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Are there any risks in surgical resident participation?

Abstract

With the spread of minimal invasive technique, laparoscopic (LA) frequency is performed with increased frequency with excellent results. The method provides an excellent opportunity for surgical residents to learn basic laparoscopic skills and prepares them for more complex interventions.

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Methods

We evaluated the results of 600 laparoscopic apers carried out by 5 surgical residents (Group A) and 5 consultant surgeons (Group B) between 2006 and 2009. Comparison of the two groups based on the demographics of patients, length of surgery, operational time depending on inflammation intensity, applied blood loss, conversion rate, stay in hospital in days, and post-operative difficulties. We also evaluated the extent to which the minimum 20 surgeries to be performed in the learning curve period as recommended by our experience. SPPS 20 was used for statistical analysis.

Results

The study period consisted of six hundred laparoscopic apers (Group A: n = 319; Group B: n = 281). There was a significant difference between the two groups during the course of the learning curve period and when the duration of the Authority’s surgeries was compared during the learning curves with the length of surgeries later in the two groups. The operational time for more severe inflammation also showed a significant difference when compared with simple apeptic operation.

Conclusions

The rapid introduction of laparoscopy involves little risk, and the surgical residents also perform the surgery quite safely, and it gives them a great opportunity to learn the basic laparoscopy skills.

Background

In recent years, the minimal invasive technique in emergency surgery has been used in increasing numbers. The most common urgent surgical condition to be treated with laparoscopic mode today is acute acids. A laparoscopic submission over open surgery (quicker recovery, less post-operative pain, reduces the need for medications and complications from wound infections, and better cosmetic results) is proven to have many benefits. In addition, the procedure is reliable and safe to treat this condition.

In many Western countries, surgery is carried out by surgical residents outside the day’s hours supervised by an adviser. Therefore, it is the first type of laparoscopic surgical residents to learn; so they learn the basics of the minimal invasive surgical technique and could develop the basic skills they can use in more complex surgeries.

Some studies assessed the results of laparoscopic appendices made by resident surgeons (length of surgery, hospital stay, and conversion rate). Therefore, laparoscopic appetology can be concluded as a safe method for both residents and consultants. Other studies reported that the complex rate is higher for surgeries carried out by residents. Some studies also focused on the learning curve, namely, how many surgeries a surgical resident needs to be able to perform laparoscopic surgeries independently. These studies estimate that 20 to 30 surgeries should be carried out during the learning curve. According to the recommendation of the European Society of Endoscopic Surgery, this number is 20.

At our clinic, laparoscopic epidemia was introduced in 2006, and, over six months, the approach to the treatment of acute apicitis has undergone a complete change, with the minimal invasive method the primary means of treating this condition. In this study, we compared residential surgeries and surgeries carried out by consultants in terms of efficiency and safety by analyzing the results of the initial learning curve period. We also assessed the extent to which the 20 surgeries that recommended the learning curve period correspond to our own outcomes and experience.

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