Resident Learning Curve for Laparoscopic Appendectomy According to Seniority

Area of Science:

• Surgical Education
• Minimally Invasive Surgery
• Medical Training

Background:

• Laparoscopic appendectomy (LA) is a common surgical procedure.
• Assessing the learning curve (LC) is crucial for resident training and patient safety.
• Understanding resident proficiency progression is essential for surgical education.

Purpose of the Study:

• To determine the learning curve (LC) for laparoscopic appendectomy (LA) in surgical residents.
• To evaluate how resident seniority impacts the LC for LA.
• To analyze perioperative outcomes and identify factors influencing resident performance in LA.

Main Methods:

• Retrospective analysis of 150 patients undergoing LA between October 2015 and November 2016.
• Three residents (first, second, and third year) performed LA under supervision.
• Learning curves were assessed using moving average and cumulative sum (CUSUM) methods for operation time and surgical completion.

Main Results:

• Operation times were similar across residents (43.9-48.4 min).
• Moving average showed decreasing operation times for all residents.
• Surgical completion reached a steady state between the 11th and 35th case, with perforation of the appendix base identified as a risk factor for failure.

Conclusions:

• The learning curve for LA in residents ranges from 11 to 35 cases.
• Surgical experience accumulation appears to influence the LC, particularly for surgical completion.
• These findings highlight the importance of supervised training and experience for resident proficiency in LA.