Advanced GI/MIS/Foregut Surgery Fellowship

Program overview

The minimally invasive surgery (MIS) fellowship at WashU Medicine is a one-year clinical fellowship that trains two fellows per year. Established in 2003, the program provides extensive operative experience in minimally invasive upper GI surgery, bariatric & metabolic surgery, and complex abdominal wall reconstruction, with integrated endoscopy and esophageal physiology. Fellows receive protected time for research and quality improvement and graduate with strong autonomy and scholarly productivity.

The program is accredited by the Fellowship Council for advanced GI MIS/foregut and hernia surgery.

Our mission is to develop the next generation of academic leaders in minimally invasive surgery.

Fellows operate primarily at Barnes-Jewish Hospital and Barnes-Jewish West County Hospital, with clinics at the Center for Advanced Medicine. Training emphasizes progressive autonomy, a weekly fellow-led MIS case conference, robust resident teaching, and scholarly work supported by dedicated research time. The program culture is collaborative and mentorship-driven, with regular feedback and individualized development plans. Graduates transition confidently into academic and community practices.

Our program offers:

• Extensive experience with complex foregut and esophageal surgery, including anti-reflux procedures, paraesophageal hernia repairs and redo hiatal hernia repair.
• High-volume exposure to all aspects of complex abdominal wall reconstruction and hernia repair, including robotic, laparoscopic, and open techniques.
• A robust bariatric surgery experience, including primary and revisional procedures.
• Dedicated mentorship and career development from internationally recognized faculty in MIS, surgical education, and clinical research.

Learn more about the Section of Minimally Invasive Surgery>>

Program director

Associate program director

See all minimally invasive surgery faculty>>

Clinical experience

Rotations and facilities

The fellow spends the majority of their time at Barnes-Jewish Hospital, a large tertiary referral center and the primary teaching hospital for Washington University School of Medicine.

A second location includes Barnes-Jewish West County Hospital, providing a smaller, community practice environment. This provides exposure to a high volume of complex cases from a wide catchment area.

Rotations are structured to maximize exposure to foregut, hernia, and bariatric surgery.

Schedule

• 3–3.5 days: Operative care
• 0.5–1 day: Outpatient clinics (foregut, bariatrics, hernia)
• 0.5-1 day: Research/QI & academic development
• Call: ~7 days/month; home call with attending backup

Operative experience

The fellow will become proficient in a wide range of advanced GI and MIS procedures, including:

• Foregut/esophageal: Laparoscopic and robotic paraesophageal hernia repair, fundoplication, redo hiatal hernia repair, LINX™ procedures, POEM, Heller myotomy, gastric electrical stimulator, esophageal diverticulectomy, diaphragmatic hernia repair, median arcuate ligament release, duodenojejunostomy for SMA syndrome
• Abdominal wall reconstruction: Advanced robotic techniques (eTAR, rTAPP), laparoscopic (TAPP, TEP), open inguinal and complex open hernia repairs
• Bariatric: Laparoscopic Roux-en-Y gastric bypass, sleeve gastrectomy, and revisional bariatric surgery
• Flexible endoscopy and esophageal physiology: Manometry, pH/impedance, EndoFLIP
• Minimally invasive solid organ surgery (adrenal/spleen)

Curriculum

Conferences and didactics

The fellow is an integral part of our academic community and is expected to attend and participate in weekly conferences, including:

• Section of Minimally Invasive Surgery Didactic Conference
• General Surgery Grand Rounds
• Morbidity & Mortality (M&M) Conference
• GI Surgery Journal Club

Courses and labs

Fellows have access to the world-class Washington University Institute for Surgical Education (WISE), which includes laparoscopic and robotic skills labs, simulation training, and cadaveric and animate labs to hone advanced surgical techniques.

Research & academic opportunities

Clinical research

Fellows are expected to complete at least one clinical research project during the year, with the goal of presenting at a national meeting and publishing in a peer-reviewed journal.

The Section of Minimally Invasive Surgery has a robust clinical research infrastructure, including data registries and faculty support to help the fellow succeed.

Teaching and education

The fellow plays an active role in the education of general surgery residents and medical students, both in the operating room and through formal didactic sessions. This includes opportunities for leading simulation sessions at the WISE center.

Mentorship and professional development

Our fellowship offers a structured mentorship program with a low fellow-to-faculty ratio, ensuring personalized attention and guidance.

Faculty provide dedicated career counseling, assistance with job searching, and opportunities to build a professional network through national society meetings.

Current fellows

Paul Kepper, MD
Residency: WashU Medicine

Dahlia Kenawy, MD, MS
Residency: The Ohio State University Wexner Medical Center

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