D Miskovic1, J Ahmed2, R Bissett-Amess2, M Gómez Ruiz3, F Luca4, D Jayne5, N Figueiredo2, R J Heald2, G Spinoglio6, A Parvaiz7,8,9. 1. Department of Colorectal Surgery, St Mark's Hospital Harrow, London, UK. 2. Champalimaud Clinical Centre - Champalimaud Foundation, Lisbon, Portugal. 3. Hospital Universitario Marques de Valdecilla, Santander, Spain. 4. Department of Surgery, Loma Linda University Health, Loma Linda, CA, USA. 5. St James's University Hospital, University of Leeds, Leeds, UK. 6. Surgical Department, National Hospital, Alessandria, Italy. 7. Director of European Academy of Robotic Colorectal Surgery (EARCS), Champalimaud Foundation, Lisbon, Portugal. 8. Head of Laparoscopic & Robotic Colorectal Surgery, Champalimaud Foundation, Lisbon, Portugal. 9. Laparoscopic and Robotic Colorectal Surgery, Poole General Hospital, Poole, UK.
Abstract
AIM: Surgery for rectal cancer is challenging for both technical and anatomical reasons. The European Academy of Robotic Colorectal Surgery (EARCS) provides a competency-based training programme through a standardized approach. However, there is no consensus on technical standards for robotic surgery when used during surgery for rectal cancer. The aim of this consensus study was to establish operative standards for anterior resection incorporating total mesorectal excision (TME) using robotic techniques, based on recommendations of expert European colorectal surgeons. METHOD: A Delphi questionnaire with a 72-item statement was sent through an electronic survey tool to 24 EARCS faculty members from 10 different countries who were selected based on expertise in robotic colorectal surgery. The task was divided into theatre setup, colonic mobilization and rectal dissection, and each task area was further divided into several subtasks. The levels of agreement (A* > 95% agreement, A > 90%, B > 80% and C > 70%) were considered adequate while agreement of < 70% was considered inadequate. Once consensus was reached, a draft document was compiled and sent out for final approval. RESULTS: The average length of experience of robotic colorectal surgery for participants in this study was 6 years. Initial agreement was 87%; in nine items, it was < 70%. After suggested modifications, the average level of agreement for all items reached 94% in the second round (range 0.75-1). CONCLUSION: This is the first European consensus on the standardization of robotic TME. It provides a baseline for technical standards and structured training in robotic rectal surgery. Colorectal Disease
AIM: Surgery for rectal cancer is challenging for both technical and anatomical reasons. The European Academy of Robotic Colorectal Surgery (EARCS) provides a competency-based training programme through a standardized approach. However, there is no consensus on technical standards for robotic surgery when used during surgery for rectal cancer. The aim of this consensus study was to establish operative standards for anterior resection incorporating total mesorectal excision (TME) using robotic techniques, based on recommendations of expert European colorectal surgeons. METHOD: A Delphi questionnaire with a 72-item statement was sent through an electronic survey tool to 24 EARCS faculty members from 10 different countries who were selected based on expertise in robotic colorectal surgery. The task was divided into theatre setup, colonic mobilization and rectal dissection, and each task area was further divided into several subtasks. The levels of agreement (A* > 95% agreement, A > 90%, B > 80% and C > 70%) were considered adequate while agreement of < 70% was considered inadequate. Once consensus was reached, a draft document was compiled and sent out for final approval. RESULTS: The average length of experience of robotic colorectal surgery for participants in this study was 6 years. Initial agreement was 87%; in nine items, it was < 70%. After suggested modifications, the average level of agreement for all items reached 94% in the second round (range 0.75-1). CONCLUSION: This is the first European consensus on the standardization of robotic TME. It provides a baseline for technical standards and structured training in robotic rectal surgery. Colorectal Disease
Authors: Catharina Müller; Johannes Laengle; Stefan Riss; Michael Bergmann; Thomas Bachleitner-Hofmann Journal: Front Oncol Date: 2021-02-16 Impact factor: 6.244
Authors: Christina A Fleming; Oroog Ali; Joshua M Clements; Johnathan Hirniak; Martin King; Helen M Mohan; Deirdre M Nally; Josh Burke Journal: J Robot Surg Date: 2021-11-26