ACS Germany Traveling Fellow reports on his life- and career-changing experience

Professor Senninger and several ACS Traveling Fellows to Germany. Left to right: Dr. Kandil; Dr. Senninger; Ali Khoynezhad, MD, PhD, FACS, Cedars-Sinai Medical Center, Los Angeles, CA (2011); and Greg J. Landry, MD, FACS, associate professor, vascular surgery,  Oregon Health and Science University, Portland (2010).

Being nominated for the 2012 American College of Surgeons (ACS) Traveling Fellowship was in itself a great honor. The ACS Germany Traveling Fellowship is awarded annually to an American or Canadian surgeon who travels to Germany, and likewise, a German surgeon is selected to travel to North America. The fellowship encourages the international exchange of surgical science, practice, and education, and helps the Fellow establish professional and academic collaboration and friendships. I deeply appreciated the honor of being selected the 2012 ACS Germany Traveling Fellow.

In addition to attending the 129th German Surgical Society annual meeting in Berlin, I visited three major institutions in Germany that specialize in endocrine surgery, and I was able to incorporate new techniques and ideas into my clinical practice and academic career planning. In between these visits and activities, I visited many of Germany’s landmarks.

Essen

My first stop was Essen, which is among Germany’s oldest and one of the nation’s 10 largest cities. During the 20th century, the city, located in the Rhine-Ruhr metropolitan region, became known as the largest industrial center in Europe for coal and steel.

In Essen, I met Prof. Martin K. Walz, MD, FACS, the chief of the department of surgery and Centre of Minimally Invasive Surgery, an institution that many consider to be the mecca of adrenal surgery. Kliniken Essen-Mitte, University of Duisburg, Essen, and I witnessed his retroperitoneal adrenal surgical procedures.

Professor Walz runs an inspiring program, with an impressive level of surgical competence and organization. He created a robust educational program for my visit, allowing me to observe and assist in almost a dozen laparoscopic retroperitoneal adrenalectomies, many of which were done using the single-port-access approach. In one of these operations, two teams performed bilateral adrenalectomies simultaneously, completing the procedure in approximately 30 minutes. It was really fascinating to witness two teams simultaneously removing two glands.

I also observed and assisted in pancreatic and thyroid procedures during my visit. In addition, I presented a lecture to the surgical team on robotic thyroid surgery and shared with them my experience with robotic transaxillary approach for thyroid and parathyroid surgery. I attended all the morning reports and rounds with Professor Walz, with whom I had daily face-to-face meetings. We discussed future collaboration.

Professor Walz will honor my institution, Tulane University Medical Center, New Orleans, LA, with his participation in our fifth annual symposium in February 2013. We discussed arranging for live surgery and cadaver training during his visit. After my visit in Essen, I boarded a train to Berlin.

Berlin

Berlin is known historically as an international city famous for its architecture, opera house, theaters, shopping, art museums, and palaces. But in this German capital city, nothing compares to seeing the remains of the Berlin Wall, which separated families from 1961 to 1989.

My host in Berlin was Prof. Martin Strik, MD, FACS, whom I met a few years earlier through my chairman at Tulane, Douglas Slakey, MD, FACS. We were honored that Professor Strik lectured in New Orleans during our annual thyroid symposium on the axillo bilateral breast approach (ABBA) technique. His participation was essential to the success of our symposium.

On Monday morning, Professor Strik and I drove to the hospital, where I observed and assisted in a number of cases and attended the morning reports and surgical rounds.
In Germany, surgery department chairs do not routinely specialize in surgical disciplines as they do in the U.S., and expert surgeons in Germany regularly operate across several subspecialties.

I was honored to share my experience with Dr. Strik’s surgical residents and faculty when I lectured on the robotic approach for thyroid surgery. From there, we went to the German Surgical Society Meeting at the International Convention Center in Berlin.

German Surgical Society Meeting

The 129th annual meeting of the German Surgical Society (Deutsche Gesellschaft für Chirurgie) was organized as a weeklong event similar to the ACS Clinical Congress. At the meeting, I met Prof. Norbert Senninger, MD, PhD, FACS. Professor Senninger is the General Secretary of the German Chapter of the ACS.

Professor Senninger and I actually met during the 2011 ACS meeting in San Francisco, CA, and we have been in contact via e-mail ever since. He helped me organize my travel agenda, and proved to be a generous and accomplished academic surgeon with extraordinary organizational talent.

The German congress included concurrent sessions and the presidential address by Prof. Markus Büchler, MD, FACS, chairman of surgery at Heidelberg University, Germany. Professor Büchler had requested a meeting with me before his presidential address. He then honored me with the certificate of the fellowship during a special award ceremony. At the very top echelon of Germany’s surgical community, he remains a humble gentleman and a generous host. I was also impressed by the number of video sessions on “How I do it” and live surgery sessions.

I was asked at the congress to share my experience with robotic surgery. On Friday, April 27, I presented a lecture titled Robotic Thyroid Surgery: Is it Ready for Prime Time? to the international session of the German Surgical Society meeting. A number of interesting discussions on robotic surgeries followed my talk. This huge, well-organized congress left a highly positive impression on me.

Halle (Saale)

Halle (Saale) is a residential town, rich in water resources and green spaces. Numerous scientific institutes are located here such as the Max Planck Association and the Fraunhofer Institute. The Martin Luther University Halle-Wittenberg and the Burg Giebichenstein Academy of Art and Design-Halle attract thousands of students to Halle (Saale) each year.

My host was Prof. Henning Dralle, MD, FRCS, FACS, whom I met during his nerve-monitoring session and his lecture on thyroid surgery at the German congress. I observed his technique and discussed with him automatic periodic stimulation, which we are currently implementing at Tulane.

I noticed that Germans would always ask about the “American way,” and I would always ask about the “German way.” In all the cases in which I participated, we were comparing and contrasting the two approaches, but in the end, our common goals for the well-being of our patients connected us. The experience helped me see clearly the importance of strengthening our relationship with German surgeons, a benefit that cannot be underestimated, and an essential part of the ACS International Relations Committee’s mission.

I intend to stay in contact and collaborate with the surgeons whom I met during my ACS Germany Traveling Fellowship. I am very grateful to the German Surgical Society and the American College of Surgeons for the privilege and honor of participating in this most prestigious endeavor and odyssey.

I am grateful to many individuals, starting with Professor Senninger. I am also grateful to Kate Early, ACS International Relations Liaison. I also thank Dr. Slakey, and Paul Friedlander, MD, FACS, otolaryngology chair at Tulane, for their support and making this opportunity possible. My thanks are also extended to my practice partners for covering my clinical responsibilities in my absence.

I also express my appreciation to Professors Walz, Strik, Dralle, and Büchler, as well as their clinical staffs for their warm hospitality. Lastly, I am blessed with a loving and supportive family, and I thank them for their endurance and sacrifice.

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