Minimally invasive surgery underused at many hospitals

Hospitals underuse minimally invasive surgery, even though for most patients, it's a better option than open surgery, a new study found.

Researchers, including Marty Makary, M.D., a professor of surgery at the Johns Hopkins University School of Medicine, found that some hospitals capable of performing minimally invasive surgery don't provide it as often as they could, even though it's associated with fewer surgical site infections, less pain and shorter hospital stays.

Makary and his team retrospectively analyzed data from the Nationwide Inpatient Sample from 2010, looking at the level of utilization of minimally invasive surgeries for appendectomies, colectomies, total abdominal hysterectomies and lung lobectomies. For each procedure, researchers categorized hospitals in thirds (low, medium and high) based on their actual to predicted proportion of minimally invasive surgery use, according to the study.

Mean hospital use of minimally invasive surgery was 71 percent for appendectomies, 28.4 percent for colectomies, 13 percent for hysterectomies and 32 percent for lung lobectomies. Surgical complications were less common with those surgeries when compared with open surgeries. Minimally invasive surgery use was associated with large, urban and teaching hospitals across various parts of the country.

Researchers attribute the varied use of minimally invasive surgery to physician training at various hospitals across the country.

Makary says many patients aren't aware that a minimally invasive surgery option exists for their condition, according to an announcement from Johns Hopkins. The study offers an opportunity to reduce practice variation and improve healthcare quality through increased transparency and patient empowerment, he said.

To learn more:
- here's the study
- read the announcement

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