • Include the fellow in the development of new applications of technology and provide guidance and resources for the development of independent investigations that evaluate treatment modalities in advanced GI and minimally invasive surgery.

The program includes clinical, academic, and research components. The minimally invasive experience includes training in advanced techniques including: antireflux surgery, surgery for dysphagia, common duct exploration, hernia repair, bowel resection, gastroesophageal surgery, bariatric surgery and solid organ removal. Experience is gained in flexible endoscopy, including diagnostic, therapeutic, and advanced upper and lower endoscopy of the GI tract and rectal ultrasound.

The advanced GI surgery component includes training in advanced surgical techniques including: Pancreaticoduodenectomy, liver resection, esophagectomy, radio frequency ablation of hepatic metastases, surgical portal decompression procedures, hepatic artery infusion devices, and complex GI surgery including removal of large tumors, regional perfusion and intraperitoneal chemotherapy and organ perfusion. Sentinel node biopsy of GI malignancy is also performed.

The fellow is trained in methods of instruction on basic and advanced laparoscopic techniques, both in the laboratory, using animate and inanimate models, and in the operating room. The fellow is expected to initiate and participate in investigational projects on the pathophysiology of gastrointestinal and liver disease, the development of experimental techniques, and the impact of new technology on the practice of surgery.

Clinical material is obtained at The University of South Florida and its affiliated hospitals including Tampa General Hospital and the H. Lee Moffitt Cancer Center and Research Institute. Each hospital is accredited by the JCAHO and is the primary site of practice of at least one faculty member. The medical school at the University of South Florida provides housing and operating rooms for large animals. The facilities are certified by State of Florida Veterinary Board and the Institutional Laboratory and Animal Use Committee. Operating room facilities under the supervision of a veterinarian and a veterinary technician are available. A fully equipped basic science laboratory with PCR, Western, Northern, Southern and Real Time PCR capabilities is available within the division. Core facilities for microarray, flow cytometry, scanning electron microscopy, gene sequencing and oligonucleotide biosynthesis are also available within this facility. Office space, computer equipment and secretarial assistance are available within the Division of General Surgery.

Year Summary

The fellowship will consist of two blocks: clinical and research. The clinical block will last 9 - 11 months and will adhere to the syllabus provided at the end of this document.

If the fellow elects and is approved to do a basic science project, he or she can be approved for up to 3 months dedicated time in the laboratory. If no benchtop research will be pursued, the fellow will have one month to execute and complete the clinical research requirement outlined herein.

Clinical Responsibilities

  • Evaluate patients preoperatively with teaching faculty.
  • Assist with and perform surgery under the supervision of the teaching faculty.
  • Provide postoperative care in conjunction with resident staff, under the supervision of teaching faculty.
  • Assist faculty with teaching residents basic laparoscopic and open procedures in the operating room.

Educational & Teaching Responsibilities

  • Prepare and attend weekly GI conference and teaching rounds.
  • Attend weekly morbidity and mortality conference.
  • Participate in presentation of open and laparoscopic techniques to PGY1, PGY2, and PGY3 residents in an animate training lab.
  • Participate in the instruction of community surgeons who desire advanced practical experience within the animal laboratory facilities.
  • Attend and present information at national meetings.
  • Attend departmental Grand Rounds.
  • Attend weekly research conference.

Research Responsibilities

  • Initiate and maintain a registry for all procedures done in the fellowship, including outcomes.
  • Initiate and complete a basic science project or clinical project with faculty and submit an abstract for presentation as a paper or poster at national meetings on a topic that encompasses the clinical focus of the fellowship.
  • Participate in accrual, evaluation and data management of various clinical protocols sponsored by the division and institution.

Supervision & Evaluation

The fellow will be supervised in all aspects of his training and provision of clinical care in accordance with HCFA guidelines. At no point will the fellow be responsible for provision of patient care without the direct coverage of an attending physician who is on-staff with privileges at the hospital where the fellow is assigned.

The fellow will undergo written evaluations by all faculty of the fellowship three times during the year and the fellowship director will discuss the evaluations directly with the fellow. The purpose of the evaluations will be to measure the fellow's progress in achieving his or her goals and to facilitate achievement of these goals. The fellow will receive constructive criticism regarding his or her performance and a progress report on the chosen research project will be discussed.

To obtain the certificate of completion, a unanimous decision on the part of the faculty will be required; this decision will be based on the written evaluations submitted by the faculty each quarter.