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Second Announcement www.ics-apcongress2013.com Supported by: 5-7 December 2013 Centara Grand at Central Plaza Ladprao Bangkok Improving patients’ lives through education and surgical advancement Improving patients’ lives through education and surgical advancement The Celebrations on the Auspicious Occasion of His Majesty the King’s 86 th Birthday Anniversary 5 December 2013
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Second Announcement

www.ics-apcongress2013.comSupported by:

5-7 December 2013Centara Grand at Central Plaza Ladprao Bangkok

Improving patients’ lives through education

and surgical advancement

Improving patients’ lives through education

and surgical advancement

The Celebrations on the Auspicious Occasion ofHis Majesty the King’s 86th Birthday Anniversary 5 December 2013

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Welcome Message Welcome message from World President of The International College of Surgeon

It is my pleasure to welcome Surgeons from all over the world; ICS

fellows and otherwise to this federation congress.This congress will be conducted in one of the most beautiful places of the world with nice people and charming landscape. Bangkok is a touristic city full of places of attraction allowing a rich enjoyable social program. The scientific program is planned to be very rich covering seventeen surgical specialties on educational and research background concentrating on new technologies and innovations.Keynote participants will partake in plenary, guest lectures, and interactive sessions. Your log "Surgeons for all " is fulfilling the goal of Dr. Max Thorek

founder of our college to offer healing surgery to all irrespective of gender, race, color or religion. The main theme "improving patients' lives through education and surgical advancement" is to the point navigating in all surgical modalities; robotic, metabolic, minimally invasive, oncologic vascular, surgery etc. The interest in the oncologic parameters is mandatory in a trial to alleviate the devastating impact of malignant tumors both at therapeutic level and prophylactic profile supported by cancer education. We look forward to enjoy your participation and company in Bangkok, Thailand. Yours truly Professor Adel Fouad Ramzy World President of ICS

ORGANIZED BY

VENUE

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Welcome Message Message from the President of the International College of Surgeons, Thailand Section and President of the Organizing Committee of the Asia Pacific Federation Congress 2013

Dear Members and Guests,

The vision of the International College of Surgeons is to improve the lives of our patients through the development and education of our members and the advancement of our field. To fulfill our goal an educational congress involving all subspecialties of surgery is held every two years. This year the venue is Thailand. The organizing committee is delighted to welcome all our members and guests in 17 specialties to participate, share their experiences and expand their networks as well as enjoy wonderful social times together. We have put together a program

with interesting topics which will showcase new technology, innovations and research studies in an integral modality. We have also invited surgeons to share upon some collaborative projects on surgical education, postgraduate training exchange program and those achieved activities on public welfare in surgery.

Highlight Topics of this conference will include ( but not limited to) the following subjects as follows:

Innovation in Hernia Repair Robotic-Assisted Prostatic Surgery in Asia Cutting Edge in Wound Management Role of HIPEC in CarcinomatosisPeritonei Advances in Minimally Invasive Aesthetic Surgery Advances in Minimally Invasive Surgery (MIS) Update in Metabolic Surgery Oncoplastic Breast Surgery Conference & Workshop Update in Advanced Trauma Life Support Vascular Surgery Hands-on Workshops in Soft Cadaver in General Surgery Surgical Education, Collaboration and Training Programs Open House Visit to Main University Hospitals in Bangkok Pre and Post Congress Local and Regional Sight-seeing Tours

This is an early bird announcement of the congress. We would like to encourage every one of you to set aside the time in your busy calendars to join us for this APFC 2013. We are open to any suggestions or recommendations which can help make this congress a superb success. Please feel free to contact us via our email address. We would be most grateful and appreciative of any suggestions from our members.

Many thanks to all and see you in Bangkok soon.

Professor Supakorn Rojananin President, ICS Thailand Section and Congress President

ORGANIZED BY

VENUE

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Committee Chairman, Advisory Committee

NopadolWora-Urai Advisory Committee

Christopher Chen Said Daee Adel Ramzy Yik-Hong Ho Max Downham SawaiLimpisathian KijjaSindhvananda ChawalitOngcharit ThonguebUttaravichien ChomcharkChuntrasakul NaronkRodwarna VajarabhongsaBhudhisawasdi PreechaSiritongtaworn ThongdeeShaipanich SonchaiSirivannabood ChumsakPruksapong PornthepPremyothin KrisadaRatana-Olarn VibulTrakulhoon Darin Lohsiriwat JongjetAojanepong SupchokeChitvanich PraphanKitisin ChesadaSangsubhan ArunRojanaskul TrichakSandhu HongsinTrakultivakorn PrasertVasinanukorn Choo-Chat Kambhu Na Ayudhya ChanchaiNimitrvanich ChusakdiSuwansirikul

Congress Organizing Chairman

SupakornRojananin

Congress Organizing Vice-Chairman ApiragChuangsuwanich SukijPanpimanmas SurinKoocharoenprasit SathienTumtavitikul PramookMutirangura

Secretary General

WichaiVassanasiri

Assistant Secretary General, Local and International Public Relations, Accommodation, F&B

SuebwongChuthapasith

Chairman of Audio-visual and Social Network

SongchaiSimaroj

Honorary Treasurer TaweewongChulakamontri

Chairman of Business Management ChairatPokawattana

Chairman of Academy and Workshops ParinyaThavichaigarn

Vice-Chairman VitoonChinswangwatanakul BoonprasitKritpracha ThawatchaiAkaraviputh

Committee Member

Rattaplee Pak-Art ChusakKuptarnond KampholLaohapensang

Chairman of Publications and Newsletter

PornpromMuangman Chairman of Social Function and Entertainment

SutdhachitLinananda Chairman of Congress Venue and Transportation

Petchkasetsuwan Chairman of Congress Feedback and Evaluation

ApichartPloysangwal Chairman of Sport and Recreation and Souvenir

SrichaiChaiyaphruk Chairman of Fundraising Activities and ICS Thailand Section’s Chronicle Production

SupakornRojananin Co-Chairman

PreechaSiritongtaworn ParinyaThavichaigarn

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Program at a glance

International College of Surgeons Asia Pacific Federation Congress 2013 in Commemoration of

60th Anniversary of ICS Thailand Section 5-7 December 2013

Centara Grand at Central Plaza Ladprao Bangkok

MAIN CONGRESS

Date/Time Dec 4, 2013 Dec 5, 2013 Dec 6, 2013 Dec 7, 2013

8.00-8.30 Registration Registration Registration

8.30-10.00

WS1: MIS WS2: Breast WS3: Breast Optionaltour(

Siriraj Hospital)

Plenary Lecture Cancer Education

Humanitarian Aspect of International College of Surgeons

Humanitarian Role of ICS Thailand Section

(8.30-9.30) Sym10 MIS4

Sym17 Wound Care 1

Sym18 Colorectal surgery1

Free papers

10.00-10.30 Coffee Break

Opening Ceremony

Coffee Break

10.30-12.00 Sym1 Breast

Cancer1

Sym2 MIS1

Sym3 Trauma1

Free papers

Sym19 Wound Care 2

Sym20 Colorectal surgery2

Free papers

12.00-13.30 Luncheon Symposium 1 Luncheon Symposium 2

13.30-15.00 Sym4 Breast

Cancer2

Sym5 MIS2

Sym6 Trauma2

Free papers

Sym11 Breast

Cancer4

Sym12 MIS5

Sym13 Patient safety

Free papers

Complimentary Tour 15.00-15.30 Coffee Break Coffee Break

15.30-17.00 Sym7 Breast

Cancer3

Sym8 MIS3

Sym9 Trauma3

Free papers

Sym14 Breast

Cancer5

Sym15 MIS6

Sym16 Surgical

Education and

Collaboration

Free papers

17.30-19.30

Welcome Reception 18.30-20.30

Gala Dinner (Thai Night)

** We would be most grateful and appreciative of any suggestions from our members.

MAIN CONGRESS – PROGRAM DETAIL

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December 5, 2013

8.30-10.00

VibhavadeeBallroom AB

Plenary Lecture Cancer Education - Adel Ramzy, EG

Humanitarian Aspect of International College of Surgeons - Max Downham, USA Humanitarian Role of ICS Thailand Section - SupakornRojananin, TH

Chairmam: NopadolWora-Urai, TH Co-Chairman: ParinyaThavichaikarn, TH

10.00-10.30 Coffee Break

10.30-12.00

Room I

Sym1: Breast Cancer1 Experience and Benefit of IORT following

BCS in Asian Breast Suebwong Chuthapisith, TH BCS vs Mastectomy Norlia Abdullah, MY Oncoplastic Technique in BCS: What is the

Frontier Between Oncologic Safety and Cosmetic Outcome?

Visanu Lohsiriwat, TH

Chairmam: Supakorn Rojananin,TH Co-Chairman: Wichai Vassanasiri,TH

Room II

Sym2: MIS1 Optimizing Outcomes of

Ventral &Inquinal Hernia Repair Prevention of Incisional Hernia Sathien Tumtavitikul, TH Customizing Lap Ventral Hernia Repair S. Rogers, USA Customizing Lap Inquinal Hernia Repair Vitoon Chinswangwatanakul,TH

Chairmam: Sukij Panpimanmas,TH

Co-Chairman: Apichai Chaiyaroj,TH

Room III

Sym3: Trauma1 Complex Abdominal Injuries

Blowout Duodenum Raywat Chunhasuwankul (SI,TH) Portal Triad Injuries Narain Chotirosniramit (CMU,TH) Mesenteric Vascular Injuries Supparerk Prichayudh (CU,TH) Open Pelvic Fractures Chiu Ming Terk (TTSH,SG)

Chairmam: Preecha Siritongtaworn,TH Co-Chairman: Taweewong Chulakamontri,TH

Room IV

Free paper

12.00-13.30 Luncheon Symposium 1

13.30-15.00

Room I

Sym4: Breast Cancer2 When to accept Contralateral and Bilateral

Prophylactic Mastectomy? Pornchai O-Charoenrat, TH Nipple Sparing Mastectomy; How I Do It? Supakorn Rojananin, TH Axillary Reverse Mapping to Prevent

Lymphedema after Breast Cancer Surgery (to be announced ) Japan Lymphovenous Anastomosis and Lymph

Node Transplantation for Lymphedema Treatment

Sirichai Kumnerdnakta, TH Chairmam: Cheng Har Yip, MY

Co-Chairman: Poramaporn Prasarttong-Osoth, TH

Room II

Sym5: MIS2 Innovative Bariatric Procedures

Update on Endolumenal Bariatric Surgery (Primary and Revisional Surgery)

Sutdhachit Linananda, TH Banding the Gastric Pouch S. Rogers, USA Metabolic Surgery- where are we? A.Zameer Pasha, IN

Chairmam: Paisal Pongchairerks, TH

Co-Chairman: Suthep Udomsawaengsup, TH

Room III

Sym6: Trauma2 Recent Approaches in Vascular Trauma

(to be announced)

Chairman: Kritaya Kritayakirana,TH Co-Chairman: Banjerd Praditsuktavorn,TH

Room IV

Free paper

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December 5, 2013 (continue)

15.00-15.30 Coffee Break

15.30-17.00

Room I

Sym7: Breast Cancer3 The Impact of Breast Reconstruction on

Oncological Outcome Adune Ratanawichitrasin, TH Abdominal Flap Selection – Pedicle TRAM or

Free TRAM or DIEP (to be announced)

LatissimusDorsi Flap for Total Breast Reconstruction

Youwanush Kongdan, TH

Chairmam: Surapong Supaporn, TH Co-Chairman: Youwanush Kongdan, TH

Room II

Sym8: MIS3 Update on Bile Duct Injuries

Bile Duct Injuries: How to Prevent? Chaiya Chansai, TH Non-Surgical Management of Bile Duct

Injuries (Endoscopic and Radiological Interventional Approach)

Thawee Ratanachu-Ek, TH Definitive Repair of Bile Duct Injuries: Who,

Where and When Boonchoo Sirichindakul, TH

Chairmam: Vajarabhongsa

Bhudhisawasdi,TH Co-Chairman: Sermsak Hongjinda,TH

Room III

Sym9: Trauma3 Updates in Damage Control Management

Damage Control Surgery: Is it Overused? Rattaplee Pak-art (CU,TH) Damage Control Resuscitation: A New Buzz

Word Burapat Sangthong (PSU,TH) How to deal with abdominal wound closure Osaree Akaraborworn (PSU,TH) Late Abdominal Reconstruction after Open

Abdomen Kamtone Chadacham (CM,TH)

Chairmam: Narain Chotirosniramit,TH Co-Chairman: Nat Krairojananan,TH

Room IV

Free paper

December 6, 2013

8.30-9.30

VibhavadeeBallroom AB

Sym10: MIS4 Essential Steps of Robotic Surgery

Robotic Pancreatic Resection – Anusak Yiengpruksawan, USA Is MIS Pancreaticoduodenectomy Ready for Primetime? – Patpong Navicharern, TH

Robotic Rectal Resection – Vitoon Chinswangwatanakul, TH

Chairmam: Sathien Tumtavitikul,TH Co-Chairman: Thawatchai Akaraviputh,TH

10.00-12.00 Opening Ceremony

12.00-13.30 Luncheon Symposium 2

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December 6, 2013 (continue)

13.30-15.00

Room I

Sym11: Breast reconstruction

Evolution and Safety Approval of Breast Implant

Apirag Chuangsuwanich, TH Roles of Breast Implant in Breast

Reconstruction Murillo Fraga, BR Tissue Expander in Breast Reconstruction Murillo Fraga, BR Lipofilling for Breast Reconstruction Visanu, TH

Chairmam:Arthi Kruavit,TH Co-Chairman:Chongdee Aojanepong,TH

Room II

Sym12: MIS5 Current Controversies in Minimally Invasive

Surgery Complications of Laparoscopic Pancreatic

Surgery: Current Data Kyoichi Takaori, JP Complications of Laparoscopic Gastric

Surgery: Current Data Eishi Nagai, JP Difficult Gall Bladders? Calot's or Gallows

A.Zameer Pasha, IN

Chairmam: Darin Lohsiriwat,TH

Co-Chairman: Patpong Navicharern,TH

Room III

Sym13: Patient safety Experience Patient Safety In Australia Yik-Hong Ho, AU Experience Patient Safety in Korea (to be announced), KR Experience Patient Safety in Taiwan Aij-Lie Kwan, TW

Chairmam: Pornthep Pramyothin,TH Co-Chairman: Monwat Ngerncham,TH

Room IV

Free paper

15.00-15.30 Coffee Break

15.30-17.00

Room I

Sym14: Breast aesthetic surgery Implant Selection for Augmentation

Mammoplasty Murillo Fraga, BR Correction of Ptosis and Asymmetric Breast Murillo Fraga, BR How to Minimize Complication in Breast

Augmentation Apirag Chuangsuwanich,TH

Chairmam: Charan Mahatumarat,TH Co-Chairman: Lek Kanjanakomut,TH

Room II

Sym15: MIS6 Update in HIPEC & CRS

Treatment Principles for Peritoneal Disease: Indication and Surgical Approach

Yutaka Yonemura, JP OR Personnel Safety Related to HIPEC Thawatchai Akaraviputh, TH Management of Complications Related to

CRS And HIPEC Asada Methasate, TH

Chairmam: Narong Lertakyamanee,TH

Co-Chairman: Chakrapan Euanorrasetr,TH

Room III

Sym16: Surgical Education and Collaboration Collaboration Surgical Research among the

Asian countries Cheng Har Yip, MY International fellowship training program:

Oncoplastic Breast Surgery Suebwong Chuthapisith, TH International fellowship training program:

Minimally Invasive Surgery Vitoon Chinswangwatanakul, TH International training program of Endovascular

surgery : Aortic and peripheral arterial diseases

Worawong Salit-attakorn, TH Chumphol Wongwanich, TH

Chairmam: Pramook Mutirangura,TH Co-Chairman: Pornchai O-Charoenrat,TH

Room IV

Free paper

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December 7, 2013

8.30-10.00

Room I

Sym17: Wound Care1 Clinical Approach to Wounds: Wound Bed Preparation including the

Use of Advanced Wound Dressing and Wound Healing Adjuvant Surawej Numhom,TH Update in Prevention and Treatment of Hypertrophic Scar Apirag Chuangsuwanich, TH Surgical Site Infection (SSI) (to be announced)

Chairmam: Vichai Srimuninnimit, TH Co-Chairman: Att Nitibhon, TH

Room II

Sym18: Colorectal Surgery1 New Surgical Advancements in the Treatment of Fecal Incontinence Steven D Wexner, USA Role of Imaging in Hepatic Metastases in Colorectal Cancer Shusilp Charnsangavej, USA Early Onset of Colorectal Cancer in Thai Population Atthaporn Trakarnsanga, TH

Chairman: Arun Rojanasakul, TH

Co-Chairman: Art Hiranyakas, TH

Room III

Free paper

10.00-10.30 Coffee Break

10.30-12.00

Room I

Sym19: Wound Care2 Negative Pressure Wound Therapy (NPWT): Indications and Clinical

Experiences from Expert Apichai Angsapatt,TH Operative Burn Wound Management Pornprom Muangman,TH A Multi-Faceted Expert's Approach Managing Diabetic Foot Ulcer Kittipan Rerkasem, TH

Chairmam: Boonprasit Kritpracha, TH Co-Chairman: Supaporn Opasanon, TH

Room II

Sym20: Colorectal Surgery2 Diagnosis and Staging of Colorectal Cancer Fabio Potenti, USA Robotic Colorectal Surgery: Is It Really a Future? Art Hiranyakas, TH Management of Colorectal Cancer with Unresectable

Secondary Metastases Yik-Hong Ho, AU

Chairman: Paisit Siriwittayakorn, TH Co-Chairman: Prayuth Sirivongs, TH

Room III

Free paper

MAIN CONGRESS – INVITED SPEAKERS

Australia, Yik-Hong Ho Brazil, Murillo Fraga Egypt, Adel Ramzy India, A.Zameer Pasha Japan, Eishi Nagai Japan, KyoichiTakaori

Japan, Yutaka Yonemura Malaysia, Cheng Har Yip Malaysia, Norlia Abdullah Singapore, Chiu Ming Terk Taiwan, Aij-Lie Kwan USA, AnusakYiengpruksawan

USA, Fabio Potenti USA, Max Downham USA, S. Rogers USA, Steven D Wexner

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WORKSHOP

December 4, 2013

Venue: Skill Lab Center and Operating Rooms, Siriraj Hospital Room: Room I Time: 8.00 – 17.00 hr. Workshop 1: MIS: Hands-On Workshop in Soft Cadaver: Lap Surgery in General Surgery

(Limited to 24 persons) Lap Gastrectomy

Lap Hepatectomy

Lap Hernia Repair

Lap Colectomy

Lap Distal Pancreatectomy

Speaker: Vitoon Chinswangwatanakul, TH Auttaporn Trakarnsanga, TH Thawatchai Akaraviputh, TH Room: Room II Time: 8.00-12.00 hr. Workshop 2: Breast: IORT Immediate After Breast Conserving Surgery

(Limited to 12 persons) 8.00 : Registration 8.30 : Principle of the IORT in Treatment of Breast Cancer 9.00 : Live Surgery Lumpectomy with Sentinel Lymph Node Dissection with Intraoperative Radiotherapy (IORT) 12.00 : Lunch

Speakers: Supakorn Rojananin, TH Suebwong Chuthapisith, TH Pornchai O-Charoenrat, TH Visanu Lohsiriwat, TH Adune Ratanawichitrasin, TH Kullarthorn Thephamongkol, TH Room: Room II Time: 13.00-17.00 hr. WS3: Breast: Nipple Sparing Mastectomy with LD Flap / and with Prosthesis Reconstruction (Limited to 12 persons) 13.00 : Cadaveric Dissection

• Nipple Sparing Mastectomy • LatissimusDorsi Flap • Implant Reconstruction

17.00 : Finish

Speakers: Supakorn Rojananin, TH Suebwong Chuthapisith, TH Pornchai O-Charoenrat, TH Visanu Lohsiriwat, TH Adune Ratanawichitrasin, TH Poramaporn Prasarttong-Osoth, TH Optional Tour : SirirajHospital Open House Under Graduated and Post Graduated (Medical Education and PostgraduateSurgical Training in Thailand) Free of charge (Limited to 30 persons, first come first served basis) Visiting the oldest medical school, Museums, library, Gross anatomy building, GI endoscopic center, Breast center, Hybrid OR, Siriraj private hospital, etc. With special presentation of medical education and surgical training in Thailand and complimentary faculty lunch!

By: SupakornRojananin, TH Cherdsak I-Ramaneerat, TH

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Call for Abstracts Abstract Instruction Please read this thoroughly before preparing your abstract.

1. Only abstracts written in English will be accepted. 2. CAPITALIZE the entire title and UNDERLINE the name of author who will present the

paper. Abbreviations must not be used in the title. After the title, list the author's names and institutional affiliations; OMIT degrees, titles, institutional appointments, address and Zip code. The text should be typed using single spacing. Do not indent the title and each paragraph.

3. Simple tables of graphs (neat and in black ink) may be included. 4. Abbreviations must be defined by placing them in parentheses after the full word the first

time they appear. Use numerals to indicate numbers except when beginning sentences. 5. Nonproprietary (generic) names, written in lower-case letters, are required the first time a

drug is mentioned. Proprietary names are always capitalized. 6. Abstracts must be submitted in form of Microsoft Word file (document file). Font used in

the abstracts must be Times New Roman and not exceed 250 words. Abstract saved in form of Picture or Clip file, such as PDF, Bitmap, JPEG or TIFF, is not acceptable

How to submit an Abstract All abstracts must be submitted the conference website only: www.ics-apcongress2013.com NOTE: Abstracts submitted by email, fax or post will NOT be accepted. Abstract Submission Deadline Abstracts must be submitted on or before September 15, 2013.The online submission system shall be closed on September 15, 2013 at 24:00hrs, GMT. Abstracts submitted after the system closure will not be accepted. Abstract Acceptance Notification Notification of acceptance/rejection will be sent via email to the corresponding author only on or before October 15, 2013. If you have not received the email notification by October 15, 2013, please contact the ICS-APFC 2013 scientific committee secretariat at [email protected]

Registration

Status Early Registration

(Until 30 September, 2013) Late Registration

(After 30 September, 2013)

Member US$ 300 US$ 400

Non-member US$ 400 US$ 500

Trainee** US$ 200 US$ 300

Nurse & Other related professional

US$ 150 US$ 200

Accompanying Person*** US$ 150

Gala Dinner (Thai Night) US$ 75

All those who register in Main congress are entitled to participate in all scientific sessions in main congress including a registration package consisting of a name badge, congress bag, and abstract book, invitation to the social events: welcome reception. **The verification letter from the institute or organization is required. ***Registration as Accompanying person will include the invitation to social events: welcome reception and complementary tour.

Ctrl&Click

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Hotel Congress Venue and Accommodation

Centara Grand at Central Plaza Ladprao Bangkok is newly renovated 5-star and superbly located near the elevated highway system, the underground Mass Rapid Transit and the BTS Skytrain, thereby ensuring that any district within the city is very easily accessible. Shopping here is a pleasure, with a covered walkway providing a direct link to the adjacent Central Plaza shopping complex – one of the biggest of its kind in Bangkok with 300 shops, boutiques, restaurants and multiplex cinema. Delegates to events staged at the Bangkok Convention Centre Hall (BCC Hall) can walk to and from the hotel through the same air-conditioned thoroughfare.

Room Type Single Twin

Deluxe Room THB 4,200 Net THB 4,500 Net

Deluxe Suite Room THB 5,000 Net THB 5,500 Net

Premium Deluxe Suite Room THB 5,950 Net THB 6,350 Net

Executive Suite Room THB 8,450 Net THB 8,850 Net

Plaza Suite Room THB 11,600 Net THB 12,000 Net *Included Breakfast, Internet for 1 User (additional user chaged @ THB 365 net)

**Download reservation from at www.ics-apcongress2013 **For more information, please contact Event Services Manager at +662 5411234 Ext 4210/4211or [email protected] or [email protected]

Satellite Hotel The Chaophya Park Hotel is ideally located in one of Bangkok’s newly emerging business, leisure and entertainment districts. Major shopping complexes and exciting entertainment centers are easily accessible through the subway system. (only 300 m. to Ratchadapisek and Suthisan Station)

Room Type Single Twin

Deluxe Room THB 1,800 Net THB 2,000 Net *Included Breakfast, **Download reservation from at www.ics-apcongress2013 **For more information, please contact hotel staff at +662 2900125 ext. 7115 or [email protected]

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Registration Form -- Deadline for Early Registration: 30 September 2013 -- Please complete this form using a typewriter or BLOCK LETTERS and send this form to: Secretariat Office: ICS-Asia Pacific Federation Congress 2013 Address: 6

th Floor, Royal Golden Jubilee Building, 2 SoiSoonvijai, New Pethburi Rd., Bangkok 10130, Thailand

Fax. 662 7165957 E-mail [email protected]

I. Identification

Title First Name Last Name

Department

Institute

Mailing Address

City State Country Zip

Tel Mobile Fax

Email

Accompanying Person Information

Title First Name Last Name

Title First Name Last Name

II. Registration fee

Status Early Registration

(Until 30 September 2013)

Late Registration (After 30 September

2013)

Member US$ 300 US$ 400

Non-member US$ 400 US$ 500

Trainee** US$ 200 US$ 300

Nurse & Other related professional

US$ 150 US$ 200

Accompanying Person*** US$ 150

Gala Dinner (Thai Night) US$ 75

**The verification letter from the institute or organization is required. ***Registration as accompanying person will include the invitation to social events: welcome reception and half day complementary tour on 7 December 2013.

Workshop - Privilege for all participants who already applied for the main congress WS1 : MIS: Hands-on Workshop in Soft Cadaver: Lap Surgery in General Surgery US$ 1,500 (Limited to 24 persons) WS2 : Breast: IORT immediate after breast conserving surgery (Limited to 12 persons)US$ 200 WS3 : Breast: Nipple sparing mastectomy with LD flap / and with prosthesis reconstructionUS$ 400

(Limited to 12 persons) (if registered both WS2&3, discount US$ 50) III. Payment

Bank transfer on date into: Account name: International College of Surgeons, Thailand Section Account number: 251-210233-2 Name of bank: Siam Commercial Bank Branch: The Ital Thai Tower Swift code: SICOTHBK Please scan the transfer document of your bank and send together with this application form into

[email protected] to notify your registration If you want to pay by credit card, please make online registrationatwww.ics-apcongress2013.com. (This form is not necessary to submit)

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Venue Map

Important Dates

Deadline for Abstract Submission: September15, 2013 Notification of Accepted Abstracts: October 15, 2013 Deadline for Early Registration: September 30, 2013 Late Registration: After September30, 2013

The Chaophya Park Hotel

MRT (Ratchadapisek

Station


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