|Rise of the Machines|
|Friday, 01 March 2013|
Mr Paul Leeder reports from the ALSGBI Annual Scientific Meeting, held in Cork, Ireland, 29-30 November 2012
The Association of Laparoscopic Surgeons Great Britain and Ireland (ALSGBI) Annual Scientific Meeting 2012 found us in the glorious Irish city of Cork with our host for the three days local consultant surgeon, Mr Colm O’Boyle.
As is tradition, the first day was an Advanced Laparoscopic Surgery Training Day, based at the Bon Secours Hospital. A lucky group of 12 trainees had the enviable opportunity of hands on practical laparoscopic training, practising upper and lower GI procedures.
Day two was the first day of the conference. Following a welcome by our President, Professor Tim Rockall, we were able to feast on a varied day of operating, beamed via satellite from Bon Secours and Cork University Maternity Hospitals. The meeting’s theme and title of ‘Rise of The Machines’ was demonstrated by local gynaecologist, Dr Matt Hewitt and we all appreciated the amazing display of pelvic anatomy that is offered by robotic 3D laparoscopy. Other surgery of gastric bypass, fundoplication and incisional hernia repair were deftly performed by local and visiting surgeons and all were positively received. An interesting debate ensued in the audience, regarding different techniques utilised in fundoplication and also the optimum pouch size in gastric bypass surgery. Dr Tim Tollens from Belgium gave a beautiful demonstration of incisional hernia repair. If not already adopted, many surgeons in the audience will now consider suture repair of the primary defect prior to intra-abdominal mesh placement.
Day three started with a worthy display of DVD and oral presentations. The winning DVD presentation was entitled ‘Laparoscopic Low Anterior Resection with Intersphincteric Dissection and Colo-Anal Anastomosis’, and presented by Mr N Siddiqui. The winner of the 2012 David Dunn Free Paper Prize was ‘Is Stroke Volume Optimisation Really Necessary in Laparoscopic Colorectal Surgery?’ given by Mr A Day. The winner of the best laparoscopic poster prize was ‘Female Gender and Diabetes Increase the Risk of Recurrence Following Laparoscopic Incisional Hernia Repair’, given by Mr F McDermott.
A large part of the meeting is the collaboration with industry partners. Our specialty is very much technology driven and we value both their financial support and the opportunity to review the latest technology. 3D imaging was demonstrated for the first time at last year’s Cardiff meeting and is now standard in any domestic screen. Probably of most practical, immediate use is the development of micro instruments. These promise to make virtually scarless surgery a reality, without compromise of the laparoscopic technique.
The BJS Lecture was given by Professor Lee Swanstrom, Head of Upper GI and Minimally Invasive Surgery in Oregon. He presented a thought-provoking talk on robotic surgery, and commented ‘a bad laparoscopic surgeon can be a good robotic surgeon’. This debate was taken further by Professor Craig Ramsay, Health Services Research Head in Aberdeen, who has recently completed a review of robotic surgery for NICE. He pointed out that there is no evidence of a reduced learning curve with robotics compared to laparoscopy. At best, outcomes are equivalent to laparoscopy, but more expensive. Whatever your feelings on the subject, we have to be prepared because the robots are definitely coming!
The broad subject material, sessions, hosts and venue have all led to this being one of the most successful ALSGBI meetings to date. We very much look forward to increasing interest and membership and hope you can encourage both your trainees and theatre staff to become members. l
Mr Paul C Leeder
ALSGBI Council Member