Surgery, Gastroenterology and Oncology

4th Jaipur Surgical Festival (JSF) 2024

Naina Kumar¹, VK Kapoor²

¹Department of Surgical Oncology, Sawai Man Singh (SMS) Medical College Jaipur, Rajasthan, India

²Department of Surgical Gastroenterology, Mahatma Gandhi Medical College & Hospital, Jaipur, Rajasthan, India

 

“Successes, every surgeon can discuss but it takes utmost courage to come up and talk about the complications.”

 

Jaipur – aka the Pink City – the capital of the state of Rajasthan in western India is known around the globe for its very popular Jaipur Literature Festival (JLF). Inspired from the largest Lit Fest in the world, the Mahatma Gandhi Medical College and Hospital (MGMCH), a unit of the Mahatma Gandhi University of Medical Sciences and Technology (MGUMST), Jaipur started the Jaipur Surgical Festival (JSF), an annual continuing medical education (CME) program, in 2021. Themes of the previous JSFs were Safe Cholecystectomy (2021), Hepato-Pancreato-Biliary (HPB) Oncology (2022) and International Study Group on Gall Bladder Cancer (ISG-GBC) (2023). Videos of the previous JSFs are available for free viewing at https://www.youtube.com/@gastrouniversity6742 /playlists. The 4th edition of the JSF was held on 6-8th December 2024 under the auspices of the International Association of Surgeons, Gastroenterologists, and Oncologists (IASGO) with the theme “Complications in Surgery”. MGMCH had earlier organized an IASGO Postgraduate Course on Jaundice in March 2023.

Surgeons are trained from the first year of their residency in managing the complications of surgery. Despite all precautions taken for their prevention and advanced techniques available for their diagnosis, adverse events (complications) do occur and will continue to occur after every procedure and in the hands of every surgeon. The best of the surgeons from all over the country (and some from even abroad) came together for the 4th JSF 2024 to have candid discussions about identifying potential risk factors and understanding the underlying causes and sharing strategies for prevention, diagnosis and management of intraoperative and postoperative complications in surgery. Open discussion was fostered about difficult moments in gastrointestinal (GI), hepato-pancreato-biliary (HPB), head and neck (H&N), breast, thyroid and general surgeries. The aim was to contribute to a culture of safety and continuous improvement in surgical practice. This was well achieved with the keynote lectures, moderated panel discussions and presentation of latest evidences.

Seventy-eight faculties, including 4 from abroad (Bangladesh, Japan and Nepal), 16 from institutions all over India, 17 from the city of Jaipur, and 28 from MGMCH itself came together for the Surg Fest; 13 faculties from India and abroad (UAE and USA) presented their views virtually joining the sessions online. Eighty delegates present on-site in the Surg Fest included 11 from various cities in India (other than Jaipur), 5 from Jaipur (other than MGMCH), and 61 from MGMCH and 3 from abroad (Cambodia and Tanzania). Most of the on-site and online delegates were the students of the Jaipur Surgical Tutorial (JST), a popular online surgical education portal launched by the MGMCH in May 2021 (students wanting to join JST can send a WhatsApp message to Anand Nagar, Professor of HPB Surgery at MGMCH at +91 95997 30280). Videos of more than 150 sessions of JST are available for free viewing at https:// www.youtube.com/@gastrouniversity6742 /playlists. Attendance of the delegates was monitored manually and with digital facial recognition by the Mahatma Gandhi Institute of Health Informatics (MGIHI). The Surg Fest was live streamed on YouTube. Online delegates were live viewers (maximum) on YouTube; Day 1 - 27, Day 2 - 16, Day 3 – 12. The recorded videos of all sessions of the 4th JSF were uploaded on YouTube channels of MGUMST https://m.youtube.com/@ MGUMSTJAIPUR/ streams and Gastro University (which provided technical support) https://www.youtube.com/@ gastrouniversity6742. The channels have gathered more than 4K views for the 3 days’ sessions within 4 months of the event.

The academic feast of the 4th JSF 2024 started on 6th December (fig. 1), a sunny winter morning. After the welcome address and a brief introduction of the JST and JSF by the Organising Chairperson VK Kapoor, Professor of Surgical Gastroenterology at MGMCH and Pro Vice Chancellor of MGUMST, the CME was virtually opened online by Dan G Duda of Harvard Medical School (HMS) and Massachusetts General Hospital (MGH), Boston MA USA and Secretary General of the IASGO. There were two key highlights of the 4th JSF. JSF 2024 replaced the usual didactic lectures with gripping interactive panels. The best of the moderators in their subjects made the discussions amongst panelists thoroughly engrossing. This created an atmosphere of healthier attention spans and facilitated the learning experience of the delegates. The first day of JSF had panels on the puzzling scenarios of complications of surgery for acute and chronic pancreatitis, intra-operative and post-operative complications in pancreato-duodenectomy and difficult situations in biliary surgeries. The crowning moments were the take-home messages about the mystifying situations during the management of a patient which no surgeon likes to discuss in day-to-day practice. Secondly, apart from discussions on surgical topics, the JSF program included panels about prehabili-tation and optimization, anesthesia, critical care, clinical microbiology, interventional radiology, pain management, adjuvant therapies and ethico-legal issues in complications.

 

Figure 1 - 4th Jaipur Surgical Festival (JSF) session in progress – from L to R Rajendra

Desai, Ajay Sharma, Patta Radhakrishna, Shahidur Rahman, Yoji Kishi

 

 

The classic quote amongst surgeons is “The only weapon with which an unconscious patient can immediately retaliate is hemorrhage!”. Day two of the academic extravaganza began with the eagerly anticipated panel of how surgeons deal with intraoperative bleeding during liver resections. This was followed by two keynote presentations. Yoji Kishi from the National Defense Medical College, Tokyo Japan talked about “post-hepatectomy liver failure (PHLF)” and Shahidur Rahman from Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka Bangladesh about “duodenal stump blow out”. Thereafter, JSF had panels on “dilemmas in esophageal surgeries” and “complex situations in upper GI and lower GI surgeries”.

The culminating day three (Sunday the 8th) of the 4th JSF commenced with dynamic oral, poster and video presentations by the participating residents. These were discussed and evaluated by faculty judges, were a huge learning point for all delegates. Awardees were given certificates and prizes in the valedictory function on the same afternoon. The general surgery session in the morning was very enlightening. Residents often hear from their seniors “Abdominal wall closure: if it looks all right, it’s too tight; if it looks too loose, it’s alright!” Surgeons from the best of institutes around the country spoke on “difficult to enter and difficult to close abdomen” and “stoma complications”. The last session of the 4th JSF 2024 laid emphasis on surgical oncology and general surgery. Panels on “barriers in breast oncoplastic surgeries”, “hiccups in head and neck surgeries and “turmoils of thyroid surgeries” laid the groundwork for many key take-away messages for the delegates.

JSF is known for its punctuality, with the sessions starting and finishing on time leaving adequate time for all attendees to enjoy conversations with the faculty over delicious lunches including Rajasthani cuisine. The panels were very well timed. Most importantly, the comments and questions at end of every session were not hurried and ample time was allotted not only to the speakers/ panelists but also for audience questions. The enthusiasm for surgical learning was mesmerizing. At the time of the concluding group photograph (fig. 2), many felt that the learning curve for surgeons seemed to have no plateau. Many speakers felt that they learnt much more than they delivered.

 

Figure 2 - Faculty and delegates of the 4th Jaipur Surgical Festival (JSF) including

VK Kapoor (front row 3rd from right) and Naina Kumar (second row 5th from left)

 

The State of Rajasthan is famous for its hospitality "padharo mhare desh" (welcome to our land) all around the world. Keeping with the tradition, MGUMST hosted all the foreign faculties as well as the foreign delegates (young surgeons and surgical residents) with complimentary registration and accommodation and the Indian faculties with complimentary registration.

Figure 3 - 4th Jaipur Surgical Festival (JSF) banquet dinner – from L to R Anand Nagar, Shahidur Rahman, VK Kapoor, ML Swarankar, Achal Gulati, SS Jaiswal

The gala dinner (fig. 3) on the first evening of the conference, hosted by ML Swarankar, Chairperson Emeritus and Vikas C Swarankar, Chairperson-cum-Chancellor of MGUMST, was attended by Achal Gulati, Vice Chancellor of MGUMST, ND Soni, Principal of MGMCH and Maj Gen (Retd) SS Jaiswal, Medical Director of Mahatma Gandhi Hospital (MGH), Naimish Mehta, Director of the Centre for Digestive Sciences (CfDS), Ajay Sharma, Head of the Department of Surgical Gastroenterology and all JSF faculties and some delegates. The felicitation of the Fest “JSF Samman (Sanskrit: Honor)” was presented to Maj Gen (Retd) RP Choubey, Former Head of the Department of Surgical Gastroenterology at MGMCH. Recipients of previous JSF Samman were Samiran Nundy, New Delhi (2021), SK Mathur, Mumbai (2022) and Lalit K Sharma, New Delhi (2023).

 

 

5th JSF has been announced to be held from 5-7 December 2025 with the theme of ‘surgical, radiological and endoscopic anatomy’.

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