Our Summary

This research paper investigates what influences the use of minimally invasive surgery (MIS) when performing a colectomy, a surgery that removes part of the colon. MIS is preferred because it often results in less pain, quicker recovery, and shorter hospital stays.

The study analyzed data from thousands of colectomies performed between 2008 and 2015 and found that 68.1% of these surgeries used the MIS approach. However, the use of MIS varied greatly among the 1,253 surgeons included in the study.

Upon further investigation, the researchers found that a large amount of this variation (62.8%) was due to differences in individual surgeon practices. Factors such as the number of years a surgeon had been practicing since their residency or fellowship and the volume of surgeries they performed explained some of this variation.

Interestingly, the older a surgeon was, the less likely they were to use the MIS method. The study concludes that referring patients to younger surgeons or providing extra training to older surgeons could potentially increase the use of MIS, improving patient outcomes and reducing the cost and resources needed for healthcare.

FAQs

  1. What is a minimally invasive surgery (MIS) and why is it preferred for colectomies?
  2. What factors were found to influence a surgeon’s use of MIS during a colectomy?
  3. How could the use of MIS be increased according to the study’s findings?

Doctor’s Tip

One helpful tip a doctor might give a patient about colectomy is to ask their surgeon about the possibility of using minimally invasive surgery (MIS) for their procedure. MIS can result in less pain, quicker recovery, and shorter hospital stays compared to traditional open surgery. Patients should inquire about their surgeon’s experience and comfort level with MIS to ensure the best possible outcome for their surgery.

Suitable For

In terms of the types of patients who are typically recommended colectomy, the study found that certain patient characteristics were associated with a higher likelihood of being recommended for MIS. These included younger age, female gender, lower body mass index, and fewer comorbidities. Patients with a higher tumor stage or who were undergoing emergency surgery were less likely to be recommended for MIS.

Overall, the study suggests that patient and surgeon factors play a significant role in the decision to perform MIS for colectomy. Understanding these factors can help improve patient outcomes and optimize healthcare resources.

Timeline

Before colectomy:

  • Patient experiences symptoms such as abdominal pain, bloating, constipation, diarrhea, rectal bleeding, and weight loss.
  • Patient undergoes diagnostic tests such as colonoscopy, CT scan, and blood tests to determine the need for surgery.
  • Patient meets with a surgeon to discuss the risks and benefits of colectomy and the different surgical approaches.

After colectomy:

  • Patient undergoes preoperative preparation, which may include bowel preparation and fasting.
  • Patient undergoes the colectomy surgery, which can be performed using either open surgery or minimally invasive surgery (MIS).
  • After surgery, the patient is monitored in the hospital for complications and pain management.
  • Patient begins the recovery process, which includes gradually reintroducing food, managing pain, and gradually increasing physical activity.
  • Patient is discharged from the hospital and continues recovery at home, with follow-up appointments with the surgeon to monitor healing and address any concerns.

What to Ask Your Doctor

Some questions a patient should ask their doctor about colectomy include:

  1. What are the potential risks and benefits of undergoing a colectomy?
  2. How will the surgery be performed - minimally invasive (MIS) or traditional open surgery?
  3. What are the specific qualifications and experience of the surgeon who will be performing the colectomy?
  4. What is the expected recovery time and post-operative care plan?
  5. Are there alternative treatments or procedures that could be considered?
  6. What is the long-term outlook and potential complications associated with colectomy?
  7. How often does the surgeon perform colectomies, and what is their success rate?
  8. What type of anesthesia will be used during the surgery?
  9. Will there be any dietary or lifestyle changes required after the surgery?
  10. What follow-up appointments or monitoring will be necessary after the colectomy?

Reference

Authors: Aquina CT, Becerra AZ, Justiniano CF, Xu Z, Boscoe FP, Schymura MJ, Noyes K, Monson JRT, Temple LK, Fleming FJ. Journal: Ann Surg. 2019 Jun;269(6):1109-1116. doi: 10.1097/SLA.0000000000002694. PMID: 31082909