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The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
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Related Experiment Video

Updated: Sep 12, 2025

Rat Model of the Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy ALPPS Procedure

Rat Model of the Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy ALPPS Procedure

Published on: August 14, 2017

Assessing Surgical Innovation: ALPPS: An IDEAL Example of Disruptive Innovation.

Michael Linecker¹, Matthias Pfister², Patryk Kambakamba³

¹Department of Surgery and Transplantation, University Hospital Schleswig-Holstein, Kiel, Germany.

Annals of Surgery

|August 7, 2025

Summary

This summary is machine-generated.

The IDEAL paradigm structured the development of Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS), improving outcomes. This framework offers a template for evaluating new surgical innovations like laparoscopic cholecystectomy and robotic surgery.

Keywords:

ALPPS: associating liver partition and portal vein ligation for staged hepatectomy CRLM: colorectal liver metastases IDEAL: innovation PVE: portal vein embolization PVL: portal vein ligation and long-term assessment development exploration

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Area of Science:

Surgical innovation and evaluation methodologies.
Comparative analysis of novel surgical procedures.

Background:

Disruptive surgical procedures often lack structured evaluation.
The IDEAL (Innovation, Development, Exploration, Assessment and Long-term) paradigm provides a framework for assessing surgical innovations.
Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS) is a complex procedure for expanding liver resection possibilities.

Purpose of the Study:

To evaluate the impact of the IDEAL paradigm on the development of ALPPS.
To compare the evaluation process of ALPPS with laparoscopic cholecystectomy (LC) and robotic surgery.

Main Methods:

Analysis of data from the international ALPPS registry.
Review of development pathways for LC and robotic surgery.
Comparative assessment using the IDEAL paradigm stages.

Main Results:

The ALPPS registry facilitated a reduction in mortality from >15% to <5% in high-volume centers.
Laparoscopic cholecystectomy (LC) development involved technical advances and registries, supported by RCTs.
Robotic surgery's adoption is rapid but lacks a comprehensive registry, undergoing scrutiny.

Conclusions:

The IDEAL paradigm, through international collaboration, has advanced ALPPS evaluation and established usage guidelines.
The IDEAL paradigm serves as a model for assessing future surgical innovations.