Maurice J W Zwart1, Burak Görgec2, Abdullah Arabiyat3, Carolijn L M Nota4, Marcel J van der Poel1, Robert S Fichtinger5, Frederik Berrevoet6, Ronald M van Dam7, Luca Aldrighetti8, David Fuks9, Emir Hoti10, Bjørn Edwin11, Marc G Besselink1, Mohammed Abu Hilal12, Jeroen Hagendoorn4, Rutger-Jan Swijnenburg13. 1. Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, the Netherlands. 2. Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, the Netherlands; Department of Surgery, Istituto Fondazione Poliambulanza, Brescia, Italy. 3. Department of Surgery, The Royal Lancaster Infirmary, University Hospitals of Morecambe Bay, United Kingdom. 4. Department of Surgery, UMC Utrecht Cancer Center/Regional Academic Cancer Center Utrecht (RAKU), Utrecht, the Netherlands. 5. Department of Surgery, Maastricht University Medical Center, Maastricht, the Netherlands. 6. Department of General and HPB Surgery and Liver Transplantation, University Hospital Ghent, Ghent, Belgium. 7. Department of Surgery, Maastricht University Medical Center, Maastricht, the Netherlands; Department of General, Visceral and Transplant Surgery, University Hospital Aachen, Aachen, Germany. 8. Department of Surgery, Hepatobiliary Surgery Unit, San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy. 9. Department of Digestive Surgery, Institut Mutualiste Montsouris, Paris, France. 10. Department of Surgery, Saint Vincent's University Hospital, Dublin, Ireland. 11. Interventional Centre and Department of Hepato-pancreato-biliary Surgery, Oslo University Hospital and Institute for Medicine, University in Oslo, Norway. 12. Department of Surgery, Istituto Fondazione Poliambulanza, Brescia, Italy. Electronic address: abuhilal9@gmail.com. 13. Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, the Netherlands. Electronic address: r.j.swijnenburg@amsterdamumc.nl.
Abstract
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.
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.
Authors: Anne-Sophie Mehdorn; Florian Richter; Katharina Hess; Jan Henrik Beckmann; Jan-Hendrik Egberts; Michael Linecker; Thomas Becker; Felix Braun Journal: J Clin Med Date: 2022-06-19 Impact factor: 4.964