TY - JOUR
T1 - European association for endoscopic surgery (EAES) consensus statement on single-incision endoscopic surgery
AU - Morales-Conde, Salvador
AU - Peeters, Andrea
AU - Meyer, Yannick M
AU - Antoniou, Stavros A
AU - Del Agua, Isaías Alarcón
AU - Arezzo, Alberto
AU - Arolfo, Simone
AU - Yehuda, Amir Ben
AU - Boni, Luigi
AU - Cassinotti, Elisa
AU - Dapri, Giovanni
AU - Yang, Tao
AU - Fransen, Sofie
AU - Forgione, Antonello
AU - Hajibandeh, Shahab
AU - Hajibandeh, Shahin
AU - Mazzola, Michele
AU - Migliore, Marco
AU - Mittermair, Christof
AU - Mittermair, Doris
AU - Morandeira-Rivas, Antonio
AU - Moreno-Sanz, Carlos
AU - Morlacchi, Andrea
AU - Nizri, Eran
AU - Nuijts, Myrthe
AU - Raakow, Jonas
AU - Sánchez-Margallo, Francisco M
AU - Sánchez-Margallo, Juan A
AU - Szold, Amir
AU - Weiss, Helmut
AU - Weiss, Michael
AU - Zorron, Ricardo
AU - Bouvy, Nicole D
PY - 2019/4
Y1 - 2019/4
N2 - BACKGROUND: Laparoscopic surgery changed the management of numerous surgical conditions. It was associated with many advantages over open surgery, such as decreased postoperative pain, faster recovery, shorter hospital stay and excellent cosmesis. Since two decades single-incision endoscopic surgery (SIES) was introduced to the surgical community. SIES could possibly result in even better postoperative outcomes than multi-port laparoscopic surgery, especially concerning cosmetic outcomes and pain. However, the single-incision surgical procedure is associated with quite some challenges.METHODS: An expert panel of surgeons has been selected and invited to participate in the preparation of the material for a consensus meeting on the topic SIES, which was held during the EAES congress in Frankfurt, June 16, 2017. The material presented during the consensus meeting was based on evidence identified through a systematic search of literature according to a pre-specified protocol. Three main topics with respect to SIES have been identified by the panel: (1) General, (2) Organ specific, (3) New development. Within each of these topics, subcategories have been defined. Evidence was graded according to the Oxford 2011 Levels of Evidence. Recommendations were made according to the GRADE criteria.RESULTS: In general, there is a lack of high level evidence and a lack of long-term follow-up in the field of single-incision endoscopic surgery. In selected patients, the single-incision approach seems to be safe and effective in terms of perioperative morbidity. Satisfaction with cosmesis has been established to be the main advantage of the single-incision approach. Less pain after single-incision approach compared to conventional laparoscopy seems to be considered an advantage, although it has not been consistently demonstrated across studies.CONCLUSIONS: Considering the increased direct costs (devices, instruments and operating time) of the SIES procedure and the prolonged learning curve, wider acceptance of the procedure should be supported only after demonstration of clear benefits.
AB - BACKGROUND: Laparoscopic surgery changed the management of numerous surgical conditions. It was associated with many advantages over open surgery, such as decreased postoperative pain, faster recovery, shorter hospital stay and excellent cosmesis. Since two decades single-incision endoscopic surgery (SIES) was introduced to the surgical community. SIES could possibly result in even better postoperative outcomes than multi-port laparoscopic surgery, especially concerning cosmetic outcomes and pain. However, the single-incision surgical procedure is associated with quite some challenges.METHODS: An expert panel of surgeons has been selected and invited to participate in the preparation of the material for a consensus meeting on the topic SIES, which was held during the EAES congress in Frankfurt, June 16, 2017. The material presented during the consensus meeting was based on evidence identified through a systematic search of literature according to a pre-specified protocol. Three main topics with respect to SIES have been identified by the panel: (1) General, (2) Organ specific, (3) New development. Within each of these topics, subcategories have been defined. Evidence was graded according to the Oxford 2011 Levels of Evidence. Recommendations were made according to the GRADE criteria.RESULTS: In general, there is a lack of high level evidence and a lack of long-term follow-up in the field of single-incision endoscopic surgery. In selected patients, the single-incision approach seems to be safe and effective in terms of perioperative morbidity. Satisfaction with cosmesis has been established to be the main advantage of the single-incision approach. Less pain after single-incision approach compared to conventional laparoscopy seems to be considered an advantage, although it has not been consistently demonstrated across studies.CONCLUSIONS: Considering the increased direct costs (devices, instruments and operating time) of the SIES procedure and the prolonged learning curve, wider acceptance of the procedure should be supported only after demonstration of clear benefits.
KW - Single incision
KW - Laparoscopy
KW - Laparoscopic surgery
KW - Consensus
KW - Statement
KW - Recommendation
KW - RANDOMIZED CONTROLLED-TRIAL
KW - LAPAROSCOPIC COLORECTAL SURGERY
KW - SITE ROBOTIC CHOLECYSTECTOMY
KW - INGUINAL-HERNIA REPAIR
KW - SHORT-TERM OUTCOMES
KW - PORT SLEEVE GASTRECTOMY
KW - SIGMOID COLON-CANCER
KW - QUALITY-OF-LIFE
KW - ANTERIOR RESECTION
KW - CLINICAL-TRIAL
U2 - 10.1007/s00464-019-06693-2
DO - 10.1007/s00464-019-06693-2
M3 - Article
C2 - 30771069
VL - 33
SP - 996
EP - 1019
JO - Surgical endoscopy and other interventional techniques
JF - Surgical endoscopy and other interventional techniques
SN - 0930-2794
IS - 4
ER -