The first international Delphi consensus statement on Laparoscopic Gastrointestinal surgery.

Autor: Omar I; Wirral University Teaching Hospital NHS Foundation Trust, UK. Electronic address: islamfawzyomar@hotmail.com., Miller K; King's College Hospital London, Dubai, United Arab Emirates., Madhok B; University Hospitals of Derby & Burton NHS Foundation Trust, UK., Amr B; Taunton & Somerset NHS Foundation Trust, UK., Singhal R; University Hospital Birmingham NHS Foundation Trust, UK., Graham Y; University of Sunderland, Sunderland, UK; Universidad Anahuac, Anahuac, Mexico., Pouwels S; Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, the Netherlands., Abu Hilal M; Department of Surgery, Poliambulanza Hospital Brescia, Italy; Southampton University Hospitals NHS Trust, UK., Aggarwal S; All India Institute of Medical Sciences (AIIMS), New Delhi, India., Ahmed I; University of Aberdeen, UK., Aminian A; Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH, USA., Ammori BJ; Burjeel Hospital, United Arab Emirates., Arulampalam T; Colchester Hospital and Anglia Ruskin University, UK., Awan A; University Hospitals of Derby & Burton NHS Foundation Trust, UK., Balibrea JM; Department of Gastrointestinal Surgery, Hospital Clínic, University of Barcelona, Barcelona, Spain., Bhangu A; University of Birmingham, UK., Brady RR; Newcastle Hospitals, UK., Brown W; Monash University Department of Surgery, Alfred Health, Australia., Chand M; University College London, UK., Darzi A; Imperial College London, UK., Gill TS; University Hospital of North Tees, UK., Goel R; Wockhardt Hospital, Mumbai, India., Gopinath BR; North Tees and Hartlepool NHS Trust, UK., Henegouwen MVB; Department of Surgery, Amsterdam UMC, Cancer Center Amsterdam, University of Amsterdam, Amsterdam, the Netherlands., Himpens JM; Delta CHIREC Hospital, Belgium., Kerrigan DD; Phoenix Health, UK., Luyer M; Catharina Hospital Eindhoven, Netherlands., Macutkiewicz C; Manchester University Foundation Trust, UK., Mayol J; Hospital Clinico San Carlos, IdISSC, Universidad Complutense, Madrid, Spain., Purkayastha S; Imperial College London, UK., Rosenthal RJ; Cleveland Clinic Florida, USA., Shikora SA; Center for Metabolic and Bariatric Surgery, USA., Small PK; Bariatric Unit, South Tyneside and Sunderland Foundation Trust, UK., Smart NJ; Royal Devon & Exeter Hospital, UK., Taylor MA; Belfast Health and Social Care, UK., Udwadia TE; Emeritus Professor of Surgery, Grant Medical Hospital, India., Underwood T; University of Southampton, UK., Viswanath YK; James Cook University Hospital, UK., Welch NT; Nottingham University Hospitals NHS Trust, UK., Wexner SD; Cleveland Clinic Florida, USA., Wilson MSJ; NHS Forth Valley, UK., Winter DC; St Vincent's University Hospital, Dublin, Ireland., Mahawar KK; University of Sunderland, Sunderland, UK; Bariatric Unit, South Tyneside and Sunderland Foundation Trust, UK.
Jazyk: angličtina
Zdroj: International journal of surgery (London, England) [Int J Surg] 2022 Aug; Vol. 104, pp. 106766. Date of Electronic Publication: 2022 Jul 13.
DOI: 10.1016/j.ijsu.2022.106766
Abstrakt: 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.
(Crown Copyright © 2022. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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