Co-chairs Prof. Camilla Carroll FRCSI, RCSI Council Member and Mr Sean Johnston FRCSI, RCSI Council Member facilitated the rest of the morning session which included presentations by Dr Clíona de Bhailís, Irish Research Council Fellow at the Centre for Disability, Law and Policy as well as by Ms Megan Power Foley MRCSI, President of the Irish Surgical Trainee Group (ISTG).  

Dr de Bhailís explored the impact of the Assisted Decision-Making (Capacity) Act that was enacted in 2015 but only came into effect in 2023. Noting that we are still in the early stages of understanding and application of the Act, Dr de Bhailís explored the guiding principles that assist to involve patients in decision-making and make informed consent possible, including timing, accessible information, communication style, environment in which consent is communicated or sought as well as the role of a chosen supporter.  

Ms Megan Power Foley presented on the evolution of Open Disclosure policy in Ireland and discussed some of the barriers to open disclosure before highlighting measures to address same. Drawing on a recent survey conducted with a group of surgical trainees, Megan noted that respondents had identified ‘fear of consequences’ as the biggest barrier to open disclosure. However, the results of the survey also showed that surgical trainees felt that observing consultants or being supported by consultants to undertake open disclosure, were the two most impactful solutions to overcoming perceived barriers.  

Prof. Helen Heneghan FRCSI, Consultant Bariatric Surgeon, presented on the lessons she had learned in her first five years of developing the National Bariatric Service. On assuming her role as Consultant Bariatric Surgeon in 2017, Prof. Heneghan inherited a waiting list of over 300 patients. In her presentation she outlined the practical and policy considerations that faced her as she built the service. Among the lessons she learned and shared with delegates was the importance of stakeholder engagement in the establishment of any service, the value of compromise in the short-term while knowing your non-negotiables in the longer-term, as well as the powerful yet unsustainable impetus that a waiting list can provide in securing funding.  

The second presentation was a truly collaborative affair with three presenters taking to the stage. Ms Christine Buckley FRCSI, Consultant Plastic Surgeon, Mr Michael Kelly FRCSI, Consultant Colorectal Surgeon, and Mr Peter Lonergan FRCSI, Consultant Urologist are all practicing in St James’ Hospital, Dublin. The trio presented on their Multidisciplinary Collaboration in Advanced Pelvic Malignancy. Inspired by the PelvEx Collaborative as well as their combined experiences from Fellowships undertaken in the US, Australia, Canada and Italy, they outlined their collaborative approach to operations on patients with pelvic malignancy which commences at the outset with a joint meeting by all three surgeons with the patient and their family. The presentation highlighted some of the challenges – primarily scheduling – as well as the importance of good communication. An interesting element was the co-leadership philosophy they espoused, which included rigorous planning, early engagement with hospital management, ensuring the right people were involved in the MDT and that the concept was socialised early and often in the hospital.  

Prof. Joseph Butler FRCSI, Consultant Spine Surgeon in the Mater, delivered the third talk of the symposium sharing his professional insight into the implementation of technology enhanced surgery. Prefacing his talk by highlighting the demographic shift toward increasingly elderly spine trauma patients, Prof. Butler looked at the role of technology as necessitated by a move to minimally invasive techniques. He presented on his use of navigation and image-based technology and gave the audience an insight into his experiences of mixed reality technology which turns scans into 3D interactive holographic simulations. Prof. Butler’s passion for new technologies was evident and his practical recommendations were hugely insightful – from gaining experience in tenders, to planning for the learning curve as well as the importance of bringing others on the journey.  

The final speaker of the symposium was Prof. Philip O’Halloran FRCSI, Consultant Neurosurgeon in the Mater, who shared insights from his research which independently assesses the effectiveness of headgear in mitigating Traumatic Brain Injury in rugby players. Noting the tension between the spectacle and the safety of sport, Phil touched upon the disinformation in this sphere before presenting on the establishment, growth and some initial findings from the study noting the potential impact on player training load management.  

Ms Christina Fleming FRCSI, Chair of the Early Career Surgical Network, concluded the session by facilitating an excellent panel discussion that covered a range of topics from mentoring to the importance of developing non-technical skills.  

Prof. Kevin Conlon FRCSI, RCSI Council Member, introduced Dr Carla Pugh, Professor of Surgery at Stanford University, California, who delivered the Johnson & Johnson Lecture entitled Precision Learning & Data Sharing through wearable technology – what’s AI got to do with it? Through her talk Dr Pugh explained how she was inspired by the rise of ‘the quantified self’ of the FitBit era to research and explore ‘the quantified surgeon’ captured through a combination of audio, video, motion and EEG analysis. Drawing on her research, her talk discussed how AI can be used to shorten the learning curve to mastery and competence. I’m pleased to share that Dr Pugh’s talk was recorded and is available to view online here. 

Under strict instructions from the keynote speaker, Mr Keith Synnott FRCSI, RCSI Council Member, provided a time-bound introduction to Mr Declan J. Magee FRCSI, Past President of RCSI, who delivered his lecture entitled A Tale of Two Colleges in which he provided the context, development and evolution of the partnership between RCSI and the College of Surgeons of East, Central and Southern Africa (COSECSA). I first had the pleasure of hearing Declan deliver this talk at the Clinical Congress of the American College of Surgeons in San Francisco, 2024 where the work of this collaboration was cited as an exemplar of good practice. Touching upon themes of empowerment, sustainability and accompaniment, it reflected the topics of collaboration and innovation, which recurred throughout the Meeting. For those of you who could not attend, you can watch it back now online . 

Mr Michael Kelly FRCSI was announced as the recipient of the Colles Travelling Fellowship in Surgery for 2025 and will assist towards the Paediatric and Adult Spine Surgery Fellowship that he will undertake in the Université de Montréal, Canada. 

The Brian Lane Medal 2024 was awarded to Dr Meghan Choy, a current ST2 in General Surgery for achieving the highest score in the OSCE exams she completed at the end of the first year of her Core Surgical Training.  

I was joined by Breda O’Sullivan, widow of Professor Gerald O’Sullivan, former President of RCSI, to present the Gerard O’Sullivan Medal to Dr Wahmby David, who graduated top of his class at the annual COSECSA exams.  

Finally, the recipients of the RCSI Colles Surgical Travel Grants were announced as Ms Alexandra Zaborowski, Mr Éanna Ryan, Ms Lena Mary Houlihan, Mr Justin M. Hintze, Ms Lorainne Scanlon and Ms Ailbhe White Gibson all of whom were recently conferred as Fellows of RCSI

First up, Ms Brenda Murphy FRCSI, Consultant Colorectal Surgeon, shared insights gathered from her experience of the Da Vinci robot which she gained when completing an International Fellowship in Colon and Rectal Surgery at the Mayo Clinic in 2022. Citing the advantages for patients – reduction of blood loss and increased precision – as well as for surgeons – reduce fatigue and improved visual – Brenda acknowledged barriers in robotics, including the absence of a standardised curriculum, which is currently being addressed by RCSI’s Department of Surgical Affairs. She noted the importance of ongoing assessment through video feedback as well as via both structured and informal debriefing.  

Prof. David Healy FRCSI, RCSI Council Member, spoke about training in robotic surgery as a mid-career surgeon. Acknowledging the challenges that present to upskilling as a mid-career surgeon – including, the fear factor, costs and barriers to access, Prof. Healy noted that he also initially believed that patients would be unwilling to undergo robotic surgery. However, as a result of his own training experiences, Prof. Healy advocated for mid-career surgeons to embrace the changes and to take confidence from their position of experience. He also shared that in his interaction with patients, he has seen that many patients now look to robotic surgery as safer than traditional techniques.  

Prof. Barry McGuire, Professor of Surgical Education and Academic Development, RCSI Department of Surgical Affairs, provided the national perspective on robotics training in Ireland. While noting that technology is reshaping our practice as surgeons, Prof. McGuire stressed the importance of preserving techniques and skills of laparoscopic and open surgery. Prof. McGuire touched upon the need to develop specialty specific curricula that would be adaptable and flexible to keep up with the rapid pace of change in tech.