International survey on opinions and use of robot-assisted and laparoscopic minimally invasive pancreatic surgery: 5-year follow up.


Journal

HPB : the official journal of the International Hepato Pancreato Biliary Association
ISSN: 1477-2574
Titre abrégé: HPB (Oxford)
Pays: England
ID NLM: 100900921

Informations de publication

Date de publication:
06 Sep 2023
Historique:
received: 16 05 2023
revised: 14 08 2023
accepted: 04 09 2023
medline: 23 9 2023
pubmed: 23 9 2023
entrez: 22 9 2023
Statut: aheadofprint

Résumé

Evidence on the value of minimally invasive pancreatic surgery (MIPS) has been increasing but it is unclear how this has influenced the view of pancreatic surgeons on MIPS. An anonymous survey was sent to members of eight international Hepato-Pancreato-Biliary Associations. Outcomes were compared with the 2016 international survey. Overall, 315 surgeons from 47 countries participated. The median volume of pancreatic resections per center was 70 (IQR 40-120). Most surgeons considered minimally invasive distal pancreatectomy (MIDP) superior to open (ODP) (94.6%) and open pancreatoduodenectomy (OPD) superior to minimally invasive (MIPD) (67.9%). Since 2016, there has been an increase in the number of surgeons performing both MIDP (79%-85.7%, p = 0.024) and MIPD (29%-45.7%, p < 0.001), and an increase in the use of the robot-assisted approach for both MIDP (16%-45.6%, p < 0.001) and MIPD (23%-47.9%, p < 0.001). The use of laparoscopy remained stable for MIDP (91% vs. 88.1%, p = 0.245) and decreased for MIPD (51%-36.8%, p = 0.024). This survey showed considerable changes of MIPS since 2016 with most surgeons considering MIDP superior to ODP and an increased use of robot-assisted MIPS. Surgeons prefer OPD and therefore the value of MIPD remains to be determined in randomized trials.

Sections du résumé

BACKGROUND BACKGROUND
Evidence on the value of minimally invasive pancreatic surgery (MIPS) has been increasing but it is unclear how this has influenced the view of pancreatic surgeons on MIPS.
METHODS METHODS
An anonymous survey was sent to members of eight international Hepato-Pancreato-Biliary Associations. Outcomes were compared with the 2016 international survey.
RESULTS RESULTS
Overall, 315 surgeons from 47 countries participated. The median volume of pancreatic resections per center was 70 (IQR 40-120). Most surgeons considered minimally invasive distal pancreatectomy (MIDP) superior to open (ODP) (94.6%) and open pancreatoduodenectomy (OPD) superior to minimally invasive (MIPD) (67.9%). Since 2016, there has been an increase in the number of surgeons performing both MIDP (79%-85.7%, p = 0.024) and MIPD (29%-45.7%, p < 0.001), and an increase in the use of the robot-assisted approach for both MIDP (16%-45.6%, p < 0.001) and MIPD (23%-47.9%, p < 0.001). The use of laparoscopy remained stable for MIDP (91% vs. 88.1%, p = 0.245) and decreased for MIPD (51%-36.8%, p = 0.024).
CONCLUSION CONCLUSIONS
This survey showed considerable changes of MIPS since 2016 with most surgeons considering MIDP superior to ODP and an increased use of robot-assisted MIPS. Surgeons prefer OPD and therefore the value of MIPD remains to be determined in randomized trials.

Identifiants

pubmed: 37739876
pii: S1365-182X(23)01923-8
doi: 10.1016/j.hpb.2023.09.004
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Tess M E van Ramshorst (TME)

Department of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy; Amsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands; Cancer Center Amsterdam, the Netherlands. Electronic address: t.vanramshorst@amsterdamUMC.nl.

Jony van Hilst (J)

Amsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands; Cancer Center Amsterdam, the Netherlands; Department of Surgery, OLVG, Amsterdam, the Netherlands.

Elisa Bannone (E)

Department of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy.

Alessandra Pulvirenti (A)

Department of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy.

Horacio J Asbun (HJ)

Division of Hepatobiliary and Pancreas Surgery, Miami Cancer Institute, Miami, FL, USA.

Ugo Boggi (U)

Department of Surgery, University Hospital of Pisa, Pisa, Italy.

Olivier R Busch (OR)

Amsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands; Cancer Center Amsterdam, the Netherlands.

Safi Dokmak (S)

Department of HPB Surgery and Liver Transplantation, APHP Beaujon Hospital - University of Paris Cité, Clichy, France.

Bjørn Edwin (B)

The Intervention Centre and Department of HPB Surgery, Oslo University Hospital, Also Institute of Medicine, University of Oslo, Norway.

Melissa Hogg (M)

Department of Surgery, NorthShore University Health System, Evanston, IL, USA.

Jin-Young Jang (JY)

Department of Surgery, Seoul National University Hospital, Seoul, Republic of Korea.

Tobias Keck (T)

Department of Surgery, University Medical Centre Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.

Igor Khatkov (I)

Department of Surgery, Moscow Clinical Scientific Center, Moscow, Russia.

Gustavo Kohan (G)

Department of Surgery, Hospital Cosme Argerich, University of Buenos Aires, Buenos Aires, Argentina.

Norihiro Kokudo (N)

Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan.

David A Kooby (DA)

Department of Surgery, Winship Cancer Institute, Emory University Hospital, Atlanta, GA, USA.

Masafumi Nakamura (M)

Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

John N Primrose (JN)

Department of Surgery, University of Southampton, Southampton, UK.

Ajith K Siriwardena (AK)

Regional Hepato-Pancreato-Biliary Unit, Manchester Royal Infirmary, Manchester, UK.

Christian Toso (C)

Division of Abdominal Surgery, University Hospitals of Geneva, Geneva, Switzerland.

Charles M Vollmer (CM)

Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.

Herbert J Zeh (HJ)

Department of Surgery, UT Southwestern Medical Center, Dallas, TX, USA.

Marc G Besselink (MG)

Amsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands; Cancer Center Amsterdam, the Netherlands. Electronic address: m.g.besselink@amsterdamUMC.nl.

Mohammad Abu Hilal (M)

Department of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy. Electronic address: abuhilal9@gmail.com.

Classifications MeSH