Which Cholecystectomy do Medical Students Prefer?

JSLS. 2019 Jan-Mar;23(1):e2018.00086. doi: 10.4293/JSLS.2018.00086.

Abstract

Introduction: This study was undertaken to identify which minimally invasive technique medical students prefer for cholecystectomy and what factors determine their decision.

Methods: Brazilian medical students watched a video reviewing the advantages and disadvantages of six different surgical approaches to cholecystectomy: open surgery, conventional laparoscopy, mini-laparoscopy (MINI), single-incision laparoscopic surgery, natural-orifice transluminal endoscopic surgery, and robotic surgery. Respondents then answered questions about hypothetical situations in which the participants would be submitted to elective cholecystectomy.

Results: One hundred eleven medical students completed the survey, 60 females (54%) and 51 males (46%). Most students were 19-26 years old. When asked whether they would consider an open cholecystectomy if minimally invasive surgery (MIS) techniques were available, only 9% answered yes. Senior medical students were the least willing to consider open surgery (P = .036). When asked if they would prefer conventional laparoscopy, MINI, or robotic surgery for their cholecystectomy, 85% of the women and 63% of the men chose MINI (P = .025). When asked if they would consider a single-incision laparoscopic surgery or natural-orifice transluminal endoscopic surgery approach, 94 respondents (84%) answered no. When asked to rank which factors they consider the most important when choosing a surgical technique, they ranked safety of the procedure first (58%) and surgeon experience second (30%).

Conclusion: When Brazilian medical students were asked to select a surgical approach for cholecystectomy, most chose MINI. The preference for MINI was strongest amongst female medical students. Both female and male medical students ranked safety as the most important factor.

Keywords: Choice; Cholecystectomy; Mini-laparoscopy; Minimally invasive surgery; NOTES; Preference.

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Brazil
  • Cholecystectomy / methods*
  • Clinical Decision-Making*
  • Female
  • Humans
  • Laparoscopy
  • Male
  • Natural Orifice Endoscopic Surgery
  • Patient Selection
  • Robotic Surgical Procedures
  • Students, Medical / psychology*
  • Surveys and Questionnaires
  • Young Adult