From the Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, The Netherlands (Korrel, Lof, Besselink).
Department of General Surgery, Instituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy (Korrel, Lof, Abu Hilal).
J Am Coll Surg. 2022 Sep 1;235(3):383-390. doi: 10.1097/XCS.0000000000000278. Epub 2022 May 20.
Previous reports suggest that structured training in minimally invasive pancreatic surgery (MIPS) can ensure a safe implementation into standard practice. Although some training programs have been constructed, worldwide consensus on fundamental items of these training programs is lacking. This study aimed to determine items for a structured MIPS training program using the Delphi consensus methodology.
The study process consisted of 2 Delphi rounds among international experts in MIPS, identified by a literature review. The study committee developed a list of items for 3 key domains of MIPS training: (1) framework, (2) centers and surgeons eligible for training, and (3) surgeons eligible as proctor. The experts rated these items on a scale from 1 (not important) to 5 (very important). A Cronbach's α of 0.70 or greater was defined as the cut-off value to achieve consensus. Each item that achieved 80% or greater of expert votes was considered as fundamental for a training program in MIPS.
Both Delphi study rounds were completed by all invited experts in MIPS, with a median experience of 20 years in MIPS. Experts included surgeons from 31 cities in 13 countries across 4 continents. Consensus was reached on 38 fundamental items for the framework of training (16 of 35 items, Cronbach's α = 0.72), centers and surgeons eligible for training (19 of 30 items, Cronbach's α = 0.87), and surgeons eligible as proctor (3 of 10 items, Cronbach's α = 0.89). Center eligibility for MIPS included a minimum annual volume of 10 distal pancreatectomies and 50 pancreatoduodenectomies.
Consensus among worldwide experts in MIPS was reached on fundamental items for the framework of training and criteria for participating surgeons and centers. These items act as a guideline and intend to improve training, proctoring, and safe worldwide dissemination of MIPS.
先前的报告表明，微创胰腺手术（MIPS）的结构化培训可以确保安全地将其纳入标准实践。尽管已经构建了一些培训计划，但全球范围内缺乏对这些培训计划基本项目的共识。本研究旨在使用德尔菲共识方法确定结构化 MIPS 培训计划的项目。
研究过程包括两轮国际 MIPS 专家的德尔菲调查，这些专家是通过文献回顾确定的。研究委员会为 MIPS 培训的三个关键领域（1）框架、（2）有资格参加培训的中心和外科医生，以及（3）有资格担任主任的外科医生制定了一份项目清单。专家们对这些项目进行了 1（不重要）到 5（非常重要）的评分。将 0.70 或更高的克朗巴赫 α 定义为达成共识的截止值。获得 80%或更高专家投票的每个项目都被认为是 MIPS 培训计划的基本项目。
所有受邀的 MIPS 专家都完成了两轮德尔菲研究，他们在 MIPS 方面的平均经验为 20 年。专家们来自四大洲 13 个国家的 31 个城市。在培训框架（35 个项目中的 16 个，克朗巴赫 α = 0.72）、有资格参加培训的中心和外科医生（30 个项目中的 19 个，克朗巴赫 α = 0.87）以及有资格担任主任的外科医生（10 个项目中的 3 个，克朗巴赫 α = 0.89）方面达成了共识。MIPS 中心的资格包括每年至少进行 10 例远端胰腺切除术和 50 例胰十二指肠切除术。
在 MIPS 方面的全球专家就培训框架和参与外科医生和中心的标准的基本项目达成了共识。这些项目作为指南，旨在提高培训、主任指导和全球范围内 MIPS 的安全传播。
