NEWS FROM AFFILIATED SOCIETIES
KESES, Kenya Society of Endoscopic Specialties
One country, one world
From the Editorial of the KESES Newsletter
……Privileges are clinical functions that a healthcare Institution permits a physician to perform while caring for patients in that Institution. This privilege belongs to each individual Hospital although “ portable ” privileges may be granted by National bodies such as the Medical Practitioners & Dentists Board. Each hospital should ideally develop criteria and mechanisms for granting clinical privileges to health professionals. Most hospitals adopt and incorporate criteria that are published by Boards or Societies. The response Department of a given hospital must develop a privilege list of specific operative procedures in each specialty which is updated and re evaluated at regular intervals. A Surgeon will require certification , proof of training and experience, along with a certificate of competence by a program Director, Instructor or peer. Initially provisional privileges are granted after adequate proctoring in which care full privileges may be issued. The issuance
of full privileges is dependant on adequate training and education with demonstration of competence in relevant procedures that are to be undertaken.
In Laparoscopic Surgery these issues have to now be addressed. In response to several deaths and complications associated with Laparoscopic procedures, Worldwide guidelines for the credentialing of Surgeons who wish to perform the Laparoscopic procedures are now being developed and are being constantly re -evaluated. At the same several recommendations regarding the indications for Laparoscopic Surgery have been published. The Kenya Society of Endoscopic Specialties ( KESES ) has recently done so too. The single most important predictor of an adverse event is the experience of the provider with the specific operation. Surgeons must
acquire the necessary skills and expertise before performing new procedures on patients. Hospitals and third party payers should help ensure that providers possess the requisite experience before allowing procedures to be performed in their facilities or paying for them since patients alone will be unable to determine the Surgeons’ competency. A number of governing bodies and Surgical societies have published guidelines that outline standards for training of
postgraduate students, the acquisition of skills in Minimal Access Surgery but it is not known how influential these are in granting of privileges. Continued research is needed to determine the threshold for safe performance of these procedures and the most effective training methods to ensure competence and strategies to minimize patient harm. For KESES, the difficult decision to consider is whether to adopt “ global ” privileges encompassing all Laparoscopic procedures or “ individual ” privileges in which each particular procedure must be approved before it is undertaken. It is with this in mind that we have now published and circulated our recommended guidelines. The danger with global privileges is that Surgeons are allowed to perform Laparoscopic procedures for which they may not be qualified, on the other hand, individual privileges may be to tedious and time consuming to adopt. It is recommended that the outcomes of a Surgeons’ performance should be monitored as part of the Hospitals’ on going performance assessment program. Proctoring, additional training or even restriction of privileges may be needed if individual high complication rates are experienced or if performance problems are identified. It is the personal responsibility of the Surgeons to keep abreast of new information for variations in technique and equipment. A periodic assessment of morbidity and mortality by the
various Departments and outcome studies in literature is crucial in offering or withdrawing privileges of an individual Surgeon. I urge you all to consider these issues seriously in the best interest of our patients.
DR. DAVID OTIENO,
Consultant Anaesthetist,
Hon. Secretary / Editor,
Kenya Society of Endoscopic Specialties,
Dr.Rafique Parkar receiving a Merit Award from Dr.Charles Okello, WHO Regional Representative in recognition of his pioneering and continuous efforts of promoting Minimal Access Surgery in East, Central and West Africa recently at the Lyko Regency Hotel, during the Kenya Obstetrical and Gynecological Society Annual Dinner.
From Dr. Rafique Parkar ‘s thanking speech
…… The Journey to develop skills in Laparoscopic Surgery in Kenya since 1994 has been long, tiring and more often so, a very frustrating one. Having attended several Workshops and Conferences Worldwide in the late 90’s, I was more than convinced that this is what our women and men will benefit from in this Region. At the onset I had to mortgage my house to purchase the equipment required since none of the Hospitals in Mombasa were willing to do so. This was
carried in the back of my car from Hospital to Hospital, Private and Public performing sometimes up to 100 cases a week. Not only did I have to set up the Tower during every session, but had to also clean and maintain the equipment
after every session. This not only gave me the confidence and the required skills but also benefited the patients in the rural areas to a large extent. I need not convince anyone here that Laparoscopic Surgery has far greater advantages and outcomes for any Gynaecological procedures. Benign Ovarian Cysts, Ectopic Pregnancies, single Fibroids, Endometriosis, to name a few are now Worldwide being handled Laparoscopically and this today is the Gold Standard.
I have made myself available without any hesitation to those who want to learn Laparoscopic Surgery, and I will continue to do so, but I must say all this has been a huge burden, both psychologically and financially. And those who
still keep on being sceptical, routinely undermining and demeaning our efforts should now look at other avenues to vent their frustrations. I have achieved and I have delivered. One must always remember that in pursuit of passion for safe
Laparoscopic Surgery by all, I have done so much more for service and honour than for any personal gain or advantage. A word of caution to those who now want to get on board, No one is stopping anyone from performing these procedures, but please acquire sufficient skills before you do any procedures Laparoscopically, so as to prevent complications and genuinely give patients the true benefits of this remarkable modality of Surgery. I know I have had my limitations and set backs but, I assure you all it has been worth it. I would like Institutions and Societies like KOGS and all our Colleagues, old and young to take Laparoscopic Surgery to greater heights in this Region, because our patients deserve the best. I am glad to note that although there are now nearly 20 Towers in Kenya at various Institutions, much more needs to be done to make Laparoscopic Surgery safe and more readily available…….
KESES ANNUAL SCIENTIFIC CONFERENCE IS ON 19 & 20TH AUGUST AT THE NAIROBI HOSPITAL.
Email : rafsan @ africaonline.co.ke
AGES, Australian Gynecological Endoscopic Society
Focus Meeting 2010
AGES Focus Meeting 2010
The Ovary and the Gynaecologist
Conference Organising
Committee
Dr Robert Ford Conference Chair
Assoc. Prof. Alan Lam
Dr Stuart Salfinger
Ms Michele Bender
AGES Board
Assoc. Prof. Alan Lam President
Dr Jim Tsaltas Vice President
Assoc. Prof. Harry Merkur Secretary
Assoc. Prof. Anusch Yazdani Treasurer
Dr Robert Ford
Dr Kym Jansen
Dr Michael McEvoy
Dr Digby Ngan Kee
Dr Anna Rosamilia
Dr Stuart Salfinger
Ms Michele Bender Executive Director
AGES Secretariat
Conference Connection
282 Edinburgh Road
Castlecrag
SYDNEY NSW 2068 AUSTRALIA
Ph: +61 2 9967 2928
Fax: +61 2 9967 2627
Email: secretariat@ages.com.au
Register Online
This brochure and online registration are
also available on the AGES website:
www.ages.com.au
Darwin Convention Centre 13–14 August 2010
Dear Colleagues
Darwin and the ‘Top End’ are a ‘must see’ for all Australians, as well as those who visit this country. What other destinations can offer the natural attractions of World Heritage listed parks, the opportunity to see a range of wildlife in its natural habitat and ancient aboriginal art, and a frontier city of cultural diversity and military history? The AGES Focus Meeting 2010 offers a robust educational program combined with an opportunity to discover this wonderful and unique part of the world. The theme of the meeting is ‘The Ovary and the Gynaecologist’ – an update on ovarian physiology and pathology relevant to Generalist Gynaecology practice. Experts in various fields will provide short, succinct
presentations, and there will be extra time allocated for discussion and audience participation.
Topics will include embryology, adolescent gynaecology, fertility, menopause,
laparoscopic management of ovarian pathology and oncology. There will also be a session on practical ways to improve the ultrasound skills of office Gynaecologists performing pelvic scans.
It is our great pleasure to provide this program to you, and we look forward to seeing you in the balmy Northern Territory in August.
Robert Ford Alan Lam
Conference Chair President AGES
Director AGES
AGES Pelvic Floor Symposium & Workshop XI
Improving Surgical Outcomes
Sofitel Brisbane Australia
October 15-16, 2010
International Faculty
Prof. Michel Cosson France
Dr Roger Goldberg USA
Dr Nathan Guerette USA
Chairman Assoc. Prof. Alan Lam
Scientific Chairman Dr Anna Rosamilia
The Brazilian Endometriosis and Minimally Invasive Gynecology Association
In 2010 we will have the following events:
- August: Belo Horizonte - adenomyosis one day event;
- September: São Paulo - endometriosis one day event;
- October: São Paulo - single port one day event;
In addition, some information campaigns on business and presence in the state and federal congresses are confirmed.
Dr. Patrick Bellelis
Executive Director, SBE - the Brazilian Endometriosis and Minimally Invasive Gynecology Association
Phone +55 11 5180-3355
www.sbendometriose.com.br
pbellelis@gmail.com
