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A multidisciplinary evidence-based guideline for minimally invasive surgery.: Part 1: entry techniques and the pneumoperitoneum.

la Chapelle CF, Bemelman WA, Rademaker BM, van Barneveld TA, Jansen FW - Gynecol Surg (2012)

Bottom Line: Identified important topics were: laparoscopic entry techniques, intra-abdominal pressure, trocar use, electrosurgical techniques, prevention of trocar site herniation, patient positioning, anesthesiology, perioperative care, patient information, multidisciplinary user consultation, and complication registration.The text of each topic contains an introduction with an explanation of the problem and a summary of the current literature.The development of a guideline on a multidisciplinary level facilitated a broad and rich discussion, which resulted in a very complete and implementable guideline.

View Article: PubMed Central - PubMed

ABSTRACT
The Dutch Society for Endoscopic Surgery together with the Dutch Society of Obstetrics and Gynecology initiated a multidisciplinary working group to develop a guideline on minimally invasive surgery to formulate multidisciplinary agreements for minimally invasive surgery aiming towards better patient care and safety. The guideline development group consisted of general surgeons, gynecologists, an anesthesiologist, and urologist authorized by their scientific professional association. Two advisors in evidence-based guideline development supported the group. The guideline was developed using the "Appraisal of Guidelines for Research and Evaluation" instrument. Clinically important aspects were identified and discussed. The best available evidence on these aspects was gathered by systematic review. Recommendations for clinical practice were formulated based on the evidence and a consensus of expert opinion. The guideline was externally reviewed by members of the participating scientific associations and their feedback was integrated. Identified important topics were: laparoscopic entry techniques, intra-abdominal pressure, trocar use, electrosurgical techniques, prevention of trocar site herniation, patient positioning, anesthesiology, perioperative care, patient information, multidisciplinary user consultation, and complication registration. The text of each topic contains an introduction with an explanation of the problem and a summary of the current literature. Each topic was discussed, considerations were evaluated and recommendations were formulated. The development of a guideline on a multidisciplinary level facilitated a broad and rich discussion, which resulted in a very complete and implementable guideline.

No MeSH data available.


Related in: MedlinePlus

Overview of the developmental process in EBGD
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Fig1: Overview of the developmental process in EBGD

Mentions: The guideline was developed consistent with the “Appraisal of Guidelines for Research and Evaluation” instrument [1]. Initially, the working group performed a problem analysis to define the scope and topics of the guideline. These problem topics were translated into clinical key questions and the scientific literature was searched for answering the key questions. Separate search strategies were developed for each problem topic. Searches were conducted in collaboration with information specialists. Studies were limited to English and Dutch language in view of the limitations on time and resources. The search strategies are appended (see Appendix). The developers selected relevant literature. The bibliographies of relevant articles were hand searched for other valuable references. The characteristics and methodological quality of the studies were assessed using the checklists from the Dutch Cochrane Center [2]. The evidence was summarized in evidence tables and in the guideline text. The grading system of the Dutch Institute for Healthcare improvement CBO was used to level the evidence (Table 1). The guideline text is structured according to a prescribed Evidence-Based Guideline Development (EBGD) format. Each defined key question has its own text-section that comprises the clinical key question followed by a summary of the literature and a conclusion including the level of evidence. Then, considerations (including: patient preferences, availability of services, organization of care, impact on costs, legal consequences) are discussed and each section ends with recommendations. The recommendations are the practical answer to the key question. They are based on ‘evidence’ (the summary of literature) and balanced with ‘experience’ (the paragraph considerations). An illustrative overview of the EBGD process is shown in Fig. 1.Table 1


A multidisciplinary evidence-based guideline for minimally invasive surgery.: Part 1: entry techniques and the pneumoperitoneum.

la Chapelle CF, Bemelman WA, Rademaker BM, van Barneveld TA, Jansen FW - Gynecol Surg (2012)

Overview of the developmental process in EBGD
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3401300&req=5

Fig1: Overview of the developmental process in EBGD
Mentions: The guideline was developed consistent with the “Appraisal of Guidelines for Research and Evaluation” instrument [1]. Initially, the working group performed a problem analysis to define the scope and topics of the guideline. These problem topics were translated into clinical key questions and the scientific literature was searched for answering the key questions. Separate search strategies were developed for each problem topic. Searches were conducted in collaboration with information specialists. Studies were limited to English and Dutch language in view of the limitations on time and resources. The search strategies are appended (see Appendix). The developers selected relevant literature. The bibliographies of relevant articles were hand searched for other valuable references. The characteristics and methodological quality of the studies were assessed using the checklists from the Dutch Cochrane Center [2]. The evidence was summarized in evidence tables and in the guideline text. The grading system of the Dutch Institute for Healthcare improvement CBO was used to level the evidence (Table 1). The guideline text is structured according to a prescribed Evidence-Based Guideline Development (EBGD) format. Each defined key question has its own text-section that comprises the clinical key question followed by a summary of the literature and a conclusion including the level of evidence. Then, considerations (including: patient preferences, availability of services, organization of care, impact on costs, legal consequences) are discussed and each section ends with recommendations. The recommendations are the practical answer to the key question. They are based on ‘evidence’ (the summary of literature) and balanced with ‘experience’ (the paragraph considerations). An illustrative overview of the EBGD process is shown in Fig. 1.Table 1

Bottom Line: Identified important topics were: laparoscopic entry techniques, intra-abdominal pressure, trocar use, electrosurgical techniques, prevention of trocar site herniation, patient positioning, anesthesiology, perioperative care, patient information, multidisciplinary user consultation, and complication registration.The text of each topic contains an introduction with an explanation of the problem and a summary of the current literature.The development of a guideline on a multidisciplinary level facilitated a broad and rich discussion, which resulted in a very complete and implementable guideline.

View Article: PubMed Central - PubMed

ABSTRACT
The Dutch Society for Endoscopic Surgery together with the Dutch Society of Obstetrics and Gynecology initiated a multidisciplinary working group to develop a guideline on minimally invasive surgery to formulate multidisciplinary agreements for minimally invasive surgery aiming towards better patient care and safety. The guideline development group consisted of general surgeons, gynecologists, an anesthesiologist, and urologist authorized by their scientific professional association. Two advisors in evidence-based guideline development supported the group. The guideline was developed using the "Appraisal of Guidelines for Research and Evaluation" instrument. Clinically important aspects were identified and discussed. The best available evidence on these aspects was gathered by systematic review. Recommendations for clinical practice were formulated based on the evidence and a consensus of expert opinion. The guideline was externally reviewed by members of the participating scientific associations and their feedback was integrated. Identified important topics were: laparoscopic entry techniques, intra-abdominal pressure, trocar use, electrosurgical techniques, prevention of trocar site herniation, patient positioning, anesthesiology, perioperative care, patient information, multidisciplinary user consultation, and complication registration. The text of each topic contains an introduction with an explanation of the problem and a summary of the current literature. Each topic was discussed, considerations were evaluated and recommendations were formulated. The development of a guideline on a multidisciplinary level facilitated a broad and rich discussion, which resulted in a very complete and implementable guideline.

No MeSH data available.


Related in: MedlinePlus