ArticleJournal of robotic surgery2026
An intra-operative checklist for low-impact robotic urologic surgery: a three-round J-ERUS/YAU Delphi consensus.
Article in Journal of robotic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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38 authors.
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Abstract
Enhanced recovery pathways emphasise peri-operative pharmacology, whereas many modifiable intra-operative practices remain under-standardised and supported by heterogeneous evidence. Standardising these practices is central to low-impact robotic surgery, aiming to minimise avoidable procedural and physiological stress, and may improve early recovery, including post-operative pain. A three-round, online modified Delphi was conducted within the J-ERUS/YAU network, inviting 21 experts (19 urologists, 2 anaesthetists). Round-1 presented 21 items (5-point Likert). A priori thresholds-blinded to panellists-were: Include = median ≥ 4 with interquartile range (IQR) ≤ 1; Exclude = median < 3; otherwise = revote. Rounds-2/-3 re-rated non-consensus items and validated new items proposed from R1 free-text; at each revote, the prior round's median and IQR were shown. Late submissions were excluded in Rounds 1 and 2. R1 analysed 20 valid responses: 5 Include, 2 Exclude, 14 to revote. R2 analysed 19 responses and re-rated 14 carried plus 9 new items from R1 suggestions: 16 reached Include, 7 to revote. R3 analysed 16 responses: 2 reached Include, 5 without consensus. In total, 23 items met Include (5 R1 + 16 R2 + 2 R3). The checklist integrates pharmacologic/anaesthetic measures (multimodal analgesia; regional techniques as appropriate; structured anti-PONV prophylaxis) with non-pharmacologic practices across surgical (pressure-point padding; low pneumoperitoneum/valveless insufflation) and environmental (active temperature management) domains. This Delphi produced a 23-item consensus checklist that standardises modifiable intra-operative practices underpinning low-impact robotic urologic surgery. Prospective implementation should evaluate effects on recovery outcomes, including post-operative pain, opioid use and PONV.
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