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The new age of surgery

On Sept. 9, 2004, Deogracias Alberto Reyes left his home in Bulacan to embark on a 22-hour trip to Scotland. It would be his first time to leave his family for a long period.

Dr. Deogracias Reyes
heads The Medical City’s
new training facility
For almost two years, he would study under one of the world’s best professors of surgery.

There, he would meet his mentor, the man who would change his life. Sir Alfred Cuschieri is one of the pioneers of keyhole surgery, which enables surgeons to operate via a very small cut. He was knighted in 1987 for his contributions to surgery.

“Professor Cuschieri shaped surgical procedure as we know it,” said Reyes, consultant-director at The Medical City’s Center for Advanced Skills, Simulation and Training Innovation (CASSTI) and associate professor at the Ateneo School of Medicine and Public Health.

The facility, a multi-disciplinary skills development facility for surgeons, will have Cuschieri as part of its international advisory committee.

“You can kill a patient with a hypodermic needle,” said Cuschieri during the opening of CASSTI.

A light moment at CASSTI with (from left)
Reyes, The Medical City president and
chief executive Dr. Alfredo Bengzon;
TMC chairman Dr. Augusto P. Sarmiento;
Sir Alfred Cuschieri, Dr. Eugenio Jose
Ramos; and Dr. Blesilda Concepcion.
“New surgery techniques reduce the risks. A good surgeon is compassionate. He has to be against anything that will hurt his patient,” explained Cuschieri.

Cuschieri became interested in minimal access surgery because of his belief that patients suffered more because of the big incision rather than the surgery in itself.

In 2004, the Cuschieri Skills Centre was opened at Ninewells Hospital. It was the first center in Europe where surgeons could train through simulation.

Minimal access surgery is a requisite in general residency training but there is a gap in the Philippines with regard to this. In other parts of the world, simulation training has been integrated into general surgery training programs using inanimate models, animal phantom models and virtual reality.

Also part of the advisory committee is Professor Koon Ho Rha, a well-know robotics surgeon from Korea. Ahmad Nassar is an expert in laparoscopic and endoscopic surgeries.

The main feature of CASSTI is simulation training. With its track record in minimally assisted procedures such as robot-assisted and laparoscopic surgeries, The Medical City hopes to further uplift the level of medical care through CASSTI.

At the center, Reyes is supported by course directors composed of specialists from The Medical City’s different departments

The simulation room at the training
center where doctors and trainees
can ‘practice.’
“CASSTI is changing surgical learning,” said The Medical City president and chief executive Dr. Alfredo Bengzon.

CASSTI offers short courses that run from two to five days and post-graduate certificate courses  that will run from one to three months. There are plans to offer a certificate course and a Master’s Degree in Minimal Access Surgery.

The center’s facilities include endoscopic stations, a virtual reality room, a simulation room, teleconference capability for live surgery transmission to CASSTI and remote locations, an animal laboratory, lecture rooms, video editing stations and a research room.

Reyes explained trainings are conducted in a controlled and safe environment.

“A procedure can be deconstructed into its critical steps for more structured and purposeful learning. The simulation environment guarantees minimal error. The ability to repeat and train  in the skills laboratory makes training pace appropriate and responsive to the individual’s learning aptitude and schedule limitations,” he added.

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