Founded in 1998, the UT Southwestern Medical Center for Minimally Invasive Surgery has a long-standing track record for innovation and excellence. Daniel Scott, M.D., was the center’s first fellow and is now the Program Director. We offer a one-year clinical fellowship position (one fellow per year), with a broad emphasis on bariatric and minimally invasive surgery cases (MIS), with the goal of graduating competent surgeons capable of succeeding in either academics or private practice.

The fellow rotates in the following areas:

• Bariatric (Roux-en-Y Gastric Bypass, Adjustable Gastric Banding, Sleeve Gastrectomy, Revisional Surgery)
• Foregut (Nissen, Heller, Paraesophageal Hernia, Upper GI, Biliary)
• Solid Organ (Adrenal, Spleen, Pancreas, Donor Nephrectomy)
• Hernia (TEP, TAPP, Ventral)
• Colon (Lap Right, Left, TAC, LAR, APR)
• Endoscopy (Upper and Lower)

Procedures

It is expected that the fellow will finish the program with more than 300 procedures (approximately a 50:50 split between Bariatric and MIS), as well as approximately 200 endoscopies. More than 95 percent of cases involve advanced laparoscopy with close supervision, with very few open or basic laparoscopic cases. The majority of cases are performed at our two UT Southwestern University Hospitals and at Parkland Memorial Hospital, all of which are centrally located on the main campus of UT Southwestern. Outpatient clinic exposure is afforded, specifically with regard to the multidisciplinary care of bariatric patients.

Up to one day per week, the fellow also rotates at the Dallas VA Medical Center to perform sleeve gastrectomies or at two community hospitals (Medical City and Medical Center of Plano to perform laparoscopic colectomies; these off-site locations are all within a 15- to 30-minute drive.

Technology

The fellow is expected to be involved with several novel approaches and technologies currently being pursued by our team, including: Natural Orifice Translumenal Endoscopic Surgery (NOTES), Single Incision Laparoscopic Surgery (SILS), and Robotics. We have IRB and hospital approval for Transvaginal NOTES Cholecystectomies and are embarking on these procedures.

We have a wealth of experience performing basic (Cholecystectomy) and advanced (Adjustable Gastric Banding) SILS procedures, and are pioneering new techniques in these areas (liver retraction, robotics, etc.). Our hospitals have two daVinci systems and we have a two-month intensive hands-on training program in robotics using a third dedicated daVinci system for this purpose in our lab (inanimate, animate, and cadaver).

Research

The fellow is encouraged to participate (up to 10 percent time allocation) in clinical and laboratory research investigations in a variety of areas, with tremendous opportunities to present at national meetings (travel provided for this purpose). The fellow is expected to have numerous opportunities to author chapters, videos, and manuscripts.

Our research lab is actively working on sponsored research protocols to further develop and launch our Magnetically Anchored Instruments (MAGS Cautery Dissector and Camera devices) for NOTES and SILS; the fellow has the opportunity to work on these device development investigations, with our multidisciplinary team of surgeons and engineers. Significant mentoring is available, including study design, data analysis, presentation and manuscript preparation, as well as video editing.

The fellow has support from the Center’s team of personnel, including our administrator, animal lab coordinator, education coordinators, manager, and research fellows (separate postdoctoral/non-clinical track), as well as Media Technology and other support services.

Skills Lab

Our Skills Lab is a Level I ACS Accredited Education Institute, a SAGES FLS Test Center, and a beta site for the SAGES FES program; this is a rich environment to refine technical skills and for additional research opportunities. The fellow serves as an instructor at all educational (CME) courses hosted by our Center with abundant networking opportunities.

The fellow receives protected time and financial support to attend national courses hosted by SAGES and numerous corporate sponsors, as well as the annual SAGES meeting. Also, the fellow participates in Bariatric and MIS journal clubs and attends Department of Surgery conferences.

Leadership

The fellow receives a faculty appointment in the Department of Surgery at an Assistant Instructor level and is expected to serve as junior faculty, when appropriate. The fellow has allocated vacation time, personal time for travel (board exams, family or personal events, etc.), an office, and other professional items (lab coats, pager, etc.). The fellow takes back-up call, with in-house resident teams taking primary call. The fellow has the option to participate in Trauma/Emergency General Surgery call at Parkland Memorial Hospital as a means of providing salary augmentation, as well as enhancing their experience staffing laparoscopic cases independently.