Abstract

Background: Despite the improvement of minimal invasive surgery (MIS) training programs over the last two decades, there is still inconsistent practice among surgeons at different centers. Thus, this study aimed to assess the practice pattern of MIS and the factors that influence MIS training among healthcare providers of general surgery, gynecology, and urology in Saudi Arabia.
Methods: A national cross-sectional study based on survey questionnaires was conducted from May to October 2021. The survey was obtained from healthcare providers in different regions of the kingdom for the three specialties: general surgery, urology, and gynecology; who are practicing in Saudi Arabia. The main outcome measure was the confidence level of performing MIS alone. Different covariates were used to study the factors contributing to the confidence level of practicing MIS.
Results: Around 73.9% of healthcare providers were confident enough to perform MIS alone. General surgeons were most confident to perform MIS alone as compared to other surgical specialties. Factors that affect the confidence level are experience, MIS training during fellowship period, current practice hours of MIS, and kingdom’s regions. The independent factors including experience represented by age of more than 45 years [14.9 times (95% CI 0.79-29.14; p-value 0.03)] and involvement in laparoscopic and robotic surgery during fellowship training [25.5 times (95% CI 4.71-46.3; p-value 0.01)].
Conclusion: The practice pattern of MIS for healthcare providers varied among different regions and surgical specialties. The confidence to practice MIS independently was affected by the experience period and the working region in the kingdom.

Key words: Laparoscopy, robotic, minimal invasive surgery, physician practice pattern, training.