ACS Icons in Surgery | Jeffrey L. Ponsky, MD, FACS
Basil Morrison in England was marking the tips of polyps with India ink to track polyp behavior over time.
Endoscopic marking of colonic lesions with India ink was developed in 1975 to enable surgeons to locate polypectomy sites when pathology revealed cancer.
India ink tattooing remains useful in the laparoscopic era when surgeons cannot palpate the colon to locate lesion sites.
The first endoscope cost $5,200 in 1974.
In the mid-1970s, endoscopes were cleaned with green soap before use.
Transillumination of the abdominal wall during pediatric endoscopy, where the endoscope light shone through the belly and finger indentation was visible, led to development of the PEG procedure.
Jacques Perrisat presented a video on laparoscopic cholecystectomy at a SAGES meeting in Louisville, Kentucky in 1989.
Dr. Jeff Ponsky's impact on surgical endoscopy has been foundational through academic advancement of technology and technique, mentorship, and leadership in professional organizations like ASGE and SAGES to bring gastroenterology and surgery together in endoscopy.
Host summaryThe host summarizes what Dr. Jeffrey L. Ponsky said — not the host's own clinical position11:19
The American Board of Surgery asked SAGES to nominate three members for a board director position representing minimally invasive surgery.
Ponsky contributed to the American Board of Surgery by developing educational components for minimally invasive surgery, creating examination questions, and establishing endoscopy training requirements for surgical residents.
Dr. Ponsky served as director and chair of the American Board of Surgery, president of both ASGE and SAGES, and vice president of the American Surgical Association and SSAT.
Host summaryThe host summarizes what Dr. Jeffrey L. Ponsky said — not the host's own clinical position14:36
Dr. Ponsky trained 35 endoscopic surgery fellows who now carry on his legacy.
Host summaryThe host summarizes what Dr. Jeffrey L. Ponsky said — not the host's own clinical position14:59
The endoscope should be conceptualized as a vehicle like a car or bus that transports surgeons to operative sites rather than primarily as a tool for mucosal inspection.
Expert opinionJeffrey L. Ponsky19:23
Surgeons use the endoscope as a vehicle to reach sites for operations including POEM, POP, Zenker's procedures, and NOTES.
SAGES Stories Episode 11 – Jeff Ponsky, MD
Ponsky graduated high school with a 2.027 GPA and his college counselor recommended trade school instead of college.
Ponsky's father sold used tires for a living and the family had no money for college.
Ponsky attended Miami University of Ohio on loans and scholarships, studying by memorizing everything and taking copious notes.
Ponsky worked as an orderly at Mount Sinai Hospital during his first college summer, giving bed baths and changing bedpans, which increased his commitment to medicine.
Ponsky was promoted to scrub tech the following summer and was allowed to close fascia, despite the head nurse objecting.
Ponsky chose Case Western Reserve medical school partly because he had to live at home due to financial constraints.
Case Western Reserve had a 'new curriculum' with pass/fail grading (pass, fail, and honors) rather than letter grades during Ponsky's time.
Ponsky received honors in every medical school clerkship including psychiatry, internal medicine, cardiology, OBGYN, and surgery.
Bill Holden, chairman of surgery at Case Western, was an elegant teacher who used the Socratic method, though not the greatest technician.
Expert opinionJeffrey Ponsky19:43
Walter Pore taught using showmanship, including having students perform pinch grafts at bedside by injecting local anesthetic, cutting postage-stamp-sized skin pieces, and placing them on scraped bedsores.
Walter Pore made Ponsky rewrite his first paper (a letter to the New England Journal about paradoxical air embolism) six times and read German poetry to teach more poetic writing.
During residency, residents worked 36 hours on, 12 hours off, every other night.
The head of GI at University Hospitals refused to train surgeons in endoscopy, telling Ponsky 'we're not training any surgeons, just forget it.'
Ponsky trained in endoscopy with Jim King in Canton, Ohio, performing about 500 cases over 5-6 months using a mid-length colonoscope not designed to reach the cecum.
Ponsky's mother-in-law purchased his first colonoscope as a Hanukkah present after hearing he couldn't use the hospital's scope.
In the early days of endoscopy, scopes were washed with green soap (no high-level disinfection) and Ponsky kept his scope and light source in the back of his car.