Imperial College Academic Surgical unit, St. Marys' Hospital, Paddington, United Kingdom.
J Surg Educ. 2011 May-Jun;68(3):185-9. doi: 10.1016/j.jsurg.2011.01.004.
There is a disproportionate ratio of male to female surgeons when compared with the ratio at medical school. Although gender differences in surgical technical ability is not known, studies have shown gender differences in visuospatial ability and manual dexterity. We devised a study to assess objectively the quality of final product of small bowel anastomosis in male and female novice surgeons to explore differences in surgical technical ability.
Thirty-six novice surgeons in the final year of medical school with minimal surgical experience were taught surgical knot tying and small bowel suturing. The students were asked to complete 7 small bowel anastomosis in 7 separate sessions. The quality of the final product was assessed looking at the "fine details" (number of sutures and accuracy, ie, ratio of sutures piercing the full thickness of the bowel) and the "gross apposition" of the bowel ends at the anastomotic site. A grading system for apposition was devised to assess apposition.
The results with fine details and accuracy of suturing revealed that female surgeons were significantly better in the fourth to the sixth sessions with no gender difference in the number of sutures placed. With gross apposition at the anastomotic ends, male surgeons were consistently better between the third to the sixth session. However, these differences were eliminated with training.
Known gender differences in visuospatial ability and manual dexterity may explain the initial gender differences in the quality of the final product. However, these differences were not present by the end of the training sessions. Therefore, with training, no difference in surgical technical ability was found between male and female novice surgeons.
与医学院的比例相比，外科医生中男性与女性的比例不成比例。尽管尚不清楚手术技术能力方面的性别差异，但已有研究表明，在空间视觉能力和手眼协调能力方面存在性别差异。我们设计了一项研究，旨在客观评估男性和女性新手外科医生小肠吻合术的最终产品质量，以探索手术技术能力方面的差异。
36 名处于医学院最后一年且手术经验极少的新手外科医生接受了外科结和小肠缝合的教学。要求学生在 7 个单独的课程中完成 7 个小肠吻合术。通过观察“精细细节”（缝线数量和准确性，即缝线刺穿肠壁全层的比例）和吻合部位肠端的“大体吻合”来评估最终产品的质量。设计了一种用于评估吻合的贴合分级系统。
在第四到第六次手术中，女性外科医生在缝合的精细细节和准确性方面表现明显优于男性，而在缝线数量方面则没有性别差异。在吻合端的大体吻合方面，男性外科医生在第三到第六次手术中始终表现更好。然而，经过培训，这些差异被消除了。
已知的空间视觉能力和手眼协调能力方面的性别差异可能解释了最终产品质量最初存在的性别差异。然而，在培训结束时，这些差异并不存在。因此，经过培训，男性和女性新手外科医生之间在手术技术能力方面没有发现差异。
