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Laparoscopic cholecystectomy performed by surgical trainees.

S G Koulas¹, J Tsimoyiannis, I Koutsourelakis

¹Department of Surgery, General Hospital of Ioannina 'G. Hatzikosta', Ioannina, Greece. skoulas@freemail.gr

JSLS : Journal of the Society of Laparoendoscopic Surgeons

|June 20, 2007

Summary

Laparoscopic cholecystectomy performed by surgical trainees (Specialist Registrars and Senior House Officers) showed similar safety and outcomes compared to consultant-led procedures. This indicates that supervised training does not negatively impact patient morbidity or surgical results.

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Area of Science:

Surgical outcomes
Minimally invasive surgery
Surgical training

Background:

Laparoscopic cholecystectomy is a common surgical procedure.
Assessing the impact of trainee surgeons on patient outcomes is crucial for surgical education and patient safety.

Purpose of the Study:

To compare morbidity, mortality, and outcomes of laparoscopic cholecystectomy performed by consultants versus trainees (Specialist Registrars and Senior House Officers).
To evaluate the safety and efficacy of supervised surgical training in a high-volume setting.

Main Methods:

A retrospective analysis of 1370 laparoscopic cholecystectomies performed between 2001 and 2005.
Comparison of outcomes between procedures performed by consultants (67%) and trainees (33%).
Data collected included operative time, conversion rates, complication types, mortality, and hospital stay.

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Main Results:

Conversion rate to open surgery was low (0.3%) and similar between groups.
Mortality rate was 0% in both consultant and trainee groups.
Major complication rates were comparable (3.7% for trainees vs. 1.7% for consultants, P=0.11), with no significant difference in specific complication types.

Conclusions:

Supervised laparoscopic cholecystectomy by trainees is safe and does not increase surgical morbidity.
Surgical outcomes are not compromised when procedures are performed by trainees under supervision.
The study supports the integration of trainees into complex surgical procedures with appropriate guidance.