Recommendations on Robotic Hepato-Pancreato-Biliary Surgery. The Paris Jury-Based Consensus Conference.

Journal

Annals of surgery
ISSN: 1528-1140
Titre abrégé: Ann Surg
Pays: United States
ID NLM: 0372354

Informations de publication

Date de publication:
24 May 2024
Historique:
medline: 24 5 2024
pubmed: 24 5 2024
entrez: 24 5 2024
Statut: aheadofprint

Résumé

To establish the first consensus guidelines on the safety and indications of robotics in Hepato-Pancreatic-Biliary (HPB) surgery. The secondary aim was to identify priorities for future research. HPB robotic surgery is reaching the IDEAL 2b exploration phase for innovative technology. An objective assessment endorsed by the HPB community is timely and needed. The ROBOT4HPB conference developed consensus guidelines using the Zurich-Danish model. An impartial and multidisciplinary jury produced unbiased guidelines based on the work of ten expert panels answering predefined key questions and considering the best-quality evidence retrieved after a systematic review. The recommendations conformed with the GRADE and SIGN50 methodologies. Fifty-four experts from 20 countries considered 285 studies, and the conference included an audience of 220 attendees. The jury (n=10) produced recommendations or statements covering five sections of robotic HPB surgery: technology, training and expertise, outcome assessment, and liver and pancreatic procedures. The recommendations supported the feasibility of robotics for most HPB procedures and its potential value in extending minimally invasive indications, emphasizing however the importance of expertise to ensure safety. The concept of expertise was defined broadly, encompassing requirements for credentialing HPB robotics at a given center. The jury prioritized relevant questions for future trials and emphasized the need for prospective registries, including validated outcome metrics for the forthcoming assessment of HPB robotics. The ROBOT4HPB consensus represents a collaborative and multidisciplinary initiative, defining state-of-the-art expertise in HPB robotics procedures. It produced the first guidelines to encourage their safe use and promotion.

Sections du résumé

OBJECTIVE OBJECTIVE
To establish the first consensus guidelines on the safety and indications of robotics in Hepato-Pancreatic-Biliary (HPB) surgery. The secondary aim was to identify priorities for future research.
SUMMARY BACKGROUND DATA BACKGROUND
HPB robotic surgery is reaching the IDEAL 2b exploration phase for innovative technology. An objective assessment endorsed by the HPB community is timely and needed.
METHODS METHODS
The ROBOT4HPB conference developed consensus guidelines using the Zurich-Danish model. An impartial and multidisciplinary jury produced unbiased guidelines based on the work of ten expert panels answering predefined key questions and considering the best-quality evidence retrieved after a systematic review. The recommendations conformed with the GRADE and SIGN50 methodologies.
RESULTS RESULTS
Fifty-four experts from 20 countries considered 285 studies, and the conference included an audience of 220 attendees. The jury (n=10) produced recommendations or statements covering five sections of robotic HPB surgery: technology, training and expertise, outcome assessment, and liver and pancreatic procedures. The recommendations supported the feasibility of robotics for most HPB procedures and its potential value in extending minimally invasive indications, emphasizing however the importance of expertise to ensure safety. The concept of expertise was defined broadly, encompassing requirements for credentialing HPB robotics at a given center. The jury prioritized relevant questions for future trials and emphasized the need for prospective registries, including validated outcome metrics for the forthcoming assessment of HPB robotics.
CONCLUSION CONCLUSIONS
The ROBOT4HPB consensus represents a collaborative and multidisciplinary initiative, defining state-of-the-art expertise in HPB robotics procedures. It produced the first guidelines to encourage their safe use and promotion.

Identifiants

DOI: 10.1097/SLA.0000000000006365 PMID: 38787528
pubmed: 38787528
doi: 10.1097/SLA.0000000000006365
pii: 00000658-990000000-00901
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

Déclaration de conflit d'intérêts

The authors report no conflicts of interest.

Auteurs

Christian Hobeika (C)

Department of Hepato-pancreato-biliary surgery and Liver transplantation, Beaujon Hospital, AP-HP, Clichy, Paris-Cité University, Paris, France.

Matthias Pfister (M)

Department of Surgery and Transplantation, University of Zurich, Zurich, Switzerland.
Wyss Zurich Translational Center, ETH Zurich and University of Zurich, Zurich, Switzerland.

David Geller (D)

Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, USA.

Allan Tsung (A)

Department of Surgery, University of Virginia, Charlottesville, VA, USA.

Albert Chan (A)

Department of Surgery, School of Clinical Medicine, University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China.

Roberto Ivan Troisi (RI)

Department of Clinical Medicine and Surgery, Division of HBP, Minimally Invasive and Robotic Surgery, Transplantation Service, Federico II University Hospital, Naples, Italy.

Mohamed Rela (M)

The Institute of Liver Disease and Transplantation, Dr. Rela Institute and Medical Centre, Chennai, India.

Fabrizio Di Benedetto (F)

Hepato-pancreato-biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena.

Iswanto Sucandy (I)

Department of Hepatopancreatobiliary and Gastrointestinal Surgery, Digestive Health Institute AdventHealth Tampa, Tampa, Florida, United States.

Yuichi Nagakawa (Y)

Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan.

R Matthew Walsh (RM)

Department of General Surgery, Cleveland Clinic, Digestive Diseases and Surgery Institution, OH, USA.

David Kooby (D)

Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA.

Jeffrey Barkun (J)

Department of Surgery, Faculty of Medicine, McGill University, Montreal, QC, Canada.

Olivier Soubrane (O)

Department of Digestive, Metabolic and Oncologic Surgery, Institut Mutualiste Montsouris, University René Descartes Paris 5, Paris, France.

Pierre-Alain Clavien (PA)

Department of Surgery and Transplantation, University of Zurich, Zurich, Switzerland.
Wyss Zurich Translational Center, ETH Zurich and University of Zurich, Zurich, Switzerland.

Classifications MeSH