Colorectal cancer is the third most common cancer in the world. For about 40% of colorectal cancer patients, the cancer is located on the right side of the colon. The standard treatment is removal of this part of the colon, or right hemicolectomy, usually along with associated lymph nodes due to potential metastases. This is a common operation that is performed in almost all hospitals in the Netherlands.
“From our experience with the courses we give to trainee surgeons, there appears to be an enormous variety in performing this operation between hospitals in the Netherlands, and even between surgeons within one hospital,” said Alexander Grüter. “Although variation in practice is not necessarily bad, it is undesirable when it does not conform to the most recent insights.”
An initiative of surgeons Jurriaan Tuynman, Pieter Tanis (formerly at Amsterdam UMC, now Erasmus MC), Boudewijn Toorenvliet, and physician-researcher Alexander Grüter, 43 Dutch hospitals are participating in the Right Study, which was initiated in 2021. The study’s aim is to identify and implement a standardized and optimized minimally invasive surgical method for right-sided hemicolectomy in the Netherlands.
“We completed Phase 2 of the study, in which we reached consensus on the best way to perform this operation,” says Jurriaan Tuynman. “With that knowledge, we were able to improve surgical training."
The training – Phase 3 – is now also finished and the surgeons are excited about the results.
The study is now entering Phase 4 - the implementation phase. Two surgeons from each 43 participating hospitals have received extensive hands-on training in the most optimal technique at one of the skills centers in Amsterdam, Rotterdam, or Nijmegen.
“Under the watchful eye of one of 11 experts appointed to supervise operations in the participating centers, the surgeons will now utilize their training and operate on patients in their respective hospitals,” says Alexander Grüter. With these 11 experts, also called the proctors, we came together in the Amsterdam Skill Centre for the so-called 'Teach the Teacher day'. During this meeting we thoroughly discussed the most optimal technique and explained to these proctors how they can best guide the trained surgeons in this. See here a link to a video about this great day.
The final phase 5 - the consolidation phase - which will continue the implementation of the most optimal technique, but now without proctoring. All patients will be followed for 5 years.
For more information contact: Alexander Grüter.
People involved:
Jurriaan Tuynman
Piete Tanis (formerly at Amsterdam UMC, now Erasmus MC, Rotterdam)
Boudewijn Toorenvliet (Ikazia Hospital, Rotterdam)
Alexander Grüter
The text was partially adapted from this article in Dutch.