Convenor Dr. Ashish Gulia
Co-Convenor Dr. Prakash Nayak
Venue Tata Memorial Hospital, Mumbai
Date September 18 – 24, 2017
Delegates 7 / 7

Continuing with the tradition of sharing the knowledge and training young surgeons, the Bone and Soft Tissue Services, Tata Memorial Hospital conducted a one week long BOS Ortho Onco Course under the aegis of Bombay Orthopaedic Society from September 18 to 24, 2017.

Orthopaedic oncology is a vast subject and lot of treatment protocols and concepts are different compared to that followed in trauma. It involves a multidisciplinary approach with active involvement from Medical Oncologist, Radiation Oncologist, Pathologist, Radiologist and Intervention Radiologist. To provide adequate exposure of how these work together, 1 week was far too less. But we tried and planned it in such a way that at the end of the course, the enrolled candidates went back satisfied. Mornings start at 8:00 am with a lecture and later on the candidates were actively involved in Outpatient Department and in the Operating room.

First day was an introductory class by Dr. Ashish Gulia. He spoke about how to approach any lesion you suspect to be a tumour. The dos and don’ts during the initial assessment and the necessary workup before proceeding to take a biopsy. Second day started with a session on Principles of biopsy. Biopsy is a very important step before arriving at  he final diagnosis and a wrongly done biopsy will many a times change the final treatment plan and who better to talk about this than Dr. Ajay Puri. Later on during the day, they had a session on Musculoskeletal Radiology by Dr. Bhavin Jankharia. He spoke about the basic concepts of differentiating benign and malignant lesions. Third day, Dr. Ashish Gulia spoke about “How to perform curettage” for a benign lesion such as GCT. This was followed by a video
demonstration. Fourth day, Dr. Girish Chinnaswamy spoke about the importance of NACT and treatment protocol for osteosarcoma. Fifth day, Dr. Nehal Khanna spoke about why Radiation Oncology was an important part of surgical oncology. This was followed by a live demo of one of their machines and how they work-up a patient before taking him up for radiotherapy. The day was concluded by a lecture by Dr. Girish Chinnaswamy on the Ewings sarcoma and the chemotherapy involved. Later on, in the evening we hosted a faculty dinner for the delegates and faculty where they could relax and interact at leisure with the faculty.

Last day, we had various sessions planned starting with a talk on Bone metastasis by Dr. Prakash Nayak. He spoke about how to work-up a case of suspected metastasis. This was followed by Dr. Kunal Gala who showed us why Interventional Radiology has become an important part of Orthopaedic oncology. This was followed by Dr. Manju Shengar’s session on Multiple myeloma and the diagnostic protocol for it. Following this, Dr. Nilendu Purandare spoke about Nuclear medicine and the importance of PET scans in the workup of oncology cases. The sessions were concluded by a talk about Tissue banking by Dr. Lobo Gajiwala. She explained about the preparation of Allografts, their storage and a tour of their lab.

The candidates had a chance to attend three full-day major OT sessions where they observed and assisted in reconstructive procedures involving the proximal femur, distal femur, proximal tibia, humerus and curettage and excision of benign lesions involving the tibia and distal radius. They could take part in 2 half-day sessions in the
Minor-OT where they had hands-on experience on how to do closed biopsies. During the course of the week, they were involved in two full-day OPD sessions which involved learning how to evaluate a new case, examining the functional outcomes of patients who underwent limb salvage and pelvic surgeries. They could witness two multidisciplinary joint clinics which helped them understand the need for such an approach in this field and the reason why TMH is the pioneer in cancer care in India.

It is the only course of its kind in India and we are thankful to Bombay Orthopaedic Society for giving us the opportunity to spread knowledge and awareness of management principles in one of the most challenging subspecialty of orthopaedics.

The course was well received by all the 7 attending delegates coming from far off places like Jammu, Srinagar, Agra, Jaipur, Mangalore, Malabar and Cochin. With the excellent feedback given by them, we look forward to come back better next year.

Dr. Ashish Gulia