BackgroundOver 1.7 billion adults worldwide are considered overweight or obese, with the prevalence of obesity in Canada increasing rapidly. Obesity has been shown to affect surgical outcomes such as local recurrence of cancer and wound infections following colorectal surgery. The objective of this study was to determine the perception/attitudes of Canadian surgeons toward the impact of obesity on the practice of colorectal surgery.MethodsA twenty-question survey was administered to Canadian surgeons through mail and email solicited via the Canadian Association of General Surgeons over a period of 2010-2011. The questions focused on surgeon demographics, experience with laparoscopic colon resections and their perception of the impact of obesity toward surgical proficiency and complications.ResultsOne hundred seventy-seven Canadian surgeons completed the survey. There was a wide range of experience among surgeons in terms of years of practice and number of colon resections performed per year. The majority (72.9%) reported having primary general surgical training. A majority of surgeons (57.7%) identified obesity as a risk factor for colorectal surgery. Furthermore, a majority agreed that obesity is a risk factor for wound infection (97.2%), stomal retraction (90.4%) and stomal herniation (82.5%). While obesity was not considered a contraindication to laparoscopic colon surgery, it was considered to increase operative time (98.3%), cardiovascular (80.2%) and respiratory (95.4%) complications.ConclusionThe majority of surgeons across Canada believe obesity is a risk factor for post-operative complications following laparoscopic colorectal surgery. However, the majority did not consider obesity a contraindication for laparoscopic colon resection. Surgical and peri-operative colorectal protocols may need to be re-assessed to identify methods to manage the obese patient more effectively.

Background:The increased use of information technology supports a resident-centred educational approach that promotes autonomy, flexibility and time management and helps residents to assess their competence, promoting self-awareness. We established a web-based e-learning tool to introduce general surgery residents to bariatric surgery and evaluate them to determine the most appropriate implementation strategy for Internetbased interactive modules (iBIM) in surgical teaching. Methods:Usernames and passwords were assigned to general surgery residents at the University of Alberta. They were directed to the Obesity101 website and prompted to complete a multiple-choice precourse test. Afterwards, they were able to access the interactive modules. Residents could review the course material as often as they wanted before completing a multiple-choice postcourse test and exit survey. We used paired t tests to assess the difference between pre-and postcourse scores.Results: Out of 34 residents who agreed to participate in the project, 12 completed the project (35.3%). For these 12 residents, the precourse mean score was 50 ± 17.3 and the postcourse mean score was 67 ± 14 (p = 0.020). Conclusion:Most residents who participated in this study recommended using the iBIMs as a study tool for bariatric surgery. Course evaluation scores suggest this novel approach was successful in transferring knowledge to surgical trainees. Further develop ment of this tool and assessment of implementation strategies will determine how iBIM in bariatric surgery may be integrated into the curriculum.

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