European consensus on essential steps of Minimally Invasive Ivor Lewis and McKeown Esophagectomy through Delphi methodology

Yassin Eddahchouri*, Frans van Workum, MIE Delphi Collaboration, Frits J.H. van den Wildenberg, Mark I. van Berge Henegouwen, Fatih Polat, Harry van Goor, Jean Pierre E.N. Pierie, Bastiaan R. Klarenbeek, Suzanne S. Gisbertz, Camiel Rosman

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

8 Citations (Scopus)
8 Downloads (Pure)


Background: Minimally invasive esophagectomy (MIE) is a complex and technically demanding procedure with a long learning curve, which is associated with increased morbidity and mortality. To master MIE, training in essential steps is crucial. Yet, no consensus on essential steps of MIE is available. The aim of this study was to achieve expert consensus on essential steps in Ivor Lewis and McKeown MIE through Delphi methodology. Methods: Based on expert opinion and peer-reviewed literature, essential steps were defined for Ivor Lewis (IL) and McKeown (McK) MIE. In a round table discussion, experts finalized the lists of steps and an online Delphi questionnaire was sent to an international expert panel (7 European countries) of minimally invasive upper GI surgeons. Based on replies and comments, steps were adjusted and rephrased and sent in iterative fashion until consensus was achieved. Results: Two Delphi rounds were conducted and response rates were 74% (23 out of 31 experts) for the first and 81% (27 out of 33 experts) for the second round. Consensus was achieved on 106 essential steps for both the IL and McK approach. Cronbach’s alpha in the first round was 0.78 (IL) and 0.78 (McK) and in the second round 0.92 (IL) and 0.88 (McK). Conclusions: Consensus among European experts was achieved on essential surgical steps for both Ivor Lewis and McKeown minimally invasive esophagectomy.

Original languageEnglish
Pages (from-to)446-460
Number of pages15
JournalSurgical Endoscopy
Issue number1
Publication statusPublished - Jan 2022

Bibliographical note

Funding Information:
This study has been fully supported and financed by the Radboud University Medical Center, Department of Surgery, Nijmegen, the Netherlands.

Publisher Copyright: © 2021, The Author(s).


Dive into the research topics of 'European consensus on essential steps of Minimally Invasive Ivor Lewis and McKeown Esophagectomy through Delphi methodology'. Together they form a unique fingerprint.

Cite this