A census of laparoscopic and robotic urological practice: a survey of minimally invasive surgery department of the Brazilian Society of Urology

Abstract

Minimally invasive urologic surgery has been developing in Brazil and now is a routine part of care in many regions and patients with different conditions benefit from it. Training in laparoscopic and robotic surgery has evolved and concerns exist both over the quality of surgical training and the practical effect on results of the urological training. This is an unprecedented study which undertook a census to determinate the current state of laparoscopic and robotic urological practice and to know the mains barriers to adequate practice in Brazil. In august 2017, surveys, consisting of an anonymous questionnaire with 15 questions, were sent via internet to the mailing list of the Brazilian Society of Urology (SBU). With these data, activities related to laparoscopy and robotic surgery of our urologists and the mains difficulties and barriers to practice laparoscopy and robotic surgery were evaluated. In our survey, 413 questionnaires were completed. Majority of the responders were currently working in the southeast region of Brazil (52.1%) and 75.5% of the surgeons performed laparoscopic surgery while, only 12.8%, robotic surgery. The lack of experience on the technique and the lack of equipment were the mains barriers and difficulties for not executing laparoscopic and robotic surgeries, respectively. Proper longitudinal training and access to good equipment in minimally invasive surgery are still barriers for urologists in our country.

Functional urology: Practice patterns and training aspirations among urologists in Brazil

“…The preferred training method among respondents was a short duration hands‐on course, which is consistent with their current professional situation and offers a faster and practical way to learn. Surgical simulation models and cadaveric laboratories have been increasingly used for medical training 3 . A study evaluated residents' performance before and after a MUS teaching session that included interactive teaching stations (cadaver pelvis, retropubic MUS pelvic model, and cystoscopy model) 19 .…”

“…Currently, most broad medical specialties have diversified into subspecialties and urology has followed this trend. The concept of sub‐specialization is based on excelling in an area of interest and it has been shown that subspecialized practice helps in improving outcomes in urology 1–5 …”

“…In addition, most pursued fellowship training to overcome perceived training deficiencies. Inadequate training in different urological subspecialties has been reported by residents and recently graduated urologists worldwide 3,4,10 …”

“…The concept of sub-specialization is based on excelling in an area of interest and it has been shown that subspecialized practice helps in improving outcomes in urology. [1][2][3][4][5] Urology is one of the most diverse and dynamic surgical specialties. It has become customary to divide urology into endourology, uro-oncology, pediatric urology, andrology, renal transplantation, reconstructive urology, benign prostatic hyperplasia, and functional urology (FU).…”

“…Inadequate training in different urological subspecialties has been reported by residents and recently graduated urologists worldwide. 3,4,10 Another important point is whether the residents who are graduating have competencies that are in line with the workforce's needs. A recent study assessed whether urologic residency training in the United States is aligned with real-world procedural demand.…”