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Hospitals Across the Country Vary Substantially in Their Use of Laparoscopy

Despite lower complication rates, study finds that some hospitals aren't performing minimally invasive surgery as often as they could.

Published: July 9, 2014

Surprising news from a study out today: Many U.S. hospitals aren't performing minimally invasive surgery as often as they could, despite evidence that minimally invasive surgery is superior to open surgery for most patients in terms of reduced rates of surgical site infections, decreased pain and shorter hospitalizations.

The new research study out today in the online British Medical Journal shows a wide variation in hospital utilization of minimally invasive surgery. A team of researchers from Johns Hopkins University School of Medicine calculated the use of laparoscopic surgical procedures at over 1,000 U.S. hospitals in 2010 for 4 of the most common minimally invasive procedures done in the U.S.: appendectomy, colectomy, total abdominal hysterectomy and lung lobectomy. The team compared the number of open procedures to minimally invasive procedures.

What they found was considerable variability in what proportion of these operations were minimally invasive surgery. For example, 71% of appendectomies could be performed laparoscopically, but one-fourth of U.S. hospitals favored the open operation for most cases. Hospitals more likely to perform minimally invasive surgery tended to be large urban teaching hospitals located in the Midwest, South or West.

Lead study author Marty Makary, MD, MPH, a professor of surgery at the Johns Hopkins University School of Medicine, attributes much of the variability to differences in physician training at various hospitals across the country. He also notes that many patients aren't aware that a minimally invasive surgery option exists for their condition. "Patients who are candidates for minimally invasive surgery could be directed to a surgeon with minimally invasive skills, sparing more patients the risks associated with open surgery," says Dr. Makary.

Dan O'Connor

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