Peritonectomy procedures
and multivisceral exeresis.
Sugarbaker's Technique.
DEFINITIVE PROGRAMME
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SIMULTANEOUS INTERPRETING ENGLISH-SPANISH-ENGLISH AVAILABLE IN ALL SESSIONS
THURSDAY JUNE 16
MORNING SESSION
8.00 Distribution of course documents
8.15 Welcome
Dr. Jordi Colomer, Ex-Managing Director of the Santa Creu i Sant Pau Hospital of Barcelona
Dr. Jordi Mauri, Chairman of the Integrated Health Consortium
Dra. Maria Rotllan, Director of Care for the Integrated Health Consortium
Dr. Pedro Barrios, Chairman of the Organising Committee
9.00 Keynote speech.
Peritonectomy procedures: basic principles and technical description.
Video: Checklist for complete cytoreductive surgery (20´)
Current and future role of CRS in oncological surgery (20´)
Discussion (5')
Paul Sugarbaker
9.45 Current indications and results of CRS (+ HIPEC) in pseudomyxoma peritonei (20´).
Discussion 10’
Jesús Esquivel
10.15 Video session 1. CRS in pseudomyxoma peritonei (PP).
VS 1.1. Unification of peritonectomy procedures in two anatomical abdominal cavities: peritonectomy of the lower
hemiabdomen, peritonectomy of the upper hemiabdomen
VS 1.2. CRS in two surgical stages
1st stage: CRS of upper left quadrant, lower hemiabdomen, extensive intestinal resection
2nd stage: CRS of upper right quadrant. Total gastrectomy
VS 1.3. Maximum tumour debulking
CRS of lower hemiabdomen and upper left quadrant, intestinal resection. Residual tumour upper right quadrant
VS 1.4. Maximum tumour debulking for PMP peritonitis
CRS in all abdominal areas. Residual tumour in region II. Digestive reconstruction: ileocolic and ileorectal
11.30 to 12:00 COFFEE BREAK
12:00 Video session 2. CRS + hyperthermic intrathoracic perfusion chemotherapy (HITHOC) for mucinous
pleuropulmonary disease. Session sponsored by ETHICON
VS 2.1. Mucinous dissemination through the thoracic and pleuropulmonary wall
Exeresis of thoracic wall. Parietal and visceral pleurectomy. HITHOC
VS 2.2. Pleuropulmonary mucinous dissemination
Parietal pleurectomy. Atypical pulmonary segmentectomy. HITHOC
12:30 Video session 3. Techniques for digestive tract reconstruction after CRS+HIPEC
VS 3.1. Oesophageal-Roux-en-Y jejunostomy
VS 3.2. Oesophageal-jejunal intestinal interposition
VS 3.3. Mechanically reinforced T-L Ileocolic Anastomosis
VS 3.4. Manual T-L Ileocolic Anastomosis
VS 3.5. Mechanically reinforced T-L Ileorectal Anastomosis
VS 3.6. Ileocolic and colorectal anastomosis and biliopancreatic-intestinal reconstruction after cephalic
duodenopancreatectomy.
VS 3.7. “True” Mechanically reinforced T-T colorectal anastomosis
13:15 Video session 4. Techniques for the slowing of digestive transit with massive resection of the digestive tract.
Session sponsored by ARAGÓ
VS 4.1. CRS associated with extensive intestinal resection. Interpostioning of an antiperistaltic ileal segment
between the jejunum and the splenic colon
VS 4.2. CRS associated with extensive intestinal resection. Interpostioning of an antiperistaltic transverse colon
segment between the jejunum and the rectum
VS 4.3. CRS associated with extensive intestinal resection. Interpostioning of antiperistaltic cecum between
the ileum and rectum
14.00-15.30 WORKING LUNCH
AFTERNOON SESSION
15.30 Current indications and results of CRS (+ HIPEC) in ovarian carcinomatosis (20´).
Discussion 10’
Marcello Deraco
16.00 Video session 5. CRS in ovarian carcinomatosis
VS 5.1. Pelvic peritonectomy and lymphadenectomy
VS 5.2. CRS in ovarian PC. All peritonectomy procedures associated with lymphadenectomy
17. 00 Video session 6. Techniques for the reconstruction of the urinary tract in CRS+HIPEC
VS 6.1. Direct ureterovesical reimplant
VS 6.2. Psoas hitch ureteral implant
VS 6.3. Partial cystectomy associated with segmental ureteral resection. Mobilisation of the renal pelvis
and T-T uretero-ureteral anastomosis
VS 6.4. Segmental ureteral replacement with appendiceal plasty (uretero-appendix-ureteral interpositioning)
VS 6.5. Segmental ureteral replacement with tubular vesical plasty
VS 6.6. Vesical augmentation with cecum plasty
VS 6.7. Double ureteral diversion to colostomy
VS 6.8. Ureteral diversion to defunctionalised ileal ansa (Bricker)
18.00-18.30 COFFEE BREAK
18.30 Current indications and results of CRS (+ HIPEC) in carcinomatosis of gastric origin. (15´)
Discussion (10’)
Pedro Barrios
18.45 Video session 7. CRS in carcinomatosis of gastric origin
VS 7.1. CRS in synchronous gastric PC. Total gastrectomy. Transverse colectomy. Parietal peritonectomies
VS 7.2. CRS in metachronous gastric PC. Total degastrogastrectomy. Hysterosalpingo-oophorectomy.
Douglasectomy. Parietal peritonectomies
19.15 Role of the anaesthetist in CRS + HIPEC (15’).
Elisenda Pujol
19.30 Preparation and application of HIPEC and HITHOC: open technique.
Video (20´)
Carmen Roldán
FRIDAY JUNE 17
MORNING SESSION
8.00 Sectorization of complex oncological surgery in Catalonia (20´)
Josep M. Borrás
8:30 Clinical results of the Catalan Programme for Peritoneal Carcinomatosis. Hospital Moisès Broggi.
10 years: 1,200 CRS (700 of which associated with HIPEC). (20´)
Pedro Barrios
9.00 Current indications and results of CRS (+ HIPEC) in colorectal carcinomatosis. (20´).
Discussion (10’)
Pompiliu Piso
9:30 Video session 8. CRS in colorectal and appendiceal (not PP) carcinomatosis
VS 8.1. CRS associated with extensive intestinal resection, mesenteric lymphadenectomy and nephrectomy.
VS 8.2. CRS associated with urinary tract repair and hepatic RDF
VS 8.3. CRS associated with extended pelvic peritonectomy and diaphragmatic resection
VS 8.4. CRS for synchronous PC of the colon associated with endoluminal prosthesis
VS 8.5. CRS for multi-occlusive PC of the colon
VS 8.6. CRS for PC of the colon with localised septic focus
10.30 Surgical management of Desmoplastic Small Round Cell Tumours in children and young adults.
Video: Pelvic Cytoreduction and Peritonectomy in Large Pelvic Tumours: Focus on Desmoplastic
Small Round Cell Tumour
Andrea Hayes-Jordan
11.00-11.30 COFFEE BREAK
11.30 Current indications and results of CRS (+ HIPEC) in malignant peritoneal mesothelioma. (20´).
Discussion (10’)
Marcello Deraco
12.00 Video session 9. CRS in malignant peritoneal mesothelioma
VS 9.1. CRS in epithelioid malignant mesothelioma. Procedures for parietal peritonectomy.
VS 9.2. CRS in multicystic mesothelioma. Procedures for parietal peritonectomy.
VS 9.3. Mesenteric peritonectomy
12:45 Video session 10. Techniques for the repair of defects of the wall and of the pelvic floor
VS 10.1. CRS with extensive exeresis of the abdominal wall
VS 10.2. Abdominal bipartition with rectus abdominis muscle
VS 10.3. Repair of pelvic defect after total exenteration with complete plasty of the rectus abdominis muscle
(TRAM)
VS 10.4 Perineal gracilis muscle fill
VS 10.5 Epiploplasty techniques
VS 10.6. CRS in multifistulated necrotic tumour with complete digestive reconstruction and abdominal-pelvic
bipartition with a mesenteric flap and epipoplasty.
13.30 Laparoscopy and peritoneal carcinomatosis. Videos
Oriol Crusellas
14.00-15.00 WORKING LUNCH
AFTERNOON SESSION
15.00 Current indications and results of CRS (+ HIPEC) in rare tumours (20´).
Discussion 10’
Isabel Ramos
15:30 Video session 11. CRS in rare tumours
VS 11.1. CRS in PC from mucinous endocervical tumour. All peritonectomy procedures.
VS 11.2. CRS in PC from neuroendocrine tumour of the small intestine. All peritonectomy procedures,
resection of the small intestine, partial diaphragmatic resection. Bicameral hyperthermic chemotherapy:
intraperitoneal (HIPEC) and thoracic (HITHOC)
VS 11.3. CRS in peritoneal sarcomatosis (not GIST)
16:15 Video session 12. CRS (+/- HIPEC) for appendiceal mucinous tumours
VS 12.1 Appendiceal mucinous tumour with extensive peritoneal dissemination (Pompiliu Piso)
VS 12.2. Infected mucinous cystadenoma of the ovary and associated tumour of the appendix (not mucinous).
VS 12.3. Broad base perforated mucinous appendiceal tumour associated with localised acellular
periappendiceal mucin
VS 12.4. Perforated mucinous appendiceal tumour associated with pelvic acellular mucin (woman)
VS 12.5. Perforated mucinous appendiceal tumour associated with mucin in the abdominal cavity
VS 12.6. Surgical treatment of an appendiceal mucocele
16:45 Panel Session 1. Recommendations to the general surgeon regarding the management of epithelial
appendiceal tumours (20´).
Moderator: Pedro Barrios
Panel members: Paul Sugarbaker, Marcello Deraco, Pompiliu Piso and Isabel Ramos
17:30-18.00 COFFEE BREAK
18:00 Panel Session 2. Recommendations to the general/gynaecological surgeon concerning the surgical strategy
to be adopted on unexpectedly finding peritoneal carcinomatosis in mid-operation. (30’)
Moderator: Pedro Barrios
Panel members: Paul Sugarbaker, Marcello Deraco, Pompiliu Piso and Isabel Ramos
18:35 Discussion and final conclusions
Paul Sugarbaker / Marcello Deraco / Pedro Barrios
19:00 END OF COURSE