National trends in minimally invasive and open operative experience of graduating general surgery residents: Implications for surgical skills curricula development?

Background: The aim of this study was to analyze national trends in minimally invasive and open cases of all graduating residents in general surgery. Methods: A retrospective analysis was performed on data obtained from Accreditation Council for Graduate Medical Education logs (19992008) of graduating residents from all US general surgery residency programs. Data were analyzed using Mantel-Haenszel χ ² tests and the Bonferroni adjustment to detect trends in the number of minimally invasive and open cases. Results: Minimally invasive procedures accounted for an increasing proportion of cases performed (3.7% to 11.1%, P <.0001), with a proportional decrease in open cases. An increase in minimally invasive procedures with a proportional decrease in open procedures was noted in subcategories such as alimentary tract, abdominal, vascular, thoracic, and pediatric surgery (P <.0001). Conclusions: The results of this study demonstrate that general surgery residents in the United States are performing a greater number of minimally invasive and fewer open procedures for common surgical conditions.