2025 Delphi consensus on robotic ventral mesh rectopexy.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Schena Carlo Alberto, Ascanelli Simona, Grossi Ugo, Gallo Gaetano, Marchegiani Francesco, Martínez-Pérez Aleix, Pavone Gaetano, Azzolina Danila, Adamina Michel, Bianchi Paolo Pietro, Bislenghi Gabriele, Braini Andrea, Carra Maria Clotilde, Celentano Valerio, Coratti Andrea, Da Pozzo Francesca, De Nardi Paola, De Simone Veronica, D'Hoore André, Espin-Basany Eloy, Genovese Alfredo, Khan Jim, Lenisa Leonardo, Martellucci Jacopo, Martinello Ruby, Masetti Michele, Milone Marco, Naldini Gabriele, Pellino Gianluca, Sileri Pierpaolo, Stuto Angelo, Talento Pasquale, Testini Mario, Tonsi Alfredo, Ratto Carlo, de'Angelis Nicola, Italian Club of Robotic Surgery (ICORS), the Società Italiana di Chirurgia Colo-Rettale (SICCR), and the Società Italiana Unitaria di ColoProctologia (SIUCP)
Аннотация
METHODS: Thirty-three experts in RVMR participated in a structured Delphi process. The panel addressed 10 key clinical questions, covering preoperative workup, surgical indications, procedural steps, learning curves, training, and RVMR outcomes. The consensus process was reached through iterative surveys, literature reviews, and a rigorous voting methodology, applying the GRADE approach.
RESULTS: A total of 27 consensus statements were formulated, providing standardized recommendations on patient selection, imaging modalities, surgical technique, and expected clinical outcomes. Concerning surgical technique, the panel addressed variations in trocar placement, robotic instrument selection, and docking strategies. Additionally, consensus statements addressed the role of mesh reinforcement, fixation techniques, and the potential for combined procedures in the treatment of multicompartment pelvic organ prolapse. Of the 27 consensus statements, 3 (11.1%) were supported by moderate-quality evidence, whereas 18 (66.7%) were based on low or very-low-quality evidence and 6 (22.2%) on expert opinion.
CONCLUSION: This consensus provides a structured, consensus-based framework for clinicians and surgeons trying to address the complexities of RVMR and promote standardization and quality improvement in RP management, while acknowledging that the underlying evidence remains largely low-quality.