KINGCA WEEK 2022

This is a program to equip participants with highly practical learning relevant to their clinical practice in performing gastric cancer surgery through surgery observation, journal & video reviews, and open discussion. The program will provide up-to-date information on surgical techniques, clinical trials and deliver practical information about perioperative patient care. Our department also frequently deals with patients with EGJ cancer esophageal cancer, providing participants with an opportunity to observe technically demanding esophageal cancer surgery via a minimally invasive approach. This program is designed to meet the educational needs of general surgeons, fellows, and residents who are interested in upper GI cancer surgery and perioperative care.

• 1. Seoul National University Hospital http://www.snuh.org/english/
• 2. SNU Cancer Hospital http://cancer.snuh.org/
• 3. Division of GI Surgery & Lab. of Gastric Cancer Biology

The Gastric Cancer Center at Seoul National University Cancer Hospital (SNUCH) is a world-renowned institution specializing in the treatment and research of gastric cancer. Each year, the center performs approximately 1,000 gastric cancer surgeries, with a morbidity rate of 10% and a mortality rate of 0.5%. As of 2007, the center has conducted over 20,000 gastric cancer surgeries, making it the global leader in terms of procedures performed at a single institution.

The SNUCH Gastric Cancer Center has provided invaluable educational opportunities to over 100 international clinicians, primarily faculty members from leading global institutions. The center has developed a comprehensive educational program tailored to academic physicians from around the world, including those from China and Japan. Since 2009, the center has maintained a fellowship exchange program with the Roswell Park Cancer Institute, hosting one or two surgical oncology fellows each year. To date, seven fellows have completed a one-month elective training course at the center.

In addition to the fellowship program, the SNUCH Gastric Cancer Center has welcomed numerous short-term visitors from various countries through a range of channels. Due to the high volume of cases handled weekly and the robust research activities conducted at the center, it is an ideal destination for international visitors seeking education in gastric cancer, even for brief periods of a few weeks. Although the visitor program was temporarily suspended in December 2019 due to the COVID-19 pandemic, it resumed in June 2022 and has since welcomed 32 short- and long-term visitors.

This comprehensive practical education course is designed to provide participants with hands-on experience in treating a diverse range of gastric cancer patients within a short span of a few weeks. The primary objective of this course is to impart a well-structured understanding and knowledge of gastric cancer treatment methodologies

Participants in this program will gain knowledge of the fundamental principles of gastric cancer treatment, with an emphasis on surgical interventions such as lymph node dissection, post-operative management, and chemotherapy. It is our hope that these experiences, coupled with exposure to a substantial number of gastric cancer patients, will enable attendees to effectively implement these practices in their home institutions. Furthermore, this course serves as a platform for introducing and discussing ongoing research projects at Seoul National University Hospital (SNUH), fostering the development of international collaborations among gastric cancer researchers.

• - Operation schedule:

  Routinely 20 gastric cancer surgeries per week

  1. · Robotic surgery: Wednesday
  2. · Laparoscopy or Open surgery: Monday to Friday
• - Types of operation: Distal Gastrectomy, Pylorus Preserving Gastrectomy, Total Gastrectomy, Proximal Gastrectomy, etc.
• - Concept and details of lymph node dissection: D1+ and D2 LN dissection
• - Review and discussion of selected articles from SNUCH on gastric cancer

• - Inpatient ward rounds
• - Outpatient clinic: Wednesday (PM), Thursday (AM. and PM)

• - Surgical Grand Round of the Department of Surgery (Wednesday 07:00)
  

  Lectures by invited speakers on all topics associated with surgical diseases (in English)

• - Multidisciplinary Stomach Case Conference (Wednesday 17:00, biweekly)
  

  Case conference for decision-making or review (participants: surgeons, medical oncologists, radiologists, gastroenterologists, pathologists, and nuclear medicine specialists)

• - Tumor Clinic of the Division of Gastrointestinal Surgery (Friday 07:00)
  

  Post-operative morbidity & mortality conference and journal review

• - Discussion of ongoing research activities by clinicians, the Gastric Cancer Biology Lab, and collaborating researchers

• - Observation of endoscopic submucosal dissection (ESD)
• - Observation of gastroscopy and endoscopic ultrasound (EUS)
• - Hans-on training course

A. Operation

• - Understand basic surgical principles of gastric cancer and lymph node dissection.
• - Understand the techniques and surgical principles of function-preserving gastric cancer surgery.
• - Observation of about 15-20 operations

B. Post-op care

• - 2 to 3-day ward rounds and 1 session at the outpatient clinic

C. Conferences

• - Multidisciplinary Stomach Case Conference: 1 time
• - Tumor Clinic and Surgical Grand Round: 1 or 2 times

D. Research meetings

• - 2 times

E. Endoscopic treatment

• - Endoscopic submucosal dissection: 1 session

F. Concluding remarks at the end of the visit

• - Presentation of a summary of each individual experience; feedback from the faculty

• 1) Following the visiting our hospital, visitor can obtain
• - the basic principles and knowledge of treatment for gastrointestinal disease including gastric cancer, benign GI disease, and others.
• - the concept of minimally invasive surgery (reduced-port laparoscopy and robotic) in GI disease.
• 2) Collaboration of clinical practice as well as academic works can be possible.

• 1) You can enjoy the hospital which is located at the center of Seoul. It has the latest equipment including da Vinci robot surgery system and the newest laparoscopic suites. Seoul St. Mary’s Hospital gained JCI and AAHARP approval that means the safety of patients as well as research activity are top class value.
• 2) We have our own training center for minimally invasive surgery (MIS) which has simulators of laparoscopy and da Vinci. This means you can experience the preclinical and clinical training tool for MIS.
• 3) Our department has unique surgical endoscopic suite to perform diagnostic and surveillance gastrofiberscopy and we have our own training module for trainee. During your stay, you can see the endoscopy which is performed by surgeons.
• 4) We have fancy guest house and dormitory for foreign doctors to serve comfortable stay.

• 1) observation of surgery: on-site training for operation
• 2) participation of academic conference: basic knowledge of treatment for gastric cancer, benign gastric disease, other upper intestinal disease
• 3) daily rounding: postoperative care
• 4) surgical endoscopy training
• 5) experience of various MIS training modules including laparoscopic, robotic simulators.

• 1^st day: Robotic gastrectomy
• 2^nd day: Open gastrectomy
• 3^rd day: Laparoscopic/robotic gastrectomy
• (Observe at least 5 surgical cases over 2 days out of 3)

Observation of various surgeries including laparoscopy, laparotomy, and robotic surgery for 3 days.

Gastroscopy description exercise, gastroscopy hands-on training and others

- Surgery Observation: Laparoscopic Subtotal/Total Gastrectomy for EGC/AGC

- Journal Conference