TY - JOUR
T1 - Robot-assisted pelvic floor reconstructive surgery: an international Delphi study of expert users
AU - Simoncini, Tommaso
AU - Panattoni, Andrea
AU - Aktas, Mustafa
AU - Ampe, Jozef
AU - Betschart, Cornelia
AU - Bloemendaal, Alexander L. A.
AU - Buse, Stephan
AU - Campagna, Giuseppe
AU - Caretto, Marta
AU - Cervigni, Mauro
AU - Consten, Esther C. J.
AU - Davila, Hugo H.
AU - Dubuisson, Jean
AU - Espin-Basany, Eloy
AU - Fabiani, Bernardina
AU - Faucheron, Jean-Luc
AU - Giannini, Andrea
AU - Gurland, Brooke
AU - Hahnloser, Dieter
AU - Joukhadar, Ralf
AU - Mannella, Paolo
AU - Mereu, Liliana
AU - Martellucci, Jacopo
AU - Meurette, Guillaume
AU - Montt Guevara, Maria Magdalena
AU - Ratto, Carlo
AU - O’Reilly, Barry A.
AU - Reisenauer, Christl
AU - Russo, Eleonora
AU - Russo, Elisa
AU - Schraffordt Koops, Steven
AU - Siddiqi, Shahab
AU - Sturiale, Alessandro
AU - Naldini, Gabriele
PY - 2023
Y1 - 2023
N2 - 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.
AB - 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.
KW - Delphi consensus
KW - Pelvic floor reconstructive surgery
KW - Robotic surgery
KW - Rectal prolapse
KW - Pelvic organ prolapse
KW - Delphi consensus
KW - Pelvic floor reconstructive surgery
KW - Robotic surgery
KW - Rectal prolapse
KW - Pelvic organ prolapse
UR - http://hdl.handle.net/10807/236062
U2 - 10.1007/s00464-023-10001-4
DO - 10.1007/s00464-023-10001-4
M3 - Article
SN - 0930-2794
VL - 2023
SP - 1
EP - 11
JO - Surgical Endoscopy
JF - Surgical Endoscopy
ER -