General info
Orsi Academy offers an Advanced Course in fluorescence application for oncological procedures and endometriosis surgery for gynaecologists, urologists and colorectal surgeons who already master the robotic surgery approach and who want to cover robotic surgical skills in more complex gynaecological indications in oncology and for endometriosis surgery.
This 1-day course consists of hands-on training on live animal tissue & theoretical sessions.
Medical device: Intuitive - da Vinci Xi
What you will learn
- To better understand surgical approaches in complex GYN oncology and endometriosis cases.
- To achieve multidisciplinary approach (GYN-URO-COL) within the complex gyn indications.
- Step-by-step guidance on using ICG and NIR imaging to improve surgical accuracy.
Prerequisites
- The trainee has completed a basic robotic device training.
- The trainee has experience (30-45 cases) as a console surgeon on the specific robot.
- The trainee is a gynaecologist, urologist or colorectal surgeon.
Faculty
Program
Arrival at Orsi Academy
Introduction & objectives of the course
Target indications:
- Complex deep infiltrating endometriosis involving the recto-sigmoid, bladder and/or ureter
- Early-stage cervical and endometrial cancer
- Anterior or posterior pelvic exenteration
- Complete pelvic exenteration
- Patient selection
- Use of imaging tools to improve patient outcome:
- ICG for sentinel nodes, for vascularisation in bowel anastomosis and endometriosis, for visualizing bladder/ureters – how to apply within the patient
- What do you want to visualize
- Complication management
Hands-on training on live animal tissue
Pelvic vascularisation and associated lymph nodes
- Port placement and robotic set-up
- Topical (uterine) administration of ICG:
- Identification of sentinel nodes in the pelvis and surgical removal
- Intravenous administration of ICG:
- For immediate visualisation of blood vessels in the bowel mesentery, in case of bowel anastomosisnodes
- For visualisation of neovascularisation in endometriosis
- When administered hours before surgery: visualisation with ICG of bladder/ureters, by excretion of ICG in the urine
Bowel vascularisation
- Isolating left ureter – transmesocolic mobilisation of ureters
- Ileal loop selection
- Ileo-ureteral anastomosis
- Urostomy and colonstomy
- Ureteric re-implantation – posterior wallace type and anterior wall ileo-ureteral anastomosis
Lunch at the Orsi restaurant
Hands-on training on anesthetized porcine model
Bowel vascularisation
- Anastomosis by use of robotic stapling with revascularisation control using ICG
Ureter identification and revascularisation
- During resection of parametrial or peri-ureteral endometriosis, ureterolysis, and anterior pelvic exenteration → ICG excretion
- Isolating left ureter – transmesocolic mobilisation of ureters
- Ileal loop selection
- Ileo-ureteral anastomosis
- Urostomy and colonstomy
- Ureteric re-implantation – posterior wallace type and anterior wall ileo-ureteral anastomosis
End of the course
Resources
Flyer Robotic Gynaecology Fluorescence Surgery for Oncology & Endometriosis
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