The Efficacy of Patient Centered Outcomes in Determining the Effectiveness of Surgical Mentorship in Rural Saskatchewan

Abstract

Background: Advanced laparoscopic skills are difficult to obtain for practicing surgeons. This issue is exponentially more difficult for surgeons in rural practice. Surgical mentorship is one way in which this can be achieved. Material and Methods: A surgical mentorship program was under taken by the author under the auspices of a senior surgeon at the same hospital he practices in. This was under taken to learn the Laparoscopic Transabdominal Pre - Peritoneal herniorrhaphy technique (TAPP). This involved supervision of the first twenty operative procedures. Once there was satisfaction with the technique the remaining surgical procedures were performed independently without supervision. Over a four-year duration, fifty-nine procedures were performed by the first author. Data was assessed retrospectively with the use of an outcome questionnaire adapted from the EuroQol© questionnaire. Results: A patient centered outcomes questionnaire was employed to determine the efficacy of the mentorship program. This was done through a retrospective audit of the first four years of this advanced technique. An established short quality of life questionnaire, the EuroQol© was used and adapted for laparoscopic hernia surgery 94 percent of patients would recommend the surgeon to other patients for this surgery. There were no hernia recurrences and three patients had inguinodynia, all of whom were managed conservatively Discussion: The patient centered outcomes clearly demonstrate satisfaction with the surgical mentorship program. While this was a small study with insufficient follow up for long term post - operative complications, it does show the feasibility of patient centered outcomes in determining the effectiveness of surgical mentorship.