As one of the recipients of the 2024 Endoscopic Training Award, I had the privilege of attending an Endoscopic Retrograde Cholangiopancreatography (ERCP) training fellowship course led by Dr. Mostafa Ibrahim and his exceptional team at the Roeya Institute in Egypt.
This immersive program provided an invaluable opportunity to enhance my expertise and broaden my perspective on advanced endoscopic techniques.
The course featured an impressive blend of theoretical and practical learning, comprising five didactic sessions, four hands-on experiences with animal and non-animal models, and numerous opportunities to observe highly skilled endoscopists in action across more than five hospitals in Giza and Cairo. These sessions provided a rich learning environment, covering diverse aspects of ERCP procedures and management strategies.
During my training, I encountered various presentations of pancreatic papillary anatomy and witnessed innovative approaches to challenging intubations, including pre-cut techniques and sphincteroplasty. Observing over 30 ERCP cases allowed me to refine my technique for esophageal intubation using duodenoscopy and achieve a short-scope position to perform sphincterotomy confidently.
One of the highlights of this experience was attending two cases of SpyGlass™ cholangioscopy. These cases demonstrated the treatment of large common bile duct stones using Electrohydraulic Lithotripsy (EHL) and the management of complicated gastric bypass procedures with esophageal leaks using endoscopic vacuum therapy. Witnessing these advanced interventions reinforced the critical role of innovation and adaptability in endoscopy.
Cairo and Giza, two of the world’s largest and busiest cities with populations nearing 20 million, provided a unique backdrop for this training. While navigating the hectic traffic was challenging, the diversity of hospitals and patients enriched the learning experience. The variety and complexity of cases I encountered in this three-week program were unparalleled.
The endoscopists at the training centers demonstrated remarkable skill and ingenuity, often overcoming intraoperative challenges with limited resources. The collaborative environment fostered engaging discussions between learners and seasoned practitioners, emphasizing the importance of continuous learning and adaptability.
Becoming a proficient endoscopist demands a combination of technical and personal qualities, including attention to detail, patience, musculoskeletal coordination, curiosity, methodical problem-solving, and self-awareness. International training experiences, particularly in high-skill procedures like ERCP and cholangioscopy, are vital for enhancing technical proficiency, confidence, and creativity. This fellowship has been a significant milestone in my career, providing insights that will undoubtedly inform my future practice.
A Call for Cross-Border Collaboration
This enriching experience underscores the importance of cross-border knowledge sharing in advancing the field of endoscopy. By fostering international collaboration, we can collectively elevate the standard of care for patients worldwide. I encourage my fellow endoscopists to seek similar opportunities for global exchange and learning.
I am deeply grateful to the following individuals and organizations for making this transformative experience possible:
- ASGE International Committee
- Talin D. Artinian (Manager of Global Strategic Partnership, ASGE)
- FUJIFILM Medical Systems, USA, Inc., Endoscopy
- Dr. Mostafa Ibrahim (Physician and founder of Roeya Institute)
- Dr. Ahmed AbdelHalim (Physician and trainer at Roeya Institute)
- Dr. Ashraf Amin (Professor at Ain Shams University School of Medicine)
- Dr. Ayman Abdul-Aziz (Professor and head of Endoscopy, Theodor Bilharz Research Institute)
- Heba Emara and Annan Hesham (Coordinators at Roeya Institute)
- Omar Hisham and Mohamed Hamed (Interns, New Giza University and Roeya Institute)
Sincerely,
Abdul R. Shahein, MD, MSc
St. Christophe’s Hospital for Children
Philadelphia, Pennsylvania