Second Department of Hepatopancreatobiliary Surgery, Chinese People's Liberation Army (PLA) General Hospital, Beijing 100853, China.
Center for Advanced Treatment of Hepatobiliary and Pancreatic Diseases, Ageo Central General Hospital, Ageo 362-8588, Japan.
World J Gastroenterol. 2019 Mar 28;25(12):1432-1444. doi: 10.3748/wjg.v25.i12.1432.
The robotic surgical system has been applied in liver surgery. However, controversies concerns exist regarding a variety of factors including the safety, feasibility, efficacy, and cost-effectiveness of robotic surgery. To promote the development of robotic hepatectomy, this study aimed to evaluate the current status of robotic hepatectomy and provide sixty experts' consensus and recommendations to promote its development. Based on the World Health Organization Handbook for Guideline Development, a Consensus Steering Group and a Consensus Development Group were established to determine the topics, prepare evidence-based documents, and generate recommendations. The GRADE Grid method and Delphi vote were used to formulate the recommendations. A total of 22 topics were prepared analyzed and widely discussed during the 4 meetings. Based on the published articles and expert panel opinion, 7 recommendations were generated by the GRADE method using an evidence-based method, which focused on the safety, feasibility, indication, techniques and cost-effectiveness of hepatectomy. Given that the current evidences were low to very low as evaluated by the GRADE method, further randomized-controlled trials are needed in the future to validate these recommendations.
机器人手术系统已应用于肝外科手术中。然而，对于机器人手术的安全性、可行性、疗效和成本效益等各种因素仍存在争议。为了促进机器人肝切除术的发展，本研究旨在评估机器人肝切除术的现状，并提供 60 位专家的共识和建议，以促进其发展。本研究基于世界卫生组织指南制定手册，成立了共识指导小组和共识开发小组，以确定主题、准备基于证据的文件并生成建议。采用 GRADE 网格方法和 Delphi 投票对建议进行制定。在 4 次会议期间，共准备、分析和广泛讨论了 22 个主题。基于已发表的文章和专家小组意见，采用循证方法通过 GRADE 方法生成了 7 项建议，重点关注肝切除术的安全性、可行性、适应证、技术和成本效益。鉴于 GRADE 方法评估的当前证据为低质量到极低质量，未来需要进一步的随机对照试验来验证这些建议。
