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Can general surgeons perform colonoscopy safely?

D N Reed¹, J D Collins, W J Wyatt

¹Department of Surgery, McLaren General Hospital, Flint, Michigan.

American Journal of Surgery

|February 11, 1992

Summary

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General surgeons can safely perform colonoscopies without fellowship training. A study of over 1,000 procedures showed complication rates comparable to other specialists, indicating no need for advanced endoscopy fellowship.

Area of Science:

Gastroenterology
Surgical Education

Background:

Assessing the safety of colonoscopy is crucial for patient care.
The necessity of formal fellowship training for general surgeons performing colonoscopies requires evaluation.

Purpose of the Study:

To review the safety and complication rates of colonoscopies performed by general surgeons without fellowship endoscopic training.

Main Methods:

A multi-institutional review of over 1,000 consecutive diagnostic and therapeutic colonoscopies.
Involved seven general surgeons lacking formal fellowship endoscopic training.
Complications including perforation, bleeding, and cardiopulmonary arrest were systematically recorded.

Main Results:

A single perforation occurred in the diagnostic group (0.12%), with no perforations in the therapeutic group.

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No instances of bleeding or cardiopulmonary arrest were reported.

The overall complication rate was 0.10% (1 per 1,025 procedures), comparing favorably to other specialties (p < 0.001).

Conclusions:

Postgraduate endoscopy fellowship training is not essential for general surgeons to achieve proficiency and safety in colonoscopy.
General surgeons can perform colonoscopies safely, achieving complication rates comparable to established benchmarks.