President’s Newsletter – May 2011 Bob Baigrie
Warm greetings to all SASES members and friends. It has been a busy start to the year and I can update you on the projects I described in the December newsletter.
EHPBA Meeting April CTICC
Our programme at the EHPBA meeting last month was most successful and we were well served by our excellent guest, Professor Abe Fingerhut. He is the current President of the European Association of Endoscopy and co-founded the European Surgical Association with Henri Bismuth. He is also President of European Society of Trauma and Emergency Surgery. This prestigious visitor gave several presentations, including an excellent plenary session address entitled "Laparoscopy for surgical emergencies". SASES sessions included colorectal, hernia, fundoplication and bariatric surgery. Several members also contributed to other sessions at the meeting. Professor Fingerhut then went on to Johannesburg to participate in a hepatobiliary workshop.
We are very grateful to Damon Bizos and Eugene Panieri, who were our representatives on the Johannesburg based LOC for this meeting. While the meeting was very much centred on the EHPBA programme, the other societies did manage to conduct worthwhile sessions with fair attendances.

Discovery Health and rigid sigmoidoscopy
This has been a topic of engagement between SASES and this funder for several years. Most members will be aware of the R2000 co-payment required for in-hospital endoscopy. This co-payment has always been applied to rigid sigmoidoscopy as well, despite the overall cost of this procedure being less than R100 to the hospital and surgeon (at the Discovery rate with the modifier for a scope performed as part of another procedure). SASES have argued that patients with severe anal pain (fissure, abscess, prolapsed thrombosed piles) who requires an emergency operation are not suitable for digital examination in the consulting room. They should have (at least) a rigid sigmoidoscopy at surgery to exclude rectal pathology. For this inexpensive procedure Discovery has required a R2000 co-payment (the surgeon's fee is R57). This negotiation began in 2009 and we are proud to announce that relentless negotiation with Dr Maurice Goodman of Discovery has resulted in an undertaking from Discovery that this co-payment will no longer be required from 1st August 2011. See his recent letter below.
Dear Bob,
I have just had notification from our systems area that this will be fully automated and tested for implementation in the first week of August.
As stated below, it is in fact currently functional, but only on a manual basis, which is subject to error on occasion.
I thank you again for your patience during this process, which I know must feel unacceptably lengthy to you. However, I do assure you that we have given this the highest possible priority within the business.
Thanks again for your patience.
Regards,
Maurice.
I would like to thank Dr Goodman for his participation in these negotiations, which were struggling to make headway within Discovery until he made himself available for us to engage directly with him. Any problems with this can be directed directly to Dr Goodman at mauriceg@discovery.co.za.
Dr Goodman has undertaken to look into several other issues for us. These include an incentivisation for endoscopists who undertake colonoscopy in their rooms without an anaesthetist. This saves the funder a substantial amount. SASES has proposed that the endoscopist should be rewarded with an increased fee (perhaps via a re-introduction of a conscious sedation fee) funded from the R2000 co-payment, which currently accrues directly to the funder.
Travelling Fellowships
SASES is proud to report that after a lot of co-operative negotiation, we have secured a contract for second annual travelling fellowship - the Storz/SASES Laparoscopic fellowship (see www.sases.co.za for details). This funds a surgeon for 3 months, to train with Dr Markus Walz in Barvaria, Germany. Markus Walz has hosted oneof our fellows, Morne Nel, in a trial run for the formal establishment of this fellowship, which has had the personal interest and endorsement of Mrs Storz. Applications are now open and the closing date for 2012 applications is 31 July.

The Covidien/SASES Travelling Fellowship was our pioneering fellowship and it has come of age now. Masee Naidoo was our first recipient in 2010 and Monde Majoli is our second fellow. We have now secured an annual slot for a surgeon in the Amsterdam Medical Centre (AMC) with Professor Willem Bemelman, an internationally recognised laparoscopic surgeon, who will also be part of our faculty at the Champagne Sports Resort meeting in October. Monde is currently in Amsterdam. Application details for this fellowship are on the website.
Website
The introduction of the new website has seen an encouraging flush of new membership applications. The website is all about making the Society an accessible organisation and improving communication and activities. Current highlights are the fellowship reports and applications, a history of the society complied by Andre Potgieter, a position statement on SILS and the October conference website link.
Champagne Sports Resort Meeting 20-23 October 2011
Extraordinary Faculty of Internationals (UK, Australia, USA, Belgium)
This is our BIG project. We have never had a "stand-alone" meeting before, besides our very first one in 1993. The original programme for this meeting is on the website. Traditionally we have linked with either SAGES or ASSA in alternate years. The early EHPBA/ASSA/SASES/SAGES/TSSA meeting this year opened up the calendar for our own meeting and we have picked the end of October for our meeting because of the ideal weather conditions at that time. It is also the weekend of the RWC final in Auckland at 10am on Sunday 23rd.
We have been overwhelmed with international faculty interest and currently have 12 confirmed high profile international visitors. These are Derek Alderson (Birmingham, UK), Michael Bailey (Guildford, UK), Ian Beckingham (Nottingham, UK), Willem Bemelman (Amsterdam Medical Centre, Holland), Karl Fuchs (Frankfurt, Germany), Mike Griffin (Newcastle, UK), Jim Hill (Manchester, UK), Glyn Jamieson (Adelaide, Australia), Mark Smithers (Brisbane, Australia), Dilip Parekh (Los Angeles, USA), David Watson (Adelaide, Australia), Tim Tollins (Belgium)
In addition to the formal conference sessions, we are going to exploit this faculty with a very strong "Coffee with the Experts" program. Each morning, faculty members will each sit at a round table with 9 delegates, marker pens and a flip chart, and engage in everyday topics with pithy no-nonsense discussions. Delegates will be asked to book these sessions closer to the time.
We are keen to attract trainees and young surgeons to attend this meeting. Trainees who have an abstract accepted, will receive major sponsorship to cover their costs. Please encourage your young colleagues to raed the abstract application form on the website.
The opportunity to play golf on this majestic course, rated the 24th best in South Africa, should not be missed. So that no one is tempted to miss a single academic session, we will book tees on Thursday morning and encourage all golfers to check in the night before and play for a society-sponsored prize.
Recent Academic meetings endorsed by SASES
We have organised, endorsed and participated in a number of academic meeting in the last period.
Covidien/SASES hernia Roadshow with Ian Daniels was based in several centres towards the end of 2010. Andre Potgieter and Stephen Grobler facilitated the Cape Town and Bloemfontein visits.
Covidien/SASES Colorectal Roadshow with Bill Heald and Ian Daniels took the same format of live operative surgery in several centres during March 2011. Bob Baigrie at UCT, Andre Potgieter at N1 City, Damon Bizos at Donny Gordon and Masee Naidoo at Albert Luthuli facilitated this roadshow.
Another roadshow is planned by Covidien in November.
Ethicon Endosurgery/SASES UCT Laparoscopic workshop formed part of the very successful UCT Surgical Update Course in March 2011. Damon Bizos, Bob Baigrie and Andre Potgieter participated in the operative surgery program.
Other Ethicon Endosurgery/SASES workshops completed this year include lap inguinal hernia surgery at RK Khan, lap cholecytectomy surgery at George Mukhari, lap incisional hernia at RK Khan. Further stapling, suturing, and cholecystectomy workshops will occur throughout the year at other centres.
National Laparoscopic Training Centre
This is an immensely exciting project which has been driven by your EXCO, various funders, Western Cape DoH, UCT and Stellenbosch University, College of Gynaecology, Red Cross Childrens Hospital and Groote Schuur Hospital. There is general acceptance of the project principles. A broad based working party of seven is preparing the business plan and implementation process. The recent elections in the Western Cape meant there was a pause in commitment by provincial government, but its re-election should mean continued impetus.
We hope to provide the membership with feedback on this exciting project at the October meeting.
Surgicom and SAPPF
Stephen Grobler commits endless hours to these commitees and has done a remarkable job for his fellow surgeons over more than a decade. a link is provided to an article written by Steve in Medical Chronicle recently. It is an excellent article combining fact, experience and wisdom. I recommend it to you.
http://sases.org/money-is-the-root-of-all-evil/
History of SASES
Andre Potgieter has put together this worthwhile document, which provides some insight into the amount of commitment required by our surgical community to keep all our specialty associations alive.
http://sases.org/history-of-the-society/
Communicating with the President
I welcome any questions, suggestions or complaints in the hope that the current exco can best serve the SASES membership. Please feel free to direct these to me at robertb@surgcare.co.za
Best Wishes,
Bob Baigrie
President