Laparoscopic Appendicectomy: The Ideal Procedure for Laparoscopic Skill Training for Surgical Registrars

Tata, Mahadevan Deva; Singh, Rajesh Kumar; Bakar, Azrina A.; Selvindoss, Paul; Kandasami, P; Gurunathan, Ramesh Kumar

doi:10.1016/s1015-9584(08)60058-5

Cited by 11 publications

(6 citation statements)

References 14 publications

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“…Surgical trainee showed a higher conversion rate (5% vs. 0) in our study. It is comparable to conversion rates demonstrated by surgical trainees in previous studies ranges from 5 -11% [7][8][9]. Possible reasons for the higher conversion rate would be the lack of experience in recognizing altered anatomical structures in the presence of local complications of appendicitis and lack of hands on experience of laparoscopic dissection.…”

Section: Discussionsupporting

confidence: 75%

“…Similarly, we observed 2.6% of pelvic abscess rates in surgical trainee group without any superficial surgical site infection. However, we did not encounter other complications including paralytic ileus, bowel injury or mortality which were described in previous studies [6][7][8][9].…”

Section: Discussionmentioning

confidence: 91%

“…Metanalyses have proven the superiority of it over open surgery in terms of complications other than deep surgical site infections, postoperative pain and the length of hospital stay [4,5]. In addition, concerns have been raised about LA as a preferred procedure for basic laparoscopic training based on a few retrospective studies conducted at teaching hospitals [6][7][8][9]. Jaffer et al concluded that the learning curve stabilizes after performing 20 LAs [8].…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic appendicectomy: a safe option for basic laparoscopic training

SIlva¹,

Karunadasa²,

Rathnayake³

2021

SL J. Med.

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Background: Laparoscopic appendicectomy has advantages over open surgery in terms of complications, postoperative pain and the length of hospital stay. It is considered as a preferred basic laparoscopic procedure for surgical trainees based on the studies performed at teaching hospitals. Objective:The aim of this study was to determine whether laparoscopic appendicectomy can safely be carried out by surgical trainees in peripheral hospitals.Methods: A retrospective analysis was conducted at a base hospital in Uva province of Sri Lanka including all laparoscopic appendicectomies performed from July 2018 to December 2018. Duration of procedure, complications, postoperative pain, and duration of hospital stay were compared between the surgeries performed by surgeon (group A) and by a supervised trainee (group B).Results: 53 laparoscopic appendicectomies, 15 (28.3%) were included in group A and 38 (71.7%) were included in group B. Demographics including age, intraoperative findings and histology were comparable between two groups. There were no significant differences observed between group A and B for the duration of procedure (34.67 min vs. 41.18 min, p = 0.30), deep surgical site infections (0 vs. 2.6%, p = 1.0), median postoperative pain score (1 vs 1, p = 0.23) and duration of hospital stay (2.27 days vs. 2.58 days, p = 0.11). However, group B had a higher conversion rate to open surgery compared to group A (5% vs. 0). Conclusion:Laparoscopic appendicectomy is a safe procedure for supervised trainees to perform in peripheral hospital setting.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Laparoscopic appendicectomy: a safe option for basic laparoscopic training

SIlva¹,

Karunadasa²,

Rathnayake³

2021

SL J. Med.

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“…Trainee surgeons play an integral role in the assessment and management of patients especially in large teaching hospitals under the supervision of experienced consultants. Laparoscopic appendicectomy has been generally considered a safe procedure for trainees with a study finding no difference in operative time and morbidity compared to qualified surgeons [20], whereas another study has reported an increase surgical operative times and complications when surgical trainees are involved [21]. However the ability of surgical trainees to make an accurate intraoperative diagnosis of appendicitis has not been fully evaluated.…”

Section: Introductionmentioning

confidence: 99%

Effect of surgical experience on the macroscopic diagnosis of appendicitis: A retrospective cohort study

Pham

Devadas

Howle

2015

International Journal of Surgery

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“…The conversion rate to open was 12.6% versus 16.3% in junior versus senior trainees' groups. A study conducted among the surgical trainees comprising 115 patients showed a conversion rate of 9.2% [8]. Many studies have shown conversion rates of LA to be 9%-12% [9].…”

Section: Wbc-white Blood Cells Crp-c Reactive Proteinmentioning

confidence: 99%

Is laparoscopic appendicectomy safe in the hands of junior trainees in surgery?

et al. 2020

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Introduction Laparoscopic appendicectomy (LA) is considered as the mainstay of treatment in acute appendicitis. LA is a basic laparoscopic procedure and therefore can be used as a training tool for surgical trainees. It is considered an index operation for junior surgical trainees. This study aims to assess whether LA is safe to be carried out by a junior surgical trainee. Methodology The study was conducted at a tertiary care unit in Colombo. Data were collected retrospectively. A total of 152 LA (including those which were converted to open appendicectomy) performed between January 2018 to May 2019, by surgical trainees (both junior and senior) were included. Gender, age, initial investigation findings, intraoperative findings, operative time, hospital stay, postoperative complications and histology data were analysed. Findings were compared in two groups-operated by junior and senior surgical trainees. Results One hundred and three surgeries were performed by junior trainees while 49 were performed by senior trainees. There was no significant difference in complicated appendicitis (21.4% vs 34.7%), operative time (71m vs 68m), conversion rate (12.6% vs 16.3%) and hospital stay (3d vs 3d) between these two groups. The overall complication rate was 3.9%. Conclusion Our findings were comparable to previously published data and no statistically significant difference was noted between the two trainee groups in terms of operative finding, hospital stay and postoperative complications. The results suggest that LA can safely be performed by the junior surgical trainees with acceptable outcomes.

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Laparoscopic Appendicectomy: The Ideal Procedure for Laparoscopic Skill Training for Surgical Registrars

Cited by 11 publications

References 14 publications

Laparoscopic appendicectomy: a safe option for basic laparoscopic training

Laparoscopic appendicectomy: a safe option for basic laparoscopic training

Effect of surgical experience on the macroscopic diagnosis of appendicitis: A retrospective cohort study

Is laparoscopic appendicectomy safe in the hands of junior trainees in surgery?

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