Caribbean College of Surgeons 13th Annual Clinical Conference

June 11-13, 2015 Radisson Aquatica Resort

Barbados, West Indies

Programme Wednesday, June 10, 2015 8:00 pm Prof. Sir Errol Walrond Pre-Conference Lime Sandy Lane, St. James Thursday, June 11, 2015 8:00 am Registration 8:50 am Welcome: Secretary CCOS

Charles Greenidge – St Lucia

8:55 am Opening Remarks: CCOS President Deen Sharma – Guyana

CME Session 1 Moderator: D Sharma / S Jackman  9:00 am Leadership in Caribbean Surgery – Vision and Role of the CCOS

Ramesh Jonnalagadda - Barbados 9:20 am Postgraduate Surgical Training for the Caribbean

Prof. Vijay Naraynsingh – Trinidad & Tobago 9:40 am Medico-legal documentation – best practice

Prof. Sir Errol Walrond - Barbados 10:00 am Challenges & Successes to set up a Laparoscopic Surgery Service in the Third World Setting Charles Greenidge – St Lucia Distinguished Guest Lecture Moderator: C Greenidge – St Lucia 10:20 am Multidisciplinary Management of Advanced / Metastatic Colon Cancer

Prof. Paul Horgan – Glasgow, United Kingdom 10:50 am Viewing of Posters and Sponsors’ Exhibits Posters (1-5) / Judges

CME Session 2 Moderator: M O’Shea / C Wilson 11:20 am Pre-operative preparation of the patient for “fast track” colorectal surgery Patrick FaSiOen - Curacao 11:40 am Centres of Excellence: What does this mean in the Caribbean?

Dilip Dan - Trinidad 12:00 am Metastasectomy for Colon Cancer Secondaries: Thoracic Surgeon’s Perspective Alan Smith - Barbados 12:20 pm Metastasectomy for Colon Cancer Secondaries: HPB Surgeon’s Perspective

Wesley Francis - Bahamas 12:40 pm Lunch  Scientific Session 1 Moderator: C Warner / N Bascombe 1:30 pm State of Emergency in Trinidad & Tobago: The Effect on Admissions for Penetrating Trauma at the National Trauma Centre Milne DM, Ramdass MJ, Cawich SO, Pooran S, Ali E, Naraynsngh V - Trinidad & Tobago 1:40 pm Cardiac Stab Wounds: A Case Series Smith AI, Powlett CL - Barbados 1:50 pm Retained Rectal Foreign Bodies: A Management Algorithm Mohammed F, Cawich SO, Thomas DA, Bobb NJ, Naraynsingh V - Trinidad & Tobago 2:00 pm Lower Limb Amputation Outcomes of a Prosthetic Fitting Programme in Barbados Sumpio BJ, Mahler D, Jonnalagadda R, Warner G, Walcott P, Sumpio B - Barbados / U.S.A. 2:10 pm MRSA Carrier Rates in Health Care Professionals in a Non-Outbreak Setting at San Fernando

General Hospital: A Prospective Study Aziz I, Islam S, Dan D, Akapaka A, Naraynsingh V - Trinidad & Tobago 2:20 pm Questions and answers Panel Distinguished Guest Lecture: Moderator: N Bascombe / C Warner - Trinidad & Tobago 2:30 pm A New Reusable Device for Trans-Anal Minimally Invasive Surgery: First Report Prof. Giovanni Dapri - Belgium 3:00 pm Viewing of Posters and Sponsors’ Exhibits Posters (1-5) / Judges

Scientific Session 2 Moderator: Prof. M Branday / S Pooran 3:20 pm Appendicitis in the paediatric population of Tobago – 2014 Gordon D, Briggs K, Lewis N – Trinidad & Tobago 3:30 pm Are we doing better? Barium Enema Reduction of Intussusception Rampersad B, Pran L, Baijoo S - Trinidad & Tobago 3:40 pm Absence of the appendix discovered during childhood Vincent MV, Doyle A, Bernstein S, Jackman S - Barbados 3:50 pm Current Practice of Myelomeningocele Management in Trinidad and Tobago Goolcharan S, Ramsingh D, Ramnarine D - Trinidad & Tobago 4:00 pm Knowledge, attitudes and practices on testicular torsion amongst interns in Trinidad & Tobago Rampersad B, Ramkissoon C, Goalan G - Trinidad & Tobago 4:10 pm Laparoscopic repair of an Anorectal Malformation in Trinidad & Tobago Payne O, Khan R - Trinidad & Tobago 4:20 pm Questions and answers Panel 4:30-5:30 pm Council Meeting Welcome Reception 7:00 pm Radisson Aquatica Barbados Ministry of Health Friday, June 12, 2015 Morning Session 7:30 am Registration Scientific Session 3 Moderator: S Ferdinand / A Baker - Barbados 8:00 am Prostate biopsy practices among Caribbean urologists: an online survey Persaud S, Gooden K, Morrison B - Trinidad & Tobago / Jamaica

8:10 am Prostate biopsies: a hospital-based 5 year review Glasgow A, Ayoung-Chee P - Trinidad & Tobago 8:20 am An Epidemiological Profile of Prostate Cancer in Guyana Prashad C, Rambaran M, Alli B - Guyana

8:30 am Complications after Prostate Biopsy at a Tertiary Hospital in Trinidad: A prospective study Gooden K, Persaud S, Geotz L - Trinidad & Tobago 8:40 am Short Term Results of Endovascular Treatment of Aorto-iliac Occlusive Disease Lall P, Rambally R - Trinidad & Tobago 8:50 am Variants of Bladder Exstrophy: A Case Series Cooblal AS, Rampersad B - Trinidad & Tobago 9:00 am Questions and answers Panel Distinguished Guest Lecture Moderator: C Greenidge – St Lucia 9:10 am The Impact of Screening on Colorectal Cancer Prof Paul Horgan – Glasgow, United Kingdom

Scientific Session 4 Moderator: M Vincent / P FaSiOen 9:40 am Best Practice for Colorectal Surgery: A Survey of Caribbean Surgeons' Use of Mechanical

Bowel Preparation Mohammed F, Cawich SO, Spence R - Trinidad & Tobago 9:50 am Clinician Compliance with Best Practice Recommendations to Repair Anal Sphincter Injuries Milne DM, Cawich SO, Ramdass MJ, Hassranah D, Naraynsingh V - Trinidad & Tobago 10:00 am Prevalence and Impact of the Dumping Syndrome on Quality of Life after Primary Gastric

Bypass Emous M, Ubels FL, Apers J, Wolffenbuttel BHR, Totte E, van Beek AP - Netherlands 10:10 am Knowledge and practice of radiation safety among health professionals: a nationwide survey Raghunanan R, Seepaul T, White K, Partap A - Trinidad & Tobago 10:20 am Intercollegiate Basic Surgical Skills Course of the Royal College of Surgeons in the West

Indies Ramdass MJ, Naraynsingh V, Parker M, Thomas WEG, Ansell J - Trinidad & Tobago / UK

10:30 am Questions and answers Panel 10:40 am Viewing of Posters and Sponsors’ Exhibits Posters (1–5) / Judges

Scientific Session 5 Moderator: H Roberts Sr. / Y Singh – Barbados 11:00 am Laparoscopic Thyroid Surgery in the Caribbean: First Clinical Experience Singh Y, Zheng J, Tinnie A, Kuruvilla T, Naraynsingh V - Trinidad & Tobago / China 11:10 am Is Emergent Laparoscopic Cholecystectomy for Acute Cholecystitis Safe in a Low Volume

Resource Poor Setting? Rattan J, Cawich SO, Bonadie KO, Mohanty SK, Naraynsingh V - Trinidad & Tobago / Cayman Islands

11:20 am Minimally Invasive Surgery for Bowel Obstruction: Experience in a Tertiary hospital in the

Anglophone Caribbean Bascombe N, Bobb K - Trinidad & Tobago 11:30 am Laparoscopic Re-Operation for Symptomatic Gallbladder Remnants: A Series from the

Caribbean Spence R, Cawich SO, Dan D, Naraynsingh V - Trinidad & Tobago 11:40 am Novel Modification of the TAMIS technique suited to Low Resource Countries Cawich SO, Mohammed F, Naraynsingh V - Trinidad & Tobago 11:50 am Questions and answers Panel Distinguished Guest Lecture Moderator: V Naraynsingh / N Bascombe – Trinidad 12:00 pm Laparoscopic Gastrectomy with Manual Esophago-Jejunal Anastomoses: A fit for the

Caribbean? Prof. Giovanni Dapri - Belgium Scientific Session 6 Moderator: M Walrond / I Ramnarine 12:30 pm Surgical Ethnicity in Barbados Crookendale W - Barbados 12:40 pm Is There An Association Between Tatoos & Skin Cancer Francois R, Huggins C, Siwaju K, Grosvenor EM, Rosin RD - Barbados 12:50 pm Hepatic Surface Anatomy: Variations in the Caribbean Population Guermo E, Cawich SO, Gardner MT, Shetty R, Naraynsingh V - Trinidad & Tobago / Jamaica 1:00 pm Case Series of TEVAR (Thoracic Endovascular Aortic Repair) for Aortic Disease including

Stanford B Dissection: Short and midterm results in a low volume, limited resource setting Lall P, Rambally R - Trinidad & Tobago 1:10 pm Microbial Profile of Diabetic Foot Infections in Trinidad & Tobago Rattan J, Cawich SO, Islam S, Budhooram S, Harnarayan P, Naraynsingh V - Trinidad & Tobago

1:20 pm Pneumomediastinum: Weeding out the Causes Persaud I, Ramnarine I - Trinidad & Tobago 1:30 pm Questions and answers Panel Ethics Session Discussant: Prof. Sir Errol Walrond Presentation from Trinidad 8:00 pm Awards Banquet Master of Ceremonies: Prof. Vijay Naraynsingh – Trinidad & Tobago

Opening Remarks

CCOS President: Ramesh Jonnalagadda - Barbados Feature Address: Minister of Health in Barbados

Hon. Mr. John Boyce - Barbados Awards Ceremony CCOS Honouree: Terry Ali – Trinidad & Tobago Special Awardee: Andrew Richardson – St. Lucia Special Awardee: June Marshall – Barbados Best Poster 2014: Adrian Ramkisoon – Trinidad & Tobago Best Oral Paper 2014: Bob Schaatsma - Netherlands

Closing Remarks

CCOS Secretary: Charles Greendinge – St. Lucia Vote of Thanks Local Organizer Christopher Warner - Barbados

Cocktails Saturday, June 13, 2015 Morning Session 7:30 am Registration Scientific Session 7: Moderator: W Crookendale / D Hassranah - Barbados

8:00 am TEP using Standard Laparoscopic Instruments in a Low Resource Environment Taams J - Curacao 8:10 am One Hundred Cases of PCNL in a Caribbean Island Setting Rampaul M, Okoli U, Gooden K, Persaud M, Sukraj R – Trinidad & Tobago 8:20 am Mesh Infection following Laparoscopic Inguinal Hernia Repair Calderon C, Clarke N, Payne O, Manjunath G, Seenath M - Trinidad & Tobago 8:30 am The evolution of orthopaedic training in Jamaica: Past, Present and Future Rose REC - Jamaica 8:40 am Guyana’s experience in the management of complex hand injuries Rajkumar S - Guyana 8:50 am Magnification Errors and Standardization of Radiography at Eric Williams Medical Sciences

Complex White K, Pandohie V - Trinidad & Tobago 9:00 am Medical informatics: Challenges faced in its implementation in a third world setting in one

surgical specialty Juman S, Ramoutar R - Trinidad & Tobago

9:10 am Questions and answers Panel Scientific Session 8: Grand Rounds Moderator: W Francis / H Howell 9:20 am A new technique for skin closure using a braided suture with no knotting required. Greenidge C – St Lucia 9:30 am Is a Cervical Incision Necessary for the Deep Retrosternal Goitre? Ramnarine I, Naraynsingh V - Trinidad & Tobago 9:40 am Role of Invasive Imaging in “Complex” Hemodialysis Access Salvage Lall P, Rambally R - Trinidad & Tobago 9:50 am Percutaneous vs open drainage of intra abdominal abscess Rambaran N - Guyana 10:00 am Prospective review of Open Long Bone Lower Limb Fractures: A single centre study Roopnarine Singh D, Partap A, Ramsamooj R, Seepaul T - Trinidad & Tobago 10:10 am An 11 year retrospective series of thyroglossal duct cysts at San Fernando General Hospital. Jugmohansingh G - Trinidad & Tobago 10:30am Questions and answers Panel 10:40 am Viewing of Posters and Sponsors’ Exhibits

Scientific Session 9: Grand Rounds Moderator: A Smith / D Dan 11:00 am The Anxious Surgical Patient Bandoo V, Byam J, BahadurSingh S, Pran L, Maharaj R - Trinidad & Tobago 11:10 am Watch What You Put in Your Mouth: Bronchotomy in a Child Cateau A, Ramnarine I - Trinidad & Tobago 11:20 am The Appendix that became a Pancreas: A Paediatric Case Report Cave C, Rampersad B - Trinidad & Tobago 11:30 am Expanding the Frame of Mind: A Case Report Cooblal AS, Lalla R, Ramnarine D - Trinidad & Tobago 11:40 am Biliary Stricture - Diagnostic Challenge Gopaul A, Bandoo V, Rambally R, Ojuro I, Maharaj R - Trinidad & Tobago 11:50 am Chemotherapy Catheter Displacement After Coughing: An Unusual Presentation Greenidge C – St Lucia 12:00 pm Right Hemothorax: Unexpected Result Post Elective Laparotomy Padmore G, Walrond M - Trinidad & Tobago 12:10 pm Non-Operative Management of Abdominal Gunshot Wounds Mohammed F, Cawich SO, Spence R, Rattan J - Trinidad & Tobago 12:20 pm Construction of a Low Cost Homemade Laparoscopic Simulator for use in a Caribbean Setting Persaud S, Dan D, Griffith PS - Trinidad & Tobago / Barbados 12:30 pm Closing remarks Charles Greendige

Secretary of CCOS 1:30 pm Golf Tournament 3:00 pm Boat Ride & Beach Lime Jolly Roger - Jammin Catamaran Cruises

Poster Programme

(P – 1) The Role of the Pre-Hospital Trauma Life Support Course in improving Caribbean Medical Practice. Adam R, Ali J, Ali E - Trinidad & Tobago / Canada

(P – 2) Options for Initial Therapy and Recurrent Cancers in the Tenacious Patient: 6511 cases Ahamad A, Selenius S, Paucar E, Ross R, Fernandez E. – U.S.A. (P – 2) Laparoscopic Management of a Neoplastic Cystic Lesion Arising From The Tail of The

Pancreas With an Intense Desmoplastic Reaction Y Singh, PR Ramraj, T Kuruvilla, T. Kawal - Trinidad & Tobago (P – 3) Surgical informed consent: A survey at a General Hospital in Trinidad Saroop S, Dan D, Singh Y - Trinidad & Tobago (P – 4) Delayed Mesh Abscess after Laproscopic Inguinal Hernia Surgery Singh Y, Tinnie A, Olivere L, Kuruvilla T, Naraynsingh V - Trinidad & Tobago (P – 5) Ligation of Inter-Sphincteric Fistula Tract (LIFT) for Fistula-in-Ano: A Prospective Study Islam S, Bheem V, Shah J. Sookhoo K, Naraynsingh V, Dan D, Singh Y, Harnarayn P, Aziz I -

Trinidad & Tobago (P – 6) Review of Fine Needle Aspiration at San Fernando General Hospital Backredee A - Trinidad & Tobago (P – 7) Radiotherapeutic Treatment Options for Castrate-Resistant Prostate Cancer with Osseous

Metastases Edwards-Bennett S, Ahamed A, Fernandez E, Fitch D – U.S.A. (P – 8) Low Cost Modified Total Contact Cast For Diabetic Neuropathic Foot Ulcers

McPhee V, Farquharson D - Bahamas (P – 9) Validation of a Chest Trauma Scoring System at San Fernando General Hospital Arra A, Jugool S, Dan D, Singh Y, Harnaryan P - Trinidad & Tobago (P – 10) Tracheostomy in the Caribbean: Preliminary Report Juman S, Richards D, Ramoutar R, Robertson DW, Shah RK. – Trinidad & Tobago / USA (P – 11) Emergency Hernia Surgery at San Fernando General Hospital Tinnie A, Islam S, Bheem V, Singh Y, Naraynsingh V - Trinidad & Tobago (P – 12) Feasibility of Laparoscopic Explantation for Infected Inguinal Hernia Mesh Rattan J, Cawich SO, Mohammed F, Spence R - Trinidad & Tobago (P – 13) Colorectal Cancer at the San Fernando General Hospital in 2014: A Retrospective Analysis Ramdin A - Trinidad & Tobago (P – 14) Venous Drainage Patterns of the Liver: Is it different in the Caribbean Population? Cawich SO, Gardner MT, Shetty R, Naraynsingh V - Trinidad & Tobago / Jamaica