Surgeon Volume Matters!


Surgeons

Data regarding outcomes based on surgical volume has been mounting.

Consider these examples:

Gynecologists performing procedures approximately once a month or less were found to have higher rates of adverse outcomes in gynecology, gynecological oncology, and urogynecology, with higher mortality in gynecological oncology.1

For many procedures, the observed associations between hospital volume and operative mortality are largely mediated by surgeon volume. Patients can often improve their chances of survival substantially, even at high-volume hospitals, by selecting surgeons who perform the operations frequently.2

When the researchers examined lower urinary tract injury (LTUI) incidence by surgical type, they found that LUTIs were 7.3 times more likely and 2.7 times more likely to occur during laparotomic hysterectomies performed by low-volume surgeons compared with high-volume surgeons.3

Low-volume surgeons have most complications with mesh slings.4

How do you know your surgeon is experienced enough? Your doctor should always have your best interest in mind and should not be offended with your questions. Your doctor should gladly refer cases that are not their specialty to a surgeon with the skills needed for your care.

Consider these questions:

  1. When is the last time you performed one of these procedures?
  2. How many have you done in the last month?
  3. How many have you done in the last year?
  4. How long have you been doing these?
  5. Do you think you are the best doctor to do this surgery or would I be better served by someone else?

Sources

American Journal of Obstetrics and Gynecology, volume 215, Issue 1, 21-33:

Conclusion

Gynecologists performing procedures approximately once a month or less were found to have higher rates of adverse outcomes in gynecology, gynecological oncology, and urogynecology, with higher mortality in gynecological oncology.

AAGL 2013: Surgical Volume Affects Risk of Lower Urinary Tract Injury, Evidence Suggests

When the researchers examined LUTI incidence by surgical type, they found that LUTIs were 7.3 times more likely and 2.7 times more likely to occur during laparotomic hysterectomies performed by low-volume surgeons compared with high-volume surgeons

Special Article

Surgeon Volume and Operative Mortality in the United States

John D. Birkmeyer, M.D., Therese A. Stukel, Ph.D., Andrea E. Siewers, M.P.H., Philip P. Goodney, M.D., David E. Wennberg, M.D., M.P.H., and F. Lee Lucas, Ph.D.

N Engl J Med 2003; 349:2117-2127November 27, 2003DOI: 10.1056/NEJMsa035205

Conclusions

For many procedures, the observed associations between hospital volume and operative mortality are largely mediated by surgeon volume. Patients can often improve their chances of survival substantially, even at high-volume hospitals, by selecting surgeons who perform the operations frequently.

News

Low-volume surgeons have most complications with mesh slings

Publish date: September 9, 2015

By: Mary Ann Moon , Ob.Gyn. News