PT  - JOURNAL ARTICLE
AU  - Husein Moloo
AU  - Fatima Haggar
AU  - Guillaume Martel
AU  - Jeremy Grimshaw
AU  - Doug Coyle
AU  - Ian D. Graham
AU  - Elham Sabri
AU  - Eric C. Poulin
AU  - Joseph Mamazza
AU  - Fady K. Balaa
AU  - Robin P. Boushey
TI  - The adoption of laparoscopic colorectal surgery: a national survey of general surgeons
DP  - 2009 Dec 01
TA  - Canadian Journal of Surgery
PG  - 455--462
VI  - 52
IP  - 6
4099  - http://canjsurg.ca/content/52/6/455.short
4100  - http://canjsurg.ca/content/52/6/455.full
SO  - CAN J SURG2009 Dec 01; 52
AB  - Background: Laparoscopic surgery may become the standard of care for the treatment of colorectal disease. Little is known regarding North American patterns of practice or the limiting factors and strategies for adoption among surgeons.Methods: We sent a 28-item questionnaire to all general surgeon members of the Royal College of Physicians and Surgeons of Canada. We derived descriptive and correlative information using χ2, Wilcoxon rank sum and Student t tests and multivariate logistic regression.Results: The return rate was 55% (694/1266). A total of 67% (462/694; 95% confidence interval 63%–70%) of respondents perform colorectal surgery. Of these, 54% perform laparoscopic colorectal surgery. Multivariate logistic regression identified 5 factors related to performing laparoscopic colorectal surgery: fewer years in practice (p < 0.001), male sex (p = 0.015), practising in the province of Quebec (p = 0.005), university-hospital affiliation (p = 0.034) and minimally invasive surgery fellowship training (p = 0.023). Lack of adequate operating time and formal training were the main reasons cited by surgeons not offering laparoscopic colon resections. Most surgeons (67%) felt that site visits from a minimally invasive surgeon would represent the most effective training method for acquiring advanced laparoscopic skills.Conclusion: About half of Canadian general surgeons offer laparoscopic colorectal resections. Recent graduation, male sex, practice location, university-hospital affiliation and minimally invasive surgery training are significant predictors for offering a laparoscopic approach. Lack of operative time and formal training are the main barriers to adoption of the technique. Site visits by trained laparoscopic surgeons is the preferred method of acquiring advanced skills.