Advanced Surgical Oncology

The Advanced Surgical Oncology Unit of the Papa Giovanni XXIII Hospital in Bergamo was created in January 2014 and entrusted to Dr. Marco Lotti, who was its Director until October 2020, the date of his transfer to the Fatebenefratelli Oftalmico Hospital of Milan.

Since the beginning of his direction, Dr. Marco Lotti has pursued three main objectives for the Advanced Surgical Oncology Unit:

1. to take care of the patient with gastrointestinal tract neoplasms, peritoneal carcinomatosis, neuroendocrine tumors and GISTs, since the moment of diagnosis or clinical suspicion, ensuring the diagnostic, therapeutic and follow-up management, in a multidisciplinary perspective shared with the other reference Specialties (Medical Oncology, Radiotherapy, Pathology, Radiology);
2. to promote the adoption and development of innovative techniques of minimally invasive surgery in the treatment of cancers of the digestive tract, neuroendocrine tumors, and peritoneal carcinomatosis;
3. to promote the conduct of clinical trials in the treatment and prevention of peritoneal carcinomatosis from ovarian, gastric and colorectal neoplasia.

During his activity as Head of the Advanced Surgical Oncology Unit, Dr. Marco Lotti:

• was a member of the Interdisciplinary Gastrointestinal Oncology Group and Team Leader for colorectal cancer treatment;
• started and was Head of the Peritoneal Surface Malignancy Surgery Program, performing cytoreductive surgery with peritonectomy and Hyperthermic IntraPEritoneal Chemotherapy (HIPEC), promoting the CARPEPACEM observational study, and launching the first Randomized Multicenter Trial on the treatment of Advanced Ovarian Carcinoma with HIPEC (the CHORINE Study);
• started the Multidisciplinary Groups for the treatment of peritoneal carcinomatosis and rare abdominal tumors.
• introduced at the Papa Giovanni XXIII Hospital of Bergamo the interventions of laparoscopic subtotal gastrectomy, abdominoperineal rectal resection with totally laparoscopic abdominal time, robot-assisted sigmoidectomy;
• devised and published an original laparoscopic right colectomy technique, introducing it into surgical practice (J Min Access Surg 2016;12:41-6);
• devised and published an original technique of laparoscopic resection of the left colic flexure, introducing it into surgical practice (J Min Access Surg 2019;15:268-72);
• devised and published an original technique of laparoscopic Witzel jejunostomy and an original technique of laparoscopic continent tubularized gastrostomy, introducing them into surgical practice (J Min Access Surg 2021;17 – Updates Surg. 2020 Sep;72(3):901-905);
• invented and published the Laparoscopy Enhanced HIPEC technique (LE-HIPEC), with the aim of combining the advantages of the closed-and open abdomen techniques (J Min Access Surg 2016;12:86-9), [J Laparoendosc Adv Surg Tech Part B, Videoscopy 2016;26(3)]; thanks to his technique he was the first researcher in the world to demonstrate the in vivo formation of early intra-abdominal adhesions after cytoreductive surgery [J Laparoendoscop Adv Surg Tech. 2016;26(12)], [J Laparoendoscop Adv Surg Tech. 2017;27(4)]. Since 2017, the article describing his technique is the first result of the "laparoscopic HIPEC" search on Google, a goal achieved and maintained without any funding or sponsorship;
• introduced the intervention of posterior retroperitoneoscopic adrenalectomy in the Papa Giovanni XXIII Hospital, an experience that is documented by several scientific publications (Surg Endosc. 2016 Apr 8. doi 10.1007/s00464-016-4884-z), (WeBSurg.com, Feb 2016;16(02). URL: http://www.websurg.com/doi-vd01en4678.htm);
• was member of the Multidisciplinary Gynecological Oncology Group and contact person for the Gynecology and Obstetrics Unit and the Urology Unit, for the implementation of combined oncological surgery of the digestive tract and surgery of the female genital and urinary tract, by means of laparoscopic and robotic techniques [WeBSurg.com, Sep 2016; 16(08)].
• published numerous teaching videos on surgical technique and anatomy some of which, following their dissemination, have been requested for use and publication by Professors and Researchers of international institutions, including theHarvard Medical School of Boston, MA (USA), and by the UTET publishing house;
• has been chosen as Reviewer by the following scientific journals: Surgical Endoscopy, Journal of Laparoendoscopic & Advanced Surgical Techniques, Oncotarget, World Journal of Gastroenterology, Journal of Urology and Research, World Journal of Surgical Oncology, World Journal of Clinical Oncology, Annals of Laparoscopic and Endoscopic Surgery, Contemporary Oncology, AIMS Public Health, European Journal of Inflammation, Videosurgery and Other Miniinvasive Techniques.