The integration of minimally invasive surgery in surgical practice in a Canadian setting: results from 2 consecutive province-wide practice surveys of general surgeons over a 5-year period

Abstract

Background: Although minimally invasive surgery (MIS) has been quickly embraced, the introduction of advanced procedures appears more complex. We assessed the evolution of MIS in the province of Quebec over a 5-year period to identify areas for improvement in the modern surgical era. Methods:We developed, test-piloted and conducted a self-administered questionnaire among Quebec general surgeons in 2007 and 2012 to examine stated MIS practice, MIS training and barriers and facilitators to the use of MIS. 'en 2007 (82,3 % c. 64,3 %, p < 0,001). L'analyse multi-variée a indiqué que l'administration du questionnaire en 2007 était associée avec moins de chirurgiens pratiquant des procédures avancées de CMI (rapport de cote 0,13, intervalle de confiance à 95 % 0,05-0,29). En 2012, plus de répondants ont indiqué avoir obtenu leur expertise en CMI durant la résidence (p = 0,028). Results Conclusion :De 2007 à 2012, la pratique de procédures avancées de CMI a augmenté significativement dans la province de Québec. L'approche minimalement invasive apparait solidement établie dans la pratique chirurgicale actuelle. La place grandissante de la CMI dans les programmes de résidence semble avoir été cruciale dans cet essor. Les résultats de cette étude peuvent maintenant servir à développer d'autres projets visant à améliorer encore davantage la pratique de la CMI.

Short and long-term outcomes of laparoscopic compared to open liver resection for colorectal liver metastases

“…MIS training has been formally incorporated in surgical curriculums, and more advanced procedures are being performed by larger groups of surgeons (9,37,38). Since Reich et al reported the first LLR in the early 1990's, its uptake has been rather slow (39).…”

“…Such technical factors may explain the ongoing concerns regarding the safety, feasibility, and superiority of LLR compared to open liver resection (OLR). As a result, the uptake of LLR has been slower than in other fields (9,11).…”

“…Advanced MIS procedures are being performed by a growing number of surgeons in various practice settings (9). Mainly owing to reduced pain, blood loss, length of hospital stay and complications, as well as faster recovery, laparoscopic offers significant benefits over laparotomy for a variety of abdominal conditions (1,(2)(3)(4)(5)(6)(7)(8).…”