Colo-Rectal Training Program (CREST-PACE-TR-300): A 20-Year Journey from Laparoscopy to Robotics- and a shared vision of teaching 10 surgeons who will, in turn, teach 10 more, multiplying the impact manifold.
Our journey in colorectal surgery training began humbly over a cup of coffee with Anirudh from J&J Ethicon in Mumbai. He invited me to be a mentor for CREST, a laparoscopic colorectal training program designed to train surgeons across India. Initially hesitant about meeting the expectations, his words, “We saw you operating, sir, and you must share your techniques,” gave me the confidence to embark on this transformative path.
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Over the years, we used to train 6-8 surgeons in each session from institutions across India. The format included two to three live cases and didactic sessions where we demonstrated procedures like laparoscopic anterior resection and hemicolectomy. Feedback and mutual learning played a vital role in refining and standardizing rectal cancer surgery techniques. The demand for training grew so much that Ethicon maintained a waiting list for participants eager to join.
As technology evolved, we transitioned from laparoscopic to robotic techniques, adapting our programs to include advanced robotic procedures. Structured training sessions now occur at the Ramaiah Cadaver Lab in Bangalore and at our hospital, in collaboration with Intuitive Surgical. While we miss the warmth and camaraderie of Ethicon representatives like Anirudh, Vipin, Ravi, Pankaj, Swati, and others, their zeal to support surgeons left an indelible mark on our journey.
A heartfelt thanks to Intuitive Surgical for their exceptional support, leadership, and facilitation, as well as all their clinical executives from different states. They help in the learning of surgeons in a very structured way. Murugan and Anand Sharma, for ensuring the program’s success.
We also did a few PACE programs by Medtronic. But now focus primarily on robotic surgery. Each session, whether with Ethicon, Medtronic, or Intuitive, reinforced a crucial takeaway: collaboration and interaction with industry and surgeons are key to designing better techniques, standardizing protocols, and ultimately improving patient outcomes.
This week, as we continue a 3-day training program with Intuitive executives in Bangalore, I reflect on how this journey—from laparoscopy to robotics—has been fueled by partnerships, feedback, and a shared vision of teaching 10 surgeons who will, in turn, teach 10 more, multiplying the impact manifold.
“What makes all the travel worth it as a mentor in colorectal robotic surgery?
It’s the privilege of engaging with eminent surgeons like Ramakrishnan (Adyar), Ayyappan (Apollo), Rohin Mittal (CMC Vellore), Pavan (Kidwai), Narsimhaiah (Apollo), Sanjiv (AIG), and Rajasundaram (Chennai).
These meaningful interactions:
1️⃣ Refine and innovate better surgical techniques.
2️⃣ Ensure reproducibility, empowering surgeons to confidently implement these techniques in their practices.
Most importantly, they drive our shared vision: Teach 10, and they will teach 10 more, creating a lasting cycle of learning that elevates surgical excellence and transforms patient care worldwide.”
