Gender Differences in the Adoption and Utilization of Robotic-assisted Laparoscopic Surgery Among Practicing Urologists: A Study of American Board of Urology Case Logs From 2012-2022

IF 2.1 3区医学 Q2 UROLOGY & NEPHROLOGY Urology Pub Date : 2025-02-01 DOI:10.1016/j.urology.2024.10.034

Alexa Steckler , Natalie Passarelli , Alexander Homer , Simone Thavaseelan , Elias Hyams

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Abstract

Objective

To evaluate the differential activity in robotic-assisted laparoscopic surgery (RALS) by urologic surgeon gender.

Methods

This was a retrospective study of American Board of Urology surgical case logs from 2012-2022. The CPT-coded laparoscopic procedures included were Partial Nephrectomy (50543), Radical Nephrectomy (50545, 50546, 50548), Pyeloplasty (50544), and Sacrocolpopexy (57425). Robotic-assisted cases were co-coded with CPT S2900. Univariate analysis and multiple logistic regression analyzed the roles of physician gender and other factors on RALS utilization. A separate analysis was performed for Robotic-Assisted Laparoscopic Prostatectomy (RALP) (55866).

Results

Women performed 10.8% of all procedures and 9.02% of robotic cases. General Urology and Urogynecology and Reconstructive Pelvic Surgery (URPS) had higher concentrations in women. Of the CPT procedures analyzed, women performed the highest percentage of sacrocolpopexies (39.2% of total), 8.09% of which were robotic. In multivariate regression, women surgeons had significantly lower odds of performing a robotic case compared to men (OR 0.803, P <.001). Endourology, Oncology, Pediatric Urology, and URPS subspecialties were associated with RALS. Upward trends were depicted across all physicians (0.012, [0.007, 0.018], P <.001) and for men (0.019, [0.010, 0.029], P = .001). Women showed no significant increase in robotic usage over time (P = .463).

Conclusion

Women have lower odds of participating in robotics, primarily specialize in URPS and their involvement in RALS is skewed toward sacrocolpopexy. As robotics continues to dominate surgical urology, ensuring equitable training opportunities is essential. Research into the roles of mentorship in residency, same-gender patient-physician concordance, practice setting, and recent graduates’ referral patterns is warranted.

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泌尿外科执业医师采用和使用机器人辅助腹腔镜手术 (RALS) 的性别差异：2012-2022年美国泌尿外科委员会病例记录研究》（A Study of American Board of Urology Case Logs from 2012-2022.

目的评估泌尿外科外科医生性别在机器人辅助腹腔镜手术（RALS）中的活动差异：这是一项对美国泌尿外科委员会 2012-2022 年手术病例记录的回顾性研究。CPT编码的腹腔镜手术包括肾部分切除术（50543）、根治性肾切除术（50545、50546、50548）、肾盂成形术（50544）和骶骨整形术（57425）。机器人辅助病例与 CPT S2900 共同编码。单变量分析和多元逻辑回归分析了医生性别和其他因素对 RALS 使用率的影响。对机器人辅助腹腔镜前列腺切除术（RALP）（55866）进行了单独分析：结果：女性实施的手术占所有手术的 10.8%，占机器人手术的 9.02%。普通泌尿外科和泌尿妇科及盆腔整形外科（URPS）的女性比例较高。在分析的 CPT 手术中，女性实施骶骨结节切除术的比例最高（占总数的 39.2%），其中 8.09% 是机器人手术。在多变量回归中，与男性相比，女性外科医生实施机器人手术的几率明显较低（OR 0.803，p结论：女性参与机器人手术的几率较低，她们主要擅长URPS手术，而她们参与的RALS手术偏向于骶骨结节成形术。随着机器人技术继续主导泌尿外科手术，确保公平的培训机会至关重要。有必要对住院医师培训中导师的作用、同性患者与医生的一致性、实践环境以及应届毕业生的转诊模式进行研究。

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来源期刊

Urology 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

9.50%

发文量

716

审稿时长

59 days

期刊介绍： Urology is a monthly, peer–reviewed journal primarily for urologists, residents, interns, nephrologists, and other specialists interested in urology The mission of Urology®, the "Gold Journal," is to provide practical, timely, and relevant clinical and basic science information to physicians and researchers practicing the art of urology worldwide. Urology® publishes original articles relating to adult and pediatric clinical urology as well as to clinical and basic science research. Topics in Urology® include pediatrics, surgical oncology, radiology, pathology, erectile dysfunction, infertility, incontinence, transplantation, endourology, andrology, female urology, reconstructive surgery, and medical oncology, as well as relevant basic science issues. Special features include rapid communication of important timely issues, surgeon''s workshops, interesting case reports, surgical techniques, clinical and basic science review articles, guest editorials, letters to the editor, book reviews, and historical articles in urology.