In this video Danilo Miskovic (Faculty) gives an overview of the Laparoscopic CME Programme and participants describe what they got from the first 2-day course in 2018.
The laparoscopic CME programme is a training initiative by ESCP's European School of Coloproctology to promote laparoscopic complete mesocolic excision for colon cancer.
- Overall programme
- Course (next course is 22-23 January 2020)
- Faculty
- Costs
- Application process (OPEN)
The course has been made possible due to the generous support of Medtronic.
Overall programme
The overall programme aim is to enable skilled laparoscopic surgeons to become proficient in performing laparoscopic CME with central vascular ligation. This is achieved in several steps:
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Surgeons interested to participate in the programme will be selected according to selection criteria (see below). |
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Successful candidates will be invited to a 2-day hands-on course at the ORSI Institute in Ghent, Belgium. |
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Faculty members of the programme will visit the candidates in their hospitals and proctor them for a number of cases over a period. |
Selection criteria
- Teams of two surgeons per hospital (1 lead surgeon, 1 assistant)
- Appropriate experience
- Lead surgeon should be proficient in laparoscopic colorectal surgery
- Minimum experience 50+ laparoscopic colorectal resections
- Board certified (e.g. EBSQ, FRCS, Specialist in General and/or Coloproctology)
- Institutional experience
- Annual turnover of colon and rectum cancer of >50/year
- Accessibility to appropriate laparoscopic infrastructure
- Letter of support by Head of Department/Hospital
Course
- Two-day course in Hamburg, with the aims:
- To understand the evidence and rationale of CME
- To master anatomy, operative planning and quality control
- To achieve optimal results for individual patients
- To learn operative technique
- Hands-on operative training in high quality cadaveric models
Proctorship
- Minimum of 2 x 2-day visits with the aim to perform 4 or more laparoscopic colon resections
- Highly qualified faculty
Course structure
Venue: ORSI Institute, Proefhoevestraat 12, 9090 Melle, Belgium
Day 1 (22 January 2020)
| Time | Session |
|---|---|
| 10:00 - 10:30 |
RegistrationA late start will allow participants to travel in the morning if they wish to do so. |
| 10:30 - 10:50 |
IntroductionPurpose, overview of training programme, aim and structure of course, introduction of all participants, addressing personal aims, expectations, concerns. |
| 10:50 - 11:20 |
Rationale for CMECurrent level of evidence, limitations, rationale for CME and for laparoscopic approach. |
| 11:20 - 11:45 |
Patient selectionIndications, workup, limitations (e.g. frailty, BMI, advanced disease, emergencies), patient selection during learning curve, levels of complexity (T stage, BMI, male…). |
| 11: 45 - 12:10 |
Pathological outcomes and quality controlMesocolic grading, benchmarks of outcomes (R1, lymphnode count, vessel lengths), resection bed, framework for auditing data, definition and extent of lymphadenectomy (D2 vs D3). |
| 12:10 - 12:30 |
Perioperative managementExpected postoperative course, deviations, rescue strategies. |
| 12:30 -12:45 | Video vignette: Right hemicolectomy - structured video of right hemicolectomy |
| 12:45 | Lunch |
| 13:40 | Faculty meeting |
| 14:00 - 15:00 |
Interactive module 1: AnatomyAll relevant anatomy, vascular (SMA and IMA territory), planes, orientation of colon and relationship to adjacent organs (e.g. ureters, kidneys, liver/ gallbladder/ spleen, stomach). |
| 15:00 - 15:10 | Video vignette: Vascular dissection of the right colon |
| 15:10 - 16:00 |
Interactive module 2: CT interpretation (AMIGO)Framework to identify vascular anatomy on arterial phase and portal venous phase CT scans (AMIGO), quality of CT, worked examples. |
| 16:00 - 16:20 | Break |
| 16:20 - 17:10 |
Interactive module 3: Operative technique ascending/transverse colonDidactic step-by-step description of technique, OR setup, patient position, port position, pitfalls and variations, critical views. |
| 17:10 - 17:20 | Video vignette: Intracorporeal anastomosis |
| 17:20 - 18:00 |
Interactive module 4: Operative technique splenic flexure and left colonDifferent techniques for anastomosis (extra- and intra-corporeal). |
| 18:00 - 18:20 |
Interactive module 5: Crisis managementExamples of bad performance, recovery mechanisms. |
| 18:20 | Questions and closure |
| 19:30 | Course dinner |
Day 2 (23 January 2020)
| Time | Session |
|---|---|
| 09:00 - 09:15 |
Welcome and reflectionA brief summary of day 1 and main learning points by interactive discussion with participants |
| 09:15 - 09:30 | Video vignette: Right hemicolectomy |
| 09:30 - 09:45 |
Repetition of critical views: Right hemicolectomy |
| 09:45 - 12:30 |
Wet Lab Session 1: Right hemicolectomy, extended right hemicolectomyWe have to think about how we can perform the operation without interrupting the left side too much…. |
| 12:30 | Lunch |
| 13:20 | Faculty meeting |
| 13:30 - 13:45 | Video vignette: Left hemicolectomy |
| 13:45 - 14:00 |
Repetition critical views: Left hemicolectomy |
| 14:00 - 16:30 |
Wet Lab Session 2: Left hemicolectomy, splenic flexure resection |
| 16:30 - 16:45 |
What next?Explanation of proctorship programme, faculty allocation, 1st case selection process, formal issues. |
| 16:45 | Faculty meeting |
| 17:00 | Closure of course |
Faculty
- Adam Stearns (Norwich, UK)
- Anders Bertelsen (Hillerød, Denmark)
- Danilo Miskovic (London, UK)
- Kristian Storli (Bergen, Norway)
- Roland Croner (Magdeburg, Germany)
- Stefan Benz (Boblingen, Germany)
Costs
- The overall programme cost is €1800.00 per surgical team, excluding travel and accommodation for the two-day course in Ghent, Belgium
- A reduced fee may be offered to teams from Albania, Azerbaijan, Belarus, Bosnia, Bulgaria, Egypt, Georgia, Macedonia, Moldova, Romania, Serbia, Turkey, Ukraine
Application process
Selection will be by email application. This will involve submission of the following:
- Number of following procedures in the last five years:
- Laparoscopic segmental colectomy or rectum resection
- How many operations for colorectal cancer are performed in your unit annually
- CV
- Letter of support from Head of Department or Hospital Director
Applicants will also be asked to upload an unedited video of their most recent right hemicolectomy or anterior rectal resection. Please send the video by https://wetransfer.com/ to This email address is being protected from spambots. You need JavaScript enabled to view it.
The successful applicants will be contacted by the organising committee. The decision of the organising committee is final.
Please send your applications to: This email address is being protected from spambots. You need JavaScript enabled to view it.
APPLICATIONS ARE NOW OPEN. CLOSING DATE 30 NOVEMBER 2019
