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Laparoscopy in German Urology: Changing Acceptance among Urologists - Zurich Open Repository and Archive


Imkamp, F; Herrmann, T; Rassweiler, J; Sulser, T; Stolzenburg, J U; Rabenalt, R; Jonas, U; Burchardt, M (2009). Laparoscopy in German Urology: Changing Acceptance among Urologists. European Urology, 56(6):1074-1081.

Abstract

BACKGROUND: Laparoscopic techniques have dramatically influenced urologic surgery in the past 2 decades. OBJECTIVES: A questionnaire was distributed in 2006 to analyse laparoscopic practice patterns in Germany. The results were compared with a survey performed in 2002. DESIGN, SETTING, AND PARTICIPANTS: In 2006, 324 German urology departments received a detailed, anonymous, and self-administered questionnaire regarding demographic data, current use, and attitudes concerning laparoscopy. Quantitative evaluation of laparoscopic procedures was performed for 20 indications. MEASUREMENTS: The response rate was 73% (238 of 324 institutions). Thirty-two responders were affiliated with universities; 95 responders were affiliated with urban hospitals; 101 responders were affiliated with general hospitals; and 9 responders were affiliated with private hospitals. Laparoscopy had been implemented as a standard operating procedure in 82% of the departments, an increase of 28% compared with the 2002 questionnaire. Forty-eight percent of participants expected a similar operating time to that of open surgery, an increase of 16% compared with the 2002 questionnaire. Concerns about the learning curve dropped from 92% in 2002 to 80% in 2006, and concerns about economic disadvantages dropped from 70% in 2002 to 45% in 2006. Criticism regarding lack of sufficient scientific data decreased from 76% in 2002 to 13% in 2006. Laparoscopic radical prostatectomies (>40 per year) were performed in 30 hospitals in 2006, an increase of 27% over 2002. Laparoscopic radical nephrectomy was performed 16-40 times per year in 33 of the responding institutions, an increase of 29% over 2002, and laparoscopic radical nephrectomy was performed >40 per year in 10 of the institutions, an increase of 9% over 2002. Laparoscopic pyeloplasty had a reported frequency of 16-40 procedures per year in 11 of the responding institutions, an increase of 10% over 2002, and laparoscopic pyeloplasty had a frequency between 5 and 15 procedures per year in 42 institutions, an increase of 37% over 2002. Only four hospitals performed cystectomy with ileum conduit and with orthotopic bladder substitute (5-15 cases per year). RESULTS AND LIMITATIONS: The results demonstrate the rising acceptance of laparoscopy in urologic surgery (an increase of 28% more departments performing laparoscopy) and an increasing interest in these techniques (an increase of 12% in the response rate). Their value is still limited by the response rate of only 73%. CONCLUSIONS: This survey demonstrates the increasing impact of laparoscopy on surgical patterns in urology and the increasing acceptance of laparoscopic techniques concerning operating time, learning curve, and scientific approval.

Abstract

BACKGROUND: Laparoscopic techniques have dramatically influenced urologic surgery in the past 2 decades. OBJECTIVES: A questionnaire was distributed in 2006 to analyse laparoscopic practice patterns in Germany. The results were compared with a survey performed in 2002. DESIGN, SETTING, AND PARTICIPANTS: In 2006, 324 German urology departments received a detailed, anonymous, and self-administered questionnaire regarding demographic data, current use, and attitudes concerning laparoscopy. Quantitative evaluation of laparoscopic procedures was performed for 20 indications. MEASUREMENTS: The response rate was 73% (238 of 324 institutions). Thirty-two responders were affiliated with universities; 95 responders were affiliated with urban hospitals; 101 responders were affiliated with general hospitals; and 9 responders were affiliated with private hospitals. Laparoscopy had been implemented as a standard operating procedure in 82% of the departments, an increase of 28% compared with the 2002 questionnaire. Forty-eight percent of participants expected a similar operating time to that of open surgery, an increase of 16% compared with the 2002 questionnaire. Concerns about the learning curve dropped from 92% in 2002 to 80% in 2006, and concerns about economic disadvantages dropped from 70% in 2002 to 45% in 2006. Criticism regarding lack of sufficient scientific data decreased from 76% in 2002 to 13% in 2006. Laparoscopic radical prostatectomies (>40 per year) were performed in 30 hospitals in 2006, an increase of 27% over 2002. Laparoscopic radical nephrectomy was performed 16-40 times per year in 33 of the responding institutions, an increase of 29% over 2002, and laparoscopic radical nephrectomy was performed >40 per year in 10 of the institutions, an increase of 9% over 2002. Laparoscopic pyeloplasty had a reported frequency of 16-40 procedures per year in 11 of the responding institutions, an increase of 10% over 2002, and laparoscopic pyeloplasty had a frequency between 5 and 15 procedures per year in 42 institutions, an increase of 37% over 2002. Only four hospitals performed cystectomy with ileum conduit and with orthotopic bladder substitute (5-15 cases per year). RESULTS AND LIMITATIONS: The results demonstrate the rising acceptance of laparoscopy in urologic surgery (an increase of 28% more departments performing laparoscopy) and an increasing interest in these techniques (an increase of 12% in the response rate). Their value is still limited by the response rate of only 73%. CONCLUSIONS: This survey demonstrates the increasing impact of laparoscopy on surgical patterns in urology and the increasing acceptance of laparoscopic techniques concerning operating time, learning curve, and scientific approval.

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19 citations in Web of Science®
22 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Urological Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2009
Deposited On:04 Nov 2009 14:18
Last Modified:05 Apr 2016 13:22
Publisher:Elsevier
ISSN:0302-2838
Publisher DOI:https://doi.org/10.1016/j.eururo.2008.09.064
PubMed ID:18849109

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