the 2nd jordanian surgical clinical...

Smoking free congress

Optimal Surgical Education for Better Care

Under the Patronage of H.E. The Prime Minister

September 7th-8th, 2017Le Royal Hotel

Amman – Jordan

Jordan Chapter of the American College of Surgeons American College of Surgeons Meeting (Region 17)

(Jordan, Egypt , Iran , Kuwait, Lebanon, Saudi Arabia, Turkey, United Arab Emirates)

& ATLS Meeting (Region 17)

Jordanian Society of Surgical Education and Training In Collaboration with

• Cardiac Surgery Society• Jordan Orthopedic Association• Jordan Society of OBS and GYN

• Jordan Society of Thoracic Surgeons• Jordan Society for Obesity Treatment

• Jordanian Association of Pediatric Surgeons• Jordanian Association of Urological Surgeons

• Department of Neurosurgery / Royal Medical Services• Jordanian Society for Plastic and Reconstructive Surgery

• The Jordanian Society of Otorhinolaryngology, Head and Neck Surgery

The 2nd Jordanian SurgicalClinical Congress

His Majesty KingAbdullah II Ibn Al Hussein

His Royal Highness Crown PrinceHussein Bin Abdullah II

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American College of SurgeonsJordan Chapter

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• Dear Colleagues,

On behalf of the Jordan Surgical Societies and the Jordan chapter of the American College of Surgeons (ACS) I’d like to welcome each of you to The 2nd Jordanian Annual Surgical Clinical Congress, American College of Surgeons Meeting (Region 17) & ATLS Meeting which will be held during 7th-8th September, 2017 in Amman Jordan.Our Vision with the Jordan Surgical Clinical Congress is to help the surgical community in Jordan to improve the surgical education and to raise the standards of surgical care.

The theme of our congress (Optimal Surgical Education for Better Care) will reflect our main concern in addition to the scientific efforts in all other surgical fields. We would greatly urge your support and encourage your participation and attendance to our congress.We wish our guests an enjoyable time in beautiful Amman.

Professor Dr. Abdalla Bashir M.D., FRCSEd. ,FACS.President of the CongressGovernor, Jordan ACS Chapter

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• Dear Colleagues,

Dear colleaguesOn behalf of the Jordan chapter of ACS it gives me great pleasure and honor to invite you to the 2nd Jordanian surgical clinical congress which will be held during 7-8 September, 2017 in Le Royal / Amman / Jordan.

We hereby warmly invite you all to share the result of your scientific research with us and be sure that your participation and attendance are highly appreciated.

We hope you will join us for what promises to be a compelling and stimulating event and that your interaction with your expert colleagues from many different countries will stimulate a creative exchange of ideas and will be personally rewarding.

We look forward to welcoming you to Amman in September 2017.

Dr. Khaled AjarmaMD, FACSPresident of Jordan Chapter of ACS

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establishing ACS Jordan ChapterThe Board of Regents appointed the Governor of Jordan Professor Abdalla Al Bashir on July 14th, 2014. The First meeting was held on November 26th, 2014 with all fellows in Jordan to discuss establishing the chapter. Following that another meet-ing was held on December 10th, 2014, during which the drafted bylaws for Jordan Chapter were discussed and approved and the Council members were elected. An official request to es-tablish the ACS Jordan Chapter with the approved bylaws was submitted to the ACS Board of Regents and an official approv-al was obtained on Feb 6th, 2015. Arrangements were made by the council for an official announcement of the Chapter in Jordan on Saturday April 25th, 2015 under the patronage of his Excellency Abdulsalam Al Majali, MD, FACS.

Join us and Become a Member!The Jordan Chapter offers a wide array of membership opportunities for those involved in the surgical profession. If you are a practicing surgeon in a specific specialty, just starting out in your surgical practice, currently enrolled in a residency program, or participating as a member of the surgical team, choose to become a member and take advantage of all the resources available to you.

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For 100 years, the ACS has been improving care for patients by helping surgeons to Grow, Engage, Advocate and Lead. Keywords such as Honor, Respect, Listen, Question, Heal, Develop, Improve, Advancement, Experience, Leaders, Fun, Innovators, Mentors, Mentees jumps to our mind once ACS Fellows are mentioned.

More reasons to Join:Unparalleled Education, Exemplary Professionalism, Verification, Accreditation, Evidence based Guidelines, Statements of Principles, Transition to Practice, Young Fellow Association, Resident and Associate Society, Career Transition Support, Patient Education Support, Highest Ethical Standards, Teamwork, Engage in Public affairs, First look at new research, etc

Looking for more?Join us in every scientific meeting, participate with us in our Clinical Congress, get involved in our workshops, become an active team member in our committees such as in the committee on cancer (CoC) or committee on trauma (CoT). Share your experiences with us and help us become even better.

For more information, ContactDr Majdi Al Soudi, MD. , FACSBreast & Endocrine Surgeon, Royal Medical ServicesSecretary of the American College of Surgeons – Jordan ChapterEmail : [email protected] Site: www.acsjordan.com

/Jordan Chapter of the American College of Surgeons /@acs_jordan /acs_jordan

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• president of Conference• Abdalla Bashir

• organizing Committee• Khaled Ajarma (Chair)• Abdul naser Shunaigat• Ahmad Bashir• Ahmad Uriqat• Ala’a Alzu’bi• Firas obeidat• Hanan Rihani• hazim Ajarma• Mahmoud Masri• Mahmoud odat • Majdi Al Soudi• Mohammad Abu taleb • Mo’taz naffa’ • Muhannad Qulaghassi• odai Al Sayegh• omar Abu Zaitoun • Said Al natour • Zaki Qulaghassi

• Social, Media & Communications Committee• Mohammad Alshobaki (Chair )• Majdi Al Soudi• Mo’taz naffa’• Muhannad Qulaghassi

• Financial & exhibition Committee• Abdul naser Shunaigat (Chair )• Ahmad Bashir• Mo’taz naffa’

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• Scientific Committee• Said Al natour (Chair)• Majdi Al Soudi (Coordinator)• Abdulnaser Al Shunaigat• Ahmad Bashir• Ahmad Uraiqat• Amer Amirah• Ayman Qatawneh• Bassam Sharawneh• Fayez Al hmoud• Hanan Rihani• hashem Al-Momani• Jamal Masad• Khaldoun Haddadin• Khaled Ajarmeh• Mahmoud Al Masri• Mahmoud Al odat• Mamoun Al Basheer• Moath AlSmadi• Moh Madani

• Mohammed Al Shobaki• Mohamoud Abu Khalaf• Muhannad Qulaghassi• Mo’taz naffa’• nader Al Bsoul• naser hamouri• nayef Fraiwan• nidal Khasawneh • nidal Younes• osama hamed• Qais Jfoot• Sahem Al Qosous• Samir Al Smadi• Salah Al-tarabsheh• Shadi hamouri• tariq Al Jaberi• Wael Al naasan• Waseem Al-Mefleh• Zaki Qulaghasi

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Courtney M. townsend

Jamal J. hoballah

Adrian Park

Alaaeldin ismail

Bruno Deval

Christian echinard

eman Sbeity

emiel rutgers

Gebrine el Khoury

Gérard Pascal

Ghassan Abu Sitta

hemant K Sharma

Herand Abcarian

Jamal Jomah

Jesus Madina

Mohammed Farid

Mohey eldin elbanna

Mostafa el Shazli

nastaran rafiei

nathan novotny

omar Aziz

Paolo Caione

remy Jacques Salmon

René Horsleben Petersen

Safa t. herfat

Safwan taha

tamra rammah

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• Dr nidal Younis, JMC Chair• Dr. Abdelkareem Al-omari, KAUh• Dr. Abdul-Aziz Ziadat, JUh• Dr. Abdul naser Shunaigat, private Sector• Dr. Abdalla Bashir, Jh• Dr. Abdullatif okla, private Sector• Dr. Adel Al-Shuraideh, private Sector• Dr. Adnan Abu-Qamer, rMS• Dr. Ahmad Al raymoony, rMS• Dr. Amer Amireh, private Sector• Dr. Amer Shurbaji, rMS• Dr. Ali Al-Sarayrah, hashemite University• Dr. Basem hamdan, KhCC• Dr. Basheer Al-Jarrah, private Sector• Dr. Basheer Bani Mustafa, private Sector• Dr. Daoud hanania, private Sector• Dr. emad habaybeh, private Sector• Dr. eyad Gargaz, hashemite University• Dr. Fahmi Al-Mohammad, private Sector• Dr. Faisal Mousa, private Sector• Dr. Fayez hmood, Moh• Dr. Ghaith Shubilat, private Sector• Dr. hashem Al Momani , JUh• Dr. hayel ejeilat , privte Sector• Dr. hisham Bani hamad, private Sector• Dr. issa Sawaqed, rMS• Dr. Jamal haddad, private Sector• Dr. Jamal Massad, JUh• Dr. Jihad Al Masri, private Sector• Dr. Kamal Bani-hani, hashemite University• Dr. Khalaf Al-Jader, private Sector• Dr. Khaldoun haddadin, private Sector• Dr. Maher Maaita, rMS • Dr. Mahmoud Al Qatarneh, privte Sector • Dr. Mahmood Abukhalaf, private Sector

• Dr. Mahmoud Wreikat, private Sector• Dr. Mazen el Zibdeh, private Sector• Dr. Moath Al-Smadi, JUh• Dr. Mohammad Abu ein, private Sector• Dr. Mohammad Abusamen, rMS• Dr. Mohammad Dweiri, rMS• Dr. Mohammad Fteha, private sector• Dr. Mustafa Steitieh, private Sector• Dr. nabeel Batarseh, private Sector• Dr. nabeel hamati, private Sector• Dr. nader Al-Bsool, JUh• Dr. naif Fraiwan , private Sector• Dr. najeh Al-omari, private Sector• Dr. naser Al-hammori, h.U• Dr. nemr Al Khtum, rMS• Dr. omar Al Zoubi, rMS• Dr. rami Yaghan, JUSt• Dr. Saeed Al-natour, private Sector• Dr. Saeed Fayoumi , private Sector• Dr. Saad Jaber, rMS• Dr. Salam Daradkeh, private Sector• Dr. Salah halaseh, private Sector• Dr. Sameer Al-Smadi, rMS• Dr. tahseen Mohajer, private Sector• Dr. tariq Al-Jaberi, JUSt• Dr. Wael naasan, rMS• Dr. Wael Fatayer, private Sector• Dr. Yousef Uraiqat, private Sector• Dr. Yousef Zreiqat, rMS• Dr. Zaki Qulaghassi, private Sector• Dr. Zahran Bdeir, private Sector

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• Main topics• Surgical education & training• Surgical oncology• Breast & endocrine Surgery• Colo-rectal Surgery• hepato-pancreatico-biliary Surgery• Bariatric & Upper Gi Surgery• vascular Surgery • plastic & reconstructive Surgery• organ transplantation

• pediatric Surgery• Urology • Cardiac Surgery• thoracic Surgery• trauma• neurosurgery • orthopaedic Surgery• Gynecology obstetric• laryngology

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prof. Courtney M. townsend, USAPresident of the American College of Surgeons (ACS) Courtney M. Townsend, Jr. Robertson-Poth Distinguished Chair in General Surgery, department of surgery, University of Texas Medical Branch (UTMB), Galveston. Dr. Townsend is a highly esteemed surgical educator and fellow of ACS since 1981. He has held many

leadership roles in the organization, including Secretary (2006-2013), Chair of the ACS Board of Governors (2004-2005), and a member of the Board’s Executive Committee (1999-2003). Dr. Townsend is professor of surgery and professor of physician’s assistant studies at the University of Texas Graduate School of Biomedical Sciences, UTMB. He completed a surgical oncology fellowship at the University of California-Los Angeles (UCLA). Dr. Townsend has been editor-in-chief of the Sabiston Textbook for Surgery. Prof Townsend is past-director and chairman of the American Board of Surgery (2000-2006); American Surgical Association president (2007-2008) He is an honorary member of the Society of Black Academic Surgeons and the Association of Women Surgeons (AWS).

prof. Jamal J. hoballah, LebanonProf Jamal Hoballah is a Consultant Vascular Surgeon, General Surgeon and also certified in Surgical Critical Care. He was appointed the Surgical Director of the University of Iowa Heart and Vascular Center in 2007. He returned in 2008 to AUBMC where he serves as Chairman of the Department of Surgery, as well as the

Head of the Division of Vascular Surgery since 2011. He is the Governor of the ACS Lebanon Chapter, and the chair of the International Governors workgroup of the ACS.

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Dr. Adrian Park, USA Chairman of the Department of Surgery at Anne Arundel Medical Center in Annapolis, MD and Professor of Surgery at Johns Hopkins University School of Medicine.Has made major advancements in the improvement of laparoscopic techniques & technology for complex hernia repair, foregut and spleen surgery. Previously Dr. Park was the Dr. Alex Gillis Professor and Chairman of the Department of Surgery at Dalhousie University in Halifax, NS

Dr. Alaa eldin ismail, egyptis a Professor of General surgery at Department of General Surgery, Faculty of Medicine Ain Shams University, Cairo, Egypt. He is Chairman of the Liver Surgery Department & Director of the Liver Research Unit & Director of Stem Cell Research Division at the same university & also Director at Ministry of Health and Population

National Hepatology and Tropical Medicine Research Institute Cairo, Egypt. Professor Alaa is also Chairman of Scientific Board of Egyptian Fellowship of Surgery, MOHP, Cairo, Egypt. He is a member of many highly esteemed councils in Egypt and Worldwide and he is the Governor of Egyptian Chapter of the American College of Surgeons and Chief Governor of Zone 17 (Middle East) of American College of Surgeons

Dr. Bruno Deval, FranceProfessor Bruno Deval is a Gynecologist and a postgraduate-trained Surgeon with a real interest in surgical technologies and techniques.

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Prof. Christian echinard, FranceProf. Christian ECHINARD is former president and founder of HumaniTerra and currently chairman of the supervisory board of the N.G.O. He is also a world-renowned Plastic Reconstructive surgeon, especially in the field of severe burn patients. He has also been co-founder and chairman of SHARE (Surgical Humanitarian Aid Resources in Europe).

Dr. eman Sbaity, LebanonDr Eman is a Surgical Oncologist at AUB with interest in breast cancer and especially in the new “Nipple Sparing Mastectomy”, also interested in retroperitoneal soft tissue sarcomas and gastric cancers.

Dr. emiel rutgers, netherland Prof Emiel Rutgers is a Surgical Oncologist. He was appointed in 2006 as Head of the Surgery Department at Netherlands Cancer institute / Antoni Van Leeuwenhoek Ziekenhuis, Amsterdam. He is a Member of the panel on the International Consensus Conference on the Optimal Primary Treatment of Early Breast Cancer update

St. Gallen, Switzerland. Prof Rutgers has been active also in conferences, steering panels, consensus panels on Breast Cancer.

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Dr. Gebrine el Khoury, BelgiumProf El Khoury is Head of the Cliniques universitaires Saint-Luc’s Cardiovascular and Thoracic Surgery Department, he is a professor at Université Catholique de Louvain (UCL). Professor El Khoury specializes in cardiac valve surgery. His key areas of scientific interest include mitral and aortic valve valvuloplasty (of which he is one of the pioneers) and aortic valve replacement.

Dr. Gérard Pascal, FranceDr Gerard Pascal is a Senior surgeon in Digestive, liver Surgery and liver transplant. In 2007 he became president of Chirugie Solidaire. In 2017 he became Head of Middle East programs for the board of Medicins du Monde (Doctors of the World).

Dr. Ghassan Abu Sitta, LebanonDr Ghassan is a Consultant Plastic and Reconstructive Surgeon; he has completed fellowships in pediatric and adult craniofacial surgery at Great Ormond Street Hospital For Sick Kids and Chelsea and Westminster Hospital respectively and also completed fellowship in Cleft Surgery at Great Ormond Street Hospital. In 2011

he moved to the American University of Beirut Medical Center and in 2012 became Head of Division of Plastic & Reconstructive Surgery.

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Dr. hemant K Sharma, UKMr. Hemant Sharma is a Consultant Orthopedic with fellowship in Limb Reconstruction. He is currently working at Hull & East Yorkshire university teaching hospitals, UK. Dr Sharma is a senior clinical tutor for Hull York medical school and Chief Investigator for PINS trial and PI for other trials.

Dr. herand Abcarian, USAProf Herand Abcarian is a consultant Colorectal surgeon. He was appointed as Head of the Division of Colon and Rectal Surgery at John H. Stroger Hospital of Cook County, and has served as the Secretary and later the President of the American Society of Colon and Rectal Surgeons and its Research Foundation and was the associate editor of the journal; Diseases of the Colon and Rectum.

Dr. Jamal Jomah, KSAis a Consultant Plastic Surgeon and General Manager – Med Art Clinics Riyadh, Saudi Arabia and in Dubai, UAE, and General Manager – Ajmal Clinics - Riyadh, Saudi Arabia. He is also certified to practice in USA, Canada and Britain. He is a member of very reputable professional societies and Royal Colleges and is the Governor of the American College of Surgeons (ACS) Saudi Arabia Chapter & Course Director of ATLS.

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Dr. Jesus e. Medina, USADr Jesus Medina is currently a Professor in the Department of Otorhinolaryngology in University of Oklahoma. . He became Chairman of that Department in 1991 and held the Paul & Ruth Jonas Professor in Cancer Treatment and Research until December 2009.

prof Mohamed Farid, egyptis a Consultant Colorectal surgeon working at Mansoura University in Egypt. He was the past chairman of General Surgery Departments, past General Director of Mansoura University Hospitals, founder and chairman of colorectal surgery unit. He is also founder and vice president of Mediterranean society of coloproctology

and editor of Journal Technique of coloproctology and founder and past president of Egyptian group of colorectal surgeons, and member of ASCRS, EAES, ISS, JSCRS. Currently, He is also the General Secretary of Egyptian Society of Surgeons.

prof. Mohey eldin elbanna, egyptProf. Mohey Eldin is a Consultant of Bariatric, GI, and Endocrine Surgery and a Professor of General and Bariatric Surgery, Ain Shams University. He is the Secretary/Treasurer of Egypt Chapter of the American College of Surgeons and Secretary General of the Egyptian Society for Bariatric Surgery

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Dr. Mostafa el Shazli, egyptMostafa El Shazli is Professor of General Surgery at Kasr Al Aini Faculty of Medicine, Cairo University since 2001. Recently he was appointed as Chairman of General Surgery Department at same institution. He is the founder and head of Hepato-Pancreato-Biliary Unit , a co - founder and the managing director of Liver Transplantation

program in Kasr Al Aini faculty of medicine hospitals and co-founder and moderator of the Egyptian Hepato-Pancreato-Biliary Fellowship (MOH).

Dr. nastaran rafiei, UKDr Nastaran Rafiei is an Antibiotic focal point trainer, Médecins Sans Frontières, Amman (Jordan). she completed the Diploma of Tropical Medicine and Hygiene at the Liverpool School of Tropical Medicine.

Dr. nathan novotny, USADr. Nathan Novotny is a Consultant Pedriatric Surgeon. When asked recently to define beauty, Nathan’s answer was ‘small incisions’. Passionately committed to the correct operation through the least access possible, Nathan strives to stir this same passion in his medical students and residents.

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Dr. omer Aziz, UKProf Omer Aziz is a consultant Colorectal Laparascopic and Peritoneal Tumor Surgeon working at the Colorectal and Peritoneal Oncology Centre, The Christie NHS foundation Trust. He completed PhD at Imperial College London in 2008 and secured the FRCS exam in 2011 then undertook a high volume laparoscopic

(Ethicon) colorectal fellowship at St. Mark’s Hospital (Harrow, London) in 2012. He was appointed a consultant colorectal and laparoscopic surgeon at St. Mark’s Hospital before moving to The Christie later that year.

prof. paolo Caione, italyProf Paolo Caione is a Pedriatric Urologist at Bambino Gesu Hospital. In 1997, he was appointed the chief of the devision of the pediatric urology and in 2008, Head of Nephrology-Urology Department, and since 2013 he was appointed Chief of Unit” Innovative Models and Training in Urology” of Nephrology-Urology Department”.

Dr. remy-Jaques Salmon, FranceFormer chief of department of Surgery at Institute Curie Paris, He is a member of the French Surgical Academy and Associated Professor at College De Médecine Des Hôpitaux De Paris.

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Dr.rené petersen, DenmarkRené Horsleben Petersen is Chief Thoracic Surgeon, Department of Thoracic Surgery, Copenhagen University Hospital, Rigshospitalet, Denmark. He is an expert in Minimal Invasive Thoracic Surgery and has personal experience of undertaking over 1000 Video-Assisted Thoracoscopic Surgery (VATS) Lobectomies, Segmentectomies and Thymectomies at his centre.

Dr. Safa t. herfat, egyptDr Safa is Assistant Adjunct Professor Orthopedic Surgery at University of California, San Francisco. He has a PhD in biomedical engineering from University of Cincinnati, Ohio. He is also a member of Médecins Sans Frontières (MSF)

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Dr. Safwan A taha, UAeis a Consultant Laparoscopic, Bariatric & Metabolic Surgeon. He is the Director of the Bariatric & Metabolic Surgery Center and Mediclinic Airport Road Hospital, Abu Dhabi; UAE. He had training in laparoscopic and bariatric surgery in the USA and France and eventually obtained Fellowship of the Royal College of Physician and Surgeons

of Glasgow, a Specialization Diploma in laparoscopic Surgery from Louis Pasteur University in Strasbourg (France). Dr. Taha is the current Governor of the UAE Chapter of the American College of Surgeons(ACS), member of the Board of Governors of the ACS, member of the International Relations Committee ACS and Vice President of ESLES (Emirates Society for Laparo-Endoscopic Surgeons).

Dr. tamra Yousef Alrammah, KSADr Tamra is a working in Ministry of health- Northern Boarders as a consultant General Surgery and Breast Surgery since December 2016. In 2015, she did research Fellowship at John Hopkins Hospital.

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time Jerasia Ishtar 3 +hamurabi 1 hamorabi 2 ishtar 2 +

ishtar 1

8:00-10:00

ACS GS Review Course:

Abdominal

Team Course Surgery Skills Course

ABMS Workshop for Jordan Medical Council

(08:00-17:00)

10:00-10:30 Coffee Break

10:30-12:30


Alimentary

Team Course Surgery Skills Course

12:30-13:30 Lunch Break

13:30-15:00ACS GS Review

Course: BreastTeam Course Surgery Skills

Course


15:30-16:15


Endocrine

16:15-17:00

ACS GS Review Course: Vascular

tUeSDAY Sep 5th, 2017

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time Jerasia hamorabi 1 hamorabi 2 ishtar 2 +ishtar 1

8:00-10:00

ACS GS Review Course: Trauma

Laparoscopic Surgical Skills

Course

Mass Casualty Plan (MCP) course by MSF-FRA

ABMS Workshop for Jordan Medical Council


10:30-12:40

ACS GS Review

Course: Critical Care


Course

Mass Casualty Plan (MCP) Course

by MSF-FRA12:40-14:00 Lunch Break

14:00-15:30


Perioperative Care 1


Course

Mass Casualty Plan (MCP) Course

by MSF-FRA


16:00-17:00 ACS GS Review Course:

Perioperative Care 217:00-17:15 Adjourn

(17:00-17:15)17:15-17:30

17:30-18:00 Certificates and Feedback

WeDneSDAY Sep 6th, 2017

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time opening Ceremony ( ishtar 2 hall)9:00-9:02 Royal Anthem9:03-9:08 Recitation from the Holy Quran

9:10-9:15 Congress President SpeechDr Abdallah Al Bashir (Jor)

9:15-9:20 American College of Surgeons Presidentprof Courtney townsend (USA)

9:20-9:25 Jordan Medical Association President SpeechDr Ali oboos (Jor)

9:25-9:30 Speech of the Patronage

9:30-10:00 Opening Congress Exhibition

10:00-10:30 Coffee Break10:30-12:30 Surgical Education Session12:30-13:30 Lunch

thUrSDAY Sep 7th, 2017(8:00-9:00) reGiStrAtion

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time ishtar 1 ishtar 2 Ishtar 3 Jerasia hamurabi 2

13:30-15:30 PediatricSession

BreastSession

Surgical Role in

Humanitarian Setup

Cardiac Session Free Papers


16:00-18:30 BariatricSession

Colorectal Session

OrthopedicSession

ACS reGionAL MeetinGtime Azure (10th floor)

18:30-19:30 ACS Chapters Regional Meeting

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FriDAY Sep 8th, 2017

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time ishtar 1 ishtar 2 Ishtar 3 Jerasia

8:00-10:00 ENT Session Surgical Jeopardy

ATLS Scientific presentations


10:30-12:30 ENT Session Women Session

Obs & Gyne Session

ATLS Update 10th Edition

12:30-14:00 Lunch and Prayer

14:00-16:00 Thoracic Session

Hepatobiliary Session

Urology Session

ATLS Update from Countries


16:30-18:30 Neurosurgery Session

Minimally Invasive Session

Plastic Session

20:00 Gala Dinner

SAnoFi SYMpoSiUMChairman: Dr Mahmoud Al-Masri

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11:30-12:30 After decades of VTE Prophylaxis in Surgical Fields, where do we stand today? by Prof Juan Arcelus

AtLS reGionAL MeetinGtime Azure (10th floor)

16:30-18:30 ATLS Regional Meeting

prof. Juan ignacio Arcelus Dr. Juan Ignacio Arcelus is Professor in general surgery at Granada Medical School University and General surgeon in the General and Digestive Surgery Unit at Virgen de las Nieves University Hospital, Granada, Spain. He obtained a PhD, specializing in thrombosis in 1998. He has been panellist in the latest American College of Chest Physicians (ACCP) Guidelines for Antithrombotic and Thrombolytic Therapy and the American Society of Clinical Oncology (ASCO) guide-lines on prevention and treatment of venous throm-boembolism in cancer patients

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ABMS WorKShop For JMC ishtar 2

time Course plan - tuesday 5th of Sep 2017

08:00-9:00 JMC participants will attend meet as full group for the morning sessions below

09:00-10:00 Purposes of assessment

10:00-12:30 Exam design: blueprints, classification schemes, and item bank development

12:30-13:30 Lunch

13:30-16:30

Participants will attend one of the two workshops below based on group assignment

ishtar 1 ishtar 2

Group IAItem writing workshop

Group IBInterpretation of test and

item statistics and designing score reports

16:30-17:00 Adjournment

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ABMS WorKShop For JMCishtar 2

time Course plan - Wed Sep 6th 2017

08:00-9:00 JMC participants will attend meet as full group for the morning sessions below

09:00-12:00

Participants will attend one of the two workshops below based on group assignment

ishtar 1 ishtar 2

Group IBItem writing workshop

Group IAInterpretation of test and item statistics and designing score reports

12:00-12:45 Lunch

12:45-13:45participants will attend meet as full group for the afternoon

sessions belowUnderstanding standard setting

13:45-16:15 Design of clinical and oral exams16:15-17:00 Question and Answer Session17:00-17:15 Adjournment

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GenerAL SUrGerY BoArD revieWJerasia

time topicsAbdominal (8:00-10:00) Moderator Dr Osama Hamed

08:00-08:20 Pancreas, Dr Osama Hamed (JOR)08:20-08:40 Liver, Dr Sameer Smadi (JOR)08:40-09:00 Biliary, Dr Khaled Obeidat (JOR)09:00-09:20 Spleen, Dr Firas Obeidat (JOR)09:20-09:40 Hernia, Dr Sahem AlQusous (JOR)09:40-10:00 Discussion10:00-10:30 Break

Alimentary (10:30-12:30) Moderator Dr Tariq AL Jaberi10:30-10:50 GERD / Hiatal Hernia / Achalasia, Dr Said Al Natour (JOR)10:50-11:10 Esophageal / gastric malignancy, Dr Salah Halasa (JOR)11:10-11:30 Colorectal Cancer, Dr Ahmad Uraiqat (JOR)11:30-11:50 Benign Colorectal Disease, Dr Tareq Al Jaberi (JOR)

11:50-12:10 Bowel Obstruction / GI Bleeding / Peptic Ulcer Disease,Dr Faiez Dawod (JOR)

12:10-12:30 Discussion12:30-13:30 Lunch

Breast (13:30-15:00) Moderator Dr Mahmoud Al Masri13:30-13:57 Benign Breast disease, Dr Majdi Al Soudi (JOR)13:57-14:24 Breast Cancer, Dr Mahmoud al Masri (JOR)

14:24-14:51 Breast Cancer in special situations and adjuvant therapies,Dr Eman Sbeity (LBN)

14:51-15:00 Discussion15:00-15:30 Break

Endocrine (15:30-16:15) Moderator Dr Mohammed Al Shobaki15:30-16:00 Endocrine, Dr Nidal Younes (JOR)16:00-16:15 Discussion

Trauma (16:15-18:20 ) Moderator Dr Khaled Ajarma

16:15-16:52 Trauma , Resuscitation, Head and Neck Injuries,Dr Ahmad Zaarour (JOR)

16:52-17:29 Chest and abdominal trauma, Dr Ahmad Kloub (JOR)17:29-18:06 Pelvic, Vascular and Extremity, Dr Mahmoud Odat (JOR)18:06-18:20 Discussion

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• Wednesday Sep 6th, 2017 •

GenerAL SUrGerY BoArD revieWJerasia

time topicsVascular ( 09:00-10:00) : Dr Mamoun Basheer

09:00-09:10 Peripheral Vascular / Critical Limb Ischemia,Dr Jamal Hoballah (LBN)

09:10-09:15 Discussion09:15-09:25 Vascular disease, Dr Mamoun Basheer (JOR)09:25-09:30 Discussion

09:30-09:40 Vascular disease : Management and diagnosis,Dr Jamal Hoballah (LBN)

09:40-10:00 Discussion10:00-10:30 Break

Critical Care (10:30-12:40) Moderator Dr Said Al Natour10:30-11:01 Perioperative Cardiac Evaluation, Dr Salah Al Tarabsheh (JOR)11:01-11:32 DVT / PE prophylaxis and treatment, Dr Mahmoud Al Masri (JOR)11:32-12:03 Critical Care: Respiratory, Dr George Abi Saad (LBN)12:03-12:34 Critical care : Cardiac, Dr George Abi Saad (LBN)12:34-12:40 Discussion12:40-14:00 Lunch

Perioperative Care 1 (14:00-15:30) Moderator Dr Hanan Al Rihani14:00-14:27 Fluids , Electrolytes, and infection, Dr Ahmad Al Bashir (JOR)14:27- 14:54 Hemostasis and Coagulation , Dr Ali Abu Seine (JOR)

14:54-15:21 Wound Healing and Wound Management,Dr Khaldoun Haddadin (JOR)

15:21-15:30 Discussion15:30-16:00 Break Perioperative Care2 (16:00-17:30) Moderator Dr Mohammad Al Shobaki

16:00-16:27 Nutrition, Dr Osama Hamed (JOR)16:27-16:54 Renal Function, Dr Hiba Barghothi (JOR)16:54- 17:21 Pharmacology, Dr Mohammad Al Shobaki (JOR)17:21-17:30 Discussion

Certificates and Feedback (17:30-18:00)

28

• tuesday Sep 5th, 2017 •

teAM CoUrSeishtar 3 + hamurabi 1 - trauma evaluation and Management (teAM) CourseDirector: Dr. Mahmoud Odat, Dr. Fadi Rosan

time topics08:00-08:15 Welcome & Introduction, Dr Mahmoud Odat

08:15-08:30 Initial Assessment Demonstration and Discussion,Dr Fadi Rousan

08:30-09:15 Slide Lectures I, Dr Fadi Rousan09:15-10:00 Slide Lectures II, Dr Mo’taz Nafaa’10:00-10:30 Break 10:30-10:55 Initial assessment Demonstration and Discussion, Dr Fadi Rousan10:55-11:00 Move to Scenario Sessions

11:00-11:40

Group SessionsFocused Discussion(40 min)Fadi RousanOsama Odat

Simulated Patient 1(20 min)Moutaz NafaaHeba Al Abadi

Simulated Patient 2 (20 min)Malik GhaishanNizar Breyhie

Groups I,IIGroup III Group IVGroup IV Group III

11:40-11:50 Switch between groups I,II and III,IV

11:50-12:30

Focused Discussion(40 min)Fadi RousanOsama Odat

Simulated Patient 1(20 min)Moutaz NafaaHeba Al Abadi

Simulated Patient 2 (20 min)Malik GhaishanNizar Breyhie

Groups III,IVGroup I Group IIGroup II Group I

12:30-13:30 Lunch13:30-14:00 Exam14:00-14:30 Summary / Adjourn, Dr. Mahmoud Odat & Dr. Fadi Rosan

29

• SCientiFiC proGrAM •

30

Ishtar 1 - Education Session (10:30-12:30)Moderators: Dr Abdalla Bashir, Dr Mahmoud Abu Khalaf, Dr Nidal Younis

time topics

10:30-10:50 ACS Educational Materials ,How to Access and Use,Prof Townsend (USA)

10:50-11:10 Reforming Graduate Medical Education in Jordan,Dr Nidal Younis (JOR)

11:10-11:30 American College of Surgeons, Education and Quality,Prof Townsend (USA)

11:30-11:50 Surgical training in Jordan; Residents Point of View,Dr Mo’taz Naffa'(JOR), Dr Muhannad Qulaghasi (JOR)

11:50-12:10Accreditation of Urology Training Programs by the ACGME Accreditation Council for Graduate Medical Education,Dr. Rami AlAzab (JOR)

12:10-12:30 Discussion

Ishtar 1 - Jordanian Association of Pediatric Surgeons Session (13:30-15:30)Moderators: Prof Hashem Al-Momani, Dr Imad Habaibeh,Dr Ahmad Al-Raymoony

time topics13:30-13:50 Laparoscopy in Hydronephrosis, Prof. Paolo Caione (ITA)

13:50-14:05 Post Natal Management of Antenatal Hydronephrosis,Prof Hashem Al-Momani (JOR)

14:05-14:15Hydronephrosis in Pediatric Age Group; Management and Follow up; JUH Experience,Dr Abeer Aldiab/ Prof Mohammad Al-Omari (JOR)

14:15-14:25 Hepatoblastoma; Neoadjuvant Chemotherapy, PRETEXT Conversion and Delayed Surgery, Dr Khalil Ghandour (JOR)

14:25-14:35 Minimal Invasive Surgery in Children, Where Do We Stand?, Dr Najeh Omari (JOR)

14:35-14:45 One- Stage Total Correction of Ambiguity in Infants & children. Our experience at KHMC, Dr Ibrahim Daradkeh (JOR)

14:45-15:05 Hypospadias, Prof. Paolo Caione (ITA)

15:05-15:15 Thoracoscopic Resection of Mediastinal Tumors in Children, Dr Ahmad Al-Raymoony (JOR)

15:15-15:25 Acute Scrotum-JUH Experience, Prof Hashem AlMomani (JOR)

15:25-15:35 The Burnia: Laparoscopic Sutureless Inguinal Hernia Repair in Girls, Dr Nathan Novotny (USA)

15:35-15:45Foreign Body Aspiration in Children: A Study of Children Who Lived or Died Following Aspiration,Dr M Essam/ Prof Mohammad Al-Omari (JOR)

• thUrSDAY Sep 7th, 2017 •

31

Ishtar 1 – Jordan Society for Obesity Treatment Session / Part I (16:00-17:17) Dr. Safwan Taha, Dr. Mohye El-Banna, Dr. Salam Daradkeh

time topics16:00-16:08 Society status, progress, and the future , Dr. Sami Salem (JOR)16:08-16:12 Questions16:12-16:20 OAGB, MGB experience, Dr. Khalil Zayyadeen (JOR)16:20-16:24 Questions

16:24-16:32 The Bariatric surgery fellowship: learning curve and challenges, Dr. Wa'el Na'san (JOR)

16:32-16:36 Questions

16:36-16:44 High Volume practice, lessons learned along the way, Dr. Mohammad Khrais(JOR)

16:44-16:48 Questions16:48-16:56 Sleeve Gastrectomy, Results Over Years, Dr. Iyad Eid (JOR)16:56-17:00 Questions

17:00-17:08 Non Sleeve Procedures in a High Volume Sleeve Practice, Dr. Hasan Hussein (JOR)

17:08-17:12 Questions17:12-17:17 5 min Break

Ishtar 1 – Jordan Society for Obesity Treatment Session / Part II (17:17-18:30)Moderators: Dr. Firas Obeidat, Dr. Sami Salem, Dr. Taghleb Mazahreh

time topics

17:17-17:25 Medico-legal aspects in a high volume practice,Dr. Osama Damra (JOR)


17:29-17:37 Gastric Plication, Complications, Results and the Future,Dr. Firas Al-Yousef(JOR)


17:41-17:49 Bariatric Surgery: Experiences and challenges in the Public Sector, Dr. Khaled Dawoud (JOR)


17:53-18:01 Portomesenteric Thrombosis after Sleeve gastrectomy,Dr Mohammad Bani Hani (JOR)


18:05-18:13 Endoscopic Sleeve Gastroplasty, results and status,Dr. Tarek Qutob (JOR)



32

Ishtar 2 – Breast Surgery Session (13:30-15:30)Moderators: Dr Mahmoud Masri, Dr Said Natour, Dr Jamal Masad,Dr Majdi Al Soudi

time topics

13:30-13:50 Optimal Surgery of the Breast and Axilla After Neo-Adjuvant Chemotherapy, Dr Emiel Rutgers (NLD)

13:50-14:10 Surgical Challenges in the Management of Locoregional Recurrence in Breast Cancer, Dr Remy Salmon (FRA)

14:10-14:20Utility of Two-Node One-Step Nucleic Acid Cytokeratin-19 Amplification Assay Total Tumor Load in Breast Cancer Survival Prediction, Dr Noor Shorbasi (GBR)

14:20-14:40 Axillary Dissection in Breast Cancer: Has it Become Obsolete? , Dr Emiel Rutgers (NLD)

14:40-15:00 Updating of Breast and Axilla Surgical Treatment of Breast Cancer in 2017, Dr Remy Salmon (FRA)

15:00-15:10 Risk Reducing Mastectomy in Sporadic Breast Cancer, Dr Layal Al Asir (JOR)



Ishtar 2 – Colorectal Surgery Session (16:00-18:30)Moderators: Dr Wael Fatayer, Dr Marwan Rosan, Dr Tareq Al-Jaberi ,Dr Mohammad Ftaiha

time topics16:00-16:20 Anastomotic Leak, Dr Aziz Omer (GBA)

16:20-16:35 Colorectal Cancer Associated with Ulcerative Colitis,Dr Tareq Al-Jaberi (JOR)

16:35-16:55 Why Do We Have Trouble Treating Fistulas?,Prof. Herand Abcarian (USA)

16:55-17:15 Cytoreductive Surgery and HIPEC, Dr Aziz Omer (GBA)

17:15-17:30Pelvic Exentration, Initial Experience and Outcome at Colorectal Unit, King Hussein Medical Center, Dr Ahmad Uraiqat (JOR)

17:30-17:50 Coloanal Anastomosis for Rectal Cancer,Prof. Herand Abcarian (USA)

17:50-18:10TEM Assisted Iintersphencteric Resection in Treatment of Llow Sited Rectal Cancer TaTem (video and talk),Dr Moh farid (EGY)


33

Ishtar 3 – Surgical Role in Humanitarian Setup (13:30-15:30)Moderators: Dr Abdalla Basheer, Dr Wael Na’san, Dr Khaled Ajarma,Dr Khladoun Haddadin

time topics

13:30-13:45 Role of Royal Medical Services in Humanitarian Aid by Brigadier Dr Salem Zawahreh (JOR)

13:45-14:00 Global Humanitarian Projects for Severe Burn Patients, Prof. Christian Echinard – Humaniterra Int / FRA

14:00-14:15 3D Technology Applications for Humanitarian Settings, Prof Safa T. Herfat – MSF-FRA


14:30-14:45 The Role of Jordan Civil Defense in Providing Ambulance Services for Refugees, Colonel Ghassan Al Zu'b

14:45-15:00Emergency Surgical Care in Disaster Situations. Challenges and Opportunities, Dr Gérard Pascal, -Médecins du Monde (MDM)/ FRA

15:00-15:15High Rates of Antibiotic Resistance in War Wounded Patients in a Reconstructive Surgical Program in Amman, Jordan , Dr Nastaran Rafiei – MSF-FRA



34

Ishtar 3 – Jordan Orthopedic Association Session (16:00-18:30)Moderators: Dr Kamel Afifi, Dr Monther Odeh, Dr Mohammd Dwairi,Dr Firas Al-Ibrahim

time topics

16:00-16:20 Management of Grade 3 Open Fractures of Tibia,Dr Hemant Sharma (GBR)

16:20-16:30 Supracondylar Fracture of Humerous in Children Ways of Management, Dr M Odat (JOR)

16:30-16:40 Open supracondylar humerous fracture in children,case presentation and management, Dr Hashim Alqudah (JOR)

16:40-16:50 Genu Recurvatum Analysis in the Context of Computer Assisted Total Knee Arthroplasty a 14 years Retrospective Study, Dr Samer Kakish (JOR)

16:50-17:00 Use of office ultrasound in diagnosis of shoulder pathology, Dr Ahmad Shalalfeh (JOR)

17:00-17:10 Principles of External Fixator, Dr M abu Ein( JOR)

17:10-17:20 The Use of TSF in Treating Diversity of Limb Deformity, our Experience at RMS, Dr Fadi Rosan (JOR)

17:20-17:30 Autologus Osteochondral Transplant for Talus,Dr Ziad alqirim (JOR)

17:30-17:40 Management of osteoporotic spine fractures,Dr Mohammad Armoti (JOR)

17:40-17:50 Aging Surgeon: Wisdom, Experience vs Complications,Dr Zyad Al Zoubi (JOR)

17:50-18:10 Strategies for Management of Severe Bone loss,Dr Hemant Sharma (GBR)



35

Jerasia – Cardiac Surgery Association Session (13:30-15:30)Moderators: Dr. Saad Jaber, Dr. Ali Abu Rumman, Dr. Khaled Shaker

time topics

13:30-13:45 Hypertrophic Cardiomyopathy, General Information and case presentation, Dr Fuad Al-Azzam (JOR)

13:45:14:05 Aortic Valve Repair Techniques, Prof. Gebrine El Khoury (BEL)

14:05-14:30Coronary Artery Bypass Surgery Debate, Off-pump vs On-pump, by Dr Amjad Bani-Hani (JOR)(Off-pump) &Dr Salah Eldien Altarabsheh(JOR) (On-pump)

14:30-14:40 Sutureless Patch Technique for the Repair of Primary Pulmonary Vein Stenosis, Dr Basel Harahsheh (JOR)

14:40-15:00 Updates in Mitral Valve Repair, Prof. Gebrine El Khoury (BEL)

15:00-15:10Aggressive Neo-Intimal Hyperplasia is associated with Increased TNF –alpha mRNA Expression in a Pig Animal Coronary Grafting Model, Dr Mutaz Al-Khateeb (JOR)

15:10-15:20 Bradycardia Due to Thrombus in the Right Atrium,Dr Emad M Hijazi (JOR)

15:20-15:30Effect of Bidirectional Cavopulmonary Anastomosis (Glenn Shunt) on Atrioventricular valve Regurgitation in Patients with single Ventricle, Dr Zeid Makahleh (JOR)

Discussion


36

Hamurabi 2 – Free Papers Session (13:30-15:30pm)Moderators: Dr Osama Hamed, Dr Mohammad Al Shobaki

time topics

13:30-13:40The Influence of Enhanced Recovery after Surgery (ERAS) Protocol on Readmission Rate for Patients Undergoing Colorectal Surgery, Dr Haitham Erbaihat (JOR)

13:40-13:50 Breast Cancer facts in Palestine, Dr Osama Atallah (PSE)

13:50-14:00

Correction of Secondary Cleft lip Deformities encountered at the Royal Jordanian Rehabilitation Center: Surgical Approaches and Review of Cases,Dr Mohammed Nayef Al-Bdour

14:00-14:10 Malignant Obstructive Jaudice in NCI Cairo University Review of 232 Patients, Dr Ashraf Sobhy (EGY)


14:20-14:30Laparascopic & Laparascopic Assisted Pyeloplasty for Repair of Pelvi-ureteric Junction Obstruction in Children,Dr Mohammad Dajah (JOR)

14:30-14:40Objective and Subjective Improvement in Children with Idiopathic Detrusor Overactivity after Intravesical Botulinium Toxin Injection, Dr Mhailan Marashdeh (JOR)

14:40-14:50Internal Mammary Artery Perforators: The Best Substitution to the Internal Mammary Artery as Recipients in Free Tissue Transfer for Breast Reconstruction, Dr Khalid El-Maaytah (JOR)

14:50-15:00New Surgical Technique for the Management of Hepaticojejunostomy Stricture,Dr abdulhamid Al-Abbadi (JOR)

15:00-15:10 Axillary Trichilemmal Carcinoma with Lymph Node Invasion: Case Report, Dr Hiba G. Dboush (JOR)

15:10-15:20 The Risk of Malignancy in Multinodular Goiter Compared to Solitary Thyroid Nodules, Dr Ashraf al Faouri (JOR)



37

• FriDAY Sep 8th, 2017 •

Ishtar 1 – Jordanian Society of Otorhinolaryngology, Head and Neck Surgery- Part I (08:00-10:00)Cochlear implant panel DiscussionChair Person: Dr Bassam Al-SharawnehModerator: Dr Suleiman Al Saudi

time topics

08:00-10:00

Cochlear implant panel DiscussionPanelistDr Mohammad AltawalbehDr Mo’tassim Al-RoosanDr Feras AlzoubiDr Abdrabo QbeilatDr Nemer AlkhtomDr Abdelsattar Wreikat

Ishtar 1 – Jordanian Society of Otorhinolayngology, Head and Neck SurgeryPart 2 (10:30-12:30)Moderators: Dr Naser Bataineh, Dr Nabeel Al-Shwaqfeh, Dr Wisam Qarqaz,Dr Amjad Tarifi

time topics

10:30 -10:50 The Mass in the Neck : Current Evaluation and Management, Dr Jesus Medina (USA)

10:50 -11:10 Advanced Parapharyngeal Space Tumors; Challenging Cases, Dr Hassan Husban (JOR)

11:10 -11:30 Management of the Neck in the Era of Organ Preservation, Dr Jesus Medina (USA)

11:30 -11:50 Prosthetic Voice Rehabilitation Following Total Laryngectomy, Dr Mohammad Ayyash (JOR)

11:50 -12:10 Cancer of the Oral Cavity: Evidence Based Management, Dr Jesus Medina (USA)

12:10 -12:30 Discussion and Closure of the Session

38

Ishtar 1 – Jordan Society of Thoracic Surgeons Session (14:00-16:00)Moderators: Dr Nayef Frewan, Dr Sa’eed Al Fayomi, Dr. Shadi Hamouri

time topics14:00-14:20 VATS Lobectomy-Learning-Simulation, Dr René Petersen (DNK)14:20-14:25 Discussion

14:25-14:45 Posterior Mediastinal Masses: what should we think about?, Dr Hani Alhadidi (JOR)

14:45-14:50 Discussion14:50-15:10 VATS Advanced Resection, Dr René Petersen (DNK)15:10-15:15 Discussion

15:15-15:30 Management of NSCLC with N2 Disease,Dr Riad Abdel Jalil (JOR)


15:35-15:55 VATS Thymectomy with 5mm ports,Dr René Horsleben Petersen (DNK)



Ishtar 1 - Royal Medical Services / Neurosurgery Department Session (16:30-18:30)Moderators: Dr Waleed AlMaani, Dr Mohammed AlHusban, Dr Amer Shurbaji, Dr Awni Musharbash

time topics

16:30-16:50Pituitary Tumors How to improve Outcome – Experience in More than 700 Cases Managed at KHMC Over the Last 15 years, Dr Amer AlShurbaji (JOR)

16:50-17:10 Management of Posterior Fossa Tumors at KHCC,Dr Maher Alayyan (JOR)

17:10-17:25 Myth- Reality and Expert Appraisal in Degenerative Cervical Myelopathy Surgery, Dr Rami AlQroom (JOR)

17:25-17:40Concepts in Spinal Tumors Surgery; Experience and Outcome at King Hussein Medical Center,Dr Firas Shaban (JOR)

17:40-17:55 Rarity of Spinal Lesions Over Two Decades Experience at KHMC- Jordan, Dr Faisal Al Shubaji (JOR)

17:55-18:10 Management of CSF Leak after Spinal Surgery,Dr Rafeed Al Droos (JOR)


39


Ishtar 2 – Women in Surgery Session (10:30-12:30)Moderators: Dr Hanan Al Rihani, Dr Ghada Nimri, Dr Lara Alex Abu Ghazaleh, Dr Eman Sbeity

time topics

10:30-11:30

Women Surgeon as a Leader “open Discussion”Dr Lara Alex Abu Ghazaleh (JOR)Dr Suzan Al Bakheet (JOR)Dr Layal Al Asir (JOR)

11:30-11:50 Perception of Physicians on Women Surgeons ; Interview with Lebanese Physicians, Dr Eman Sbeity (LBN)

11:50-12:10 Saudi Women in Surgery : Changing the Social Norm,Dr Tamra Al Rammah (KSA)

12:10-12:30 Women Leadership in Surgery, Prof Townsend (USA)

Ishtar 2 - Surgical Jeopardy (08:00-10:00)Moderators: Dr Osama Hamed, Dr Mo’taz Naffa’, Dr Muhannad Qulaghassi

teams Candidates

Royal Medical Services Dr Ghassan Swaity,Dr Eyas Momani

Jordan University Dr Omar NobaniDr Ebraheem Obeidat

Jordan University of Science and Technology

Dr Mahmoud Al DariDr Rasheed Elyan

Jordan Hospital Dr Mazen Sentaresi,Dr Laith Rabadi

Specialty Hospital Dr Khaled Abu Ghali,Dr Abdelqader Asha

Islamic Hospital Dr Eyad Ju’edi,Dr Mahmoud Qandeel

40

Ishtar 2 – Hepatopancreaticobiliary Surgery Session (14:00-16:10)Moderators: Prof Abdalla Al Bashir, Dr Abdelaziz Ziadat, Dr Osama AL Bishtawi, Dr Khaled Ajarma

time topics

14:00-14:15 Stem Cell Therapy Improves the Outcome of Liver Resection in Cirrhotics, Dr Alaa Ismail (EGY)

14:15-14:30 Performing Safe Cholecystectomy, Dr Mostafa Elshazli (EGY)

14:30-14:40 Foreign Bodies in the Liver; Report of a Case and Review of the Literature, Dr Osama Hamed (JOR)


14:50-15:00 Surgical Role in Potential Respectable Pancreatic Cancer,Dr Sameer Smadi ( JOR)

15:00-15:10 Role of Surgery in Advanced Pancreatic Cancer,Dr Aiman Obaid (JOR)

15:10-15:20 Determining Resectability in Pancreatic Tumors,Dr Ashraf Sobhy (EGY)


15:30-15:40 GI reconstruction after Whipple; Different Procedures,Dr Mohammad Kofahi (JOR)

15:40-15:50 Laparoscopic pancreaticoduodenectomy, our initial experience at JUH, Dr Firas Obaidat (JOR)

15:50-16:00 Role of Neo-adjuvant Treatment in Potentially Respectable Pancreatic Cancer, Dr Reem Turfeh (JOR)



41

Ishtar 2 – Minimally Invasive Surgery Session (16:30-18:30)Moderators: Dr. Wael Na’san, Dr Khalil Zayadeen, Dr Ahmad Bashir,Dr. Osama Hamed

time topics

16:30-16:45 Accessing the peritoneal cavity in laparoscopy: what is the best approach? , Dr. Mohy Aldeen Albanna (EGY)

16:45-17:05 Innovative approaches to challenging diaphragmatic hernias, Dr. Adrian Park (USA)

17:05-17:15 Vascular Injury in Abdominal Laparoscopic Surgery, Dr. Mahmoud Abu Khalaf (JOR)

17:15-17:30 Optimal approach for Inguinal Hernia Repair: Open, TEP or TAPP?, Dr. Safwan Taha (UAE)

17:30-17:50 New vistas in ventral hernia care, , Dr. Adrian Park (USA)

17:50-18:05 Groin Pain after Inguinal Hernia Repair: What should you do? , Dr. Safwan Taha (UAE)

18:05-18:15 Tips and Tricks for Bleeding Control in Laparoscopic Surgery, Dr. Osama Hamed (JOR)



42


Ishtar 3 – Jordanian Society of Obstetricians & Gynecologists (10:30-12:30)Moderators: Dr Zuhair Ghosheh, Dr Mohammad Madani

time topics

10:30-10:50 Female Urinary Incontinence: Which Tape Do We Have to Use, Dr Bruno Deval (FRA)

10:50-11:10 Fetal Gastrointestinal Abnormalities, Dr Maher Maaita (JOR)

11:10- 11:30 Surgical Sperm Retrieval. What to Do, What not to do,Dr Khaldoun Sharif (JOR)

11:30-11:50 Laparoscopic, Vaginal and Open Way for Uterine Fibroids: State of Art, Dr Bruno Deval (FRA)

11:50-12:10 New Classification of Radical Hysterectomy,Dr Mazen Freij (JOR)

12:10- 12:30 Vesicovaginal Fistula in Jordan, Dr Ayman Qatawneh (JOR)

Ishtar 3 – Jordanian Association of Urological Surgeons Session (14:00-16:00)Moderators: Zyad Awwad, Khaldoun Gharaybeh, Adnan Abu Ghamar,Prof. Ibrahim Ghalayeeni

time topics

14:00-14:25 (Video Session) Laparoscopic Urology,Dr Gazi Edwan (JOR), Dr Samer Rawashdeh (JOR)


14:30-14:50 (Pediatric Urology) Minimally invasive pediatric surgery,Dr Nathan Novotny (USA)

14:50-15:10 (Pediatric Urology) Pediatric urology guidelines updates,Dr Mohammed Soob (JOR)

15:10-15:15 Questions15:15-15:35 (Surgical Oncology) Upper tract TCC, Dr Firas Hammouri (JOR)15:35-15:55 (Surgical Oncology) Lower tract TCC, Dr Rami AlAzab (JOR)15:55-16:00 Questions

43


Ishtar 3 - Jordan Society of Plastic and Reconstructive Surgery (16:30-18:30)Moderators: Dr. Mutaz Al-Karmi, Dr. Majed Jarrar

time topics

16:30-16:50 Overcoming the challenges of Thick Skin in Middle Eastern Rhinoplasty (video presentation), Dr. Jamal Jomah (KSA)

16:50-17:10 Management of Craniofacial War Injuries, Dr. Ghassan Abu Sitta (LBN)

17:10-17:30Difficult Secondary Breast Augmentations and Reconstructions using Polyurethane Implants and/or Adipose Tissue Grafting, Dr Christian Echinard (FRA)

17:30-17:50 Epidemiology of Parotid Masses in Jordan, Dr. Mahmoud Bataineh (JOR)

17:50-18:10 Staging of Revision Cleft Lip Repair, Dr. Ghassan Abu Sitta (LBN)

18:10-18:30 3 D in Plastic Surgery, Dr. Jamal Jomah (KSA)

Jerasia – ATLS Scientific Presentations Session (08:00-10:00)Moderators: Dr Saud Al Turki, Dr George Abi Saad, Dr Subash Gautam,Dr Mahmoud Odat

time topics08:00-08:05 Welcome , Mahmoud Odat (JOR)08:05-08:20 Trauma courses activities in the region XVII, Saud Al Turki (KSA)

08:20-08:35 TEAM Course as introductory for trauma management and for ATLS course, Abdulhakim Kholy (EGY)

08:35-08:50 Review of Trauma related injuries Bahrain, Jamal Saleh (BHR)

08:50-09:05 Setting Priorities in the Polytrauma Patient (Orthopedic point view) , Mahmoud Odat (JOR)

09:05-09:20 Evaluation of patients with abdominal trauma in Al Kadhymia teaching hospital in Baghdad, Anees K Nile (IRQ)

09:20-09:35 Penetrating trauma to abdomen in Children, Subash C Gautam (UAE)

09:35-09:50 Traumatic splenic rupture with peculiar findings (Case Presentation and litreture review), George Abi Saad (LBN)

09:50-10:00 Q & A & Discussion

44


Jerasia – ATLS 10ed Update Session (10:30-12:30)Moderators: Jamal Saleh, Abdulkarim Al Kholy, Khalil Zadeh, Khalid Ajarmeh

time topics

10:30-10:40 Introduction, Chief Region MENA 17 ACS-COT, Dr Saud Al Turki (KSA)

10:40-11:00 mATLS 10th Edition Overview and Implementation, Dr Wesam Abu Znadah (KSA)

11:00-11:30 10th Edition update student course, Dr Wesam Abu Znadah (KSA)

11:30-12:00 10th Edition update instructor course, Dr Wesam Abu Znadah (KSA)

12:00-12:15 Cruising the literature 2016, Diaa Ageib (SDN)12:15-12:30 Q & A & Discussion

Jerasia – ATLS Update from Countries Session (14:00-16:00pm)Moderators: Anees Nile, Diaa Ageib, Hazem Ajarmeh, Ahmad Uraiqat

time topics

14:00-14:05 Introduction, Chief Region MENA 17 ACS-COT,Saud Al Turki (KSA)

14:05-14:10 Introduction, Chair, ATLS-MENA region, George Abi Saad (LBN)

14:10-14:20 Update from ATLS Bahrain, Jamal Saleh (BHR)14:20-14:30 Update from ATLS Egypt, Abdulhakim Kholy (EGY)14:30-14:40 Update from ATLS Iran, Khalil Ali Zadeh (IRN)14:40-14:50 Update from ATLS Iraq, Anees K Nile (IRQ)14:50-15:00 Update from ATLS Jordan, Mahmoud Odat (JOR)15:00-15:10 Update from ATLS Lebanon, George Abi Saad (LBN)15:10-15:20 Update from ATLS Saudi Arabia, Saud Al Turki (KSA)15:20-15:30 Update from ATLS Sudan, Diaa Ageib (SDN)15:30-15:40 Update from ATLS UAE, Subash C Gautam (UAE)15:40-16:00 Q & A & Discussion

45

• pArALLeL CoUrSeS •

46

• pArA

LLeL Co

UrSeS •

Date: Tuesday, 5th sep ,2017Location: le Royal Hotel Amman, Jordan Faculty: Highly Qualified Mentors from many sectors in JordanTaregeted Audience: Surgical Residents,Junior Specialists ,

This Intense One day course is for surgical residents that want to excel in surgery and surgical techniques especially if they are preparing for junior surgery examinations. The

course's main purpose is to teach safe operating techniques and emphasizes the importance of precautions for safe theatre practice.

This program covers: Gowning and gloving, Handling instruments, Knots, Suturing techniques, Haemostasis, Handling bowel, Fine tissue handling, Electro-surgery, Wound

management and much more

The American College of Surgeons Jordan Chapter

Surgical Skills Course

Date: Wednesday, 6th sep ,2017Location: le Royal Hotel Amman, Jordan Faculty: Highly Qualified Mentors from Many Sectors in JordanTaregeted Audience: Surgical Residents, Junior Specialists.

This is an intensive one day course that focuses on the skills required for safe laparoscopic surgical practice. The course is a hands-on experience to say the least. The course is

designed for junior surgeons and surgical residents starting in minimal access surgery.This program covers: Camera manipulation, abdominal access and insufflation, ergonomics,

clip application electrosurgery, looping, and much more..

The American College of Surgeons Jordan ChapterLaparascopic Surgical Skills Course

(LSSC)

47

• pArA

LLeL Co

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Date: Tuesday 5th September, 2017.Location: Le Royal Hotel Amman JordanSpeakers: Highly Qualified International, Regional & national Experts ATLS Faculty

Trauma Evaluation and Management® (TEAM®) introduces the concepts of trauma assessment and management to medical students during their clinical years.The core content is adapted from the American College of Surgeons (ACS) Advanced Trauma Life Support® (ATLS®) course. Developed by the ATLS Committee of the ACS Committee on Trauma, TEAM is an expanded version of the ATLS "Initial Assessment and Management" lecture.

The American College of Surgeons Jordan ChapterTrauma Evaluation & Management Course


General Surgery Review CourseDate: Tuesday & Wednesday 5th, 6th September, 2017.Location: Le Royal Hotel Amman JordanSpeakers: Highly Qualified International, Regional & National Expert SpeakersTargeted Audience: Senior Surgery Residents, New Surgeons Preparing for the Surgery Board, and Experienced Surgeons for CME.Topics : Abdominal, Alimentary, Breast, Endocrine, Vascular, Trauma, Critical Care, Perioperative Care, and Pharmacology.

The most comprehensive General Surgery Review Course

The main objective of this two-day, multi-faceted course is to provide general surgeons with a review of the essential content areas of general surgery. The Expert speakers will use case-based approach to facilitate the

translation of the course content into practice.

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Date: Wednesday & Thursday 6th , 7th September, 2017.Location: National Emergency Medical Services Education Centre (NEMSEC), RMSFaculty: Prof. Dr. Wesam Abu Znadeh (Educator), Dr. Mahmoud Odat (Director) and Highly Qualified Regional & National ATLS Certified instructors.Targeted Audience: Doctors who satisfy the qualifications & characteristics of the model ATLS Instructor.Course Objective:The ATLS Instructor Course is a highly intensive one & half day course. Course Educator and faculty concentrate on teaching a variety of methods used to present information, guide the learner, communicate constructive criticism and evaluate performance. The Instructor Course teaches doctors how to teach in the ATLS Program. Knowledge of the medical core is not evaluated during this course; however, the ability to teach the Student course interactively and the affect as a potential

instructor candidate is carefully evaluated.

The American College of Surgeons Jordan ChapterAdvanced Trauma Life Support Course

(Instructor Course)

Date: Wednesday, 6th sep ,2017Location: le Royal Hotel Amman, Jordan Faculty: Highly Qualified Mentors from MSF-FRA.Taregeted Audience: Physicians, Nurses, Administrators, Hospital Emergency Planners who comprise a Hospital Emergency Response Team.Registeration is based on first come, first served basis (seats are limited)

A Mass Casualty plan implements a systematic delivery that integrates the immediate involvement of first responders when community resources, mutual aid, strike teams, and task forces are requested by incident commanders.The course focuses on how tasks are

divided and what to do in the event.

The American College of Surgeons Jordan Chapterin collaboration with Medecins Sans Frontieres- FRA Mass Casualty Plan Course

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Date: Friday 8th September, 2017. at 8 amLocation: Le Royal Hotel Amman Jordan

Jordanian Residency Programs are invited to nominate teams from 2 residents to participate in the Competition, Surgical Jeopardy allows teams of residents to showcase their surgical

knowledge. There will be valuable prizes for the winning team.


ACS Surgical Jeopardy

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reforming Graduate Medical education in Jordan Nidal Younes, MD, MA, TSRF

Residency and fellowship training in Jordan, is facing many challenges. Over the past few decades, Jordan has suffered from growing consultant shortage. In spite of the increasing number of medical school graduates, the number of residency training positions in Jordan has not kept pace. The number of Jordanian and non-Jordanian medical schools graduates has exceed the number of first-year residency positions in 2016.Adding to the problem, are the difficulties related to findings positions in training programs outside Jordan i.e. In the US and UK that were the most favorable sites for graduate training in the last century.The pass rates for all graduating residents on the Jordanian board Parts I and II, still low and varies between different specialties and among different health care sectors.Recent and emerging trends, such as population growth, changes in disease patterns, technology, and aging and are demanding rapid and simultaneous changes in medical education and health care delivery.Graduate medical education must play a vital role in adapting to these external and internal forces and leading health care change to the ideal health care system that provides the highest quality, most affordable, patient-centered care.Today, the challenges confronting GME in Jordan , and the solution requires a concerted effort to align graduate education to current and future health care and societal needs. Driven by our desire to rise to these challenges and by our mission to train, qualify and empower Jordanian physicians, JMC, working with the teaching hospitals, residency programs and health care sectors, is undertaking a comprehensive and sustained 2 year plan to optimize GME in Jordan.

Surgical training in Jordan, resident’s point of view Mo’taz Naffa’, MD, Muhanad Qulaghassi, MD, Mahmoud Al Masri, MD

The improvement in Jordanian health surgical services is a reflection of the development of the training system over the last several years; in which surgical residents are the corner stone. One of the major obstacles faced by surgical residents is limited understanding of their perspective about training and their teaching program. The objective is to study three main aspects; the satisfaction of surgical residents regarding the Jordan medical council and its role in supervising and developing their training, the variation in surgical training amongst the different health care providing sectors, and the impact of residency on the residents’ social and familial life. This study will be applied using on-line questionnaire, with a target of more than 300 responders. Conclusions will be based on the analysis of the feedback of Jordan Medical Council accredited surgical residents about their training through the several health care providing sectors in Jordan.Key words : training, residenc, surgery.

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Utility of two-node one-Step nucleic Acid cytokeratin-19 amplification assay total tumour load in breast cancer survival prediction N Al-Shurbasi1, V. Fung1, S. Kohlhardt1, G. Zardin2, P. Vergani21 Department Breast, Plastic and Reconstructive Surgery, Royal Hallamshire Hospital, Sheffield, United Kingdom.2 Department of Histopathology, Royal Hallamshire Hospital, Sheffield, United Kingdom.

Introduction: One-Step Nucleic acid Amplification (OSNA) was approved for routine use in the United Kingdom in 2013 as a technique for intra-operative nodal staging in early invasive breast cancer. The intra-operative reporting of macro-metastatic sentinel lymph node (SLN) disease using total tumour load (TTL) confidently predicts ≥ 2 nodal macrometastasis and facilitates the decision to adopt axillary conservation in a single procedure and has recently been reported to predict subgroups in disease-free and overall survival. We assessed the feasibility of two-node OSNA TTL as a substitute for traditional axillary node staging in determining prognosis in well-established and validated prediction models. Methods: The pathology reports of 700 consecutive patients who received OSNA (RD-100i, Sysmex) analysis for breast cancer at a single unit were reviewed. Patients who received neo-adjuvant chemotherapy, or underwent OSNA for extensive ductal carcinoma in-situ were excluded. Absolute, objective, quantitative CK19 mRNA copy numbers defined negative (< 250/uL), micro-metastatic (250 - 5000/uL) and macro-metastatic (> 5000/uL) node status (>5000-15,000/uL: ≤2 node +; > 15,000/uL: >2 node +; >54,000/uL: ≥ 4 node +). Patients with at least one macro-metastasis on whole-node analysis underwent ANC. The total CK19mRNA copy number TTL of each SLN sample was compared with the corresponding Nottingham Prognostic Index (NPI) and Predict status derived from routine axillary histological assessment for each patient.Results: 122/683 patients (17.9%) were found to have OSNA CK19 mRNA copy numbers indicative of macro-metastasis and underwent ANC. 50/122 (41%) patients had NSLN metastases on ANC. Independently, TTL failed to correlate or agree with any of the prediction models. When TTL results were transformed from continuous into categorical data, partitioned into disease burden subgroups then combined with tumour grade, correlation was very strong for overall (R2=0.78), > 2 positive nodes (R2=0.82) and ≥ 4 positive node (R2= 0.81) thresholds. The Limits of Agreement (Bland-Altman) were narrow and clinically sound (2SD=0.25, NPI). Conclusions: OSNA TTL stratification can substitute traditional axillary node staging and be used as a surrogate in prediction modeling.

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risk reducing Mastectomy in Sporadic Breast Cancer Layal Al Asir, MD

Although breast conservation techniques have greatly advanced, especially with the use of neoadjuvant chemotherapy and downsizing of tumors, many women are still requesting a more radical approach to their treatment; namely mastectomy with or without reconstruction. Often, with this decision, comes the request for a contralateral mastectomy, even though they do not have any demonstrated genetic risk. The decision whether to perform this procedure, and whether to perform it concomitantly or as a later delayed procedure will be addressed in this presentation. This presentation addresses our patients’ reasons for requesting contralateral “prophylactic” mastectomy, the difference between perceived risk and actual risk, as well as the impliations of this request in terms of physical and psychological benefits and complications. We will present the evidence that contralateral mastectomy does not improve overall survival or disease free survival. We will also present the approach we suggest when discussing this request with patients. Some cases will be presented for discussion.

pelvic exenteration, initial experience and outcome at Colorectal Unit, King hussein Medical Center.Ahmad Uraiqat FRCS FACS, Haitham Rubehat FACS, Mohamad Lababdeh JBS, Khaled Mestarihi JBS, Fadi Maaitah JBS.

Objective: To present the initial experience and postoperative outcome of pelvic exenteration procedure for advanced or recurrent pelvic malignancies.Methods: Between January 2016 and March 2017 all patients who underwent pelvic exenteration procedure were included in this study. Demographics, type of procedure, completeness of excision and postoperative morbidity and mortality were analyzed. Results: There were 11 females and one male with a mean age of 57 (range 37-77). Mean BMI and mean ASA score were 22.6 and 2, respectively. There were thirteen operations in 12 patients, ten surgeries were for advanced primary tumours and 3 for recurrent malignancies, eleven (10 patients) surgeries were for colorectal malignancies and 2 for gynecological tumors (one cervical and 1 uterine). Six patients received neoadjuvant radio-chemotherapy. There were 10 posterior pelvic exenterations, two total pelvic exenterations and 1 posterior pelvic exenteration with sacrectomy. Completeness of tumour excision R0 (> 2mm from circumferential resection margin) was observed in 10 specimens, not mentioned in two and incomplete in 1. Post operative morbidity was 42% (5 patients), and 30 day mortality was 17% (2 patients ). Conclusion: Pelvic exenteration operation is a complex procedure that requires a multidisciplinary approach involving the colorectal surgeon, urologist, orthopedic surgeon, plastic surgeon, radiologist, clinical oncologist,

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radiation oncologist and gastroenterologist. Gaining experience in this type of procedure will diminish postoperative morbidity and mortality. We need to assess the 5 years survival that approaches 45% in advanced centers.

Colorectal Cancer in Ulcerative Colitis patients: A Surgical perspective.Tareq M. Al- Jaberi, MD, FRCS. Professor of surgery- JUST.

Although ulcerative colitis (UC) is primarily treated medically, surgery may be required in patients who become refractory to medical therapy or develop severe complications. Approximately 15% to 30% of patients with UC will require or elect operative intervention at some point in their lives. The role of surgery becomes more pronounced when it comes to the management of colorectal cancer which is a known complication in ulcerative colitis patients. This role can be prophylactic or therapeutic. Surgery for UC should be indicated by interdisciplinary means. The choice of operation requires consideration of the advantages and disadvantages of each option and must be tailored to an individual patient’s needs and circumstances. This presentation aims at throwing some light on the role of surgery in the management of colorectal cancer in patients with UC, operative choices, complications and their management.

Global humanitarian projects for Severe Burn patientsProf. Christian Echinard – Humaniterra International Marseille - France

The author is reporting here a twenty year survey in the management of severe burn patients, all over the world, by a European surgical NGO , HumaniTerra, between 1977 and 2017. This NGO has been performing surgical procedures in all types of surgery, in more than 15 countries, providing also at the same time surgical and intensive care training and teaching, and surgical facilities refurnishing or rebuilding. This paper aims at considering the NGO’s work in a very specific topic : the burn patient. It will show the involvement of our surgeons, anesthetists, nurses, and physiotherapists in that very difficult, expansive, and time consuming activity. All types of acute burns (flame, chemical , electrical) are treated. All types of burn secondary contractures and tissue losses are operated using the most accurate techniques. Thousands of severe patients have been treated within the 20 last years. Our programs include: • The HumaniTerra burn project in Cambodia.• The management of acid and flamme burns on our three hospital boats in Bangladesh with our local partner.• The building and organization of a 3000 square meter pilot burn center in

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Afghanistan for the women self inflicted burns• The logistical help for burn care in Pakistan• The treatment by some 20 different teams of the numerous burn patients during the Haïti earthquake. • It also include the surgical care and assistance given to the near east and Middle East Countries during the recent political conflicts and crisis in the last five years, in south Tunisia, Libya, Gaza strip, and for the Syrian refugees. The author is reviewing these numerous situations and is giving a modern approach to the type of help that can be provided, including surgical local care, rehabilitation follow up, specific European training grants and invitations to lectures and international round tables on this topic.

3D technology Applications for humanitarian SettingsSafa T. Herfat, PhD, Pierre H. Moreau, PT, MSc, Rasheed M. Fakhri, MD

As the conflicts in the Middle East continue, surgeons in the region continue to perform an alarming amount of reconstructive surgeries and amputations for the war wounded. MSF Doctors Without Borders has recently initiated an innovation project in Jordan, which aims to evaluate the value of applying 3D technologies in humanitarian contexts to 1) improve the outcomes of complex reconstructive surgeries and 2) increase access to prosthetic care.Surgical ApplicationsThe use of patient-specific anatomical models for pre-operative planning, patient specific surgical guides for deformity correction and patient-specific implants have been previously reported. Most institutions have used expensive software and 3D printers to design and print even the anatomical models. We aim to evaluate cost-effective solutions and remote strategies for the pre-operative planning and intra-operative surgical guide applications. One key limitation of implementing these 3D applications is that a CT scan is required to create the 3D models. Also, designing patient-specific surgical guides and implants may require significant design experience and is often a time consuming process. The project is initially focusing on implementing the pre-operative planning and dental/surgical guide solutions. Finally, we will evaluate the use of this 3D technology to design and print patient-specific external fixator attachments to guide deformity corrections. These external guides could provide a safer option as the ex fix approach requires less invasive methods, less surgeon experience, and limited setup. Designing the guides remotely and printing on-site could offer a potential solution for settings where experienced designers are unavailable. Prosthetics and Orthotics ApplicationsFollowing amputation, patients may not have access to a prosthetic clinician or prosthetics. Furthermore, there is an overwhelmingly limited access to prosthetic care in many developing countries beyond the Middle East. The majority of organizations that deliver prosthetic care in humanitarian situations are focusing on lower limb amputees, a population

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much larger than the upper limb amputee population in most settings. This often leaves upper limb amputees as a neglected population. Even after an upper limb prosthesis is provided, there is often a high rejection rate by the amputee for various reasons including heavy weight, poor aesthetics, need for maintenance, lack of proper rehabilitation and training. These are all issues that we seek to address with our interdisciplinary team, which includes: orthopaedic surgeons, a prosthetic clinician, a physical therapist, an occupational therapist and a biomedical engineer. Due to the stigma with having a missing limb in the Middle East and other regions in the world, the project will initially focus on the design and delivery of a lightweight and durable cosmetic solution. The next aim will be to design easily interchangeable patient-specific terminal devices (i.e. tools). Clinical assessments will be conducted with each patient to determine the specific prosthetic needs of each patient and to perform iterative design cycles with each patient. The final aim will be to develop active body-powered solutions that will offer a multi-functional prosthesis.All patient-specific prosthetics and orthotics applications will require 3D surface scanning, rather than CT scanning, to capture surface geometry. There are cost-effective scanners on the market but they need to be validated for each application. Other potential applications include burn masks and breathable, washable fracture casts.

emergency Surgical Care in Disaster SituationsChallenges and opportunitiesGérard PASCAL, M.DHospital surgeon. Henri Mondor Hospital (Paris-France)Head of Médecins du Monde Middle-Est programs

Key words Surgery. Emergency. Operational. Partnership.IntroductionIn developing countries, the precarious, unstable and insecure contexts affect the ability to respond to the humanitarian emergencies where surgical teams are often on the “front line” and where setting up a surgical program is challenging, both for direct and collateral victims, both for an immediate answer as well for post-emergency. This presentation, focused on disaster situations, will be based on the experience of Médecins du Monde in emergency humanitarian situations, with the example of the earthquake in Haiti in 2010.Concerns• In operational terms, four main issues must be raised as a priority. Is it necessary to intervene? Where? Which team? Which equipment?• In terms of human resources it is becoming more and more difficult to recruit teams of general surgeons and it necessitates training and support for the more junior amongst them.• On ethical plan, it is difficult to find a balance between the quality of care and adhering to a minimum standard in order to reduce the mortality rate.

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ConclusionAll of these challenges will not be overcome without the help of the balanced and harmonious partners along with other Southern actors that facilitate humanitarian action

high rates of antibiotic resistance in war wounded patients in a reconstructive surgical program in Amman, Jordan Nastaran Rafiei,MD, Naghem Hussein, William Thompson, Luma Kilani, Caroline Seguin, Nada Malou, Rasheed M. Fakhri, Rupa Kanapathipillai

Background: Médecins Sans Frontières (MSF) has been running a surgical reconstructive program in Amman Jordan since 2006. War wounded individuals from Iraq, Syria, Yemen and Gaza are referred to the facility to undergo orthopaedic, maxillofacial and plastic surgery. Most patients have had extensive medical and surgical treatment in their home countries prior to referral, with infections playing a significant role in treatment failure and referral to the MSF program. MSF established its own microbiological laboratory in Amman in 2015 with the aim of improving microbiological diagnoses and antibiotic treatment of patients. Methods: A retrospective analysis of all patients and microbiological data from January to December 2016 was undertaken to describe the rates and patterns of antibiotic resistance. Results: A total of 536 patients were admitted and 1078 surgeries were performed, comprising of 531 orthopaedic, 191 maxillofacial and 263 plastic surgery operations. In addition, 93 mixed specialty or dental operations were undertaken. The nationalities of the patients were as follows: Yemeni 21%, Iraqi 30%, Syrian 43% and Palestinian 5%. The average age of the patients was 28.6 years and 78.5% were male. One thousand four hundred and eighty two samples were processed from 649 patients. The majority of samples (86%) were collected intraoperatively, with bone cultures representing the most frequently sampled site (49%). The most commonly isolated organisms from bone samples were Staphylococcus aureus (26%), coagulase negative Staphylococcus (22%), Klebsiella pneumoniae (6%), Pseudomonas aeruginosa (6%), E.coli (5%) and Enterococcus spp (4%). Antimicrobial resistance was common with 54% of all Staphylococcus aureus isolates testing resistant to methicillin (MRSA). Of the Enterobacteriacae isolates, 69% (117) were ESBL (extended spectrum β-lactamase producing). 19 strains of carbapenem resistant Enterobacteriacae strains (CRE) were isolated. The greatest expenditure for antibiotics was on meropenem, vancomycin and tigecycline. Conclusions: We show a high rate of antibiotic resistance in war wounded patients in the Middle East. There is a need for ongoing microbiological surveillance to monitor the rates and patterns of antibiotic resistance in this unique patient population. Greater knowledge will help ensure treatment guidelines are tailored to the local context and that patient care is optimised.

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the Use of tSF in treating Diversity of Limb DeformityFadi M. AlRousan, MD1, Firas Suleiman,MD, Fatima Mahmoud hussen althodan, SN(1)Senior Orthopedic, Orthopedic Department, Royal Medical Services

Tylor spatial frame is one of the recently introduced devices in orthopedic practice. It’s unique design, strut distribution, and the simplicity of the frame and it’s application allows the use of it in a wide variety of musculoskeletal conditions, ranging from simple lengthening procedures to more complex deformities as well as complex fractures and fractures of non union. Since its introduction to our institute, we have used it in to treat more than 50 cases with different pathologies, and the results proved to be satisfactory to the patient and treating surgeon as well.But despite the frames advantages, there are many complications that may arise with using it similar to those in other circular fixators. However, the key for achieving better results is knowledge of deformity correction principles.

effect of Bidirectional Cavopulmonary Anastomosis (Glenn Shunt) on Atrioventricular valve regurgitation in patients with Single ventricle Zeid Makahleh, FRCS (C-Th), Nairooz Al-Momany,MSc Departement of Cardiac Surgery, Queen Alia Heart Institute, King Hussein Medical Centre, Amman, Jordan

Background: In some patients with single ventricle and moderate atrioventricular valve regurgitation (AVVR), there might be some improvement in the degree of valve regurgitation after the bidirectional cavopulmonary anastomosis (BCPA) without undertaking concomitant valve repair.Methods: We retrospectively reviewed our experience with patients who underwent the BCPA between February 2010 and February 2017 and who have moderate AVVR. The degree of AVVR was assessed by color Doppler echocardiography. We operated on 521 patients who underwent BCPA at a median age of 11.4 months (range7 months to 3.2 years). Significant (moderate or severe) AVVR before BCPA was noted in 26 of 521 patients (5%) and was significantly more prevalent in patients with a common atrioventricular canal (10 of 49 patients, 20%)Results: Of the 26 subjects with moderate or severe AVVR, 5 had concomitant interventions (atrial septectomy in 2 cases, pulmonary artery angioplasty in 3 cases) at BCPA. There were 2 hospital deaths (7.7%). Of the remaining 24 survivors who did not undergo additional interventions at BCPA, improvement in AVVR (mild or none) was noted in 4 (16%) at intermediate follow-up (median, 1.5years; range, 0.3 to 6.7 years). Three survivors required interventions for AVVR (2 valve repair, one replacement). The rest of survivors 17(65%) maintain a moderate degree of AVVR and were managed

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conservatively. The presence of significant AVVR before BCPA was not significantly associated with hospital survival or intermediate-term freedom from death.Conclusions: We conclude that AVVR improves in some patients after BCPA and that systematic valve repair is not justified in all patients with moderate preoperative AVVR.

the influence of “enhanced recovery after Surgery” protocol (erAS) on readmission rate for patients Undergoing Colorectal Surgery.Haitham S. Rbihat, MD, JBS, FACS, Khaled Mestareehy, MD, JBS, Mohammad Lababdeh, MD, JBS, Fadi Maita, MD, JBS, Abdallah Abu Anzeh,MD, JBS, Mahmoud Sawalqa, MD,JBS, Ahmad Uraiqat, MD, JBS,JBCRS, FRCS, FACS.

Objective: To investigate the role of ERAS Protocol on readmission rate for patients undergoing colorectal surgery at King Hussein Medical Center (KHMC).Materials & Methods: In the period from January 2015 to May 2017, all patients who underwent colorectal resections at colorectal unit were included in this study. Data collected are demographics, type of procedure, hospital stay, post operative mortality & morbidity and readmission rate.Results: Among 200 patients included in this study 115 were females (57.5%) and 85 were males (42.5%), the mean age was 55.3 years (range 20 -84 years). The mean duration of hospital stay was 4 days (2-8 days). Type of procedure as follow: Total proctocolectomy 11 (5.5%), Right hemicolectomy 26 (13%), Left hemicolectomy 41 (20.5%), Low anterior resection 46 (23%), Abdominoperineal resection 26 (13%), pelvic exenteration 12 (6%) and others 38 (19%). Thirty-day Mortality rate was 2.5% (5 patients) due to cardiac cause 2, massive pulmonary embolism 1, sepsis 1 and suspicious adrenal insufficiency 1. Thirty-day readmission rate was 15.5% (31 patients): General weakness & dehydration 3, Intestinal obstruction (ileus) 7, Wound infection 14, Thromboembolic events 3, Stoma dehiscence 1, Urinary tract infection 1 and Urinary retention 2.Conclusion: ERAS Protocol has a higher rate of readmission in patients undergoing colorectal surgery in comparison with traditional perioperative care.

Breast Cancer Facts in PalestineOsama Atallah, MD - Head of surgical department at PMC

All over the world, big efforts were applied to decrease the mortality and morbidity related to breast cancer, and in some studies, the overall benefit from early detection was gaining 18 years of life. This was achieved by

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implementing screening programs, utilizing mammography, BSE, CBE with complementary US or MRI. In Palestine the leading cause of cancer deaths in women is breast cancer. Furthermore, statistics show an increase in its percentage in relation to deaths from other cancers, in spite of implementing governmental and non-governmental screening programs. In our Study, We found that 90% of women had tumor size more than 2 cm, 67% had lymph node metastasis,32 % had distant metastasis, and only 18% had well differentiated tumors. In addition, we found that a very small percentage of women go for screening. This may be the result of the lack of centralized, specialized breast care centers, and the lack of complementary investigations. We can conclude that the increasing rate of deaths from breast cancer is related directly to a deficient screening program in addition to scattered not centralized medical efforts. We also can say that the peak age of incidence of breast cancer in Palestine is 55 years which is similar to other countries ,but there is an increase in the mortality rate. This fact should trigger the health care providers to look in depth in this problem and make conclusions and decisions in order to change these facts regarding breast cancer mortality.

Correction of Secondary Cleft lip Deformities encountered at the royal Jordanian rehabilitation Center: Surgical Approaches and review of CasesMohammed Nayef AL-Bdour, MD, Khaldoun Dweikat AL-Abbadi, MD, Imman hijazeen, RN, Razan Sabri Almulla, RN, Mohammed Saleh Khataibeh, RN, Bder Faisal Albanna, ATDepartment of Plastic and Reconstructive Surgery, King Hussein Medical Center, Royal Jordanian Rehabilitation Center, Royal Medical Services, Amman, Jordan

Background: Cleft lip is common congenital anomaly in our population. It imposes serious psychological and social disturbances in both children and their families. With the great evolution of pre surgical orthodontist management and the continuous rejuvenation in surgical techniques, primary cleft lip repair with primary rhinoplasty has become the keystone of successful management. Unfortunately, secondary deformities may persist due to severity in the primary deformity or lack of proper techniques in management. In this review we present our approach and current practice at the Royal Jordanian Rehabilitation center. Methods: This is a retrospective study of 37 patients with secondary cleft lip and nasal deformities who were classified, and surgically treated from January 2014 to January 2017. Surgical technique included a hybrid combination of multiple modalities. For secondary cleft lip deformities, total lip repair revision with conversion to inferior triangle technique in unilateral cases, total revision with variant techniques in bilateral cases and local flaps rearrangement, dermal fat grafts, fat grafts and nano-fat grafting

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for both groups were performed. For secondary nasal deformities, open septorhinoplasty was performed in adult patients and semi-open tip plasty in children. Average follow up period was one year.Results: The age of the patients ranged between 3 to 24 years (mean age 13 years). Pediatric to adult patients ratio was 1:2, male to female ratio was 1:1, ratio of unilateral to bilateral deformity was 6:1. The most common presenting motive for surgery was psychosocial disturbances. The most common form of deformities were nasal deformities and white roll/vermilion mismatch. 51.3% of the patients had a combination of three or more deformities and were managed with total lip revision.Conclusion: Secondary cleft lip and nasal deformities are not uncommon after primary cleft lip repair. A wide range of deformities addressed and a combination of deformities might be the problem to encounter in the same patient. Different surgical options are used with a hybrid combination of multiple techniques may be needed and tailored individually. Still the best management of these secondary deformities is prevention. This is ideally achieved as a multidisciplinary team work at the time of initial surgery, where the plastic surgeons and the orthodontists play the major role.Key words: secondary cleft lip deformity, cleft lip, cleft lip repair, cleft lip revision.

Malignant obstructive Jaundice in the nCi Cairo University review of 232 patientsMohammed Gamil MD; Nelly Hassan Ali Eldin MD; Ali Hassan Mebed MD; Ashraf Sobhy Zakaria* M.Sc.Surgical oncology department; biostatistics and cancer epidemiology department;Surgical oncology department; surgical oncology department at National Cancer Institute Cairo University, Egypt.

Background: Obstructive jaundice is a common problem in the medical and surgical gastroenterological practice. Malignant obstructive jaundice can be caused by cancer head of pancreas, periampullary carcinoma, carcinoma of the gall bladder and cholangiocarcinomas.Objective: to review the etiological spectrum of malignant obstructive jaundice in NCI Cairo University during a period of 3 years (2008 till 2010).Patients and Methods: retrospective study including 232 patients who presented with malignant obstructive jaundice between (2008 to 2010). Data was collected from the biostatistics and cancer epidemiology department.Results: out of 232 patients; 156 (67.2%) were male and 76 (32.8%) were female; the median age of the study population was 49 years (range 19-80 years). The commonest cause of malignant obstructive jaundice was pancreatic head cancer 72% (167/232), followed by the ampullary carcinoma 15% (36/232).The last cause was cholangiocarcinoma12.5% (29/233). Regarding the commonest symptoms; clay colored stools (98.7%)

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was more frequent in patients with malignant disease whereas abdominal pain (97.7%) was the 2nd common cause.Conclusion: Obstructive jaundice is more common in males and cancer head of pancreas is the commonest malignancy. US, ERCP and CT-Scan are important diagnostic modalities for evaluation of patient with obstructive jaundice with ERCP having the additional advantage of being therapeutic as well.Keywords: Obstructive jaundice, ERCP, Ca Head of pancreas, Ca gall bladder.

Laparoscopic & Laparoscopic Assisted pyeloplasty for repair of pelvi-ureteric Junction obstruction in ChildrenMohamad Dajah, MD, JBPS, JBGS , Najeh yousef Alomari, MD, FACS, IMRCS/FRACS, FEBPS, JBPS, JBGS, Dr Asma Aref Idamat, Pharmacist, Queen Rania Hospital for Children/ KHMC/ RMS/ Jordan

Objectives: Over the past 4 years, the treatment of choice for pelvi-ureteric junction obstruction in our team is by laparoscopy & laparoscopic assisted technique. The aim of this study is to evaluate our experience in transperitoneal laparoscopic & laparoscopic assisted pyeloplasty in children with pelvi-ureteric junction obstruction. We review the safety, efficacy, outcome parameters of operative time, analgesic requirement, and hospital stay. We present the follow up protocol and the complications.Methods: With Institutional Review Board approval, the data of all patients undergoing laparoscopic & laparoscopic assisted pyeloplasty at Queen Rania Hospital for Children / King Hussein Medical Center were retrospectively reviewed of prospectively collected data over 4 years (June 2009-2013). The medical records of 80 children who underwent transperitoneal laparoscopic and laparoscopic assisted Anderson Hynes dismembered pyeloplasty were reviewed. The indication for pyeloplasty was kidney obstruction with deterioration of renal function on diuretic dynamic renogram (MAG3) scan and ultrasound. In the first group, laparoscopic assisted pyeloplasty performed in 62 patients and in the second group, totally laparoscopic pyeloplasty was performed in 18 patients, reduction of the renal pelvis performed in 60 renal units in both groups. JJ stent was inserted by laparoscopy and laparoscopic assisted maneuver in 74 renal units in both groups. Perianastomotic drain was placed for 2 days in 15 patients in both groups. Bladder catheter was inserted in all patients of both groups for 24-48 hours for protection of anastomosis. Follow-up included clinical assessment, functional assessment by ultrasound and (MAG3) scan after removing the JJ stent at 2 and 6 months.Results: The patients included 34 females and 46 males; the mean age was 6.4 years (range 2 months -12 years). Right sided pyeloplasty N=32, left sided pyeloplasty N=48. An aberrant crossing vessel N=12. Out of the 80 patients, 6 patients underwent bilateral pyeloplasty in the same operation, 2 patients out of them had bilateral pyeloplasty for crossing vessels. Re-do pyeloplasty

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by laparoscopy N=3. Mean operating time for the totally laparoscopic pyeloplasty was 200 min (range 120-400 minutes), while for the laparoscopic assisted pyeloplasty was 70 minutes (range 50-95 minutes), P value (<0.05). Six patients had other laparoscopic surgery with the pyeloplasty simultaneously. Mean hospital stay range from 2 to 5 days. There were no peri-operative complications, no conversion to open pyeloplasty. No blood transfusion required no anastomotic leak and no mortalities. Seventy four patients showed improvement of renal function after removal of JJ stent by ultrasound and diuretic dynamic renogram (MAG3) scan , 6 patients underwent once balloon dilation for anastomotic stenosis 3 months post-operatively after follow up (MAG3) scan and US demonstrating a reduction of drainage and an increase in hydronephrosis .Conclusion: Transperitoneal laparoscopic and laparoscopic assisted pyeloplasty in children are feasible, effective and safe techniques with minimal complications and gives excellent long-term cosmetic and functional results. The hospital stay and convalescence are short and hence rapid return to normal activity is expected with less analgesia requirements, however, the laparoscopic pyeloplasty is more difficult and the operative time remains longer than open pyeloplasty, while the laparoscopic assisted pyeloplasty operative time is even less than the open procedure and the operative time could be reduced by experience. These procedures should be standardized and practiced in pediatric surgical units under the supervision of expert pediatric laparoscopic surgeons with high experience in pediatric urology to achieve the best outcome and learning curve.Keywords: laparoscopy, laparoscopic assisted ,pyeloplasty, children

objective and Subjective improvement in Children with idiopathic Detrusor overactivity after intravesical Botulinum toxin injectionMhailan Marashdeh, MD, Ghazi Al Edwan, MD

Objective: To evaluate the effect of Intravesical Botulinum toxin injection on the symptoms and urodynamic parameter in pediatric patients with idiopathic over active bladder (iOAB) refractory to medical treatment.Materials and Methods: The study was designed as an open-label uncontrolled therapeutic clinical trial, in which the eligible patients who underwent intravescial botulinum toxin injection (iOAB) were evaluated pre and postoperative, and the results were compared using paired samples t-test. The evaluation included 7-day paper bladder diary to assess OAB symptoms (frequency, UUI, nocturnal enuresis (NE)), filling the Arabic International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI short form, and conducting urodynamic study. The Urodynamic parameters obtained were the maximum detrusor pressure during filling, cystometric bladder capacity, and compliance.Results: 75 patients were enrolled in the study. Statistical Analysis was done on 46 patients who followed the study protocols, the mean of age was 8.9 years, and female to male ratio was 4:1. The mean of over active bladder

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symptoms ( frequency, UUI, nocturnal enuresis (NE)), the Arabic International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form(ICIQ-UI short form ,and urodynamic parameters were evaluated pre and post intravesical botulinum toxin injection at 12 weeks, and it showed statistically significant improvement in all parameters with minimal side-effect Conclusions: The evidence in this study would support the safety and efficacy of Botulinum Toxin A in children with refractory idiopathic OAB with significant improvement of OAB symptoms, quality of life as well as urodynamic parameters including uninhibited contraction, compliance and bladder capacity.Keywords: Idiopathic detrusor over activity , Intravesical botulinum toxin injection, Overactive bladder ¬¬

internal Mammary Artery perforators: the Best Substitution to the internal Mammary Artery As recipients in Free tissue transfer For Breast Reconstruction. Khalid A. El-Maaytah, MD Senior Specialist, Department of Plastic and Reconstructive Surgery / Jordanian Royal Medical Services, Jordan Armed Forces, Amman, Jordan

Breast reconstruction is becoming an essential procedure post mastectomies or secondary breast deformities. Autologous breast reconstruction using free tissue transfer became widely accepted and done routinely in most centers. The historical use of the internal mammary artery (IMA) as a recipient vessel to the flap is still the power horse for most surgeons in the last two decades and preferred to thoracodosal artery (TDA) which was popular in the 1990s. Some critics raised their concern regarding the sacrifice of the IMA and the possible need for future coronary revascularization. In addition, the need for a longer flap pedicle and a proper flap positioning motivated surgeons to look for a substitute. The internal mammary artery perforators (IMAPs) were the best answer in addition to more advantages, however, it is still not widely popular. In this study, we highlight the experiences of some experts who achieved satisfactory results in using IMAPs as recipient vessels in different kinds of free tissue transfer for breast reconstruction through a systematic review of the literature.Key words: breast reconstruction, internal mammary artery perforators, recipient vessels.

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new surgical technique for the Management of hepaticojujenostomy Stricture: Case reportAbdulhamid Al-Abbadi MD, Tariq.AlMunaizel MD, Raed Al-jarrah MD, Mohammad AljbourMD,Mo’tazNaffa’MD,EmanOudat RN, Sameer smadi MD.Introduction: Hepaticojejunostomy stricture development after hepaticojejunostomy for benign diseases is one of the difficult and serious complications of biliary surgery. Untreated stricture is associated with jaundice; recurrent cholangitis, intrahepatic stone formation, and may end with secondary biliary cirrhosis that may further need liver transplantation in the end.Method: Three patients presented with benign hepaticojejunostomy stricture, one patient following choledochal duct excision and two patients following common bile duct injury. The three patients initially underwent an endoscopic retrograde cholangiography (ERCP) using double-balloon enteroscope. Unfortunately all were unsuccessful due to the sharp angle between the jujenal limb and the biliary tree. Following ERCP, Percutaneous transhepatic cholangiogram (PTC) was performed to all patients but also failed to drain the biliary tree or dilate the stricture after 3 trials. In one of the three patients, the cause was the presence of intrahepatic stone. Next step was the use of surgical intervention. During the operation, we performed a 5 cm longitudinal incision at the jujenal limb, about 2 cm below the anastomotic edge. The narrowed anastomosis was cannulated with a 4 or 5 French catheter then two 5/O or 4/O Polydioxanone sutures placed at the edges of the catheter at 9 and 3 O’clock position. The Next step was to make an incision in between at 12 O’clock for 3-5 mm with traction applied on the lateral sutures, and several stitches then placed between the wall of the CHD and the jujenal mucosa using the same suture material. The incision then was further extended in the similar manor until the dilated part of the common hepatic duct reached and extended for another 5-7 mm with multiple sutures placed every 2-3 mm. Biopsy is always taken from the incision site by scalpel and sent for frozen section to rule out malignancy. Jujenal wall closed in two layers and the abdomen is closed without drains. Results and conclusion: Postoperative course was uneventful and the patients were followed for 9-12 months, in terms of Liver function tests and ultrasound exams all done every 3 months. The liver function tests showed normal enzymes. The transabdominal ultrasound also showed normal biliary tree and patent anastomosis. This new simple procedure and its promising result may replace more sophisticated procedures for the management of benign hepaticojejunostomy strictures. Further studies consisting of larger number of patients and longer period of follow up are needed to reach a definite conclusion.

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Axillary trichilemmal Carcinoma with Lymph node invasion: Case report Heba G. Dboush, MD, JBGS, Doaa A. Rahamneh, RN Haijar A. Hussein, RN

Trichilemmal carcinoma is a rare malignant lesion of the outer hair sheath, originating from a hair follicle cell. It usually occurs on photoexposed areas especially on the face, scalp, neck and back of hands, mainly in elderly subjects. It is considered to be a low-grade carcinoma with low metastatic potential. The number of reported cases has been increasing lately. Surgical excision is considered to be the first choice for curative treatment. Local recurrence and metastasis are rare after surgical excision. Prognosis is generally good. Here, we present a case of trichilemmal carcinoma of the axilla that presented with an axillary lump and found to be invading the axillary lymph nodes. The only significant risk factor seems to be the prolonged use of a topical skin preparation for hair removal on the axilla. The patient was treated successfully with surgical excision.

the risk of Malignancy in Multinodular Goiter Compared to Solitary thyroid nodules.Ashraf F. Faouri, MD, MRCSI, Maysoon K. Al Ruhaibeh, MD, FRCPath, Abdallah O. Al-Shawabkeh, MD, JBS, Feras A. Almbaidin, MD, MRCS.

Aim: It’s generally believed that multinodular goiter is associated with a lower risk of malignancy compared to solitary thyroid nodules. In this retrospective study, this will be our null hypothesis and we aim to prove or reject it.Material & Methods: The medical files and histopathology reports of 600 patients who underwent thyroidectomy at King Hussein Medical Center were reviewed. Data including patient’ age, gender, presentation, ultrasonography, FNAC, surgical procedures, final histopathologic diagnosis and the stage of malignant tumors were collected and analyzed. The primary end point was the assessment of prevalence of differentiated thyroid carcinoma in patients with multinodular goiter (MNG) compared to those with solitary thyroid nodules (STN). Secondary endpoints included demographic differences and prognosis.Results: Over a period of 4 years, 600 patients who underwent thyroid surgery were included in this study. There were 459 females (76.5%) and 141 males (23.5%) with a mean age of 44.3±14.5 years (range 14-85). After exclusion of 33 patients, 224(39.5%) presented with STN while the remaining 343(60.5%) had more than one nodule. The prevalence of thyroid cancer was 41.1% (92/224) in STN compared to 29.2% (100/343) in MNG (Chi-Square=8.593, P = 0.003). However, on multiple logistic regression analysis this correlation was found insignificant (p=0.640). Only male gender (p= <0.000005) and preoperative impression of malignancy (p=0.000082) were significantly associated with thyroid carcinoma.

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Conclusion: The risk of thyroid carcinoma in STN and MNG is equivalent. Male gender and preoperative diagnosis of malignancy by clinical findings, US or FNAC are the main risk factors for thyroid carcinoma. US should be routinely employed for assessment of thyroid nodule whether single or multiple. Each nodule in MNG should be managed independently based on US-characteristics. Keywords: thyroid cancer, solitary thyroid nodule, multinodular goiter

pituitary tumors, how to improve outcome ?experience in more than 700 cases managed at King hussein Medical Center over the last 15 yearsFiras Sha’ban, MD, Hareth Ma’aya,MD, Amer Al Shurbaji,MD

Pituitary tumors are common cranial pathologies encountered mostly in adult patients .They can present with different syndromes and clinical scenarios involving endocrine, visual and nervous systems. These tumors can be surgically approached via a variety of corridors including Cranial, Microscopic Endonasal, and Endoscopic Endonasal. Teamwork management of these tumors can improve the surgical outcome, decrease morbidity and mortality, and help in preserving the pituitary gland function if possible. We will discuss our experience in management of more than 700 cases at our Center (King Hussein Medical Center, Amman-Jordan).

Myth- reality and expert Appraisal in Degenerative cervical myelopathy SurgeryRami Alqroom MD, Wafa’a Albtoush SN, Arwa Al zu’bi SN, Doha Al ajarmeh SN, Amer Al Shurbaji,MD.Neurosurgery Specialist, King Hussein Hospital, Royal Medical Services, Jordan

Objective: Cervical spondylotic myelopathy is a disabling and increasingly prevalent condition. The Proposed mechanisms include axonal stretch-associated injury and spinal cord ischemia from impaired microcirculation. Symptoms often develop insidiously and include (gait instability, bladder dysfunction, fine finger motor weakness). Surgery to decompress and stabilize the spine is often advocated for severe or progressive symptoms, with mixed results. This paper compares patients who underwent surgical treatment to those treated conservatively and highlights the clinical and surgical features that are taken in consideration in decision making in the course of treatment.Material and Methods: A retrospective review of patients who presented with spondylotic cervical myelopathy and underwent surgical intervention, compared to patients who were treated conservatively, between January,2008 and January,2015. The mean follow up was 32.4 months. It included radiographic and clinical exam. The radiographic follow-up

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included static and flexion/extension radiographs and the clinical outcome was evaluated by a physical exam, and neck disability index (NDI).Results: 242 patients were operated vs 88 patients treated conservatively. For the surgical group: mean age at presentation was 52.5 years (Range 40-67), 137 patients were male (56.6%). 105 female (43.2%) and all patients had been operated either from anterior or Posterior. Minimal Follow of 32.4 months. Thirty nine patients deteriorated after surgery, while 47 patients still the same. In the group treated conservatively, mean age 66.2 years (range 58-79), 37 patients were females, 51 patients were male, mean follow up 3.1 years. In this group 42 patients improved, 21 patients deteriorated, and 25 patients remain the same. The NDI from 64% to 18 % in the group with surgeries, while in the second group NDI was from 76 % to 64 %. Most common level C4/C5 for myelopathic patients (55%) then C5/C6 (52%) and finally C6/C7 (48%) due to disc herniation. Conclusions: There is a variety of surgical approaches in the management of cervical myelopathy. The main aim of surgical intervention for myelopathy is to prevent further neurological loss, however, deciding which is the best approach and management for any individual is still debatable. Conservative treatment for cervical myelopathy might be effective if it is performed in selected patients.Keywords: myelopathy, surgical intervention, conservative management.

Concepts in Spinal tumors surgery; experience and outcome at King Hussein Medical CenterFiras Sha’ban; Amer Alshurbaji, Duaa Amer Abdelrazzaq

Purpose: Spinal tumors are difficult and uncommon clinical entities, adaptations of meticulous surgical techniques and steps can change the high morbidity with these lesions. The advent of intraoperative monitoring and the concept of “the first chance is the best chance” have changed the approach in dealing with these tumors.Methods: Two hundred and fifty two cases of different spinal tumors operated during the last 12 years were analyzed retrospectively according to age of presentation, pathology and location.Results : Different pathologies were encountered including : meningioma , neurofibroma , hemangioblastoma , epidermoid and ependymoma each with good rates of total excision , 90% for ependymomas , 75% for filum terminale ependymoma , 95% for both meningiomas and neurofibromas , comparable with the standard international figures .Conclusion: Spinal tumors are challenging lesions with a good outcome if a clear philosophy is adopted and handled in a teamwork approach.Keywords: Spinal tumors, microsurgical resection.

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rarity of Spinal Lesions over two decades experience at KhMC- JordanFaisal Al Shurbaji , Amer Al Shurbaji, Alhareth Ma’aya, Bakir Al Saudi

Introduction: Some of the unusual and rare lesions may be encountered once during the surgical career. We are presenting a collection of very rare pathologies and lesions affecting the spine and spinal cord. These lesions can be difficult to diagnose and to manage due to their rarity.Discussion: Over the last 20 years we have encountered a variety of very rare lesions, as extradural spinal pneumatocel, neuroenteric cyst, idiopathic spinal cord herniatio, invasive Meningioma, granulomas and rare other tumor. We will present and discuss each entity elaborating on radiological appearance, surgical management, and outcome.

Management of CSF Leak after Spinal SurgeryRafeed Al Drous,MD, Amer Al-Shurbaji,MD, Faisal Alshurbaji,MD, Othman Obeidat,MD

CSF leak is a major cause of postoperative morbidity and mortality in patients who undergo spinal surgery either for decompression or fixation. Also it is a major problem after spinal tumor resection. CSF leak may be encountered intraoperatively or become apparent in the immediate or late postoperative periods. They can be asymptomatic or present as persistent headaches. They may have risks of developing meningitis, fistulas or pseudomeningoceles. Treatment strategies range from nonoperative to primary repair and diversion techniques. If left untreated CSF leaks can lead to subcutaneous collection which may impair wound healing and result in a CSF fistula with risk of wound infection, epidural abscess and meningitis. We will present our experience in managing the complications of CSF leak following spinal surgery over the last seventeen years at King Hussein Medical Center with elaboration of the techniques used to avoid and to treat these complications.

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Determining resectability in pancreatic tumors; review of 70 cases.Ashraf Sobhy Zakaria MSc *; Mohammed Gamil, MD1, Hussein Okasha, MD2, Ali Hassan Mebed, MD1 , Reda Hassan Tabashy, MD3(1) Surgical Oncology Department National Cancer Institute Cairo University.(2) Gastroenterology & Hepatology Faculty of Medicine Cairo University.(3) Radiodiagnosis National Cancer Institute Cairo University NCI Cairo University.

Background: Pancreatic adenocarcinoma is one of the most aggressive tumors of the digestive system, with a prevalence of 10%. Despite treatment options involving chemotherapy and radiotherapy, surgical resection offers the only chance for a cure. Objective: Evaluating Modalities for determining resectability of pancreatic tumors Patients and Methods: Retrospective study including 70 patients who presented with pancreatic tumors who underwent imaging modalities like endoscopic US (EUS), MSCT scan abdomen and MRCP at Faculty of Medicine Cairo University and National Cancer Institute, Cairo University. Results: Out of 70 patients, males were 32 (46%) and females were 38 (54%). median age was 55 years (range 32-73 years). Jaundice was the main symptom 47 (67%), clay colored stool 46 (65.7%), dark urine 47 (67%) and abdominal pain 50 (71%). There were 20 patients with benign disease and 50 patients with malignant disease. The EUS had the best accuracy reaching 90.0% in detecting malignant pancreatic tumors as the following results; Sensitivity: 96.0%, specificity: 75%, PPV: 90.6%, NPV: 88.2%. In addition, EUS has the best results in determining vascular invasion (SMV/PV) in these patients.Conclusion: EUS can clarify locoregional spread when CT/MR are equivocal. The combination of superior detection, adequate staging, tissue diagnosis, determining vascular invasion makes EUS, and EUS guided FNA a cost-effective modality.Keywords; local treatment; Endosonography; pancreatic tumors.

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Jordan is a land steeped in history. It has been home to some of mankind’s earliest settlements and villages, and relics of many of the world’s great civilizations can still be seen today. As the crossroads of the Middle East, the

lands of Jordan and Palestine have served as a strategic nexus connecting Asia, Africa and Europe. Thus, since the dawn of civilization, Jordan’s geography has given it an important role to play as a conduit for trade and communications, connecting east and west, north and south. Jordan continues to play this role today. Take an interactive tour through Jordan’s history starting from the Paleolithic Era, right up to modern day with our Interactive Historical Timeline.Jordan is located in the Middle East and borders Syria, Saudi Arabia, the Red Sea, Palestine, and Iraq. Covering some 89,342 sq.km, it is located at 31 00 N, 36 00 E.

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Mobile phonesDelegates are kindly requested to switch off their mobile phones during the sessions.

WeatherTo check the weather please visit:www.arabiaweather.com

CurrencyOne Jordanian Dinar is equivalent to 1.4 USD.

Wifi available free on site

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Conference venueLe Royal Hotel Amman

Registration Fees Registration Fees 70 JD, (Medical Students and Residents free registration).

RegistrationRegistration starts on 7th September,from 8:00 am to 17:00 pmand from 8:30 am to 16:00 pm daily thereafter.

Registration Fees Include• Congress bag.• Programme book• Opening ceremony and reception• Admission to the exhibition.• Meals.• Coffee breaks

Badges• The participants name badges serve as an admission pass to all scientific sessions, theexhibition and the congress area.

• Participants are kindly requested to keep their name badges displayed at all times during the congress.

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hotel accommodation

Main Venue Congress Le Royal Hotel Amman

All the above rates are in Jordanian Dinar and subject to 10% service charge & 16% sales tax, and inclusive of buffet Breakfast.Free parking available at hotel( Congress Badge requested )

optional tours1. Amman City tour(Roman theatre , citvadel, shopping)2. Jerash, Ajloun.3. Madaba, Mount Nebo, Dead Sea, Baptism Site.4. Desert Castles.5. Petra” the 2nd of the seventh world wonders”6. Wadi Rum, Aqaba.

For details of other hotel alternatives please contact the organizers.

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Conference Secretariat:Tel.: +962 6 582 0738Fax: +962 6 582 0873Mobile: +962 799 193 733Email: [email protected] www.gec-jo.com

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