Practice Guideline

. 2021 Jan;35(1):1-17.

doi: 10.1007/s00464-020-08131-0. Epub 2020 Nov 10.

EAES Recommendations for Recovery Plan in Minimally Invasive Surgery Amid COVID-19 Pandemic

Alberto Arezzo¹, Nader Francis^{2

3}, Yoav Mintz⁴, Michel Adamina^{5

6}, Stavros A Antoniou^{7

8}, Nicole Bouvy⁹, Catalin Copaescu¹⁰, Nicolò de Manzini¹¹, Nicola Di Lorenzo¹², Salvador Morales-Conde¹³, Beat P Müller-Stich¹⁴, Felix Nickel¹⁴, Dorin Popa¹⁵, Diana Tait¹⁶, Cenydd Thomas¹⁷, Susan Nimmo¹⁸, Dimitrios Paraskevis¹⁹, Andrea Pietrabissa²⁰; EAES Group of Experts for Recovery Amid COVID-19 Pandemic

Collaborators, Affiliations

Collaborators

EAES Group of Experts for Recovery Amid COVID-19 Pandemic:
Muriel Eck, Emina Letić, Silviu Daniel Preda, Alice Tsai, Ewelina Malanowska, Dusan Lesko, Wlodzimierz Majewski, Ludovica Baldari, Luca Morelli, Andreas Shamiyeh, Gil Faria, Francesco Maria Carrano, Piotr Mysliwiec, Gunnar Ahlberg, Elisa Cassinotti, Samir Delibegović, Lubomír Martinek, Eugenia Yiannakopoulou, Marguerite Gorter-Stam, Marguerite Gorter-Stam, George Hanna, Hans Fuchs, Miloš Bjelovic, Sheraz Markar, Philip Wai Yan, Chiu, Bang Wool Ecom, Young-Woo Kim, Carmen Balagué Ponz, Marlies Schijven, Luigi Boni, Thomas Carus, George Theodoropoulos, Antonello Forgione, Marco Milone, Wanda Luisa Rita Petz, Predag Andrejevic, Dejan Ignjatovic, Thanjakumar Arulampalam, Kenneth Campbell, Manish Chand, Mark Coleman, Christos Kontovounisios, Chen Sagiv, F Anny Ficuciello, Stefania Marconi, P Ietro Mascagni, K Iyokazu Nakajima, Francisco Miguel Sánchez Margallo, Tim Horeman, George Mylonas, Pietro Valdastri

Affiliations

¹ Department of Surgical Sciences, University of Torino, Corso AM Dogliotti 14, 10126, Torino, Italy. alberto.arezzo@unito.it.
² Department of General Surgery, Yeovil District Hospital NHS Foundation Trust, Yeovil, UK.
³ The Griffin Institute, The Northwick Park Institute for Medical Research, Northwick Park and St Marks Hospital, Watford Road, Harrow, Middlesex, London, HA1 3UJ, UK.
⁴ Department of Surgery, Hadassah, Hebrew University Medical Center, Jerusalem, Israel.
⁵ Department of Surgery, Clinic of Visceral and Thoracic Surgery, Cantonal Hospital Winterthur, Winterthur, 8401, Zurich, Switzerland.
⁶ Faculty of Medicine, University of Basel, 4051, Basel, Switzerland.
⁷ Medical School, European University Cyprus, Nicosia, Cyprus.
⁸ Department of Surgery, Mediterranean Hospital of Cyprus, Limassol, Cyprus.
⁹ Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
¹⁰ Department of Gastrointestinal and Bariatric Surgery, Ponderas Academic Hospital, Bucharest, Romania.
¹¹ General Surgery Clinic, Department of Medical, Surgical and Health Sciences, University of Trieste, University Hospital of Trieste, Trieste, Italy.
¹² Department of Surgical Sciences, University of Rome "Tor Vergata", Rome, Italy.
¹³ Unit of Innovation in Minimally Invasive Surgery, Department of General and Digestive Surgery, University Hospital "Virgen del Rocio", University of Sevilla, Sevilla, Spain.
¹⁴ Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
¹⁵ General Surgery, Linköping University Hospital, Linköping, Sweden.
¹⁶ The Royal Marsden NHS Foundation Trust, London, UK.
¹⁷ Department of Radiology, Yeovil District Hospital NHS Foundation Trust, Higher Kingston, Yeovil, UK.
¹⁸ Department of Anaesthesia, Critical Care and Pain Medicine, Western General Hospital, Edinburgh, Scotland.
¹⁹ Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
²⁰ Department of Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

PMID: 33170335
PMCID: PMC7653984
DOI: 10.1007/s00464-020-08131-0

Practice Guideline

EAES Recommendations for Recovery Plan in Minimally Invasive Surgery Amid COVID-19 Pandemic

Alberto Arezzo et al. Surg Endosc. 2021 Jan.

. 2021 Jan;35(1):1-17.

doi: 10.1007/s00464-020-08131-0. Epub 2020 Nov 10.

Authors

Collaborators

EAES Group of Experts for Recovery Amid COVID-19 Pandemic:
Muriel Eck, Emina Letić, Silviu Daniel Preda, Alice Tsai, Ewelina Malanowska, Dusan Lesko, Wlodzimierz Majewski, Ludovica Baldari, Luca Morelli, Andreas Shamiyeh, Gil Faria, Francesco Maria Carrano, Piotr Mysliwiec, Gunnar Ahlberg, Elisa Cassinotti, Samir Delibegović, Lubomír Martinek, Eugenia Yiannakopoulou, Marguerite Gorter-Stam, Marguerite Gorter-Stam, George Hanna, Hans Fuchs, Miloš Bjelovic, Sheraz Markar, Philip Wai Yan, Chiu, Bang Wool Ecom, Young-Woo Kim, Carmen Balagué Ponz, Marlies Schijven, Luigi Boni, Thomas Carus, George Theodoropoulos, Antonello Forgione, Marco Milone, Wanda Luisa Rita Petz, Predag Andrejevic, Dejan Ignjatovic, Thanjakumar Arulampalam, Kenneth Campbell, Manish Chand, Mark Coleman, Christos Kontovounisios, Chen Sagiv, F Anny Ficuciello, Stefania Marconi, P Ietro Mascagni, K Iyokazu Nakajima, Francisco Miguel Sánchez Margallo, Tim Horeman, George Mylonas, Pietro Valdastri

Affiliations

¹ Department of Surgical Sciences, University of Torino, Corso AM Dogliotti 14, 10126, Torino, Italy. alberto.arezzo@unito.it.
² Department of General Surgery, Yeovil District Hospital NHS Foundation Trust, Yeovil, UK.
³ The Griffin Institute, The Northwick Park Institute for Medical Research, Northwick Park and St Marks Hospital, Watford Road, Harrow, Middlesex, London, HA1 3UJ, UK.
⁴ Department of Surgery, Hadassah, Hebrew University Medical Center, Jerusalem, Israel.
⁵ Department of Surgery, Clinic of Visceral and Thoracic Surgery, Cantonal Hospital Winterthur, Winterthur, 8401, Zurich, Switzerland.
⁶ Faculty of Medicine, University of Basel, 4051, Basel, Switzerland.
⁷ Medical School, European University Cyprus, Nicosia, Cyprus.
⁸ Department of Surgery, Mediterranean Hospital of Cyprus, Limassol, Cyprus.
⁹ Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
¹⁰ Department of Gastrointestinal and Bariatric Surgery, Ponderas Academic Hospital, Bucharest, Romania.
¹¹ General Surgery Clinic, Department of Medical, Surgical and Health Sciences, University of Trieste, University Hospital of Trieste, Trieste, Italy.
¹² Department of Surgical Sciences, University of Rome "Tor Vergata", Rome, Italy.
¹³ Unit of Innovation in Minimally Invasive Surgery, Department of General and Digestive Surgery, University Hospital "Virgen del Rocio", University of Sevilla, Sevilla, Spain.
¹⁴ Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
¹⁵ General Surgery, Linköping University Hospital, Linköping, Sweden.
¹⁶ The Royal Marsden NHS Foundation Trust, London, UK.
¹⁷ Department of Radiology, Yeovil District Hospital NHS Foundation Trust, Higher Kingston, Yeovil, UK.
¹⁸ Department of Anaesthesia, Critical Care and Pain Medicine, Western General Hospital, Edinburgh, Scotland.
¹⁹ Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
²⁰ Department of Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

PMID: 33170335
PMCID: PMC7653984
DOI: 10.1007/s00464-020-08131-0

Abstract

Background: COVID-19 pandemic presented an unexpected challenge for the surgical community in general and Minimally Invasive Surgery (MIS) specialists in particular. This document aims to summarize recent evidence and experts' opinion and formulate recommendations to guide the surgical community on how to best organize the recovery plan for surgical activity across different sub-specialities after the COVID-19 pandemic.

Methods: Recommendations were developed through a Delphi process for establishment of expert consensus. Domain topics were formulated and subsequently subdivided into questions pertinent to different surgical specialities following the COVID-19 crisis. Sixty-five experts from 24 countries, representing the entire EAES board, were invited. Fifty clinicians and six engineers accepted the invitation and drafted statements based on specific key questions. Anonymous voting on the statements was performed until consensus was achieved, defined by at least 70% agreement.

Results: A total of 92 consensus statements were formulated with regard to safe resumption of surgery across eight domains, addressing general surgery, upper GI, lower GI, bariatrics, endocrine, HPB, abdominal wall and technology/research. The statements addressed elective and emergency services across all subspecialties with specific attention to the role of MIS during the recovery plan. Eighty-four of the statements were approved during the first round of Delphi voting (91.3%) and another 8 during the following round after substantial modification, resulting in a 100% consensus.

Conclusion: The recommendations formulated by the EAES board establish a framework for resumption of surgery following COVID-19 pandemic with particular focus on the role of MIS across surgical specialities. The statements have the potential for wide application in the clinical setting, education activities and research work across different healthcare systems.

Keywords: COVID-19; Delphi consensus; EAES guidance; Minimally invasive surgery; Priority.

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Conflict of interest statement

Alberto Arezzo has financial disclosures unrelated to this manuscript being consultant for Karl Storz, BBraun and Medrobotics. Nader Francis has financial disclosures unrelated to this manuscript being consultant for Pharmacozmos, Fisher & Paykel Healthcare, Medtronic and Olympus. Yoav Mintz, Michel Adamina, Stavros A Antoniou, Nicole Bouvy, Catalin Copaescu, Nicolò de Manzini, Nicola Di Lorenzo, Salvador Morales-Conde, Beat P Müller-Stich, Felix Nickel, Dorin Popa, Diana Tait, Cenydd Thomas, Susan Nimmo Dimitrios Paraskevis Andrea Pietrabissa have no conflict of interest or financial ties to disclose.

References

1. AHA Letter to Surgeon General Re: Elective Surgeries and COVID-19 | AHA. Am. Hosp. Assoc. https://www.aha.org/lettercomment/2020-03-15-aha-letter-surgeon-general-.... Accessed 26 May 2020
1. Evans M, Mathews AW. Hospitals Push Off Surgeries to Make Room for Coronavirus Patients - WSJ. https://www.wsj.com/articles/hospitals-push-off-surgeries-to-make-room-f.... Accessed 26 May 2020
1. Joint Statement: Roadmap for Resuming Elective Surgery after COVID-19 Pandemic. Am. Coll. Surg. https://www.facs.org/covid-19/clinical-guidance/roadmap-elective-surgery. Accessed 18 May 2020
1. CMS Issues Recommendations to Re-Open Health Care Systems in Areas with Low Incidence of COVID-19 | CMS. Cent. Medicare Medicaid Serv. https://www.cms.gov/newsroom/press-releases/cms-issues-recommendations-r.... Accessed 26 May 2020
1. Yoon DH, Koller S, Duldulao PMN, Ault GT, Lee SW, Cologne KG. J COVID-19 Impact on Colorectal Daily Practice-How Long Will It Take to Catch Up? Gastrointest Surg. 2020 doi: 10.1007/s11605-020-04722-3. - DOI - PMC - PubMed

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EAES Recommendations for Recovery Plan in Minimally Invasive Surgery Amid COVID-19 Pandemic

Collaborators

Affiliations

EAES Recommendations for Recovery Plan in Minimally Invasive Surgery Amid COVID-19 Pandemic

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical