Mentorship for participants in a laparoscopic colectomy course

Despite data suggesting improved outcomes with laparoscopic colectomy (LC), less than 10% of colectomies in the Unites States are currently performed laparoscopically. One mechanism for incorporating LC into practice is to attend an LC course (LCC). Postcourse mentorship is recommended by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) and the American Society of Colon and Rectal Surgeons (ASCRS), in addition to course participation, to encourage adoption of the new techniques. Recommendations also include access to at least 25 colectomies annually. Because the use of LC likely will increase, access to mentorship is an important consideration for LCC participants. This study aimed to evaluate mentorship access and related factors for participants in an ongoing LCC.

Participants in seven consecutive single-center LCCs were anonymously surveyed regarding age, specialty, surgical experience, practice, and mentorship availability. Factors associated with mentorship were identified via chi-square and univariate logistic regression.

Of the 90 participants surveyed, 81 (90%) were men, 51 (56.7%) were general surgeons, 43 (48.9%) were older than 40 years, and 49 (54.4%) had access to a mentor. A majority of the participants (86.7%) performed five or fewer open colorectal cases per month, and 81 (90%) performed five or fewer noncolorectal advanced laparoscopic cases monthly. Factors associated with lack of mentor access included age older than 40 years (P = 0.004), practice as a general surgeon (P = 0.014), and status as a senior attending surgeon (P = 0.029).

A significant number of surgeons (45.6%) participating in LCC have limited or no access to mentors. In particular, older surgeons, senior attending surgeons, and general surgeons have the least access to mentors. To encourage adoption of LC, training methods should be adopted that accommodate general surgeons, surgeons with a limited advanced laparoscopic case load, and surgeons without access to mentors. Possible strategies include longer or multisession courses, simulator training, and remote mentoring.