A study has revealed that female surgeons perform robot-assisted surgery less frequently than male surgeons compared to open surgery or laparoscopic surgery. This finding was reported by a research group led by Assistant Professor Emiko Kono of Osaka Medical and Pharmaceutical University and Professor Yukiyo Nomura of the University of Tokyo.
Surgical experience significantly impacts a surgeon's career development, but generally, the head of the department or supervising physician at each institution decides which doctor performs which surgery. Previous research has indicated that female surgeons have fewer opportunities to perform surgeries than male surgeons, and this difference is particularly pronounced for complex surgeries.
This study focused on robot-assisted surgery, which has rapidly spread throughout Japan since 2018, and investigated whether there are gender differences in opportunities for gaining experience with new surgical techniques, even in the initial stages of their introduction.
Using the National Clinical Database (NCD), a large-scale database in which over 95% of surgical procedures in Japan are registered, we analyzed the number of surgeries performed per surgeon for distal gastrectomy and low anterior resection, broken down by years of experience and gender, for robot-assisted surgery, open surgery, and laparoscopic surgery.
The results showed that while the gender gap in surgical opportunities improved in open and laparoscopic surgeries, the gender gap was more pronounced in robot-assisted surgery. Male surgeons saw an increase in the number of robot-assisted surgeries they performed with increasing years of experience, whereas a similar increasing trend was not observed in female surgeons. In particular, the gender gap tended to widen from around 10 years after obtaining medical licenses, suggesting that the allocation of surgical opportunities to female surgeons may be insufficient during the introduction of new surgical procedures.
Robot-assisted surgery is one of the central surgical techniques in future gastrointestinal surgery practice, and the uneven distribution of training opportunities in the early stages of its introduction could affect future skill acquisition and career development. This research demonstrates the importance of ensuring equitable training opportunities in order to promote gender equality in the field of surgery and to build a sustainable surgical healthcare system.
Paper information: [Surgery] Sex Differences in Operative Opportunities with Early Adoption of Robot-assisted Surgery
