557: Standing on the Shoulders of Giants: A Conversation with the Pioneers of MIGS
Sunday, November 15, 2026
3:15 PM-4:15PM
Room: 311

Chair: Assia Stepanian
Faculty: Leila Adamyan, Javier Magrina, Liselotte Mettler, Camran Nezhat, Harry Reich

Description: The evolution of minimally invasive gynecologic surgery was shaped by visionary surgeons who challenged established practices, introduced transformative technologies, and persevered through skepticism, obstacles, and resistance. Yet MIGS represented far more than a change in surgical access or the introduction of new operative techniques. It marked a fundamental shift in the philosophy of gynecologic surgery and women’s healthcare, redefining not only how surgery is performed, but what surgery should ultimately achieve.

In this engaging fireside chat, five internationally recognized pioneers— Drs. Leila Adamyan, Harry Reich, Camran Nezhat, Javier Magrina, and Lilo Mettler—will reflect on the origins and evolution of minimally invasive gynecologic surgery. Moderated by Dr. Assia Stepanian, founder of SurgeryU, the session will motivate and guide current and emerging MIGS surgeons by exploring how these leaders began their careers, the innovations and surgical advances they introduced, the barriers they encountered, and the personal qualities that helped them achieve meaningful and lasting change.

Before sharing their vision of surgeons’ experiences in the future, they will walk us through their work that transformed the entire logic of surgical decision-making: how gynecologic disease is understood and classified, how indications are defined, how the appropriate extent of surgery is determined, how surgical strategy and treatment tactics are individualized, how outcomes are predicted, and how results can be standardized, measured, and critically evaluated, turning surgery from an isolated technical act into part of a structured, continuously evolving, evidence-based, and scientifically and personally enhanced continuum of care.

The discussion will highlight landmark contributions, including the expansion of minimally invasive gynecologic surgery throughout various regions of the world; the development and adoption of robotic gynecologic surgery; the international dissemination of operative laparoscopy through surgical education, scholarship, and mentorship; the advancement of video laparoscopy and endometriosis surgery; and the performance of the world’s first laparoscopic hysterectomy. Together, these advances redefined the very criteria of surgical success; they enhanced the biological, functional, reproductive, psychological, and social impact of surgery and by implementing new models of surgical education, mentorship, live surgical teaching, international collaboration, and real-time dissemination of operative experience across institutions, countries, and generations.

MIGS’ close relationship with Fundamental Science deepened the understanding of disease mechanisms, refined diagnoses, and provided the basis for increasingly precise and individualized surgical decisions, ensuring long-lasting surgical results, preventing complications of surgery, suppressing the development of disease and maximizing organ/tissue function. In this way, advances in MIGS opened “new horizons” of gynecologic surgery, moving the field toward a more predictive, preventive, personalized, and measurable model.

Rather than delivering individual podium presentations, the pioneers will participate in a candid and interactive discussion that encourages ideas through storytelling, reflection, and dialogue among the speakers. Their experiences will provide historical context in addressing issues that remain highly relevant to the current and emerging generation of surgeons: introducing innovation responsibly, navigating setbacks, developing mentorship networks, maintaining professional courage, and balancing technological progress with sound surgical judgment.

At its core, the legacy is not defined by a single technique, device, or surgical access, but by a philosophy: rigorous surgical judgment, scientific evidence, patient safety, preservation of function and reproductive potential, responsible innovation, measurable outcomes, education, mentorship, and the transformation of healthcare delivery--- ultimately advancing both the quality of healthcare and the quality of women’s lives far beyond the operating room. The session will conclude with the panelists’ perspectives on the future of MIGS, the principles that should be preserved as the field continues to advance, and the responsibilities of the next generation in carrying this legacy forward.

Learning Objectives: After attending this session, the participant will be able to: 1) Describe the landmark innovations that transformed modern gynecologic surgery; 2) Apply enduring surgical principles developed by pioneering surgeons to contemporary practice; and 3) Identify future opportunities for innovation in minimally invasive gynecologic surgery and reproductive surgery.

COURSE OUTLINE

3:15 PM Welcome, Introductions
A. Stepanian

3:20 PM Where It Began
All Faculty

3:28 PM Innovation and Contribution
All Faculty

3:36 PM Resistance, Obstacles, and Persistence
All Faculty

3:44 PM Lessons for the Current Generation
All Faculty

3:52 PM The Evolution and Future of MIGS
All Faculty

4:00 PM Closing
All Faculty

4:08 PM Discussion, Questions & Answers

4:15 PM Adjourn