Citizen Perceptions of Less Surgery and Notes: the Impact of Age, Gender, and Bmi
Sharona B. Ross*, Connor a. Morton, Robert Boyle, Seaborn a. Roddenbery, Linda K. Barry, Jennifer C. Cooper, Carl B. Bowers, Alexander S. Rosemurgy
Surgery, University of South Florida, Tampa, FL
Introduction: Recently, minimally invasive forms of surgery, such as Laparo-Endoscopic Single Site (LESS) surgery and NOTES have received significant recognition in the lay press. Increased public awareness of the advent and benefits of LESS surgery and NOTES could have a profound impact on their public perception. This study was undertaken to determine public attitudes toward LESS surgery and NOTES and to determine how these attitudes are impacted by age, gender, and obesity. Methods: College educated Americans completed a validated questionnaire with unbiased guidance. Questions about personal appearance and physical condition were scored utilizing a Likert scale (1=disagree to 5=agree). Statistical analysis was undertaken to evaluate relationships between citizen perceptions and age, gender, and BMI utilizing Spearman regression. Where appropriate, data are presented as median (mean ± SD).Results: 152 people, 56% female, of age 29 years (38 years ± 17.9), and BMI 24 kg/m2 (25 kg/m2 ± 4.6) completed the survey. They generally liked their physique (4, 4 ± 1.0), felt they were attractive (4, 4 ± 1.0), and felt that others found them attractive (4, 4 ± 0.8). LESS surgery was appealing if it involved no more risks, no / minimally more pain, no / minimally longer operative time, no longer recovery and no / minimally more cost. Reduced pain and quicker return to usual activities were particularly valued. While there were no appreciable differences between men and women, older persons were more interested in reduced risk, pain, and recovery time and less interested in scarring/appearance. Heavier persons were more interested in reduced pain, operative time, and pain medication use and were less interested in scarring / appearance. With regard to NOTES, only 32% were willing to consider it. Older people regarded NOTES more favorably. However, NOTES would be acceptable only with no more risks, no / minimally more pain, no / minimally longer operative time, and no / minimally more cost (<$200). Lack of visible scarring with NOTES was considered most important by only 30%.Conclusion: With evolution of minimally invasive surgery and increased public awareness, acceptance of LESS surgery and NOTES depends upon no additional risk and no or minimally increased pain, recovery time, and cost. Improved cosmesis is not generally a priority, particularly in older or heavier people. Improved cosmesis beyond conventional laparoscopy is not considered a major factor by most Americans; safety, pain, and recovery time remain major issues in deciding operative choices.
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