TY - JOUR
T1 - Nationwide standardization of minimally invasive right hemicolectomy for colon cancer and development and validation of a video-based competency assessment tool (the Right study)
AU - Grüter, Alexander A. J.
AU - Toorenvliet, Boudewijn R.
AU - Belgers, Eric H. J.
AU - Belt, Eric J. T.
AU - van Duijvendijk, Peter
AU - Hoff, Christiaan
AU - Hompes, Roel
AU - Smits, Anke B.
AU - van de Ven, Anthony W. H.
AU - van Westreenen, Henderik L.
AU - Bonjer, Hendrik J.
AU - Right collaborators group
AU - Tanis, Pieter J.
AU - Tuynman, Jurriaan B.
N1 - Funding Information: We have not received funding for this work. However, Medtronic and Ethicon have provided financial support for the hands-on training and proctoring of the standardized technique. It is important to note that their support was provided without exerting any influence over the standardized procedure. Publisher Copyright: © The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd.
PY - 2024/1/1
Y1 - 2024/1/1
N2 - BACKGROUND: Substantial variation exists when performing a minimally invasive right hemicolectomy (MIRH) due to disparities in training, expertise and differences in implementation of innovations. This study aimed to achieve national consensus on an optimal and standardized MIRH technique for colon cancer and to develop and validate a video-based competency assessment tool (CAT) for MIRH. METHOD: Statements covering all elements of MIRH were formulated. Subsequently, the Delphi technique was used to reach consensus on a standardized MIRH among 76 colorectal surgeons from 43 different centres. A CAT was developed based on the Delphi results. Nine surgeons assessed the same 12 unedited full-length videos using the CAT, allowing evaluation of the intraclass correlation coefficient (ICC). RESULTS: After three Delphi rounds, consensus (≥80% agreement) was achieved on 23 of the 24 statements. Consensus statements included the use of low intra-abdominal pressure, detailed anatomical outline how to perform complete mesocolic excision with central vascular ligation, the creation of an intracorporeal anastomosis, and specimen extraction through a Pfannenstiel incision using a wound protector. The CAT included seven consecutive steps to measure competency of the MIRH and showed high consistency among surgeons with an overall ICC of 0.923. CONCLUSION: Nationwide consensus on a standardized and optimized technique of MIRH was reached. The CAT developed showed excellent interrater reliability. These achievements are crucial steps to an ongoing nationwide quality improvement project (the Right study).
AB - BACKGROUND: Substantial variation exists when performing a minimally invasive right hemicolectomy (MIRH) due to disparities in training, expertise and differences in implementation of innovations. This study aimed to achieve national consensus on an optimal and standardized MIRH technique for colon cancer and to develop and validate a video-based competency assessment tool (CAT) for MIRH. METHOD: Statements covering all elements of MIRH were formulated. Subsequently, the Delphi technique was used to reach consensus on a standardized MIRH among 76 colorectal surgeons from 43 different centres. A CAT was developed based on the Delphi results. Nine surgeons assessed the same 12 unedited full-length videos using the CAT, allowing evaluation of the intraclass correlation coefficient (ICC). RESULTS: After three Delphi rounds, consensus (≥80% agreement) was achieved on 23 of the 24 statements. Consensus statements included the use of low intra-abdominal pressure, detailed anatomical outline how to perform complete mesocolic excision with central vascular ligation, the creation of an intracorporeal anastomosis, and specimen extraction through a Pfannenstiel incision using a wound protector. The CAT included seven consecutive steps to measure competency of the MIRH and showed high consistency among surgeons with an overall ICC of 0.923. CONCLUSION: Nationwide consensus on a standardized and optimized technique of MIRH was reached. The CAT developed showed excellent interrater reliability. These achievements are crucial steps to an ongoing nationwide quality improvement project (the Right study).
UR - http://www.scopus.com/inward/record.url?scp=85181769326&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/bjs/znad404
DO - https://doi.org/10.1093/bjs/znad404
M3 - Article
C2 - 38103184
SN - 0007-1323
VL - 111
JO - The British journal of surgery
JF - The British journal of surgery
IS - 1
M1 - znad404
ER -