December 5, 2019
By Dr Jonathan Potts, Sheila Sherlock Liver Centre, Royal Free Hospital, London, UK
I was fortunate to be one of ten endosonographers selected to attend the second WEO International School of EUS (WISE) in 2019. This intensive course is the brainchild of Professor Dong Wan Seo, a visionary and world-leader in EUS and inspirational pancreatobiliary physician. The WISE participants included physicians and surgeons at the start of consultant/attending careers with a wide range of experience from around the globe, who quickly formed a tight knitted group.
Picture: Dr Jonathan Potts with Professor Dong-Wan Seo, WEO International Course Director
The experience began in June 2019 with module 1, held over 10 days in Seoul, South Korea. The course commenced with attendance at the Korean Society of Gastrointestinal Endoscopy (KSGE) EUS hands-on workshop, held at the state-of-the-art Olympus K-TEC training facility in Incheon. The meeting began with a pre-course quiz on EUS anatomy, followed by didactic lectures focusing on the physics and anatomy of the EUS examination. WISE participants were afforded the opportunity to present their experience to date, share difficulties and challenges encountered, and receive advice from the expert faculty. The latter part of the workshop involved hands-on EUS using porcine models, focusing on identification of the vascular anatomy and fine needle aspiration (FNA) technique. The following five days were spent with Professor Seo and his team at Asan Medical Centre (AMC). This 2700 bed hospital is one of just 18 WEO Centres of Excellence worldwide, with a tertiary HPB endoscopy service that conducts approximately 15,000 pancreatobiliary endoscopies per year. The days were spent observing a broad mix of procedures, including diagnostic and therapeutic EUS and ERCP, as well as attending ward rounds with Professor Seo. Further hands-on sessions took place in small groups in the laboratories attached to AMC, practicing identification of the key anatomy on porcine models, as well as FNA technique using phantoms. The evenings included lectures from experts within Asan, as well as further afield in Korea. The course focused heavily on video editing as part of the learning experience, and each participant produced a video demonstrating different aspects of the EUS examination, which were shared amongst the team. The formal teaching component of the module culminated with a practical examination on vascular anatomy identification and FNA technique by Professor Seo. At the end of the first module all participants attended the 2019 International Digestive Endoscopy Network (IDEN), enjoying lectures by an array of renowned speakers on all aspects of gastrointestinal endoscopy.
Between modules 1 and 2 there was a web-based video case conference at which each participant presented a case from their clinical practice in the 6 weeks since the first module. This was supervised by Professor Seo who provided invaluable feedback and tips.
The WISE participants returned to Seoul for module two at the end of September 2019. The focus for the second module switched from diagnostic to therapeutic EUS. The course followed a similar format to the first, comprising of observership within the AMC’s pancreatobiliary unit and wards, interspersed with didactic lectures and hands on practice in the labs. The techniques learnt included a wide array of EUS interventions, including radiofrequency and ethanol ablation and pancreatic fluid collection drainage. The lectures, again delivered by experts from Asan and other major Korean centres, focused on procedure indications and case selection, as well as technical aspects. The latter part of the second module included attendance at the 2019 EUS Summit, which was also held at Asan. This course included a fabulous selection of didactic lectures on all aspects of EUS intervention, followed by an intensive hands-on session using specific phantom models simulating EUS-guided biliary drainage (EUS-BD), EUS hepaticogastrostomy (HGS) and pancreatic fluid collection drainage. The WISE group submitted an oral abstract on pancreatic cystic lesion recognition and management, drawing upon the global experience of the international participants. The WISE finale was a graduation ceremony, held on the 8th October.
My WISEst experience
There have been so many benefits of attending WISE that it is difficult to know where to begin. The rigorous technical approach taught during the two modules has transformed my endoscopic practice, and opened my eyes to new diagnostic and therapeutic techniques that will benefit patients in my home centre, and those of the other participants. Professor Seo has been a truly inspirational mentor and his enthusiasm for EUS is contagious; he and his colleagues could not have been more welcoming or accommodating. The organisation by Laura and the team from WEO were exceptional throughout. The WISE group remain in frequent contact and regularly discuss cases via messaging or email. The formal learning continues following the course, with a further video conference scheduled in early December, and a reunion due at the Asian EUS Summit to be held in Hyderabad in February 2020, which most participants will be attending.
On behalf of the whole WISE group I would like to convey our heartfelt thanks to the WEO, Professor Seo and all involved in the organisation for providing this unique and invaluable educational opportunity.
Jonathan Potts, MD
Application for the third WISE course 2020 is now open.
Deadline for application is December 15, 2019.
The Basic Anatomy Workshop and Two WISE modules are taking place as below:
(1) Basic Anatomy Workshop
Date: February 7-9, 2020
Venue: Olympus Korea Medical Training & Education Center (K-Tec), Songdo, Incheon, South Korea
(2) WISE 2020 Modue One
Date: June 6-13, 2020
Venue: K-Tec, Asan Medical Center, Grand Hilton Seoul, South Korea
(3) WISE 2020 Module Two
Date: 23-29 September, 2020
Venue: Asan Medical Center, South Korea
An expert group of international trainers will ensure the quality of the training, with the help of first class lab facilities and advanced technical equipment.
For more detailed information about the program, please go to: www.worldendo.org/education/weo-international-school-of-eus-wise