Master Class on "Esophageal Diseases"
Live Operative Workshop on Robotic Esophageal Surgery

Conducted @ Institute of Robotic Surgery,
Sir Ganga Ram Hospital, New Delhi

 

"The Master Class on Esophageal Diseases & Live Operative Workshop on Robotic Esophageal Surgery" was successfully conducted at Sir Ganga Ram Hospital, New Delhi on 2nd and 3rd February, 2015.

Over 250 delegates from across the country, including Thoracic Surgeons, Surgical Oncologists, Gastrointestinal and General Surgeons interacted with over 75 experts in the field of esophageal diseases during this 2 days interactive program. A series of lectures and panel discussions on the "A to Z of Esophageal Surgery" kept the participants engrossed.

Esophagus can be involved by cancer or other tumors. With increasing incidence of Barrett's esophagus, the incidence of cancer of esophagus is on the rise. This disease usually presents with difficulty in swallowing, initially to solids and then liquids also.

The treatment for most cases of esophageal cancer is multi-modal i.e. combination of Surgery, Chemotherapy and Radiotherapy. For early tumors, complete surgical removal can even provide cure. Conventionally, Esophagectomy has been done by Thoracotomy, with its attendant complications. VATS (Thoracoscopy) provides an opportunity to carry out same operation without the morbidity of Thoracotomy. This approach is called Minimally Invasive Esophagectomy (MIE). It provides similar cure rates with minimal morbidity. However, there are limitations in VATS Esophagectomy - like doing an Intra thoracic anastomosis. Robotic assisted Thoracoscopic Esophagectomy is an interesting development which provides all the benefits of Minimally Invasive Esophagectomy.

Prof. Arvind Kumar and his team at SGRH , New Delhi have taken the minimally invasive Esophagectomy to the next level by offering state of the art Esophagectomy using the da Vinci Si Robotic Surgical System. Robot assisted surgery helps the surgeon in being more precise, leading to more accurate surgery with lesser blood loss. This translates into patient's benefits in terms of lesser pain, faster recovery and better cosmetic results with improved quality of life.

Institute of Robotic Surgery at Sir Ganga Ram Hospital, New Delhi organized a two-day Master Class on Esophageal Surgery & Live Operative Workshop on Robotic Esophageal Surgery on 2nd & 3rd February, 2015.

This event had Prof. Robert J Cerfolio, Chief of Thoracic & Robotic Surgery, University of Alabama, Birmingham, USA as International Faculty and over 75 leading Gastroenterologists and GI & Esophageal Surgeons of the country as National Faculty. Over 300 delegates from across the country, including Thoracic Surgeons, Surgical Oncologists, Gastrointestinal and General Surgeons interacted with experts. During this 2 days interactive program, every aspect of esophageal disease from its anatomy to foreign body to robotic surgery was discussed in the form of lecture, panel discussion & Video presentations. Some of the interesting topics discussed during the master class were:

  1. Applied Esophageal Anatomy
  2. Esophageal Foreign Body
  3. Esophageal Injuries and perforations
  4. Corrosive Injuries of Esophagus
  5. Esophageal Motility disorders
  6. GERD (Including Barret's Esophagus and Peptic Strictures)
  7. Why Robotics for Esophagectomy?
  8. Para-Esophageal Hernia
  9. Carcinoma Esophagus
       Diagnosis, Staging & pre-operative preparation
       Treatment overview
  10. The Surgical approach to Esophagectomy: Video Presentations
  11. Technical Issues in Esophagectomy: The Evidence
  12. Post operative care after Esophagectomy

A series of lectures and panel discussions on the "A to Z of Esophageal Surgery" kept the participants engrossed.

Dr. Robert J. Cerfolio, Professor of Surgery and Chief Thoracic Surgery at University of Alabama at Birmingham USA mesmerized everyone with his craftsmanship and enviable skill sets and he demonstrated the following two cases:

  1. Robotic Esophagectomy and Gastric Pull-up with Robot assisted high intra thoracic hand sewn Esophago-gastric anastomosis.
  2. Robotic Enucleation of Esophageal Leiomyoma.
The vast experience of the faculty & the intense involvement of the participants made this program an academic feast.

 

 

  Dr. Arvind Kumar
Organizing Chairman
Dr. Belal Bin Asaf
Organizing Secretar
 

 


 

 

Patron
Dr. D.S. Rana
Chairman Sir Ganga Ram Hospital, New Delhi

    Mentors    
 

Prof. BML Kapur
Apollo Hosp., Delhi

Prof. S. Nundy
Sir Ganga Ram Hosp, Delhi
Prof. T.K. Chattopadhyay
ILBS, Delhi
 

International Faculty
Prof. Robert J Cerfolio
Chief of General Thoracic & Robotic Surgery
University of Alabama, Brimingham, USA

National Faculty
Galaxy of Gastroenterologists & Esophageal Surgeons from across the country

Program at a Glance!


Day 1: Monday 2nd February, 2015

 

Applied Esophageal Anatomy

9:00 am

  •  Surgeon's perspective : The "MUST KNOW for SAFE Esophagectomy"
     (Transhiatal / Transthoracic / VATS or Robotic)

Dr. K. Sendhil Kumar
Gateway Clinics, Coimbatore
10+5 mins

9:15 am

  • An Endoscopist's and
    Endo-ultrasonologist's perspective

Dr. Vikas Singla
Sir Ganga Ram Hospital, Delhi
10+5 mins

9:30 am

  • Applied "Esophageal Anatomy" on imaging: Barium Swallow and CECT Chest  

Dr. Samarjeet
Sir Ganga Ram Hospital, Delhi
10+5 mins
       
 

Esophageal Foreign Body

9:45 am

  • Endoscopic Management of Esophageal Foreign Body: How I do it: DO'S and DON'TS!

Dr. Sandeep Nijhawan
SMS Medical College, Jaipur
15+5 mins

10:05 am

  • Surgery for Esophageal Foreign Body:
    When and How?

Dr. Bhabatosh Biswas
RGKAR Medical College, Kolkata
15+5 mins
       
 

Esophageal Injuries and Perforations: (Lectures & Panel discussion)
Including Iatrogenic (endoscopic and operative) injuries.

 
Moderator: Dr. Chandramohan
Madras Medical College, Chennai

10:25 am

  • Introduction to Esophageal Injuries

Dr. Chandramohan
Madras Medical College, Chennai
5 mins

10:30 am

  • Esophageal Injuries and Perforations:
    Can Stents avoid Surgery?

Dr. Anil Arora
Sir Ganga Ram Hospital, New Delhi
15+5 mins

10:50 am

  • Esophageal Injuries and Perforations:
    The Surgeon's Role:
     
    Conservative management / repair/ resect

Dr. Chandramohan
Madras Medical College, Chennai
15+5 mins
     
 
Panel Discussion on Esophageal Injuries and Perforations
 
Panelists: Dr. Rakesh Kochar, Dr. Anil Arora, Dr Sandeep Nijhawan
Dr. Bhabatosh Biswas, Dr. Arvind Kumar
15 Mins

11.25 am
11.35 am

TEA BREAK    

  Corrosive Injuries of Esophagus:

11:35 am

  • Initial and Early Management by first responders: Do's & Don'ts
    (Acute Management in Emergency: The points you must not forget, should every patient be scoped, When to suspect perforation, Early Management: Can we Prevent strictures.)

Dr. Vikram Bhatia
ILBS, New Delhi
15+5 mins

11:55 am

  • Endoscopic Management: Short & Long Term
    (Dilatation: timing, methodology, frequency and end point, do stents have a role in benign strictures?)

Dr. Rakesh Kochhar
PGI, Chandigarh
15+5 mins

12:15 pm

  • Surgery for Corrosive Strictures
    Surgery: Indication, Choice of Conduit: Stomach / Colon (left or Right) / Free Jejunal interposition / Myocutaneous flaps / Native Diseased Esophagus: To Remove or To leave? Difficult Strictures (High Strictures with Pharyngeal / Airway Involvement)

Dr.Anantha Krishnan
Ex- JIPMER, Pondicherry
15+5 mins

12:35 pm

  • Video Presentation : Colonic mobilization
     and Pull up

Dr. Chandramohan
Madras Medical College, Chennai
8+2 mins
       
 

Esophageal Motility Disorders: (Lecture, Debate & Panel discussion)

 
Moderator: Dr. Anil Agarwal
GB Pant Hospital, Delhi

12:45 pm

  • Current concepts in Pathophysiology, Investigations & Classification of Esophageal motility disorders

Dr. Pankaj Tyagi
Jaypee Hosp, Noida
15+5 mins
 

      Debate: The best approach for Achalasia Cardia: Status 2015

1:05 pm

  • Pneumatic Dilatation should be the first choice.

Dr. Vineet Ahuja
AIIMS, New Delhi
8+2 mins

1:15 pm

  • POEM is "a promising alternative " to dilatation and surgery

Dr. G.V. Rao
Asian Institute of Gastroenterology, Hyderabad
8+2 mins

1:25 pm

  • Laparoscopic Heller's Myotomy is the Gold Standard.

Dr. Yogesh Agarwal
Saket City Hosp, New Delhi
8+2 mins
 
Panel Discussion on Esophageal Motility Disorders
 
Panelists: Dr. Pankaj Tyagi, Dr. Vineet Ahuja, Dr. G.V. Rao, Dr. Yogesh Agarwal
15 mins
     

1.40 pm
2.15 pm

                 LUNCH BREAK                     
  GERD (including Barret's Esophagus and Peptic Strictures)

2:15 pm

  • Medical management: From Drugs to Surveillance for Barret's.

Dr. Anil C Anand
Apollo Hosp., New Delhi
15+5 mins

2:35 pm

  • Surgical Management of GERD: choosing the correct option.

Dr. Parveen Bhatia
Sir Ganga Ram Hospital, Delhi
15+5 mins

2:55 pm

  • Barret's Esophagus & Peptic Stricture: when to consider

Dr. Mandhir Kumar
Sir Ganga Ram Hospital, Delhi
15+5 mins

3.00 pm
Onward

Why Robotics for Esophagectomy?
Prof. Robert J Cerfolio
Followed by Live Telecast of Robotic Esophagectomy

 
 

Day 2: Tuesday 3rd February, 2015

 

Para-Esophageal Hernia

9:00 am

  • Management of Para-esophageal Hernia in Laparoscopcic Era 

Dr. Subhash Aggarwal
Action Balaji Hosp, D elhi
15+5 mins
 

Carcinoma Esophagus

9:20 am
10:20 am

Diagnosis, Staging & Pre-operative Preparation

 
  • What I must know about the disease and the patient.
    (Resectability, Planning Surgical Approach & Risk assessment )

Dr. Saumitra Rawat
Sir Ganga Ram Hospital, Delhi
10+2 mins
 
  • The Gastroenterologist's role: UGIE & EUS

Dr. Malay Sharma
Jaswant Rai Hosp, Meerut
10+2 mins
 
  • The Radiologist's role: Ba Swallow, CECT and MRI  

Dr. Krishan Rawat
Sir Ganga Ram Hospital, Delhi
10+2 mins
 
  • The Nuclear Physicist's role: PET Scan 

Dr. Promila Pankaj
Sir Ganga Ram Hospital, Delhi
10+2 mins
 
  • Preoperative Evaluation and preparation 

Dr. Jayshree Sood
Sir Ganga Ram Hospital, Delhi
10+2 mins
   

10:20 am
11:20 am

 Treatment Overview: Panel Discussion

 
Moderator: Dr. Adarsh Chaudhary
Medanta-The Medicity, Gurgaon
 
  • Introduction and Surgeon's Perspective

Dr. Adarsh Chaudhary
Medanta-The Medicity, Gurgaon
12+3 mins
 
  • Multi modality treatment : A Medical Oncologist's perspective

Dr. Shyam Aggarwal
Sir Ganga Ram Hospital, Delhi
12+3 mins
 
  • Multi modality treatment : A Radiation Oncologist's perspective

Dr. B. K. Mohanti
Fortis Memorial Institute Gurgaon
12+3 mins
       
 
Panel Discussion: A balanced multimodality approach based on current evidence
   
Panelists: Dr. T. Subramanyeshwar Rao, Dr. Shyam Aggarwal,
Dr. B. K. Mohanti, Dr. Bhabatosh Biswas
15mins

 

     

11.20 am
11.30 am

                 TEA BREAK                     

11:30 am
01:00 pm

The Surgical Approach to Esophagectomy : Video presentations

 
Moderator: Dr. Saumitra Rawat
Sir Ganga Ram Hospital, New Delhi
 
  • Transhiatal

Dr. Chandramohan
Madras Medical College, Chennai
8+2 mins
 
  • 3 field esophagectomy open

Dr. Sanjay Sharma
Somaiya Medical College, Mumbai
8+2 mins
 
  • Thoraco-laparoscopic

Dr. Subramanyeshwar Rao
Indo American Cancer Hosp., Hyderabad
8+2 mins
 
  • 3 Field lymphadenectomy VATS

     
Dr. Sabita
Tata Memorial Hosp, Mumbai
8+2 mins
 
  • Robotic

Dr. Belal Bin Asaf
Sir Ganga Ram Hospital, Delhi
8+2 mins
 
  • Gastric Mobilisation : Step by step 

Dr. K. Sendhil Kumar
Gateway Clinics, Coimbatore
8+2 mins
       

 

Panel Discussion: Pros and Cons of various approaches,
How to choose?
   
Panelists: Dr Chandramohan, Dr. Sanjay Sharma, Dr A.K. Kriplani, Dr. Subramanyeshwar Rao, Dr. Sabita Jiwnani, Dr. Belal Bin Asaf

 

15 mins

01:00 pm
02:00 pm
  

 Panel Discussion
 Technical Issues in Esophagectomy :
      The Evidence                                          

 

60 Mins 

 
Moderator: Dr. Peush Sahni 
AIIMS, New Delhi 

 
Panelists: Dr. Rajesh Bhojwani, Dr. Rajesh Gupta,
Dr. Rajesh Kapoor, Dr. Rajneesh Kumar Singh
 
 
Anastomosis related issues  Conduit related issues
  • Neck Vs Chest Anastomosis
  • Single Layer Vs Double Layer Anastomosis
  • Interrupted Vs Continuous Suturing
  • Silk Vs Vicryl Vs PDS
  • Drainage procedure
    Pyloroplasty, myotomy, Stretching, Nothing
  • Ryle's Tube Drainage - Yes or No?
  • Choice of Conduit - Stomach, Colon or Jejunum?
  • Route of Conduit - Mediastinum / Retrosternal

 

 

         Surgeon's Experience: important?

02.00 pm
02.30 pm

               LUNCH BREAK                     

2:30 pm

Lecture
Post Operative Care after Esophagectomy
(Fluid Management, Timing of jejunostomy feeds, Pulmonary Care, Delayed Oral Feeding.) 

Dr. Arun Prasad
Apollo Hosp, Delhi
15+5 mins
     

2:50 pm -
4:20 pm

Panel Discussion
Management of Complications
(To be discussed under the headings: incidence, cause, tips for prevention and management) 
 
Moderator: Dr. Arvind Kumar
Sir Ganga Ram Hospital, Delhi
Panelists 
Session 1 : Dr. Chandramohan, Dr. Saumitra Rawat, , Dr. Sanjay Sharma, Dr. Anil Agarwal, Dr. Durgatosh Pandey, Dr. Anil Kapoor
   
Session 2 : Dr. Adarsh Chaudhary, Dr. Harit Chaturvedi, Dr. SVS Deo, Dr. Subramanyeshwar Rao, Dr. Arun Prasad, Dr. Sujoy Pal
   


90 Mins

 
Session 1
Intra operative Complications 
Session 2
Post operative complications 
  • Bleeding during Esophagectomy
  • Injury to Airway
  • Conduit Not Reaching the neck
  • Mobilised Conduit appears dusky before anastomosis
  • Recurrent Laryngeal Nerve Injury
  • Conduit Necrosis
  • Anastomotic Leak
  • Chyle Leak
  • Gastric Emptying Issues
  • Conduit Airway Fistula
  • Anastomotic Stricture

4.30 pm

             Closing remarks and valedictory function                    

 

 

Who should participate ?
Gastroenterologists / General Surgeons / G.I. Surgeons / Thoracic Surgeons / Surgical Oncologists

 

For Further details, please feel free to write to us

 

Prof. (Dr.) Arvind Kumar
(09810765405)
arvindreena@gmail.com
  Dr. Belal Bin Asaf
(09999965855)
asafbelal@gmail.com

 

 

 

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