Female Surgeons Versus Male Surgeons in Laparoscopic Appendectomy: Equal Surgical Outcomes?

BACKGROUND: Despite advances in addressing sex disparities, inequities persist in the surgical field. Although some medical specialties have achieved a more balanced sex representation, female surgeons continue to face challenges. This study aimed to determine if a surgeon's sex influences surgical performance by comparing surgical outcomes between male and female surgeons performing laparoscopic appendectomy. METHODS: We conducted a retrospective analysis of adult patients (>16 y) undergoing laparoscopic appendectomy for acute appendicitis at our institution from 2014 to 2022. Patients were categorized based on the surgeon's sex: female (FS) or male (MS). We examined demographics, intraoperative variables, and postoperative outcomes. A multivariable logistic regression analysis assessed the independent effect of the surgeon's sex on conversion to open surgery. RESULTS: A total of 1426 patients were analyzed; 1034 (72.51%) operated by MS and 392 (27.48%) by FS. Female surgeons had longer operative times (61.1 vs. 51.6 min, P<0.0001) and a higher conversion rate to open surgery (2.80% vs. 1.06%, P=0.01). Overall morbidity (12.0% vs. 13.8%, P=0.36) and major morbidity (5.1% vs. 4.8%, P=0.83) were similar between FS and MS. Length of hospital stay and readmission rates were also comparable. Multivariable analysis identified female surgeon as an independent risk factor for conversion (OR: 3.62, 95% CI: 1.39-9.36). CONCLUSIONS: Although FS and ML showed similar postoperative outcomes, differences in operative times and conversion rates suggest a need for further investigation into factors affecting surgical performance. Efforts to address gender disparities in surgical training and leadership are essential for ensuring equal opportunities for all surgeons.