Training residents in laparoscopic colorectal surgery: is supervised surgery safe?

Area of Science:

• Surgical Education
• Minimally Invasive Surgery
• Colorectal Surgery

Background:

• Laparoscopic colorectal resections are increasingly common.
• Surgical training has shifted to a residency-based model in the Netherlands.
• The impact of resident-supervised surgery on patient outcomes is under investigation.

Purpose of the Study:

• To evaluate the short-term patient outcomes of laparoscopic colorectal surgery performed by supervised residents versus experienced surgeons.
• To determine if the shift in training affects patient safety and surgical results.

Main Methods:

• Retrospective analysis of 523 patients undergoing laparoscopic colorectal resection from a single-center database (2010-2014).
• Comparison of outcomes between surgeries performed by supervised fifth/sixth-year residents and dedicated colorectal surgeons.
• Statistical analysis using Chi-square and t tests for categorical and continuous variables, respectively.

Main Results:

• No significant differences in operative time, blood loss, major complications, oncological outcomes, or stoma creation.
• Higher conversion rates observed in resident-performed surgeries (17.34% vs. 9.17%, p=0.01).
• Increased bladder retention noted in the surgeon group (4.6% vs. 1%, p=0.03).

Conclusions:

• Patient safety and short-term outcomes are not negatively impacted by supervised laparoscopic colorectal surgery performed by residents.
• The current residency training model for laparoscopic colorectal surgery is safe and effective.
• Further research may explore case selection and specific procedure outcomes.