Report: first ESUT fellowship in endourology and laparoscopy

06 December 2010

Fuelled by my goal to pursue an academic career, I realised that it is necessary to extend the basic urological training I have acquired during my residency. My special interest is endourology, including emerging urological technologies and minimal invasive techniques particularly in BPH and stone management. I therefore decided to join the Department of Urology, Academic Medical Center, Amsterdam (AMC) in the Netherlands, an internationally recognised European centre of excellence.

The department was perfectly organised and fully equipped with the latest computer technology which facilitates, among others, data collection, utilisation and storage, communication among the personnel and the quality of patient care. The unit included around 20 urology in-patient beds; it was extremely well equipped with the most up-to-date urological technology, a comprehensive outpatient facility, a perfectly organised diagnostic centre, specialist uro-radiological support and day-care unit.

Although at first I had some concerns regarding my lack of knowledge of the Dutch language, my worries vanished when I realised that nearly everyone was fluent in English. The issue of finding accommodation was also very easily resolved by the special section of the AMC Hospital that takes good care of visiting foreign doctors participating in exchange projects. Also noteworthy was the quality of the relationship between me and the department staff. Within the context of the fellowship, we followed a task-oriented programme based on a modular approach.

Department: We had two meetings per day, with the first at 08:00 am. Emergency admissions, medical problems in the ward and complicated cases were discussed. The second was scheduled at 04:15 pm. Indications for surgery, problems in the ward and cases in the consultation were discussed. Additional meetings included those with the radiologists on Mondays, a Tuesday meeting to discuss surgical indications, another meeting with the nephrologists on Wednesdays, a uro-oncology meeting with the pathologists, radio-oncologists and medical oncologists on Thursdays and a meeting with the paediatric urologists on Fridays.

Operating theatre: The regular operating theatre programme consisted of five days every week, including paediatric urology. The activities included laparoscopic renal tumour cryoablation (centre of reference), uretero-reno-scopy (flexible, rigid ± laser uretero-reno-lithotripsy), laparoscopic radical prostatectomy, laparoscopic (total/ partial) nephrectomy, laparoscopic pyeloplasty and percutaneous nephro-lithotripsy (PCNL). Furthermore, many new procedures were performed such as bipolar transurethral resection of the prostate and laser (KTP) prostatectomy and contrast-enhanced trans-rectal ultrasound guided prostate biopsies. I actively participated in all surgical procedures either by assisting or performing operations with supervision.

Other activities included research and training responsibilities. Regarding research activities, the main topics of research interest in the department were related to oncology, endourology, laparoscopy and imaging. I was given the task to participate, conduct and evaluate several research projects, which later on enabled me to participate or be involved in many presentations at national and international congresses, book chapter preparations and the publication of a number of manuscripts in renowned urological journals.

The Department of Urology is also involved in several postgraduate training courses It was a unique chance for me to be actively involved in all these meetings and workshops such as focal therapy and imaging in prostate/kidney cancer (www.focaltherapy.org) . This two-year period provided me with an invaluable experience not only from a scientific or clinical perspective but also from a social point of view. I would like to note, however, that the net benefit is not always a function of the host institution’s qualities but also of one’s own expectations, motivation, theoretical scientific background, skills, personality and psychological resources. I strongly recommend to young colleagues, especially those with an academe-based career to pursue such an experience.

Note: During the Annual EAU Meeting in Barcelona, Dr. Charalampos Mamoulakis and Dr. Ali Serdar Gözen received from Prof. Jens Rassweiler, Chairman of ESUT, their certificate for a fellowship in endourology and laparoscopy. This fellowship programme, established throughclose collaboration between the EUSP and the ESUT, is important in further strengthening the training of European endourologists and laparoscopists.

Full article published in the October/November 2010 issue of EUT

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