Adoption of Laparoscopic Colectomy: Results and Implications of ASCRS Hands-On Course Participation

• Published in: Surgical innovation 2008-09, Vol.15 (3), p.179-183
• Main Authors: Ross, Howard M., Simmang, Clifford L., Fleshman, James W., Marcello, Peter W.
• Format: Article
• Language: English
• Subjects: Clinical Competence; Colectomy - education; Colectomy - methods; Colonic Neoplasms - surgery; Education, Medical, Continuing; Gastroenterology - education; Humans; Laparoscopy; Middle Aged; Societies, Medical; Treatment Outcome
• ISSN: 1553-3506; 1553-3514
• DOI: 10.1177/1553350608322100

Introduction. Beginning in 2003, the American Society of Colon and Rectal Surgeons has annually sponsored a laparoscopic colon and rectal surgery instructional course using a cadaver model. This study reports the adoption rate and postcourse practice patterns of participants. Methods. All prior participants of hands-on courses from 2003 to 2005 were asked to participate in a 25-question survey. Questions probed practice setting, prior laparoscopic experience, motivation for course participation, time to, indication for, and type of first laparoscopic colectomy, experience prior to cancer resection, factors facilitating skill acquisition, and impact on practice from course completion. Results. A total of 43 of 63 participants completed the survey and 53% had performed at least 1 laparoscopic colon resection prior to the course. A laparoscopic colon resection was performed within 1 week of the course by 52% of participants and within 1 month by 90%. Laparoscopic colectomy was performed frequently postcourse with 42% performing between 1 and 5 laparascopic colectomies/month and 42% between 5 and 10. Hand-assisted technologies lowered the threshold for performance of first laparascopic colectomy for 62% of participants. Cancer resection was the first procedure for 31% and 36% performed between 5 and 10 colectomies prior to cancer resection. Most important factor in particular course selection was a cadaver model (77%). A majority of the participants would require course completion prior to granting hospital privileges (73%) and would recommend the course to other surgeons (97%). Conclusions. Cadaver course completion enables rapid integration of laparoscopic colon resection into clinical practice. Experience prior to laparoscopic resection of cancer is modest. Hand-assisted technologies promote technique acquisition.