Garrett Friedman

@ManishChandSurg As @MarkSoliman says, the only thing I’ll commit to blindly is my wife! I usually start MIS first then take down stoma once we know reversal is feasible

Often worth taking down colostomy first and using as an optical port to determine feasibility of an MIS approach.

Proposed cuts to Medicare will be devastating to surgeons and their patients (opinion) - CNN cnn.com/2020/08/20/per…

My first photo shoot after surgery, I'd never taken my top off and showed anyone my "bag" literally felt sick on my journey to Matts studio but sharing that first picture changed me as a person it lifted this huge weight off my shoulders and helped me accept the new me. #stoma

@justinmaykel Unquestionably real. Most interesting data point from a pt of mine with hand-sewn coloanal and LARS- brought his yearly water bills in. +500 gallons used this year due to clustering.

#LARS is real. It’s a struggle for ALL patients following #LAR. Patients definitely need to be counseled but nearly impossible to comprehend until AFTER surgery. Virtually every patient chooses anastomosis over stoma but not sure this is best #qualityoflife. #PatientCare

@venky72 @Some4SurgeryIT1 @me4_so @juliomayol @SWexner @ManishChandSurg @Neil_J_Smart @DeliaCortesGuir @debby_keller @SurgJournal @ColorectalDis @ASCRS_1 @ACPGBI @escp_tweets You made it look good anyway! Good work!

@gfriedmanMD @Some4SurgeryIT1 @me4_so @juliomayol @SWexner @ManishChandSurg @Neil_J_Smart @DeliaCortesGuir @debby_keller @SurgJournal @ColorectalDis @ASCRS_1 @ACPGBI @escp_tweets Thanks.. fully agree robotic staplers would be great.. still not available in 🇮🇳 .. can't wait to get hold of them

Robotic Low Rectal Intersphincteric Dissection + Stapling for rectal cancer @Some4SurgeryIT1 @me4_so @juliomayol @SWexner @ManishChandSurg @Neil_J_Smart @DeliaCortesGuir @debby_keller @SurgJournal @ColorectalDis @ASCRS_1 @ACPGBI @escp_tweets youtu.be/db4lmrM5AzA

Join myself and @ehaasmd this Thursday for @SAGES_Updates @IntuitiveSurg Colon Channel Event! We will be discussing Value in Robotic Colorectal Surgery, the NICE procedure and much more! Register: rb.gy/ny7v8q there will also be a shout-out to @amirbastawrous!

Every day on the console is a good day

@FezaRemziMD @AnnalsofSurgery Are you able to post your letter and the response here? I think I remember reading some of your letter but I cannot see the response due to usual #paywall issues. Would be curious to see both... shouldn't be silencing unpopular opinions, if that is what happened here

I wonder without publishing our actual letter why @AnnalsofSurgery selectively & only publishes the response to our letter on a topic that is so controversial. THIS IS SIMPLY WRONG. Response to Comment on “Local Recurrence After TaTME for Rectal Cancer” insights.ovid.com/pubmed?pmid=32…

@P_DeepakIBDMD @EdwardLoftus2 @IBDMD @ibddoctor @JeanFredericCo1 This patient should be referred to a colorectal surgeon. Timely surgery will give this patient the best shot at a good long term outcome @FezaRemziMD

Any experience with getting approval for ozanimod for UC in a very refractory UC pt, has failed all 4 FDA UC biologic/small molecule classes @EdwardLoftus2 @IBDMD @ibddoctor @JeanFredericCo1

@SWexner Sometimes a really good tool makes an emboldened fool

many quotes including these 2 from Mark Twain "To a man with a hammer, everything looks like a nail." and Grady Booch “A Fool with a Tool is Still a Fool.” could potentially apply to many scenarios....

@JaroslawMichal3 @SWexner @LeeOcuin @SurgJournal @asbun_hj @herbert_zeh Performing the *exact* same operation lap vs robotic will never show a difference. Question is can the techniques that benefit the pt- ICA, NICE etc be performed consistently and safely. Not many can do straight lap. Robot democratizes access to these techniques

@LeeOcuin @SWexner @SurgJournal @asbun_hj @herbert_zeh Hold on, so there is a study that shows patient advantage of these experts performing robotic surgeries I listed over laparoscopic?

surgjournal.com/article/S0039-… @SurgJournal “...we found a dramatic increase in the use of robotic-assisted cholecystectomy with no difference in mortality or duration of hospital stay, but there was a statistically significant increase in complications and costs.”

@TAMISYoda An excellent approach in appropriately skilled hands. These are difficult no matter how you approach it- lap, robotic, transanal, open. It’s always good to have a big toolbox

A perfect approach to the complex pelvis that I’ve utilized multiple times in order to get a normal distal rectal stump. The limitation nearly always is whether you have an adequate conduit. For a non malignant entity I continued with this approach . No need to pause and reflect.

@LeeOcuin @SWexner @SurgJournal @asbun_hj @herbert_zeh I think it depends how the operation is being done. If robotics allows consistent execution of ICA for a surgeon vs lap, for example, then the benefits and improvement in outcomes are tangible. Using any tool optimally and wisely is a key to success.

@SWexner @SurgJournal We need to take a step back and stop comparing lap to robo surgery. Both are MIS. Prob no advantage to one over the other if only experts at each were compared (John Martinie vs. @asbun_hj, or @herbert_zeh vs. Mike Kendrick). The learning curve is where we see differences.

The reflection on TaTME adoption is refreshing. I’d be equally interested to audit how it was aggressively pushed by certain big names/societies, who simultaneously dismissed robotics. Interesting message sent, particularly on intellectual bias

excellent video worthy of re-visiting cadaveric anatomy for the modified Hanley procedure (and how the spaces communicate), plus demonstration of the procedure. a must for residents and fellows to watch! youtube.com/watch?v=GmcJBS…

@sjnurkin Always a pleasure when you post a video Steve!

Beautiful views and great approach to Presacral Tumors

@docmartin22 @smstreit @proctothiago @pferrada1 @SWexner @kmattox1 @MarkSeamonMD @juliomayol @TecSurgeon @almagoch @SurgicalClinics @Cirbosque @MISIRG1 @hpb_so @SoSurg @Some4SurgeryIT1 @ScottRSteeleMD Not so sure... I fight with robotic assistance!

@smstreit @proctothiago @pferrada1 @SWexner @kmattox1 @MarkSeamonMD @juliomayol @TecSurgeon @almagoch @SurgicalClinics @Cirbosque @MISIRG1 @hpb_so @SoSurg @Some4SurgeryIT1 @ScottRSteeleMD @gfriedmanMD Yes, but my colorectal surgeon can beat up your colorectal surgeon

The surgery was a procrocolectomy with an ileal pouch. What do you think of pelvic neuromonitoring? Comment, please. @pferrada1 @SWexner @kmattox1 @docmartin22 @MarkSeamonMD @juliomayol @TecSurgeon @almagoch @SurgicalClinics @Cirbosque @MISIRG1 @hpb_so @SoSurg @Some4SurgeryIT1

This sucks. There is no way to sugarcoat this fiasco. Hoping that there is a path to take care of current examinees, and accountability for those responsible for the circumstances @AmBdSurg #MedTwitter