ALTEC - LATES

Dear colleague,
The Emergency Surgery Course (ESC), which is part of the ESTES and AAST portfolio, is an advanced two-day course aimed at general emergency surgeons, essentially interactive, based on the presentation and discussion of the most relevant topics in this area of General Surgery and on the discussion of related clinical cases.
The next edition in Portugal is planned for 19 and 20 September 2025, in Vila Real, for 24 candidates, and we would very much like to be able to count you among.

The registration fee is 450 € and includes a manual. Bank transfers, mentioning the candidate's name, medical career status and ESC, will be considered on a first-come, first-served basis. They will be processed through ALTEC's IBAN: PT50 0007 0229 0000 3180 0003 3
I would like to thank you in advance for any attention you may pay to this subject and for its dissemination.
Carlos Mesquita
General and Emergency Surgeon
ESC National Coordinator
Former ESTES President

Dear colleague,

A new Emergency Surgery Course (ESC, AAST/ESTES) is being organised and should take place in Viseu, Portugal, on 8th and 9th May 2025. I am therefore taking the liberty of asking for your co-operation in publicising the event among your close colleagues, especially seniors and residents from the last three years, given its advanced nature.

For replies, please use my personal email address, [email protected].

As in previous editions, the course will last two days, during which, under the guidance of accredited emergency surgeons, topics such as the following will be covered interactively and supported by concrete clinical cases, including operative videos:
• Abdominal sepsis
• Appendicitis
• Intestinal obstruction
• Cholecystitis
• Colorectal emergencies
• Gastrointestinal haemorrhage
• Mesenteric ischaemia
• Obstetric and gynaecological emergencies
• Open abdomen
• Necrotizing Soft-Tissue Infections
• Pancreatitis
• Peptic ulcer
• Post-operative complications
• Radiology in emergency surgery
• Spontaneous haemoperitoneum

The afternoon of the second day will be dedicated to evaluations.

Registration, priced at €450, will entitle you to a copy of ‘The AAST/ESTES Emergency Surgery Course Handbook - A Practical Reference In Expecting The Unexpected’, coordinated by Andrew (Andy) Peitzman, as well as catering for the course.

Without further ado, and grateful in advance for any cooperation you may be able to offer in promoting the course, please accept my best wishes.

Carlos Mesquita
General and Emergency Surgeon

EMERGENCY SURGERY SUBSPECIALITY IN PORTUGAL

After a long process of advances and setbacks, now 17 years old, the Portuguese Medical Association has just approved, together with the speciality of Emergency Medicine, the proposal to create the subspeciality of Emergency Surgery (in between, we had UEMS approve a similar proposal in two years and nine years ago, in 2015, on the initiative of the same group). With all those involved having many reasons to celebrate and certainly a lot of work ahead of them, the current board of the College of the Speciality of General Surgery, chaired by our colleague Jorge Paulino, is to be congratulated for its farsightedness and sense of timing. The creation of this subspeciality of Emergency Surgery is a very important step towards having well-coordinated emergency teams, especially with regard to traumatology, with increasingly accredited members.
It is important here to thank all those, foreign and national, who over the last quarter of a century have made themselves available to collaborate with us in the various training programmes that have progressively been implemented at national level, with emphasis on the work carried out within the Portuguese Society of Surgery (SPC) and the Lusitanian Association of Trauma and Emergency Surgery (ALTEC), institutional members of the European Society for Trauma and Emergency Surgery (ESTES): ATLS and TEAM (1999), DSTC (2003), DATC (2009), ETC (2009 / 2014), MRMI (2010), EASC and MUSEC (2013), CCRISP (2019) and ESC (2023), without forgetting, firstly, the international or foreign organisations behind each of them (1) and, secondly, that with DSTC also came DPNTC (2006), for operating theatre nurses (2) .
On the other hand, a great deal of knowledge has been acquired through exchanges with colleagues from other countries – come to mind, straight away, Brazil, the United States of America, Australia, Finland, Spain, Argentina, Greece, Singapore, Italy, Sweden, Switzerland, the United Kingdom, Ireland, the Netherlands, Sri Lanka, Canada, Austria, Poland, North Macedonia, Albania, Qatar and soon Uruguay – which have opened doors for us with invitations to work with them.
The recognition of this subspecialty (the first in our context of the General Surgery specialty) is a kind of icing on the cake in a particularly happy year, 2024, during which we were able to host and chair the European Congress of Trauma and Emergency Surgery (ECTES 2024) in Estoril, organised as part of ESTES. In three-dimensional conceptual terms, it completes a tetrahedron of competences, making it possible to add to the existing intensive training processes, geared towards 1) essential individual action, 2) team action and 3) specialised action, 4) a real continuous training process. As far as I know, at global level, only Brazil, in Campinas, has managed to bring together the four faces of this tetrahedron.
So let's take the opportunity to celebrate all this with honour.
Carlos Mesquita

Footnotes
(1) Advanced Trauma Life Support (ATLS) and Trauma Evaluation and Management (TEAM), American College of Surgeons (ACS) / Definitive Surgical Trauma Care (DSTC) and Definitive Anaesthetic Trauma Care (DATC), International Association for Trauma Surgery and Intensive Care (IATSIC) / European Trauma Course (ETC), European Trauma Course Organization (ETCO) / Medical Response to Major Injuries (MRMI), European Society for Trauma and Emergency Surgery (ESTES) and Medical Response to Major Injuries and Disasters Association (MRMIDA) / Emergency Abdominal Surgery Course (EASC), Donegal Clinical and Research Academy (DCRA) and World Society of Emergency Surgery (WSES) / Modular UltraSound ESTES Course (MUSEC), ESTES / Care of the Critically Ill Surgical Patient (CCRISP), Royal College of Surgeons (RCS) / Emergency Surgery Course (ESC), ESTES and American Association for the Surgery of Trauma (AAST).
(2) Definitive Perioperative Nurses Trauma Care (DPNTC), linked to the Royal Australasian College of Surgeons (RACS).

Dear colleague,
A new Emergency Surgery Course (ESC, AAST/ESTES) is being organised and should take place in Viseu, Portugal, in the first half of 2025, on a date to be announced. I am therefore taking the liberty of asking for your co-operation in publicising the event among your close colleagues, especially seniors and residents from the last three years, given its advanced nature.
We would like to receive feedback on your preferred dates, so that we can meet the interests of the majority of those interested. For replies, please use my personal email address, [email protected].
As in previous editions, the course will last two days, during which, under the guidance of accredited emergency surgeons, topics such as the following will be covered interactively and supported by concrete clinical cases, including operative videos:
• Abdominal sepsis
• Appendicitis
• Intestinal obstruction
• Cholecystitis
• Colorectal emergencies
• Gastrointestinal haemorrhage
• Mesenteric ischaemia
• Obstetric and gynaecological emergencies
• Open abdomen
• Necrotizing Soft-Tissue Infections
• Pancreatitis
• Peptic ulcer
• Post-operative complications
• Radiology in emergency surgery
• Spontaneous haemoperitoneum
The afternoon of the second day will be dedicated to evaluations.
Registration, priced at €450, will entitle you to a copy of ‘The AAST/ESTES Emergency Surgery Course Handbook - A Practical Reference In Expecting The Unexpected’, coordinated by Andrew (Andy) Peitzman, as well as catering for the course.
Without further ado, and grateful in advance for any cooperation you may be able to offer in promoting the course, please accept my best wishes.
Carlos Mesquita
General and Emergency Surgeon

Um processo que se arrastava há mais de 20 anos. De certo modo e formalmente, poderemos dizer que teve início em 2002, com a criação do Colégio da Competência em Emergência Médica (CEM) da Ordem dos Médicos.
Houve, desde início, entre os defensores da nova especialidade, duas correntes, ainda que com idêntico objetivo.
• Uma, maioritária, a favor da solução atual, da criação direta da nova especialidade;
• Outra, na qual sempre me incluí (presidi àquele colégio por duas vezes, de 2004 a 2009 e de 2012 a 2015), defendendo duas etapas: uma, primeira, de evolução da CEM para Competência em Medicina de Urgência e Emergência (CMUE), através da criação de um ciclo de estudos especiais, outra, segunda, de atribuição por consenso da nova especialidade aos detentores da nova competência que o desejassem, no sentido de se tornarem os primeiros role models dos novos internos, processo com muitas semelhanças com o que precedeu a criação da especialidade de Medicina Intensiva.
A questão que se colocará, a seguir, será, precisamente esta: quem serão ou como serão escolhidos os role models dos novos internos?

Desde quando é que para atender e estabilizar minimamente uma doente nesta situação é necessário um ginecologista ou obstetra?

Insisto, já o escrevi e venho defendendo há muitos anos e a vários níveis, que o INEM deveria ter um papel integrador dos diversos agentes e estruturas físicas envolvidas na emergência médica a nível nacional, não se limitando ao pré-hospitalar. As salas de emergência, locais de interface com as estruturas hospitalares, deviam estar na sua dependência, com inversão da atual situação, o que teria efeitos práticos em termos de homogeneização de procedimentos e de equipamentos. Nada justifica que continuem a ser geridas na ótica de cada administração hospitalar e respetivo corpo clínico, cada uma à sua maneira. Por outras palavras, o INEM necessitaria de uma profunda reestruturação e de um grande investimento em recursos não, só, materiais mas, também, humanos, tirando proveito das evoluções que se desejam no tocante ao reconhecimento da medicina de emergência como área de competência ou, mesmo, de especialização.

Nomeado um “novo” novo presidente do INEM O Ministério da Saúde nomeou Sérgio Dias Janeiro para a presidência do Instituto Nacional de Emergência Médica, depois do anterior...

Thanks to everyone who contributed to ECTES 2024!

Dear friends,

Almost a month on from ECTES 2024, I would like to thank everyone, past and present members of the ESTES board and members of the national committee, for the trust you have placed by allowing me to chair the Congress in my country, and for the way you have contributed to its success, not forgetting the participants, speakers and other registrants, and the commendable work of those responsible for the various pre-congress courses, as well as the ESTES and Conventus secretariats, and the Cascais City Council (and without forgetting my family and especially my wife).

Aware that my presence in ESTES since its foundation has not always been a source of consensus, I saw this choice as a sign of great understanding and friendship, which is essential if societies like ours are to strengthen and secure their place in the future.

I also took this congress as a jubilation, at 70 years of age and 47 years of medical career, 42 of which in General and Emergency Surgery. This will not, however, mean a total break with everything that has been my professional life and, even less so, the many friends I have made in Portugal and around the world, mainly as a result of the large number of training programmes we have all been involved in and, I hope, will continue to be involved in for as long as we have the strength and capacity to do so.

Many thanks to everyone, from

Carlos Mesquita

Dear colleagues, Dear friends,
It is with justified pride, as congress president and on behalf of the Portuguese Society of Surgery (SPC) and the Lusitanian Association of Trauma and Emergency Surgery (ALTEC-LATES), institutional members of ESTES, that I welcome you to ECTES 2024, to Portugal, to Lisbon, to the Sun Coast and to the Estoril Congress Centre, where ECTES 2024, our next European Congress of Trauma and Emergency Surgery, will take place from 28 to 30 April.
Firstly, I would like to commend Radko Komadina, from Slovenia, from whom I received the presidential testimonial medal, and congratulate him for the excellent congress he and his team provided us with in Ljubljana.
As in previous editions, ECTES 2024 will maintain its global character, with speakers from all over the world and related national, foreign and international scientific societies, in a highly diverse and dynamic context as it has been in the last decades, with many innovations and different treatment strategies.
The days from 24 to 27 April will be dedicated to pre-congress courses and workshops (MRMI, ETC, DSTC, DATC, DPNTC, ESC, Abdomen Wall Reconstruction, MUSEC and Polytrauma), which will take place in different historical cities with easy access to the capital and will be organised not only by SPC and ALTEC but also by other entities and ESTES itself, taking advantage of the presence of an extraordinary foreign faculty; congress participants and/or ESTES members will have preference and better conditions for registration in these pre-congress activities.
With the collaboration of our Sections – Emergency Surgery, Disaster and Military Surgery, Skeletal Trauma and Sports Medicine, Polytrauma and Visceral Trauma – and Committees – Education Committee and the recently established Research Committee and Young ESTES Committee –, we will have an excellent multidisciplinary programme, focused on trauma and the critically ill surgical patient, in order to promote contacts and exchange of knowledge.
I am sure that ECTES 2024 will be a stimulating event. Join us in Estoril. Together we will rediscover the World of Trauma and Emergency Surgery.
Kind regards,
Carlos Mesquita
Congress President