Weigt A, Rauchfuss F, Dittmar Y, Settmacher U, Scheuerlein H
Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Jena, Erlanger Allee 101, 07747, Jena Lobeda-Ost, Deutschland.
Chirurg. 2015 Jun;86(6):587-94. doi: 10.1007/s00104-014-2853-4.
A survey about perceptions concerning natural orifice transluminal endoscopic surgery (NOTES) and single port operations (SPO) was conducted among medical professionals at hospitals in Central Germany. The identity of the participants remained anonymous. The focus was on the subjective perception of medical colleagues and included a statement of preferred methods if the medical professional would need to undergo surgery.
Within a radius of 120 km of the city of Erfurt, all 150 surgical departments were approached and asked to complete a series of questionnaires containing general and personal questions. The analysis was performed according to the professional rank, age and sex of the participants. The questionnaires contained questions on patient preferences, cosmetic aspects and other factors, such as marketing, industry-driven, playful approach of the surgeon and appeal of a new procedure.
In total 83 surgical departments participated in the survey resulting in 432 eligible questionnaires. Of the participants 29 % were female, the average age was 44 years, 20 % were heads of departments, 37 % senior surgeons, 20 % specialist surgeons and 23 % residents. The proportion of conventional minimally invasive surgical procedures was on average 30 % of all surgical interventions. Two hospitals offered transvaginal hybrid NOTES (cholecystectomy), 45 % performed SPOs, 36 % of the participants agreed strongly or moderately with the concept of SPO and 34 % rejected NOTES. The factors industry-driven, promotion/marketing and appeal of a new procedure were evaluated as very important or relatively important by the majority of the participants (> 70 %). When evaluating the factor playful approach of the surgeon, the proportion was 55 %. The factor patient preferences was evaluated as very high or high by 25% of the participants while it had no impact on 8 % or only a minor impact on 36 %. In case of undergoing surgery themselves, conventional laparoscopy would be preferred and NOTES was rated last among all options.
The soft factors that were analyzed (i.e. marketing, industry-driven, playful approach of the surgeon and appeal of something new) were evaluated as much more important in the surgeons' opinion compared to patient criteria (i.e. patient preferences and cosmetic results). The soft factors are, however, not to be judged as generally negative as they are to a certain extent necessary (marketing), useful (impulses from industry) or are part of the surgical creativity (playfulness). The discrepancies in the medical professional evaluation of the different factors shows that the reasoning and the motivation of the actions are not necessarily identical.
在德国中部的医院中，对医学专业人员进行了一项关于自然腔道内镜手术（NOTES）和单孔手术（SPO）认知的调查。参与者的身份保持匿名。重点是医学同事的主观认知，包括如果医学专业人员需要接受手术时对首选方法的陈述。
在距离爱尔福特市120公里的范围内，联系了所有150个外科科室，要求他们完成一系列包含一般和个人问题的问卷。根据参与者的专业级别、年龄和性别进行分析。问卷包含关于患者偏好、美容方面以及其他因素的问题，如市场推广、行业驱动、外科医生的趣味性方法和新手术的吸引力。
共有83个外科科室参与了调查，得到432份合格问卷。参与者中29%为女性，平均年龄为44岁，20%为科室主任，37%为高级外科医生，20%为专科外科医生，23%为住院医师。传统微创手术的比例平均占所有手术干预的30%。两家医院提供经阴道混合NOTES（胆囊切除术），45%进行SPO，36%的参与者强烈或中度认同SPO的概念，34%拒绝NOTES。大多数参与者（>70%）认为行业驱动、推广/营销和新手术的吸引力等因素非常重要或相对重要。在评估外科医生的趣味性方法这一因素时，这一比例为55%。25%的参与者认为患者偏好这一因素非常高或较高，而8%的参与者认为其没有影响，36%的参与者认为其只有轻微影响。如果他们自己接受手术，会首选传统腹腔镜手术，NOTES在所有选项中排名最后。
在外科医生看来，所分析的软因素（即市场推广、行业驱动、外科医生的趣味性方法和新事物的吸引力）比患者标准（即患者偏好和美容效果）更为重要。然而，软因素不能一概而论地被判定为负面，因为它们在一定程度上是必要的（市场推广）、有用的（行业推动）或外科创造力的一部分（趣味性）。医学专业人员对不同因素的评估差异表明，行动的推理和动机不一定相同。
