Charles KnowlesYear of primary qualification: 1992

Current institution: Barts and the London School of Medicine & Dentistry, London (UK)

Title of presentation: Sacral nerve stimulation for bowel disorders (Keynote Lecture)

Learning objectives: To receive an update on the place of sacral neuromodulation in the treatment of bowel disorders. In particular, the lecture will cover: new outcome data for the main established indications (faecal incontinence and chronic constipation); new techniques including procedural optimisation; new indications including IBS and IBD; new insight on mechanisms including experimental and human data.

Clinical/research background

Charles Knowles is Professor of Surgical Research at Queen Mary University of London and Consultant Colorectal surgeon at Barts Health NHS Trust. He qualified from the University of Cambridge and undertook general surgical training and a PhD in London before being awarded a HEFCE clinical senior lectureship (2006-2011).

Professor Knowles is Director of the NIHR Enteric Healthcare Technology Cooperative, Co-director of the National Centre for Bowel Research and Surgical Innovation and Chair of the Whitechapel Society for Gastroenterology. He is research lead to the sections of Neurogastroenterology (British Society of Gastroenterology) and pelvic floor (Association of Coloproctology of Great Britain and Ireland). He has authored over 120 peer reviewed publications.

His main clinical interests are the surgical management of benign (degenerative and inflammatory) coloproctological conditions with a focus on the pelvic floor. His main research interests are:

  • The evaluation of new technologies for the treatment of chronic GI diseases (especially focusing on neuromodulation)
  • The development of advanced in-vivo and in-vitro GI diagnostics for treatment stratification
  • The patho-aetiology and management of gastrointestinal neuromuscular diseases

Relevant peer-reviewed publications

  1. Carrington EV, Knowles CH. The effects of SNS on anorectal function. Colorectal Dis. 2011; 13 (suppl 2): 5-9.
  2. Knowles CH, Thin N, Gill K, Bhan C, Grimmer K, Lunniss PJ, Williams NS, Scott M. Prospective randomized double-blind study of sacral nerve stimulation in patients with rectal evacuatory dysfunction and rectal hyposensitivity. Ann Surg 2012; 255: 643-9.
  3. Thin NN, Horrocks EJ, Hotouras A, Palit S, Thaha MA, Chan CL, Matzel KE, Knowles CH. Systematic review of the clinical effectiveness of neuromodulation in the treatment of faecal incontinence. Br J Surg. 2013;100:1430-47.
  4. Carrington EV, Evers J, Grossi U, Dinning PG, Scott SM, O'Connell PR, Jones JF, Knowles CH. A systematic review of sacral nerve stimulation mechanisms in the treatment of fecal incontinence and constipation. Neurogastroenterol Motil 2014; 26:1222-1237.
  5. Evers J, Devane L, Carrington EV, Scott SM, Knowles CH, O'Connell PR, Jones JF. Effects of stimulation frequency and intensity in sacral  neuromodulation on anorectal inputs to the somatosensory cortex in an experimental model. Br J Surg 2014;101:1317-28.

Information submitted for ESCP Dublin 2015

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