wetenschapsdag 2023 | 61 Sessie 2a: Den Nederlanden - en Daar Voorbij x5 Auteurs A.A.J. Grüter, B.R. Toorenvliet, E.H.J. Belgers, E.J.T. Belt, P. van Duijvendijk, C. Hoff, R. Hompes, A.B. Smits, A.W.H. van de Ven, H.L. van Westreenen, P.J. Tanis, J.B. Tuynman Abstract titel Nationwide Standardization of the Minimally Invasive Right Hemicolectomy and Development and Validation of Video-based Competency Assessment Tool (phase 2 of Right Study) Background Currently, substantial variation is present in the surgical performance of a minimally invasive right hemicolectomy (MIRH). The aim of this study was to reach national consensus about the most optimal and standardized surgical technique for MIRH and to develop and validate a video-based competency assessment tool (CAT) to assess MIRH. Methods The standardization of MIRH was accomplished using a threeround Delphi method, with the first 2 rounds being online and the last physically with 76 colorectal surgeons. A systematic review on all the elements of MIRH was utilized together with opinions from European experts in MIRH to draw up 24 detailed statements for the Delphi rounds. A CAT was developed using the Delphi results and 12 unedited full-length videos of the Right study’s database were all assessed by 9 different expert colorectal surgeons validating the CAT using intra-class correlation coefficient (ICC). Results After 3 rounds, at least 80% consensus has been reached on 23 of the 24 statements. Consensus statements included the use of low-pressure pneumoperitoneum, the performance of a complete mesocolic excision (CME) with detailed definitions and steps how to achieve central vascular ligation (CVL) and D2 lymphadenectomy, the creation of an intracorporeal anastomosis, and the extraction of the specimen through a Pfannenstiel incision with the use of a wound protector. The CAT consists of 7 consecutive steps, starting with “Setup and exposure of the operating field” and ending with “Anastomosis”. The CAT was validated with a high consistency amongst surgeons with an overall ICC of 0.923. Conclusion Nationwide standardization and optimization of the MIRH for right-sided colon cancer for the Right study was reached with detailed description of procedural steps. An objective detailed CAT was developed and validated to evaluate learning curves and implementation of the standardized MIRH in the Netherlands with the goal to improve clinical outcomes.
RkJQdWJsaXNoZXIy MTk4NDMw