CNS: UPASICON 2009

Showing posts with label UPASICON 2009. Show all posts

Endoscopic breast surgery - a new hope for cancer patients

Endoscopic breast surgery - a new hope for cancer patients

Exclusive CNS interview with Internationally acclaimed expert Dr Eisuke Fukuma (Japan)

Dr Eisuke Fukuma, Director of Breast Cancer, Kameda Medical Centre at Chiba, Japan, has done pioneering work in the field of endoscopic breast surgery and cryosurgery as a nonsurgical ablation.

He was recently in India to attend a conference on Minimal Invasive Surgery, hosted during the 35th Annual Conference of the Association of Surgeons of India, UP Chapter, at Lucknow, India, where he wowed everyone with his simplicity of manners and surgical expertise in the field of Endoscopic Breast Surgery.

In an exclusive interview to Citizen News Service (CNS), he spoke at length on the recent advances made in the area of breast surgery.

Breast cancer is on the rise in India, with 80,000 new cases being added every year and an annual death toll of more than 14,000. Yet there is very little awareness about the disease, especially in its earlier stages. Also, India has very few female breast surgeons, which very often acts as a deterrent to the female patients in seeking medical/surgical interventions.

According to Dr Fukuma, this issue merits a lot of attention, as women need to seek medical intervention during the first stage of the disease. Surgery is ruled out completely in the third stage. He stressed upon the dire need of good quality and sustained breast screening programmes in India, in the same manner as polio eradication programmes.

In Japan, with 40,000 new cases added every year, one, out of every 20, Japanese women suffers from breast cancer. But government sponsored breast screening /awareness programmes done, with the help of MRI, under strict quality control are helping in early detection. Hence timely treatment of the disease is saving many lives.

At Kameda Medical Centre, 50% of the breast surgeons are women. At present, out of the 5 resident doctors in the hospital’s department of breast surgery, 4 are women. This has gone a long way in encouraging women to seek medical advice.

When asked about the reason for the growing incidence of breast cancer, Dr Fukuma rued that the jet set pace of modern living was the main culprit. More and more women are marrying late and opting for late/no child bearing, which affects them biologically. Add to this the high consumption of junk food, as against the more nutritional traditional food. We have a perfect recipe for developing breast cancer

Endoscopic breast conserving surgery was developed originally in Japan, with a view to improve the cosmetic shape of the breast by reducing the scar-size and by changing the position of the surgical wounds. The purpose of endoscopic breast surgery (EBS) is to minimise skin incision and excision, as a skin sparing mastectomy.

This technique uses a long, narrow tube, called endoscope, which allows tiny surgical instruments to be inserted at a point far from the actual site of surgery. It is non invasive surgery, allowing for very small and precise incisions, without damaging nearby healthy tissues.

The surgeon is able to reach the entire breast through a one cm. hole made in the anterior auxilla (lower armpit), through which the tumour is removed. This is called the ‘trans auxiliary retro maminary route’. The cut is so small that it leaves no scar, and the front/upper part of the breast is untouched, obliterating the necessity of contour surgery in most cases. Post surgery, sometimes a depression may appear in the breast which can be simultaneously corrected with breast implants, working through the same holes. Thus, this scar less breast surgery, avoids the second corrective/cosmetic surgery to reshape the breast contour, as both can be done at the same time.

Dr Fukuma started the technique of OSEA - ‘Oncoplastic Surgery With Endoscopic Approach’ in 1995, at the 900 bedded Kameda Medical Centre in Chiba, Japan. Till to date, he has operated upon 2000 patients, with this new technique, and has performed more than 400 total mastectomies with simultaneous reconstruction. According to him, the survival rate in endoscopic breast surgery is an encouraging 95%. Currently about 80% of the patients in Japan are opting for this type of breast surgery, as its cost is the same as that of conventional surgery, and the benefits are immense.

The cosmetic goal of OSEA is to maintain the four S – size, shape, softness and symmetry of the breast. Add to this two more S of Scar Minimize and Spare the Normal Tissue.

This hybrid technique, perfected by Dr Fukuma, to suit the Asian women (who have smaller breasts as compared to their western sisters), entails simultaneous/staged reconstruction after endoscopic total mastectomy; augmentation of breast and mobilization of tissue from the breast or other than the breast.

Dr Fukuma is also very optimistic about the future of Cryosurgery, which is the latest in the field of surgery, and can be used for removing small tumours of the size of 1cm or less. In cryosurgery, an image guided needle is inserted through a 3mm incision (the size of a mosquito bite). The tip of this needle, which is kept at a temperature of -68oC, forms an ice ball around the tumour. The cancerous tissue is killed at this low temperature.

More than 30 such non surgical cryo ablations have been performed successfully by Dr Fukuma under local anaesthesia, with the patient going back home after a few hours of hospital stay. The field of cryosurgery offers exciting possibilities. But it is still in its infancy, just being three years old, and more research is needed in this area before it replaces other conventional methods.

He expressed his gratitude for being given a platform to showcase his technique through video presentations, and to share his ideas with the medical fraternity at the UPASICON 2009. He hoped that his visit to India would mark the beginning of a new chapter of collaboration between surgeons of the two countries. Dr Anand Misra of CSM Medical University, Lucknow has already trained under Dr Fukuma in Japan, and is using these techniques in treating patients, albeit partly, due to lack of proper instruments.

Surely, more such training programmes can be organized, to disseminate the benefits of this latest technology to all and sundry.

Dr Fukuma hopes to extirpate breast cancer completely by developing endoscopic and cryo surgery. His aim is to give a new hope to the patients and to save lives. He has assisted in endoscopic surgeries in the USA and UK, and stresses upon the need of international collaboration in this exciting field of surgery.

His message is loud and clear - Fight the Menace of Breast Cancer Rather Than Surrender.

We hope that he succeeds in his mission to provide high quality relief to breast cancer patients, at affordable prices, without compromising upon the beauty of the end result.

Shobha Shukla

(The author is the Editor of Citizen News Service (CNS), has worked earlier with State Planning Institute, UP, and teaches Physics at India's prestigious Loreto Convent. Email: shobha@citizen-news.org, website: www.citizen-news.org)

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Prof Rama Kant takes charge as PRESIDENT of Association of Surgeons of India (ASI), UP

Prof Rama Kant takes charge as PRESIDENT of Association of Surgeons of India (ASI), UP

Lucknow's noted Surgeon and Head of Surgery department at CSMMU - Professor (Dr) Rama Kant - took charge as President of Association of Surgeons of India (ASI), UP Chapter, at the closing ceremony of the 35th Annual Conference of ASI, UP Chapter (UPASICON 2009) which concluded in Lucknow. Prof Rama Kant was already the President of the Lucknow College of Surgeons (LCS) since past many years. He has also served as the national secretary of Indian Association of Endocrinal Surgeons, Association of Surgeons of India,

more than a decade back. ASI is the largest and most reputed network of Surgeons in India.

"In my tenure as President of ASI, UP, I envision to enhance the team spirit among surgeons of UP state, strengthen academic interactions between surgeons all across the state on pragmatic approaches to surgical management of major health concerns in UP that demand effective and affordable surgical interventions, and transfer knowledge and help build skills in state-of-the-art operative techniques through continuing medical education (CME) programmes conducted by stalwarts from around the world" said Prof Rama Kant, who took over as President of ASI, UP. “I wish to reach to our members at their place through physical, electronic or printable communications and will try to ensure to work as a bridge between young surgeons aspiring for training and National and international trainers” said Prof Rama Kant.

It was a momentous occasion indeed when the baton of presidentship of the UP Chapter of the Association of Surgeons of India was passed on to the much revered Prof (Dr)

Rama Kant. Earlier, historic Surgeons from Lucknow have led the august body of ASI, UP - including Prof PC Dubey and Prof NC Misra who are undoubtedly noted doyens from Lucknow in chronicles of Surgery in the world.

While ASI UP outgoing leader Dr Rajeev Sinha reaffirmed his faith in the dynamic leadership of Prof Rama Kant, the latter accepted his new responsibility in all humility and promised to take UPASI to new heights, by working in close contact with all the members of the association and by acting as a facilitator to expose them to the latest surgical techniques. He vowed to bring back the team spirit for making the association stand tall and not fall down as a divided house. He expressed confidence in able and dedicated Honorary Secretary of ASI-UP Dr SK Mishra who was instrumental in achieving the target of this chapter being declared as Best Chapter of the ASI.

Prof Rama Kant, who is also the World Health Organization (WHO) Director-General's Awardee (2005), will officiate as President of ASI, UP for 2009-2010. He was also the Chairman of the 35th Annual Conference of Association of Surgeons of India, UP Chapter which brought over 500 surgeons and noted International experts from around the world and hosted rich academic exchanges between surgeons during 6-8 November 2009 which also included a live operative workshop.

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UPASICON 2009 ends with updates on cutting-edge laparoscopic and endoscopic surgeries

UPASICON 2009 ends with updates on cutting-edge laparoscopic and endoscopic surgeries

The three-days surgeons' conclave - 35th annual conference of Association of Surgeons of India (ASI), UP Chapter, (UPASICON 2009) entered its third day on Sunday, 8 November 2009. UPASICON 2009 is being organized by Department of Surgery (General), CSMMU in collaboration with Society of Endoscopic, Laparoscopy Surgeons of India (SELSI), UP, under the leadership of ASI-UP President-elect and UPASICON 2009 Chairman Professor (Dr) Rama Kant, Secretary Dr HS Pahwa, and Joint-Secretary Dr Suresh Kumar.

The last day of the Conference saw the presentation of more Video Workshops and very informative guest lectures. It gave an opportunity to the participating surgeons to interact directly with noted experts, to understand the various aspects of laparoscopic and open surgical procedures.

Prof Dr E Fukuma (Japan) a pioneer in the field of endoscopic breast surgery and cryosurgery, gave an insight on hybrid skills with such surgeries for breast cancer. This lecture ably augmented his Video Presentation on Oncoplastic Breast Surgery With Endo videoscopic Approach, given yesterday.

In keeping with his passionate involvement of management of trauma, Dr Mohammad Zubair Ansari from Sandville Hospital, Birmingham, UK, spoke on ATLS – Advance Trauma and Life Support. He also conducted a trauma workshop for surgeons.

Other informative lectures enlightened the medical fraternity about the Mess Created By Hernia Meshes, Cost Effective Laser Ablation of Varicose Veins Treatment, Management of Urinary Tract Obstruction in Children, Management of Acute Pancreatitis and treatment of male infertility.

Video presentations, touching upon a vast range of topics, proved to be as lively and educative as of the day before.

Dr S.K.Mishra of Kanpur gave a video presentation on ‘Complications of Laparoscopic Cholecystectomy, while ‘Points of Technique of Radical Cholecystectomy’ were discussed by Dr Sonkar.

While Dr Kureel taught the audience How To Do A Proper Colostomy, Dr Rawal of Rajiv Gandhi Cancer Research Institute presented techniques of various permanent Urinary Diversions.

Dr Anant Kumar of Apollo Hospital, gave a video presentation on ‘Laparoscopic Radical Nephrectomy’.

The curtains were drawn on the conference with the Valedictory Function.

UPASICON 2009 more than succeeded in its aim to provide an excellent platform for all practicing surgeons of various streams (gynaecologists, paedriatic surgeons, gastro-surgeons, urologists) interested in advanced laparoscopic procedures; as well as surgeons and residents aspiring for trauma care – a vital component of medical education.

Shobha Shukla

Cutting-edge surgical techniques for management of breast surgery, cancer, piles at UPASICON 2009

Cutting-edge surgical techniques for management of breast surgery, cancer, piles at UPASICON 2009

The three-days surgeons’ conclave - 35th annual conference of Association of Surgeons of India (ASI), UP Chapt

er, (UPASICON 2009) entered its second day on 7th November 2009. UPASICON 2009 is being organized by Department of Surgery, CSMMU in collaboration with Society of Endoscopic, Laparoscopy Surgeons of India (SELSI), UP, under the leadership of ASI-UP President-elect and UPASICON 2009 Chairman Professor (Dr) Rama Kant, Secretary Dr HS Pahwa, and Joint-Secretary Dr Suresh Kumar.

The second day of the Conference could aptly be called a day of Video Workshops and Enlightening Orations. It gave an opportunity to more than 500 participating surgeons to interact directly with globally acclaimed experts to understand the various aspects of cutting edge surgical techniques, particularly laparoscopic and open surgical procedures.

The star presentation of the day belonged to Prof Dr E Fukuma from Japan, the ‘land of the rising sun’, who has done pioneering work in the field of endoscopic breast surgery. He gave a Video Presentation on Oncoplastic Breast Surgery With Endo videoscopic Approach. This is the latest technique in the field of Mastectomy and is yet to begin in India. It leaves no injury on the whole breast, and can become a single standard method for breast-conserving surgery, wherever a cancer is situated.

A Video presentation on Surgical Management of early breast cancer was given by Prof Dr Gaurav Agarwal, Endocrine Surgery Department, SGPGIMS, Lucknow.

Prof Rama Kant, Head of Surgery Department, CSMMU, delivered a guest lecture on “Journey from Piles to Smiles.” A very recent technique for the treatment of Piles, called Doppler Guided Haemorroidal Artery Liga

tion (DGHAL) and Recto Anal Repair (RAR), was presented by Prof Kant. This requires hospital stay of a few hours only, and the patient can go back to work the very next day.

'Laparoscopic Hemicoleectomy' and 'Duodenal Perforation' video presentations were the specialized domains of the stalwarts Dr Rao and Dr Puntambekar respectively.

Dr Amit Srivastava presented ‘A Novel Approach For Management Of Lower One Third Uretric Calculus’. Dr Maurya, the renowned laparoscopic surgeon from Agra, showcased ‘Laparoscopic CBD Exploration in Minimal Access Surgery’.

The medical names for these minimal access surgical interventions might sound very high brow for the common person, but then these are big names for procedures that make small cuts (or no cuts) in the patients and make their pain smaller and life easier.

Besides these lively video presentations, there were several informative lectures on a wide variety of topics ranging from ‘Common Surgical Procedures In Breast Disease’ by Dr Sandeep Kumar, to Basic Management of Fistula, by Dr Ashok Kumar.

The gold standard technique of Laparoscopic Cholecystectomy in difficult situations was discussed alongside with the current approaches to follicular malignancy of thyroid.

The participants, though advocators of single PORT and E PORT surgeries, did not neglect conventional open surgery procedures, which are still practiced in general hospitals, probably due to the lack of requisite instruments and gadgets. The doctors of CSMMU spoke at length on the management of common cancer in general surgical set ups for carcinoma of Breast, Oral Cavity and Gall Bladder. Queries related to the symptoms, confirmatory tests and treatment options for these types of cancers were dealt with in a lucid manner.

Shobha Shukla

Spotlight on big surgeries with minimal or no incisions at regional Surgeons' Conclave

Spotlight on big surgeries with minimal or no incisions at regional Surgeons' Conclave

The three-days regional surgeons' conclave - 35th annual conference of Association of Surgeons of India (ASI), UP Chapter, (UPASICON 2009) began on 6th November 2009. UPASICON 2009 is being organized by Department of Surgery (General), CSMMU in collaboration with Society of Endoscopic, Laparoscopy Surgeons of India (SELSI), UP, under the leadership of ASI-UP President-elect and UPASICON 2009 Chairman Professor (Dr) Rama Kant, Secretary Dr HS Pahwa, and Joint-Secretary Dr Suresh Kumar.

"The Live Operative Workshop on Single Port Total Hysterectomy; Single Port Cholecystectomy; and Laparoscopic Hernioplasty, held on the first day of the conference, exposed over 500 delegates to the latest advancements made in the field of Minimal Access Surgery. It was not only the surgeons’ delight to be a part of the revolutionary changes sweeping the field of conventional surgery, but also the attention bestowed on the common patients by the uncommon doctors" informed Prof (Dr) Rama Kant.

The conference began on a very practical and professional note, with renowned surgeons showcasing their skills and expertise in performing ‘big operations with minute or no incisions'. The star performer was none other than Dr Prashant Rao, aptly called the “Father Of Single Port Surgery”. He performed Single Port Cholecystectomy (no perforation) on a female patient.

Dr Shailesh Puntambekar of Pune, did Single Port Hysterectomy. Laparoscopic Hernioplasty was done by Dr M.C.Misra of AIIMS, Delhi. Dr S.D.Maurya from Agra, showed his expertise in Non Descent Vaginal Hysterectomy.

A very recent technique for the treatment of Piles was performed by Prof (Dr) Rama Kant, Head of the Surgery Department of CSMMU. It is called Doppler Guided, Haemorroidal Artery Ligation (DGHAL) and Recto Anal Repair (RAR). This requires hospital stay of a few hours only, and the patient can go back to work the very next day.

“The main thrust of the workshop is to bring the state-of-art surgical techniques to the aid of the common people. With more and more doctors honing their skills in this direction, and with the people becoming more aware of the overall benefits of Minimal Access Surgery, these surgical procedures are likely to replace conventional open surgeries in a big way, and become available to all strata of society, irrespective of their social status” said Dr HS Pahwa.

Even though the direct cost of such surgical interventions, may be slightly higher than conventional surgery, but the overall gains are far too many. Dr Pahwa informed that there is less tissue trauma, chances of post operative infections are minimised, recovery is faster, and duration of hospital stay is reduced. All this adds up to be more patient friendly and more economical in the long run.

As 60-70% of the patients coming to hospitals like CSMMU are poor, this workshop should go a long way in making the latest technologies affordable. Dr Rama Kant was very optimistic about the outcome of the conference and rightly believed in Thinking Big in order to Achieve Big.

Shobha Shukla

"Greater the surgeon, smaller the incision": UPASICON 2009

"Greater the surgeon, smaller the incision": UPASICON 2009

Lucknow, the erstwhile 'City of The Nawabs' will be host to the 35th Annual Conference of the Association of Surgeons of India (ASI), UP chapter (UPASICON 2009). The surgeons' conglomerate is being organized by the Department of Surgery of CSM Medical University (upgraded King George's Medical College - KGMC) in association with the Society of Endoscopic & Laparoscopic Surgeons of India(SELSI), UP Chapter, under the dynamic leadership of Professor (Dr) Rama Kant, Head of the Surgery Department and President-Elect of Association of Surgeons of India (ASI), UP.

"We have come a long way from the days of 'greater the surgeon, bigger the incision' to 'greater the surgeon, smaller the incision'. And now we are progressing from Multiple Keyholes to Single Port Laproscopic Surgery" said Prof Rama Kant.

He added that all this is developed with utmost precaution so that the safety of patients is not compromised. Laproscopic surgeries lead to minimum post operative pain, and a very early 'back to normal' recovery.

This mega event will be an occasion to interact with around 500 doyens of surgery, especially laproscopic surgery, from around the world, from 6-8 November 2009, to learn, update and keep abreast of the moving jet set technology in the field of surgery.

The stalwarts who have consented to grace the conference include Dr Fukuma from Japan, Dr Mohd Ansari from UK, Dr Prashant Rao of Mumbai, Dr Shailendra Puntambekar of Pune, Prof SD Maurya from Agra and Dr SK Mishra from Kanpur.

Prof Rama Kant is indeed happy to bring this conference back to Lucknow after a gap of 12 years and treat the medical fraternity to the latest techniques in the field of minimal invasive surgery, as well as take part in a broad based scientific programme, covering most of the important issues of surgery.

Of special interest will be the operations performed in the 'Live Operating Workshop' on the first day of the conference, which will focus on 'Single Port Laproscopic Surgery' NOTES (Natural Orifice Transluminal Endoscopy Surgery), Laproscopy in trauma, emergency, endocrine, thoracic, gynaecological surgeries. In a lay person's language, Single Port surgery is performed by making a single hole, instead of the normal four to five holes. This technique has been pioneered in India, by Dr Prashant Rao of Mumbai, who will demonstrate this revolutionary surgical procedure at UPASICON 2009.

The second and third day of the conference will showcase various Operative Master Video Presentations with emphasis on the practical aspects of Minimal Access Surgeries and Open Surgeries.

Dr Eisuke Fukuma, the Endoscopic Endocrine Surgery expert from Japan, purports be the star attraction on the second day. He will give a videoscopic presentation of Endoscopic Mastectomy - a technique which he has mastered. He and his group at Kameda Medical Centre, Chiba, Japan, has performed 385 such breast surgeries between 1995 and 2007. This type of mastectomy involves minimal scarring and post operative pains.

Apart from Video Presntations, there will be sessions of informative panel discussions, debates, symposia by faculties from all over the world, with special emphasis on the practical aspects of Emergency Care (in management of Melema, Bleeding Per Rectum,etc), basics of surgical suturing and surgical site infections, and Laproscopy in emergency (bowel perforation, appendix removal, abdominal trauma etc).

As if this was not enough food for the mind, there will be paper/ poster presentations, guest lectures, orations and a quiz for the resident doctors.

Last, but not the least, Prof Rama Kant will give a live demonstration of a unique non-surgical technique for the management of Piles called Doppler-guided haemorrhoidal artery ligation (DGHAL) and Recto-Anal Repair (RAR). The beauty of this procedure lies in the fact that the patient is discharged within a few hours and is back to work, the very next day.

So all ye Lucknowites, please brace up to welcome and reap the benefits of this international gathering of surgeons.

Shobha Shukla