Transoral robotic surgery for residual and recurrent oropharyngeal cancers: Exploratory study of surgical innovation using the IDEAL framework for early-phase surgical studies

Head & Neck ◽  
2017 ◽  
Vol 40 (3) ◽  
pp. 512-525 ◽  
Author(s):  
Vinidh Paleri ◽  
Hannah Fox ◽  
Sarah Coward ◽  
Maniram Ragbir ◽  
Andrew McQueen ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
Exploratory Study ◽  
Early Phase ◽  
Transoral Robotic Surgery ◽  
Surgical Innovation ◽  
Ideal Framework ◽  
The Ideal

scholarly journals Evolution of transanal total mesorectal excision according to the IDEAL framework

2019 ◽  
Vol 1 (1) ◽  
pp. e000004 ◽  
Author(s):  
Sapho Xenia Roodbeen ◽  
Annalisa lo Conte ◽  
Allison Hirst ◽  
Marta Penna ◽  
Willem A Bemelman ◽  
...  
Keyword(s):  
Total Mesorectal Excision ◽  
Rectal Cancer Surgery ◽  
Transanal Total Mesorectal Excision ◽  
Mesorectal Excision ◽  
Surgical Innovation ◽  
The Past ◽  
Ideal Framework ◽  
New Surgical Technique ◽  
The Ideal

Tremendous innovations have taken place in surgical procedures, but contrary to drug development, this process has been unregulated in the past. IDEAL promotes a structured framework for the safe implementation and assessment of a new surgical technique or intervention, by describing five stages for evaluating and reporting of innovations: Idea, Development, Exploration, Assessment and Long term. Transanal total mesorectal excision (TaTME) is a relatively new technique in rectal cancer surgery that has attracted huge interest and increasing adoption worldwide. This review article aims to provide an overview of the evolution of TaTME, according to the IDEAL framework, which guides us in the difficult yet exciting process of surgical innovation.

VP22 Applying The IDEAL Framework To NICE Interventional Procedure Guidance

2019 ◽  
Vol 35 (S1) ◽  
pp. 80-81
Author(s):  
Sharika Anjum ◽  
John Powell ◽  
Kevin Harris
Keyword(s):  
Interventional Procedure ◽  
Evidence Base ◽  
Primary Outcome Measure ◽  
Population Characteristics ◽  
Surgical Innovation ◽  
Equity Issues ◽  
Stage 4 ◽  
Procedure Guidance ◽  
Ideal Framework ◽  
The Ideal

IntroductionThe IDEAL (Idea, Development, Exploration, Assessment, Learning) Framework measures the maturity of evidence base behind surgical innovation. The NICE Interventional Procedures (IP) programme issues guidance for the United Kingdom National Health Service (NHS) on use of surgical innovation. One of four recommendations can be made: (a) standard arrangements, (b) special arrangements, (c) research only, and (d) do not use. This study aimed to investigate whether the recommendation of NICE IP guidance corresponded with the stage of innovation as determined by IDEAL, thus IDEAL's role in informing future guidance production.MethodsA retrospective sample of 103 pieces of guidance issued between 2015 and 2018 was analysed. One researcher examined the evidence base and determined the corresponding stage of the IDEAL framework, numbered 1, 2, 2a, 3 and 4. The primary outcome measure was the association between stage of evidence on IDEAL framework and the recommendation of published NICE IP guidance.ResultsThere were twenty-one (20 percent), thirty-three (32 percent), three (3 percent), forty (39 percent) and six (6 percent) procedures at IDEAL stages 1, 2, 2a, 3 and 4, respectively. Of those at stage 1 (idea), 48 percent were given research only arrangements, 43 percent special arrangements, and 10 percent standard. Many of the procedures at stages 2 (development) and 2a (exploration) were given standard arrangements (39 percent and 67 percent respectively). Forty-three percent of stage 3 (assessment) and 67 percent of stage 4 (learning) guidance were identified standard. At stage 4 none were given a ‘research only’ recommendation.ConclusionsProcedures given ‘standard’ arrangements guidance are more likely have a mature and robust evidence base as determined by IDEAL. Those with limited evidence are more likely to be given a more cautious ‘research only’ guidance. Routine use of this framework could help inform future guidance production however cannot replace the decision-making function of the NICE committee which also involves patient experiences, population characteristics, risk of serious safety events, and equity issues.

The IDEAL Framework for Evaluating Surgical Innovation

JAMA Surgery ◽  
2019 ◽  
Vol 154 (8) ◽  
pp. 685 ◽  
Author(s):  
Justin B. Dimick ◽  
Art Sedrakyan ◽  
Peter McCulloch
Keyword(s):  
Surgical Innovation ◽  
Ideal Framework ◽  
The Ideal

scholarly journals Retrospective analysis of a surgical innovation using the IDEAL framework: radical cystectomy with epidural anaesthesia

2017 ◽  
Vol 45 (2) ◽  
pp. 714-722 ◽  
Author(s):  
Holger Gerullis ◽  
Thorsten H. Ecke ◽  
Dimitri Barski ◽  
Carsten Bantel ◽  
Andreas Weyland ◽  
...  
Keyword(s):  
Radical Cystectomy ◽  
Epidural Anaesthesia ◽  
Operating Time ◽  
Functional Results ◽  
Surgical Innovation ◽  
Male Patients ◽  
Ideal Framework ◽  
Stage 1 ◽  
Spinal Epidural ◽  
The Ideal

Objectives To retrospectively analyse experience of radical cystectomy using spinal/epidural anaesthesia and to classify this method using the IDEAL criteria. Methods Data from patients who had undergone radical cystectomy using spinal/epidural anaesthesia were evaluated retrospectively, focusing on clinical data, intraoperative and perioperative parameters and postoperative complications. Current literature reporting on this technique was reviewed and, together with the present study, evaluated according to the IDEAL recommendations. Results Three male patients aged 66–79 years who had undergone radical cystectomy with epidural anaesthesia were identified. The operating time ranged from 159–261 min and only minor complications occurred. Between 2013 and 2015, three published studies reported experiences with radical cystectomy with epidural/spinal anaesthesia; one was prospective and two were retrospective in nature and they included a total of 55 patients. According to the IDEAL classification, the present study corresponds to stage 1 (idea) and overall the surgical technique can be ranked as stage 2a (development). Conclusions Radical cystectomy with epidural anaesthesia is feasible and applicable for those who are not fit for general anaesthesia. The present study confirmed the functional results of this technique, which can be classified as IDEAL stage 2a on the basis of published studies.

Transoral Robotic Surgery for Parapharyngeal Space Masses: Indications and Results

2013 ◽  
Vol 74 (S 01) ◽  
Author(s):  
Christopher Rassekh ◽  
Shayanne Lajud ◽  
Courtney Shires ◽  
Laurie Loevner ◽  
Ara Chalian ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
Parapharyngeal Space ◽  
Transoral Robotic Surgery

Outcomes of Transoral Robotic Surgery for Parapharyngeal Space Salivary Gland Neoplasms

2015 ◽  
Vol 76 (S 01) ◽  
Author(s):  
Christopher Rassekh ◽  
Gregory Weinstein ◽  
Laurie Loevner ◽  
Ara Chalian ◽  
Bert O'Malley
Keyword(s):  
Salivary Gland ◽  
Robotic Surgery ◽  
Parapharyngeal Space ◽  
Transoral Robotic Surgery ◽  
Salivary Gland Neoplasms
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