On Thursday 26th September at ESCP’s 14th Annual Conference in Vienna, three renowned speakers from across Europe took the stage to present at the joint ESCP/EAES (European Association for Endoscopic Surgery) Symposium held in Plenary Hall A. The morning session was chaired by Alexey Petrov (Russia) and Des Winter (Ireland).
Antonino Spinelli (Italy) kicked off with a presentation on SILS (single incision laparoscopic surgery) for colectomy. He ran through common criticisms which included the procedure presenting no aesthetic advantage, questionable significance on pain levels and a lack of exposure to the rectum. While he agreed that that he’s experienced frustrations in the past due to the complexity and clash of camera and instruments, he argued SILS in 2019 is much more advanced.
Curved and advanced energy devices are now available, meaning crossed instruments are no longer an issue and with abdominal use of robotic single port systems on the horizon, the game is set to change even further.
He also put forward advantages and disadvantages regarding single-incision laparoscopy versus multiport laparoscopy for colonic surgery, concluding that they are not all that different. While single port may offer a poor first impression, it is undeniably a flexible tool and not restricted to periumbilical. Single port is also essential for transanal approaches (endo+extraluminal).
Robin Kennedy (UK) from St. Mark’s Hospital and Imperial College began the second presentation on complex polyps. He presented the results from the FLEX study (in its second phase) – an evaluation of complete polyp excision with secure closure of the excision site. These polyps are often large and situated within a difficult position of the bowel.
A detailed video of the FLEX procedure was shown to attendees which showcased the intricacy required.
While the procedure saw local success overall, Robin stated that it’s still very much under development. Early data does suggest it is safe for excision of selected benign polyps however modifications of transcolonic suture placement are required. Robin concluded that wider adoption is needed before a more definitive evaluation can be performed.
Lastly, Roland S. Croner (Germany) from the University of Magdeburg discussed techniques and pitfalls regarding laparoscopic complete mesocolic excision (Lap CME).
Roland provided commentary on a series of videos including vessel dissections which showcased both successes and difficulties. He went on to explain the rationale, current level of evidence and limitations regarding CME as well as laparoscopic approach in order to achieve optimal results for patients.
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