What's new in the field of endoscopic surgery and minimally-invasive surgery?

This it was discussed in Florence between 4 and 6 June during a conference organized by the Italian Society for Surgical Endoscopy (ISSE) with the participation of the University of Florence, the Florence University Hospital Careggi with the support of Region Tuscany.

The event saw the participation of international experts and Italian "discussants”, was held at the Auditorium al Duomo in Florence.

As declared by Dr. Riccardo Naspetti of the Scientific Committee of the ISSE speaking on HealthyItalynet: " It's the first edition realized on this format; the special feature of this conference was the participation as speakers of only foreign professionals, while the discussants were all Italian. This mode was chosen to bring excellence from various countries such as Japan, Cuba, Israel, Russia, Germany, Holland, USA and others. "

The meeting was also sponsored by the following scientific societies: Italian Society of Endoscopic Surgery (SICE), the Italian Society of colon rectal surgery (SICCR) by the Company and Italian digestive pathology (SIPAD).

The chairman of the meeting prof. Bandettini Luca, president of the ISSE international board, said in his greetings included in the program of the conference: "This event highlighted the latest developments in surgical endoscopy and minimally-invasive surgery, new approaches that in many cases replaced the traditional ones and that have  benefit for the patients,  reduce the hospital stay and costs.”

The congress opened with the formalization of the collaboration between the University of Yaroslavl and the University of Florence.

"The University of Florence has a program of cooperation not only with the prof. Pavlov, rector of Yaroslavl University, but also with the University of Havana with the Surgery structure director, prof. J. Ruiz-Torres, who has offered the opportunity for our trainees to go at their facilities and learn new techniques. "

The second day opened with the reading of prof J.P. Ruurda from Utrecht University in Holland, that showed their experience on robot-assisted esophagectomy with a large series of 250 cases.

“Dr Ruurda, continued dr Naspetti, is devoted to robotic upper GI only. In their modus operandi they’ve concentrated all patients in a centre, while in Italy they usually do all surgery together. In Tuscany they are trying to regulate by doing Units for rare or complex tumors as of the esophagus or of the pancreas or GIST tumors, concentrating the activities in the main three Tuscan hospitals (Careggi of Florence, Cisanello of Pisa and Le Scotte of Siena), from this point of view with the best clinical specialists. There are several difficulties, because in addition to the presence of specific equipment, surgeons are required 24 hours a day.”

Still from the University of Yaroslavl were presented data on computerized support to superficial gastric lesions. "The conclusion of the assessment of this support, added Dr. Naspetti, it is that the "eye" has still the predominant part; you can do a depth study but the experience of the surgeon is still fundamental. We have not a computer that can detect the mucous pattern, or put in suspicion for a possible presence of a dysplasia or even adenocarcinoma etc. We'll get there with more powerful computers that must give the answers in real time.”

“Endoscopically is possible to perform a depth study, pointed out dr Napetti, until now you could only see the mucosa. Now, the under-mucosa too, and leave a muscular layer only and the serosa of the bowel, enlarging in this way the endoscopic possibilities."

During the conference there was also room for a session devoted to the laparoscopic techniques for liver and pancreas resection using torsional ultrasound, entrusted to a great expert on this subject,  Professor. M. Abu Hilal of Southampton.

We remind that the team of prof. Abu Hilal has published numerous studies on laparoscopic techniques, highlighting in recent works the concept of saving parenchymal in the hepatic resections for non-peripherals hepatic lesions. In his latest work published in March 2015 on the Journal of American College Surgeons he showed how these techniques are safe and do not affect perioperative and oncological outcomes in patients with liver metastases and rectal colon.

The bilio-pancreatic session, that ended the second day of the conference, has seen an update on new devices and sampling techniques, and interesting reports on endoscopic treatment of bile duct injuries and diseases of the pancreas.

The third and final day of the conference was devoted to Lower GI, with the endoscopic approach to the diagnosis and surgical treatment of injuries of this section, to the EMR and ESD techniques and outcomes, and to the single sign-on laparoscopy in the treatment of restorative proctolectomy and colorectal resection.

Emilia Vaccaro