My name is Jacqueline van Laarhoven and since 2016 I’m part of the Medical Team of AIS Channel. In 2012 I finished my Medical Degree in the Netherlands at Utrecht University and in 2015 I obtained my PhD. Currently I am a senior resident General Surgery with the focus on Gastrointestinal and Minimal Invasive Surgery. In my role as Dutch AIS Ambassador I aim to contribute to provide my international and national colleagues with cutting edge surgical training. Especially to those for whom state of the art training is not available in daily practice. And by doing this I am continuously learning myself: AIS Channel provides the extra challenge and depth I was looking for next to my daily training in becoming a skilled and well educated surgeon. My goal for the future is to inspire other female students who aspire to become a surgeon themselves.
Welcome to the AIS Awards 2023! The event acknowledges the collective efforts of residents, surgeons, healthcare professionals, and the AIS Team in democratizing medical training through online content. With 11 awards across four categories and 45 nominees, the ceremony reflects the remarkable achievements of the AIS Community. Awards are based on real AIS Channel metrics, with two categories determined by audience votes. While celebrating winners, we also recognize the dedication of outstanding surgeons not nominated today. The prizes to be distributed will be as follows: Emerging KOLs Category Most Listened Podcast Most Viewed SOC Most Viewed ACW More Events Held KOL Category More Events Held Most Viewed OOO Live Webinar Category Most Viewed Live Surgery Greatest Social Impact Special Awards Category Best Academic Initiative Congress of the year Surgical Event of the year The virtual gathering provides a unique opportunity for professionals to connect, making the ceremony unforgettable. Join us in honoring the AIS Community's achievements this 2023!
Published
Dec 2023
In this podcast episode, Dr. Jacqueline Van Laarhoven, an accomplished surgeon and mom of three, talks about her journey becoming a mother during her surgical training. Dr. Romina Pena, an experienced surgeon without kids, shares her opinion and inquiries about the experience of being a surgeon and being a mother. In the second and final episode of these podcast series, Dr. Pena wonder about the essential support Dr. Van Laarhoven received from her surgical team when returning to work after becoming a parent, emphasizing the role of colleagues in her successful reintegration. Meanwhile, Dr. Van Laarhoven discusses her journey as a mother and surgeon, underlining the support from her team and the emotional challenges she faced in the initial days of working, constantly thinking about her children at home.
Published
Nov 2023
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In this podcast episode, Dr. Jacqueline Van Laarhoven, an experienced surgeon and mom of three, talks about her journey becoming a mother during her surgical training. Dr. Romina Pena, a relevant surgeon without kids, shares her opinion and inquiries about the experience of being a surgeon and being a mother. In the first episode of a two-part podcast series, Dr. Pena and Dr. Van Laarhoven opened up about their respective paths, exploring personal journeys of managing the demands of surgery and motherhood, shedding light on the balance between career aspirations and family life. Finally, they talk about the childcare expenses offering financial insights for aspiring surgeon parents.
Published
Sep 2023
Desmoid tumors (DTs) are rare. They account for less than 3% of all soft tissue tumors. DTs are histologically benign proliferations of stromal cells but may grow locally aggressive. They are classified as a non-metastasizing, intermediate malignant tumor and they can be characterized clinically by a variable and often unpredictable course. The molecular events that lead to desmoid tumor formation are incompletely understood. However, increasing evidence points to involvement of the APC gene and beta-catenin in the molecular pathogenesis of desmoids both in Gardner syndrome as well as in sporadic desmoids . Antecedent trauma has been described in up to 30% of patients with DTs. Most commonly from surgical interventions in patients with FAP. DTs have been associated with high estrogen states and extra-abdominal and abdominal desmoids tend to occur in females during or following pregnancy. First line treatment for most patients should start with active surveillance with initial MRI or CT as an alternative. Some may think that a resectable tumor should be treated with surgery upfront, however, up to 50 to 60% do not grow after diagnosis, also 20 to 30% may shrink and even disappear after initial progression. Pain control and quality of life are to be considered the 2 priorities in the overall management strategy of patients with desmoid tumors. In case of progressive symptoms or persistent growth, intervention might be 1 considered and assessed with further assessments and possibly not before 1 year after initial diagnosis. This avoids overtreatment in patients who could spontaneously regress and avoids interventions for stable disease. If the desmoid tumor location is close to critical structures, an earlier decision towards therapy can be made. The review by Kasper et al. is discussed, summarizing the latest guidelines to desmoid tumor management.
Published
Apr 2022
Rectal carcinomas are divided into early, intermediate and locally advanced stage. The early rectal carcinoma has a low risk on local recurrence after TME surgery and is defined as limited growth in or thru the rectal wall: clinically T1-T3b, which has no threatened mesorectal fascia, no suspected lymph nodes and no metastasis. The intermediate rectal carcinoma is defined as a clinically T3c-d with no evidence of lymph node metastasis, or a T1-3 with metastasis in up to 3 regional perirectal lymph nodes, with no threatening of the mesorectal fascia. For patients with an intermediate rectal carcinoma, the benefit of neoadjuvant radiotherapy lies in reducing the risk of local recurrence. Neoadjuvant radiotherapy with 5x5Grey , with short interval until surgery, has become the standard from the TME study. The absolute risk reduction in this group is approximately 12% over 10 years. A negative effect of neoadjuvant radiotherapy is an increased risk of perineal complications after abdominoperineal resection. Also there are reduced functional outcomes after neoadjuvant radiotherapy with TME surgery: more faecal incontinence, a higher defecation frequency and more sexual function disorders such as erectile dysfunction and vaginal dryness compared to treatment with TME surgery alone. Locally advanced rectal carcinoma is defined as a tumor with a high risk of local recurrence after surgical treatment. This includes T4, involved mesorectal fascia, N2 features or extramesorectal pathological nodes. Almost all available literature recommends neoadjuvant chemoradiation followed by resection in locally advanced rectal carcinoma to reduce the tumor volume before resection and increase the number of R0 resections and reduce the number of locoregional recurrences after resection. A negative effect is a significant amount of acute toxicity, such as radiation proctitis, diarrhea and irradiated skin effects. There is also an effect on functional outcomes after treatment with chronic diarrhea and urinary complaints.
Published
Feb 2021
Local excision alone has only been considered oncological safe for low risk T1 rectal cancer. In case of any unfavourable histological characteristic, there is a substantial increase in the risk of lymph node metastases with impaired oncological outcome after local excision alone, requiring completion total mesorectal excision (TME). The histological characteristics which are associated with increased risk of local recurrence are: poor differentiation, deep submucosal infiltration, lymphatic or vascular invasion, SM3 and tumour size. For pT1 larger than 5 cm and larger than 3 cm for pT2. Adequate MRI-based staging of early rectal cancers is essential for decision-making. The aim of this study was to determine the accuracy of routine daily MRI staging of early rectal cancer. A populaton based study by the Dutch ColoRectal Audit Group shows that the MRI has a sensitivity of 45.3 % and a specificity of 92.6 % in clinically diagnosing T1 lesions. In T2 tumours the sensitivity is 91.8 % and the specificity is 25.7 %. Overstaging of pT1 tumours occurred in 54.7 % and understaging of pT2 tumours in 8.2 %. The accuracy for cN0 category was 69.0 %, with a sensitivity of 82.7 % and specificity of 33.8 %. Overstaging of pN0 disease occurred in 17.3 %, and understaging of pN1 and N2 in 66.3 %. A meta analysis published in 2016 in the British Journal of Surgery analyzed the oncological outcomes after local excision of T1 and T2 rectal cancer which required adjuvant chemoradiotherapy or completion surgery. Results showed that the local recurrence rate appeared to be higher in the locally excised category rectal cancer treated by adjuvant chemoradiotherapy. Many characteristics differed among the included cohorts, which makes interpretation of outcome for each treatment modality difficult. Despite all shortcomings, the authors concluded that the local recurrence rate after adjuvant radiotherapy for locally excised early-stage rectal cancer is relatively high, based on the best available evidence to date. So in conclusion, 5 things you should know about therapies for early rectal cancer: 1. Local excision alone has only been considered oncological safe for low risk T1 rectal cancer, which may be defined as well or moderately differentiated without lymphatic or vascular invasion and excised with at least 1 mm margin. 2. If pathological results warrant adjuvant treatment, based on the best available evidence to date the additional treatment is TME. 3. the MRI was accurate in staging T1 tumours in 79.6% and accurate in staging T2 tumors in 55.5%. 4. Assessment of overall node category by MRI was accurate in 65.4% 5. A rectum sparing treatment with adjuvant chemo-radiotherapy after local excision may be a valid alternative to completion TME in the intermediate-risk early rectal cancer, which is currently investigated in a randomized controlled trial. Treatment of rectal cancer is very patient specific and dependent of the patients wishes to have organ preserving surgery. If a patient does not want to undergo a LAR or APR, a alternative oncological treatment should be discussed.
Published
Oct 2020
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