TY - JOUR
T1 - Defining benchmarks for fellowship training in foregut surgery
T2 - a 10-year review of fellowship council index cases
AU - Weis, Joshua J.
AU - Pryor, Aurora
AU - Alseidi, Adnan
AU - Tellez, Juan
AU - Goldblatt, Matthew I.
AU - Mattar, Samer
AU - Murayama, Kenric
AU - Awad, Michael
AU - Scott, Daniel J.
N1 - Funding Information:
Drs. Weis, Awad, Alseidi, Mattar, Telles, and Scott have nothing to disclose. Dr. Goldblatt reports grants and personal fees from WL Gore, Inc, grants and personal fees from Medtronic, grants from BD, Inc, outside the submitted work. Dr. Pryor reports personal fees from Ethicon, personal fees from Gore, personal fees from Merck, personal fees from Medtronic, personal fees from Stryker, outside the submitted work.
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2022
Y1 - 2022
N2 - Introduction: Surgical treatment of foregut disease is a complex field that demands advanced expertise to ensure favorable outcomes for patients. To address the growing need for foregut surgeons, leaders within several national societies have become interested in developing a foregut fellowship. The aim of this study was to develop data-driven benchmarks that will aid in defining appropriate accreditation criteria for these fellowships. Methods: We obtained case log data for Fellowship Council fellows trained from 2009–2019. We identified 78 complex foregut (non-bariatric) case codes and divided them into 5 index case categories including (1) hiatal/paraoesophageal hernia repair, (2) fundoplication, (3) esophageal myotomy, (4) major organ resection, and (5) minor organ resection. Median volumes in each index category were compared over time using Kruskall–Wallis tests. The share of cases done using open, laparoscopic, or robotic approaches were analyzed using linear regression analysis. Results: For the 10 years analyzed, 1362 fellows logged 82,889 operations and 111,799 endoscopies. Median foregut cases per fellow grew significantly from 42 (IQR = 24–74) cases in 2010 to 69 (IQR = 33–106) cases in 2019. Median endoscopy volumes also grew significantly from 42 (IQR = 7–88) in 2010 to 69 (IQR 32–123) in 2019.The volume of hiatal/paraoesophageal hernia repairs increased significantly over time while volumes in the remaining 4 index categories remained stable. The share of robotic cases exhibited near perfect linear growth from 2.2% of all foregut cases in 2010 to 14.4% in 2019 (R = 0.99, p < 0.0001). Open cases exhibited linear decay from 7.2% of cases in 2010 to 4.7% of cases in 2019 (R = 0.92, p = 0.0001). Laparoscopic/thoracoscopic cases also exhibited linear decay from 90.6% of cases in 2010 to 80.9% of cases in 2019 (R = 0.98, p < 0.00001). Conclusions: FC fellows are exposed to robust volumes of foregut cases. This rich data set provides an evidence-based guide for establishing criteria for potential foregut fellowships.
AB - Introduction: Surgical treatment of foregut disease is a complex field that demands advanced expertise to ensure favorable outcomes for patients. To address the growing need for foregut surgeons, leaders within several national societies have become interested in developing a foregut fellowship. The aim of this study was to develop data-driven benchmarks that will aid in defining appropriate accreditation criteria for these fellowships. Methods: We obtained case log data for Fellowship Council fellows trained from 2009–2019. We identified 78 complex foregut (non-bariatric) case codes and divided them into 5 index case categories including (1) hiatal/paraoesophageal hernia repair, (2) fundoplication, (3) esophageal myotomy, (4) major organ resection, and (5) minor organ resection. Median volumes in each index category were compared over time using Kruskall–Wallis tests. The share of cases done using open, laparoscopic, or robotic approaches were analyzed using linear regression analysis. Results: For the 10 years analyzed, 1362 fellows logged 82,889 operations and 111,799 endoscopies. Median foregut cases per fellow grew significantly from 42 (IQR = 24–74) cases in 2010 to 69 (IQR = 33–106) cases in 2019. Median endoscopy volumes also grew significantly from 42 (IQR = 7–88) in 2010 to 69 (IQR 32–123) in 2019.The volume of hiatal/paraoesophageal hernia repairs increased significantly over time while volumes in the remaining 4 index categories remained stable. The share of robotic cases exhibited near perfect linear growth from 2.2% of all foregut cases in 2010 to 14.4% in 2019 (R = 0.99, p < 0.0001). Open cases exhibited linear decay from 7.2% of cases in 2010 to 4.7% of cases in 2019 (R = 0.92, p = 0.0001). Laparoscopic/thoracoscopic cases also exhibited linear decay from 90.6% of cases in 2010 to 80.9% of cases in 2019 (R = 0.98, p < 0.00001). Conclusions: FC fellows are exposed to robust volumes of foregut cases. This rich data set provides an evidence-based guide for establishing criteria for potential foregut fellowships.
KW - Fellowship
KW - Foregut
KW - Fundoplication
KW - Graduate medical education
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U2 - 10.1007/s00464-022-09317-4
DO - 10.1007/s00464-022-09317-4
M3 - Article
C2 - 35641699
AN - SCOPUS:85131066809
SN - 0930-2794
JO - Surgical endoscopy
JF - Surgical endoscopy
ER -