What Surgical Skills Rural Surgeons Need to Master

Halverson, Amy L.; Hughes, Tyler G.; Borgstrom, David C.; Sachdeva, Ajit K.; DaRosa, Debra A.; Hoyt, David B.

doi:10.1016/j.jamcollsurg.2013.07.001

Cited by 29 publications

(18 citation statements)

References 19 publications

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“…A review of cases performed by practicing surgeons noted that the average number of endoscopic procedures performed by all general surgeons nationwide has doubled from 1999 to 2011 [1]. Additionally, endoscopy is the second most commonly performed procedure by rural surgeons [2], with one study noting that flexible endoscopy accounts for over half of all cases performed in community practice [3]. Not surprisingly, this growth is also being experienced by surgeons in training; an analysis of graduating surgery resident operative case logs revealed that the category with the greatest increase in cases from 2005 to 2011 was endoscopy [4].…”

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confidence: 99%

Is current surgery resident and GI fellow training adequate to pass FES?

et al. 2016

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confidence: 99%

Is current surgery resident and GI fellow training adequate to pass FES?

et al. 2016

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“…As previously mentioned, practicing rural surgeons have several barriers to keeping up with advancing technology. In a recent needs assessment administered to a sample of rural surgeons, colon resection was reported as a commonly performed procedure and respondents indicated a strong desire to learn how to perform laparoscopic colon resections . The challenges to rural surgical providers and to rural patients are not new; however, technological advancements in MIS techniques are driving the need for strategic solutions .…”

Section: Discussionmentioning

confidence: 99%

“…In a recent needs assessment administered to a sample of rural surgeons, colon resection was reported as a commonly performed procedure and respondents indicated a strong desire to learn how to perform laparoscopic colon resections. 22 The challenges to rural surgical providers and to rural patients are not new; however, technological advancements in MIS techniques are driving the need for strategic solutions. 45 We recommend an increase in the number of general surgeons who have training in minimally invasive surgery techniques and who work in rural communities.…”

Section: Discussionmentioning

confidence: 99%

“…We do not know if the laparoscopic colectomy is being utilized by rural residents. As a large proportion of the US population ages, there will be an increasing demand for the scientifically proven superior MIS procedures for cancer treatment . The disparities in colon cancer treatment outcomes will persist and potentially worsen if rural cancer patients cannot access these services.…”

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confidence: 99%

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Disparities in the Utilization of Laparoscopic Surgery for Colon Cancer in Rural Nebraska: A Call for Placement and Training of Rural General Surgeons

Gruber

Soliman

Schmid

et al. 2015

The Journal of Rural Health

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Background Advances in medical technology are changing surgical standards for colon cancer treatment. The laparoscopic colectomy is equivalent to the standard open colectomy while providing additional benefits. It is currently unknown what factors influence utilization of laparoscopic surgery in rural areas and if treatment disparities exist. The objectives of this study were to examine demographic and clinical characteristics associated with receiving laparoscopic colectomy and to examine the differences between rural and urban patients who received either procedure. Methods This study utilized a linked dataset of Nebraska Cancer Registry and hospital discharge data on colon cancer patients diagnosed and treated in the entire state of Nebraska from 2008–2011 (N=1,062). Multiple logistic regression analysis was performed to identify predictors of receiving the laparoscopic treatment. Results Rural colon cancer patients were 40% less likely to receive laparoscopic colectomy compared to urban patients. Independent predictors of receiving laparoscopic colectomy were younger age (<60), urban residence, ≥3 comorbidities, elective admission, smaller tumor size, and early stage at diagnosis. Additionally, rural patients varied demographically compared to urban patients. Conclusions Laparoscopic surgery is becoming the new standard of treatment for colon cancer and important disparities exist for rural cancer patients in accessing the specialized treatment. As cancer treatment becomes more specialized, the importance of training and placement of general surgeons in rural communities must be a priority for health care planning and professional training institutions.

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“…In fact, flexible endoscopy has become a substantial part of general surgery practice. Not only does endoscopy account for a majority of cases among rural surgeons [1,2], but the caseload among all general surgeons nationwide has doubled in the past few years [3].…”

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confidence: 99%