Generating Operative Workflows for Vestibular Schwannoma Resection: A Two-Stage Delphi's Consensus in Collaboration...

Area of Science:

• Neurosurgery
• Skull Base Surgery
• Otolaryngology

Background:

• Operative workflows systematically categorize surgical procedures.
• Understanding surgical variation is crucial for education and training.
• This study focuses on the translabyrinthine approach for vestibular schwannoma resection.

Purpose of the Study:

• To present a codified operative workflow for the translabyrinthine approach to vestibular schwannoma resection.
• To establish a standardized framework for surgical education and analysis.
• To provide a foundation for future research in vestibular schwannoma surgery.

Main Methods:

• A mixed-method consensus process involving literature review and Delphi consensus.
• Collaboration with the British Skull Base Society (BSBS).
• Multiple rounds of Delphi consensus until data saturation and over 90% agreement.

Main Results:

• Seventeen experienced skull base surgeons participated.
• A 100% response rate was achieved across Delphi rounds.
• The translabyrinthine approach was codified into five phases and 57 unique steps.

Conclusions:

• A national, consensus-derived operative workflow for the translabyrinthine approach to vestibular schwannomas is presented.
• The workflow includes operative steps, instruments, technique errors, and event errors.
• This codified approach serves as foundational research for AI applications and comparative surgical studies.