SANTHI SWAROOP VEGE: Hello, everybody. My name is Santhi Swaroop Vege. I'm the director of the pancreas clinic at the Mayo Clinic. Many of you may be knowing about this pancreas clinic. This is one of the most renowned pancreatic diseases clinics in the whole world.

When you look at the pancreas clinics, quote unquote, many of the prestigious institutions all over the world, the top-notch institutions, we stand out quite a lot compared to many of them in the following ways. A, we have very high volumes of patients with pancreatic disease alone who come to Mayo Clinic. We see anywhere between 1,000 to 1,500 new patients with the pancreatic diseases at the clinic. ,

Also, many of the big institutions have biliary and pancreatic diseases clinics combined together or when they have these diseases, these diseases are run by surgeons or by endoscopists whose full-time job is to do surgery or endoscopy but also see the patients. What distinguishes the Mayo Clinic. pancreas clinic besides the volumes is a very renowned model which I personally call as the hub and radiating spokes model. What I mean is geographically we're located on a floor.

The clinic is run by pancreatologists. Pancreatologists by definition, are gastroenterologists or GI endoscopists who see pancreatic disease patients for the most part of their time or a significant proportion of the time. These are the quarterbacks and the patients are seen here but radiating into this clinic are the pancreatic surgeons who practice mostly pancreatic surgery.

Interventional endoscopists who do specialized procedures called EUS and ERCP. Interventional radiologists who can put the catheters into any of the pancreatic or surrounding organs, diagnostic radiologists dealing with sophisticated MRI scans, nuclear medicine scans, CT scans of the pancreatic disease, then we have the pancreatic pathologists who exclusively look at the pancreatic resected specimens or biopsies which are done in large numbers here compared to elsewhere. And we have basic science people. So with all these matrix of people and with the quarterbacks who are dealing with the patients right from the time they come to the time they leave the institution with input from all these experts that what makes this pancreas clinic uniquely different from any other pancreas clinic at a large comparable institution.

Next, this is not the only reason why you should come to Mayo Clinic. When you have a complex medical pancreatic disease, either a diagnostic dilemma or a treatment dilemma, the advantage of coming here is in a very condensed period of time, the patient can complete the itinerary. By this I mean the disease is sorted out, the proper input is given, the proper endoscopic procedure or surgical procedure is done. All of this is done so quickly compared to any other place and that's the reason people go and spread the word of mouth and other people come here.

I'll give you an example. A patient with pancreatic cancer recently diagnosed comes to Mayo Clinic on Monday morning to see me in the clinic. If the CT scan that he brought from outside is satisfactory, and if we do the blood tests on Monday morning, and they come in the evening saying that this mass onset is looking like pancreatic cancer and nothing else. It is operable. It's not a benign disease. There's no need for any endoscopic ultrasound or ERCP and biopsies.

The pancreatic surgeon sees the patient on Monday evening itself. And during Monday, we get all the blood studies, get the surgeons, see the patient, get this cancer reviewed, prepare him to be OK for anesthesia, patient goes onto the table on Tuesday morning. This type of condensed itinerary is not possible elsewhere.

And then if the patient is having a major pancreatic resection called Whipple, we can even do it laparoscopically. As some of you may have seen the video of Dr. Mike Hendrick, who is the world's topmost laparoscopic surgeon, and we have other surgeons who are equally good, so we have about four pancreatic surgeons here who have enormous experience in the pancreatic surgery. And you are very familiar that the resource of the pancreatic surgery are directly dependent on the number of--