Even though evidence has shown minimally invasive surgery is superior to open surgery for most patients, its use varies widely from hospital to hospital in the United States, according to a new study by Johns Hopkins Medicine researchers.
The researchers, including Marty Makary, MD, MPH, a professor of surgery at the Johns Hopkins University School of Medicine in Baltimore, collected and analyzed data from the Nationwide Inpatient Sample to identify how many MIS procedures hospitals could be performing for four different operations: appendectomy, colectomy, hysterectomy and lung lobectomy.
Though there were not large differences in patient candidacy for MIS, the researchers found variability in which operations were actually performed as MIS. For example, one-quarter of hospitals favored open surgery for the majority of appendectomy cases, even though 71 percent of them could be performed by the minimally invasive operation.
Large urban teaching hospitals in the Midwest, South or West were more likely to perform MIS.
The underuse of MIS is a problem for patients, as complication rates for MIS are lower for many operations when compared to open surgery, according to the researchers.
The variation in MIS use can be attributed to differences in physician training, Dr. Makary and colleagues concluded.
"We think there could be a better division of labor at hospitals," he said in a news release. "Patients who need an open procedure could be sent to surgeons skilled in open surgery. Those 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."
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