Background The technical proficiency of a surgeon is intricately linked to training and experience. Reduction in working hours, decreased operating time and ethical imperatives to protect patients have all resulted in a decrease in hands‐on experience. The introduction of laparoscopic procedures has also decreased trainees' exposure to open operative procedures not routinely performed in the current era. Methods The Clinical Training and Evaluation Centre at The University of Western Australia introduced the Core Skills Workshop for general surgical trainees in 2007. The workshop provides cadaveric dissection time for a range of open procedures. We describe in this article the logistics of setting up and running a cadaveric workshop, the performance and report our trainees' evaluation of the workshop. Results The Clinical Training and Evaluation Centre has hosted 26 General Surgery Core Skills Workshops since 2007. There were 227 participants with 196 evaluations returned (response rate 86%). Feedback was strongly positive for the course meeting the participants' expectations as well as its contribution to their skillset. Participants value the use of cadavers and high instructor:student ratios along with performance of a large number of open procedures in the setting of a stress‐free workshop and looked forward to more similar courses in the future. Conclusions Fresh frozen cadaver workshops are of value in the face of current surgical training challenges in providing an efficient, effective and safe environment.
Background: Carcinoid tumours of the appendix are the most common primary malignant lesion of the appendix. However, the overall incidence remains low; found in as few as 0.3-0.9% appendicectomy specimens. Almost all appendiceal carcinoids are found incidentally during surgery for suspected appendicitis. Methods: A retrospective review of all appendiceal carcinoids was performed in six hospitals from January 1990 until December 2013. Demographic data, operative technique, histopathological characteristics, clinic reviews and need for further treatment were recorded and compared with literature. Results: Appendiceal carcinoids were identified in 175 specimens. The mean age is 32 years (range 8-87 years), with 69 (39.4%) males and 106 (60.6%) females (P < 0.0001). Of these, 106 underwent open surgery with standard McBurney incision, nine underwent full laparotomy and 60 underwent laparoscopic surgery. Six of the laparoscopic surgeries were converted to open procedures. We recorded 159 (90.75%) classical carcinoids and 16 (9.25%) goblet cell carcinoids. Overall, 131 (75.7%) had concurrent appendicitis; classical carcinoid 72.6% versus goblet cell carcinoid 93.8%. The median size of the goblet cell carcinoids was significantly larger than classical carcinoids. Classical carcinoids were mostly distal to the base, while goblet cell carcinoids had equal distribution. It appears that the involvement of resection margins was not influenced by the surgical technique. Thirty patients required further right hemicolectomy as treatment for high-risk features; open 19 (15.9%) versus laparoscopic 11 (20.4%). Conclusions: Laparoscopic appendicectomy did not seem to adversely influence the margin clearance in appendiceal carcinoid, though we recommend that all appendicectomies should include the mesoappendix.
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