Pan-European survey on the implementation of robotic and laparoscopic minimally invasive liver surgery,HPB

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Pan-European survey on the implementation of robotic and laparoscopic minimally invasive liver surgery
HPB ( IF 2.7 ) Pub Date : 2021-08-21 , DOI: 10.1016/j.hpb.2021.08.939
Maurice J W Zwart ₁ , Burak Görgec ₂ , Abdullah Arabiyat ₃ , Carolijn L M Nota ₄ , Marcel J van der Poel ₁ , Robert S Fichtinger ₅ , Frederik Berrevoet ₆ , Ronald M van Dam ₇ , Luca Aldrighetti ₈ , David Fuks ₉ , Emir Hoti ₁₀ , Bjørn Edwin ₁₁ , Marc G Besselink ₁ , Mohammed Abu Hilal ₁₂ , Jeroen Hagendoorn ₄ , Rutger-Jan Swijnenburg ₁ ,

Affiliation

Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, the Netherlands.
Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, the Netherlands; Department of Surgery, Istituto Fondazione Poliambulanza, Brescia, Italy.
Department of Surgery, The Royal Lancaster Infirmary, University Hospitals of Morecambe Bay, United Kingdom.
Department of Surgery, UMC Utrecht Cancer Center/Regional Academic Cancer Center Utrecht (RAKU), Utrecht, the Netherlands.
Department of Surgery, Maastricht University Medical Center, Maastricht, the Netherlands.
Department of General and HPB Surgery and Liver Transplantation, University Hospital Ghent, Ghent, Belgium.
Department of Surgery, Maastricht University Medical Center, Maastricht, the Netherlands; Department of General, Visceral and Transplant Surgery, University Hospital Aachen, Aachen, Germany.
Department of Surgery, Hepatobiliary Surgery Unit, San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy.
Department of Digestive Surgery, Institut Mutualiste Montsouris, Paris, France.
Department of Surgery, Saint Vincent's University Hospital, Dublin, Ireland.
Interventional Centre and Department of Hepato-pancreato-biliary Surgery, Oslo University Hospital and Institute for Medicine, University in Oslo, Norway.
Department of Surgery, Istituto Fondazione Poliambulanza, Brescia, Italy.

Background

Laparoscopic and robotic minimally invasive liver surgery (MILS) is gaining popularity. Recent data and views on the implementation of laparoscopic and robotic MILS throughout Europe are lacking.

Methods

An anonymous survey consisting of 46 questions was sent to all members of the European-African Hepato-Pancreato-Biliary Association.

Results

The survey was completed by 120 surgeons from 103 centers in 24 countries. Median annual center volume of liver resection was 100 [IQR 50–140]. The median annual volume of MILS per center was 30 [IQR 16–40]. For minor resections, laparoscopic MILS was used by 80 (67%) surgeons and robotic MILS by 35 (29%) surgeons. For major resections, laparoscopic MILS was used by 74 (62%) surgeons and robotic MILS by 33 (28%) surgeons. The majority of the surgeons stated that minimum annual volume of MILS per center should be around 21–30 procedures/year. Of the surgeons performing robotic surgery, 28 (70%) felt they missed specific equipment, such as a robotic-CUSA. Seventy (66%) surgeons provided a formal MILS training to residents and fellows. In 5 years’ time, 106 (88%) surgeons felt that MILS would have superior value as compared to open liver surgery.

Conclusion

In the participating European liver centers, MILS comprised about one third of all liver resections and is expected to increase further. Laparoscopic MILS is still twice as common as robotic MILS. Development of specific instruments for robotic liver parenchymal transection might further increase its adoption.

中文翻译：

机器人和腹腔镜微创肝脏手术实施的泛欧调查

背景

腹腔镜和机器人微创肝脏手术 (MILS) 越来越受欢迎。缺乏有关在整个欧洲实施腹腔镜和机器人 MILS 的最新数据和观点。

方法

一项由 46 个问题组成的匿名调查已发送给欧洲-非洲肝胆胰协会的所有成员。

结果

该调查由来自 24 个国家 103 个中心的 120 名外科医生完成。肝切除的年中心体积中位数为 100 [IQR 50-140]。每个中心的 MILS 年中位数为 30 [IQR 16-40]。对于小切除术，80 名 (67%) 外科医生使用腹腔镜 MILS，35 名 (29%) 外科医生使用机器人 MILS。对于主要切除术，74 名 (62%) 外科医生使用腹腔镜 MILS，33 名 (28%) 外科医生使用机器人 MILS。大多数外科医生表示，每个中心的 MILS 最小年手术量应在 21-30 次/年左右。在进行机器人手术的外科医生中，28 名 (70%) 认为他们错过了特定设备，例如机器人 CUSA。七十名 (66%) 外科医生为住院医师和研究员提供了正式的 MILS 培训。在 5 年的时间里，106 名 (88%) 外科医生认为 MILS 与开腹肝脏手术相比具有更高的价值。