Report of EGMLLS 2017

EGMLLS 2017, Southampton

The devil was in the detail when 220 delegates gathered in the chilly Southampton air to work on European Guidelines for Laparoscopic Liver Surgery.

Intense discussions of the draft recommendations was leavened with the addition of the Countdown TV programme theme tune (funny to the UK-based delegates, puzzling to everyone else) as people voted to show agreement – or disagreement – with a raft of proposals.

Guest lectures, Q&As, networking, a busy trade exhibition, trial updates (Orange II Plus) and a Gala Dinner added to the mix of the hugely successful meeting.

Delegates were warmly welcome by Mr Mo Abu Hilal, EGMLLS 2017 Congress Chair, followed by friendly words from Cllr Cathie McEwing, the Mayor of Southampton and Prof Ian Cameron, Dean of the Faculty of Medicine at Southampton University.

The prestigious meeting was endorsed by I Go MILS, ILS, E-HPBA and GBIHPBA and AUGIS and attracted 220 delegates, three-quarters from abroad.

Validation committee member Mr Mark Taylor commented: “There is a view that laparoscopic liver surgery takes all the pain from the patient and places it with the surgeon. We hope that after this conference our pain will be lessened.”

The format of the meeting was for Guidelines to be presented and discussed – followed by voting from the floor, interspersed with guest lectures, Oral Presentations and a My Case series of short video-based lectures.

The Guidelines under discussion were:

  1. Guidelines on Indication: These looked at colorectal liver metastases, benign and rare non-colorectal metastases, Hepatocellular carcinoma and living donors.
  2. Guidelines on Patients and complex disease. This covered High Risk Patients (elderly and high BMI), technically complex settings – redo liver resections and large lesions and lesions close to major vascular structures.
  3. Guidelines on procedures. These studied Major hepatectomy outcomes, minor liver resections and difficult segments, segmentectomies and parachyma-sparing resections.
  4. Guidelines on Technique: These focused on Mmnimally invasive approaches / surgical devises / intra-operative planning and staging, Anatomic major re-sections (techniques), Bleeding control / conversion
  5. Guidelines on Implementation: This looked at surgeons / centres/ training,

In addition guest lectures included Prof Pierre Clavien on Complications in liver surgery – prevention is better than cure; Prof Go Wakabayashi on Laparoscopic anatomical and non-anatomical liver re-sections; Prof Daniel Cherqui on Techniques and results – what did change in more than a decade; and Dr Joseph Amaral on The role of advanced energy in laparoscopic liver surgery.

The challenge of training and education, the role of the MDT and trial results all featured in the lectures.

The conference finished with a talk from Prof Thomas van Gulik on Wise advice to the lap liver community – lessons learned from open surgery. He said: “This not a discussion any more. Lap is here. Now let’s look at what the robot can offer us.”

Mr Mo Abu Hilal added “We love laparoscopic liver surgery and we want it to expand, however we are very keen to ensure safe and steady continuos implementation. I am quiet sure that both open and laparoscopic liver surgery will continue to have space and be part of our daily practice.

After hearing all the discussions over the two days, the Validation committee met several times and then reported back to the conference and gave a detailed description of suggested changes and amendments and the rationale for them.

Delegates were to continue discussions with the committee and the next step will be the publication of a paper on the Guidelines.

Watch this space.