ISGE July 2005 Volume 13

Editor: Togas Tulandi, MD
ISGE Secretariat
Dr. Bruno van Herendael
Italilei, 62,
2000 Antwerp, Belgium,
tel 00 32 3 2133750 / fax 00 32 3 2720797
info@isge.be  

Inside this Issue:

• Editor's Corner
• President's Message
• ISGE website 
• Registry of Cervical Pregnancy  
• Situation of Gynaecologic Endoscopic Surgery in Belgium

Editor's Corner
Togas Tulandi, MD

Innovative Technologies
E-mail communication

We are in the cyber-era. Many conventional “snail” mails have been replaced with emails. Electronic mails allow easy, fast and economical communication. It is ideal for short messages, and quick questions and replies. For ISGE with members from around the world, it is a convenient way to communicate; time-zone is not a factor anymore. You send your e-mail and the receiver replies at his or her convenience. It helps us stay connected. 

The ease of communication electronically has been noticed by editors of many journals. For most publications, we can submit the manuscript electronically. For us who regularly review manuscripts for medical journals, electronic reviewing has been time-effective. 

The executives of ISGE have used e-mail widely. They communicated with each other electronically. E-mail does not replace telephone calls or meetings, but it has been effective and economical. 

The ease of communication should encourage you to communicate with us. Send your view or opinion to the Society’s office or to me for publication in ISGE NEWS. As an International Society, we wish to know for example endoscopic work or activity in your hospital or country. Your article or message will be printed in the newsletter and also in the ISGE website. 

For more information about the website (www.isge.org), in this issue of ISGE NEWS you could read a message from our webmaster, Tamer Seckin. Our administrative director, Bruno J. van Herendael discusses the situation of gynecologic endoscopy in Belgium. 

Togas Tulandi MD, MHCM 
Editor

President’s Message
Harry Reich, MD

Dear Members, 

Buenos Aires is a special place! Please join me, Roberto Sainz, and the ISGE community at the 15th Annual Congress of the International Society for Gynecologic Endoscopy. I have had the privilege of teaching at two ISGE workshops here and am sure that by the time the meeting ends, you will have learned much about the latest endoscopic advances and about the charm of this great country, including, of course, the tango. 

Also of great importance at this meeting is the opportunity for all of us interested in furthering the acceptance of gynecologic endoscopy to get closer to the formation of a real world wide federation of gynecologic endoscopic societies. 

We hope to see you in South America in 2006 and will do our best to make this a most enjoyable meeting! 

Dr. Harry Reich 
ISGE President

ISGE website 
Tamer Seckin MD 

ISGE website has been online since the early months of 2004. The Society strongly believes that its presence on the worldwide web with a most advanced format, will serve the mission of our society; helping  women from all around the globe with the option of "no scar surgery"- endoscopic surgery, and offering our members and surgeons a hub of information platforms linking to global health communication networks.

 Since the launching of the website, over 300 new members have registered to our society via the website which accepts online major credit card transactions. Website has successfully promoted our Annual Congress and Regional Meetings. 

The website is designed as static in its behavior for the visitors but dynamic for ISGE members. The facade of the site consists of four gateways. These gateways are respectively designed for patients, healthcare professionals, industries, and members. 

Visitors can enter freely without any password and browse around the hallways of ISGE. For example, patient looking for hysteroscopic treatment of her fibroid can retrieve static information at the uterus kiosk. Similarly other kiosks supply written and graphic basic information. 

Dynamic aspect is the interactivity of the site for our members. This particular feature distinguishes us from the other societies' websites. As activation is initiated by entering a password, members enjoy the benefits of ISGE membership at different levels. Members can have their isge.org emails if they wish, or they can have their web page customized under ISGE flag from templates. 

The ISGE website team guarantees top “google” search sensitivity to this URL. In the near future, online chat forums will be available for special topics chaired by experts, as will be patient referral by city and country. 

The Website has a more complex level of functionality at the administrative level, where entry is only permitted to EXCO members and administrative officers. Database of members, mass emailings, remote site managements and accounting management are among the few other features. 

Even though our society has limited financial resources for launching the website, significant progress has been made with the help of programmers and designers who generously donated their initial work. The Singapore Endoscopic Society has pledged to assist us financially. This monetary amount was equally matched by contribution from an anonymous lifetime member to balance our present monthly expenses. In London April 2005, we added new advisors. I welcome Drs. Charles Miller and Thomas Lyons as advisors to the website team. 

We are still in Beta-version of our customized software. Website Team realizes perfecting the features of the program and I need your feedback. Please visit the site, and send your suggestions to drseckin@isge.org.

Registry of Cervical Pregnancy 

Cervical pregnancy is a rare form of ectopic pregnancies. However, it is far more common in pregnancies achieved through assisted reproductive technologies. There are many reports on medical and surgical management of these conditions. However, due to its low incidence, most authors published only case reports of small number of patients. In order to evaluate the best management of cervical pregnancy, a registry is needed. Gynecologists who encounter this condition are requested to contact Dr. Togas Tulandi to obtain a simple and standardized form. He can be contacted at togas.tulandi@mcgill.ca or by fax at 1-514-843-1448. Your participation is important.

Dear colleagues and Friends 

The International Society for Gynecologic Endoscopy has honored Argentina as the venue for its XV Annual Congress in the year 2006, precisely in the privileged, fantastic though real city of Buenos Aires, where we will be glad to offer you our best. Once again, ISGE summons highly educated specialists from all over the world, allowing us to show the final check of high technology, and letting us enjoy the tuning of gynecological endoscopy and minimally invasive surgery. 

I am very pleased to officially invite you to Buenos Aires, committing myself to lead this Congress to a successful end. 

Sincerely yours, 

Dr. Roberto J. Sainz 
Congress President

Situation of Gynaecologic Endoscopic Surgery in Belgium 

Bruno J van Herendael 
Professor endoscopy Universit degli studi dell’ Insubria Varese Italy 
Coordinator Gynaecologe and Gynaecological Oncology ZNA STER Site Stuivenberg Antwerp Belgium 

Introduction 
For non-Belgians, the situation in the Kingdom of Belgium is somewhat complex and difficult to understand. We have a federal government in Brussels, as well as three others: the Flemish, the Walloon and the Brussel governments. The ministry of health is under the federal government but healthcare is decentralized and under the jurisdiction of the three regional provincial governments. 

Practical situation 
In Flanders, all gynecologists are members of the national society, the Vlaamse Vereniging voor Gynaekologie en Verloskunde (VVOG). A similar society in the Walloon part is the Groupement de Gyncologues et Obsttriciens de Langue Franaise en Belgique (GGOLFB). Both organizations are under the umbrella of the Royal Belgian Society for Obstetrics and Gynaecology. Here, all official contacts between the two societies take place. 

On the Flemish side, Jan Bosteels and I are the founders of the Gynaekologisch Endoscopisch Platform (GEP) a commission of the VVOG. Currently, there is no similar organization in the French side. However, our immediate past president Jacques Donnez is in the process of setting up a task force for endoscopic surgery within the GGOLFB. The GEP has 64 members dedicated to the promotion of gynecologic endoscopic surgery. This represents 12% of all VVOG members. 

Although Belgium has a unique federal system of incentives to promote endoscopic surgery, the number of endoscopic procedures is still limited. On the federal level, a system was created to reward surgeons who operate using an endoscopic approach. Between 75 € and 180 € are added to procedures performed by endoscopy. 

In order to reduce operating, we mainly use non-disposable instruments. However, we also use non-disposable products such as endo-bag and sutures. 

The government realized that endoscopic surgery is cost effective; it is associated with rapid return to work, and reduced cost of medication and hospitalization. As a result, the federal government infused more funds for endoscopic related activities. 

The mission statement of GEP is: 

• to promote endoscopic surgery by organising courses and conferences 

• to develop guidelines for endoscopic surgery 

• to provide accreditation to endoscopic surgeons and surgical facilities 

• to develop a registry for endoscopic surgery allowing quality assessment 

• to negotiate better payment from third party payers including the insurance companies 

Our activities include writing guidelines for abdominal entry and for hysteroscopic surgery. With the help of our colleagues including Ivo Brosens, Philippe Koninckx, and Rudy Campo’s group, Jan Bosteels and I have also completed a consensus text on the future of endoscopic surgery in Flanders. Although endoscopy has become a standard of care in gynaecologic surgery, we believe that endoscopic surgery is not for every gynaecologist. Each gynaecologist should know his or her own skill and limitation in practicing endoscopic surgery. However, all gynecologists should possess basic endoscopic skill, whereas advanced endoscopic surgery should be performed by experts in specialised centres. These experts and institutions should be accredited. 

Conclusions Many experts in gynaecologic endoscopic surgery are from Belgium. They include Jacques Donnez, Ivo Brosens, Rudy Campo, Stephan Gordts, Patrick Puttemans, Philippe Koninckx, Jan DePrest, and me. My centre in Antwerp, the Endoscopic Training Centre Antwerp (ETCA) provides hysteroscopic training to all Flemish residents. However, only 12% to 15 % of all gynaecologic operations in Belgium are performed by endoscopic route. It is hope that endoscopy will become our standard surgical procedure. Until then, more work remains to be done.