title: Survey of urological laparoscopic practice patterns in the midwest.
abstract: OBJECTIVE
  Laparoscopic surgery is assuming a greater role in the management of many urological disorders. We performed a survey of urologists in the Midwest United States to define laparoscopic practice patterns regarding urological disease.
  
  
  METHODS
  Surveys were mailed to 1,450 members of the North Central Section of the American Urological Association. Questions pertained to age, practice demographics, residency training and amount of laparoscopy performed.
  
  
  RESULTS
  A response rate of 33% was obtained. A total of 49% of urologists perform no laparoscopy, 30% devote less than 5% of their practice and 21% devote 5% or more of their practice to laparoscopy. Of the responders 15% believed they were adequately trained during residency to perform laparoscopy. Among those who performed hand assisted laparoscopy (HAL), 52% used it to gain familiarity with laparoscopic techniques. There was an inverse correlation between time in practice and amount of laparoscopy performed (p <0.0001). Urologists in academia perform laparoscopy at a greater proportion versus those in private practice (p <0.01). Urologists who incorporated laparoscopy during fellowship performed the most laparoscopy (p = 0.003). Those who considered themselves adequately trained during residency were more likely to perform laparoscopy (p <0.0001). Urologists who perform HAL devote more of their operating time to laparoscopy than those who do not (p <0.0001). The number of laparoscopic cases performed correlated with decreased time in practice (p <0.0001), academic setting (p = 0.001) and use of HAL (p <0.0001).
  
  
  CONCLUSIONS
  Urological laparoscopic surgery remains at an early stage of development in the Midwestern United States. Although HAL has widened the scope of laparoscopy among urologists, increased training for urologists and residents is necessary.
authors.affiliation: Department of Urology, Boston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Wang
authors.forename: Howard N
authors.initials: HN
authors.lastname: Winfield
mesh_terms: D000328:Adult; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data*; D008875:Middle Aged; D015146:Midwestern United States; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013520:Urologic Surgical Procedures / Q000379:methods / Q000706:statistics & numerical data*