From the President’s Desk I feel honoured to be here as the President of our august association and all of us are in interesting times why, because we are reaping the harvest of the seeds sown by our Founder President Dr C Palanivelu and pioneers. And so I begin by raising a toast to these pioneers—to pay tribute to them—after all, if we are able to do more, to see more, it is because we are now standing on their shoulders. We are in our 15th year as a AMASI association. We have made a lot of progress in not only on the national but also on the international scene. We have now reached a stage where we can put forward our views and experiences with confidence and authenticity and can be sure that minimal access surgeons across the globe listen to us with conviction.Association of Minimal Access Surgeons of India (AMASI) has always been academic oriented, since its  inception, through FMAS, DIPMAS, multiple workshops and conferences We have trained thousands of surgeons from across the globe.AMASI is striving towards it's goal of MAS for Masses. Over the past years, there has been a lot of exchange of knowledge and clinical experience in the form of CME's, skills courses, conferences, and workshops across the country.. My congratulations to all the organizers. We now live in exciting times—We have a community whose members are contributing new techniques and treatments, achieving positions in international associations and organizing international conferences. Be it newer techniques in Robotic surgery, awards for best videos in international conferences and Text books by our founder president Dr.C. Palanivelu —we have our finger in every pieI would like to seek support from all my friends and seniors ,all my executive committee members and past Presidents and AMASI members during my tenure as President of this august association. WITH BLESSINGS and guidance of our founder President Dr.C.Palanivelu, I assure you that I will take the association to further heightsAnd I pledge to you, all the members, on behalf of the executive committee, that we will march forward, ensuring transparency and establishing systems, with focus and determination, with passion and conviction, to take AMASI to its logical place in the surgical community.

Prof. Bhupinder S. PathaniaPresident, AMASI.

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AMASI Newsletter

(Association of Minimal Access Surgeons of India)

AMASI 15 JANUARY 2019

Executive Committee East Zone

Makhan Lal SahaAlok Abhijit

West Zone

Roysuneel PatankarKaushik Shah

North Zone

Bhanwar Lal YadavNikhil Singh

Central Zone

Devendra NaikRajdeep Singh

South Zone

Parthasarathi R S Soppimath

Co-opted Member P. SenthilnathanBhartendu KumarSamir RegeBiswarup Bose Biju PottakkatRajesh ShrivastavaRoshan ShettyRakesh ShivhareHimanshu YadavManoj K ChoudhuryRajendra Mandia

Founder President C.Palanivelu

Immediate Past President Tamonas Chaudhuri

President B S Pathania

President Elect Jugindra S

Senior Vice President Varghese C J

SecretaryKalpesh Jani

Joint SecretaryAbhimanyu BasuN.K. Chaudhry

TreasurerIshwar R Hosamani

Zonal Vice Presidents

Manash R SahooRamesh DumbreG Laxmana SastryRajeev Sharma Deborshi Sharma

IN THIS ISSUE

Regular Features:

• Your Representative Speaks: This will be short message from one of the Executive Committee Members to all the AMASI members. The first in this series is by our Hon. President, Prof. B. Pathania.

• “GURUBHASYAM”: We are blessed by teachers and Gurus in our country, who do not limit their roles to teaching and training us in their speciality subjects but also share their wisdom and experience in life. We aim to traverse the country and abroad to collect these pearls of philosophy and morality from these wise men and women. The inaugural article this collectible series is from our founder President, Professor C. Palanivelu as he guides us along the treacherous path of this journey of Life.

• Updates: Here we will try to encapsulate what is new in the Association. This month, we have two articles. One is a general briefing on the AMASI website and the activities that we have planned.

• Events in pictures: All the events and conferences that were held under the aegis of AMASI as captured through the photographer’s lens.

FROM THE NEXT ISSUE In addition to the above regular features, we shall be adding the following new features, provided our members also participate enthusiastically:

• Journal Watch: A ‘collectible’ series consisting of a brief summary of three major articles in each of the following sections: Upper GI, Hernia, Colorectal, Bariatrics, HPB and General. These will be brought to you by prominent academicians from our ranks who will be credited with the same.

• How to Write a Scientific Paper: Another ‘collectible’ series consisting of articles dealing with each and every aspect of writing a scientific paper right from framing the research question to submitting it to an appropriate journal. Our published authors will hold your hand and guide you step by step along your journey to academic fame!

• Your Corner: This section is exclusively for you AMASIans. You can contribute an anecdote or real-life experience related to surgery or laparoscopic surgery, or it can be a sample of your hobby like photography, sculpture or painting. As long as its original, we will publish it with a one line credit.

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As the new Executive Committee assumes charge for the term of 2018-2020, we are extremely excited at the prospect of certain changes that we are initiating that I would like to share with you.

AMASI conducts academic events under different categories apart from its annual showcase – AMASICON. The other types of events are workshops, CMEs (one and a half or two day conferences), rural surgical workshop and Skills Course. Each of these events has separate rules and regulations. To provide clarity to all these events and to encourage transparency, we have drafted separate documents for each of these events that are called ‘Memorandum of Understanding’ which has to be signed by the Organizing Secretary of the event and the Hon Secretary of AMASI. Members are encouraged to evince interest in holding such events and can apply for such events by downloading, filling up and submitting the application form from the AMASI website.

The website (amasi.org) has been revamped and now has a lot of current information that would be useful to our members. I would request our members to visit it at least once a week to keep abreast of the new developments.

The website major features

The top scroller shows the immediate upcoming events with links (where available) for online registration. You can apply for AMASI membership and track your application right from the Home page. The tab about the membership tab is for knowing the process of hosting an academic event under the aegis of AMASI and downloading application forms and MoUs for the same. The home page also has the links to important announcements and forthcoming events. The right side of the home page provides link to a brief introduction about the prestigious DipMAS program as well as the last published newsletter.

Again, to ensure and enhance transparency, the last three years audited financial statements are made accessible to all members on login in from the home page link. A small video library will also be created and edited videos of common procedures performed by our national faculty shall be posted. Apart from these, the website has a lots of other information which we encourage you to explore.

An AMASI flag has been designed and soon, shall be unfurled at every AMASI event, lending a sense of pride and uniqueness to all AMASI members.

This term onwards, we would like out members to be more pro-active and let us know directly by emailing us at amasi.india@gmail.com regarding any changes or innovations that they feel would enrich their AMASI experience. We would love to see some input from you as to how to make our association more vibrant and more useful for our members.

In AMASI, the focus has always been on academics and we realize that our brethren in smaller states and remoter areas of this vast country of ours may not always have access to academic events that are held in metro and tier I cities. The motto of AMASI, given by our founder president, Prof Palanivelu, has been “MAS for the masses”. In keeping with this motto, we have decided to encourage the organization of academic events in small states like Jammu & Kashmir, Uttarakhand, Himachal Pradesh, Tripura, Meghalaya, Manipur, Nagaland, Arunachal Pradesh, Mizoram, Sikkim & Goa. Recognizing the financial constraints faced by the organizing team in such small states, the Executive Committee has decided that the association shall bear the expenses of two or three national faculties attending AMASI events in the above states.

These are the glimpses of some of the changes that are already in place for the coming year. As more exciting things happen, we shall keep you abreast of the same.

HERE’S LOOKING FORWARD TO A VIBRANTLY EXCITING 2019!!

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Surgeons - The Healers

Surgical expertise and technology go together when we talk about evolution of surgery. 

Surgery in the Ancient era

There are skulls with burr holes kept in the museum at many centres. We don’t know the reason for burr holes, but the people had lived then . When I visited Egypt I saw the mummies, but was surprised to see no holes in the skull, yet  the contents within skull had been removed. What technology they used to remove could not be deciphered. 

We all know Susrutha the father of surgery ,the first surgeon known in the world who practiced surgery and developed lot of instruments. He also brought first surgical book - Sushrutha Samhitha. Knowledge persisted to renaissance. In UK Barbers were known as barber surgeons and surgeons in the past. 

Merciless surgery- Pre Anaesthetic era

Before invent of anaesthesia, surgery was an act of performance. Bladder stone was removed in a matter of  minutes . Invent of ether anaesthesia in Massachusets heralded the dawn of painless surgery. Surgeons started experimenting and performing deeper surgery. Anaesthesia brought a revolution in surgery, however many still died of massive infection. 

Principles of Asepsis

Lister popularised the principles of asepsis in surgery. Mortality reduced profoundly. It was truly a great revolution. Surgeons at Mayo Clinic went to Europe to learn the principles of asepsis, came to US and advised to wash hand before and after surgery.  

After surgery many left home alive after surgery. People consider surgical profession as holy profession and surgeons as Gods or next to gods. After principles of anaesthesia and asepsis were established, surgery on gut, heart, lung, brain, organ transplantation all became successful..           

What is surgery? Who are surgeons?

It is not just cutting, suturing, reshaping, bypasssing, joining or fixing . It is more than that, eradication of disease without morbidity and mortrality. Surgeon is one who treats individual whole and intact , making them disease free and functionally normal. When the results are poor, people call them butchers.          

Era of ‘Big incision, Big surgeon’ became popular. However outcomes after surgery were not the same always  Healthy people recovered well. But unhealthy people especially  malnourished and cancer patients, needed prolonged recovery after laparotomy and wound related problems were very hig

Newer energy devices

Conventional surgery had lots of complications. Blood transfusion was needed often. We remember earlier,  10 - 15 bottles of blood were transfused at many occasions for major surgeries . Now newer energy devices are available that facilitate surgery to be done without transfusion.  Liver resection can now be done without a single unit of blood transfusion.

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Gurubhasyam - C. Palanivelu

Laparoscopic surgery 

Laparoscopic surgery is done using slim long instruments through small incisions. Magnification, angled view and enhanced clarity of tissue are the advantages in laparoscopy. Laparoscopy really changed the landscape of surgery.

Now we are able to see abdominal structures and perform the same operations done earlier by  open method , through tiny holes. Pain is less, recovery is faster. Most of the Laparoscopic operations are day care. I did radical distal Gastrectomy for cancer stomach couple of months ago at Madrid Spain. That patient was discharged in two days. 

Undisturbed immune system 

Undisturbed immune system reduces severe infection, and prevents cancer recurrences.

Development of Laparoscopic surgery 

Once laparoscopic cholecystectomy in cirrhotic liver was considered a contraindication. I developed my own modified technique which got selected for SAGES award in 1996 and I was given plenary lecture during the World Congress of Endoscopic Surgery at Philadelphia. During the 

s a m e s e s s i o n , Micheal Gagner presented his experience on lap assisted pancreatic resection (Whipple's operation) for head of pancreas. He did resection by laparoscopic approach and reconstruction by open method. In his short experience of nine cases, he said complications were higher, it takes longer operative time and no benefit, hence he had stopped doing. He did not adopt proper technique which was the reason for poor results, I understood. I felt the result could be improved. 

In 1998, I performed totally laparoscopic Whipple operation, successfully first time in the world. When I presented the video at Atlanta during SAGES congress entire audience was surprised and started talking that an Indian made it.

The first lap Whipple was done in a 28 year old male, 3 months since marriage. Now he has completed 20 years since then. 

Many leading surgeons were initially sceptical about Laparoscopic  Whipple's procedure. Markus Bucheler of Heidelberg, Germany was one amongst them blocking the progress of Laparoscopic Whipple. During a live worshop here, I made him perform live open Whipple in one screen and I myself did lap Whipple's in the  other screen simultaneously. Looking at the positive response he himself said during oration at the national congress that Laparoscopic Whipple's is better. 

Japanese and American societies jointly hosted International Olympic competition in minimal access surgery. I got silver medal by presenting lap Whippl

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Subsequently, many surgeons across the globe started doing laparoscopic Whipple operation.  I was the convernor for the international consensus conference at Coimbatore and the guidelines got published as “Coimbatore statements”in Surgical oncology. 

I became GI surgeon because I witnessed lack of treatment for esophageal cancer during my postgraduate studies. I saw Prof. Cusheri presenting his animal study  on feasibilty of thoracoscopic exploration in prone position. I developed thoracolaparoscopic esophagectomy in prone position and demonstrated at Boarduex France in 2001.  Prof GB Cadiere named this technique after my name. In 2005 Prof. Luketich, proponent of lateral approach was the chairman for the video committee said “ till I saw video of Palanivelu I considered mine was the best. After seeing the video I changed my opinion” during the American college of Surgeons conference at  SanFrancisco . Later I was called to Hongkong to demonstrate live thoracolaparoscopic esophagectomy during Asia Pacific conference of ELSA in 2005. Single lumen endotracheal, double lung ventilation, ergonomically excellent approach, wider exposure of mediastinum was demonstarted and the entire audience was fascinated to see a new operation. JSES Japanese society of endoscopic surgeons invited me as Course director to Kyoto in 2006. Japanese surgeons also did a prospective study and published this technique which carries excellent results and is followed as standard procedure in japan and also across the globe. 

In 2004, I was invited to UK to demonstrate live thoracolaparoscopic esophagectomy at Liverpool during annual conference of Association of Upper Gastro Intestinal surgeons AUGIS. General Medical Council of UK gave special license for that becuase I have not studied nor do I possess any  postgraduate degree of UK. They honoured me with Honorary Phd, and at the the parliament of UK, House of Commons presented the “Award of original contributuion towards developing Laparoscopic Surgery”.

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I  innovated many procedures first time in the world. European Association of Endooscopic Surgeons nominated me for the award of top two great contributors towards development of laparoscopic surgery globally after conducting opinion poll amongst the members. 

In 2001, Adyar cancer hospital hosted the international live workshop cum conference on minimally invasive cancer surgery. Prof H Kim from Korea demonstrated hemicolectomy for cancer colon and anterior resection for cancer rectum. I demonsatrated total radical gastrectomy for cancer stomach and esophagectomy for cancer esophagus.  Subseguently many such conferences and wokshops were conducted at Coimbatore and various parts of india.

Majority of the operations are performed through laparoscopic approach, as standard of care. Complications are less , operative time is shorter and minimal blood loss. Clearance of cancer was far better in laparoscopic surgery compared to open surgery. Japanese government enhanced the insurance premium almost 100 % more for minimally invasive approach to cancer. 

In spite of better outcomes, lap surgery has not replaced open surgery for complex operations particularly cancer due to inherent limitations of laparoscopy 

Limitations in laparoscopic surgery 

3D vison changed to 2D in laparoscopy. Restricted  movements at the tip and loss of wrist movements and uncomfortable ergonomics are the limitations. Many had frustration due to opposite movement of the instruments inside the abdomen. Even after performing larger number of laparoscopic operations, surgeons are finding it difficult to perform endosuturing. 

Robotic surgery

Robotic surgery came in to overcome the limitations of laparoscopic surgery. 3D vision was restored at the console. Endowrist like movement of robotic arms, made surgery easier. Tremor filtering, enhanced dexterity and better ergonomics made surgery easy. 

Surgeon operates on the console and movements translates at the other side of the instruments. Robot in between the surgeon and the instruments. Delicate dissection at the tip with 7 degree rotation of the instruments. I am finding finer dissection in controlled fashion as the camera is under control of surgeons. Surgical performance may be enhanced by improving the function of the instruments. 

Quality of surgery by robotic approach is far superior than open and also better than laparoscopy. Only concern is the cost. New robotic companies are in the pipeline and most likely the cost may come down

Limitations of robotic surgery

Problem of docking patient cart is time consuming and cumbersome. For single quadrant surgery such as prostatectomy , gastrectomy it is  fine, but multiquadrant surgery such as total colectomy need additional additional incisions and resetting of ports. New robots have been introduced from SI to X andXi ,  to overcome these limitations.

Further developments are also happening to enhance the capability of surgeon and benefits for the patients. Initially single incision multiport surgery and now single port robotic is already in clinical use. Camera and instruments all together passes through one small tube, same instruments having the same performance. Truly this may create another revolution in surgery.  Most of the procedures are likely to be done in future by single port surgery .

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When one develop problem

And when he/she get to that point, the maladies don't care , how much one has earned ?how much professional excellence has achieved ? how many awards has received ? and then decides to spend time with the children.

These maladies may come to any one of us too.

Is that going to make that diagnosis any less terrifying ?

Because facing our own mortality and functional disability, need a re-evaluation of our priorities and realignment our goals in life. The prospect of new surgery I am describingis an easier provides better outcome, may improve still further. Surgeon should aim only that to recover completely to serve the community at large. ``

Other new technologies in futuristic surgery : enhancing the safety and improving the surgeon performance. 

Enhanced vision : ICG Cybernectic flouresence imaging 

Sometimes identification of structures such as Ureter, bile ducts and vessels becomes difficult due to inflammations or mass lesions. Injections of markers into the blood stream or tissue, structures may be clearly visualised by its glow . Tumor borders may be identified and excision is done in toto. Multiple lesions can be identified. Vascularity of the anastomotic segments can be assessed and leak rate is minimised. Morbidity reduced and survival enhanced. 

Macro vision: Microscopic probes 

Identification of presacral nerves and pelvic plexus during resection for cancer rectum provides continence, bladder control, and sexual function after surgery. Preventing injury to recurrent laryngeal nerves during esophagectomy and thyroidectomy  preserves voice and prevents aspiration into lungs which are very important.  

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"I - knife" intelligent surgical knife

Detects whether it is cancer or benign using a mass spectrometer which analyses vaporised smoke to detect the chemicals in the biological sample. It guides the boundaries of tumor dissection, assures complete excision of tumor. The technology is especially useful in detecting cancer in its early stages and thus shifting cancer treatment towards prevention.

Virtual Reality- 

New horizon in education and training. 360 degree view of the performing surgery, everyone can participate in real time anywhere in the world 

Augmented Reality 

Real time with enhanced reality of image reconstruction adds information of particular patient during procedure and enable constant touch with reality, helping surgeons to become more efficient in surgery 

3D printing of the anatomy 

Pre operatively provides information and also helps simulating surgery. Complicated and risky surgeries lasting hours need a lot of careful planning. It helos in reforming medical practice and learning methods as well as modelling and p lanning success fu l ly complex surg ica l procedures. For example in case of liver tumors we may print 3D image of the tumor.  Relationship to blood vessels and bile duct will be clearly delineated for a particular patient. Surgeon may workout multiple times simulating surgery before going for regular  surgery. 

Artificial intelligence will take surgery to the next level with the combination of surgical robotics and artificial intelligence. AI concepts such as the deep learning system, Enlitic, will soon be able to diagnose diseases and abnormalities. It will also give surgeons guidance over their difficult surgical decisions. Right now AI reads ECG, CT detects coloscopic polyps. 

With combinations of technologies we can localise lesion and reach any where , can assess the nature of the lasion , can treat the disease as a whole making patient free from disease, whole and intact, and functional afterwards. 

The prospect of new surgery I am describing is an easier option that provides better outcome which may improve still further. Surgeon should aim only for that, to recover completely and  to serve the community at large. 

Technology and surgical expertise complement each other’s work in such a successful way that we had never seen nor dreamt about it before. We cannot ignore emerging technology. But surgeons should know when to use and how to use it optimally.  When  treating cancer, its  important that we should use highest level technology to cure and make him/her normal . For simple surgery, we need to use the most commonly available technology, that is cost effective and suits a larger cross section of the population

Conclusion - Surgeon are indeed the healers 

Surgeon is one who treats patients as a whole and intact, makes them disease free and functionally normal. From the perspective of common people, surgeons are considered true healers.

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Diploma in Minimal Access Surgery (DipMAS) Accredited by College of AMASI

Overview

Association of Minimal Access Surgeons of India (AMASI) began its Fellowship program in Minimal Access Surgery (FMAS) way back in 2005-06. Since then more than 50 such skill courses have been completed and FMAS is awarded to more than 2500 surgeons from across the globe.

Minimal access surgery (MAS), over the years has grown multiple folds. AMASI started its educational foundation 'College of AMASI', to spread the reach of minimal access surgery. We received feedback from our members for the need for a more structured and detailed course with an option to specialize further in a particular field of laparoscopic surgery. From this need was born the concept of the DipMAS course.

About the Course

Diploma in Minimal Access Surgery (DipMAS) is offered as a flagship program of College of AMASI. DipMAS is carefully designed by internationally renowned Minimal Access Surgeons and Academicians.

DipMAS is first of its kind mentor led, blended learning program in minimal access surgery.

All due care has been taken to ensure that, the standards are not diluted, and a meaningful diploma is awarded to the deserving surgeons. The modern methods of teaching, learning & evaluation are being used to ensure global acceptance.

DipMAS endeavours to educate, enhance and enable minimal access surgeons with state-of-the-art surgical skills and encourage clinical research.

Course Objectives

1. To acquire and upgrade the basic knowledge for clinical laparoscopic applications

2. To understand all the basic principles (instruments, materials, equipment and anaesthesia) and be able to perform the most frequently used basic laparoscopic techniques

3. To be able to perform basic technical tasks in laparoscopic surgery including intra-corporeal suturing and knotting techniques, two hand coordination for dissection and safe use of energy sources

4. To be able to describe results and potential complications of laparoscopic procedures and manage them

5. To be able to perform some advanced laparoscopic procedures like in fields of HBP, Bariatric, Upper GI, Hernia, Gynaecology and Colorectal surgeries and to gain hands on experience of the advanced procedures

Eligibility Criteria

I. Should be an AMASI Member and non-members should enroll online as members of AMASI

II. MS (General Surgery/ Surgery) or DNB (Surgery) passed surgeons with 2 years of experience who are performing laparoscopic surgeries routinely

III. Associate AMASI members

IV. Should have passed their qualifying exam (MS/MD/DGO in Obs & Gynaec)

V. Should be regularly performing laparoscopic surgery (Certificate from HOD/ Head of Institute necessary / Self for consultants.

Enrollment:

The candidates who fulfill the eligibility criteria and are interested in enrolling for the course, should apply online at https://dipmas.mediknit.org/.

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After filling out the application, they will be required to submit certified copies of certain documents, which will be scrutinised, and if found satisfactory, the candidate would be admitted in the program.

Course Curriculum:

This is a one year program, divided into two semesters, each lasting approximately 6 months. The first semester is common and compulsory for all. For the second semester, the candidates have to choose one of the six subspecialities, viz. Upper GI, Hepato-pancreato-biliary, Bariatric Surgery, Colorectal surgery, Hernia and Gynecology.

Once you enroll and are admitted to the course, you can log in and access the course material on www.mediknit.org. The course material will consist of lectures and videos of surgical procedures in a step-wise manner. For example, during week 5-10 of semester I, the following topics are covered: Energy Sources in Laparoscopy, Ergonomics in Laparoscopic Surgery, Troubleshooting in Laparoscopy, How to Create a Pneumoperitoneum, Laparoscopic Suturing & Knotting, Microbiology of Port Site Infections. The candidates would be able to access the powerpoint presentations and videos related to these topics on the website. If they have any queries, they can send in their queries and the concerned faculties will respond to them and solve their doubts.

In addition to weekly video lectures, there will regular live mentor connect session and, in the second semester, live surgery demonstration via webcasts.

Observership:

After completing two semesters, the students are supposed to attend an observership of 7 days at a center allocated to them. DipMAS team coordinates with all the faculties and the shortlisted observership centers for allocation.

Observership centers are categorised based on faculty, key specialty, region and case density. It is ensured that student will be assigned a center within 150 Kms from his practice, until and unless there is no option or student opts to be in a specific center.

Dates of availability of faculty are finalised first by the faculty management team and then a roster is a sent out to learner management team.

LM team coordinates with the students, at least a month prior and finalises their slots of observership.

Same is communicated with the point of contact at each center.

Assessment:

At the end of each semester, the candidates have to undergo an online assessment consisting of MCQs based on what they have learnt in the respective semester. Thus, there are two online assessments, one after the completion of each semester. Each student is provided with a maximum of two attempts and for the third attempt, he/she will have to take with the next batch, after revisiting the lectures.

In addition, there is an offline examination is conducted during the one week observership, towards the completion of semester 2. Student will be evaluated by his mentor for his observer skills, surgical skills, specialty knowledge, publications and overall clinical practice skills.

Course Fees:

55,555 INR* *GST and other taxes, if any are applicable. Fees is applicable for India and SAARC countries. Currency conversion and bank charges for international transfers will be additional.

Course Report:

A total of 403 students, enrolled in the program since its inception in July 2017, distributed over 4 batches. Usually, the intake occurs in 2 batches a year, in January and June of each calender year. As of now, 45 faculties are providing their expertise to the program and 25 centers have been accredited for the observership program. The online academic material of around 175 video lectures and surgeries are already archived and more are added as time passes.

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AMASIans! Do you have a life beyond MAS?

Do you have a hobby, a passion, a pastime that you excel in but no one knows about?

It can be anything mainstream – musical instrument playing, singing, dancing, photography, painting, philately, numismatics. Or it can be something esoteric like bonsai, macrame, ballroom dancing, philumeny, pigeon racing or Renaissance fencing. Your family may think you are eccentric, your friends may find you amusing, your spouse may not encourage you. But we, at AMASI, will support you. Let us know about your hobby along with a sample of it and if you excel at it, we will do our best to showcase it to all our members.

Write in to us a amasi.india@gmail.com

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14-17, November 2018

AMASIAssociation of Minimal Access Surgeons of India

45-A, Pankaja Mill Road, Ramanathapuram, Coimbatore - 641 045. Ph : 0422- 4223330

Email : amasi.india@gmail.com

Web : www.amasi.org