Life long learning

Posted 12 years ago

One day, when I was a young registrar in Vienna, I accidentally made a small bowel injury at entry into the abdomen. I was visibly upset because of my failure. My boss at the time laughed it off, repaired the hole in the bowel and let me continue to operate. After the operation I was still so disturbed that I considered resigning as a general O&G trainee.

15 years later – in July 2012, I went to Shanghai to organise a surgical workshop targeted at senior gynaecologists from Asia – mostly from under-resourced countries. The 2-day workshop focussed on surgery to bowel, bladder, ureters and haemostasis because these are the issues that most likely give us trouble.

The workshop was run in partnership between the International Gynaecological Cancer Society (IGCS) and Covidien and focussed entirely on ”How to get out of trouble in the operating theatre”.

My job was to put an attractive program together, invite international faculty and make sure each table of surgeons has a tutor and a theatre nurse that speaks their language as well. We had colorectal, urological and gynaecological oncology input. There were 33 gynaecologists and 15 faculty members to operate on 11 pigs in the animal lab.

Each day was kick started with theory lectures followed by a hands-on animal lab (pigs). On the first day we did open surgery; small and large bowel resections, end-to-end anastomoses, resections of ureter and re-implantation into the bladder, liver mobilisation and resection of diaphragm, etc. Laparoscopic surgery was the theme for the second day.

Particularly, I found fascinating that gynaecologists from one particular country baulked at bowel surgery. We still got them to do the tasks but they required a little convincing. In that particular country gynaecologists are not allowed to operate on the bowel, even to repair an iatrogenic small bowel injury.

I find learning and teaching very inspiring and satisfying. I had the great pleasure to work with an upper GI surgeon early this week. My team and I encountered an unexpected difficult situation during a challenging, 6-hour operation. He was very generous explaining what the key issues for success are and also sharing what he did to make this operation a true success. Many people I collaborate with seem to have plenty and they are very happy to give.

We need to protect our enthusiasm for our profession. To reflect from time to time why we chose our job many years ago. For me personally, ongoing learning, never succumb to curiosity, ask "impertinent" questions is what I am here for.

Regulations that someone must not do this operation or that test will starve off our energy and willingness to learn. By contrast, asking for help and inviting another surgeon to the operating theatre will enhance a surgeon’s meaning in life. Surgical workshops also satisfy our keenness to learn and the need for meaning. To go and visit another surgeon to see what s/he does will also serve the purpose. I have been to see my colleagues at the Memorial Sloan Kettering Cancer Centre a couple of years ago for a week and that is still in my memory in a most positive way. To phone a colleague and chat about a recent “case” can be inspiring, too.

From time to time its great to go on a plane and see other surgeons work. I’d like to go and see a uterus transplant that apparently has been done for the first time in Sweden this week. http://www.medicalnewstoday.com/articles/250456.php.

Next week we will have a look at hysterectomy trends: Is abdominal hysterectomy an out-dated operation?