In several GI surgical specialties, laparoscopic surgery has nearly supplanted open surgery. However, the fundamentals of laparoscopic GI surgery have not yet been the subject of a published professional consensus statement. This could have had an impact on how new surgeons were trained. For a study, researchers sought to reach an agreement among experts on key laparoscopic GI surgery concepts.

Following a stringent modified Delphi process, a committee of 38 worldwide experts in laparoscopic GI surgery offered and voted on 149 statements in 2 rounds.

After 2 rounds of voting, 133 statements were agreed upon. While 84.2% of experts recommended avoiding the umbilical region for pneumoperitoneum in patients who had a prior midline laparotomy, all experts agreed that the initial port placement should be customized to the patient. Furthermore, 86.8% of respondents were in favor of sealing all 15 mm ports, regardless of the patient’s BMI. The use of cartridges of the proper height, verifying the doughnuts after utilizing circular staplers, and keeping the vibrating blade of the ultrasonic energy device in view and away from vascular structures were all unanimously agreed upon. A port site hernia is more likely when a drain is inserted through a site with a port smaller than ≥10 mm, according to 84.2% of respondents. There was 94.7% agreement that laparoscopic retrieval bags should be included in the operative count and that any surgical specimen left within should also be included.

On 133 assertions relating to various elements of laparoscopic GI surgery, 38 experts agreed. However, their greater understanding might simplify training and enhance patient outcomes.

Reference: sciencedirect.com/science/article/abs/pii/S174391912200543X