The second day of ESCP’s Virtually Vilnius kicked off with the highly anticipated symposium ‘ESCP’s Global Reach and Related Research’. Chaired by Dion Morton (UK) and Simon Ng (Hong Kong), Chair and Co-Chair of ESCP’s celebrated Global Reach Committee, the session welcomed several expert speakers from across the globe to share their knowledge and recent learnings – particularly around the COVID-19 pandemic.

The first topic was on meeting the COVID-19 challenges and Kaori Futaba (Hong Kong) started by sharing an insightful presentation on how the pandemic influenced clinical practice in Hong Kong. The country was in a rather unique position, she explained, as they had experienced the SARS outbreak in 2003 (resulting in 1,750 cases and 286 deaths) which affected many medical personnel. Due to this, most of the public wore masks, complied with safety measurements, and understood the severity of the COVID-19 situation early on, without the need for a push from the Government.

Kaori explained that, in her experience, face-to-face consultations continued to go ahead, however 50-56% of patients cancelled or postponed their appointments due to the fear of catching the virus. Reducing the risks associated with aerosol-generating procedures became incredibly important, as did implementing effective undergraduate and graduate training. Strict rules were implemented to protect healthcare workers including safety measures in communal areas as well as for those responsible for patient meal preparation, to ensure the chance of any cross contamination was kept extremely low.

Antonino Spinelli (Italy) was up next. He discussed experiencing a very early and steep peak at the end of March and explained just how unprepared clinicians were for the first wave in his region. “We did not have any previous experience and even data generated in the early stages turned out to be misleading,” he said. “The most critical issues we faced were a shortage of ICU beds, a shortage of PPE equipment for healthcare professionals and eventually inadequate burial space due to a high concentration of deaths.”

Antonino went on to say how it was imperative that everything shut down if it wasn’t essential – hospitals reorganised patient inflow based on urgency and established Covid-dedicated areas, such as special wards and staff areas. The training of healthcare workers, particularly around using PPE effectively, through courses and lectures became mandatory.

Aneel Banghu (UK), chief investigator of the CovidSurg collaborative research group, then discussed the studies and international trials underway.

The CovidSurg group is a fantastic and valuable initiative which has published insightful papers and guidance about COVID-19 within the surgical field which include contributions from 2,000 centres across 110 countries.

Aneel discussed research on elective surgery cancellations from post-operative mortality and pulmonary complications with perioperative SARS-CoV-2 infection (infected state - including those asymptomatic) which also identified patients at risk.

Further research outputs from the collaborative will be presented during the final day of Virtually Vilnius including machine learning and patient selection, laparoscopic versus COVIDopen surgery and which preoperative COVID-19 test is best. Aneel concluded his talk by advising clinicians to prepare their hospitals for a second wave and move from opinion to data driven decisions.

A lively discussion was then held with the panel of expert speakers which gave those viewing a chance to submit their questions and discuss differing practices and challenges across the world.

The session then heard industry updates from colorectal specialists across the globe, starting with a presentation from Nadine Hachach-Haram (UK) on the future of proctoring which outlined the innovative opportunities that Proximie offers.

The augmented reality platform designed for virtual surgical collaboration, enables surgeons to remotely connect with colleagues across the world. Combining real-time communication, artificial intelligence, and machine learning, Proximie can support surgeons to deliver life-saving operations while also supporting the future of surgery given its ease of use and scalability.

Professor Per Nilsson (Sweden) then held a talk in which he discussed the training available for surgeons around the globe, which focused on valuable books, educational videos, and e-learning such as virtual masterclasses and conferences.

He pointed viewers in the direction of PubMed, where surgeons can find a plethora of valuable papers across a range of topics (including eight specifically on colorectal surgery), and encouraged the use of ESCP’s online resource library and CREST platform.

He concluded his talk by encouraging surgeons to read ‘Rectal cancer lateral pelvic sidewall lymph nodes – a review of controversies and management’ - a hot topic within current colorectal research and development.

Alvaro Garcia Granero (Spain) was up next to show viewers the importance of 3D reconstruction when preparing for colorectal surgery using a 3D mathematical model for preoperative strategies to assess the infiltration of pelvic structures.

Alvaro chatted through the benefits of this tool for patients, which included a decrease in intraoperative complications and an increase in R0 resection probability, and he noted that wider teaching would allow for more patient-tailored surgery.

Then, the #ESCP2020 watchers were treated to some fantastic abstract presentations. First up, Laura Mora-López (Spain), presented ‘Efficacy and safety of non-antibiotic outpatient treatment in mild acute diverticulitis’ which is also referred to as the DINAMO-study - a multicentre, randomised, open-label, non-inferiority trial. .

The next abstract presentation ‘Randomised phase III trial comparing low-pressure versus standard-pressure pneumoperitoneum in laparoscopic colectomy’ was delivered by Quentin Denost (France) which looked at comparing the length of hospital stay between low and standard pressure in laparoscopic surgery.

The highly engaging and educational session concluded following a wrap-up discussion which saw hosts Dion Morton and Simon Ng share topical questions with the panel of speakers.

Make sure you follow the latest updates from #ESCP2020 by following @escp_tweets on Twitter.

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