Laparoscopic and Transanal Colorectal Supermaster Course

2019, May 23 - 25

COURSE OBJECTIVES

The course will be focused on the treatment of colorectal cancer patients with the following objectives:
  • To improve surgical and oncological outcomes in colorectal surgery
  • To learn about modern technologies for preoperative diagnosis and planning
  • To learn about new technologies for intraoperative navigation and manipulation
  • To improve multimodal colorectal cancer treatment
  • To undertake hands-on practice on pelvic trainer, live tissue (mini-pigs) and anatomical specimens in the experimental lab


COURSE DIRECTOR

J. Marescaux (F - RW)

FACULTY PANEL

S. Atallah (USA), R. Barthelemy (F), F. Corcione (I), A. D'Urso (I), A. Forgione (I), R.J. Heald (UK), M. Ito (J), J. Marks (USA), A. Melani (BR),  E. Parra Davila (USA),  L. Romagnolo (BR), E. Rullier (F), B. Salky (USA), X. Serra Aracil (SP), P. Sylla (USA), M.H. Zheng (CHI).

THURSDAY

7.45 am Registration and welcoming of participants

8.00 am
LIVE AND PRE-RECORDED OPERATIVE DEMONSTRATIONS

  • Right colectomy with central mesocolic resection
  • Transverse colon resection
  • Sigmoidectomy for cancer
  • Total mesorectal excision (TME) for rectal cancer
  • Robotic TME

12.00 pm Lunch at the Institute

1.00 pm

FOR OPTION A

"SURGICAL TIPS AND TRICKS"  VIDEOS COMMENTED BY THE FACULTY
Discussion around short presentations of difficult or particular cases, pitfalls and technical details of colorectal surgery through pre-recorded operative demonstrations.

FOR OPTION B

TRAINING ON LIVE TISSUE (MINI-PIGS)
  • Operative strategy:
  • Right ileo-caecal resection and anastomosis
  • Left sigmoid resection with end to end Knight-Griffen anastomosis
  • Vascular approach
FOR OPTION C

1. TRAINING ON LIVE TISSUE (MINI-PIGS)
  • Operative strategy:
  • Right ileo-caecal resection and anastomosis
  • Left sigmoid resection with end to end Knight-Griffen anastomosis
  • Vascular approach
2. TRAINING ON PELVIC TRAINER FOR TRANSANAL APPROACH

6.30 pm End of session / Evening free

FRIDAY

7.45 am Evaluation of the previous day

8.00 am

FOR OPTION A

"SURGICAL TIPS AND TRICKS"  VIDEOS COMMENTED BY THE FACULTY
Discussion around short presentations of difficult or particular cases, pitfalls and technical details of colorectal surgery through pre-recorded operative demonstrations.

FOR OPTION B

TRAINING ON LIVE TISSUE (MINI-PIGS)
  • Operative strategy:
  • Right ileo-caecal resection and anastomosis
  • Left sigmoid resection with end to end Knight-Griffen anastomosis
  • Vascular approach
FOR OPTION C

TRAINING ON ANATOMICAL SPECIMENS FOR TRANSANAL APPROACH

12.00 pm Lunch at the Institute

1.00 pm

THEORETICAL SESSION / FOR OPTION A, B and C

VIDEO SESSION 1: LAPAROSCOPIC COLECTOMY: TECHNICAL PEARLS
  • Laparoscopic right colectomy
  • Transverse colectomy with total mesocolic excision for cancer
  • Understanding the splenic flexure – embryology is the key once again
  • Laparoscopic left colectomy and sigmoid resection: standard steps for benign and malignant diseases
  • Laparoscopic approach for T4 colon cancer
  • Metallic stent for right or left side obstructing cancer: impact on oncological outcomes
  • Q&A
SESSION 2: LAPAROSCOPIC COLONIC RESECTION FOR BENIGN DISEASE
  • Diverticular disease: no, the elective surgeon is not dead!
  • Functional outcomes in symptomatic colonic diverticular disease: preoperative, intraoperative, and postoperative issues
  • Laparoscopic management of complex fistulas in Crohn’s disease
  • Laparoscopic restorative proctocolectomy for ulcerative colitis
  • Management of rectal prolapse
  • Q&A
SESSION 3: LAPAROSCOPIC PROCTECTOMY: TECHNICAL PEARLS
  • MRI for proper staging to predict and monitor clinical response
  • Lessons learned from open TME
  • 6-step approach for laparoscopic TME
  • Sphincter-saving approaches during laparoscopic TME
  • Laparoscopic intersphincteric resection for low rectal cancer
  • How to close the pelvic space after a Miles operation?
SESSION 4: ROBOTIC TME
  • Robotics for rectal cancer: more than a fantastic toy, especially for superobese patients
  • Tips and tricks in robotic TME
6.00 pm End of session

8.00 pm Dinner in honor of Participants and Faculty

SATURDAY

7.45 am Evaluation of the previous day

8.00 am
THEORETICAL SESSION / FOR OPTION A, B and C

SESSION 5: TRANSANAL ENDOSCOPIC SURGERY (TES)

  • TES toolkit, preparation and technical steps
  • Local excision with TES for early rectal cancer: indications and limitations
  • Transanal endoscopic surgery: from polypectomy to full TME
  • Robotic transanal TME

SESSION 6: DEBATES
  • What is the best approach for Total Mesorectal Excision (TME)?
    • Laparoscopic TME is better than open TME
    • Robotic TME is better than laparoscopic TME
    • TaTME will replace both
  • Complete clinical response following neoadjuvant treatment for rectal cancer
    • Watch and Wait
    • Local excision and/or radical resection
  • One-port surgery: a less invasive approach
    • Pros / Cons
SESSION 7: PREVENTING AND MANAGING INTRAOPERATIVE AND POSTOPERATIVE COMPLICATIONS
  • Laparoscopic treatment of bleeding, leaks, obstruction, and other complications
  • Local recurrence – an avoidable complication?
  • Perforation into the peritoneal cavity during TEM/TEO procedure
  • Management of chronic anastomotic leaks, fistulas, and sinuses
12.00 pm Lunch at the Institute

1.00 pm
THEORETICAL SESSION / FOR OPTION A, B and C

SESSION 8: LATEST TRENDS IN LAPAROSCOPIC COLORECTAL SURGERY
  • From the ERAS program to ambulatory procedure: a logical way?
  • What is the place of fluorescence imaging in colorectal surgery for lymph node and vascular assessment?
  • Flexible operative endoscopy in the treatment of colorectal lesions: for surgeons or gastroenterologists?
  • Combined endolaparoscopic approaches for localized resection
  • Laparoscopic colectomies with natural orifice extraction (transanal - transvaginal)
  • New developments in endoluminal robotic platforms
  • Virtual reality in colonic surgery for tumor localization and vascular anatomy assessment
  • Digital smart apps for outcome prediction and postoperative management
3.30 pm
CLOSING LECTURE
  • Skeletons in the cupboard: when bad things happen to good surgeons
4.00 pm End of course / Delivery of certificates of attendance
Program may be subject to modifications