I was given a personal tour of the campus by Dr. Victor Fazio and was fascinated by its history and sheer size. I observed several procedures in the operating theatre, including an impressive single port panproctocolectomy plus pouch-anal anastomosis performed by Dr. Dan Geisler. I met Dr. Ian Lavery – who was particularly friendly – and watched him perform several procedures, including a diverticular resection and an ileal-pouch. I also met the British Traveling Fellow, Mr. Angus Watson, from Inverness, Scotland, who was visiting Cleveland at the same time.
The following day, I attended a research symposium for the residents and fellows in Cleveland, and listened to several excellent presentations.
I next visited the Department of Colon and Rectal Surgery at the University of Minnesota. Here I met with Dr. David Rothenberger and spent the morning observing in his outpatient clinic. I then spent time on the wards and went on rounds with Dr Rothenberger, where I encountered many interesting and extremely complex cases. Afterwards, I observed an endoscopy list with Drs. Mary Kwaan and Robert Madoff, and saw some unusual cases.
The following day was spent at the “Quirke Symposium”, a meeting that concentrated on different aspects of rectal cancer management. It featured wonderful lectures from international guest speakers, including Prof. Philip Quirke, Mr. Bill Heald, and Dr. Anders Mellgren and Nancy Baxter, to name but a few.
The symposium offered me the opportunity to meet with Dr. Andrew Renehan from Manchester and Dr. Stanley Goldberg. The symposium finished with a trip to the pathology laboratory where Prof. Quirke examined some colon and rectal resection specimens from the department. His ideas on mesocolonic and mesorectal excision, and grading of surgical specimens, made for an interesting discussion.
Next, at the International Council of Coloproctology meeting, I presented audience members with an update on colorectal surgery and training in Ireland and interacted with some of the other traveling fellows – including Mr. Ian Jenkins from St Mark’s Hospital, London, and Dr. Joseph Plummer from Jamaica. Both gave excellent presentations from their own countries.
The ASCRS meeting then took place over the following few days and I learned a great deal from the many lectures and presentations. In particular, I found the presentations on rectovaginal fistula repair (Dr. Andrew Shelton), LIFT procedure (Dr. Goldberg), Norman Nigro lecture (Prof. Quirke) and the Harry E. Bacon Lecture (Prof. Lord Darzi) fascinating. I also met with Dr. Werner Hohenberger at a late night welcome reception and enjoyed listening to his lecture on mesocolonic excision. I plan on keeping in contact with several fellows and residents from around the world with whom I met during the meeting.
On the last day of the meeting, I had the privilege of presenting a short update on “New Frontiers in Colorectal Surgery,” with particular focus on some of the changes currently taking place in Ireland.
Overall, I thoroughly enjoyed my time in the U.S. and feel that I have gained a lot from the experience. I learned a lot from the people I met and various lectures I attended. This knowledge will benefit me and, more importantly, my patients, in my future career. I would have spent even more time on the fellowship, but work and family commitments prevented this.
I would like to thank Profs. Ronan O’Connell and Des Winter for supporting my application for the fellowship. I would also like to thank the International Council of Coloproctology, including Dr. Graham Newstead, and the ASCRS for this wonderful opportunity.