President’s Annual Report – Sept 2014

Dear SASES members

Welcome to our AGM, and to the end of a busy but I believe productive year for your Society and its members. An election year AGM is an occasion to look back at what was achieved in the last two years, but also to plan for the future, and decide on the course that your Society should take and who should lead it. Thank you all for attending and ensuring that our society stays vibrant and relevant.


  • A new three-month SASES/J&J laparoscopic fellowship to Leuven in Belgium has been created and a fellow chosen who will leave in a month’s time. He will spend time in the University hospital, with 2000 beds, more than 100 ICU beds and 4 general surgery theatre slates per day. This is a general laparoscopic fellowship, and according to the principal there, Prof Andre D’Hoore, the candidate should be able to start a fully laparoscopic service after completing the fellowship. This is an unparalleled opportunity, and I cannot praise the efforts of Bob Baigrie and Masee Naidoo from your Exco, as well as Leanne Cook from Ethicon enough. The amount of work required to get this off the ground is astounding, and it is purely through their perseverance that we are able to offer this wonderful fellowship to our members.
  • You have heard from Emile Coetzee about his wonderful stay in Amsterdam.       Zaheer Moolla from Stanger is jetting off shortly on the SASES/Covidien colorectal fellowship to the AMC with Willem Bemelman. Hylton Strauss and the Covidien team has been tireless in ensuring the smooth operation of this fellowship.
  • Heather Bougard spent a European summer in Germany, you have heard her report and from first hand experience I can vouch that she has really turned her experience during the SASES/Storz fellowship to Streubing into practice at Somerset Hospital. It is an absolute pleasure to work together with Storz on this fellowship. Hugo Stark has already been, and has started changing to a  laparoscopic service in George Hospital.
  • We had a strong field of applicants, and am happy to have such quality candidates applying. We will shortly be advertising for next year. I would really like to see our more senior members apply for the fellowships as well. It is not only for fellows or newly qualified surgeons, and the scoring system actually favours older surgeons. It may be just what is needed to give your practice a mid-life kick-start! Yes, it means a long time from your current job, but what a sabbatical! What an opportunity! What an antidote for a midlife crisis!

Imagine the amount of work, time and perseverance needed to organize a fellowship, multiply it by ten, and one may approximate the true effort needed. To organize three and go through an election process for each is a gigantic task. For this I must thank Masee Naidoo and Bob Baigrie specifically and profusely. Well Done!

The SASES training courses have been well attended, and we are also involved with helping SASREG, our gynaecological sister society, with their suturing and myomectomy master classes. We have developed a definitive format for a two-day SASES Intermediate Course, which will cover lap cholecystectomy, appendicectomy and basic suturing skills. This will be presented to the College of Surgeons in October to be incorporated as a requirement for writing the final FCS exams. We have trained up faculty to present the course, and believe we now have the infrastructure available to offer it to the whole country. Please visit for the schedules.

In the meantime, our full suturing course will continue, as will our procedural courses and workshops on an ad hoc basis.

I must specifically mention Alp Numanoglu here, who is the Director of the Red Cross Hospital training unit and does much more than can be expected of anyone to make our courses run smoothly.

Alp has also been instrumental in creating and managing our Webinars, which has been a new project for SASES and works wonderfully. We have had excellent subjects and speakers, and wide participation. I urge you to make time to attend; it is clear, interactive and fully educational. All the old webinars are available on the website

We have received a wonderful selection of local and international videos for our Legacy video prize at this conference. It was something we started last year, and with the kind support of Legacy it now carries substantial prize money. All videos will also be loaded onto our website for posterity. Please keep this in mind throughout the year; when you are doing an interesting case, prepare it for presentation and maybe a share of the spoils.

The Hernia Interest Group, a subgroup of SASES, has been very active and we are proud parents of this fledgling grouping. In the year since birth, they have created a functional corporate alliance, written an excellent inguinal hernia guideline for South Africa which is in print, and Zach Koto has developed and started a roadmap for hernia training. Well done to Chairman Ravi Oodit and Vice-Chair Dino Sofianos. As SASES members, you are all automatically part of the HIG, and I would urge you to become involved in its activities; it addresses our commonest surgeries.

The formal SASES position statement on Laparoscopic Appendicectomy was published in August. This important document reflects current best practice, and sets the standard to which surgeons in South Africa should adhere. We believe that this draws a line in the sand in interactions with Medical Aids, and puts the responsibility and choice where it belongs: with the attending surgeon. The document was thoughtfully and elegantly put together by Dick Brombacher, helped by Eugenio Panieri. Please use it in your interaction with Funders; it has been endorsed by the majority of HOD’s of the academic institutions and is the definitive guideline.

Hospital groups are putting more and more pressure on surgeons to use equipment from specific device manufacturers, often with no justification apart from cost. We are concerned about this, as it is one more attempt to subvert our independence and ability to do what we consider best for our patients. SASES have therefore commissioned Elsabe Klink, a lawyer very well versed in medical matters, to draft a position statement on the rights of surgeons and their choices regarding the devices they use. It has been finalized, is a very comprehensive and compelling document, and is available on our website. There is also a draft letter that can be attuned to your specific circumstances. I hope this will be a big stick to carry in our negotiations with the bean counters. Thank you to our honorary Secretary, Dick Brombacher, for putting this together. See

Your Society has met with device manufacturers and medical aids in an effort to smooth the application of laparoscopic surgery. Although this is a time-consuming and onerous task, we believe that ongoing interaction is the way to eventual cooperation. In this vein, I must also make a plea to members to remain gatekeepers of applicable and efficacious surgical care. Laparoscopic surgery is, rightly or not, perceived to be plagued by the two C’s: Cost and Complications. The only way around this is to ensure that we are at all times safe and cost-conscious surgeons. Eventually, it is to the benefit of everybody.

Lastly: any Society is only as good as its members and Exco. I believe our Society is vibrant, and it is a real pleasure to interact with members. Our “face” and very able administrative secretary is Susan Parkes, and she makes the Society machine run so smoothly that one tends to forget all the hard work it requires. Thank you Susan.

The Exco members spend an enormous amount of time and effort in service of the Society, mostly unsung, and I would like to thank and commend each one of them for making this Society alive, interesting and innovative. They have become good friends and have been unfailing in their support during my presidency.   I had the opportunity to entertain them and their spouses in George for a weekend around an Exco meeting, at no extra cost to the society, I may add. I would like to again thank each and every one of them for their unique contributions.

It is also a time to say goodbye to 4 long serving Exco members. Pottie Potgieter has been giving his all for the Society for 16 years, tirelessly and unselfishly working to advance our discipline. Every member know and respect him. He is still writing the history of the Society for us, and makes the most beautiful scrolls for our visitors. Dankie Pottie, ons gaan jou mis.

Stephen Grobler became chair of SAMA’s PPC recently, where he will continue to work for all our benefit. His almost superhuman stamina in making his various societal commitments despite a busy private practice has become legendary. I am happy that his huge knowledge of medical matters will be used at SAMA.

Bob Baigrie has been instrumental in making this a vibrant and innovative Society, and his efforts have taken us to a different level. He was the driving force behind the fellowships, our website, enhanced interaction with funders and industry… The list continues. Thanks Bob, well done and you leave SASES better than ever.

Reniel de Beer has served as treasurer with distinction. His calm, well thought out contributions have steadied many heated exchanges. I grant him his rest, but we will for sure press on his number again.

It has been a lovely two years. Thank you for entrusting me with your Society.

Danie Folscher