Minimally invasive surgery in emergency surgery: a WSES survey
Marco Ceresoli, Michele Pisano, Fikri M. Abu‐Zidan, Niccolò Allievi, Kurinchi Selvan Gurusamy, Walt Biffl, Giovanni Domenico Tebala, Fausto Catena, Luca Ansaloni, Massimo Sartelli, Yoram Kluger, Gian Luca Baiocchi, WSES MIS working group, Andreas Fette, Andreas Hecker, Andrey Litvin, Antonello Forgione, Ari Leppäniemi, Belinda De Simone, Boris Sakakushev, Casey R. Palmatier, Cino Bendinelli, Dimitris Damaskos, Edoardo Picetti, Edward Tan, Elia Poiasina, Emmanouil Pikoulis, Enrico Cicuttin, Ernest E. Moore, George C. Velmahos, Gustavo Pereira Fraga, Harry van Goor, Ian Civil, Imtiz Wani, Isidoro Di Carlo, Joseph M. Galante, Kjetil Søreide, Luca Degrate, Luigi Zorcolo, Marc De Moya, Marco Braga, Marco Cereda, Micheal Sugrue, Mircea Chirica, Nicola De Angelis, Philip F. Stahel, Rao R. Ivatury, Richard P. G. ten Broek, Salomone Di Saverio, Solomon Gurmu Beka, Stefano Magnone, Yunfeng Cui, Zsolt J. Balogh, Micheal Dennis Kelly, Kenji Inaba, WSES MIS consortia, Federico Coccolini
Abstract
BACKGROUND: The diffusion of minimally invasive surgery in emergency surgery still represents a developing challenge. Evidence about the use of minimally invasive surgery shows its feasibility and safety; however, the diffusion of these techniques is still poor. The aims of the present survey were to explore the diffusion and variations in the use of minimally invasive surgery among surgeons in the emergency setting. METHODS: This is a web-based survey administered to all the WSES members investigating the diffusion of minimally invasive surgery in emergency. The survey investigated personal characteristics of participants, hospital characteristics, personal confidence in the use of minimally invasive surgery in emergency, limitations in the use of it and limitations to prosecute minimally invasive surgery in emergency surgery. Characteristics related to the use of minimally invasive surgery were studied with a multivariate ordinal regression. RESULTS: The survey collected a total of 415 answers; 42.2% of participants declared a working experience > 15 years and 69.4% of responders worked in tertiary level center or academic hospital. In primary emergencies, only 28,7% of participants declared the use of laparoscopy in more than 50% of times. Personal confidence with minimally invasive techniques was the highest for appendectomy and cholecystectomy. At multivariate ordinal regression, a longer professional experience, the use of laparoscopy in major elective surgery and bariatric surgery expertise were related to a higher use of laparoscopy in emergency surgery. CONCLUSIONS: The survey shows that minimally invasive techniques in emergency surgery are still underutilized. Greater focus should be placed on the development of dedicated training in laparoscopy among emergency surgeons.