ANDRE LUIS MONTAGNINI
Projetos de Pesquisa
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Instituto Central, Hospital das Clínicas, Faculdade de Medicina
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- Worldwide survey on opinions and use of minimally invasive pancreatic resection(2017) HILST, Jony van; ROOIJ, Thijs de; HILAL, Mohammed Abu; ASBUN, Horacio J.; BARKUN, Jeffrey; BOGGI, Uggo; BUSCH, Olivier R.; CONLON, Kevin C. P.; DIJKGRAAF, Marcel G.; HAN, Ho-Seong; HANSEN, Paul D.; KENDRICK, Michael L.; MONTAGNINI, Andre L.; PALANIVELU, Chinnusamy; ROSOK, Bard I.; SHRIKHANDE, Shailesh V.; WAKABAYASHI, Go; ZEH, Herbert J.; VOLLMER, Charles M.; KOOBY, David A.; BESSELINK, Marc G. H.Background: The introduction of minimally invasive pancreatic resection (MIPR) into surgical practice has been slow. The worldwide utilization of MIPR and attitude towards future perspectives of MIPR remains unknown. Methods: An anonymous survey on MIPR was sent to the members of six international associations of Hepato-Pancreato-Biliary (HPB) surgery. Results: The survey was completed by 435 surgeons from 50 countries, with each surgeon performing a median of 22 (IQR 12-40) pancreatic resections annually. Minimally invasive distal pancreatectomy (MIDP) was performed by 345 (79%) surgeons and minimally invasive pancreatoduodenectomy (MIPD) by 124 (29%). The median total personal experience was 20 (IQR 10-50) MIDPs and 12 (IQR 4-40) MIPDs. Current superiority for MIDP was claimed by 304 (70%) and for MIPD by 44 (10%) surgeons. The most frequently mentioned reason for not performing MIDP (54/90 (60%)) and MIPD (193/311 (62%)) was lack of specific training. Most surgeons (394/435 (90%)) would consider participating in an international registry on MIPR. Discussion: This worldwide survey showed that most participating HPB surgeons value MIPR as a useful development, especially for MIDP, but the role and implementation of MIPD requires further assessment. Most HPB surgeons would welcome specific training in MIPR and the establishment of an international registry.
- Standardizing terminology for minimally invasive pancreatic resection(2017) MONTAGNINI, Andre L.; ROSOK, Bard I.; ASBUN, Horacio J.; BARKUN, Jeffrey; BESSELINK, Marc G.; BOGGI, Ugo; CONLON, Kevin C. P.; FINGERHUT, Abe; HAN, Ho-Seong; HANSEN, Paul D.; HOGG, Melissa E.; KENDRICK, Michael L.; PALANIVELU, Chinnusamy; SHRIKHANDE, Shailesh V.; WAKABAYASHI, Go; ZEH, Herbert; VOLLMER, Charles M.; KOOBY, David A.Background: There is a growing body of literature pertaining to minimally invasive pancreatic resection (MIPR). Heterogeneity in MIPR terminology, leads to confusion and inconsistency. The Organizing Committee of the State of the Art Conference on MIPR collaborated to standardize MIPR terminology. Methods: After formal literature review for ""minimally invasive pancreatic surgery"" term, key terminology elements were identified. A questionnaire was created assessing the type of resection, the approach, completion, and conversion. Delphi process was used to identify the level of agreement among the experts. Results: A systematic terminology template was developed based on combining the approach and resection taking into account the completion. For a solitary approach the term should combine ""approach + resection"" (e.g. ""laparoscopic pancreatoduodenectomy""); for combined approaches the term must combine ""first approach + resection"" with ""second approach + reconstruction"" (e.g. ""laparoscopic central pancreatectomy"" with ""open pancreaticojejunostomy"") and where conversion has resulted the recommended term is "" first approach"" + ""converted to"" + ""second approach"" + ""resection"" (e.g. ""robot-assisted"" "" converted to open"" ""pancreatoduodenectomy"") Conclusions: The guidelines presented are geared towards standardizing terminology for MIPR, establishing a basis for comparative analyses and registries and allow incorporating future surgical and technological advances in MIPR.