Role of appendectomy in laparoscopic training

Purpose: This study aimed to evaluate whether laparoscopic appendectomy is suitable for training residents to become proficient in laparoscopic surgery. Materials and Methods: A total of 1574 laparoscopic appendectomies were performed at En-Chu-Kong Hospital between January 1998 and December 2003 (788 men and 786 women). These cases were divided into three groups: 543 cases (in 1998-1999) performed by 5 attending surgeons during the learning and trial stage; 536 cases (in 2000-2001) performed by 5 attending surgeons assisted by 2 senior residents with prior experience in open appendectomy; and 495 cases (in 2002-2003) done by these 2 senior residents, supervised by the attending surgeons. Demographic data, intraoperative findings, operative time, conversion rate, frequency of analgesic injection, timing of oral intake, hospital stay, morbidity, and mortality were analyzed. Results: There were no statistically significant differences in the operations performed by attending surgeons (mature stage) vs. senior residents in terms of intraoperative findings, operative time (60.1 ± 60.4 minutes vs. 56.3 ± 25.6 minutes), conversion rate (1.12% vs. 0.81%), frequency of analgesic injection (0.57 ± 1.37 times/stay vs. 0.43 ± 0.94 times/stay), timing of oral intake (23.7 ± 30.2 hours vs. 20.8 ± 27.5 hours), hospital stay (73.9 ± 61.8 hours vs. 70.3 ± 51.6 hours), morbidity, or mortality (0% vs. 0.2%). Conclusion: Laparoscopic appendectomy can be safely incorporated into the training of surgical residents under the supervision of experienced surgeons. Laparoscopic appendectomy also provides knowledge of the basics of laparoscopic technique before going on to more complex operations.