The MOGS Indo-Israeli Gynecological Endoscopy Workshop & Conference

The MOGS academic year began with a memorable and hugely successful event. Our first academic event -The MOGS Indo-Israeli Workshop on Gynecologic Endoscopy was held on 25th & 26th April 2009 at ITC Grand Central, Parel, Mumbai. This was organized by the MOGS Team 2009-10 headed by Dr Gautam Allahbadia (President, MOGS 2009-10) (yours truly) and Dr Ashwini Bhalerao-Gandhi (Secretary, MOGS 2009-10). Dr Sulbha Arora and Dr Reena Wani worked hard as Program Conveners to make the conference a grand success. Here I must mention that the Congress/Workshop planning was entirely Sulbha's baby & was done with pinpoint precision. Yashesh Shah from Drake Medical (Distributors of Richard Wolf GmBH, Germany) and his excellent team of engineers really worked on this project like possessed men. All the instrumentation was pre-approved from the Israeli surgeons in Tel Aviv & the missing instrumentation was especially flown in from the Richard wolf head-offices in Germany. Gurunandan Masurkar & his AV Medicon engineering team laid down a fibre-optic cable between KEM Hospital Gynecology OR and the Banquet Hall at ITC Grand Central. The trial run was made on Friday to rule out any bloopers on the workshop day.

The Pre-Congress Workshop on Saturday 25th april 2009 was conducted at the KEM Hospital with the support of the entire Gynecology Department headed by Prof SV Parulekar. The Coordinators for the Workshop were Dr Anahita Chauhan and Dr Niranjan Mayadeo. The Operating Team included Dr Motti Goldenberg & Dr Chen Goldchmit from Israel as well as Dr Rajendra Sankpal, Dr Pritesh Naik, Dr Vivek Salunke & Dr Ameya Padmawar from Deccan Fertility Clinic & Keyhole Surgery Center (Richard Wolf Center of Excellence for Gynecological Endoscopy), Shivaji Park , Mumbai. Surgical procedures were demonstrated by the operating team and relayed live to the attending delegates at ITC with a one way video link & a two way audio link.. The same procedures were also relayed simultaneously to the KEM Main Lecture Theatre for the benefit of post graduate students & the KEM Faculty. We are grateful to Drake Medical & Richard Wolf for undertaking the entire sponsorship for this cutting edge CME program. The morning live surgery session at ITC Grand Central was ably chaired by Dr Kiran Coelho, Dr Makrand Masrani and Dr Swati Allahbadia . The post-lunch live surgery session was chaired by Dr Sudhir Gokral, Dr Kevin Quadros and Dr Sudha Tandon. Almost the entire gamut of Gynecological Endoscopic Surgical cases were demonstrated by the Indo-Israeli team. Ovarian Endometrioma Excision, Adhesiolysis, Laparoscopic Hysterectomies, Lap Myomectomies, Hysteroscopic Adhesiolysis, Hysteroscopic Myoma Resection and Hysteroscopic Tubal Recanalization amongst other diagnostic cases were demonstrated via a digital beam to ITC Grand Central which is almost a kilometer away from the OR. The Israeli team felicitated the Head of Dept., Prof SV Parulekar for having hosted one of the most successful & flawless workshops for the MOGS (see Video). One must mention the generous & unstinting support from the Director & Dean, Seth GS Medical College & KEM Hospital - Prof. Sanjay Oak. With such a young and dynamic Director of Medical Education, I'm sure KEM Hospital will be a role model for other Medical Institutions in the country! The best part according to me was the live interaction between the surgical team and the discerning audience!

The Workshop/Conference had an attentive "glued-to-the-seat" 150+ delegates and 22 post graduate students. The Scientific Program covered varied topics & interesting cases of Gynecologic Endoscopy; and the contents were highly appreciated by attending delegates.The conference on Sunday, 26th April 2009 started with a session on Invited Videos. International and national experts enthralled the audiences with their expertise. Dr Pritesh Naik's video was one of the highlights of this session.The official Conference inauguration began with the President's Introductory speech followed by the National anthems of both countries. This moment brought tears to many eyes & there was a strange surge of pride running through the hall hearing & watching the Jana Gana Mana first & then the Hatikva! Im sure the Israeli duo were moved by a hall full of Indian Medical Professionals standing alongside them honoring both the countries for this joint continuing medical education mission.

The MOGS Indo-Israeli Keynote Address was delivered on 'Modern Endoscopic Management of Asherman's Syndrome' by Dr Chen Goldchmit, President of the Israel Society of Gynecologic Endoscopy.

This was followed by an interesting Panel Discussion on Complications of Gynecologic Endoscopy moderated by Dr Rajendra Sankpal. The panelists were Dr Motti Goldenberg, Dr Chen Goldchmit, Dr Prakash Trivedi, Dr Pritesh Naik, Dr Vasant Kawade, Dr Kiran Coelho and Dr Kusum Zaveri.

Invited Lectures were delivered by Dr Mufazzal Lakdawala on 'Stretching the Limits of Laparoscopic Bariatric Surgery'; Dr Ravi Ramadwar on 'Pediatric Laparoscopy: Sky is not the Limit' and Dr Rajendra Sankpal on 'Laparoscopic Myomectomy: When do you call it a day?'. Seeing is Believing - We had focussed on videos in this meeting & we had a veritable feast. The MOGS will now be offering the Workshop & Congress proceedings on sale in India & abroad. Proceeds of the same will be used for charity.

Post Lunch there was a Competitive Video Session in two halls simultaneously. Eight-minute videos with finished soundtracks pertaining to Gynecologic Endoscopy were presented by various speakers and judged by a panel of four experts in each hall. All the videos presented were of excellent quality making it a tough competition. The three award winning videos were presented by:

1st - Dr Makrand Masrani - Lost & Found Department of Operative Laparoscopy (41.50/50)
2nd - Dr Nagendra Sardeshpande - Laparoscopic Correction of Uterine Inversion (39.25/50)
3rd - Dr Kundan Ingale - Role of Endoscopy in Genital Tuberculosis (39.00/50)

Makarand walked away with a hand-engraved silver plaque presented by our Israeli Duo - Motti & Chen.

The coup-de-resistance was the much-awaited MOGS Dr Subhash J Penkar & Dr Marie Pereira Silver Jubilee Oration which was delivered by Dr Motti Goldenberg, recipient of two Golden Hysteroscope Awards at the International Congress of Gynecologic Endoscopy. The subject of his oration was 'Hysteroscopic Resection of Intramural Myoma'. The wonderful talk with the rarest of rare videos was enjoyed by all.

Eleven pharmaceutical and instrumentation companies exhibited stalls during the conference. The Banqueting facilities were appreciated by one and all. The famous Bukhara & Peshawari cusine took even the most hardened-conference-attendees by surprise. The food was outstanding. Our kudos to the ITC Grand Central team - in particular Mr Zubin Songadwala (GM) and Mr Vishrut Gupta who is coordinating all 7 academic events this year for MOGS!

World Builder

World Builder from Bruce Branit on Vimeo.

Natural Breast Implants

'Natural' breast implants, using stem cells extracted from a woman's own
stomach or thigh tissue, could soon be offered to women in the UK following
the announcement of a trial beginning in May this year. Although the
experimental treatment has already been successfully trialled on a small
number of UK breast cancer patients, and has been available in Japan for six
years, this is the first time that it will be offered to healthy women.
At present the maximum increase that women undergoing the treatment can
expect is up to one cup-size, however more dramatic enlargements may be
possible as the technology develops. The treatment involves extracting stem
cells from fat extracted from stomach or thigh tissue and then injecting
them into the woman's chest. Previous trials which attempted to implant fat
tissue directly, without isolating stem cells, failed to re-grow adequate
blood vessels; however stem cells positively encourage this. Ten women are
expected to have the experimental treatment when the trial commences in May.
The treatment is less likely to lead to long-term complications than
conventional silicon implants, according to consultant breast surgeon Kefah
Mokbel, who is leading the trial at the London Breast Institute at the
Princess Grace hospital, because it involves only the woman's own tissue and
thus avoids implanting foreign objects in the body.
'This is a very exciting advance in breast surgery,' he said. 'Breasts
treated with stem cells feel more natural because this tissue has the same
softness as the rest of the breast. Implants are a foreign body. They are
associated with long-term complications and require replacement. They can
also leak and cause scarring.' The treatment could be available privately
within six months and will cost approximately £6,500, according to Professor
Mokbel.
However, some specialists are concerned about the prospect of beginning
trials on healthy patients, before results from trials on cancer patients
are available. Eva Weiler-Mithoff, a consultant plastic surgeon at
Canniesburn hospital in Glasgow, who is involved in running a European trial
of the treatment for patients who need breast reconstruction following
surgery to remove cancerous lumps, has expressed concern that patients
undergoing cosmetic surgery would be liable to skip vital follow-up
appointments.

Shocked Russian surgeons open up man who thought he had a tumour... to find a Fir Tree inside his lung

A fir tree has been found growing inside a man's lung by surgeons who were operating on him for suspected cancer.

The tree, measuring 5cm, was discovered by Russian doctors when they opened up Artyom Sidorkin, 28, to remove what they thought was a tumour.
Medical staff believe that Mr Sidorkin somehow inhaled a seed, which later sprouted into a small fir tree inside his lung.

The patient had complained of extreme pain in his chest and had been coughing up blood. Doctors were convinced he had cancer.

'We were 100 per cent sure,' said surgeon Vladimir Kamashev from Izhevsk in the Urals. 'We did X-rays and found what looked exactly like a tumour. I had seen hundreds before, so we decided on surgery.'
Before removing the major part of the man's lung, the surgeon investigated the tissue taken in a biopsy.

'I thought I was hallucinating,' said Dr Kamashev. 'I asked my assistant to have a look: "Come and see this - we've got a fir tree here".

'He nodded in shock. I blinked three times as I was sure I was seeing things.'

They believed the coughing of blood was caused by the tiny pine needles piercing blood capillaries. 'It was very painful. But to be honest I did not feel any foreign object inside me,' said Mr Sidorkin. 'I'm so relieved it's not cancer.'

The report appeared in popular tabloid Komsomolskaya Gazeta, and was picked up by Russian news service Novosti.

Crab Migration

Nature given a helping hand to make endangered frogs spawn

WITH fewer than 200 adult southern corroboree frogs left in the wild, scientists have initiated an IVF program to try to bring the tiny black and gold amphibians back from the brink of extinction.

The technique, carried out on the thumbnail-sized frogs in Sydney and Melbourne, involves injecting the males and females with a synthetic hormone under the skin.

Eggs are then collected by gently squeezing the females, and sperm are obtained by placing a catheter into a male's cloaca, or rear opening.

This was one of the trickier aspects of the method, said Phil Byrne, a biologist carrying out the IVF for the NSW Department of Environment and Climate Change.

"They're tiny little frogs," said Dr Byrne, of Monash University. "It's better if you have small hands."

To mimic natural processes during the frogs' "nuptial embrace" the sperm are then squirted with force onto the eggs in the laboratory.

Dr Byrne and his colleague, Aimee Silla, of the University of Western Australia, had initial success in a pilot study of IVF on corroboree frogs in Melbourne earlier in the year.

About a dozen IVF embryos were obtained. "We got fertilisation, which was exciting. But the embryos failed during the early stages of development," Dr Byrne said.

For the past fortnight they have carried out IVF with a further 38 corroboree frogs bred in captivity at Taronga Zoo, but no embryos had formed, Dr Byrne said yesterday.

A Department of Environment scientist, David Hunter, said the development of frog IVF was part of a multi-pronged strategy to try to save the southern corroboree species, which is found only in Kosciuszko National Park.

"Scientists believe its sudden and dramatic decline is due largely to the effects of a fungus known as the amphibian chytrid, which has devastated frogs worldwide," Dr Hunter said.

Installation of 25 large plastic breeding ponds at five sites in the park began last month. Eggs collected in the wild will be placed in the ponds to grow in fungus-free water until the corroboree frogs are big enough to hop out.

Girl born a record 22 years after father's sperm is frozen

A former leukaemia patient who had his sperm frozen as a teenager has fathered a baby after doctors successfully thawed his sample a record 22 years later.

Chris Biblis was 16 when doctors told him that he needed radiotherapy that would leave him sterile and recommended before going ahead with the life-saving treatment that they put a sample of his sperm into cryogenic storage for future use.

Now aged 38, he is celebrating the birth of a healthy baby daughter, Stella, who was conceived after scientists injected a defrosted sperm into an egg from his wife, Melodie, and implanted it in her uterus.

The 22-year lapse between storage in April 1986 and conception in June 2008 is a world record, according to specialists at the US fertility clinic who carried out the procedure.

The 5lb 12oz girl was born to Mrs Lesley Brown, 29, by ceasarean section just before midnight

“From my life being saved to being able to create a life, words just can’t describe where we are now,” said Mr Biblis, of Charlotte, North Carolina, who has been free of leukaemia since the age of 18.

“I’ve got this bundle of joy to appreciate. It’s truly a miracle,” he told ABC News.

The case is being hailed as an illustration of how far infertility treatment has advanced in the past two decades and proof that sperm can remain viable for decades if they are preserved in liquid nitrogen. The previous record was 21 years.

The procedure used to create Stella did not even exist when Mr Biblis gave the sample in 1986 during his six-year struggle against leukaemia.

“I was trying to get through high school and, you know, living one day at a time just hoping I was going to make it,” he said.

It was not until 1992 that the method of intracytoplasmic sperm injection (ICSI) – by which scientists carefully select a healthy sperm cell and insert it into an egg in the laboratory – was successfully pioneered.

The technique carries an increased chance of conception beyond conventional IVF procedures, in which sperm and eggs are mixed in the laboratory to fertilise spontaneously, and was used because only 35 per cent of Mr Biblis’s sperm cells were deemed viable after thawing.

Doctors selected the best of the remaining cells and injected them into ten eggs harvested from Mrs Biblis, of which seven fertilised successfully in the laboratory. Two of the embryos were implanted, though only one survived, and five remain in storage, allowing the couple the option of having more children.

“They achieved pregnancy on their first cycle of ICSI . . . We had every reason to expect a perfect baby but are thrilled nonetheless,” said Richard Wing, a fertility specialist and founder of Reproductive Endocrinology Associates of Charlotte: “I had no concern about working with old sperm – bovine and equine sperm has been frozen for long periods and has resulted in successful gestations.”