Benchmarking of robotic and laparoscopic spleen-preserving distal pancreatectomy by using two different methods

Tess M E van Ramshorst; Alessandro Giani; European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS); Michele Mazzola; Safi Dokmak; Fadhel Samir Ftériche; Alessandro Esposito; Matteo de Pastena; Sanne Lof; Bjørn Edwin; Mushegh Sahakyan; Ugo Boggi; Emanuele Federico Kauffman; Jean Michel Fabre; Regis Francois Souche; Alessandro Zerbi; Giovanni Butturini; Quintus Molenaar; Bilal Al-Sarireh; Marco V Marino; Tobias Keck; Steven A White; Riccardo Casadei; Fernando Burdio; Bergthor Björnsson; Zahir Soonawalla; Bas Groot Koerkamp; Giuseppe Kito Fusai; Patrick Pessaux; Asif Jah; Andrea Pietrabissa; Thilo Hackert; Mathieu D'Hondt; Elizabeth Pando; Marc G Besselink; Giovanni Ferrari; Mohammad Abu Hilal

doi:10.1093/bjs/znac352

Benchmarking of robotic and laparoscopic spleen-preserving distal pancreatectomy by using two different methods

Tess M E van Ramshorst, Alessandro Giani, European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS), Michele Mazzola, Safi Dokmak, Fadhel Samir Ftériche, Alessandro Esposito, Matteo de Pastena, Sanne Lof, Bjørn Edwin, Mushegh Sahakyan, Ugo Boggi, Emanuele Federico Kauffman, Jean Michel Fabre, Regis Francois Souche, Alessandro Zerbi, Giovanni Butturini, Quintus Molenaar, Bilal Al-Sarireh, Marco V MarinoTobias Keck, Steven A White, Riccardo Casadei, Fernando Burdio, Bergthor Björnsson, Zahir Soonawalla, Bas Groot Koerkamp, Giuseppe Kito Fusai, Patrick Pessaux, Asif Jah, Andrea Pietrabissa, Thilo Hackert, Mathieu D'Hondt, Elizabeth Pando, Marc G Besselink, Giovanni Ferrari, Mohammad Abu Hilal^*

^*Corresponding author for this work

Surgery

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

BACKGROUND: Benchmarking is an important tool for quality comparison and improvement. However, no benchmark values are available for minimally invasive spleen-preserving distal pancreatectomy, either laparoscopically or robotically assisted. The aim of this study was to establish benchmarks for these techniques using two different methods.

METHODS: Data from patients undergoing laparoscopically or robotically assisted spleen-preserving distal pancreatectomy were extracted from a multicentre database (2006-2019). Benchmarks for 10 outcomes were calculated using the Achievable Benchmark of Care (ABC) and best-patient-in-best-centre methods.

RESULTS: Overall, 951 laparoscopically assisted (77.3 per cent) and 279 robotically assisted (22.7 per cent) procedures were included. Using the ABC method, the benchmarks for laparoscopically assisted and robotically assisted spleen-preserving distal pancreatectomy respectively were: 150 and 207 min for duration of operation, 55 and 100 ml for blood loss, 3.5 and 1.7 per cent for conversion, 0 and 1.7 per cent for failure to preserve the spleen, 27.3 and 34.0 per cent for overall morbidity, 5.1 and 3.3 per cent for major morbidity, 3.6 and 7.1 per cent for pancreatic fistula grade B/C, 5 and 6 days for duration of hospital stay, 2.9 and 5.4 per cent for readmissions, and 0 and 0 per cent for 90-day mortality. Best-patient-in-best-centre methodology revealed milder benchmark cut-offs for laparoscopically and robotically assisted procedures, with operating times of 254 and 262.5 min, blood loss of 150 and 195 ml, conversion rates of 5.8 and 8.2 per cent, rates of failure to salvage spleen of 29.9 and 27.3 per cent, overall morbidity rates of 62.7 and 55.7 per cent, major morbidity rates of 20.4 and 14 per cent, POPF B/C rates of 23.8 and 24.2 per cent, duration of hospital stay of 8 and 8 days, readmission rates of 20 and 15.1 per cent, and 90-day mortality rates of 0 and 0 per cent respectively.

CONCLUSION: Two benchmark methods for minimally invasive distal pancreatectomy produced different values, and should be interpreted and applied differently.

Original language	English
Pages (from-to)	76-83
Number of pages	8
Journal	The British journal of surgery
Volume	110
Issue number	1
Early online date	2 Nov 2022
DOIs	https://doi.org/10.1093/bjs/znac352
Publication status	Published - 1 Jan 2023

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van Ramshorst, T. M. E., Giani, A., European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS), Mazzola, M., Dokmak, S., Ftériche, F. S., Esposito, A., de Pastena, M., Lof, S., Edwin, B., Sahakyan, M., Boggi, U., Kauffman, E. F., Fabre, J. M., Souche, R. F., Zerbi, A., Butturini, G., Molenaar, Q., Al-Sarireh, B., ... Hilal, M. A. (2023). Benchmarking of robotic and laparoscopic spleen-preserving distal pancreatectomy by using two different methods. The British journal of surgery, 110(1), 76-83. https://doi.org/10.1093/bjs/znac352

@article{ddeda87a627f4c63a60e80c04b157593,

title = "Benchmarking of robotic and laparoscopic spleen-preserving distal pancreatectomy by using two different methods",

abstract = "BACKGROUND: Benchmarking is an important tool for quality comparison and improvement. However, no benchmark values are available for minimally invasive spleen-preserving distal pancreatectomy, either laparoscopically or robotically assisted. The aim of this study was to establish benchmarks for these techniques using two different methods.METHODS: Data from patients undergoing laparoscopically or robotically assisted spleen-preserving distal pancreatectomy were extracted from a multicentre database (2006-2019). Benchmarks for 10 outcomes were calculated using the Achievable Benchmark of Care (ABC) and best-patient-in-best-centre methods.RESULTS: Overall, 951 laparoscopically assisted (77.3 per cent) and 279 robotically assisted (22.7 per cent) procedures were included. Using the ABC method, the benchmarks for laparoscopically assisted and robotically assisted spleen-preserving distal pancreatectomy respectively were: 150 and 207 min for duration of operation, 55 and 100 ml for blood loss, 3.5 and 1.7 per cent for conversion, 0 and 1.7 per cent for failure to preserve the spleen, 27.3 and 34.0 per cent for overall morbidity, 5.1 and 3.3 per cent for major morbidity, 3.6 and 7.1 per cent for pancreatic fistula grade B/C, 5 and 6 days for duration of hospital stay, 2.9 and 5.4 per cent for readmissions, and 0 and 0 per cent for 90-day mortality. Best-patient-in-best-centre methodology revealed milder benchmark cut-offs for laparoscopically and robotically assisted procedures, with operating times of 254 and 262.5 min, blood loss of 150 and 195 ml, conversion rates of 5.8 and 8.2 per cent, rates of failure to salvage spleen of 29.9 and 27.3 per cent, overall morbidity rates of 62.7 and 55.7 per cent, major morbidity rates of 20.4 and 14 per cent, POPF B/C rates of 23.8 and 24.2 per cent, duration of hospital stay of 8 and 8 days, readmission rates of 20 and 15.1 per cent, and 90-day mortality rates of 0 and 0 per cent respectively.CONCLUSION: Two benchmark methods for minimally invasive distal pancreatectomy produced different values, and should be interpreted and applied differently.",

author = "{van Ramshorst}, {Tess M E} and Alessandro Giani and {European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS)} and Michele Mazzola and Safi Dokmak and Ft{\'e}riche, {Fadhel Samir} and Alessandro Esposito and {de Pastena}, Matteo and Sanne Lof and Bj{\o}rn Edwin and Mushegh Sahakyan and Ugo Boggi and Kauffman, {Emanuele Federico} and Fabre, {Jean Michel} and Souche, {Regis Francois} and Alessandro Zerbi and Giovanni Butturini and Quintus Molenaar and Bilal Al-Sarireh and Marino, {Marco V} and Tobias Keck and White, {Steven A} and Riccardo Casadei and Fernando Burdio and Bergthor Bj{\"o}rnsson and Zahir Soonawalla and Koerkamp, {Bas Groot} and Fusai, {Giuseppe Kito} and Patrick Pessaux and Asif Jah and Andrea Pietrabissa and Thilo Hackert and Mathieu D'Hondt and Elizabeth Pando and Besselink, {Marc G} and Giovanni Ferrari and Hilal, {Mohammad Abu}",

note = "{\textcopyright} The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd.",

year = "2023",

month = jan,

day = "1",

doi = "10.1093/bjs/znac352",

language = "English",

volume = "110",

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van Ramshorst, TME, Giani, A, European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS), Mazzola, M, Dokmak, S, Ftériche, FS, Esposito, A, de Pastena, M, Lof, S, Edwin, B, Sahakyan, M, Boggi, U, Kauffman, EF, Fabre, JM, Souche, RF, Zerbi, A, Butturini, G, Molenaar, Q, Al-Sarireh, B, Marino, MV, Keck, T, White, SA, Casadei, R, Burdio, F, Björnsson, B, Soonawalla, Z, Koerkamp, BG, Fusai, GK, Pessaux, P, Jah, A, Pietrabissa, A, Hackert, T, D'Hondt, M, Pando, E, Besselink, MG, Ferrari, G & Hilal, MA 2023, 'Benchmarking of robotic and laparoscopic spleen-preserving distal pancreatectomy by using two different methods', The British journal of surgery, vol. 110, no. 1, pp. 76-83. https://doi.org/10.1093/bjs/znac352

Benchmarking of robotic and laparoscopic spleen-preserving distal pancreatectomy by using two different methods. / van Ramshorst, Tess M E; Giani, Alessandro; European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS) et al.
In: The British journal of surgery, Vol. 110, No. 1, 01.01.2023, p. 76-83.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Benchmarking of robotic and laparoscopic spleen-preserving distal pancreatectomy by using two different methods

AU - van Ramshorst, Tess M E

AU - Giani, Alessandro

AU - European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS)

AU - Mazzola, Michele

AU - Dokmak, Safi

AU - Ftériche, Fadhel Samir

AU - Esposito, Alessandro

AU - de Pastena, Matteo

AU - Lof, Sanne

AU - Edwin, Bjørn

AU - Sahakyan, Mushegh

AU - Boggi, Ugo

AU - Kauffman, Emanuele Federico

AU - Fabre, Jean Michel

AU - Souche, Regis Francois

AU - Zerbi, Alessandro

AU - Butturini, Giovanni

AU - Molenaar, Quintus

AU - Al-Sarireh, Bilal

AU - Marino, Marco V

AU - Keck, Tobias

AU - White, Steven A

AU - Casadei, Riccardo

AU - Burdio, Fernando

AU - Björnsson, Bergthor

AU - Soonawalla, Zahir

AU - Koerkamp, Bas Groot

AU - Fusai, Giuseppe Kito

AU - Pessaux, Patrick

AU - Jah, Asif

AU - Pietrabissa, Andrea

AU - Hackert, Thilo

AU - D'Hondt, Mathieu

AU - Pando, Elizabeth

AU - Besselink, Marc G

AU - Ferrari, Giovanni

AU - Hilal, Mohammad Abu

PY - 2023/1/1

Y1 - 2023/1/1

N2 - BACKGROUND: Benchmarking is an important tool for quality comparison and improvement. However, no benchmark values are available for minimally invasive spleen-preserving distal pancreatectomy, either laparoscopically or robotically assisted. The aim of this study was to establish benchmarks for these techniques using two different methods.METHODS: Data from patients undergoing laparoscopically or robotically assisted spleen-preserving distal pancreatectomy were extracted from a multicentre database (2006-2019). Benchmarks for 10 outcomes were calculated using the Achievable Benchmark of Care (ABC) and best-patient-in-best-centre methods.RESULTS: Overall, 951 laparoscopically assisted (77.3 per cent) and 279 robotically assisted (22.7 per cent) procedures were included. Using the ABC method, the benchmarks for laparoscopically assisted and robotically assisted spleen-preserving distal pancreatectomy respectively were: 150 and 207 min for duration of operation, 55 and 100 ml for blood loss, 3.5 and 1.7 per cent for conversion, 0 and 1.7 per cent for failure to preserve the spleen, 27.3 and 34.0 per cent for overall morbidity, 5.1 and 3.3 per cent for major morbidity, 3.6 and 7.1 per cent for pancreatic fistula grade B/C, 5 and 6 days for duration of hospital stay, 2.9 and 5.4 per cent for readmissions, and 0 and 0 per cent for 90-day mortality. Best-patient-in-best-centre methodology revealed milder benchmark cut-offs for laparoscopically and robotically assisted procedures, with operating times of 254 and 262.5 min, blood loss of 150 and 195 ml, conversion rates of 5.8 and 8.2 per cent, rates of failure to salvage spleen of 29.9 and 27.3 per cent, overall morbidity rates of 62.7 and 55.7 per cent, major morbidity rates of 20.4 and 14 per cent, POPF B/C rates of 23.8 and 24.2 per cent, duration of hospital stay of 8 and 8 days, readmission rates of 20 and 15.1 per cent, and 90-day mortality rates of 0 and 0 per cent respectively.CONCLUSION: Two benchmark methods for minimally invasive distal pancreatectomy produced different values, and should be interpreted and applied differently.

AB - BACKGROUND: Benchmarking is an important tool for quality comparison and improvement. However, no benchmark values are available for minimally invasive spleen-preserving distal pancreatectomy, either laparoscopically or robotically assisted. The aim of this study was to establish benchmarks for these techniques using two different methods.METHODS: Data from patients undergoing laparoscopically or robotically assisted spleen-preserving distal pancreatectomy were extracted from a multicentre database (2006-2019). Benchmarks for 10 outcomes were calculated using the Achievable Benchmark of Care (ABC) and best-patient-in-best-centre methods.RESULTS: Overall, 951 laparoscopically assisted (77.3 per cent) and 279 robotically assisted (22.7 per cent) procedures were included. Using the ABC method, the benchmarks for laparoscopically assisted and robotically assisted spleen-preserving distal pancreatectomy respectively were: 150 and 207 min for duration of operation, 55 and 100 ml for blood loss, 3.5 and 1.7 per cent for conversion, 0 and 1.7 per cent for failure to preserve the spleen, 27.3 and 34.0 per cent for overall morbidity, 5.1 and 3.3 per cent for major morbidity, 3.6 and 7.1 per cent for pancreatic fistula grade B/C, 5 and 6 days for duration of hospital stay, 2.9 and 5.4 per cent for readmissions, and 0 and 0 per cent for 90-day mortality. Best-patient-in-best-centre methodology revealed milder benchmark cut-offs for laparoscopically and robotically assisted procedures, with operating times of 254 and 262.5 min, blood loss of 150 and 195 ml, conversion rates of 5.8 and 8.2 per cent, rates of failure to salvage spleen of 29.9 and 27.3 per cent, overall morbidity rates of 62.7 and 55.7 per cent, major morbidity rates of 20.4 and 14 per cent, POPF B/C rates of 23.8 and 24.2 per cent, duration of hospital stay of 8 and 8 days, readmission rates of 20 and 15.1 per cent, and 90-day mortality rates of 0 and 0 per cent respectively.CONCLUSION: Two benchmark methods for minimally invasive distal pancreatectomy produced different values, and should be interpreted and applied differently.

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U2 - 10.1093/bjs/znac352

DO - 10.1093/bjs/znac352

M3 - Article

C2 - 36322465

SN - 0007-1323

VL - 110

SP - 76

EP - 83

JO - The British journal of surgery

JF - The British journal of surgery

IS - 1

ER -

Benchmarking of robotic and laparoscopic spleen-preserving distal pancreatectomy by using two different methods

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