Dr. W. Gotlieb

@IJGConline @pedroramirezMD @agz_eriksson @ESGO_society @IGCSociety @ENYGO_official @OncoAlert Good morning Dr. Batista, you are right. Half of our patients have a bmi above 30 and 25% a bmi above 40. Our experience has been that the higher the bmi, the more value there is in the hook compared to the scissors. It is just one more technique that could improve effectiveness

What's your preferred instrument in #SLN in endometrial cancer? This #video demonstrates usage of the articulated HOOK monopolar. 🔗ow.ly/OHE750GgAg5 pmid 34493585 @pedroramirezMD @agz_eriksson @ESGO_society @IGCSociety @ENYGO_official @OncoAlert

@leitaomd This just supports that there is room to further improve some of the technical aspects of MIS in order to allow patients to benefit, and not to discard the entire approach

Minimally invasive surgery versus laparotomy for radical hysterectomy in the management of early-stage cervical cancer: Survival outcomes. - PubMed - NCBI ncbi.nlm.nih.gov/pubmed/3191899…

@IJGConline No #ijgcclub

#IJGCclub Poll4 Clinical scenario

limitations: major residual disease post chemo that is retracted and difficult to resect and disease in difficult to reach areas, such as smaller curvature, post diaphragm, gastrosplenic lig, multiple bowel sites #ijgcclub, @ESGO_society, @AAGLJMIG, @IGCSsociety, ijgconline

@IJGConline major residual disease post chemo that is retracted and difficult to resect and disease in difficult to reach areas, such as smaller curvature, post diaphragm, gastrosplenic lig, multiple bowel sites

#IJGCclub Q2 for Dr. Gotlieb @GotliebW In your opinion, what are the limitations of robotic surgery/MIS in cytoreductive surgery?

@IJGConline @ESGO_society @GynMe4 @me4_so @AAGLJMIG Patients who responded well and are expected to achieve R=0 by robotics. Criteria include disappearance of signs of carcinomatosis and unresectable disease on CT, a drastic decrease in CA125, and a final evaluation by laparoscopy confirming the possibility that R=0 can be reached

Q1 for Dr. Gotlieb @GotliebW - In your opinion, which patients would benefit from a robotic approach for interval debulking surgery? What would your preoperative selection criteria be? #IJGCclub @ESGO_society @GynMe4 @me4_so @AAGLJMIG

@pedroramirezMD @IJGConline @IGCSociety @ESGO_society Thank you Pedro, a RCT is definitely warranted to confirm cohort data, and with the available data today one can consider offering it to patients in whom complete cytoreduction can be achieved, as long as the patients are well informed and correctly consented

First question from me: should MIS interval surgery be performed outside of a clinical trial? #IJGCclub @IJGConline @IGCSociety @ESGO_society @GotliebW

Expectation that you can obtain complete cytoreduction: such as disappearance of signs of carcinomatosis and unresectable Dz on CT, drastic decrease in CA125, and then evaluation by laparoscopy to make the final decision

Thank you Pedro, no doubt a RCT is warranted to confirm the cohort data, and until then based on the results available, good selection of patients that will attain complete cytoreduction seems an acceptable option to be offered to well informed and consented patients

@agz_eriksson @JennyMueller_ @RobinsonRossiGO @PamSolimanMD @twigem2a @duciej13 @beth_karlan @DrLB @me4_so Absolutely

November #IJGCclub Poll2 Would you take part in the #LANCE trial? I would ✅ @JennyMueller_ @RobinsonRossiGO @PamSolimanMD @twigem2a Join our discussion today at 8pm CET @duciej13 @beth_karlan @DrLB @me4_so

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