title: A survey of current practices and barriers to expanding laparoscopic HPB surgery in Canada.
abstract: The purpose of this survey was to determine the extent to which laparoscopy is used in hepatopancreatobiliary (HPB) resections in Canada, and to assess HPB surgeons' attitudes and their perceived barriers to its further adoption.
  
  
  
  Using an electronic questionnaire, 68 Canadian Hepatopancreatobiliary Association (CHPBA) surgical members were surveyed. The questionnaire consisted of 12 questions regarding: surgeon demographics, the use and limitations of laparoscopy in their practice, and interest in increasing the use of laparoscopic techniques.
  
  
  
  The survey response rate was 75%. Of the 51 respondents, 86% reported performing minor laparoscopic resections such as hepatic wedge resections. Only 23% of surgeons reported performing laparoscopic liver lobectomies. Eighty-two percent of respondents indicated a wish to increase the use of laparoscopy in their practice. Barriers identified included operating time constraints (61%), a lack of equipment (41%) and lack of adequate training (43%).
  
  
  
  This survey demonstrates that currently, most Canadian HPB surgeons use laparoscopy for minor HPB resections; however, there is a strong desire to expand the use of minimally invasive techniques amongst Canadian HPB surgeons. Training centered on addressing the limitations and barriers to the uptake of minimally invasive techniques in HPB surgery are needed.
authors.affiliation: University of Toronto, Division of General Surgery, St. Joseph Health's Centre, Canada.
authors.forename: Ricky
authors.initials: R
authors.lastname: Jrearz
authors.affiliation: University of Toronto, Division of General Surgery, St. Joseph Health's Centre, Canada.
authors.forename: Anand
authors.initials: A
authors.lastname: Govindarajan
authors.affiliation: University of Toronto, Division of General Surgery, St. Joseph Health's Centre, Canada. Electronic address: sjayaraman@stjoestoronto.ca.
authors.forename: Shiva
authors.initials: S
authors.lastname: Jayaraman
mesh_terms: D001291:Attitude of Health Personnel; D002170:Canada; D002983:Clinical Competence; D003695:Delivery of Health Care / Q000639:trends*; D013505:Digestive System Surgical Procedures / Q000193:education / Q000639:trends*; D004501:Education, Medical / Q000639:trends; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000639:trends; D006801:Humans; D010535:Laparoscopy / Q000193:education / Q000639:trends*; D061646:Operative Time; D010818:Practice Patterns, Physicians' / Q000639:trends*; D066231:Surgeons / Q000193:education / Q000523:psychology / Q000639:trends*