Pan-European survey on the implementation of robotic and laparoscopic minimally invasive liver surgery
Pan-European survey on the implementation of robotic and laparoscopic minimally invasive liver surgery
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DOI：
10.1016/j.hpb.2021.08.939
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发表时间：
2022-02-18
期刊：
影响因子：
2.9
通讯作者：
Swijnenburg, Rutger-Jan
中科院分区：
文献类型：
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作者：
Zwart, Maurice J. W.;Gorgec, Burak;Swijnenburg, Rutger-Jan
背景：腹腔镜和机器人微创肝脏手术（MILS）越来越受欢迎。最近的数据和意见的实施腹腔镜和机器人MILS整个欧洲是缺乏的。方法：向欧洲非洲肝胆胰协会的所有成员发送了一份由46个问题组成的匿名调查。结果：调查由来自24个国家103个中心的120名外科医生完成。中位年中心肝切除量为100 [IQR 50-140]。每个中心的MILS年中位量为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。对于大切除术，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，每家临床试验机构的MILS最低年手术量应为21-30例/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的设备，例如机器人CUSA。70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与开放性肝脏手术相比具有上级价值。结论：在参与的欧洲肝脏中心，MILS约占所有肝切除术的三分之一，预计将进一步增加。腹腔镜MILS仍然是机器人MILS的两倍。开发机器人肝实质横切的专用器械可能会进一步增加其采用。
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 EuropeanAfrican 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.