Evidence map›Paper›PMID 42143159›Full record

ArticleJournal of gastroenterology2026

A modified Delphi consensus on fusion (laparoscopic and robotic) approaches to colorectal surgery in Asia-Pacific.

Jun Watanabe, Yoshinori Kagawa, Takashi Nonaka, Hyejin Kim, Siripong Cheewatanakornkul, Peter Chien-Chih Chen, William Tzu-Liang Chen, Ashwin deSouza, Atsushi Hamabe, Hiroyasu Kagawa and 7 more

Abstract readConsensus Statement
In one paragraph

Article in Journal of gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Jun WatanabeDepartment of Colorectal Surgery, Kansai Medical University, 2 Chome-5-1 Shinmachi, Hirakata, Osaka, 573-1191, Japan. watanabe.jun@kmu.ac.jp.ORCID http://orcid.org/0000-0002-7187-3664
Yoshinori KagawaDepartment of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan.
Takashi NonakaDepartment of Surgical Oncology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
Hyejin KimColorectal Cancer Center, Kyungpook National University Medical Chilgok Hospital, Daegu, South Korea.
Siripong CheewatanakornkulDepartment of Surgery, Minimally Invasive Surgery Unit, Prince of Songkla University, Hat Yai, Thailand.
Peter Chien-Chih ChenDepartment of Surgery, Sun Yat-Sen Cancer Center, Koo Foundation, Taipei, Taiwan.
William Tzu-Liang ChenDepartment of Colorectal Surgery, China Medical University Hospital, China Medical University, Taichung, Taiwan.
Ashwin deSouzaDepartment of Surgery, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India.
Atsushi HamabeDepartment of Gastroenterological Surgery, Graduate School of Medicine, The University of Osaka, Osaka, Japan.
Hiroyasu KagawaDepartment of Gastrointestinal Surgery, Institute of Science Tokyo, Tokyo, Japan.
Yoon Suk LeeDivision of Colorectal Surgery, Department of Surgery Seoul St. Mary Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Simon Siu-Man NgDepartment of Surgery, The Chinese University of Hong Kong, Hong Kong SAR, China.
Andrew R L StevensonDepartment of Surgery, Division of Colorectal Surgery, The Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.
Nan Zun TeoDepartment of Surgery, Changi General Hospital, Singapore, Singapore.
Mamoru UemuraDepartment of Gastroenterological Surgery, Graduate School of Medicine, The University of Osaka, Osaka, Japan.
Kar Yong WongDepartment of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore.
James Chi-Yong NguDepartment of Surgery, Changi General Hospital, Singapore, Singapore.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFusion surgery, where laparoscopic techniques are purposefully integrated into robotic surgery, is a novel approach that can be used in colorectal surgery. However, a standard definition and practical guidance are lacking. Therefore, this study aimed to generate consensus to standardise the definition of fusion surgery and consequently raise awareness of fusion surgical approaches and their appropriate use cases.

methodsWe conducted a two-round modified Delphi study with 17 colorectal surgeons from Asia-Pacific (5 Steering Committee [SC]; 12 Expert Panellists [EP]). Statements were drafted by the SC based on clinical experience, published literature and comments from the EP. The EP rated these statements anonymously on a 5-point Likert scale. A virtual expert meeting was held between voting rounds to discuss the statements. Consensus was predefined as ≥ 75% "agree"/"strongly agree" or "disagree"/"strongly disagree".

resultsUltimately, consensus was reached on 23 statements: "Defining Fusion Surgery in Colorectal Surgery" (n = 2); "When to Consider Fusion Surgery in Colorectal Surgery" (n = 10; 5 statements each on "Device Factors" and "Surgeon Factors"); "Task- or Procedure-Specific Considerations in Colorectal Surgery" (n = 11).

conclusionThe Expert Panel were aligned on the definition of fusion surgery as a procedure where laparoscopic tools and techniques are electively combined with robotic surgery. Fusion surgery may achieve similar safety and effectiveness as fully robotic surgery, whilst potentially offering advantages such as improved ergonomics, shorter operating times and educational opportunities for bedside assistants. This consensus serves as a valuable guide containing considerations for surgeons to encourage the appropriate adoption of fusion approaches in colorectal surgery.

Indexed as

LaparoscopyRobotic Surgical ProceduresAsiaColorectal Surgical ProceduresDelphi TechniqueHumansColorectal cancerConsensusFusion surgeryLaparoscopic surgeryRobot-assisted surgery

Identifiers

PMID42143159
PMCPMC13506586

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.