Minimally Invasive Surgery Fellowship: What is it Good for?

IntroductionMinimally invasive surgery fellowship is a popular choice for general surgery residents in the United States, but it serves an unclear role in an era where laparoscopic surgery has become commonplace. In this study, our goal was to examine the case volume for common open and laparoscopic surgery procedures for general surgery residents over the past 20 years to better understand the training needs that minimally invasive surgery fellowship can fill.MethodsWe reviewed the American Council on Graduate Medical Education (ACGME) Accreditation Data System to determine average case numbers for selected procedures among general surgery residents in the United States. Data was compared across 3 time points from 2002 to 2022. Descriptive statistics and chi-squared tests were used for analysis.ResultsResidents met our predefined competency threshold of twenty cases for 3 laparoscopic procedures in 2022 (cholecystectomy, colectomy, and inguinal hernia repair). There has been a trend towards increasing number of laparoscopic and decreasing number of open surgeries performed amongst our selected cases. Some procedures, including common bile duct exploration and splenectomy, remain rare over the entire study period.ConclusionsGeneral surgery residents receive good exposure to some laparoscopic procedures, but minimally invasive surgery fellowship serves a role in training for advanced laparoscopic cases, including anti-reflux and bariatric surgery.