Daniel W Birch1, Al Hassan Asiri, Christopher J de Gara. 1. Center for the Advancement of Minimally Invasive Surgery, Department of Surgery, University of Alberta, Royal Alexandra Hospital, Capital Health, 10240 Kingsway, Edmonton, Alberta, Canada T5H 3V9. dbirch@ualberta.ca
Abstract
BACKGROUND: Surgeons need a process by which to safely introduce new procedures, such as minimally invasive surgery (MIS), into practice. Emerging evidence would suggest that an effective strategy is the implementation of a mentorship program. This study analyzed the effect of mentoring on a single institution's advanced MIS practice. METHODS: We analyzed clinical outcomes by completing a retrospective review of patient charts 1 year before and 1 year after the recruitment of a fellowship-trained advanced MIS surgeon in July 2004 whose job description included facilitating the introduction of advanced gastrointestinal MIS. RESULTS: A total of 7 general surgeons were mentored at 1 site. After 1 year of intense mentoring, the number of surgeons completing >12 cases/y increased from 2 to 4, and the number of advanced MIS cases completed (excluding mentored ones) increased from 35 to 102. Fifty-three cases (52% of total) were formally mentored. Total conversions to open surgery decreased from 14.3% to 6.4% (P = .12). The number of colorectal resections increased from 11 to 92 (P = .0027). Intraoperative complications were not significantly decreased, eg, from 17.1% to 7.1% (P = .06). Postoperative complications remained unchanged (15.0% to 16.5%). CONCLUSIONS: Surgeons and the institutions in which they work have a duty to adopt advanced MIS techniques in a safe and appropriate manner. We believe our data demonstrate that a mentorship program is an effective strategy for safely introducing advanced MIS into practice.
BACKGROUND: Surgeons need a process by which to safely introduce new procedures, such as minimally invasive surgery (MIS), into practice. Emerging evidence would suggest that an effective strategy is the implementation of a mentorship program. This study analyzed the effect of mentoring on a single institution's advanced MIS practice. METHODS: We analyzed clinical outcomes by completing a retrospective review of patient charts 1 year before and 1 year after the recruitment of a fellowship-trained advanced MIS surgeon in July 2004 whose job description included facilitating the introduction of advanced gastrointestinal MIS. RESULTS: A total of 7 general surgeons were mentored at 1 site. After 1 year of intense mentoring, the number of surgeons completing >12 cases/y increased from 2 to 4, and the number of advanced MIS cases completed (excluding mentored ones) increased from 35 to 102. Fifty-three cases (52% of total) were formally mentored. Total conversions to open surgery decreased from 14.3% to 6.4% (P = .12). The number of colorectal resections increased from 11 to 92 (P = .0027). Intraoperative complications were not significantly decreased, eg, from 17.1% to 7.1% (P = .06). Postoperative complications remained unchanged (15.0% to 16.5%). CONCLUSIONS: Surgeons and the institutions in which they work have a duty to adopt advanced MIS techniques in a safe and appropriate manner. We believe our data demonstrate that a mentorship program is an effective strategy for safely introducing advanced MIS into practice.
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