Enhanced Recovery after Surgery: Benefits, Challenges and Solutions for Implementation

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1 Enhanced Recovery after Surgery: Benefits, Challenges and Solutions for Implementation November 2015 MILAN (IT) IN PARTNERSHIP WITH

2 Enhanced Recovery after Surgery: Benefits, Challenges and Solutions for Implementation Chairs: Sergio Sandrucci, S.Giovanni Battista Hospital, University of Turin, Turin, IT Luigi Beretta, San Raffaele Hospital Milan, IT Marco Braga, San Raffaele Hospital, Milan, IT Co-Chairs: Geerard Beets, Maastricht University Medical Center, Maastricht, NL Kees Dejong, Maastricht University Medical Center, Maastricht, NL Faculty Members Nicolas Demartines, Centre Hospitalier Universitaire Vaudois, Lausanne,CH Roberta Monzani, Humanitas Hospital, Rozzano, IT Nicolò Pecorelli, San Raffaele Hospital, Milan, IT Ajit Pothen, Utrecht University Medical Center, Utrecht, NL Danilo Radrizzani, Hospedale Civile, Legnano, IT Stefano Turi, San Raffaele Hospital, Milan, IT

3 Aim of the course The course will address issues related to the organization of enhanced recovery (ERAS) programs for gastrointestinal and oncological surgery. ERAS is a multimodal perioperative care programme which replaces traditional practices concerning parenteral analgesia, intravenous fluids and nutrition, bed rest and postoperative drain care with evidence-based best practices, covering all areas of the patient s surgical journey. The ERAS programme can reduce care time by more than 30% and postoperative complications by up to 50%, if all the professionals involved in perioperative care work as a well-coordinated team. The course is designed for the whole multidisciplinary team that wants to initiate an enhanced recovery after surgery (ERAS) program in their hospital. Participants profile Surgeons Anesthesiologists Nurses and allied health professionals interested in how to improve patient outcomes and shorten patient stays Educational Methods Interactive discussions Plenary lectures Course Venue San Raffaele Hospital Via Olgettina Milan Italy Course coordination Ana Galán European Society of Surgical Oncology (ESSO) . ana.galan@essoweb.org

4 Application Procedure Please go to (education/projects & courses) to complete your application and apply for the course. Participation fee The participation fee is 400 for ESSO members and 550 for non-members. It includes registration to the 2-day course, catering and a social dinner. Accreditation An application for accreditation has been submitted to the European Accreditation Council for CME (EACCME) of the European Union of Medical Specialists (UEMS).

5 Programme Friday 06 November 13:30-13:45 Introduction S. Sandrucci, G. Beets 13:45-14:05 Overview of the enhanced recovery program: philosophy and team working K. Dejong 14:05-14:35 Reducing metabolic stress in elderly and frail surgical patients M. Braga Preoperative care Chair: M. Braga 14:35-14:55 Counselling and prehabilitation N. Pecorelli 14:55-15:15 Pre-operative nutritional assessment and analysis of sarcopenia A. Pothen 15:15-15:35 Avoiding preoperative dehydration: overnight fasting and bowel preparation G. Beets 15:35-16:05 Discussion 16:05-16:20 Coffee break Anaesthesia Chair: D. Radrizzani 16:20-16:40 Pre-anesthesia medication and anesthetic protocols R. Monzani 16:40-17:10 Body temperature and fluid balance maintenance L. Beretta 17:10-17:30 Prevention of post operative nausea and vomiting K. Dejong 17:30-18:00 Discussion 18:00-18:15 Coffee break Surgery Chair: S. Sandrucci 18:15-18:35 Minimally-invasive surgery protocols N. Demartines 18:35-18:55 Surgical drains and NG tubes: are they really necessary? K. Dejong 18:55-19:30 Discussion

6 Saturday 07 November Pain control Chair: L. Beretta 09:00-09:20 Mid thoracic epidural before surgery D. Radrizzani 09:20-09:40 Alternatives for regional anaesthesia R. Monzani 09:40-10:00 Drug selection to optimize outcomes D. Radrizzani 10:00-10:20 The role of the Acute Pain Service S. Turi 10:20-10:40 Discussion 10:40-11:00 Coffee break Postoperative care Chair: K. Dejong 11:00-11:20 Urinary catheterization and the need for gastric tube reinsertion G. Beets 11:20-11:40 Early oral feeding: timelines, safety and benefits N. Pecorelli 11:40-12:00 Early mobilization A. Pothen 12:00-12:20 Postoperative ileus and the indications for artificial enteral or parenteral nutrition N. Demartines 12:20-12:40 Discussion 12:40-13:45 Lunch Approaching the end of the ERAS journey Chair: N. Demartines 13:45-14:05 Objective criteria for discharge N. Pecorelli 14:05-14:25 Audit S. Sandrucci 14:25-14:45 Difficulties and bottlenecks in setting up a full ERAS service N. Demartines 14:45-15:15 Discussion 15:15-15:30 Closing summary: outcomes, health costs and savings, perspectives M. Braga

7 ESSO is grateful for the continuous support of its corporate sponsors European Society of Surgical Oncology (ESSO) Avenue E. Mounier 83 B 1200 Brussels Tel: +32 (0) Fax : +32 (0) info@essoweb.org Website :

8 ESSO-EYSAC Course on Colorectal Cancer Surgery January 2016 LJUBLJANA (SI) Young Surgeons & Alumni Club

9 ESSO-EYSAC Course on Colorectal Cancer Surgery Chairs Ibrahim Edhemovic, Institute of Oncology Ljubljana, Ljubljana, SI Franco Roviello, Università degli Studi di Siena, IT Karol Polom, Università degli Studi di Siena, IT Sven Mieog, Leiden University Medical Center, NL Faculty members Erik Brecelj, Institute of Oncology Ljubljana, Ljubljana, SI Marco C. DeRuiter, Leiden University Medical Center, Leiden, NL Paolo Delrio, Istituto Tumori Napoli, Fondazione G. Pascale, Naples, IT Werner Hohenberger, Universitätsklinikum Erlangen, Erlangen, DE Dawid Murawa, Wielkopolska Oncological Centre, Poznán, PL Mirko Omejc, University Medical Center Ljubljana, Ljubljana, SI Dean Ravnik, Institute of Anatomy, Faculty of Medicine, University of Ljubljana, Ljubljana, SI Theo Wiggers, University Medical Centre Groningen, Groning, NL

10 Aim of the course The purpose of this hands-on workshop is to present and transfer the key anatomical knowledge and surgical skills to young surgeons and residents, necessary for contemporary surgical treatment of colorectal cancer. Main topics Surgical anatomy of colon Surgical anatomy of rectum Surgical technical aspects of approach, dissection and reconstruction of cancer in colon and rectum highlighting the oncological approach Educational Methods Hands on workshops with human cadavers Video based discussions (including 3D videos) Plenary lectures Ideal participants Young surgeons or surgical trainees (between 25 and 40 years old) interested in developing a specific knowledge in colorectal cancer surgery. Course venue Institute of Anatomy Faculty of Medicine, University of Ljubljana Korytkova 2 SI Ljubljana Slovenia Course Coordination Ana Galán European Society of Surgical Oncology (ESSO) . ana.galan@essoweb.org

11 Registration Participation is limited to 24 participants. Registration fee is 750 for ESSO members and 900 for nonmembers. The fee includes the course registration, catering and a social dinner. To register please visit ESSO website ( and masterclasses). Accreditation An application for accreditation has been submitted to the European Accreditation Council for CME (EACCME) of the European Union of Medical Specialists (UEMS).

12 ESSO-EYSAC Course on Colorectal Cancer Surgery Programme 13:00-14:00 Registration Thursday 21 st January 14:15-15:00 Colon Cancer I Surgical anatomy D. Ravnik, F. Roviello 15:00-15:45 Colon cancer II (Extended) Right hemicolectomy, transversectomy following the principles of complete mesocoloic excision (CME) W. Hohenberger 15:45-16:15 Anastomosis technique and stoma formation K. Polom 16:15-16:30 Coffee break 16:30-19:00 Workshop Colon I (Extended) Right colectomy: approach and dissection with side to side stapled anastomosis terminal ileum/ transverse colon Tutors: all surgeons 19:30 Social dinner

13 Friday 22 nd January 08:30-09:15 Colon cancer III (Extended) Left hemicolectomy, sigmoidectomy, following the principles of CME W. Hohenberger 09:15-12:00 Workshop colon II Left colectomy with mobilization of splenic flexure, end to end anastomosis Tutors: all surgeons 12:00-13:00 Lunch 13:00-13:30 Rectal Cancer I Planes and nerves in the pelvis M. C. DeRuiter 13:30-14:15 Workshop pelvic anatomy with human specimens M. C. DeRuiter 14:15-15:00 Rectal cancer II (Low) Anterior resection following the principles of total mesorectal excision (TME) P. Delrio 15:00-15:30 Coffee break 15:30-16:15 Rectal cancer III Abdominoperineal resection extralevator approach and filing the pelvic space T. Wiggers 16:15-19:30 Workshop Rectal Cancer Tutors: all surgeons Saturday 23 rd January 09:00-09:50 Video session: surgical techniques 09:50-10:10 Inferior mesenteric artery: high vs. low tie in low anterior resection I. Edhemovic 10:10-10:30 Routine mobilization of the splenic flexure: is it mandatory for a low anterior resection? M. Omejc 10:30-10:50 Coffee break 10:50-11:10 Extralevator abdominoperineal excision: pro et contra D. Murawa 11:10-11:30 Low anterior resection: how low can we go? E. Brecelj 11:30-11:50 Defunctioning stoma. Which type and when? S. Mieog 12:00 Conclusions and end of the course

14 ESSO is grateful for the continuous support of its corporate sponsors The course is supported by: European Society of Surgical Oncology (ESSO) Avenue E. Mounier 83 B 1200 Brussels Tel: +32 (0) Fax : +32 (0) info@essoweb.org Website :

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