COLORECTAL SURGERY:

FROM VALDONI TO WEEK SURGERY

From surgical technique to ever evolving technology

Hononary President Gerald J. Marks Presidents Antonio Brescia  Luigi Masoni

In the ‘50s Pietro Valdoni set technical standards for colorectal surgery which stood the test of time. In those years the Masters of Surgery were outlining and teaching the “perfect operation” and the evaluation of good surgical practice relied almost exclusively on the assessment of morbidity and mortality rates.

The last decades have seen an explosion of new technology, especially laparoscopy, that has impacted upon the practice of surgery. Interest has progressively switched to address new issues, such as quality of life, cancer cure rates, function, duration of hospitalization, costs,etc.The surgical management of the disease has evolved from the mere application of technical skills (achieve complete removal of the affected organ in the best possible way) to a multidisciplinary approach where the best possible result is represented by the cure of the illness.This is particularly true in the management of benign and malignant colorectal diseases.

No doubt, the role of the surgeon has a little faded out because of this change in attitude, but it still remains crucial.

Better understanding of the disease has prompted personalized treatment plans, meaning that we are now curing not only the disease but also the patient as an individual subject. The refinement of medical science would not have produced this result without merging with cutting edge technology. One of the best examples in this field is represented by the treatment of rectal cancer, an often devastating disease. Surgery was once limited to mutilating procedures impacting upon patient lifestyle. Instead, now it is part of a multi-modality management program; in select cases neo-adjuvant therapy can now be followed by local excision (TEM) or by simple clinical observation.

This conference, gathering the foremost Italian, European and American experts, aims at discussing and comparing the various procedures in order to produce guidelines that will hopefully be valid for many future evolutions.