Background

Since its first clinical introduction in 2000 (first Da Vinci platform from Intuitive Surgical), the robotic approach has emerged as a new route in minimally invasive surgery.
In the first part of its development, the robotic approach was mainly used in urology, especially for prostate resection. In recent years, the use of the robotic approach inadditional specialties such as colorectal surgery, gynecology, thoracic surgery and HPB surgery has grown. In the latter case, the use of a robotic platform was not only reported as a natural extension of the laparoscopic approach, but it was also developed by "non-laparoscopic" surgeons. In the last 5 years, the number of publications has more than doubled, both for liver and pancreas resections, witnessing the interest of HPB surgeons in this strategy. In addition, new platforms are currently being marketed and many patents fall in the public domain at the present time.

However, precise indications, early and late outcomes, technical advantages and constraints over other routes, cost effectiveness, instrumentation, training, and credentialing are still being debated. It appears timely to perform a comprehensive assessment of the value of robotic platforms in HPB surgery through a formal Consensus Conference format providing evidence-based guidelines.

 DATE

December 7-9, 2023 - Duration 2,5 Days

The first two days will be devoted to report on the experts' work. On the 3rd day, the Jury will deliberate behind closed doors and issue recommendations

LOCATION

NOVOTEL Paris Centre Tour Eiffel, France

FORMAT

The main goal is to provide clear guidelines for robotic HPB surgery based on the analysis of the scientific literature and experts’ recommendations. The best way to warrant a low risk of bias of recommendations is to organize a consensus conference based on the Zurich-Danish model.

The first step was to determine the appropriate questions to answer, and this was done by the Local organizing Committee (LOC).

A group of literature reviewers was formed to retrieve the scientific data, analyze them and transmit the results to the experts. These international experts were divided in small panels of 4 to 5 people who will draft recommendations.

Third step: these recommendations will be transmitted to an independent jury of 10 members 3 months before the meeting. The final step will be represented by the conference itself during which the faculty will present the recommendations resulting from the preliminary work in front of the audience and the Jury.

The Jury will formulate the final recommendations and possibly grade them.

PARTICIPANTS

• A local organizing committee (LOC) in charge of defining the topics and questions to be analyzed and answered by the panels of international experts.
• An international faculty: 42 international academic experts from North and South America (n=18), Europe (n=9), and Asia (n=15) have been selected based on their personal experience and publications. These experts were divided into 10 panels of 4 to 5 members including a panel chair without any conflict of interest with the robotic industry. Each working group is responsible for three to five questions and will carry out an analysis of the literature with the help of the literature reviewers to answer the respective questions. The panel chair will be responsible to coordinate a short draft (maximum 4 pages) with clear answers to the questions to be submitted to the Jury.
• A Group of literature reviewers: 12 surgical fellows with research interest and experienced in the literature search and review are working to retrieve all relevant publications related to the selected topics from 2017 to 2022. Most importantly, they will perform a double-checked quality assessment for every publication using the PICO analysis. The protocol of literature search has been registered in PROSPERO. The deadline for delivery of the literature review to the experts is July 2023.
• An independent Jury of 10 members, mostly recognized physicians (with no involvement in robotic surgery), mostly but not only involved in HPBsurgery. The final recommendations and their grading will be the sole responsibility of the Jury. Prof. Jeffrey Barkun (Montreal, Canada) has accepted to chair this Jury and Laurence Chiche (Bordeaux, France) is Vice-Chair.

• At last, a manuscript reporting the methodology, propositions from the faculty experts, and statements and recommendations from the Jury will be submitted to an international journal of surgery.