Practice of medicine has been the most gratifying experience of our lives as much as it is life-transforming for our patients. Yet, despite its amazing preventive and therapeutic achievements, it’s not free of complications, sometimes making the treatment worse than the disease. Though encountered in all fields of medicine, Complications in Neurosurgery can be truly devastating. Having participated in conferences over 4 decades I realised that most presentations harped on the success of techniques and skills, with scant mention of their pitfalls, complications and adverse events. I realised that though success gives one satisfaction, especially when tackling a complex case, there is little learning otherwise; on the other hand, encountering mishaps or catastrophes left a deep scar that would never be forgotten. True learning came from such disasters, and it does not spare any surgeon, irrespective of his / her experience, nor depended on the complexity of the disease, ironically, often occurring with so-called ‘minor’ cases which one tended to take on too lightly and without adequate planning. So, it became clear that everyone of us had faced minor or major complications on several occasions during our career, but very little was documented, discussed or even reflected upon, even while inflicting severe morbidity or even mortality on our patients. Were we shy, embarrassed or just not too seriously bothered? Whatever be it, we are ethically and morally answerable to our patients and sometimes (even) legally punishable. It would therefore be wiser to learn from complications, both of our own making as well as of others.

With that concept we announced our intent to hold the first International Conference on Complications in Neurosurgery – ICCN, in March 2017. It aroused great curiosity and interest among neurosurgeons worldwide as it was the first time an entire 3-day conference was dedicated to discuss Complications in Neurosurgery. The ground rule was that the Complication(s) ought to have been directly experienced by the presenter or a member of his / her team, and contents of the conference would not be exposed to the social media. The presentations were grouped in sessions concerning a region or sub-speciality of our field and controlled by panelists or moderators who would discuss and cross-examine why the complication occurred and was not anticipated or prevented, and lessons learnt. The first 2 days of this 3-day conclave were devoted to brain problems and the last day to the Spine. Owing to the overwhelming response (about 80 papers per day) most presentations were restricted to 3 - 5 minutes. In the process discussion time was limited and we tried to correct that in the subsequent conferences. We also had couple of speakers each day to talk on ethical, moral and legal aspects of Complications. The value and success of this conference was realised all over in the world as a breakthrough in the field of medical conferencing, and the President of WFNS initiated a new Committee on Complications in Neurosurgery as a unique educational initiative.

A board was constituted by inviting committee members from across the world and pledged to hold this meeting once every 2 years. But in order to keep the concept serve its purpose of documenting complications and learning from them and from each other all the year round, we contemplated on creating a NeuroComplications web-based platform that would serve as a ‘Repository’ of all Complications, submitted by any member who registers on that platform, and also as a means to stage regular virtual meetings. It was a kind of premonition, as, when the pandemic struck, prohibiting international travels, the platform was ready to serve through our monthly webinars in NeuroComplications which continue till date, thanks to the interest exhibited by colleagues worldwide. Selected papers of this 1st ICCN were edited and published as a supplement of Acta Neurochirurgica by Springer.

The 2nd ICCN was held with great expectation and enthusiasm in Jan 2019, and was physically attended by over 500 delegates from 50 countries. Then came the pandemic, but by then we already had been hosting regular webinars, and used the opportunity by holding a spectacular virtual 3rd ICCN using the most modern technology, where, on the platform we had virtual registration desk, Conference Hall, Chat rooms, Industry stalls and one-on-one interaction among delegates. This 3rd ICCN was held from 5th – 7th March 2021, carefully planned to cover maximum times zones, and permitting those unable to participate in certain regions, to go on our platform in retrospect (which they can do even today 24 x 7 as all physical conferences and virtual webinar presentations will remain available for posterity).

The 3rd ICCN secured the distinction of being attended over 38 hours, spread over 3 days, by a staggering 12,890 delegates worldwide from 90 countries, and by Who’s Who, of the World of Neurosurgery.

ICCN has secured its firm footing in Neurosurgical education and we are now on the threshold of its 4th meeting to be held 10 – 12 March 2023, once again in Mumbai, India. Learning from our past experiences, we have tweaked the format by highlighting a specific Complication at a time, with presenters, discussing its occurrence in a given case-setting or a series of cases and emphasising on its avoidance, complication, prevention; their management and outcome, and again lessons learnt! Since this, is a face-to-face meeting, we will rejoice with handshakes and hugs and direct discussion on a vast array of issues that were kept in our closets during the pandemic. As usual this will be an open forum of interactive brainstorming but strictly within closed doors.

We urge neurosurgeons, seniormost to residents, from all corners of the world, to join us and have a free, frank and fearless discussion of various Complications encountered during their career. We welcome you to this one and only International Conference in the world that deals entirely and exclusively with Complications in Neurosurgery -- their Avoidance and Management.