Report of the Gateshead Meeting

The 17th AUGIS Annual Scientific Meeting in Gateshead, held in the impressive surroundings of The Sage Centre on the banks of the River Tyne, proved to be a great success.

World class international speakers joined high-ranking specialists from across the UK and these, combined with highly informative parallel sessions for oesophago-gastric, hepato-pancreato-biliary and bariatric surgery made for a full and exciting two days.

The Meeting included a busy trade exhibition from our partners in industry and the Annual Dinner was held in the historic surroundings of the Discovery Museum across the river in Newcastle.

An Upper GI training day preceded the Meeting and was held at the Institute of Transplantation at the Freeman Hospital in Newcastle. It included practical sessions on bariatric surgery and radiofrequency ablation (RFA) for Barrett’s Oesophagus, lively and interactive OG and HPB MDT sessions and viva sessions. Trainees rotated through six different viva stations – malignant OG, benign OG, bariatric surgery, emergency upper GI surgery, pancreatic and hepatobiliary.

The educational part of the day culminated in an insightful lecture on how to approach the academic viva.

The main meeting opened with a symposium on ERAS for UGI surgery offering a comprehensive selection of talks from Prof Dileep Lobo, Nottingham, who gave overview and then later addressed ERAS and the pancreas, Mr Ollie Lundqvist, Sweden on the Implementation of ERAS, Prof Christophe Mariette, Lille on ERAS and OG and, finally, Mr James Catton, Nottingham, gave the meeting an update on UK Implementation of ERAS explaining how it had largely stalled following this year’s re-organisation of the NHS .

ERAS was also discussed by Mr Lundqvist, in one of the Plenary lectures and was entitled Why metabolism matters.

An OG session at the Meeting offered five speakers on a range of topics. Professor Giovanni de Manzoni from Verona spoke first discussed Should N3 Gastric Cancer by resected? Professor Christophe Mariette, from Lille, addressed the question of Managing Diffuse Gastric Cancer and Professor Arnulf Holscher from Cologne spoke about Managing T-3NI Adenocarcinoma of the Oesophagus. Mr Richard Hardwick, lead clinician for NOGCA, then gave a NOGCA update and Mr Willium Allum, President of AUGIS and Chair of the upper GI Audit Committee for ESSO, concluded the session by updating the audience on the EURECCA Project – looking at pan-European data and said the project was “aiming to define a dataset for a European upper GI cancer audit.”

HPB sessions were held on both Thursday and Friday, giving the audience a range of speakers and subjects.

Speakers included Mr Giles Toogood on Surgery – when all else fails and was followed by case study presentations by Mr John Hammond. Dr Manu Nayar from Newcastle spoke on Endoscopy, describing case studies and the importance of accurate recording of data, saying: “Every step must be measured.” Dr Ralph Jackson spoke about Radiological investigation and drainage. State-of-the-art multidisciplinay management of HPB disease and data collection were discussed in the Friday session.

A well-attended Bariatric session looked in detail at the problem of weight re-gain and how to manage it. Speakers included Dr Vanessa Snowden-Carr from Taunton who gave the view from psychology, Ms Mary O’Kane from Leeds who gave a dietitian’s perspective and Mr Shaw Somers from Portsmouth who offered a surgical solution. Professor John Pinkney from Plymouth asked Can the NHS afford re-operative surgery for weight re-gain?  and the session ended with a fascinating talk by Dr Rachel Batterham from ULC entitled Can we pick the winners and avoid the problem?

It was great to see such a strong AHP presence in Gateshead, possibly drawn to the full programme on offer and the chance to network with other specialists. Three sessions were geared towards AHPs, one on aspects of bariatric surgery, one on the early diagnosis and awareness of UGI disease while the third covered OG disease and patient care.

The BJS Keynote lecture, Intraoperative problems during complex laparascopic HPB surgery: management and avoidance was delivered by Dr Michael Kendrick, USA, in which he described the “real world” of HPB surgery with a focus on haemorrhage.

Dr Kendrick used extensive video clips to highlight his talk and gave many useful pieces of advice on managing problem. He finished his talk saying: “Patience is a great quality in a surgeon, especially one undertaking new types of surgery.”

In a second plenary lecture Mr Euan Dickson from Glasgow discussed extreme pancreatitis, describing management dilemmas around the condition and the case for intervention. He said: “In pancreas surgery everything you do tends to come with a price. In complex case one guiding rule is that you do the least you can at any one time.”

The meeting also heard from Professor Ben Bridgewater, HQIP on the subject of surgeon outcome data – and were told to expect more calls for more results to be put into the public domain over the coming years.