Section of General Surgery, Department of Surgery, Rady College of Medicine, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
St. Boniface General Hospital, Z3039-409 Tache Avenue, Winnipeg, MB, R2H 2A6, Canada.
Surg Endosc. 2022 Jul;36(7):4969-4976. doi: 10.1007/s00464-021-08853-9. Epub 2021 Nov 15.
Synoptic operative reporting has been used as a solution to the poor quality of narrative reports. The aim of this study was to develop operative report quality indicators for the laparoscopic sleeve gastrectomy and to generate parameters by which these reports can be evaluated and improved.
A Delphi protocol was used to determine quality indicators for LSG. Bariatric surgeons across Canada were recruited along with key physician stakeholders to participate via a secure web-based platform. Transferrable consensus items for LSG from previously developed Roux-en-Y gastric bypass operative indictors were put forward for consideration. Participants also initially submitted potential QIs. These were grouped by theme. Items were rated on 5-point Likert scales in subsequent rounds. Scores of 70% or higher were used for inclusion and 30% or less denoted exclusion. Elements scoring 30% to 70% agreement were recirculated by runoff in subsequent rounds to generate the final list of quality indicators.
Seven bariatric surgeons, representing all regions preforming LSG in Canada, were invited to participate in the Delphi group. Multidisciplinary invitees included one academic minimally invasive/acute care surgeon, one tertiary abdominal radiologist, and one academic gastroenterologist with bariatric expertise. Two rounds were required to achieve consensus. Both rounds achieved a 100% response (10/10). In round 1, forty items reached consensus. In Round 2, an additional 28 items reached consensus, with three items excluded, bringing the total number of quality indicators to 65.
This study establishes consensus-derived multidisciplinary quality indicators for LSG operative reports. Application of these findings aims to advance the quality and completeness of operative reporting in LSG in order to improve communication of important surgical details and quality measures to the multidisciplinary team involved in bariatric surgery care.
摘要式手术报告已被用作提高叙事式报告质量的方法。本研究旨在为腹腔镜袖状胃切除术制定手术报告质量指标，并生成可用于评估和改进报告的参数。
采用 Delphi 法确定 LSG 的质量指标。邀请加拿大各地的减重外科医生以及关键的医师利益相关者通过安全的网络平台参与。从先前开发的 Roux-en-Y 胃旁路手术指标中转交了适用于 LSG 的可转移共识项目供考虑。参与者还最初提交了潜在的 QI。这些按照主题进行分组。在随后的轮次中，使用 5 分 Likert 量表对项目进行评分。得分在 70%或以上的项目被纳入，得分在 30%或以下的项目被排除。评分在 30%至 70%之间的项目将通过后续轮次的 runoff 重新循环，以生成最终的质量指标列表。
邀请了 7 名代表加拿大所有地区进行 LSG 的减重外科医生参加 Delphi 小组。多学科邀请者包括一位学术微创/急性护理外科医生、一位三级腹部放射科医生和一位具有减重专业知识的学术胃肠病学家。需要两轮才能达成共识。两轮都达到了 100%的回复率（10/10）。在第一轮中，有四十个项目达成共识。在第二轮中，又有 28 个项目达成共识，有 3 个项目被排除，使质量指标总数达到 65 个。
本研究为 LSG 手术报告制定了共识驱动的多学科质量指标。这些发现的应用旨在提高 LSG 手术报告的质量和完整性，以便将重要手术细节和质量措施更有效地传达给参与减重手术护理的多学科团队。
