Model for teaching laparoscopic colectomy to surgical residents

This study was undertaken to determine the impact that a resident teaching model for advanced laparoscopic skills has on performance, using outcome for laparoscopic colectomy as an indicator of efficacy.

Six senior surgical residents took part in a model for teaching advanced laparoscopic procedures over 3 years. Animal laboratory sessions, tutorial sessions, and feedback were the principle components of this model with residents evaluating each component and their operative experiences. Conversion rates, hospital length of stay, and operating time during the 3 years (n = 100) were compared with a previous year (baseline year) where the faculty performed most of a procedure (n = 20).

Each resident performed an average of 17 cases, being the primary surgeon after the sixth case. There were no differences in operative time for both right and left colectomies compared with the baseline year. Postoperative length of stay was less than 5 days by year 3, with a 14% conversion rate to open surgery. Feedback and tutorials were deemed most important for strategic planning and for reducing operative time.

Resident participation in advanced laparoscopic surgery, concurrent with structured skills development and feedback, portends very favorable outcomes.