TY - JOUR
T1 - The first international Delphi consensus statement on Laparoscopic Gastrointestinal surgery
T2 - Laparoscopic GI Surgery Consensus
AU - Omar, Islam
AU - Miller, Karl
AU - Madhok, Brijesh
AU - Amr, Bassem
AU - Singhal, Rishi
AU - Graham, Yitka
AU - Pouwels, Sjaak
AU - Abu Hilal, Mohammad
AU - Aggarwal, Sandeep
AU - Ahmed, Irfan
AU - Aminian, Ali
AU - Ammori, Basil Jaser
AU - Arulampalam, Tan
AU - Awan, Altaf
AU - Balibrea, José María
AU - Bhangu, Aneel
AU - Brady, Richard Raymond
AU - Brown, Wendy
AU - Chand, Manish
AU - Darzi, Ara
AU - Gill, Talvinder Singh
AU - Goel, Ramen
AU - Gopinath, Bussa R.
AU - Henegouwen, Mark van Berge
AU - Himpens, Jacques M.
AU - Kerrigan, David Daniel
AU - Luyer, Misha
AU - Macutkiewicz, Christian
AU - Mayol, Julio
AU - Purkayastha, Sanjay
AU - Rosenthal, Raul Jacobo
AU - Shikora, Scott Alan
AU - Small, Peter Kenneth
AU - Smart, Neil James
AU - Taylor, Mark A.
AU - Udwadia, Tehemton E.
AU - Underwood, Tim
AU - Viswanath, Yirupaiahgari KS
AU - Welch, Neil Thomas
AU - Wexner, Steven D.
AU - Wilson, Michael Samuel James
AU - Winter, Des C.
AU - Mahawar, Kamal K.
N1 - Funding Information:
MH: Consultant for Medtronic, Johnson and Johnson, Mylan, Alesi Surgical, BBraun and received unrestricted grants from Stryker (all funding paid to institution).
PY - 2022/8/1
Y1 - 2022/8/1
N2 - Background: 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. 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: 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: 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.
AB - Background: 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. 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: 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: 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.
KW - Ergonomics
KW - Gastrointestinal surgery
KW - Guidelines
KW - Hepatobiliary
KW - Laparoscopic surgery
KW - Minimally invasive
KW - Patient safety
KW - Surgical training
UR - http://www.scopus.com/inward/record.url?scp=85134580472&partnerID=8YFLogxK
U2 - 10.1016/j.ijsu.2022.106766
DO - 10.1016/j.ijsu.2022.106766
M3 - Article
C2 - 35842089
AN - SCOPUS:85134580472
SN - 1743-9191
VL - 104
JO - International Journal of Surgery
JF - International Journal of Surgery
M1 - 106766
ER -