The first international Delphi consensus statement on Laparoscopic Gastrointestinal surgery.

Consensus Delphi Technique Digestive System Surgical Procedures Humans Laparoscopy Surgeons

Ergonomics Gastrointestinal surgery Guidelines Hepatobiliary Laparoscopic surgery Minimally invasive Patient safety Surgical training

Journal

International journal of surgery (London, England)

ISSN: 1743-9159

Titre abrégé: Int J Surg

Pays: United States

ID NLM: 101228232

Informations de publication

Date de publication:
Aug 2022

Historique:

received: 19 04 2022

revised: 16 06 2022

accepted: 28 06 2022

pubmed: 17 7 2022

medline: 31 8 2022

entrez: 16 7 2022

Statut: ppublish

Résumé

Laparoscopic surgery has almost replaced open surgery in many areas of Gastro-Intestinal (GI) surgery. There is currently no published expert consensus statement on the principles of laparoscopic GI surgery. This may have affected the training of new surgeons. This exercise aimed to achieve an expert consensus on important principles of laparoscopic GI surgery. A committee of 38 international experts in laparoscopic GI surgery proposed and voted on 149 statements in two rounds following a strict modified Delphi protocol. A consensus was achieved on 133 statements after two rounds of voting. All experts agreed on tailoring the first port site to the patient, whereas 84.2% advised avoiding the umbilical area for pneumoperitoneum in patients who had a prior midline laparotomy. Moreover, 86.8% agreed on closing all 15 mm ports irrespective of the patient's body mass index. There was a 100% consensus on using cartridges of appropriate height for stapling, checking the doughnuts after using circular staplers, and keeping the vibrating blade of the ultrasonic energy device in view and away from vascular structures. An 84.2% advised avoiding drain insertion through a ≥10 mm port site as it increases the risk of port-site hernia. There was 94.7% consensus on adding laparoscopic retrieval bags to the operating count and ensuring any surgical specimen left inside for later removal is added to the operating count. Thirty-eight experts achieved a consensus on 133 statements concerning various aspects of laparoscopic GI Surgery. Increased awareness of these could facilitate training and improve patient outcomes.

Sections du résumé

BACKGROUND BACKGROUND

METHODS METHODS

A committee of 38 international experts in laparoscopic GI surgery proposed and voted on 149 statements in two rounds following a strict modified Delphi protocol.

RESULTS RESULTS

A consensus was achieved on 133 statements after two rounds of voting. All experts agreed on tailoring the first port site to the patient, whereas 84.2% advised avoiding the umbilical area for pneumoperitoneum in patients who had a prior midline laparotomy. Moreover, 86.8% agreed on closing all 15 mm ports irrespective of the patient's body mass index. There was a 100% consensus on using cartridges of appropriate height for stapling, checking the doughnuts after using circular staplers, and keeping the vibrating blade of the ultrasonic energy device in view and away from vascular structures. An 84.2% advised avoiding drain insertion through a ≥10 mm port site as it increases the risk of port-site hernia. There was 94.7% consensus on adding laparoscopic retrieval bags to the operating count and ensuring any surgical specimen left inside for later removal is added to the operating count.

CONCLUSION CONCLUSIONS

Thirty-eight experts achieved a consensus on 133 statements concerning various aspects of laparoscopic GI Surgery. Increased awareness of these could facilitate training and improve patient outcomes.

Identifiants

DOI: 10.1016/j.ijsu.2022.106766 PMID: 35842089

pubmed: 35842089

pii: S1743-9191(22)00543-X

doi: 10.1016/j.ijsu.2022.106766

pii:

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Pagination

106766

Subventions

Organisme : Cancer Research UK

ID : 23924

Pays : United Kingdom