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They adapted and shared to do their best for patients
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Head-table: From left - ACTSSL Secretary Dr. Nalaka Dissanayake; Chief Guest Prof. David Taggart; ACTSSL President Dr. Muditha Lansakara; Ravi Pillai Memorial Orator Dr. Rajeeva Pieris; and ACTSSL Treasurer Dr. Malik De Soysa. Pix by Akila Jayawardene
- Dr. Muditha Lansakara gives the ups and downs of challenging times, while urging for steps to prevent heart disease among the young
By Kumudini Hettiarachchi
It has been about adapting, sharing, innovating and teamwork, captured succinctly in the very theme of ‘Advancing Equitable Cardiac and Thoracic Surgical Care’ of the 3rd Annual Academic Sessions of the Association of Cardiothoracic and Thoracic Surgeons of Sri Lanka (ACTSSL) which were inaugurated on Friday evening.
Detailing the “ups” and “downs” that Sri Lanka’s Cardiothoracic and Thoracic Surgeons experienced in the past year, ACTSSL President Dr. Muditha Lansakara said it was two years after the pandemic and then the economic crisis. All the challenges were causing agitation not just for him but also for all medical professionals.
Dr. Muditha Lansakara addressing the gathering
He said that the Health Ministry has 700+ formulary items for cardiothoracic surgery. Almost all are essential to offer an uninterrupted service. Due to financial constraints, the ministry was not in a position to get most of the items required to maintain services and they were in constant dialogue with the officials to get the necessary supply of consumables.
“We created WhatsApp groups incorporating cardiothoracic surgeons and ministry officials. They really helped in many ways to expedite the supply of consumables. Another unique feature was that we shared limited consumables among the different cardiothoracic units, which helped. When we were constrained by a lack of supply, we changed our practices,” said Dr. Lansakara, citing a severe shortage of oxygenators essential for cardiac surgeries using the heart-lung machine. They had only four of them at one point and they increased off-pump coronary artery bypass surgeries which did not need oxygenators.
The statistics said it all – while in November 2022, there had been no off-pump coronary artery bypass surgeries at the Kandy National Hospital, in November 2023, there had been 12 and in December 2023 there had been 18.
While facing these challenges, they had also concentrated on working with other specialties and strengthening teamwork as cardiothoracic and thoracic surgery is all about teamwork.
Changing track, Dr. Lansakara reiterated that they need to facilitate the lifetime management of diseases, whether it is valvular heart disease or coronary artery disease.
Concerned over more and more younger patients being diagnosed with coronary artery disease needing coronary artery revascularization, he gave a case just three days before of colleague Dr. Nalaka Dissanayake, operating on a 24-year-old youth on an emergency basis.
The late Dr. Ravi Pillai’s family and friends at the oration
The late Dr. Ravi Pillai
Orator Dr. Rajeeva Pieris
“I feel the medical community and administrators should pay attention to this serious problem. Hence, while improving our surgical services, we need to place emphasis on primary prevention as well, along with risk-factor modification,” he said, adding that thoracic surgeons too have similar challenges.
In the light of these critical developments, Dr. Lansakara expressed grave concern over Sri Lanka having only one fully-fledged thoracic unit for the whole country.
During the inauguration, the ACTSSL honoured the late Dr. Y.K.M. Lahie with the ‘Lifetime Achievement Award’ and presented honorary Fellowships to pioneering Cardiothoracic Surgeon Dr. Nihal Kulatilaka and Chief Guest Prof. David Taggart, Professor of Cardiovascular Surgery, University of Oxford, United Kingdom.
| ACTSSL formalizes quality assessment for Cardiothoracic and Thoracic Surgeons to enhance patient safety In a first among medical specialists, the ACTSSL turned the searchlight inward and set in motion on Friday, the ‘Quality Assessment of a Surgeon (QAS): A novel framework for assessing & enhancing surgical competence, attitudes and accountability’. The assessment is for Cardiothoracic and Thoracic Surgeons. This was the hot topic dealt with in the Ravi Pillai Memorial Oration delivered by ACTSSL’s Immediate Past President Dr. Rajeeva Pieris. Describing Dr. Pillai as an eminent Cardiothoracic Surgeon who practised in Oxford, United Kingdom, Dr. Pieris said he was also a warm human being, friend and mentor for the cardiothoracic community in Sri Lanka. In 2013, Ravi founded the Oxonian Heart Foundation to offerfree and heavily subsidized heart surgery for Sri Lankans. With regard to the QAS, Dr. Pieris said it was a first in the country among doctors. It is designed to ensure that patients receive the highest standard of care by guiding, evaluating and improving the performance of surgeons, thereby enhancing patient safety, treatment outcomes and professional standards. The implementation of the QAS is anticipated to significantly advance the landscape of surgical governance in Sri Lanka. “Surgical training and apprenticeship are vital, offering aspiring surgeons practical experience supervised by experienced professionals. This mentorship fosters the development of technical skills, clinical judgment and professional competencies essential for delivering excellent patient care. Rigorous training and hands-on exposure enable trainees to gain expertise in safely and effectively performing complex surgical procedures,” he said. He added that inspired by global literature and a strong determination for progress, the ACTSSL has developed a unique tool designed for assessment, self-evaluation and continuous improvement. “We believe that this is the first of its kind in any professional organization in Sri Lanka.” Those who had laboured over producing the QAS were Convener & Editor Dr. Pieris, Dr. Panna Gunaratne, Dr. Mahendra Munasinghe, Dr. Sumana Handagala, Dr. Muditha Lansakara, Dr. M.S. Mugunthan, Dr. Renuke Kannangara, Dr. Nalaka Dissanayake and Dr. Nallathamby Sivashangar. Its contents include:
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