Monday, June 15, 9:00 – 10:30 am
Auditorium Richelieu

1. Belch or no belch: what is the approach to belching disorders?
2. When to suspect and confirm the diagnosis of rumination?
3. How does symptom-specific anxiety and hypervigilance intersect with esophageal conditions?
4. What is the role of brain-gut behavioral therapy in treating esophageal symptoms?
5. How to leverage pharmacologic neuromodulation for esophageal symptoms
6. Are there roles for complementary therapies such as acupuncture and nerve stimulation for treating esophageal conditions?

Panel Chat/Q&A

Monday, June 15, 11:00 am – 12:30 pm
Auditorium Richelieu

1. How should non-cardiac chest pain be diagnosed?
2. How is functional heartburn different from reflux-induced heartburn?
3. Should reflux hypersensitivity be managed as a DGBI, GERD, or both? 
4. Is globus a LPRD symptom or a primary DGBI?
5. What test(s) should be performed to diagnose functional dysphagia?
6. How does functional dyspepsia overlap with esophageal symptoms or disorders?

Panel Chat/Q&A

Monday June 15, 11:00 am – 12:30 pm
Auditorium Condé

   I. POEM and Third-Space Procedures

1. Does the side of mucosal entry affect POEM procedure outcomes? 
2. What is the true incidence of reflux after POEM & how can that be reduced? 
3. Does it matter whether full-thickness or circular muscle-only myotomy is performed for POEM? 
4. Do we know the long-term durability of POEM? 
5. Can we predict which patients will fail POEM? 
6. Should we aim for same day discharge after POEM? 
   
   
   II. Endoscopic Submucosal Dissection & Tumor Resection
    
7. How large is too large for ESD in 2026? 
8. How deep is too deep for ESD in 2026?
9. Is endoscopic ultrasound helpful or required for optimal ESD? 
10. Will artificial intelligence change the way we perform ESD?
11. What technological advances are needed for ESD to make the next leap forward? 
12. What are the next steps for 3rd space endoscopy in the esophagus? 

Monday, June 15, 2:00 – 3:30 pm
Auditorium Lulli

Talks:

1. What does the San Diego Consensus change in clinic?  
2. Is GMA biomarker subtyping the key to understanding and treating GERD/LPR?  
3. Alginate, H2RA, PPI, neuromodulation, or lifestyle first—what’s your first script? 
4. What is the current understanding of the role of reflux in promoting laryngopharngeal cancer? 
5. Are PCABs effective for LPRD?  
6. What is the status of pepsin inhibitors for LPR? 
7. Which surgical or endoscopic options work for extra-esophageal disease?
8. Pediatrics: are kids just little adults when it comes to LPRD?

Motion: "This house supports the San Diego Consensus Statement as the governing guideline for LPRD."

• FOR: (defending the Consensus statements & pathways). 
• AGAINST: (challenging external validity, symptom-first pathways, and laryngology-specific nuances). 

Format: 5-minute opening per side → 5-minute discussion → 5-minute audience Q&A → live poll - vote on the debate motion.

Case-Based Panel + Audience Interaction:

Rapid Cases (5 minutes each x3)

1. Professional singer with chronic throat clearing and normal EGD: “Treat or test first?”
2. Chronic cough with normal acid exposure but high non-acid events: “Does therapy change?”
3. Mucosal protection: formulations and their place in the management of GERD and LPR
4. Refractory LPS after maximal PPI & alginate: “Is it time for surgery or is it not reflux?”

3 take-home messages aligned to consensus language 

Monday, June 15, 2:00 – 03:30 pm
Auditorium Richelieu

1. Why and when to resect thoracic duct during RAMIE and in which anatomical plane?
2. da Vinci Single Port subcostal Esophagectomy – How to and first results?
3. Cardia cancer – how to treat differently compared to esophageal adenocarcinoma?
4. Vision of Robot Assisted Cervical Esophagectomy (RACE)
5. Results of the randomized prospective multi-center ROBOT-2 Trial of MIE vs RAMIE
6. Different robotic systems for esophageal surgery, where do we go?

Panel Chat/Q&A

Monday, June 15, 4:00 – 05:30 pm
Auditorium Richelieu

1. ICG during RAMIE
2. RAMIE in Middle East – Multiport Results
3. RAMIE in difficult Cases – Proximal esophagus
4. New techniques treating early cancer with robotic surgery vs. endoscopy
5. Benign Foregut – Robotic Update
6. Implementation of AI / Digital Assist in robotic surgery

Panel Chat/Q&A

Monday June 15, 4:00 – 5:30 pm
Auditorium Condé

1. What is the true prevalence of EoE and is it increasing? 
2. What do we know about the microbiome in EoE?
3. How should esophageal biopsies ideally be analyzed for EoE patients?
4. What is the role of allergy testing for EoE patients?
5. Does the presentation and management of EoE differ in South America?
6. What is the role for non-endoscopic techniques for diagnosis & surveillance? 
   
   II. Management
7. ​How to transition EoE patients from pediatric to adult practices? 
8. Is there still a role for proton pump inhibitors in the management of EoE? 
9. Topical steroids: who, what & how long? 
10. How to approach biologic therapies for EoE in 2026? 
11. How I approach endoscopic dilation for EoE 
12. Is EoE therapy forever? 

Tuesday June 16, 9:00 – 10:30 am
Auditorium Richelieu

1. Which classification system we need 2026?                             
2. Double Tract reconstruction after limited resection           
3. How long we can wait after neoadjuvant treatment for surgery and how long we should wait?
4. Which access is the best open, HYBRID or minimal invasive?   
5. What is the safest anastomotic technique after esophagectomy?          
6. How we can prevent and treat Enterothorax after Esophagectomy?      

Panel Chat/Q&A

Tuesday June 16, 9:00 – 11:30 am
Auditorium Condé

Tuesday, June 16, 11:00 am – 12:30 pm
Auditorium Richelieu

1. Is there a place for surgery in proximal cancer?
2. When we need McKeown, when Ivor-Lewis approach is sufficient? 
3. What is necessary extent of lymphadenectomy in thoracic esophageal cancer?
4. Technical aspects of cervical anastomosis after McKewon esophagectomy?
5. What are the arguments for surgery in squamous cell carcinoma?
6. What are the pitfalls for salvage esophagectomy?

Panel Chat/Q&A

Tuesday June 16, 11:00 am – 12:30 pm
Auditorium Condé

Tuesday June 16, 2:00 – 3:30 pm
Auditorium Richelieu

1. Do we really know what causes EoE?
2. Is EoE really a new disease or just unrecognized previously?
3. How should one ideally pursue an EoE-elimination diet?
4. How to approach medical therapy for EoE: my algorithm?
5. What is the role for artificial intelligence in EoE?
6. How will we treat EoE in 10 years?

Panel Chat/Q&A

Tuesday June 16, 2:00 – 3:30 pm
Auditorium Condé

1. Dynamic Esophageal Radiology
2. Benign stenosis: measurements for treatment
3. Dynamic Radiology in esophageal carcinoma
4. Dynamic Radiology of the PE segment: the perspective of surgery
5. Dynamic Radiology: the perspective of bariatric surgery
6. Dynamic Radiology: the gastroenterologic perspective             

Panel Chat/Q&A

Tuesday, June 16, 4:00 – 5:30 pm
Auditorium Richelieu

1. When do PPI fail and when should PCAB be considered in treating reflux symptoms?
2. How should reflux symptoms refractory to PPI be evaluated?
3. What other primary or adjunctive non-surgical options are useful for reflux symptoms?
4. What are the causes of failed fundoplication?
5. How should symptomatic post-fundoplication patients be assessed?
6. When should endoscopic anti-reflux interventions be considered?

Panel Chat/Q&A

Tuesday June 16, 4:00 – 5:30 am
Auditorium Condé

Panel Chat/Q&A

Wednesday, June 17, 9:00 – 10:30 am
Auditorium Lulli

1. When to FLIP – up-front, at the end, any time, or never?
2. Advantages of barium esophagram versus FLIP for EGJ outflow obstruction 
3. Achalasia subtyping: FLIP + Barium versus HREM alone 
4. Achalasia treated, recurrent – how to evaluate? 
5. Achalasia treated, recurrent – recut or dilate? 
6. Treatment of spastic disorders in the esophagus (non-achalasia): pharmacologic versus endoscopic interventions
7. Only time for one provocative maneuver today – how do you choose – MRS, Rapid drink or SLR? 
8. Treatment or observation for Ineffective Esophageal Motility, which is better? 
9. Pre-operative testing for GERD: esophageal manometry AND imaging or is less more?  
10. Absent contractility and proven GERD: lifestyle modification and medical management or wrap? 
11. Should we care more or less about bolus clearance during HREM? 
12. An abnormal looking manometry that is NORMAL by Chicago 4.0 – Explore or ignore?

Wednesday, June 17, 9:00 – 10:30 am
Auditorium Richelieu

1. Current Art of Antireflux Surgery
2. Current Art of Surgery for Achalasia
3. Current Art of Surgery for Esophageal Diverticula
4. Current Art of Surgery for Esophageal Squamous Cell Carcinoma
5. Current Art of Surgery for Esophageal and Junctional Adenocarcinoma

Panel Chat/Q&A

Wednesday, June 17, 11:00 am – 12:30 pm
Auditorium Lulli

1. How does obesity impact esophageal physiology? 
2. Should esophageal physiologic testing be routinely performed prior to bariatric intervention?
3. How should dysphagia following bariatric surgery be evaluated? 
4. Can bariatric surgery cause achalasia and achalasia-like disorders? 
5. How do weight regain and associated interventions affect esophageal symptoms? – 
6. What are the consequences of intragastric balloons on esophageal and gastrointestinal symptoms? 
7. What are the mechanisms underlying excessive reflux following bariatric surgery? 
8. How should reflux following bariatric surgery be managed? 
9. What is the approach to a hiatal hernia following bariatric surgery? 
10. Do endoscopic gastric remodeling procedures cause esophageal symptoms? 
11. What are the esophageal and gastrointestinal side effects of GLP-1 receptor agonist use? 
12. What is the impact of obesity and weight loss interventions on the risk of Barrett’s esophagus and esophageal cancer? 

Wednesday, June 17, 11:00 am – 12:30 pm
Auditorium Richelieu

Panel Chat/Q&A

Wednesday, June 17, 2:00 – 3:30 pm
Auditorium Lulli

1. How should the optimal reflux monitoring modality and protocol be selected for different reflux presentations?
2. Can patients with AET <4% off PPI have actionable GERD?
3. How should reflux-symptom association data on reflux monitoring tests be used for planning symptom management?
4. Is there a role for anti-reflux therapy in treating reflux hypersensitivity
5. The AET is 4-6% off PPI – now what?
6. Can total reflux episode count on impedance monitoring direct management?
7. What methods are available for clinical measurement of esophageal mucosal integrity?
8. What are the roles of mucosal impedance metrics in evaluating typical and atypical reflux symptoms?
9. Are there roles for barium esophagram and high-resolution manometry in GERD evaluation?
10. How can FLIP be utilized for GERD diagnosis and management?
11. What is the diagnostic approach to suspected reflux-related airway diseases?
12. How can reflux management protect the lungs in pre- and post-transplant patients?