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Minimally invasive surgery: the pediatric surgery experience
A M Firilas1, R J Jackson, S D Smith
1University of Arkansas School for Medical Sciences and Arkansas Children's Hospital, Little Rock 72202-3591, USA.
Background:
Minimally invasive surgery (MIS) has become an important aspect of general surgery. The degree to which pediatric surgeons have incorporated MIS into their practice is not known.
Study Design:
An MIS survey was sent to all members of the American Pediatric Surgical Association. Respondents were separated into two groups: nonperformers and performers of MIS. Performers were asked how they were trained in MIS and the total number and types of minimally invasive procedures they have performed.
Results:
Eighty-two percent of surveyed pediatric surgeons perform MIS. Eighty-seven percent received some or all of their training in a postgraduate course. Two percent received their only training during their general surgery residency. Forty-seven percent of performers reported 50 or fewer total procedures. A wide variety of procedures were reported, but laparoscopic cholecystectomy (95%) was the procedure most frequently reported. Thoracoscopic procedures (71%) were also reported at high rates.
Conclusions:
Most pediatric surgeons in our survey perform MIS. The high rate of laparoscopic cholecystectomies reported suggests that the initial MIS experience of pediatric surgeons in our survey is similar to adult general surgeons. The frequency, however, of thoracic cases reported indicates that MIS techniques are being applied to all areas of pediatric surgery. The total minimally invasive procedure experience of our respondents also suggests that pediatric surgeons are early in their learning curve.
Insights
Most pediatric surgeons now use minimally invasive surgery (MIS). While many are early in their learning curve, common procedures like laparoscopic cholecystectomy are frequently performed.
Area of Science:
- Pediatric Surgery
- Surgical Innovation
- Minimally Invasive Techniques
Background:
- Minimally invasive surgery (MIS) is increasingly vital in general surgery.
- The extent of MIS adoption by pediatric surgeons was previously unknown.
Purpose of the Study:
- To determine the prevalence of MIS adoption among pediatric surgeons.
- To understand the training and experience levels of pediatric surgeons in MIS.
Main Methods:
- A survey was distributed to all members of the American Pediatric Surgical Association.
- Respondents were categorized as MIS non-performers or performers.
- Performers reported on their MIS training and the volume/types of procedures performed.
Main Results:
- 82% of surveyed pediatric surgeons perform MIS.
- Laparacopic cholecystectomy (95%) and thoracoscopic procedures (71%) were most common.
- 47% of performers had completed 50 or fewer MIS procedures.
Conclusions:
- The majority of pediatric surgeons utilize MIS, with adoption rates comparable to adult general surgeons for certain procedures.
- MIS is being applied across various subspecialties within pediatric surgery.
- Pediatric surgeons appear to be in the early stages of their MIS learning curve, indicated by procedure volumes.