Study shows minimally invasive surgery underused

Open surgeries lead to poorer outcomes, but laparoscopic procedures not always chosen

July 09, 2014|By Meredith Cohn

Minimally invasive surgery leads to fewer infections and other complications than traditional open surgery but not all hospitals are regularly offering such procedures, according to a new study from Johns Hopkins University.

 The researchers looked at a database of more than seven million hospitals stays at more than 1,000 hospitals and found laparoscopic methods were underused in several specific surgeries -- appendectomies, colectomies and hysterectomies, which studies have shown have better outcomes when they are done using minimally invasive techniques.

 Lung lobectomies were also studied, though it’s not clear if less invasive methods are better.

 The researchers found, for example, 71 percent of appendectomies could be done the less invasive way but a quarter of U.S. hospitals tended to use traditional open surgery.

 Minimally invasive surgeries require a few small incisions rather than one large one. They typically lead to fewer surgical site infections, cause less pain and require less hospital time.

 The study found hospitals more likely to go with less invasive surgery were large urban teaching hospitals in the Midwest, South or West.

 Doctors chose the different procedures largely because of how they were trained, sticking with what they were taught, said Dr. Marty Makary, a professor of surgery in Hopkins’ School of Medicine who led the study.

 He said patients should ask about and be informed about their options.

 “Some surgeons specialize in complex open operations, and we should endorse that expertise,” Makary said. “But we think there could be a better division of labor at hospitals. 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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