Lillian Reza, 2026 ACPGBI–ASCRS Travelling Fellow

01 June 2026

Innovation, translational science, and robotics were central themes throughout my two weeks in the United States as the 2026 ACPGBI–ASCRS Travelling Fellow. However, I was most struck by the incredible people who shaped my experience in the USA. The surgeons, fellows, residents, and research teams welcomed me, shared their work openly, and demonstrated that the challenges encountered in the United Kingdom closely mirror those faced internationally.

My first stop was Scripps Research and the Calibr-Skaggs Institute for Innovative Medicines in La Jolla, California, where I was hosted by Professor Amy Lightner. Prof Lightner is a colorectal surgeon at Scripps Clinic and Professor of Molecular and Cellular Biology at Scripps Research. Her laboratory works at the intersection of drug discovery and clinical translation. The Lightner Lab focuses on inflammatory bowel disease, especially patient-derived organoids and mesenchymal stem cell therapies. This work has led to several active Phase II trials, including pioneering studies in perianal fistulising Crohn's disease. It was remarkable to see how a physician-scientist can combine clinical practice, a translational laboratory, and international academic leadership in a single programme. I was especially grateful to be invited to product development meetings led by Professor Peter Schultz, President and CEO of Scripps Research. These meetings offered a rare look at how therapies are evaluated, prioritised, and advanced through a drug discovery pipeline.

My next stop was Vanderbilt University Medical Center in Nashville, hosted by Dr Alexander Hawkins. The Division of Colon and Rectal Surgery is a high-volume academic unit with a strong research footprint in shared decision-making, enhanced recovery, and implementation science. Alongside this sits the robotic and single-port colorectal programme led by Dr Aimal Khan, an early adopter of the da Vinci SP platform in colorectal surgery, whose research extends into robotics and image-guided precision tools for rectal cancer. The robotic footprint at Vanderbilt extends well beyond elective colorectal work. They have also built a fully operational robotic Emergency General Surgery service, led by Dr Michael Smith, which runs 7 days a week. Both services are operating at genuine scale, and embedding robotic capability into around-the-clock acute care, demonstrating the depth of institutional commitment to innovation that I have not previously seen.

I enjoyed experiencing the intentional approach to research in American academic surgery. There is sustained investment in people, infrastructure, protected time, and the broader ecosystem, enabling ambitious programmes to be developed and completed. Research and innovation is integrated into institutions and seen as inevitable for the leap our generation is about to take with technology enabled care. This growth mindset is the most significant lesson I have brought back.

The fellowship concluded at the ASCRS Annual Scientific Meeting in Tampa, my first ASCRS, and the experience exceeded all expectations. The breadth and quality of research were impressive, but the most notable aspect was the strong culture of collaboration, mentorship, and support for early-career academic surgeons.

I was honoured to present two podium abstracts. The first focused on the St Mark's Pouch Fistula Classification System and outcomes from our extensive retrospective database at St Mark's Hospital, developed over several years in collaboration with Mr Phil Tozer, Professor Sue Clark, and Professor Ailsa Hart. This work addresses a particularly challenging morbidity faced by patients with an ileoanal pouch. The second abstract examined the Virtual Hospital pathway in colorectal surgery at West Hertfordshire Teaching Hospitals NHS Trust, led with Mr Vanash Patel, which facilitates early discharge following elective colorectal surgery. I was delighted when this presentation received the 2026 Research Forum Works in Progress Award, a recognition that belongs to the entire team. This project demonstrates how digital pathways, robotic practice, enhanced recovery, and remote monitoring can fundamentally transform postoperative colorectal care. The international interest in Tampa showed that virtual surgical pathways and digitally enabled recovery models are leading a cultural shift in colorectal practice.

Beyond the scientific and surgical advancements, the most enduring impression is the sense of shared purpose. Challenges in colorectal surgery, including workforce, training, demand, and equitable access to innovation, are consistent across countries. This consistency underscores the necessity of international collaboration.

I return with new collaborations, ideas, friendships, and numerous opportunities for professional growth. I extend my sincere gratitude to the ACPGBI Council and ASCRS for this opportunity. I strongly encourage colorectal trainees and surgeons to apply for next year's fellowship, as it is truly a career-shaping experience.

 

Lillian Reza, 2026 ACPGBI–ASCRS Travelling Fellow

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