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Psychomotor Retardation
Everything in the library about psychomotor retardation — built automatically from the recorded discussions that name it
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
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SAGES Stories Episode 11 – Jeff Ponsky, MD
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Welcome to the SAGES Stories Podcast!
In episode 11, we have extraordinary privilege of listening to one of the funniest smart guys (or smartest funny guys) to ever be a part of SAGES: Dr. Jeff Ponsky!
Your hosts Shirin Towfigh, MD an
video1:01:24 · Jul 2026
SAGES Stories: Dr. Jeffrey Ponsky on surgical endoscopy and the PEG tube legacy
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In episode 11 we talk to Dr. Jeff Ponsky about endoscopy, Cleveland, and living on a compound. Plus, surgery, SAGES, family, and the importance of not taking oneself too seriously.
podcast1:01:24 · Jul 2026
The invention of the PEG tube with Dr. Jeffrey Ponsky
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Dr. Ponsky discusses his innovation of the PEG tube
podcast33:47 · Jul 2026
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Every expert statement below comes from the recorded discussions, with its speaker and moment.
SAGES Stories Episode 11 – Jeff Ponsky, MD
Ponsky had a 2.027 GPA graduating from Cleveland Heights High School and his college counselor recommended trade school instead of college.
clinicalJeffrey Ponsky6:49 ↗
Ponsky's transformation in college came from memorizing everything and studying constantly, discovering he had an exceptional memory that allowed him to 'eat the book and spit it out.'
opinionJeffrey Ponsky9:17 ↗
Gastroenterologists at University Hospitals refused to train surgeons in endoscopy, telling Ponsky 'we're not training any surgeons.'
clinicalJeffrey Ponsky25:21 ↗
Ponsky trained in endoscopy with Jim King in Canton, Ohio, performing approximately 500 cases over 5-6 months during an extended elective.
clinicalJeffrey Ponsky25:47 ↗
Early endoscopes were cleaned with green soap and stored in the back of cars, without high-level disinfection protocols. Operators did not wear gloves during procedures.
clinicalJeffrey Ponsky26:57 ↗
The PEG (percutaneous endoscopic gastrostomy) was developed in May 1979 by Ponsky and pediatric gastroenterologist Mike Gower, with the first five cases performed on babies with birth asphyxia and psychomotor retardation.
clinicalJeffrey Ponsky31:23 ↗
The PEG procedure was developed without IRB approval, only discussing the approach with patients' families.
clinicalJeffrey Ponsky31:31 ↗
Ponsky became chief of surgery at Mount Sinai Hospital at age 32 in 1979.
clinicalJeffrey Ponsky31:50 ↗
Ponsky performed 1,600 colonoscopies in a single year during his practice.
clinicalJeffrey Ponsky41:34 ↗
The distal splenorenal shunt, once considered a great operation based on physiology to reduce variceal pressure without decreasing portal flow, became obsolete when endoscopic variceal banding was introduced.
clinicalJeffrey Ponsky40:27 ↗
Ponsky performed 180 vertical banded gastroplasties in one year in the mid-1980s, an operation that later required reversal in many patients.
clinicalJeffrey Ponsky41:05 ↗
ERCP was developed primarily in Japan by Itaru Oi and colleagues, with contributions from German physicians and Peter Cotton's group in London.
clinicalJeffrey Ponsky43:09 ↗
Ponsky learned ERCP primarily through watching videos and self-teaching, then traded training with George Brodmerkel in Pittsburgh—teaching him laparoscopy under local anesthesia in exchange for learning sphincterotomy.
clinicalJeffrey Ponsky43:40 ↗
Walter Pore taught pinch grafting technique at Metro Hospital, where students would inject local anesthesia, harvest small 'postage stamp' skin grafts from the thigh, and apply them to debrided bedsores. Pore emphasized giving patients zinc supplementation.
clinicalJeffrey Ponsky21:12 ↗
Early SAGES meetings focused on surgical problem-solving with endoscopy, addressing topics like managing bowel obstruction, evaluating suture lines, and treating intestinal volvulus endoscopically—distinct from ASGE's focus.
clinicalJeffrey Ponsky48:24 ↗
When SAGES started, it had approximately 300 members. When Ponsky became president in 1990, the society was giving courses on surgical endoscopy and its relationship to surgical problem-solving.
clinicalJeffrey Ponsky28:30 ↗
Jacques Perissat showed the video of laparoscopic cholecystectomy in the exhibit hall at the SAGES meeting in Louisville, Kentucky, marking a pivotal moment when Ponsky was SAGES president.
clinicalJeffrey Ponsky28:48 ↗
When laparoscopic cholecystectomy was introduced, instruments could not be purchased and surgeons had to use gynecologic instruments initially.
clinicalJeffrey Ponsky29:04 ↗
Ponsky took one of the first laparoscopic cholecystectomy courses taught by Nat Soper, George Bercy, John Hunter, and John Sackier in Salt Lake City.
clinicalJeffrey Ponsky29:10 ↗
Ponsky's first two laparoscopic cholecystectomies at Mount Sinai were proctored by David Dupper, who had performed only 8 cases himself at that time. The first patient was a member of the hospital's board of trustees.
clinicalJeffrey Ponsky29:27 ↗
Ponsky advocated to the Residency Review Committee (when Joe Fisher was head) for a minimum endoscopy requirement in general surgery training. The initial requirement of 50 cases was controversial but established endoscopy as a required component of general surgery.
clinicalJeffrey Ponsky50:09 ↗
Ponsky became director of surgical endoscopy at University Hospitals at age 29 as a new attending.
clinicalJeffrey Ponsky30:31 ↗
Mount Sinai Hospital had an animal laboratory that was larger than Cleveland Clinic's laboratory, providing Ponsky freedom to conduct courses and train fellows.
clinicalJeffrey Ponsky32:54 ↗
The invention of the PEG tube with Dr. Jeffrey Ponsky
In the late 1970s, surgical residents were on call every other night (36 hours on, 12 hours off) for five years of training.
clinicalJeffrey Ponsky15:31 ↗
In 1974-1975, there were no pediatric gastroenterologists, and Ponsky performed endoscopy on children, young adults, and neonates with GI problems using his personally owned scope.
clinicalJeffrey Ponsky3:27 ↗
During neonatal endoscopy, the room would light up because babies were so thin; when pediatric surgeon Michael Gower pushed on the transilluminated light with his finger, an indentation was visible endoscopically.
clinicalJeffrey Ponsky4:33 ↗
The first PEG tubes were constructed from OR gastrostomy tubes (small Pezzer catheters) with sutures threaded through the end and passed through an IV catheter (medicut) to create a dilator tip.
clinicalJeffrey Ponsky4:59 ↗
The first five PEG procedures in May 1979 were performed in neonates with severe psychomotor retardation who were brain dead, fed by nasogastric tubes, had no chance of recovery, and were being sent for open gastrostomy before long-term nursing facility placement.
clinicalJeffrey Ponsky5:42 ↗
Informed consent for the first PEG cases consisted of telling mothers that if the new technique failed, immediate laparotomy and open gastrostomy would be performed.
clinicalJeffrey Ponsky6:25 ↗
The first PEG procedures succeeded easily within a few minutes.
clinicalJeffrey Ponsky6:42 ↗
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