Date of visit: 1-09-2022 – 1-10-2022
In September 2022, I visited Poliambulanza Hospital in Brescia to participate in the development of the 2022 European evidence-based guideline on minimally invasive pancreatic surgery. These guidelines focused on all new developments in laparoscopic and robot-assisted pancreatic surgery: the safe introduction, different techniques and terminology, the impact of conversion to open surgery, and the future role of artificial intelligence.
The preparations for this guideline already started in the beginning of 2022. Together with a PhD-student from Poliambulanza, I developed and performed a survey among pancreatic surgeons worldwide questioning the use of minimally invasive techniques and terminology. This survey was used as a basis for the development of the research questions concerning this guideline. In Brescia, Italy, at the European Guidelines on Minimally Invasive Pancreatic Surgery (EGUMIPS) meeting, I also presented the outcomes of the survey. The manuscript will be soon be submitted for publication.
After determination of the questions that had to be answered by the guideline, an extensive literature review was performed to provide information for answers. Review groups, consisting of European PhD-students and experts (surgeons, pathologists etc), were formed and together we performed a systematic literature review for all topics involved. I was part of the review groups on terminology, conversion from minimally invasive to open, and indications for minimally invasive distal pancreatectomy and pancreatoduodenectomy. Based on the literature review, several statements regarding the research questions were proposed.
Following the review phase, consensus regarding the statements was reached through a Delphi-survey involving all involved international experts in the field of minimally invasive pancreatic surgery. Approval of a statement was reached when 90% of respondents agreed.
The final step of validation was performed during the guideline meeting (29-30th of September, Brescia) according to the AGREE II-GRS tool. During the meeting, all literature was presented and discussed, and an additional round of voting was performed. Also, an independent international validation committee endorsed all statements.
To be able to participate in this project, I decided to take a one month leave from surgical residency. During the visit to Brescia, I was able to be closely involved in the final preparations for the meeting and develop several research projects for the coming years. Two manuscripts are currently submitted and four more are currently in preparation as output from this guideline project.
Also, several new projects have been developed in which I am closely involved. As a post-doc researcher, I supervise several Cancer Center Amsterdam PhD students positioned in Poliambulanza for a longer period (12-18 months) during their PhD based on the close research bond between Amsterdam UMC and Poliambulanza. This work visit also provided me with the opportunity to work closely with them and boost our other projects.
This visit also provided me with more insights on the differences between the Dutch and Italian health system. I visited the pancreas institute in Verona where I joined in the operating theatre and participated in rounds. Besides improving my medical and research skills, I was also able to improve my Italian during my stay in Brescia. Additionally, my family joined me during this month and we were able to enjoy the beautiful city of Brescia and its surroundings during the weekends.
I would like to thank the Cancer Center Amsterdam again for this opportunity!
For more information, contact Dr. Jony van Hilst.
Text by Jony van Hilst.