Impact of Resident Performed Laparoscopic Appendectomy on Patient Outcome and Safety

Author(s): Hassan Mohsin, Awais Amjad Malik, Rohma Akhtar, Talha Talib, Muhammad Jawad Farooq, Muhammad Farooq Afzal

Objective: To evaluate the impact of resident performed laparoscopic appendectomy on patient’s outcome and safety.

Methodology: This retrospective review included 120 individuals who underwent laparoscopic appendectomy (LA) for acute appendicitis between January 2022 and December 2023. Surgical consultants monitored laparoscopic surgery at our hospital. Clinical data, pathological results, and surgical notes were analysed retrospectively. Age, sex, histological findings, surgical time, requirement of conversion to open surgery, incidence of complications, Length of Stay in Hospital (LOS), and death were all recorded. Group A had residents with a less surgical experience than group B that had Senior Registrars (SRs). In order to offer each resident an equal opportunity of doing LA, the difficulty of each case was not taken into consideration. The patient outcomes were recorded.

Results: Comparison of post operative surgical outcome shows an operative time of 85+8 min and 66+3 min in group A&B respectively, p-value=0.024, length of hospital stay (LOS) of 2 (1-6) days and 2 (1- 4) days in group A&B respectively, p-value=0.678, conversion to open instances of 4(6%) in group A and 3(6%) in group B, p-value=0.232, post operative complications of 14(19%); residual abdominal abscess in 2(3%) and SSI in 12(17%) in group A cases and 9(19%), 1(2%) and 8(16%) in group B with no significant difference, p-value=0.435.

Conclusion: We conclude that laparoscopic appendectomy performed by residents yields acceptable results and safety. Nonetheless, further multicenter studies are needed to verify these findings.