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Table 3 Limiting factors in performing minimally invasive emergency surgery

From: Minimally invasive surgery in emergency surgery: a WSES survey

 

Appendicitis, Cholecystitis

(Grade 1)

Perforation of Gastric and Duodenal Ulcer, Bowel Obstruction due to peritoneal adhesions

(Grade 2)

Colon resection for Hinchey 3 and 4 Acute Diverticulitis

(Grade 3)

Dehiscence of intestinal, colorectal, gastrointestinal anastomosis; bile leak after cholecystectomy, bile leak after liver resection, postoperative hemoperitoneum, postoperative intestinal obstruction

(Grade 4)

Median (IQR)

Median (IQR)

Median (IQR)

Median (IQR)

Limiting factors

    

 Your own surgical skills

1 (0–4)

2 (0–3)

2 (1–4)

2 (1–4)

 Nursing skills

1 (0–3)

1 (0–3)

1 (0–3)

1 (0–3)

 Night-time operation

1 (0–3)

2 (0–3)

2 (1–4)

2 (1–4)

 Technology availability

2 (0–4)

2 (0–4)

2 (0–4)

2 (0–4)

 Estimated prolonged surgical duration

1 (0–3)

2 (1–3)

2 (1–4)

3 (1–4)

Patient-related limiting factors

    

 Shock condition

3 (1–5)

4 (2–5)

4 (3–5)

4 (3–5)

 Age

1 (0–3)

1 (0–3)

2 (0–3)

2 (0–3)

 ASA score

2 (1–3)

2 (1–4)

3 (1–4)

3 (1–4)

 APACHE score

2 (1–3)

2 (1–4)

3 (1–4)

3 (1–4)

 P-POSSUM

2 (1–3)

2 (1–3)

2 (1–4)

3 (1–4)

 ACSNSQUIP Surgical Risk

2 (1–3)

2 (1–3)

2 (1–4)

3 (1–4)

 Previous abdominal surgery

2 (1–4)

3 (1–4)

3 (2–4)

3 (2–4)

Intraoperative limiting factors

    

 Duration of the surgical procedure

2 (1–3)

2 (1–4)

3 (1–4)

3 (1–4)

 Bleeding

3 (2–4)

3 (1–4)

3 (2–4)

3 (1–4)

 Unclear/suboptimal visualization of anatomical structures

4 (2–5)

4 (2–5)

4 (2–5)

4 (3–5)

 Bowel perforation

3 (1–4)

3 (1–4)

3 (2–4)

3 (2–4)

 Intraoperative clinical deterioration

4 (2–5)

4 (2–5)

4 (3–5)

4 (3–5)