Marek Zawadzki
Marek Zawadzki
Roel Hompes
Roel Hompes

Date: Tuesday 24 September 2019
Times: 08:30 - 17:00
Venue: Austria Center Vienna
Cost: €300 ESCP Member / €400 Non-Member

Course directors: Roel Hompes (The Netherlands), Marek Zawadzki (Poland)

Faculty: Pieter Tanis (The Netherlands), Tomasz Banasiewicz (Poland)

Please note: If you wish to have a coffee before the course starts, there is a café on the ground level.


This skills lab is reserved for 16 participants aimed at surgeons with an established practice in colorectal surgery and senior colorectal trainees/fellows.

Course content

Anastomotic leaks are unfortunately still a common problem after resections for benign and malignant colorectal pathology. When significant abdominal sepsis ensues after a leak, the patient might end up with an open abdomen. The management of the open abdomen can be complex, particularly when stomas are required that may be located in the proximity of a laparotomy wound. The open abdomen section of the workshop will comprise theoretical lectures and practical exercises that will allow the attendees to familiarize themselves with modern treatment methods of open abdomen both with and without stoma, with a central focus on Negative Pressure Wound Therapy (NPWT).

When a Leak occurs after low anterior resection or ileal pouch anal anastomosis, the sepsis is usually restricted to the pelvis and often these leaks are management with either a transanal or percutaneous drainage. Another more pro-active treatment with encouraging early results would be the use of an Endosponge. Through didactic lectures, clinical cases and hands-on simulation model, delegates will be thought correct use of the Endosponge and learn to identify which patients might benefit from this approach. Various treatment pathways will be discussed dependant on the initial appearance of the anastomotic leak and subsequent response to the Endosponge treatment.

Learning objectives

Attendees should gain the following:

  • Understand diagnostic criteria for the Open abdomen and indications for treatment with Negative Pressure Wound therapy
  • Learn modern treatment methods of the open abdomen both with and without stoma
  • To identify patients that would benefit from Endosponge placement for the management of acute and chronic anastomotic leaks after a low anterior resection or ileal pouch anal anastomosis
  • Correct use with 'tips and tricks' for Endosponge treatment
  • To determine a final management plan after initiation of Endosponge therapy

Programme

TimeSession
08:00 - 08:30 Registration
08:30 - 10:00

Session 1: The Open Abdomen

  • General strategies (3xS), techniques and pitfalls - Marek Zawadzki (08:30 - 09:00)
  • The Open Abdomen and complicated stoma: goals, tips and tricks - Tomasz Banasiewicz (09:00 - 09:15)
  • How to close the Open Abdomen: from 'frozen abdomen' to primary fascia closure - Tomasz Banasiewicz (09:15 - 09:40)
  • Optimising Healing in NPWT for the Open Abdomen. Everything you ever wanted to know about the Instill VAC - (09:40 - 10:00)
10:00 - 10:30 Coffee and Tea Break
10:30 - 12:00

Session 2: Management of Anastomotic Leaks

  • Setting the Scene: the "true" incidence and implications of acute and chronic pelvic sepsis - Pieter Tanis (10:30-11:00)
  • Endosponge in Management of pelvic sepsis: rationale, step-by-step and results - Roel Hompes (11:00-11:30)
  • Case based discussions - Pieter Tanis and Roel Hompes (11:30-12:00)
12:00 - 13:00 Lunch
13:00 - 16:00

Hands-on session and cases from participants

Delegates will rotate among four different stations to simulate the topics that were discussed in the morning sessions. Any clinical case from the delegates own practise can be discussed with faculty and management plan drawn out:

  1. Model for Open Abdomen
  2. Model for Open Abdomen + instill VAC
  3. Model for Open Abdomen with complicated stoma
  4. Model for endoscopic placement of endosponge
16:00 Course ends

 

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