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Robot-assisted pelvic floor reconstructive surgery: an international Delphi study of expert users

BACKGROUND: 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 th...

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Autores principales: Simoncini, Tommaso, Panattoni, Andrea, Aktas, Mustafa, Ampe, Jozef, Betschart, Cornelia, Bloemendaal, Alexander L. A., Buse, Stephan, Campagna, Giuseppe, Caretto, Marta, Cervigni, Mauro, Consten, Esther C. J., Davila, Hugo H., Dubuisson, Jean, Espin-Basany, Eloy, Fabiani, Bernardina, Faucheron, Jean-Luc, Giannini, Andrea, Gurland, Brooke, Hahnloser, Dieter, Joukhadar, Ralf, Mannella, Paolo, Mereu, Liliana, Martellucci, Jacopo, Meurette, Guillaume, Montt Guevara, Maria Magdalena, Ratto, Carlo, O’Reilly, Barry A., Reisenauer, Christl, Russo, Eleonora, Schraffordt Koops, Steven, Siddiqi, Shahab, Sturiale, Alessandro, Naldini, Gabriele
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10035464/
https://www.ncbi.nlm.nih.gov/pubmed/36952046
http://dx.doi.org/10.1007/s00464-023-10001-4
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author Simoncini, Tommaso
Panattoni, Andrea
Aktas, Mustafa
Ampe, Jozef
Betschart, Cornelia
Bloemendaal, Alexander L. A.
Buse, Stephan
Campagna, Giuseppe
Caretto, Marta
Cervigni, Mauro
Consten, Esther C. J.
Davila, Hugo H.
Dubuisson, Jean
Espin-Basany, Eloy
Fabiani, Bernardina
Faucheron, Jean-Luc
Giannini, Andrea
Gurland, Brooke
Hahnloser, Dieter
Joukhadar, Ralf
Mannella, Paolo
Mereu, Liliana
Martellucci, Jacopo
Meurette, Guillaume
Montt Guevara, Maria Magdalena
Ratto, Carlo
O’Reilly, Barry A.
Reisenauer, Christl
Russo, Eleonora
Schraffordt Koops, Steven
Siddiqi, Shahab
Sturiale, Alessandro
Naldini, Gabriele
author_facet Simoncini, Tommaso
Panattoni, Andrea
Aktas, Mustafa
Ampe, Jozef
Betschart, Cornelia
Bloemendaal, Alexander L. A.
Buse, Stephan
Campagna, Giuseppe
Caretto, Marta
Cervigni, Mauro
Consten, Esther C. J.
Davila, Hugo H.
Dubuisson, Jean
Espin-Basany, Eloy
Fabiani, Bernardina
Faucheron, Jean-Luc
Giannini, Andrea
Gurland, Brooke
Hahnloser, Dieter
Joukhadar, Ralf
Mannella, Paolo
Mereu, Liliana
Martellucci, Jacopo
Meurette, Guillaume
Montt Guevara, Maria Magdalena
Ratto, Carlo
O’Reilly, Barry A.
Reisenauer, Christl
Russo, Eleonora
Schraffordt Koops, Steven
Siddiqi, Shahab
Sturiale, Alessandro
Naldini, Gabriele
author_sort Simoncini, Tommaso
collection PubMed
description BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
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spelling pubmed-100354642023-03-23 Robot-assisted pelvic floor reconstructive surgery: an international Delphi study of expert users Simoncini, Tommaso Panattoni, Andrea Aktas, Mustafa Ampe, Jozef Betschart, Cornelia Bloemendaal, Alexander L. A. Buse, Stephan Campagna, Giuseppe Caretto, Marta Cervigni, Mauro Consten, Esther C. J. Davila, Hugo H. Dubuisson, Jean Espin-Basany, Eloy Fabiani, Bernardina Faucheron, Jean-Luc Giannini, Andrea Gurland, Brooke Hahnloser, Dieter Joukhadar, Ralf Mannella, Paolo Mereu, Liliana Martellucci, Jacopo Meurette, Guillaume Montt Guevara, Maria Magdalena Ratto, Carlo O’Reilly, Barry A. Reisenauer, Christl Russo, Eleonora Schraffordt Koops, Steven Siddiqi, Shahab Sturiale, Alessandro Naldini, Gabriele Surg Endosc Article BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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. Springer US 2023-03-23 2023 /pmc/articles/PMC10035464/ /pubmed/36952046 http://dx.doi.org/10.1007/s00464-023-10001-4 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Simoncini, Tommaso
Panattoni, Andrea
Aktas, Mustafa
Ampe, Jozef
Betschart, Cornelia
Bloemendaal, Alexander L. A.
Buse, Stephan
Campagna, Giuseppe
Caretto, Marta
Cervigni, Mauro
Consten, Esther C. J.
Davila, Hugo H.
Dubuisson, Jean
Espin-Basany, Eloy
Fabiani, Bernardina
Faucheron, Jean-Luc
Giannini, Andrea
Gurland, Brooke
Hahnloser, Dieter
Joukhadar, Ralf
Mannella, Paolo
Mereu, Liliana
Martellucci, Jacopo
Meurette, Guillaume
Montt Guevara, Maria Magdalena
Ratto, Carlo
O’Reilly, Barry A.
Reisenauer, Christl
Russo, Eleonora
Schraffordt Koops, Steven
Siddiqi, Shahab
Sturiale, Alessandro
Naldini, Gabriele
Robot-assisted pelvic floor reconstructive surgery: an international Delphi study of expert users
title Robot-assisted pelvic floor reconstructive surgery: an international Delphi study of expert users
title_full Robot-assisted pelvic floor reconstructive surgery: an international Delphi study of expert users
title_fullStr Robot-assisted pelvic floor reconstructive surgery: an international Delphi study of expert users
title_full_unstemmed Robot-assisted pelvic floor reconstructive surgery: an international Delphi study of expert users
title_short Robot-assisted pelvic floor reconstructive surgery: an international Delphi study of expert users
title_sort robot-assisted pelvic floor reconstructive surgery: an international delphi study of expert users
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10035464/
https://www.ncbi.nlm.nih.gov/pubmed/36952046
http://dx.doi.org/10.1007/s00464-023-10001-4
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