Minimally invasive surgery adoption into an established surgical practice: impact of a fellowship-trained colleague
- PDF / 270,256 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 43 Downloads / 151 Views
and Other Interventional Techniques
Minimally invasive surgery adoption into an established surgical practice: impact of a fellowship-trained colleague Edward P. Dominguez • Cory Barrat • Lynn Shaffer • Ryan Gruner • Donald Whisler Philip Taylor
•
Received: 16 May 2012 / Accepted: 17 September 2012 / Published online: 12 December 2012 Ó Springer Science+Business Media New York 2012
Abstract Background Practicing general surgeons adopt minimally invasive techniques using training opportunities such as weekend courses, videos, hands-on conferences, and traveling proctors with varying success. By integrating a fellowship-trained surgeon into an established practice, we show that minimally invasive techniques can be readily adopted. Methods A retrospective review of operative reports from July 2004 through June 2008 obtained the number of laparoscopic and open appendectomies, colectomies, ventral/ incisional hernias, and inguinal hernias performed by five practicing surgeons. Three time intervals were formed: 18 months before arrival of the MIS-trained surgeon, a 12-month transition period, and the 18 months following. Only cases performed by the five surgeons, and not by the MIS-trained surgeon, were included. A survey elicited the opinions of the five surgeons on various aspects of the transition, including barriers and effectiveness of different methods for learning MIS techniques.
E. P. Dominguez (&) C. Barrat P. Taylor Department of Surgery, Riverside Methodist Hospital, 3535 Olentangy River Road, Columbus, OH 43214-3998, USA e-mail: [email protected] L. Shaffer McConnell Heart Health Center, 3773 Olentangy River Road, Columbus, OH 43214, USA R. Gruner Northeast Ohio Medical University, 4209 SR44, PO Box 95, Rootstown, OH 44272, USA D. Whisler University of Toledo College of Medicine, 2801W Bancroft, Toledo, OH 43606, USA
Results A total of 4,016 cases were reviewed. The percentage of total cases performed laparoscopically increased from 12.1 to 48.3 %. Laparoscopic appendectomies significantly increased across time periods from 19 to 80 % (p \ 0.0001). Adoption of laparoscopic ventral/incisional hernia repairs increased from 4.8 to 20.1 % (p = 0.0322). Laparoscopic inguinal hernias increased from 0.6 to 31.1 % (p \ 0.0001). Finally, laparoscopic colectomies significantly increased from 25 to 52 % (p \ 0.0001). Survey responses indicated that ‘‘mentoring by a colleague with MIS training’’ was superior to other methods for learning MIS procedures (p = 0.0327–0.0516). Conclusions The integration of a fellowship-trained MIS colleague into a general surgery practice resulted in a 300 % increase in the proportion of appendectomies, ventral hernias, inguinal hernias, and colectomies performed laparoscopically by the other members of the practice. When surveyed, the surgeons felt that mentoring by a colleague with MIS training was the most effective method for adopting MIS procedures into their practice. Keywords Minimally invasive surgery Minimally invasive surgery fellowship Laparoscopy Laparoscopic
Data Loading...
