# Trends in Gender Disparities in Surgical Experience: A National Clinical Database Study

## TL;DR

This study examines changes in gender disparities in surgical experience among Japanese gastrointestinal surgeons before and after efforts to address gender inequality.

## Contribution

The study evaluates the effectiveness of measures introduced in 2021 to reduce gender disparities in surgical practice.

## Key findings

- Female surgeons showed improvement in medium-difficulty surgeries but still lagged in high-difficulty procedures.
- Disparities in high-difficulty surgeries like low anterior resection and pancreaticoduodenectomy persisted over the study period.
- Measures by the Japanese Society of Gastrointestinal Surgery helped reduce some gender disparities but more work is needed.

## Abstract

We previously reported the gender disparities in surgical procedures between male and female surgeons using National Clinical Database covering more than 95% of all operations performed in Japan. This study aims to examine the changes in gender disparity in the surgical experience of gastrointestinal surgeons in Japan before and after implementation of measures by the Japanese Society of Gastrointestinal Surgery to address gender inequality commenced in 2021.

We conducted a nationwide retrospective study to compare the number of operations performed by male and female surgeons using National Clinical Database. The number of operations per surgeon was calculated based on every 2 years of a surgeon's experience, and a comparison was made between male and female surgeons. The years selected for analysis were 2015, 2019, and 2023.

Almost no gender differences were observed in the number of low‐difficulty surgeries. For medium‐difficulty surgeries, the number performed by female surgeons showed an improving trend over the study period, yet some disparities remained. The number of high‐difficulty surgeries (low anterior resection and pancreaticoduodenectomy) performed by male surgeons was higher than the number performed by female surgeons, except for protrusions. This disparity remained unchanged over the study period.

The efforts of the Japanese Society of Gastrointestinal Surgery has been shown to be effective in mitigating gender disparities in the number of surgeries performed. High‐difficulty surgeries have emerged as the primary target for further improvement initiatives.

This nationwide study evaluated gender disparities in gastrointestinal surgical experience in Japan before and after 2021, when the Japanese Society of Gastrointestinal Surgery implemented measures to address gender inequality. While female surgeons showed increased involvement in medium‐difficulty procedures, disparities in high‐difficulty surgeries persisted, highlighting the need for continued efforts targeting equitable surgical opportunities.