Surgical Endoscopyhttp5/doi.org/10.1007/s00464-023-09895-x8SAGES/EAES OFFICIAL PUBLICATIONSAGES/AHPBA guidelines for the use of minimally invasive surgeryfor the surgical treatment of colorectal liver metastases(CRLM)Timothy J.Vreeland1.AmeliaT.Collings2.Ahmad Ozair3.Alexandra M.Adams'.Rebecca Dirks2.Bradley S.Kushner.Iswanto Sucandy5.David Morrell5.Jake Whiteside2.Mohammed T.Ansari?.Jordan Cloyd.Sean P.Cleary9.Eugene Ceppa2.Ahmed M.Abou-Setta10.Adnan Alseidi11.Ziad Awad12.Subhashini Ayloo13.Joseph Buell14.Georgios Orthopoulos15.William Richardson16.Samer Sbayi17.Go Wakabayashi18.Horacio Asbun19.Bethany J.Slater20.Aurora D.Pryor17.D.Rohan Jeyarajah21Received:25 August 2022/Accepted:16 January 2023The Author(s),under exclusive licence to Springer Science+Business Media,LLC,part of Springer Nature 2023AbstractBackground Colorectal liver metastases(CRLM)occur in roughly half of patients with colorectal cancer.Minimally invasivesurgery (MIS)has become an increasingly acceptable and utilized technique for resection in these patients,but there is a lackof specific guidelines on the use of MIS hepatectomy in this setting.A multidisciplinary expert panel was convened to developevidence-based recommendations regarding the decision between MIS and open techniques for the resection of CRLM.Methods Systematic review was conducted for two key questions(KQ)regarding the use of MIS versus open surgery forthe resection of isolated liver metastases from colon and rectal cancer.Evidence-based recommendations were formulatedusing the GRADE methodology by subject experts.Additionally,the panel developed recommendations for future research.Results The panel addressed two KQs,which pertained to staged or simultaneous resection of resectable colon or rectalmetastases.The panel made conditional recommendations for the use of MIS hepatectomy for both staged and simultaneousresection when deemed safe,feasible,and oncologically effective by the surgeon based on the individual patient character-istics.These recommendations were based on low and very low certainty of evidence.Conclusions These evidence-based recommendations should provide guidance regarding surgical decision-making in thetreatment of CRLM and highlight the importance of individual considerations of each case.Pursuing the identified researchneeds may help further refine the evidence and improve future versions of guidelines for the use of MIS techniques in thetreatment of CRLM.Keywords Colorectal cancer.Colorectal liver metastases.Minimally invasive hepatectomy Open hepatectomyAim of these guidelines and specificstaged resection of the primary tumor and hepatic metasta-objectivesses.Key target audience includes patients,surgeons,oncolo-gists,and other health care providers in a clinical setting.InThe purpose of these guidelines is to provide evidence-basedaddition,policy-makers and insurance providers involvedrecommendations from a surgeon and patient perspectivewith healthcare services involving the treatmen
