BOIS:DSU:ZDISU587XA.92 FF: ZUP9 E1: 12.11.2004 P R O O F Original Paper Dig Surg 587 DOI: 10.1159/0000XXXXX The Development of Laparoscopic Surgery in Spain Xavier Feliu Eduardo Marı´a Targarona Ana Garcı´a-Agustı´ Albert Pey Angel Carrillo Antonio Marı´a Lacy Salvador Morales José Luis Salvador Antonio Torres Enrique Veloso For the Section of Endoscopic Surgery, Spanish Association of Surgeons Received: February 16, 2004 Accepted: August 9, 2004 Published online: $$$ Xavier Feliu Cavall Bernat 8 ES–08230 Matadepera (Spain) Tel. +34 93 7871691, Fax +34 $$$ E-Mail 16255xfp@comb.es ABC Fax + 41 61 306 12 34 E-Mail karger@karger.ch www.karger.com © 2005 S. Karger AG, Basel 0253–4886/05/0000–0000$22.00/0 Accessible online at: www.karger.com/dsu Key Words Colon cancer, laparoscopic surgery W Laparoscopic surgery, development/acceptance level W Laparoscopic appendectomy W Laparoscopic antireflux disease surgery W Laparoscopic cholecystectomy W Laparoscopic inguinal hernia repair W Opinion survey, laparoscopic surgery Abstract Aim: To assess degree of development and level of acceptance of laparoscopic surgery in Spain. Method: A questionnaire was sent to all members of the Spanish Association of Surgeons in April 2003. It included 32 questions, 9 of which were general, and 23 referred to specific clinical situations, techniques, and standard practice. Results: Eight hundred and fifty-eight (33.1%) surgeons replied. Only 211 (25%) surgeons reported per- forming advanced laparoscopic procedures. Four hundred and twenty (49%) surgeons believed that the results obtained with laparoscopic surgery were better than those obtained with conventional surgery, and 325 (40%) surgeons believed that laparoscopy would be- come a superspecialty. Laparoscopic surgery was con- sidered the method of choice in the treatment of gall- bladder stones (99%), gastroesophageal reflux disease (94%), acute cholecystitis (81%), in selected cases of inguinal hernia repair, and in procedures to be per- formed in spleen and adrenals, benign colon disease, and obesity. Three hundred and ninety-eight (47%) sur- geons considered laparoscopic surgery the preferred ap- proach for colon cancer, 292 (34%) for appendicitis, and 155 (18%) for incisional hernia. Five hundred and five (59%) surgeons considered that the use of laparoscopic surgery had grown less than expected. Conclusions: The vast majority of surgeons advocated laparoscopic sur- gery for the treatment of gallbladder stones and gastro- esophageal reflux disease. Although most hospitals had the appropriate technical facilities for performing ad- vanced laparoscopic procedures, few surgeons actually did so. Copyright © 2005 S. Karger AG, Basel Introduction Laparoscopic surgery has been one of the most impor- tant breakthroughs in recent years. Many interventions that used to be performed using an open approach are now successfully performed by laparoscopy, and this ap- proach has had a great impact on current surgical prac- tice, modifying many established surgical concepts [1, 2]. At present, no consensus exists on many of the indica- tions for laparoscopic surgery, and the results obtained with these techniques are still controversial. There is also little understanding of the current level of development and acceptance of laparoscopic surgery. In Spain, there is an impression that laparoscopic surgery has not reached