Current attitudes in laparoscopic colorectal surgery

Area of Science:

• Colorectal Surgery
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Assessing current surgeon attitudes towards laparoscopic colorectal surgery (LCS).
• Understanding trends in LCS adoption and application among North American colorectal surgeons.

Purpose of the Study:

• To evaluate the current adoption rates and indications for LCS.
• To identify surgeon preferences for LCS in treating various colorectal conditions, including cancer.
• To gauge surgeon willingness to undergo LCS themselves.

Main Methods:

• A survey was distributed to members of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) and the American Society of Colon and Rectal Surgeons (ASCRS).
• A total of 3628 questionnaires were sent, with a 40% response rate (approximately 1500 respondents).
• Data collected included current LCS practice, indications, and personal willingness to undergo LCS.

Main Results:

• 85% of respondents perform laparoscopic surgery; 48% utilize LCS for 21% of patients.
• LCS is frequently used for diverticular disease (74%), polyps (68%), and villous adenoma (61%), but less so for cancer (15%).
• Surgeons show a higher willingness to undergo LCS for benign conditions (56% for rectal villous adenoma) than for distal rectal cancer (9%).

Conclusions:

• The overall performance of LCS has declined in the last three years.
• Surgeons exhibit increased reluctance to perform LCS for colorectal cancer treatment.
• The low response rate and reported port site recurrences (4.4%) prevent definitive conclusions on recurrence prevalence.