★Dear President of ECTA, when did the interest for Coloproctology began in your career?

★As I understand you also perform Digestive Endoscopy. What do you think today is the relationship between Surgery and Flexible Endoscopy?

I do a lot of endoscopic work. Colonoscopy both diagnostic and therapeutic take up a lot of my time.  I find that as surgeons we should invest them and effort to learn endoscopy as it gives us the freedom to diagnose and to treat our patients as we see fit.  Having to depend on a gastroenterologist to do an emergency or even an elective procedure may sometimes take a lot of effort in co-ordination. I have seen sigmoid pathology diagnosed as caecal lesions and vis versa by the non surgical endoscopist far too many times to recount.

★Which was the milestone during your education in surgery? Where were you educated?

This is a very interesting question and I had to think twice before answering.  I have to say that studying and education are two different things.  I can tell you that I went to kindergarten at 6 years of age and to school for twelve years from the ages of 7 to 18 years of age.  Then to the University to do my MBBS where I graduated in 1981.  I got my FRCS from the Royal College of Surgeons of Edinburgh in 1987 followed by my FAMS in 1991. 

★Who has been your mentor? Who the colleague you remember with more pleasure? Who the man you met if not a colleague you remember with more pleasure?

The Chinese philosopher Confucius had a saying “ When three persons walk together, one will have a teacher”. I find this so true.  Poor is the man who think so highly of himself that he can learn from no one.  Honestly; almost every one I have interacted has taught me something.  The best teaching have been given me actually when I was teaching people and often these students have so much insight that is is amazing.  I think it is because these students are not hindered by what “people in the know” know are truths cast in stone.

In truth though, my best mentors during my training years were people like John Nicholls and Robin Phillips who never ceased to question and probed even the simplest of concepts and never accepted anything just because everyone else says so.

★Which is the role of Coloproctology in your country? Is it considered an independent discipline or is it part of the General Surgery activity?

Coloproctology is a new discipline in Singapore but since the formation of the first department here in 1987 had become a beacon of light in this country.  Now every young trainee wants to be a colorectal surgeon as we publish the most papers, have the most vocal practitioners, have all the new techniques and perhaps have the most patients and therefore the potential to earn the most money.

Unfortunately we are still a part of general surgery as we do not yet have our own specialty post graduate examinations.

★You direct one of the worldwide most famous Colorectal Centers. Tell us about the activity of your center.

Actually I left as head of The Department of Colorectal Surgery at Singapore General Hospital in 2004.  I am however proud to say that during that time we built up quite an impressive array of services which includes endoscopic surgery, laparoscopic surgery which now includes robotic surgery, ano-rectal physiology, transanal ultrasound services, molecular biology services as well as the whole range of trainng facilities.  But I am now thinking of another big project which is the setting up of an all purpose and specially designed colorectal hospital here in this country.

★ECTA’s saying declaims “...is aimed at promoting and teaching the use, and discouraging the abuse, of advanced technologies...“. Which is your comment?

I think that as technologies advance so must we all. If we do not, we will be left behind.  I was really disappointed to learn that so many colorectal surgeons are not even on Facebook.  If we are not even willing to learn these new technologies which affect our everyday life ;how are we to learn anything new to help us in surgery.  New technologies like Facebook can be abused and have been abused but if the right people learn it and use it properly it can be a very powerful tool put in its right place and for the right use.  So shame on those of you who dismiss something because you think you are too old or because you are scared of abuse.  Sex is very often abused and misused but listen without sex man will be history.

★You look very keen in the application of new technologies in your activity. Which is you position towards Single Port Access laparoscopy and Natural Orifices Translumenal Endoscopic Surgery?

I think we must all try it before dismissing it.  I have till today i.e. May 2010 done 5 single port right hemicolectomies. I have given it up for appendicectomies as the normal three port appendicectomies are so much easier and the patients recover much faster as the extraction port is so much smaller compared to a single port site.  NOTES has it s place but not in every case. We are still evaluating this procedure.

★During your career you had a fundamental role in the education of new trainees. How do you see their future? Which the differences between your generation and the younger?

I think that the world is a much more difficult place for trainees now then when we were in training.  The world is smaller and patients have more knowledge But not necessarily wiser and therefore give more problems to a really caring and good doctor. The modern trainee is also less likely to want to work as hard or to do as much.  People of this present generation are more likely to want to take their leave, have their rest and go on vacation much more than previously as the world values rest above work, acknowledgement above accomplishment.  Honest  good hard work is passe for the new generation which is really quite sad.

★ You cooperate with a number of foreign Universities: which is the one you are more linked to?

I have many appointments in the People’s republic of China and I love that country as it is the country of my ancestors.  It is developing very fast and many of the techniques practiced by traditional medicine doctors there are worthy of further study and analysis.

★ Which is the role of research in the trainees education?

Research is a very important activity for junior doctors.  Without doing research many of us would not really understand the issues and also doing research helps us to have a more critical mind to judge what others say about anything and everything in life.

★ Which is your advise to those coloproctologist who are keen to perform flexible endoscopy?

I think that we must do endoscopy ourselves if we are to really understand our patient.  I mean we do not need to be a mechanic to drive a car but if we do know how to repair a car and especially if we understand how to diagnose what the problem is with our cars we drive, we can maintain and keep our cars much better and do a better job of it.

★ Which is your goal as President of the ECTA?

★I would like to see Asia and Europe together exchanging ideas and technologies and manpower. Actually Asia and Europe is one continent. Look at any atlas or map. I am not sure which idiot decided it was two separate continent.

★ Which was your secret dream when you were a child?

★ ... and which now?

The dream is still the same.

★ In a famous sentence you state that surgery is an art. Apart from surgery which is your favorite art and artist?

I actually do quite a lot of drawing but mainly of my stick insects and leaf insects as part of my hobby. I also play the guitar and I have been kicked out to choir twice so I do still sing sometimes when no one is listening. Therefore as I dabble in so many things I do not have an all time favorite artist as such. But in every sphere of life I have favorites but these also changes with time. For example I have a favorite rock singer, a favorite band, a favorite chinese painter, a favorite painter, a favorite poet and so forth.

★ You have been traveling through all the world for professional reasons. Which is the trip you remember with more pleasure and why?

It would not be fair to say which trip is my best trip as there are so many that are so memorable and for so many different reasons.  But I can tell you that I love traveling to tropical countries where I can skip the dinners to go out to the deepest forests where I can look for new species of my favorite stick or leaf insects. This is one activity which really excites me. I have so far published three Torino on stick and leaf insects and quite a lot of papers in per reviewed journals describing new species or the as yet unknown behavior of these insects.