Robot-assisted pelvic floor reconstructive surgery : an international Delphi study of expert users
Simoncini, Tommaso (University of Pisa)
Panattoni, Andrea (University of Pisa)
Aktas, Mustafa (Maasstad Hospital)
Ampe, Jozef (AZ Sint-Jan Bruges Hospitals)
Betschart, Cornelia (University of Zurich)
Bloemendaal, Alexander L. A. (Reinier de Graaf Hospital)
Buse, Stephan (Alfried Krupp Hospital)
Campagna, Giuseppe (University Hospital A. Gemelli IRCCS)
Caretto, Marta (University of Pisa)
Cervigni, Mauro (La Sapienza University-Polo Pontino ICOT)
Consten, Esther C. J. (University Medical Center Groningen)
Davila, Hugo H. (Cleveland Clinic Indian River Hospital)
Dubuisson, Jean (Geneva University Hospitals and University of Geneva)
Espin-Basany, Eloy (Hospital Universitari Vall d'Hebron)
Fabiani, Bernardina (Cisanello University Hospital)
Faucheron, Jean-Luc (Grenoble Alps University Hospital)
Giannini, Andrea (University of Pisa)
Gurland, Brooke (Stanford University School of Medicine)
Hahnloser, Dieter (Lausanne University Hospital)
Joukhadar, Ralf (University of Wuerzburg)
Mannella, Paolo (University of Pisa)
Mereu, Liliana (Cannizzaro Hospital)
Martellucci, Jacopo (Careggi University Hospital (Florència, Itàlia))
Meurette, Guillaume (CHU de Nantes)
Montt Guevara, Maria Magdalena (University of Pisa)
Ratto, Carlo (Università Cattolica del Sacro Cuore)
O'Reilly, Barry A. (Cork University Maternity Hospital)
Reisenauer, Christl (University Hospital Tuebingen)
Russo, Eleonora (University of Pisa)
Schraffordt Koops, Steven (Meander Medical Center)
Siddiqi, Shahab (Broomfield Hospital)
Sturiale, Alessandro (Cisanello University Hospital)
Naldini, Gabriele (Cisanello University Hospital)
Universitat Autònoma de Barcelona

Data:	2023
Resum:	Robotic surgery has gained popularity for the reconstruction of pelvic floor defects. Nonetheless, there is no evidence that robot-assisted reconstructive surgery is either appropriate or superior to standard laparoscopy for the performance of pelvic floor reconstructive procedures or that it is sustainable. The aim of this project was to address the proper role of robotic pelvic floor reconstructive procedures using expert opinion. We set up an international, multidisciplinary group of 26 experts to participate in a Delphi process on robotics as applied to pelvic floor reconstructive surgery. The group comprised urogynecologists, urologists, and colorectal surgeons with long-term experience in the performance of pelvic floor reconstructive procedures and with the use of the robot, who were identified primarily based on peer-reviewed publications. Two rounds of the Delphi process were conducted. The first included 63 statements pertaining to surgeons' characteristics, general questions, indications, surgical technique, and future-oriented questions. A second round including 20 statements was used to reassess those statements where borderline agreement was obtained during the first round. The final step consisted of a face-to-face meeting with all participants to present and discuss the results of the analysis. The 26 experts agreed that robotics is a suitable indication for pelvic floor reconstructive surgery because of the significant technical advantages that it confers relative to standard laparoscopy. Experts considered these advantages particularly important for the execution of complex reconstructive procedures, although the benefits can be found also during less challenging cases. The experts considered the robot safe and effective for pelvic floor reconstruction and generally thought that the additional costs are offset by the increased surgical efficacy. Robotics is a suitable choice for pelvic reconstruction, but this Delphi initiative calls for more research to objectively assess the specific settings where robotic surgery would provide the most benefit.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Delphi consensus ; Pelvic floor reconstructive surgery ; Pelvic organ prolapse ; Rectal prolapse ; Robotic surgery
Publicat a:	Surgical endoscopy, march 2023, p. 1-11, ISSN 1432-2218

DOI: 10.1007/s00464-023-10001-4
PMID: 36952046

11 p, 601.5 KB

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