Dr. Willem Bemelman

Rectal NOSES

In recent decades, China has seen significant growth in the medicine field, standing out as a leader in medical research and treatment advancements. To offer a thorough understanding of Chinese medicine's practices and its impact on global health, we introduce "Meet the Institutions" as part of the Healing in China series. This initiative provides access to leading medical centers in China, offering opportunities for collaboration and participation in their activities and projects. In this event, AIS specially invites top colorectal surgery experts from China, Ireland and the Netherlands to share academic insights on rectal NOSES. This event features medical presentations, operation videos, and interactive discussions to enhance surgical skills and improve global standards in this field.

With Johnson & Johnson MedTech

Right Colectomy Best Practices To Avoid Anastomotic Leaks Complications

PROGRAM     1. Right colon resection - Dr. Joep Knol Dr. Joep Knol gives comments and advice about the procedure using 4 videos that cover different stages of right colon resection: D2 medial to lateral approach, lateral mobilization, resection, and reanastomosis. In addition to Dr. Knol’s comments, the videos are subtitled, providing information on the actions being performed during the operation.      2. Laparoscopic CME/CVL for right colon cancer - Dr. Yoon Suk Lee Experience in operations makes surgeons better, forcing them to overcome different challenges and finding the best way to perform the surgery. Laparoscopic CME with CVL is no different in this regard. In this video, Dr. Yoon Suk Lee gives his recommendations to achieve successful outcomes. 3 key points for a good surgery are covered. One, an effective technique for traction and counter traction, used by the surgeon and the assistant. Two, surgical energy systems to prevent leakage. And three, the placement of the trocars and the surgeons during the operation. To illustrate his recommendations, Dr. Lee comments on a laparoscopic operation. Finally, Dr. Less discusses the use of ICG for ICA to check the state of some organs. procedure for checking states of some organs, and gives 3 recommendations for a successful operation…     3. Interoperative anastomotic leak diagnosis: what to do. - Dr. Willem Bemelman Anastomotic leaks are severe complications in colorectal surgery, increasing the need to improve performance to prevent its consequences. In this video, Dr Willem Bemelman describes the 3 main factors to achieve the perfect anastomosis, and discusses the last one: technical integrity. However, there is no perfect technique. Various test techniques are explained using diagrams and studies on specific techniques (e.g. air leak testing). Dr. Bemelman also gives examples from his own cases. Nonetheless, tests can give us insufficient information. Dr. Bemelman explains some techniques to deal with this problem and discusses the overview technique. Finally, he summarizes the video giving some important points.

With Johnson & Johnson MedTech

ILEAL POUCH 14/15: What to Do With the Leaking Pouch

Pouch leak can affect up to 20% of patients in the first year after surgery. Treatment options will take in consideration the timing to diagnosis and the presentation. In this lecture, Dr. Willem Bemelman MD PhD shows the role of vacuum therapy in the treatment of pouch leaks and some results of his institution's study on the matter. Vacuum therapy with early closure was instituted with good results, not only regarding function of the pouch but also chronic sinuses and redo surgery.

ILEAL POUCH 9/15: Ileoanal pouch anastomosis: does size matter?

The ideal pouch size has been on debate for decades. Some authors have defended a longer pouch size, while others advocate the benefits of a shorter one. In this lecture, Dr. Willem Bemelman MD PhD explains the pros and cons of the different lengths and shapes of the pouch, and what other factors are of influence on its functioning.

Cost-effectiveness and Quality of Life of Laparoscopic Ileocecal Resection Versus Infliximab of Active Terminal Ileitis in Crohn's Disease: a Randomized Controlled Trial

Clinical Case Crohn's disease is an inflammatory bowel disease that affects the entire gut, especially the terminal ileum. Primary medical treatment is the preferred treatment as it may avert surgery and because of the potential morbidity associated with surgery. Major drawbacks of medical therapy are long-term use of medication , associated with high costs , morbidity and impairment of quality of life . Furthermore, it is unclear for how long treatment with infliximab should continue. In how many patients with recurrent Crohn's disease surgery can eventually be avoided remains unclear. On the other hand, ileocolic resection is an effective and low-morbidity operation resulting in quick relief of complaints and fast restoration of quality of life with a recurrence of 15% at 8 years. Dr. Bemelman (Academic Medical Center, Amsterdam, the Netherlands) reviews the first randomized clinical trial comparing infliximab therapy vs. laparoscopic ileocecal resection in patients with limited Crohn’s disease . The hypothesis of this work was that in patients with active Crohn’s disease located in the terminal ileum who did not respond to conventional therapy, laparoscopic ileocecal resection is more effective than infliximab in improving quality of life, with lower associated costs. This multicenter randomized unmasked open label study enrolling 143 patients concluded that laparoscopic ileocecal resection is as effective as infliximab in improving quality of life but is not significantly better as regards the disease-specific quality of life as measured by the IBDQ; that 20% of the patients treated with infliximab needed surgical rescue within one year ; and that laparoscopic ileocecal resection was less costly and more effective than treatment with infliximab. [Image]

TAMIS Pouch

Transanal close rectum restorative proctocolectomy with a pouch is a novel approach to perform the completion proctectomy and pouch in patients who had emergency colectomy for ulcerative colitis. Since most patients currently have a laparoscopic emergency colectomy with specimen extraction via the stoma site or a small Pfannenstiel incision, a double single port approach (transstomal site abdominal single port and transanal TAMIS port) is feasible. Possible advantages are a more tailored transection of the distal rectum, easy close rectal dissection, avoidance of additional abdominal incisions, single stapling anastomosis, and working in two teams. The first collaboration data from Aarhus, Leuven and Amsterdam published in Annals of Surgery (de Buck et al. Ann Surg 2017 online) showed favorable results.

With Olympus