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Role of appendectomy in training for laparoscopic surgery
M Carrasco-Prats1, V Soria Aledo, J A Luján-Mompeán
1Servicio de Cirugía General y Aparato Digestivo I, Hospital Universitario Virgen de la Arrixaca, Carretera de Cartagena, s/n, El Palmar, 30120 Murcia, Spain. med018949@saludalia.com
Background:
This study aimed to evaluate a program of training in laparoscopic surgery based on clinical practice in the emergency room, in which laparoscopic appendectomy is the first technique that residents perform as surgeons.
Methods:
A prospective nonrandomized study was conducted involving all the laparoscopies performed in emergencies with a diagnosis of acute abdomen, appendicular in origin, during the period between June 1991 and December 1997.
Results:
There were no statistically significant differences between residents and assistants in terms of conversion rates (22/242 vs 15/158), mean hospital stay for each type of surgeon (5.2 days for residents and 5.1 days for assistants), and complications (12.8% for residents and 13.7% for assistants). Operating time, was significantly longer (p < 0.05) for residents (52.2 min) than for assistants (48 min).
Conclusions:
Apprenticeship in laparoscopic appendectomy can be accomplished with gradual clinical training and without the need for resort to animal experimentation laboratories.
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