Access to common laparoscopic general surgical procedures: do racial disparities exist?

Area of Science:

• Surgical Oncology
• Health Services Research
• Health Disparities

Background:

• Minimally invasive laparoscopic surgery offers faster recovery for common procedures like hernia repair, cholecystectomy, appendectomy, and colectomy.
• Despite its benefits, the study investigates potential racial disparities in accessing laparoscopic approaches.

Purpose of the Study:

• To determine if a racial disparity exists in the utilization of laparoscopic surgery for common general surgical procedures.
• To analyze the association between race and the likelihood of undergoing a laparoscopic approach.

Main Methods:

• Retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database for 2016.
• Inclusion of patients undergoing inguinal hernia repair, cholecystectomy, appendectomy, and colectomy.
• Propensity matching was used to control for confounding variables and assess the impact of race on surgical approach.

Main Results:

• Black patients showed a significantly lower likelihood of undergoing laparoscopic surgery across all four procedures compared to white patients.
• Specific disparities noted: hernia repair (21.69% vs 33.86%), cholecystectomy (94.29% vs 97.98%), colectomy (48.60% vs 70.93%), and appendectomy (92.81% vs 98.85%).
• Statistical significance (p < 0.0001) was observed for all procedures, indicating a consistent racial disparity.

Conclusions:

• A significant racial disparity exists in the application of laparoscopic surgery for routine intra-abdominal procedures.
• Further research is needed to identify and address barriers preventing equitable access to minimally invasive surgical options for certain populations.