Editorial: 14th pediatric endoscopic surgeons of India 2019 annual conference
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Satya Mulani Sarvani, Satyan na Asti Param Padam (Sanskrit-English translation: All are rooted in truth and there is nothing higher than the truth)
Figuratively in search of the truth about the current status of endoscopic surgeries in children, the Pediatric Endoscopic Surgeons of India Conference (PESICON) is organized as an annual event. This year the PESICON 2019 was held in the historical Sun City, Jodhpur, set in the glaring landscape of the Thar Desert of Western India in the state of Rajasthan. At the same time, coincidentally, the largest peaceful congregation of mankind, the Kumbh festival was being celebrated in Prayagraj. The Venue for the Conference was the All India Institute of Medical Sciences (AIIMS), Jodhpur which was established by the Ministry of Health and Family Welfare, Government of India with the aim of correcting regional imbalances in tertiary level healthcare in the country and for attaining self-sufficiency in graduate and postgraduate medical education. AIIMS Jodhpur was established in 2012 and over the past 6–7 years of its subsistence it has grown into a centre of excellence in Medical Education, Research and Patient Care. The Centre has dedicated faculty members, exemplary infrastructure and has adopted cutting-edge technology to provide avant-grade patient care. AIIMS Jodhpur also acquired da-Vinci Surgical System in 2018 and has successfully completed more than hundred cases of different specialties in a short span of time.
PESICON 2019 was a three-day event attended by more than 200 national and international delegates. The submissions were presented in various categories: oral presentations, e-posters and video presentations. Additional events included hands on endotrainer workshop, wet lab on thoracoscopy and demonstration of percutaneous nephrolithotomy (PCNL) simulation.
Young trainees engaged in large numbers and the pre-conference workshops were successful. The challenges presented by the thoracosocpic procedures in the wet lab were also appreciated by many faculty members who also engaged themselves in thoracoscopic suturing between sessions. PCNL simulation was another area of interest for the delegates as PCNL is one of the procedures that does not routinely fall under the domain of Pediatric Surgeons. The faculty of the workshop included Dr. Rasik Shah, Dr. Mohan Abraham, Dr. Nitin Patwardhan, Dr. Ravi Ramadwar and Dr. VVS Chandrashekharam.
The Karl Storz video award is the most prestigious award of PESICON. Eight videos were presented during this intensely competitive session. Dr. Karpaga Vinayagam Natrajan and Dr. Rishi Dwivedi were the first and second prize winners, respectively. Winners of the best free paper award for gastrointestinal surgery, urology, and thoracic session were Dr. Saalim Naazki, Dr. Rishi Dwivedi/Dr. Suramya Anand and Dr. Anand Sinha, respectively. Dr. Gyanendra received the best video award.
Travel bursary award was the new initiative taken by the organizers of PESICON 2019. As a sub-specialty organization of the Indian Association of Pediatric Surgeons (IAPS), PESI followed other sub-specialties that have a very well-developed Travel Bursary and award mechanism which provides the best trainees and young surgeons with an incentive to further their learning by providing monetary and institutional support. PESICON Travel bursary award was based on the combination of the quality of scientific abstract, brief write-up by the applicant and their curriculum vitae. Four trainees that were given the travel bursary award were Dr. Saalim Naazki, Dr. Ashwitha Shenoy, Dr. Cherian Jerin and Dr. Suramya Anand.
One of the highlights of the conference is the PESI-Oration where a Pediatric Surgeon of eminence delves deep into a topic providing both a broad overview of the topic along with small details and intricacies, which is only possible after years of work in the field. Lot of thought process and many rounds of discussions culminated into choosing Prof. Amulya Saxena from London, UK as PESI-IAPS Orator. The topic of his oration was “Pediatric Minimal Access Surgery: Tribute to the pioneers and back to the future”. His oration was commended by the faculty members and delegates, and he received the PESI-IAPS Oration 2019 Medal.
The scientific program also got a new flavor of debates and passionately run panel discussions. Panel discussion on “Pediatric surgical training in the era of laparoscopy” was moderated by Prof. Minu Bajpai and panelists which included Dr. Ketan Parikh, Dr. S. Ramesh and Dr. VVS Chandrasekharam. This panel discussion raised some important issues and PESI office bearers decided to work toward devising ways of incorporating the minimal access surgery as a structured program within the pediatric surgical training. This was followed by another debate on “Live operative workshop is an integral part of pediatric surgical endoscopic workshop”. Pertinent points were put both for and against the motion by the debaters and it also involved participation by the audience. Prof. Amulya Saxena and Dr. Ketan Parikh spoke against the motion, while Dr. Nitin James Peters and Dr. Shilpa Sharma articulated in favor of having live operative workshop.
Neonatal Surgery symposium was moderated by Dr. VVS Chandrasekharam and was a very well-attended session. PESICON 2019 also focused on the advances in minimally access surgery including robotic procedures in children. There was an operative demonstration on the use of Surgical Robotics in the management of vesico-ureteric reflux. Prof. Arvind Sinha presented the journey of All India Institute of Medical Sciences, Jodhpur in the establishment of the robotic program.
A panel discussion on “Problems faced by young surgeons to initiate minimal access surgery” was moderated by Dr. Virender Sekhon. Tech savvy young surgeons decided to broadcast this discussion live on video streaming site. Though this was the last session before the valedictory function, the extremely enthusiastic participation made this session very lively. Valedictory function was chaired by Prof. G. Rajamani, Dr. HPS Miglani, Prof. Arvind Sinha and Dr. Manish Pathak. Prizes in various categories were announced and awarded and the function ended with the announcement to meet in Pune, Maharashtra next year.
It has been heartening to note the progress and change in nature of PESICON over the years. In the initial years, when most delegates were learning the ropes of laparoscopy, the conference mostly focused on operative videos and presentation of singular successful laparoscopic cases. With increasing incorporation of laparoscopy in day-to-day working of a pediatric surgery unit, the nature of PESICON changed to a mix of papers with outcomes and operative videos. With advancing expertise in laparoscopy, it is expected that the conferences would focus exclusively on long term results of various laparoscopic procedures rather than on intricacies of techniques. PESION is on the cusp of making the transition from the second stage to the next stage where the focus will shift to presentation with higher levels of evidence. The role of training/teaching laparoscopy will gradually go to its rightful place, i.e., to the training departments. Some initial hints and signs of the change were obvious at PESICON 2019.
We are truly blessed to be working in such an exciting era with rapid advances in minimally invasive surgery (MIS) in children and PESICON is ideally positioned to disseminate the knowledge and to push the boundaries of minimal access surgery for the benefit of children.
Compliance with ethical standards
Conflict of interest
The authors declare that there is no conflict of interest.