title: Pan-European survey on the implementation of minimally invasive pancreatic surgery with emphasis on cancer.
abstract: BACKGROUND
  Minimally invasive (MI) pancreatic surgery appears to be gaining popularity, but its implementation throughout Europe and the opinions regarding its use in pancreatic cancer patients are unknown.
  
  
  METHODS
  A 30-question survey was sent between June and December 2014 to pancreatic surgeons of the European Pancreatic Club, European-African Hepato-Pancreato-Biliary Association and 5 European national pancreatic societies. Incomplete responses were excluded.
  
  
  RESULTS
  In total, 237 pancreatic surgeons responded. After excluding 34 incomplete responses, 203 responses from 27 European countries were included. 164 (81%) surgeons were employed at a university hospital, 184 (91%) performed advanced MI surgery and 148 (73%) performed MI distal pancreatectomy. MI pancreatoduodenectomy was performed by 42 (21%) surgeons, whereas 9 (4.4%) surgeons had performed more than 10 procedures. Robot-assisted MI pancreatic surgery was performed by 28 (14%) surgeons. 63 (31%) surgeons expected MI distal pancreatectomy for cancer to be inferior to open distal pancreatectomy concerning oncological outcomes. 151 (74%) surgeons expected to benefit from training in MI distal pancreatectomy and 149 (73%) were willing to participate in a randomized trial on this topic.
  
  
  CONCLUSIONS
  MI distal pancreatectomy is a common procedure, although its use for cancer is still disputed. MI pancreatoduodenectomy is still an uncommon procedure. Specific training and a randomized trial regarding MI pancreatic cancer surgery are welcomed.
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Thijs
authors.initials: T
authors.lastname: de Rooij
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands. Electronic address: m.g.besselink@amc.nl.
authors.forename: Marc G
authors.initials: MG
authors.lastname: Besselink
authors.affiliation: Department of Surgery, Southampton University Hospital, NHS Foundation Trust, Southampton, United Kingdom.
authors.forename: Awad
authors.initials: A
authors.lastname: Shamali
authors.affiliation: Department of Surgery, Verona University Hospital Trust, Verona, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Butturini
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Olivier R
authors.initials: OR
authors.lastname: Busch
authors.affiliation: Interventional Centre and Department of HPB Surgery, Oslo University Hospital and Institute for Clinical Medicine, Oslo University, Oslo, Norway.
authors.forename: Bjørn
authors.initials: B
authors.lastname: Edwin
authors.affiliation: Department of Surgery, Ghent University Hospital, Ghent, Belgium.
authors.forename: Roberto
authors.initials: R
authors.lastname: Troisi
authors.affiliation: Department of Surgery, Barcelona University Hospital, Barcelona, Spain.
authors.forename: Laureano
authors.initials: L
authors.lastname: Fernández-Cruz
authors.affiliation: Department of Surgery, Antoine Béclère Hospital, Paris-Sud University, Paris, France.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Dagher
authors.affiliation: Department of Surgery, Verona University Hospital Trust, Verona, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Bassi
authors.affiliation: Department of Surgery, Southampton University Hospital, NHS Foundation Trust, Southampton, United Kingdom. Electronic address: abuhilal9@gmail.com.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Abu Hilal
mesh_terms: D019538:Health Care Surveys; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000639:trends; D010180:Pancreatectomy / Q000639:trends*; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000639:trends*; D010818:Practice Patterns, Physicians' / Q000639:trends*; D065287:Robotic Surgical Procedures / Q000639:trends*