Implications of laparoscopic cholecystectomy for surgical residency training.

BACKGROUND

Widespread adoption of minimal access techniques forced a generation of abdominal surgeons to re-learn many standard abdominal procedures. This threatened to reduce the pool of suitable "training" operations for surgical residents.

METHODS

Operator grade, duration of operation, acute/elective operation, conversion rate, complications, and postoperative stay were recorded prospectively on all laparoscopic cholecystectomies (LC) since 1992. This data was evaluated to determine how the introduction of LC affected residents' training.

RESULTS

The percentage of LCs performed by residents increased progressively to reach 58%. Operating time was longer for trainee surgeons, particularly for acute cases (145+/-50 minutes vs 111+/-54 minutes, p<0.05); however, conversion rate, incidence of complications, and postoperative stay were no different.

CONCLUSIONS

LC can be performed by surgical trainees with similar complication rates and outcomes as those of qualified surgeons. Once institutional experience has accumulated, this procedure can be integrated into residency training.