Across Borders and Disciplines: Inside the Amrita Skull Base and Microsurgery Program 2026

In early 2026 an international group of surgeons, trainees, and observers gathered in India for the Amrita Skull Base and Microsurgery Program, an educational initiative combining skull base surgical demonstrations with intensive microsurgical training and cadaveric dissection. The program brought together faculty and participants from multiple countries and was organized through the Amrita Institute of Medical Sciences in Kochi, with additional laboratory training conducted at the Amrita Delhi campus anatomy dissection laboratory.The course was coordinated through a partnership between the Amrita Institute of Medical Sciences and the international medical consulting organization AF Medico d.o.o.The overall program leadership was shared between:Dr. Subramania Iyer — Course Director and Primary Instructor for the Microsurgery ProgramProf. Andrew Fishman — International Course Coordinator and Faculty Instructor, representing AF Medico d.o.o.This partnership reflected the collaborative nature of the program, combining Amrita’s surgical training infrastructure with international academic and surgical expertise through AF Medico.The skull base demonstration sessions also featured Dr. Krishnakumar T, who served as a guest skull base instructor, contributing to the teaching of complex skull base surgical approaches and participating in surgical demonstrations and discussions.Among the visiting international contributors was Dr. Andrzej Zarowski of Antwerp, Belgium, who participated as a guest instructor during the skull base demonstration sessions, contributing his experience in neurotology and skull base surgery.

Participants represented several countries and surgical communities, forming a diverse group of surgeons and trainees from Bosnia and Herzegovina, Serbia, Poland, India, and the United States.

Global Travel During Wartime Disruptions

The journey to India occurred during a period of geopolitical conflict that had disrupted many traditional aviation routes between Europe and Asia. Airspace closures forced travelers to abandon direct routes and navigate complex detours across several regions of the world.

Participants therefore traveled through Astana in Kazakhstan, Hong Kong, Shanghai, and Baku in Azerbaijan before eventually reaching India. What might normally have been a straightforward international journey became a multi-stage passage across continents.

Although the rerouting was a consequence of wartime aviation restrictions, it also turned the journey into an unexpected global expedition. Surgeons traveling for the course crossed Central Asia, East Asia, and the Caucasus before finally descending into the Indian subcontinent.

Arrival in Kochi

The first phase of the program took place in Kochi, a historic port city in the Indian state of Kerala. For centuries Kochi has served as a maritime gateway between India and the wider world. Arab traders, Portuguese navigators, Dutch merchants, and British colonial administrators all left their mark on the region, producing a cultural landscape that remains remarkably diverse.

Participants gathered at the Amrita Institute of Medical Sciences, one of the largest tertiary care hospitals in India. The institution serves as a major teaching hospital with advanced surgical suites, research facilities, and a wide array of specialized medical services.

Skull Base Surgical Demonstrations

The opening portion of the course focused on skull base surgery, with demonstrations and lectures covering both lateral and anterior skull base approaches.

Lateral Skull Base Approaches

The first day examined lateral corridors to the skull base, including:

• lateral transcervical approach to the parapharyngeal space

• lateral temporal bone resection

• approaches to the infratemporal fossa and nasopharynx

• jugular foramen and hypoglossal canal pathways linking intracranial and extracranial compartments

These demonstrations emphasized the intricate anatomical relationships that characterize the skull base, where cranial nerves and major vascular structures must be carefully preserved while achieving oncologic resection.

Anterior Skull Base Approaches

The second day focused on anterior skull base surgical access, including:

• endoscopic exploration of the parasellar region

• facial translocation approaches

• orbitozygomatic craniotomy and transorbital pathways

• midline mandibulectomy for deep skull base access

These sessions highlighted the integration of open craniofacial techniques and minimally invasive endoscopic approaches.

Surgical Pathology Observed

Participants were able to observe a wide range of complex surgical cases typical of a tertiary referral center. These included:

• facial nerve tumors

• skull base tumors

• maxillary cancers

• soft tissue sarcomas

• extensive facial tumors

• major head and neck oncologic resections

Particular attention was given to maxillary cancer and midfacial defects, which often require complex reconstructive strategies following tumor removal.

Reconstructive objectives discussed during the course included:

• separation of oral and nasal cavities

• support of the orbital contents

• dental rehabilitation

• restoration of facial symmetry and aesthetics

Participants also reviewed reconstructive classification systems including the Brown classification and Cordero classification for maxillary defects.

Microsurgery Training and Cadaveric Dissection in Delhi

Following the skull base demonstrations in Kochi, the program continued at the Amrita Delhi campus anatomy dissection laboratory, where participants engaged in intensive hands-on microsurgical training.

The laboratory program included:

• microvascular anastomosis training

• microscope-guided suturing techniques

• vessel preparation and troubleshooting

• individualized instruction from experienced faculty

Cadaveric flap harvesting demonstrations covered both commonly used and advanced reconstructive techniques, including:

• radial forearm free flap

• anterolateral thigh flap

• fibular free flap

• deep inferior epigastric perforator flap

• scapular and parascapular flaps

• lateral arm flap

• gracilis muscle flap

• regional head and neck flaps

These dissections were performed on soft-embalmed cadaveric specimens, allowing participants to practice microsurgical techniques under conditions that closely resemble live surgery.

Research and Technological Innovation

Participants also visited research facilities associated with the Amrita medical system. A highlight was the 3D printing laboratory, where engineers and surgeons collaborate to produce patient-specific anatomical models and surgical implants.

These technologies enable surgeons to simulate complex craniofacial and skull base procedures before entering the operating room, improving surgical planning and reconstruction outcomes.

Cultural Exploration Across India

Beyond the surgical program, participants also explored several historic and cultural landmarks across India.

Among the most memorable excursions was a visit to Agra, where participants saw the Taj Mahal, widely regarded as one of the most iconic architectural monuments ever constructed. They also visited the Red Fort, a historic Mughal imperial complex that once served as the seat of imperial power.

Participants also experienced the beaches of Kerala, known for their tropical coastline along the Arabian Sea.

Visit to the Ashram of Amma

Another meaningful part of the journey was a visit to the ashram of Mata Amritanandamayi, widely known as Amma.

Amma is an internationally respected spiritual leader often referred to as the “hugging saint.” Her ashram attracts visitors from around the world who come to receive blessings through a traditional embrace known as darshan.

Members of the course group visited the ashram, observed the community life there, and received Amma’s blessings and embraces, an experience that many participants described as deeply moving.

Friendship Across Borders

Perhaps the most enduring outcome of the course was the friendships that formed among participants from different countries.

Doctors from Bosnia and Herzegovina, Serbia, Poland, India, and the United States spent days working side by side in anatomy laboratories, operating rooms, lecture halls, and during travel throughout the program. Conversations extended far beyond surgical technique, touching on culture, history, and personal experiences.

These relationships developed during a time when the world was experiencing increasing political tension, ethnic conflict, and cultural polarization. In that context, the collaboration among surgeons from different national, ethnic, and religious backgrounds carried special meaning.

The course became a reminder that medicine frequently transcends political boundaries, bringing together individuals united by a shared commitment to patient care and scientific progress.

Kerala as a Model of Cultural Harmony

The setting of the course in Kerala further reinforced this message. Kerala has long been recognized as one of the most culturally and religiously diverse regions of India. Hindu temples, Christian churches, and Muslim mosques exist side by side, reflecting centuries of coexistence among different faiths.

Participants frequently remarked on the remarkable sense of social harmony and mutual respect present in the region. Kerala’s long history of education, cultural exchange, and tolerance provided a powerful backdrop for a course that itself brought together physicians from many parts of the world.

India’s broader tradition as a multicultural and tolerant society, and Kerala’s particularly strong example of religious coexistence, made the location especially meaningful for an international medical gathering.

Those who wish to support the training of doctors in underdeveloped countries and help strengthen access to advanced surgical education worldwide are invited to contribute through Dr. Andrew Fishman’s GoFundMe at https://www.gofundme.com/f/donate-to-train-doctors-in-disadvantaged-regions?attribution_id=sl:325970be-fa2f-4292-a8c7-8df1949f8dc6&lang=en_US&ts=1760007196&utm_campaign=fp_sharesheet&utm_content=amp13_c-amp17_te&utm_medium=customer&utm_source=messenger

Conclusion

The Amrita Skull Base and Microsurgery Program 2026 demonstrated how international collaboration in surgical education can flourish even during periods of global disruption.

Through a partnership between the Amrita Institute of Medical Sciences and AF Medico d.o.o., and under the academic leadership of Dr. Subramania Iyer and Prof. Andrew Fishman, the program brought together surgeons and trainees from multiple countries to advance their understanding of skull base surgery, microsurgical reconstruction, and head and neck oncology.

With additional contributions from Dr. Krishnakumar T and Dr. Andrzej Zarowski of Antwerp, the program combined surgical teaching, international collaboration, and cultural exchange.

By the end of the program, participants had gained new technical skills, formed lasting professional relationships, and shared an experience that spanned continents, cultures, and disciplines.