During the COVID 19 epidemic, all health professionals have suffered difficult times accompanied by uncertainty.
On the other hand, this crisis has shown us new ways of being in contact.
Our society is acutely aware of the need to continue carrying out its mission of sharing knowledge.
Within the Educational Committee, we are pleased to offer a new training initiative that we find very attractive.
Once a month, usually the last Thursday of each month at 6:00 pm we will meet in this online meeting called "Meet the surgeon."
We will have an excellent opportunity to share from the hands of an expert a specific surgical technique of our specialty.
In these 60-minute live webinars, leading surgeons will present and discuss with participants their approach to specific surgical techniques in gynaecological oncology.
The webinars will include:
+ 30-minute presentation of the surgical technique and approach, including real case videos, to demonstrate practical tips and recommendations.
+ 30-minute discussion and Q&A, participants will be able to send questions to the surgeon during the webinar.
The monthly “MEET THE SURGEON” webinars, will be the first edition of the new concept of web-based education. Each webinar will be dedicated to a specific topic. The list of topics and experts will be available soon.
ESGO would like to thank Ethicon for their support of this educational series.
Get 1 CME credit for every live webinar you attend!
Speaker: David Cibula (CZE)
Date: January 28, 2021 at 18:00 CET
Moderators: Luis Chiva (ESP) and Maximilian Lanner (AUT)
Panellists: Artem Stepanyan (AM), Denis Querleu (FR) and Cagatay Taskiran (TUR)
Three separate structures on both sides of the uterus entail the parametria. Each of them, running ventrally, laterally, and dorsally, is a massive structure extending from the cervix to the pelvic sidewall. Historically described as ligaments in anatomical atlases, they are mostly composed of vessels, lymphatic channels, lymphatic nodes, fatty tissue, nerves, and only scarcely fibrous connective tissue resembling ligaments. It is the technique of pelvic spaces dissection that determines their identification and exposure during the surgery. Understanding the anatomy and mastering surgical dissection are the key prerequisites for the adjustment of parametrial resection radicality and performance of different types of radical parametrectomy, either as a part of radical hysterectomy or radical parametrectomy or even as a separate procedure in a patient after inadequate simple hysterectomy. And isn´t a more radical parametrectomy, causing delayed voiding recovery, an outdated surgery in the era of minimal invasiveness and low radicality? It is the contrary. If the next generation loses skills in radical parametrectomy, all patients with intermediate-risk tumors will require pelvic radiotherapy, and the role of radical surgery in the management of cervical cancer will inevitably fade away.
Speaker: Reitan Ribeiro (BR)
Date: February 25, 2021 at 18:00 CET
Speaker: Eric Leblanc (FR)
Date: March 25, 2021 at 18:00 CET
Speaker: Anna Fagotti (ITA)
Date: December 10, 2020 at 18:00 CET
Panellists: Artem Stepanyan (AM), Denis Querleu (FR), Cagatay Taskiran (TUR) and Giovanni Aletti (ITA)
In most of the cases, liver involvement in ovarian cancer is expression of the peritoneal disease spread, as shown by capsule deposits at various sites. Indeed, primary parenchymal liver involvement in advanced ovarian cancer is less frequent due to the intrinsic biology of the disease, occurring in approximately 30% *of patients.
The surgical treatment of liver metastases is highly influenced by the site of the tumor itself and sometimes its removal is not surgically feasible without sacrificing various amount of healthy tissue. For this reason, the approach to hepatic disease is often multidisciplinary, which makes it quite challenging in the decision-making process.
On this background, with this video we aimed to demonstrate different approach modalities to liver metastatic disease in ovarian cancer patients and their indications in relation to tumor’s characteristics, including disease site tailored surgery, interventional radiology procedures and radiotherapy local treatment.
* Deng K, Yang C, Tan Q, Song W, Lu M, Zhao W, Lou G, Li Z, Li K, Hou Y. Sites of distant metastases and overall survival in ovarian cancer: A study of 1481 patients. Gynecol Oncol. 2018 Sep;150(3):460-465. doi: 10.1016/j.ygyno.2018.06.022. Epub 2018 Jul 9. PMID: 30001833.
Speaker: Artem Stepanyan (ARM)
Date: November 19, 2020 at 18:00 CET
Panellists: Cagatay Taskiran (TUR), Denis Querleu (FR) and Santiago Domingo (ESP)
Historically the anatomy of the pelvic sidewall is a point of the special interest for a gynecologic oncologist. The complex and variable vascular anatomy, major nervous structures and difficult surgical access make the dissection in this area demanding and even dangerous sometimes. In other hand the wide implementation of the video endoscopic surgery brings a new knowledge and understanding of the pelvic anatomy due to high magnification. In this pre- LACC era video the laparoscopic extended pelvic lymphadenectomy with the resection of internal iliac vessel system and demonstration of the sciatic nerve roots and pelvic sidewall muscles will be shown.
Speaker: Christina Fotopoulou (UK)
Date: October 22, 2020 at 18:00 CEST
Panellists: Artem Stepanyan (AM), Cagatay Taskiran (TUR) and Denis Querleu (FR)
We will review cytoreductive and reconstructive techniques applied in advanced ovarian cancer surgery, focusing on challenging key areas like mesenteric carcinosis, bowel anastomosis after extended en bloc resections where conventional methods to reach into the pelvis fail and so we have to apply dextroversio of the bowel and upper abdominal dissections. We will discuss different surgical scenaria and how to adapt the most optimal option into each situation such as in multilevel bowel obstruction, but also address the complications that may arise and how to solve them. We will, furthermore, touch on significant aspects of postoperative care that are pertinent to the overall patients recovery and surgical success.
Speaker: Prof. Denis Querleu (France)
Date: September 24, 2020 at 18:00 CEST
Panellists: Artem Stepanyan (AM), Cagatay Taskiran (TUR) and Anna Fagotti (ITA)
Everything you need to know about radical vaginal surgery for cervical cancer
The famous Vienna controversy of the early 20th century between Wertheim and Schauta is over, in favour of the abdominal approach. Unfortunately, nowadays only a few gynecologic oncologists master the radical vaginal approach. The number of teaching centres is not sufficient to cover the need. The vaginal radical trachelectomy is often substituted by costly and lengthy procedures. Interestingly, the impact of the LACC study has highlighted the need to resuscitate the initial step of radical vaginal hysterectomy with the objective to avoid contamination of the operative field during laparoscopy. This videowebinar will be focused on two topical points: formation of the vaginal cuff and localization of the ureter. The material will be taken from surgeries invented and videos taken by the speaker and by his master Daniel Dargent, a giant of the late 20th century.
Speaker: Prof. Cagatay Taskiran (Turkey)
Date: July 23, 2020 at 18:00 CEST
Panellists: Artem Stepanyan (AM), Denis Querleu (FR) and Anna Fagotti (ITA)
Paraaortic lymphadenectomy is a crucial part of the surgical staging and cytoreductive surgery if there is a bulky disease. The paraaortic region is defined anatomically between the left renal vein cranially and bifurcation of the aorta caudally, and it is bordered laterally by both ureters and anterior vertebral ligament dorsally. Although all the lymph nodes are interconnected, they are named as latero-caval, pre-caval, interaorto-caval, pre-aortic, latero-aortic retrocaval and retroaortic groups according to the respective regions. Another important landmark is the inferior mesenteric artery, which divides the infrarenal paraaortic region into two halves. The paraaortic region's most important anatomical feature is the existence of several vascular abnormalities, which necessitates extensive knowledge of anatomy. Therefore, the resection of bulky disease should follow a very precise dissection technique to prevent unwanted results. Sometimes the bulky disease circulates the renal veins, and it may involve suprarenal lymph nodes. The purpose of this webinar is to teach a detailed anatomy and dissection technique of bulky disease from this particular area.
Speaker: Santiago Domingo (Spain)
Date: June 30, 2020 at 18:00 CEST
Panellists: Artem Stepanyan (AM), Denis Querleu (FRA) and Cagatay Taskiran (TUR)
Although it is not a common procedure in gynecology oncology, splenectomy is increasingly performed if malignant involvement is noticed (superficial or intraparenchymal), especially in women who undergo debulking surgery for advanced ovarian cancer. Less common, due to an accidental injury during the surgery.
As with any surgical procedure, it is mandatory to have a deep knowledge of the anatomy, in this particularly case, of the superior hemiabdomen, focused on vascularization, landmarks and its relationship with adjacent organs. Once the tumor involvement has been thoughtfully studied (CT Scan, exploratory laparoscopy, etcetera), a proper technique must be learned in order to standardize the procedure, step by step. Two different approaches can be done for removing the spleen, according to the approach to the hilium: anterior, most commonly used in patient with bulky carcinomatosis, and posterior. We will show a step-by-step academic technique video, outstanding the anatomical landmarks and consecutive steps of the procedure. Post-operative considerations and complications will be disclosed along wih the oncological outcome in our serie.
Speaker: Gwenaël Ferron (France)
Date: May 28, 2020 at 18:00 CEST
Panellists: Anna Fagotti (ITA), Denis Querleu (FRA) and Cagatay Taskiran (TUR)
Colorectal resection is a surgical procedure frequently employed when performing cytoreductive surgery for ovarian carcinomatosis in order to obtain complete cytoreduction. However, gynecologic oncologic surgeons are not always used to this surgical technique and acquiring the surgical skills to perform this kind of procedure is crucial to offer our patients an optimal management.
The anatomical knowledge of bowel blood supply is essential to perform bowel resections. Moreover, according to the principles of colorectal surgery, we will also discuss about the type of colorectal resection depending on the extent of the disease.
Though, bowel resections are not exempt from postoperative morbidity. Not only they are associated to severe postoperative complications such as anastomotic leakage or fistulas, but also to a decreased quality of life. For this reason, before discussing about the surgical technique of colorectal resection, we will highlight how to avoid bowel resections. There are some organ-sparing techniques which allow to perform less radical and morbid surgeries without precluding from achieving complete cytoreduction. Mesentery and mesocolon vaporization or extended peritonectomy and modified-Hudson procedure may help to reduce the rate of bowel resection during cytoreductive surgery. As well, it is important to strictly select the patients who will undergo this kind of procedure.
Afterwards, we will focus our presentation on the tips and recommendations on how to perform a colorectal resection and anastomosis, such as the mobilization of the colic spleen flexure, the selective ligation of the inferior mesenteric artery with the preservation of the left colic artery, the ligation of the inferior mesenteric vein close to the inferior border of the pancreas, the verification of the viability of the descending colon, the type of colorectal anastomosis, the importance of a tension-free anastomosis, the quality of the stapled rectum, and the role of a transient colostomy or ileostomy.