Laparoscopic sigmoidectomy in Germany--a standardised procedure?
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Laparoscopic sigmoidectomy in Germany--a standardised procedure? / Neudecker, Jens; Bergholz, Robert; Junghans, Tido; Mall, Julian; Schwenk, Wolfgang.
In: LANGENBECK ARCH SURG, Vol. 392, No. 5, 01.09.2007, p. 573-579.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Laparoscopic sigmoidectomy in Germany--a standardised procedure?
AU - Neudecker, Jens
AU - Bergholz, Robert
AU - Junghans, Tido
AU - Mall, Julian
AU - Schwenk, Wolfgang
PY - 2007/9/1
Y1 - 2007/9/1
N2 - BACKGROUND: Laparoscopic resection of the sigmoid colon is generally considered as feasible option to open surgery, but standardised guidelines on surgical details have not been adopted yet. The aim of this survey was to investigate which techniques were applied by laparoscopic surgeons who are members of the Surgical Working Group for Minimal Invasive Surgery (CAMIC) of the German Surgical Society.MATERIALS AND METHODS: In 2005, we conducted a written survey among all members of the CAMIC asking them for their routine surgical strategy of laparoscopic sigmoid resection in a standardised multiple-choice questionnaire. This questionnaire consisted of 20 questions covering main technical issues of laparoscopic sigmoid resection including trocar and team positioning, mobilisation and resection of the left colon, specimen retrieval as well as anastomosing technique. The results were classified into four levels of consensus depending on the level of agreement between participating surgeons.RESULTS: There were 292 surgeons who took part in the survey. Strong consensus (>95% agreement) was only found in 1 of 20 technical details: the operating surgeon standing at the patient right's side. Consensus (75-95% agreement) was found for: position of the first assistant standing to the patient's left side, size of the camera port is 10 mm, lateral mobilisation of the left hemicolon before ligating the inferior mesenteric artery, extracorporeal resection of the sigmoid via minilaparotomy, transrectal stapling of the colorectal anastomosis, intraoperative testing of the anastomosis for leakage, no regular suturing over the anastomosis and irrigating of the abdominal cavity after surgery.CONCLUSIONS: Variability of technical details of laparoscopic sigmoidectomy was surprisingly high among German laparoscopic surgeons. This fact should be considered when discussing clinical studies about laparoscopic sigmoidectomy because trocar position, type of minilaparotomy and dissection techniques may very well influence patient outcome after laparoscopic surgery. Therefore, publications of clinical results concerning laparoscopic sigmoid resection should include a precise description of the technical details of the operation.
AB - BACKGROUND: Laparoscopic resection of the sigmoid colon is generally considered as feasible option to open surgery, but standardised guidelines on surgical details have not been adopted yet. The aim of this survey was to investigate which techniques were applied by laparoscopic surgeons who are members of the Surgical Working Group for Minimal Invasive Surgery (CAMIC) of the German Surgical Society.MATERIALS AND METHODS: In 2005, we conducted a written survey among all members of the CAMIC asking them for their routine surgical strategy of laparoscopic sigmoid resection in a standardised multiple-choice questionnaire. This questionnaire consisted of 20 questions covering main technical issues of laparoscopic sigmoid resection including trocar and team positioning, mobilisation and resection of the left colon, specimen retrieval as well as anastomosing technique. The results were classified into four levels of consensus depending on the level of agreement between participating surgeons.RESULTS: There were 292 surgeons who took part in the survey. Strong consensus (>95% agreement) was only found in 1 of 20 technical details: the operating surgeon standing at the patient right's side. Consensus (75-95% agreement) was found for: position of the first assistant standing to the patient's left side, size of the camera port is 10 mm, lateral mobilisation of the left hemicolon before ligating the inferior mesenteric artery, extracorporeal resection of the sigmoid via minilaparotomy, transrectal stapling of the colorectal anastomosis, intraoperative testing of the anastomosis for leakage, no regular suturing over the anastomosis and irrigating of the abdominal cavity after surgery.CONCLUSIONS: Variability of technical details of laparoscopic sigmoidectomy was surprisingly high among German laparoscopic surgeons. This fact should be considered when discussing clinical studies about laparoscopic sigmoidectomy because trocar position, type of minilaparotomy and dissection techniques may very well influence patient outcome after laparoscopic surgery. Therefore, publications of clinical results concerning laparoscopic sigmoid resection should include a precise description of the technical details of the operation.
KW - Anastomosis, Surgical
KW - Colon, Sigmoid
KW - Consensus
KW - Feasibility Studies
KW - Germany
KW - Humans
KW - Laparoscopy
KW - Practice Guidelines as Topic
KW - Questionnaires
KW - Sigmoid Diseases
KW - Sigmoid Neoplasms
KW - Societies, Medical
KW - Surgical Procedures, Minimally Invasive
U2 - 10.1007/s00423-007-0172-7
DO - 10.1007/s00423-007-0172-7
M3 - SCORING: Journal article
C2 - 17375318
VL - 392
SP - 573
EP - 579
JO - LANGENBECK ARCH SURG
JF - LANGENBECK ARCH SURG
SN - 1435-2443
IS - 5
ER -