Pituitary society expert Delphi consensus: operative workflow in endoscopic transsphenoidal pituitary adenoma resection
Authors
Khan, Danyal Z.
Borg, Anouk
Buchfelder, Michael
Cetas, Justin S.
Collins, Justin W.
Dorward, Neil L.
Fleseriu, Maria
Gurnell, Mark
Javadpour, Mohsen
Jones, Pamela S.
Koh, Chan Hee
Layard Horsfall, Hugo
Mamelak, Adam N.
Mortini, Pietro
Muirhead, William
Oyesiku, Nelson M.
Schwartz, Theodore H.
Sinha, Saurabh
Stoyanov, Danail
Syro, Luis V.
Tsermoulas, Georgios
Williams, Adam
Winder, Mark J.
Zada, Gabriel
Laws, Edward R.
Publication Date
2021-07-06Journal Title
Pituitary
ISSN
1386-341X
Publisher
Springer US
Volume
24
Issue
6
Pages
839-853
Language
en
Type
Article
This Version
VoR
Metadata
Show full item recordCitation
Marcus, H. J., Khan, D. Z., Borg, A., Buchfelder, M., Cetas, J. S., Collins, J. W., Dorward, N. L., et al. (2021). Pituitary society expert Delphi consensus: operative workflow in endoscopic transsphenoidal pituitary adenoma resection. Pituitary, 24 (6), 839-853. https://doi.org/10.1007/s11102-021-01162-3
Abstract
Abstract: Purpose: Surgical workflow analysis seeks to systematically break down operations into hierarchal components. It facilitates education, training, and understanding of surgical variations. There are known educational demands and variations in surgical practice in endoscopic transsphenoidal approaches to pituitary adenomas. Through an iterative consensus process, we generated a surgical workflow reflective of contemporary surgical practice. Methods: A mixed-methods consensus process composed of a literature review and iterative Delphi surveys was carried out within the Pituitary Society. Each round of the survey was repeated until data saturation and > 90% consensus was reached. Results: There was a 100% response rate and no attrition across both Delphi rounds. Eighteen international expert panel members participated. An extensive workflow of 4 phases (nasal, sphenoid, sellar and closure) and 40 steps, with associated technical errors and adverse events, were agreed upon by 100% of panel members across rounds. Both core and case-specific or surgeon-specific variations in operative steps were captured. Conclusions: Through an international expert panel consensus, a workflow for the performance of endoscopic transsphenoidal pituitary adenoma resection has been generated. This workflow captures a wide range of contemporary operative practice. The agreed “core” steps will serve as a foundation for education, training, assessment and technological development (e.g. models and simulators). The “optional” steps highlight areas of heterogeneity of practice that will benefit from further research (e.g. methods of skull base repair). Further adjustments could be made to increase applicability around the world.
Keywords
Article, Endoscopic transsphenoidal surgery, Endoscopic endonasal, Skull base surgery, Pituitary adenoma, Pituitary, Consensus, Delphi
Identifiers
s11102-021-01162-3, 1162
External DOI: https://doi.org/10.1007/s11102-021-01162-3
This record's URL: https://www.repository.cam.ac.uk/handle/1810/329979
Rights
Licence:
http://creativecommons.org/licenses/by/4.0/
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