Brighton 2014
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Challenging times but
outlook is still sunny
The sun shone for the 18th AUGIS
Scientific Meeting in Brighton, adding
to the upbeat mood of the conference
and the belief that AUGIS is a force to be
reckoned with despite the challenges
facing our professions.
Once again we welcomed highly
informative specialists who provided a
fascinating two days of talks and
discussions including parallel sessions
for
oesophago-gastric,
hepatopancreato-biliary,
bariatric
and
affiliates,
all
well-attended
and
appreciated by almost 400 delegates.
The Meeting was preceded by a
successful teaching day. Rob Jones
(outgoing Trainee rep) and Mark Taylor
(Northern Ireland rep) organised a
superb morning wet lab session
(sponsored by Covidien) and viva/MDT
afternoon, supported by a Faculty of
local surgeons, past Presidents and
Council. Prof Jane Blazeby (Surgical
Speciality Lead in Upper GI) held an
innovative, highly educational and fun
Dragons Den, which looks destined to
become a regular feature of future
meetings.
The
educational
and
scientific
programme was of a very high standard
thanks to Mr Giles Toogood (Education
& Training) with many stand-out talks
and discussions. There were debates on
the future of training plus audit
updates.
Our partners in industry supported the
meeting with a busy trade exhibition on
the ground floor of the Brighton Centre,
enjoying wonderful sea views as they
worked.
The view was also enjoyed by delegates
Wonderful
weather and
great
science –
images from
the ‘breakout’ sessions
at the 18th
AUGIS
conference
on the Thursday evening who
crowded into the window-lined top
floor bar of the Centre for a drinks
reception.
The meeting was opened by outgoing
president Mr Bill Allum who
introduced the first speaker - Mr Sean
Duffy, National Clinical Director for
Cancer for NHS England. He headed a
session on the early diagnosis of
upper GI and HPB cancers by pointing
to a “relentless focus” on improving
outcomes at all levels, removing
variation and offering better healthcare
experiences. He concluded: “There are
gaps in survival and we need an
effective plan to tackle capacity delays.
The evidence for volume linked to
survival cannot be ignored and there is
an age bias we must tackle.”
In the same session, Prof Marco del
Chiaro of Sweden discussed the early
diagnosis of pancreatic cancer, Dr
Rebecca Fitzgerald from Cambridge
discussed new ways to detect Barrett’s
dysplasia and Dr Rebecca Jones, Leeds,
addressed the question: “How hard do
we chase dysplastic nodules in the liver?”
Closer to home, Prof Mike Griffin from
Newcastle described a successful
regional campaign - Raising Awareness
of oesophageal cancer - in which a TV
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Dr Dimick, above, and Prof
Blazeby and colleagues, right
campaign in the north-east proved
effective in getting more people to
report to GPs. He said: “We can change
what, 30 years ago, would have been a
death sentence. We are also moving
towards disease prevention.”
The BJS lecture is always a highlight of
the meeting and this year was no
exception - Dr Justin Dimick, from
Michigan delivered a very entertaining
and informative lecture on surgical skill.
He described a study in which surgeons
submitted videos of “typical” lap gastric
band operations. These were blind
peer-reviewed to identify the best
surgical work based on technical
criteria.
He also recommended a coaching
approach to surgery involving a
programme of continued professional
improvement.
Another highlight was the Plenary
lecture given by Prof Keith Gardiner
from Northern Ireland on Nutritional
guidance for UGI patients, which
followed talks on managing acute
pancreatitis
and
dealing
with
complications.
It fell to the outgoing president Bill
Allum to lead a session on the future
for UGI surgery. He detailed new
commissioning structures, referred to
consultant outcomes publication and to
the Everyone Counts agenda. The role
and approach of the new NHS chief was
also discussed.
The incoming president Mr Ian
Beckingham then took to the floor to
describe SWORD - the Surgical
Workload
Outcomes
Research
Database which will allow surgeons to
review data and compare themselves
with their peers.
The session continued with Prof
Rowan Parks, Edinburgh on Training
the Upper GI surgeon for the future, Ms
Asha Senapati, Portsmouth, on
Training the Emergency Surgeon, and
Mr Rob Jones on The Trainee
Perspective. Mr Jones told the
meeting: “Clinical excellence is
essential and the historical approach just turn up and see who is on the
operating table - is over.”
Nurses and allied health professionals
enjoyed a series of specialist talks
with a focus on ERAS from specialist
dietitian Fiona Huddy from Surrey
and clinical specialist physiotherapist
May Nel from Imperial College. The
AHP session also heard from Andrew
Jervoise on the longterm management
of a patient after GI surgery and Prof
Jane Blazeby updated delegates on
surgical trials.
Parallel sessions threw up a host of
interesting lectures, with Mr Sean
Woodcock, Northumbria, starting off
Topical questions in UGI surgery with
Our new
president, Mr
Ian
Beckingham,
left, and the
Royal
Pavilion,
right, setting
for the
Council
Dinner
a host of practical observations
in his talk, Peri-operative care of
the severely obese patient. He
gave lessons learned from
managing patients who have had
bariatric surgery transferred to
the management of obese
patients in a general surgical
setting.
Mr Krishna Moorthy, London,
spoke on Managing the acutely ill
obese patient - raising the
question of whether super-obese
patients who need general
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Our bright and busy trade exhibition
surgery should be moved to
specialist bariatric centres if
local facilities aren’t able to
cope with their size, while Mr
Shaw Somers from Portsmouth
offered his views on Bariatric
surgical lessons for the general
upper GI surgeon, emphasising
the role of the MDT.
In another area of surgery, Mr
Richard Hardwick, Cambridge,
discussed the management of
UGI GISTS and Mr Michael
Booth from Reading spoke
about BSG guidelines for
oesophageal manometry.
Elsewhere, a highly informative
series of talks on Strategies and
Evidence for the management of
HPB patients were taking place.
Among others, Prof Marco Del
Chiaro,
Sweden,
discussed
cystic tumours of the pancreas
and urged delegates to join the
relevant European Study Group;
Mr Merv Rees, Basingstoke,
spoke about the timing of
surgery for crim and Prof
Stephen Wigmore, Edinburgh,
discussed
maximising
the
remnant liver.
The final session of the
conference
concerned
the
Management of the acute
gallbladder and included talks
from Mr Simon Dwerryhouse,
Gloucester, on cholecystitis, Mr
Giles Toogood, Leeds, on acute
cholecystectomy
and
Mr
Richard Sturgess, Aintree, on
CBD stones post-gastrectomy.
Dr Dimick then returned to the
conference hall to round off the
conference with an excellent
final talk on bile duct injury.
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Much of interest
for Affiliates at the
Brighton Meeting
The Annual Scientific Meeting was
preceded by an Affiliate Training Day.
This is the first time we have organised
such an event and I am grateful to the
AUGIS Council for proposing it.
The day was divided into four perioperative workshops: pre-operative
assessment and optimization, an
overview of HPB surgery, an overview of
OG surgery and post-operative
management. It was attended by a
varied selection of ward nurses,
dietitians, physiotherapists and clinical
nurse specialists - and the feedback has
been extremely positive.
Particular thanks must go to Graham
Pinn, Fiona Huddy and Claudia Rueb for
helping to organise such a successful
day and all the Faculty for their time and
expertise.
The main Affiliate Sessions took place
the following day and it was great to see
such a fantastic turnout. The focus was
ERAS and involved a series of talks on
the role and perspective of the
physiotherapist, specialist nurse and
dietitian and outlined the challenges
and successes of implementing
Enhanced Recovery Programmes of Care
in Upper GI. These sessions clearly
demonstrated that the success of ERAS
in UGI is only possible if there is a well
co-ordinated, multi-professional
approach across the whole perioperative spectrum.
Professor Jane Blazeby presented on the
need for more trials for patient benefit
and improved experience, marking a
new era of multi-professional research.
The final presentation of the day was
from Dr Jervoise Andreyev on the
practical management of the long term
consequences following UGI resection.
Dr Andreyev emphasised the vital role
that CNSs and AHPs have in managing
the patients post-operatively and in
particular once they have been
discharged. The needs of this patient
group are complex and the impact on
quality of life following curative UGI
resection is well documented.