Laparoscopic Gynecology in Israel

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Dr. Larry Demco: "I’m at the World Congress of Endoscopy here in Tel Aviv, Israel, and I’d like to now interview the Chairperson of the Organizing Committee - Dr. Abraham Golan who’s been instrumental in launching laparoscopy here in Israel. Dr. Golan, can you please give the OBGYN.net listeners a little background on laparoscopy and the status of laparoscopy in Israel?"

Dr. Abraham Golan: "Laparoscopy has been practiced in Israel for many years obviously, however, operative laparoscopy started in Israel relatively later than in the United States, I would say some time at the first half of the last decade of the 20^th century. We got more organized last year, and in February of 1999 we founded the Israel Society of Gynecological Endoscopy, although endoscopies were done in Israel in many places a few years before. So the society has been established in February of last year and we’re a young society. I’m the first elected President of the society and we’re trying our best to promote operative laparoscopy and operative hysteroscopy to get more and more young doctors to do the procedures. I can say in my own department about 50%-60% of all operations are done endoscopically today, however, I cannot say that for all the departments in Israel. There’s still some hospitals and some departments where the proportion is much, much, much lower and we hope to change all this."

Dr. Larry Demco: "The turn out in the society here and looking over the program, I was very impressed in the quality of the speakers the society here got together. Can you just give us an overview of some of the highlights as you saw from the Congress here?"

Dr. Abraham Golan: "It seems to me that the Congress is going very well. We learned quite a lot here, all of us, about supracervical hysterectomy which seems to be a new trend in operative laparoscopy before total hysterectomy, this is my own impression. I am quite impressed, and actually practicing myself in trying to push it here in Israel, the operative hysteroscopy and normal saline, which I think is very, very important especially for somebody that had a chance to see great complications from distension media like glycine, the hyporosmotic distension medium with the grave complication of hyponatremia. There were two cases of that in Israel from regular glycine so I’m very impressed by the operative hysteroscopy in physiological solution, and I think this is one of the highlights of the convention here.

There are many other things, safety and safety methods, which were discussed here quite in length, which is always going to be an important subject. Safety was discussed concerning the port of entry especially in the complicated cases with previous abdominal pelvic surgery, obese patients, and open laparoscopy as against various types of trocars. They’re readily expanding the new - I’m not sure how they term it - Dr. Artin Temormin from Canada, I believe is the one that goes and turns in, and in fact, lifts up the abdominal wall. It seems very promising and safety measures and precautions concerning the use of electrical power. These subjects are always going to be of major concern to all of us. I’m sure that if somebody comes to a convention, let’s say, in five or six years time, we’ll still argue about it and discuss it again and again as long as we do surgery.

Endometriosis is a subject on which you did quite a lot on, Dr. Demco. As somebody said - there’s problems about the diagnosis of endometriosis, there are problems about the treatment of endometriosis, obviously there’s problems about the explanation of how does it occur and - problems, problems, problems. One of the subjects that you presented so well is the method of pain mapping in endometriosis which I think is fascinating. Carrying the diagnostic procedure where the patient is conscious and your being able to actually map it according to the patient’s response, I was very impressed. I thought it’s very important. And chronic pelvic pain, adhesions, and fibroids are various alternative treatment to fibroids like myoma coagulation on the one side and embolization of the uterine artery besides, of course, all the operative techniques, myomectomy that way and the other way and bipolar electrosurgery."

Dr. Larry Demco: "One of the things, as you pointed out, there’s some of these new techniques that are on the horizon and it was highlighted here at the conference. Are you planning to have an annual conference or when do you think the people in Israel are going to put on another conference for us?"

Dr. Abraham Golan: "We definitely are going to put on an annual conference. In fact, we have the Israel Society meeting once every three months for short half days usually just the edge of the weekend on Friday. We discuss various case presentations and some of the specialists are giving state of the art lectures in various subjects. We’re going to do one Congress a year only, I’m not sure that we can lift up such a Congress with such an enormous serious and fascinating faculty as we have this time so I’m optimistic but the future will tell."

Dr. Larry Demco: "I really appreciate you having this Congress to bring us all together here, and we’ll be looking forward to the announcements of your future conferences which I hope will be well attended as this one was. Thank you very much."