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Surgery Fellows Performing More Endoscopies
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SAN DIEGO — The number of endoscopies performed by surgery fellows has increased during the last 10 years, and that trend is likely to continue, according to data presented at Digestive Disease Week.
David Morrell, MD, a general surgery resident at Penn State Health Milton S. Hershey Medical Center, said in his presentation that endoscopy has become a common part of surgical practice, but little information is available on the volume of endoscopic surgery.
“In particular, the trends of those case volumes from year to year remain relatively unknown,” he said during his presentation. “With that in mind, our study aimed to estimate trends in endoscopic surgery practice using surgical fellow case logs as a substitute for that.”
Researchers performed a retrospective analysis using case logs of 1,613 surgery fellows who started their fellowship training between 2007 and 2016. They grouped individuals by year of fellowship matriculation and categorized them further by fellowship program. They calculated mean number of flexible endoscopy cases per fellow, subcategorized them by endoscopic subcategory and created a model to anticipate mean endoscopy cases in 2021 and 2026.
Data showed that 725 fellows were enrolled in advanced GI, 667 in bariatric, 67 in colorectal, 49 in hepatobiliary, 43 in thoracic, 39 in flexible endoscopy, 7 in foregut, and 16 were enrolled in uncategorized fellowships. The mean annual flexible endoscopy cases per fellow was 93.5, with a range from 0 to 1,072 cases. Over the course of the 10 years analyzed in the study, the mean increased from 78 cases per fellow in 2007 to 100.1 cases per fellow in 2016. The increase was largely due to a 52.4% increase in diagnostic upper endoscopy and a 40.1% increase in therapeutic upper endoscopy.
While cases increased 28.3% over 10 years, the number of fellows increased by just 21.5%, from 135 in 2007 to 164 in 2016. Using their model, Morrell and colleagues projected continued increases in the future, with mean total endoscopy cases per fellow of 127.7 in 2021 and 146.1 in 2026.
“This reflects increased intraoperative endoscopic guidance and increased therapeutic use,” Morrell said. “As such, we believe efforts to increase endoscopic exposure in surgical training are well warranted.” – by Alex Young
Reference:
Morrell D, et al. Abstract 188. Presented at: Digestive Disease Week; May 18-21, 2019; San Diego.
Disclosures: Morrell reports no relevant financial disclosures. Please see the meeting disclosure index for all other authors’ relevant financial disclosures.