Chuck Miller by Tamer Seckin
Hello everyone. This is Dr. Tamer Seckin. We in São Paulo of Brazil joint meeting of ISGE and Brazilian Endometriosis Society. I have the pleasure of Dr. Chuck Miller here whose expertise and leadership is known throughout the world endoscopic community. He was a previous president of AAGR minimally invasive surgery.
Right.
Hi Chuck, how are you?
Tamer I’m great. I’m here in Brazil.
Hi, hi.
Anything upgrade.
I really wanted to give this synopsis of how you are feeling to be in Brazil in the tone of this whole meeting and what does it tell you, what kind of inspirations you are feeling towards the future of ISGE with respect to this Brazilian experience. We had a great meeting just minutes ago and you were one of the panelists.
This has been a fantastic meeting. This is my sixth time to have an opportunity to speak to the Brazilian community and I can tell you that each year, each time I come, I am able to see the development of minimally invasive surgery in this country takes on just more and more and more. Not only from the standpoint of the surgery itself but also from a standpoint of the diagnosis.
It truly is exciting and I always say that I learn so much more from coming here than I am able to give. I also think that it has been a tremendous meeting because it truly has been an international forum. Through the ISGE, we have nearly 20 guests from around the world. So it is both an excitement for the Brazilians having an opportunity to show what they can do and what they are capable of, but also an excitement for us international professors who are able to be involved in this tremendous environment and to give them first hand some of our experience and knowledge. It truly is what the ISGE should be. It is one of my most favorite conferences from both an academic as well as social experience that I have ever been involved.
I cannot agree much. We are so much excited. I like to focus on the topic though. The endometriosis and the way Mauricio has taken this one step above everything else. I mean it strikes me with excitement. Department of endometriosis exists in a universal structure. I have never seen this throughout United States, nowhere else.
Again I think that I had an opportunity to chair a session today with involving the head of minimally invasive surgery in Melbourne, and Monash, famous Monash with that is Jim Saltes from our Board. I was with Charles Chaperone who is doing research, not only involved in the surgical aspect of research Tamer, but also involved in….
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_, gene mapping, I mean, truly exciting aspects, and than what Mauricio is involved with, with actually having a unit that is devoted to endometriosis. All these professors involved in a session. It truly is exciting to someone who has spent much of their life devoted to the treatment of women, both from a standpoint of pregnancy as well as pain, with endometriosis as you know both of us have had lived parallel lives in that respect to see what is happening out there on an international front. It makes this for a truly special time.
The numbers are very clear. So many cases, different surgeons, yet they agree and we cannot disagree on that. The recurrences are most likely due to incomplete excision. That says a lot for the suffering woman out there.
It really says a lot for our need to better educate ourselves, to better train ourselves and to begin to develop these centers of excellence that can be tremendous resource sites for women, so that they are not in situations that they are at greater risk of recurrence because there have been unsatisfactory dissection of the disease in the first place. I actually spoke yesterday on impact of endometriosis of fertility. As you know that I quoted an interesting paper from Italy from Pusaka's Group talking about the fact that that first time in with surgery that has yielded better results overall fertility wise than subsequent surgery. So it shows the importance of our patients. I know, you and I both are huge patient advocates. You head the foundation in New York. I have been involved in a very large patient awareness program through the AAGL. I helped to fund that for many years. It is very, very important that and the necessity to get our patients to the right place the first time. I will only add one more comment to that is that, during _ professor Brough’s talk today, he talked about 20% of his patients having deep endometriosis. If you look at that, six million women potentially in Brazil, 10 million women in the United States, you are talking about over 1.2 million women in Brazil having deep-seated disease than in the United States. At least 2 million women suffering from deep-seated endometriosis and it is my feeling that what we need to take back from this meeting is that we all have to do it better. We really have to begin to identify who should be treated by generalists, who needs to go to a referral type center.
Yes, we have challenges, great challenges. Young women, infertility patients, pain patients and deep, deep patients, but in all these challenges the commonality goes to late diagnosis, misdiagnosis, wrong treatment and delay. Come to education and awareness and it keeps us on the toes to do more.
You know as people were talking today about the late diagnosis that of course we know so well and it appears in the most recent paper on that said the delay is in the young women, the teenaged women. One of the things I thought to myself perhaps this is something that not only will improve because of recognition, we know that this is particularly an age group that we need to be concerned about, but may even be an advantage of as we get more and more women involved in our specialty there will be a greater comfort level to see a woman when we are dealing with a teenager. Perhaps some, the young teen would be more reluctant to see you or me, although I hate to consider that, but the fact is, maybe they will gravitate toward a female and get that diagnosis earlier.
Chuck now you are the Vice President of ISGE and the coming President. I think you should give some good news to the world endometriosis concern groups in the world what ISGE could be doing in your Presidency, what we could do and I would like to close up with you answering this question.
Well you know when I discussed at the Board, why I thought I was a good candidate for, to be involved with the ISGE and to subsequently become Vice President and subsequent President, I talked about a couple of different areas. I talked about the need for patient awareness. That we are already doing some things in the United States in patient awareness, we have to bring that to our international community. People have to realize that it is not okay to continue month after month after month with menstrual pain, that is not something that is just a natural phenomenon, and it should be potentially checked out. We need to be more aware of centers of excellence and finally I read on a platform of need for physician education as well. To get out to the communities of physicians that endometriosis needs to be treated correctly the first time, because it is the best time both from the standpoint of pregnancy as well as pelvic pain and that is what I hope to do, to teach, to teach, to teach. Make patients aware, make physicians aware that should be our direction in the ISGE.
The first surgery has to be done correctly.
You got it.
Chuck Miller from Chicago, USA. Thanks Chuck.
Thank you Tamer. I appreciate it.
