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2018 ESSO-SSO Observership Report 19/02/2019


2018 ESSO-SSO Observership

Ching-Wei D. Tzeng, MD

Assistant Professor

MD Anderson Cancer Center

Houston, TX


The 2018 ESSO Traveling Observership was an amazing experience that exceeded my high expectations. I would like to thank the ESSO for its generosity and vision in creating this opportunity for cultural and educational exchange.  As advertised, the intent of the award was to support the attendance of the ESSO 38 meeting in Budapest, Hungary, and to visit two European cancer centers with ESSO member hosts. I chose to visit Prof. Michel Rivoire (Centre Leon Berard) in Lyon, France, and Prof. Guido Torzilli (Humanitas Research Hospital) in Milan, Italy. 

My journey started with the attendance at the ESSO 38 conference in Budapest, from October 10-12, 2018.  As soon as I checked in, I went straight to the welcome reception to start meeting ESSO members. I had the opportunity to chat with the outgoing ESSO President, Dr. Santiago Moreno-Gonzalez (Madrid, Spain) and with my future host Prof. Rivoire at this event.  The next two days included many great talks from European leaders of Surgical Oncology, including many names which I had read in PubMed but finally got to see and meet.  One of the highlights of the conference was the invitation to sit in on the EYSAC (ESSO Young Surgeons and Alumni Committee), which is unique committee of young surgeons including national reps from member countries.  In this meeting of the future leaders of ESSO, I could see a desire to continue the great efforts of collaboration, research, and education, across the member countries.  Certainly, they realized that the greatest strength of ESSO was its diverse membership. The dinner cruise on the Danube was another highlight, allowing great networking in the setting of a memorable night cruise on a historic river.  I briefly chatted with Dr. Dave Bartlett (Pittsburgh, PA) who was representing the SSO leadership at ESSO.

My next stop from Budapest was Lyon. In this wonderful ancient city known for its history and gastronomic culture, I visited Prof. Rivoire at Centre Leon Berard, which is a regional cancer center.  Here, I observed in the operating room and the outpatient clinic.  I witnessed the universal language of operating room culture.  Of course there are nuances in the setup of the OR and how the patient is prepped, but ultimately, a surgeon from anywhere in the world will always feel at home in any other OR in the world.  I was both surprised and reassured about our commonality in seeing how their OR functioned very much like ours.  Even the surgical workday was the same, with the chief resident “running the list” with faculty before breaking off and taking care of floor work and covering cases. Prof. Rivoire hosted me at a traditional French brasserie to experience the gastronomic culture.  We had a great exchange of thought in comparing and contrasting surgery training and surgery practice in the U.S. and France. Even though France has a national healthcare system, the U.S. system could learn from portions of it.

My final stop was in Milan, another city of incredible culture. There, I visited the liver surgery team of Prof. Torzilli and observed two days of operating as well as their preoperative planning conference.  I was impressed with the surgical planning conference in which the resident and junior faculty work together to present cases for the following week, so that the entire team [regardless of who was actually operating on the patient] could weigh in and agree upon the surgical game plan.  In the OR, I witnessed great harmony among the entire team led by the scrub nurse who stayed scrubbed for the entire liver resection side by side with the surgeons.  I was able to watch the highly skilled intraoperative ultrasound ability of Prof. Torzilli and his faculty. They have published many papers on this ultrasound technique to perform very exact parenchymal resections using image guidance. By using ultrasound guidance and by taking care of every single biliary and vascular branch crossing the transection line, the final liver transection surfaces were amazingly clean and dry with no hemostatic agent, no clips, and no coagulation/burns on the surface. We had a great Milano dinner with his team. We had a very interesting conversation about surgery training and surgery culture in Italy, comparing it to other European countries and to the U.S.  

In all, my observership was a memorable experience which I will value the rest of my surgical oncology career. Certainly, I learned technical tips from Lyon and Milan on how to improve my personal surgical technique, but the real value in my trip was the camaraderie and networking.  My eyes were opened to new ways of taking care of patients, and my hope is that I was able to share American ideas with my European counterparts as well.  I invited all those who I met to come visit my institution in Houston as well. In fact, I was able to host Prof. Torzilli and his partner Dr. Matteo Donadon in Houston at our EWALT 2019 Symposium in Houston, TX.  Again, I want to thank the ESSO for funding this observership and SSO for its partnership in promoting this tremendously enlightening program for SSO members.

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