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Advanced GI - Minimally Invasive Surgery (Foregut)

Dr. Lee Swanstrom of the GI/Minimally Invasive Surgery Division of The Oregon Clinic, established one of the first Surgical Endoscopy Fellowships in the country in 1993. Today, our faculty has grown to include not only renowned Dr. Lee Swanstrom, but also leading foregut surgery experts Dr. Christy M. Dunst (Program Director), Dr. Kevin Reavis, Dr. Steven DeMeester and Dr. Daniel Davila Bradley. Together, the faculty's complimentary skills provide an unparalleled experience in advanced foregut surgery, offering a wide variety and exposure to esophageal surgical techniques and pathology. The Fellowship is intended for physicians who have completed a general surgery residency and have a specialty interest in all aspects of foregut disease including pathophysiology, flexible endoscopy and laparoscopic surgery. Because of our expert teaching faculty, the breadth and volume of our clinical cases as well as our innovative research programs, these fellowships has consistently been rated as among the best training experiences in the US.

The Advanced GI: Foregut position concentrates on all aspects of foregut (esophageal and gastric surgery) including diagnostic testing, esophageal physiology, diagnostic and therapeutic flexible endoscopy, laparoscopic and open surgery and care of these patients. Our center has a high volume of both benign and malignant foregut cases. Fellows are exposed to a large experience in both laparoscopic and trans-oral approaches to anti-reflux surgery, repair of hiatal and paraesophageal hernia, and achalasia, as well as the treatment of esophageal and gastric malignancies. A key component of the fellowship is exposure to a wide range of interventional flexible endoscopy techniques and procedures, including endoscopic mucosal resection, endoscopic submucosal dissection, radio-frequency ablation, dilation, stent placement, endoscopic suturing, and per-oral endoscopic myotomy (POEM).

Rotations are specially designed to achieve mastery in foregut disease and treatment. In addition to extensive esophageal surgery, fellows will have some exposure to bariatric surgery, intended to train the fellow to master both Roux-en-Y gastric bypass and sleeve gastrectomy, and hepatobiliary surgery, to gain exposure to duodenal and pancreatic procedures required with certain gastric cancer resections. Previous Fellows have accumulated a clinical experience of between 200 and 350 advanced laparoscopic surgeries and between 100 and 150 flexible endoscopies (primarily interventional endoscopy), depending on their degree of interest in each field.

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