3rd Annual Minimally Invasive Approaches to Rectal Cancer Symposium

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presents Minimally Invasive Approaches to Rectal Cancer Symposium May 3 & 4, 2019 InterContinental Hotel and Conference Center Cleveland, Ohio Hands On Lab Limited slots available Register today! ccfcme.org/rectal2019

presents Minimally Invasive Approaches to Rectal Cancer Symposium Don t Miss This Activity. Limited slots available! Course Description / Overview The utilization of minimally invasive techniques in performing colon resections has increased significantly since the 2004 publication of the COST trial. Despite solid evidence supporting improved patient outcomes, adoption of minimally invasive approaches for rectal cancer has been relatively slow. With the introduction of the Total Mesorectal Excision (TME) by Heald in 1979 and subsequent dissemination worldwide, rectal cancer recurrence rates have decreased and survival rates have increased. Concomitant with this, laparoscopic surgery has been shown to have equivalent outcomes to open surgery for rectal cancer with proper experience and expertise. In addition to improvements in short-term benefits such as decreased length of stay, reduced pain, and improved morbidity, a proposed technical benefit of a laparoscopic approach to rectal cancer is improved visualization in the small operative field. Despite these benefits, the anatomic challenges presented in rectal cancer surgery, especially in patients with a bulky tumor, mid-to-low location, and/or narrow pelvis, have not been completely solved by laparoscopic surgery. For early stage lesions, transanal platforms [i.e., local excision, transanal endoscopic microsurgery (TEM), transanal minimally invasive surgery (TAMIS)] have been developed to provide near equivalent outcomes with lower morbidity. However, these methods only address the local disease in the rectal wall, potentially leaving local-regional disease in the mesorectum. Robotics have filled in some of this gap, allowing for improved visualization, wrist-like movement at the instrument level as well as additional arms and retraction at the pelvic floor. More recently, the transanal TME (tatme) approach has found to be feasible in animal models and cadavers prior to the first case report in humans in 2010. Since 2010, there have been multiple studies reporting on safety and feasibility of tatme, with the largest study including 140 cases. Similar to other disease processes, the ideal approach needs to be individualized based on tumor and patient-specific criteria (size of lesion, recurrent operations, distance from anal verge). Additionally, surgeon expertise and experience factor critically into the ability to possess all approaches safely and effectively into the armamentarium and to ensure optimal outcomes. This course will focus on all three (laparoscopic, transanal TME and robotic) approaches for rectal cancer. Robotic approaches to TME Transanal TME approaches to rectal cancer Laparosocopic approaches to rectal cancer Learning Objectives After completing this educational activity, the participant will be able to do the following: 1. Discuss the potential advanced approaches to complex situations encountered during laparoscopic colorectal resection. 2. Describe the appropriate utilization of available stapling and energy technology for proctectomy. 3. Reproduce the basic approaches to a proctectomy including the principles of a total mesorectal excision (TME) from an abdominal and transanal approach. 4. Explain tips and tricks of laparoscopic, transanal and robotic rectal mobilization. 5. Describe potential advantages to the laparoscopic, transanal and robotic approaches to pelvic dissection. 6. Identify the capabilities and tools associated with different minimally invasive platforms. 7. Recall the proper technical issues of both abdominal and pelvic rectal surgery Who Should Attend? The symposium is directed to all surgeons treating rectal cancer. Colorectal surgeons looking to expand their skillset and general surgeons and trainees performing more complex colorectal surgery.

Faculty Course Director Faculty Bradley J. Champagne, MD Chairman of Surgery, Fairview Hospital Director of Services, DDSI West Region Professor of Surgery, Lerner School of Medicine Medical Director of Fairview Ambulatory Surgery Center Fairview Hospital Conor P. Delaney, MD, MCh, PhD Chairman, Digestive Disease and Surgery Institute Victor W. Fazio MD Endowed Chair in Colorectal Surgery Professor of Surgery, Lerner School of Medicine Emre Gorgun, MD Krause-Lieberman Chair in Laparoscopic Colorectal Surgery Staff Surgeon Department of Colorectal Surgery Scott R. Steele, MD, MBA Professor of Surgery Lerner College of Medicine Chairman, Department of Colorectal Surgery Rupert B. Turnbull, M.D. Endowed Chair in Colorectal Surgery Guest Faculty Roel Hompes, MD Surgical Oncology and Gastrointestinal Surgery (Lower GI) Department of Surgery Academic Medical Center - Amsterdam Amsterdam-Zuidoost, Netherlands David Larson, MD, MBA Chair of Colorectal Surgery Director of Cancer Quality Professor of Surgery Mayo Clinic Rochester, MN Justin Maykel, MD Gladys Smith Martin Endowed Chair in Oncology Chief, Division of Colorectal Surgery UMass Memorial Medical Center Worcester, MA Matthew Kalady, MD Professor of Surgery Co-Director, Comprehensive Colorectal Cancer Program Director, Sanford R. Weiss, MD, Center for Hereditary Colorectal Neoplasia James M. Church, MD, and Edward J. DeBartolo, Jr. Family Endowed Chair Vice Chairman, Department of Colorectal Surgery Sherief Shawki, MD Staff Surgeon Department of Colorectal Surgery

Agenda Day 1: Friday, May 3, 2019 (Dinner/Didactic) Intercontinental Hotel & Conference Center 5:30 PM Registration / Reception 6:00 6:15 PM Course Introduction Scott R. Steele, MD Provide background on rectal cancer, the course itself and why this is a novel and needed course. Review goals of the participants. 6:15 6:45 PM Principles of Rectal Cancer Surgery Conor P. Delaney, MD Cover basic and advances principles of rectal cancer surgery to include total mesorectal excision (TME), vascular ligation (high vs. low), lymph node dissection, and pelvic anatomy pearls and pitfalls. 6:45 7:15 PM Tools of the Trade - Energy, Stapling, & Access Emre Gorgun, MD Cover the various platforms for proctectomy used in this course (trocars, hand assist devices, transanal platforms and robotics) as well as understanding the science behind the equipment we use and tips and tricks to use them in the pelvis. 7:15 7:45 PM Break (Dinner) 7:45 8:45 PM Individualizing the Approach to Your Patient Bradley J. Champagne, MD Evaluate the basics of robotics and straight laparoscopic approaches and transanal approaches to rectal cancer. Day 2: Saturday, May 4, 2019 Intercontinental Hotel & Conference Center 6:30 AM Continental Breakfast 7:00 7:30 AM Introduction and Implementation of a TaTME Program Justin Maykel, MD 7:30 8:30 AM Transanal TME: Technique, Tips and Tricks Roel Hompes, MD Video-based discussions from set-up & anatomy to technical how-to for the tatme for proctectomy. 8:30 9:30 AM Robotic Approaches to Rectal Cancer David Larson, MD Video-based discussions from set-up & anatomy to technical how-to for the robotic approach to proctectomy. 9:30 10:00 AM Laparoscopic Approaches to Rectal Cancer Bradley J. Champagne, MD Video-based discussions from set-up to anatomy to technical how-to for the laparoscopic approach. 10:00 10:45 AM Complications of Minimally Invasive Approach to Rectal Cancer Matthew Kalady, MD Video and technique-based forum to cover tips and tricks to avoid common complications of proctectomy. 10:00 10:45 AM Working lunch / Question and Answer Session Scott R. Steele, MD, Bradley J. Champagne, MD, Conor P. Delaney, MD, Emre Gorgun, MD, Roel Hompes, MD, Matthew Kalady, MD, David Larson, MD, Justin Maykel, MD, Sherief Shawki, MD 11:30 11:45 AM Shuttle to Surgical Skills Training Lab 12:00 4:00 PM Cadaver Lab Scott R. Steele, MD, Bradley J. Champagne, MD, Conor P. Delaney, MD, Emre Gorgun, MD, Roel Hompes, MD, Matthew Kalady, MD, David Larson, MD, Justin Maykel, MD, Sherief Shawki, MD The cadaver lab will consist of 10 cadavers, 2 to 3 surgeons at a station. Two stations will be dedicated to robotic use. All participants will perform straight laparoscopy and transanal approaches. The robotic approach will rotate participants through the dissection phase. Attendees will be placed into focus groups for the robot, straight lap, hand assist and transanal TME depending on their goals and objectives of attending the course.

presents Minimally Invasive Approaches to Rectal Cancer Symposium General Information Meeting Location InterContinental Hotel and Conference Center 9801 Carnegie Avenue 44106 (Lab will be held at Case Western Reserve University Surgical Skills Center) Hotel Accommodations A block of rooms has been reserved at InterContinental Hotel until 5:00 pm April 3, 2019. To make your reservations, contact the Hotel Reservations Department at 216.707.4100 or 877.707.8999 and identify yourself as being with the Minimally Invasive Approaches to Rectal Cancer course for the special rate of $169 single/double plus tax. Parking Parking is available at the InterContinental Hotel for an additional charge. Overnight and guest parking for all attendees will be provided at the discounted rate of $20 per day with in and out privileges. Parking is also available in the East 100th Street Visitor s Parking Garage at prevailing rates. REGISTER ONLINE AT ccfcme.org/rectal2019 Fee includes: Friday dinner; Saturday breakfast, lunch, refreshment breaks and Faculty PowerPoint presentations in pdf format, post-course. Category Fee ON OR BEFORE Feb. 23, 2019 Fee AFTER Feb. 23, 2019 Physician $695 $795 Resident / Fellow $495 $595 Registration and Cancellation Preregistrations are accepted online until April 26, 2019. Slots are limited so we cannot accommodate walk-ins. In case of cancellation, a full refund will be made if canceled by March 30, 2019. After March 30, a $100 cancellation fee will be deducted from your refund. Written notification of cancellation is required in order to process your refund. NO REFUNDS WILL BE ISSUED AFTER April 12, 2019. For further information about this activity, contact Rita Rys, DDSI CME Manager, at rysr@ccf.org. Website: ccfcme.org/rectal2019

NON-PROFIT U.S. Postage PAID Permit No. 1918 presents Minimally Invasive Approaches to Rectal Cancer Symposium May 3 & 4, 2019 InterContinental Hotel and Conference Center Cleveland, Ohio Register today! ccfcme.org/rectal2019 The Foundation 9500 Euclid Avenue, A80 44195