TY - JOUR
T1 - Advancing minimally invasive hepato-pancreato-biliary surgery
T2 - ensuring safety with implementation
AU - SAGES HPB Committee
AU - Wang, Jane
AU - Lu, Pamela
AU - Armstrong, Misha
AU - El-Hayek, Kevin
AU - Cleary, Sean
AU - Asbun, Horacio
AU - Alseidi, Adnan
AU - Wei, Alice
AU - Tran Cao, Hop S.
AU - Asbun, Domenech
AU - Ayloo, Subhashini
AU - Fretland, Åsmund Avdem
AU - Georgakis, Georgios
AU - Gleisner, Ana
AU - Hogg, Melissa
AU - Kutlu, Onur
AU - Kwon, David
AU - Onkendi, Edwin
AU - Patel, Ankit D.
AU - Pecorelli, Nicolò
AU - Polanco, Patricio M.
AU - Ross, Sharona
AU - Shah, Mihir M.
AU - Simoneau, Eve
AU - Soubrane, Olivier
AU - Sucandy, Iswanto
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024.
PY - 2024/8
Y1 - 2024/8
N2 - Background: Although minimally invasive hepato-pancreato-biliary (MIS HPB) surgery can be performed with good outcomes, there are currently no standardized requirements for centers or surgeons who wish to implement MIS HPB surgery. The aim of this study was to create a consensus statement regarding safe dissemination and implementation of MIS HPB surgical programs. Methods: Sixteen key questions regarding safety in MIS HPB surgery were generated after a focused literature search and iterative review by three field experts. Participants for the working group were then selected using sequential purposive sampling and snowball techniques. Review of the 16 questions took place over a single 2-h meeting. The senior author facilitated the session, and a modified nominal group technique was used. Results: Twenty three surgeons were in attendance. All participants agreed or strongly agreed that formal guidelines should exist for both institutions and individual surgeons interested in implementing MIS HPB surgery and that routine monitoring and reporting of institutional and surgeon technical outcomes should be performed. Regarding volume cutoffs, most participants (91%) agreed or strongly agreed that a minimum annual institutional volume cutoff for complex MIS HPB surgery, such as major hepatectomy or pancreaticoduodenectomy, should exist. A smaller proportion (74%) agreed or strongly agreed that a minimum annual surgeon volume requirement should exist. The majority of participants agreed or strongly agreed that surgeons were responsible for defining (100%) and enforcing (78%) guidelines to ensure the overall safety of MIS HPB programs. Finally, formal MIS HPB training, minimum case volume requirements, institutional support and infrastructure, and mandatory collection of outcomes data were all recognized as important aspects of safe implementation of MIS HPB surgery. Conclusions: Safe implementation of MIS HPB surgery requires a thoughtful process that incorporates structured training, sufficient volume and expertise, a proper institutional ecosystem, and monitoring of outcomes.
AB - Background: Although minimally invasive hepato-pancreato-biliary (MIS HPB) surgery can be performed with good outcomes, there are currently no standardized requirements for centers or surgeons who wish to implement MIS HPB surgery. The aim of this study was to create a consensus statement regarding safe dissemination and implementation of MIS HPB surgical programs. Methods: Sixteen key questions regarding safety in MIS HPB surgery were generated after a focused literature search and iterative review by three field experts. Participants for the working group were then selected using sequential purposive sampling and snowball techniques. Review of the 16 questions took place over a single 2-h meeting. The senior author facilitated the session, and a modified nominal group technique was used. Results: Twenty three surgeons were in attendance. All participants agreed or strongly agreed that formal guidelines should exist for both institutions and individual surgeons interested in implementing MIS HPB surgery and that routine monitoring and reporting of institutional and surgeon technical outcomes should be performed. Regarding volume cutoffs, most participants (91%) agreed or strongly agreed that a minimum annual institutional volume cutoff for complex MIS HPB surgery, such as major hepatectomy or pancreaticoduodenectomy, should exist. A smaller proportion (74%) agreed or strongly agreed that a minimum annual surgeon volume requirement should exist. The majority of participants agreed or strongly agreed that surgeons were responsible for defining (100%) and enforcing (78%) guidelines to ensure the overall safety of MIS HPB programs. Finally, formal MIS HPB training, minimum case volume requirements, institutional support and infrastructure, and mandatory collection of outcomes data were all recognized as important aspects of safe implementation of MIS HPB surgery. Conclusions: Safe implementation of MIS HPB surgery requires a thoughtful process that incorporates structured training, sufficient volume and expertise, a proper institutional ecosystem, and monitoring of outcomes.
KW - HPB surgery
KW - Laparoscopy
KW - MIS
KW - Robotic surgery
KW - Safety
UR - https://www.scopus.com/pages/publications/85200276217
U2 - 10.1007/s00464-024-10957-x
DO - 10.1007/s00464-024-10957-x
M3 - Article
C2 - 38886227
AN - SCOPUS:85200276217
SN - 0930-2794
VL - 38
SP - 4365
EP - 4373
JO - Surgical Endoscopy
JF - Surgical Endoscopy
IS - 8
ER -