Related Experiment Video
Updated: Apr 16, 2026
Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023
Effect of surgical experience on the macroscopic diagnosis of appendicitis: a retrospective cohort study
Helen Pham1, Michael Devadas1, Julie Howle1
1Department of Surgery, Westmead Hospital, Corner of Darcy and Hawkesbury Rd, Westmead, NSW, Australia.
Background:
We aimed to determine whether intraoperative macroscopic assessment of the appendix improves with surgical experience and whether the accuracy of the intraoperative assessment of the appendix is different in respect to sex of the patient.
Methods:
Medical records of all appendicectomies performed during an 18-month period (2011-2012) at Westmead Hospital, Australia were reviewed. Accuracy of intraoperative macroscopic description correlating to histopathology was compared between groups based on the training level of the surgeon.
Results:
Correlation between the intraoperative diagnosis and final histopathology result was 83.5% of the 303 cases. The diagnostic accuracy amongst junior trainees, senior trainees and consultants did not differ with accuracy rates of 85%, 81.6% and 88.2% respectively, (P = 0.44). The false negative rate was higher in females than in males (19.1% versus 7.2%; P = 0.007).
Conclusions:
Our findings demonstrated that operator experience does not affect the accuracy of the intraoperative assessment of appendixes. We recommend that an appendicectomy be performed when clinically indicated regardless of macroscopic appearance.
Insights
Surgical experience does not impact the accuracy of intraoperative appendix assessment. Appendicectomy should be performed based on clinical indication, not just visual inspection, as sex influences false negative rates.
Area of Science:
- Surgical pathology
- Clinical diagnostics
Background:
- Intraoperative macroscopic assessment of the appendix is a key diagnostic step.
- Understanding factors influencing diagnostic accuracy, such as surgeon experience and patient sex, is crucial.
Purpose of the Study:
- To evaluate if surgical experience enhances intraoperative appendix assessment accuracy.
- To determine if patient sex affects the accuracy of intraoperative appendix evaluation.
Main Methods:
- Retrospective review of 303 appendicectomy cases from 2011-2012 at Westmead Hospital.
- Comparison of intraoperative macroscopic descriptions against histopathology findings.
- Analysis of accuracy based on surgeon's training level and patient sex.
Main Results:
- Overall correlation between intraoperative diagnosis and histopathology was 83.5%.
- Diagnostic accuracy did not significantly differ among junior trainees, senior trainees, and consultants (P = 0.44).
- The false negative rate for appendix assessment was significantly higher in females (19.1%) compared to males (7.2%; P = 0.007).
Conclusions:
- Surgeon experience does not influence the accuracy of intraoperative appendix assessment.
- Clinical indication should guide appendicectomy decisions, irrespective of macroscopic findings.
- Sex is a significant factor affecting the accuracy of intraoperative appendix evaluation, with higher false negatives in females.
More Related Videos
Related Concept Videos
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
01:22Appendicitis-I: Introduction
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...