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Background COVID-19 pandemic presented an unexpected challenge for the surgical community in general and Minimally Invasive Surgery (MIS) specialists in particular. This document aims to summarize recent evidence and experts’ opinion and formulate recommendations to guide the surgical community on how to best organize the recovery plan for surgical activity across different sub-specialities after the COVID-19 pandemic. Methods Recommendations were developed through a Delphi process for establishment of expert consensus. Domain topics were formulated and subsequently subdivided into questions pertinent to different surgical specialities following the COVID-19 crisis. Sixty-five experts from 24 countries, representing the entire EAES board, were invited. Fifty clinicians and six engineers accepted the invitation and drafted statements based on specific key questions. Anonymous voting on the statements was performed until consensus was achieved, defined by at least 70% agreement. Results A total of 92 consensus statements were formulated with regard to safe resumption of surgery across eight domains, addressing general surgery, upper GI, lower GI, bariatrics, endocrine, HPB, abdominal wall and technology/research. The statements addressed elective and emergency services across all subspecialties with specific attention to the role of MIS during the recovery plan. Eighty-four of the statements were approved during the first round of Delphi voting (91.3%) and another 8 during the following round after substantial modification, resulting in a 100% consensus. Conclusion The recommendations formulated by the EAES board establish a framework for resumption of surgery following COVID-19 pandemic with particular focus on the role of MIS across surgical specialities. The statements have the potential for wide application in the clinical setting, education activities and research work across different healthcare systems.

Background: COVID-19 pandemic presented an unexpected challenge for the surgical community in general and Minimally Invasive Surgery (MIS) specialists in particular. This document aims to summarize recent evidence and experts’ opinion and formulate recommendations to guide the surgical community on how to best organize the recovery plan for surgical activity across different sub-specialities after the COVID-19 pandemic. Methods: Recommendations were developed through a Delphi process for establishment of expert consensus. Domain topics were formulated and subsequently subdivided into questions pertinent to different surgical specialities following the COVID-19 crisis. Sixty-five experts from 24 countries, representing the entire EAES board, were invited. Fifty clinicians and six engineers accepted the invitation and drafted statements based on specific key questions. Anonymous voting on the statements was performed until consensus was achieved, defined by at least 70% agreement. Results: A total of 92 consensus statements were formulated with regard to safe resumption of surgery across eight domains, addressing general surgery, upper GI, lower GI, bariatrics, endocrine, HPB, abdominal wall and technology/research. The statements addressed elective and emergency services across all subspecialties with specific attention to the role of MIS during the recovery plan. Eighty-four of the statements were approved during the first round of Delphi voting (91.3%) and another 8 during the following round after substantial modification, resulting in a 100% consensus. Conclusion: The recommendations formulated by the EAES board establish a framework for resumption of surgery following COVID-19 pandemic with particular focus on the role of MIS across surgical specialities. The statements have the potential for wide application in the clinical setting, education activities and research work across different healthcare systems. © 2020, The Author(s).

BACKGROUND: Surgical outcomes are traditionally evaluated by post-operative data such as histopathology and morbidity. Although these outcomes are reported using accepted systems, their ability to influence operative performance is limited by their retrospective application. Interest in direct measurement of intraoperative events is growing but no available systems applicable to routine practice exist. We aimed to develop a structured, practical method to report intraoperative adverse events enacted during minimal access surgical procedures. METHODS: A structured mixed methodology approach was adopted. Current intraoperative adverse event reporting practices and desirable system characteristics were sought through a survey of the EAES executive. The observational clinical human reliability analysis method was applied to a series of laparoscopic total mesorectal excision (TME) case videos to identify intraoperative adverse events. In keeping with survey results, observed events were further categorised into non-consequential and consequential, which were further subdivided into four levels based upon the principle of therapy required to correct the event. A second survey phase explored usability, acceptability, face and content validity of the novel classification. RESULTS: 217 h of TME surgery were analysed to develop and continually refine the five-point hierarchical structure. 34 EAES expert surgeons (69%) responded. The lack of an accepted system was the main barrier to routine reporting. Simplicity, repro- ducibility and clinical utility were identified as essential requirements. The observed distribution of intraoperative adverse events was 60.1% grade I (non-consequential), 37.1% grade II (minor corrective action), 2.4% grade III (major correction or change in post-operative care) and 0.1% grade IV (life threatening). 84% agreed with the proposed classification (Likert scale 4.04) and 92% felt it was applicable to their practice and incorporated all desirable characteristics. CONCLUSION: A clinically applicable intraoperative adverse event classification, which is acceptable to expert surgeons, is reported and complements the objective assessment of minimal access surgical performance.

Background: Although bariatric surgery is the most effective treatment for severe obesity, a subgroup of patients shows insufficient postbariatric outcomes. Differences may at least in part result from heterogeneous patient profiles regarding reactive and regulative temperament, emotion dysregulation, and disinhibited eating. This study aims to subtype patients based on these aspects before and two years after bariatric surgery and tests the predictive value of identified subtypes for health-related outcomes three years after surgery.

Aim: To investigate the rate of laparoscopic colectomies for colon cancer using registries and population based studies. To provide a position paper on mini-invasive (MIS) colon cancer surgery based on the opinion of experts leader in this field. Methods: A systematic review of the literature was conducted using PRISMA guidelines for the rate of laparoscopy in colon cancer. Moreover, Delphi methodology was used to reach consensus among 35 international experts in four study rounds. Consensus was defined as an agreement >= 75.0%. Domains of interest included nosology, essential technical/oncological requirements, outcomes and MIS training. Results: Forty-four studies from 42 articles were reviewed. Although it is still sub-optimal, the rate of MIS for colon cancer increased over the years and it is currently >50% in Korea, Netherlands, UK and Australia. The remaining European countries are un-investigated and presented lower rates with highest variations, ranging 7-35%. Using Delphi methodology, a laparoscopic colectomy was defined as a "colon resection performed using key-hole surgery independently from the type of anastomosis". The panel defined also the oncological requirements recognized essential for the procedure and agreed that when performed by experienced surgeons, it should be marked as best practice in guidelines, given the principles of oncologic surgery be respected (RO procedure, vessel ligation and mesocolon integrity). Conclusion: The rate of MIS colectomies for cancer in Europe should be further investigated. A panel of leaders in this field defined laparoscopic colectomy as a best practice procedure when performed by an experienced surgeon respecting the standards of surgical oncology. (C) 2018 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Einleitung: Das Auftreten und die Therapie von abdominellen Narbenhernien sind ein alltägliches Problem in der Visceralchirurgie. Nach medianen Laparotomien kommt es im weiteren Verlauf laut Literatur in 10-25% der Patienten zu Narbenhernien. Zur operativen Versorgung stehen eine Vielzahl [for full text, please go to the a.m. URL], 132. Kongress der Deutschen Gesellschaft für Chirurgie

Einleitung: Abdominelle Messerstichverletzungen sind in Deutschland vergleichsweise selten. Daraus resultiert für die meisten Chirurgen eine fehlende Routine sowohl in der primären Notfallversorgung als auch in der postoperativen Betreuung. In unserer Klinik treten aufgrund der integrierten[for full text, please go to the a.m. URL], 131. Kongress der Deutschen Gesellschaft für Chirurgie

Einleitung: In den letzten Jahren wurden mehrere 3D Systeme entwickelt, die in der minimal-invasiven Chirurgie eingesetzt werden können. Bisher existieren keine randomisierten Studien, die Vorteile für den Patienten oder den Laparoskopiker nachweisen. Auch die Messparameter zum Vergleich zwischen[for full text, please go to the a.m. URL], 131. Kongress der Deutschen Gesellschaft für Chirurgie

Einleitung: Alle Verfahren der thermischen Blutstillung führen zu einem kollateralen Gewebeschaden. Gleichzeitig ist v.a. bei der minimal-invasiven Chirurgie eine schnelle und sichere Blutstillung von großer Bedeutung. In dieser Studie untersuchten wir den Gewebeschaden und die benötigte[for full text, please go to the a.m. URL], 130. Kongress der Deutschen Gesellschaft für Chirurgie

Einleitung: Die Ausbildung in der minimal-invasiven Chirurgie erfolgt in der Regel im klinischen Alltag am Patienten. Feste Konzepte fehlen häufig, was zur Gefährdung der Patientensicherheit führen kann. Eine strukturierte Ausbildung ermöglicht das schrittweise Erlernen laparoskopischer[for full text, please go to the a.m. URL], 126. Kongress der Deutschen Gesellschaft für Chirurgie

Einleitung: Die Visualisierung des Operationsgebietes ist bei der laparoskopischen Chirurgie durch die Verwendung von starren Optiken eingeschränkt. Der Einsatz einer speziellen Optik (EndoCAMeleon) mit einer schwenkbaren Linse verschafft dem Chirurgen neue laparoskopische Perspektiven und Möglichkeiten.[for full text, please go to the a.m. URL], 127. Kongress der Deutschen Gesellschaft für Chirurgie

Einleitung: Der Wert der laparoskopischen Appendektomie wird auch heute noch kontrovers beurteilt und von vielen Chirurgen aus Sorge vor erhöhten Komplikationsraten gänzlich abgelehnt. Wir haben die laparoskopische Appendektomie seit Juli 2001 als Klinikstandard eingeführt und berichten[for full text, please go to the a.m. URL], 126. Kongress der Deutschen Gesellschaft für Chirurgie

Einleitung: Auch im Jahr 2008 stößt das "fast track" Konzept in der kolorektalen Chirurgie teilweise auf Widerstand und Skepsis. In unserer Klinik werden die Patienten mit kolorektalen Resektionen - laparoskopisch und konventionell - seit 2004 nach einem eigenen Konzept behandelt,[for full text, please go to the a.m. URL], 126. Kongress der Deutschen Gesellschaft für Chirurgie