The impact of a formal mentoring program for minimally invasive surgery on surgeon practice and patient outcomes.
BACKGROUND
Surgeons need a process by which to safely introduce new procedures, such as minimally invasive surgery (MIS), into practice. Emerging evidence would suggest that an effective strategy is the implementation of a mentorship program. This study analyzed the effect of mentoring on a single institution's advanced MIS practice.


METHODS
We analyzed clinical outcomes by completing a retrospective review of patient charts 1 year before and 1 year after the recruitment of a fellowship-trained advanced MIS surgeon in July 2004 whose job description included facilitating the introduction of advanced gastrointestinal MIS.


RESULTS
A total of 7 general surgeons were mentored at 1 site. After 1 year of intense mentoring, the number of surgeons completing >12 cases/y increased from 2 to 4, and the number of advanced MIS cases completed (excluding mentored ones) increased from 35 to 102. Fifty-three cases (52% of total) were formally mentored. Total conversions to open surgery decreased from 14.3% to 6.4% (P = .12). The number of colorectal resections increased from 11 to 92 (P = .0027). Intraoperative complications were not significantly decreased, eg, from 17.1% to 7.1% (P = .06). Postoperative complications remained unchanged (15.0% to 16.5%).


CONCLUSIONS
Surgeons and the institutions in which they work have a duty to adopt advanced MIS techniques in a safe and appropriate manner. We believe our data demonstrate that a mentorship program is an effective strategy for safely introducing advanced MIS into practice.
Birch
Daniel W
DW
Center for the Advancement of Minimally Invasive Surgery, Department of Surgery, University of Alberta, Royal Alexandra Hospital, Capital Health, 10240 Kingsway, Edmonton, Alberta, Canada T5H 3V9. dbirch@ualberta.ca
Asiri
Al Hassan
AH
de Gara
Christopher J
CJ
D013502:General Surgery / Q000193:education*; D006801:Humans; D010535:Laparoscopy; D008611:Mentors; D019060:Minimally Invasive Surgical Procedures / Q000193:education*; D012189:Retrospective Studies; D016896:Treatment Outcome