Alexa Steckler , Natalie Passarelli , Alexander Homer , Simone Thavaseelan , Elias Hyams
{"title":"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.","authors":"Alexa Steckler , Natalie Passarelli , Alexander Homer , Simone Thavaseelan , Elias Hyams","doi":"10.1016/j.urology.2024.10.034","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the differential activity in robotic-assisted laparoscopic surgery (RALS) by urologic surgeon gender.</div></div><div><h3>Methods</h3><div>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).</div></div><div><h3>Results</h3><div>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, <em>P</em> <.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], <em>P</em> <.001) and for men (0.019, [0.010, 0.029], <em>P</em> = .001). Women showed no significant increase in robotic usage over time (<em>P</em> = .463).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":"196 ","pages":"Pages 333-339"},"PeriodicalIF":2.1000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"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\",\"authors\":\"Alexa Steckler , Natalie Passarelli , Alexander Homer , Simone Thavaseelan , Elias Hyams\",\"doi\":\"10.1016/j.urology.2024.10.034\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>To evaluate the differential activity in robotic-assisted laparoscopic surgery (RALS) by urologic surgeon gender.</div></div><div><h3>Methods</h3><div>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).</div></div><div><h3>Results</h3><div>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, <em>P</em> <.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], <em>P</em> <.001) and for men (0.019, [0.010, 0.029], <em>P</em> = .001). Women showed no significant increase in robotic usage over time (<em>P</em> = .463).</div></div><div><h3>Conclusion</h3><div>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.</div></div>\",\"PeriodicalId\":23415,\"journal\":{\"name\":\"Urology\",\"volume\":\"196 \",\"pages\":\"Pages 333-339\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Urology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0090429524009129\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Urology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0090429524009129","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
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
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.
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.
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