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Previous ESAP
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PGMI, Block 6 Level 1, Singapore General Hospital
7-8 April 2010

Pleura and Pleuroscopy 2010

Post workshop report

This ESAP Workshop was held at the Singapore General Hospital, sponsored by the APSR as an Educational Seminar of the APSR (ESAP) activity and organized by the Singapore Thoracic Society as the local host.

The symposium consisted of lectures on pleural disease management conducted in a lively pro-con style debate by overseas and local faculty.

2010 is a special year as it marks a hundred years since the inception of thoracoscopy by Jacobaeus, and a full day was dedicated to flex-rigid pleuroscopy, rigid thoracoscopy and video-assisted thoracic surgery that culminated in a hands-on workshop on dogs.

The symposium was oversubscribed and registration was limited to 60 participants due to the hands-on session. Participants came from Dubai, India, Pakistan, Bangladesh, Malaysia, Singapore, Indonesia, Macau, Hong Kong, Taiwan, Philippines, Korea and Australia.

Feedback about the symposium and hands-on workshop was excellent, and we saw a lively exchange of questions between faculty and participants after each pro-con debate. In addition, we had special segments on staging classification, early detection and targeted therapy of lung cancer, which were well-received.

Overall, most participants have expressed interest in attending another ESAP symposium in Singapore and we, as organizers of the 2nd ESAP (the first being on lung cancer and bronchoscopy in 2009), are extremely encouraged by the response.

(Pyng Lee, Course Director, April 14, 2010)

Group photo

Click photos to enlarge (1.5MB)
Drs. Jett, Colt and Lee

Course Director Dr. Pyng Lee with the international faculty: Drs. Jett, Colt & Lee


  • Dr. Henri Colt
    (University of California, Irvine, USA)
  • Dr. James Jett
    (Mayo Clinic, USA)
  • Dr. Gary Lee
    (University of Western Australia)
  • Dr. Pyng Lee (Singapore General Hospital)
  • Dr. Lim Tow Keang (National University of Singapore)
  • Dr. T Agasthian (National Cancer Center)
  • Dr. Cheah Foon Koong (Singapore General Hospital)
  • Dr. Yap Wee See (Tan Tock Seng Hospital)
  • Dr. Lim Chong Hee (National Heart Center)
  • Dr. David Ng (Singapore General Hospital)
  • Dr. Constance Lo (Singapore General Hospital)
  • Dr. Khoo Kay Leong (National University Hospital)
  • Dr. Devanand (Singapore General Hospital)

Pleural Controversies

7 April 2010
  • Separating transudates from exudates. Pro: Light's criteria are good enough
  • Separating transudates from exudates. Con: More tests are needed
  • Closed pleural biopsy for pleural effusion. Pro: Closed pleural biopsy is easy to do
  • Closed pleural biopsy for pleural effusion evaluation. Con: Bury the closed pleural biopsy
  • Imaging of the Pleura. Pro: Current Imaging tools (CXR, U/S, CT, MRI) are good enough
  • Imaging of the Pleura. Con: Advanced Imaging tools (PET, CT-PET) are needed
  • Bulla in pneumothorax. Pro: Surgical bullectomy, they are causative
  • Bulla in pneumothorax. Con: Surgical bullectomy unnecessary, they are bystanders
  • Management of Early Empyema. Pro: Early thoracoscopy improves outcome
  • Management of Early Empyema. Con: Still time for tubes and fibrinolytics
  • Pleurodesis. Pro: Talc is all we need
  • Pleurodesis. Con: We need new agents
  • New Staging Classification of Lung Cancer
  • Dinner Symposium: Early detection and Targeted Therapy of Lung Cancer

Centennial Celebration of Pleuroscopy since Jacobaeus

8 April 2010
  • Pro-Con of Flex-rigid Pleuroscopy (Pyng Lee)
  • Pro-Con of Rigid Pleuroscopy (Henri Colt)
  • Pro-Con of VATS (T Agasthian)
  • Management of Malignant Pleural Effusion and Mesothelioma
  • Hands-on practice (Models and animals):
    • Case discussions
    • Patient positioning
    • Chest tube
    • Techniques of Flex-Rigid Pleuroscopy
    • Rigid Thoracoscopy and VATS