Message from the Interim Administrative Director

Although I am the new interim administrative director, I am familiar with the society. In fact, I am one of the founding members and I was the first ISGE secretary. Compared to the early years of the society, endoscopy today is much more advanced. We have better instrumentations and many operations that previously required a laparotomy are now done by minimally invasive approach. I believe that endoscopy is the best surgical approach to treat our patients.

In order to improve our communication, I need:

• Your correct address, including telephone number and particularly your e-mail address. Most of our communications will be done electronically.
• Your membership dues.

Note that membership dues will remain the same:

Presently, our web site is under construction (www.isge.org). In any event, you can always reach me at my address:
Bruno J van Herendael
Endoscopic Training Centre Antwerp
ACZA Campus Stuivenberg
Lange Beeldekensstraat, 267, B-2060
Antwerp Belgium
Tel: 00 32 3 2133750
Fax: 00 32 3 2720797
Mobile: 00 32 475 447544
e-mail: info@isge.be 
web: www.etca.be 

Report of Training Committee ISGE 2003/2004
Peter J. Maher

This program is now in its sixth year. Successful courses have been completed in all zones with second centres being developed in Europe, China and America.

Co-ordinators have worked very hard to recruit suitable surgeons who wish to be up-skilled in laparoscopic and hysteroscopic surgery in the regions selected.

The numbers of visiting surgeons willing to give up a week of income-producing surgery in their own practices have diminished over the years. Many surgeons involved in the program have alluded to the possibility of being paid for their attendance at the courses. Another issue is the difficulty of the Executive committee to evaluate the surgical expertise of those who wish to become part of the faculty.

With the advent of new ISGE web site, it will be possible to have a section devoted to the Training Program with a continuous update of available courses and when extra help is needed. Surgeons can submit their names to the site and will be selected by the Regional Coordinators (RC) in consultation with the Chairman, Vice-Chairman and President of ISGE. Volunteer trainers are again reminded that no payment is offered. A return air ticket (business class), accommodation and meals (local faculty should ensure at least a couple of nights entertainment with participating trainers) are provided.

Storz continues to be the major (and only at this stage) sponsor of this program and their generosity thus far has been outstanding. Without their vision and co-operation, this program would not have survived. In the spirit of partnership, all RC’s should confer the proposed program with the Chairman, who will then discuss it with the sponsor for funding.

The expected and accepted justification of future budgets is a stimulus for all ISGE Board members to approach industry representatives for participation in this successful program. In view of Storz’ long history of contribution to the program, co-sharing of sponsorship is a particularly sensitive area. Future support must be discussed with ISGE Board.

Several excellent suggestions and comments from trainer surgeons may contribute to an improvement of the program. They are:

• Using the training course to either lead to or follow ISGE regional meeting
  which would involve live surgery and lectures by the visitors. This would focus
• on the centre itself and
• on the ISGE program.
  It is a way of engendering enthusiasm so others may wish to join the program or be trained.
• It is mandatory for the local surgeons to be trained to be present for the
  duration of the course (3-4 days) and not doing private practice. After all, the visiting surgeons give up their time and income to teach.
• The objective of the program is to promote endoscopic surgery and not
  to make local endoscopic surgeons experts in advanced and complicated
  surgery such as surgery for severe endometriosis, pelvic floor surgery etc. There are plenty of specialty courses around the world for those desiring to refine their skills.
• The objective is therefore to have a balanced and clear approach to intermediate laparoscopy.

Summary of Activities

• China/Asia (Yap, L.K.) – No courses in China due to SARS then bird flu.
  Plan to have the next course in Beijing. Y.L.K. looking at possible sites in Pakistan, and Western China. P.M. and Y.L.K. have approached doctors
  for training in their own respective centres i.e. Singapore and Melbourne.
• South America (Ray Valle): A course has been completed in Buenos Aires.
  It was successful and provided a template for future courses. We express
  our appreciation to Roberto Sainz for his contribution to the success of this module. A possible future course is in Mexico City. R. Valle will arrange a site visit.
• South Africa (Johan van der Wat). All training modules have been completed in Johannesberg. The availability of a single operating theatre only and the shortage of staff have been a problem. Alan Gordon has site-visited Kenya, but there has been no further action to establish a training centre.
• Hungary (Ivo Brosens). There have been very detailed reports from workshops held in Szeged. There were three teaching modules over a period of 18 months. There have been chronic problems that need to be addressed. "Private practice" in this public health domain provided a huge
  conflict of interest (P.M. personal experience).
• Budapest (Visit October 2003 by H. Brolmann). It was felt that the laparoscopic skills of participants were already advanced. Trainees are comfortable with LAVH, myomectomy and moderate/severe endometriosis.
  Poor case selection resulted in conversion to laparotomy on several occasions. Similar to other regions, there has been poor compliance on behalf of the trainees (a real problem throughout the program). The availability of a single operating room only was a problem. Next course is
  planned in Bucharest (Romania).

Summary
This is a successful program. Funding will undoubtedly become an issue. It is important that we approach industries for contribution or personal support. Storz will not be able to carry this financial burden alone indefinitely. We need a pool of competent teachers from which we can select appropriate trainers based on their geographic location. This is to minimise travel expenses.

As the Chairman of Training Committee of ISGE, I have a clear vision of the objectives of the course i.e. basic laparoscopic and hysteroscopic skills to Level 2/3 including important issues such as entry techniques and electro-surgical modalities. It is not the scope of this program to teach doctors how to perform pelvic floor repair or to treat severe endometriosis. If this is to be the case in the future, those visiting surgeons seeking an honorarium may have a very good case to support its introduction.

Following completion of the teaching modules, the regional coordinator should provide a progress report a year later on courses organized by the surgeons who have been taught (i.e. the pyramid theory).

The success of this program will be measured only by the progressive spread of safe endoscopic surgical practice. This will only happen after those trainee surgeons, upon completion of their training modules, teach their own colleagues the skills they have obtained from our course.

Peter J. Maher, Chairman
ISGE Training Committee
March, 2004