Whose appendicectomy?--Do laparoscopic appendicectomies impair SHO training?

Area of Science:

• Surgical Education
• Minimally Invasive Surgery
• Appendiceal Surgery

Background:

• Open appendicectomy is a foundational procedure for surgical trainee skill development.
• A trend of decreasing open appendicectomies by basic surgical trainees and increasing laparoscopic appendicectomies has been observed.
• This study investigates the impact of laparoscopic appendicectomy on surgical house officer (SHO) training.

Purpose of the Study:

• To determine if the rise of laparoscopic appendicectomy negatively affects the training experiences of surgical house officers (SHOs).

Main Methods:

• A retrospective review of 857 appendicectomies performed over seven years (August 1999 - August 2006).
• Data extraction from case notes focused on operating surgeon and surgical technique.
• Analysis of trends in appendicectomy procedures performed by SHOs versus laparoscopic techniques.

Main Results:

• A significant decrease in SHO-performed appendicectomies occurred between February 2002 and July 2003 (78.7% to 29.3%).
• Laparoscopic appendicectomy rates began increasing significantly after February 2004.
• SHO appendicectomy rates remained stable before and after the observed decline, and no laparoscopic appendicectomies were performed by SHOs.

Conclusions:

• No evidence suggests laparoscopic appendicectomy popularity caused the decline in SHO-performed open appendicectomies.
• Balancing training opportunities is crucial given the increasing popularity of laparoscopic appendicectomy for both junior and senior trainees.