Surgical training and implementation of emerging surgical technologies

Institutional review board-approved trials were in place at an institutional level but did not have the statistical power to detect the increased incidence of biliary tract injury because of their small size, pointing out the need for all "early adapting" surgeons to record their experience [15]. Other interested parties include government agencies such as the Food and Drug Administration, the National Committee for Quality Assurance, public and private purchasers of health care insurance (e.g., the Leapfrog group), and medical malpractice insurance companies [25].