Laparoscopic Colon Cancer Mentorship Program

 

In Partnership with the Ontario Association of General Surgeons and Cancer Care Ontario

 

The laparoscopic colon cancer mentorship program is designed to allow practicing Ontario General Surgeons to meet the Cancer Care Ontario guidelines by providing an opportunity to be mentored in laparoscopic colon cancer surgery.

A pilot project for this initiative will take place at Humber River Regional Hospital - Finch site, lead by Dr. John Hagen. The site mentors are Drs. Hagen, Klein, Starr and Whiteacre.

Operative time is precious and it can take a long time for a single surgeon to accumulate 20 patients. Therefore, the program has been designed to minimize these problems. If you refer a patient to the program, you will continue to be the operating surgeon. We will provide you and your patient with OR time at the Humber River Regional Hospital. Likely, there will be one or two additional laparoscopic colon resections planned for that day which we would like you to participate in as either assistant or observer. This will allow you to gain experience in two or three cases per trip to HRRH. The immediate post-operative care will be provided at HRRH and the patient will be discharged home with follow-up to be arranged by the referring surgeon. The referring surgeon will bill as the primary surgeon.

Cancer Care Ontario Guidelines

 

The evidence-based guideline, The Laparoscopic Surgery for Cancer of the Colon, developed by Cancer Care Ontario is available here. The guideline recommends that before embarking on laparoscopic surgery for curable colon cancer, at least one member of the surgical team should have performed at least 20 cases for either benign or malignant disease. Similar recommendations can be found on the SAGES website.

In order to help interested surgeons meet these recommendations, a pilot project has begun at Humber River Regional Hospital with plans for a province-wide initiative including the programs in Southwestern Ontario, Hamilton, and Ottawa. The initiative is being administered by the Ontario Associate of General Surgeons.

Patient Selection and Patient Referral

 

Surgeon selection criteria:

1. Practicing surgeon in Ontario
2. Experience in colorectal surgery
3. Should have taken (or be willing to take) a laparoscopic colon resection course
4. Agree to follow the CCO Guidelines for Laparoscopic surgery for the treatment of cancer of the colon

Patient selection criteria for mentoring:

1. Biopsy proven right colon or left colon cancer. No rectal cancers, transverse colon cancers or tumors fixed to adjacent structures will be included.
2. All patients should have a complete colonoscopy
3. All tumors should be marked with "spot" in 4 quadrants of the colon wall just distal to the tumor
4. All patients should have a staging CAT scan of the abdomen
5. All patients should have a BMI < 35 with ASA 3 or less

 

Process for referring patient:

A brief outline of the patient history and findings should be emailed to mentor@misgroup.ca. This should include patient history, co-morbidities, colonoscopic findings, CAT scan, and pathology. This will be reviewed and a response will be sent within 24hrs.

If you have any further questions about the program, please send an email at mentor@misgroup.ca or call 416 782-2616 to speak to Drs. John Hagen or Laz Klein.