THE EAES CONSENSUS DEVELOPMENT CONFERENCES ON LAPAROSCOPIC CHOLECYSTECTOMY, APPENDECTOMY, AND HERNIA REPAIR - CONSENSUS STATEMENTS - SEPTEMBER 1994

Under the mandate of the Educational Committee of the European Associa tion of Endoscopic Surgery (E.A.E.S.), three consensus development con ferences (CDCs) were performed in order to assess the current status o f the endoscopic surgical approaches for the treatment of cholelithias is, appendicitis, and inguinal hernia. Consensus panels for the differ ent disease states (10-13 members each) selected by the education comm ittee on the basis of members' clinical expertise, academic activity, community influence, and geographical location weighed the evidence on the basis of published results according to the criteria for technolo gy assessment: feasibility, efficacy, effectiveness, economy. Draft st atements were prepared, discussed by the panels, and presented at plen ary sessions of the 2nd European Congress of the E.A.E.S. in Madrid Se ptember 15-17, 1994. Following discussions final consensus statements were formulated to provide specific answers for each topic to a minimu m of the following questions: 1. What stage of technological developme nt is the endoscopic surgical procedure at (in September 1994)? 2. Is endoscopic surgery safe and feasible? 3. Is it beneficial to the patie nts? 4. Who should undergo endoscopic surgery? 5. What are the trainin g recommendations? Laparoscopic cholecystectomy is the procedure of ch oice for symptomatic cholelithiasis. Laparoscopic appendectomy is pres ently at the efficacy stage of development, because most of the data o n feasibility and safety originate from centers with special interest in endoscopic surgery: it is not yet the gold standard for acute appen dicitis. Endoscopic hernia repair is presently a feasible alternative for conventional hernia repair if performed by experienced endoscopic surgeons. It appears to be efficacious in the short-term. The full tex t of the consensus panel's statements is given in this publication.