Whose Appendicectomy? – Do Laparoscopic Appendicectomies Impair SHO Training?

Abstract

Ann RC oll Surg Engl 2008; 90:5 77-580 577Open appendicectomy is an ideal procedure for junior surgical trainees to develop their operative skills. However, we have noticed ad ecline in the number of appendicectomies performed by basic surgical trainees over recent years. An umber of studies published after the implementation of the New Deal in 1993 have demonstrated adramatic effect of changing in shift patterns of working on junior doctors. 1,2One of these studies found that the number of appendicectomies performed by SHOs might have fallen by 40% between 1985 and 1999.More recently,w eh ave also witnessed as hift towards increasing use of laparoscopic appendicectomy,a tt he possible expense of SHO training. One study,e xamining a structured approach to training registrars in laparoscopic appendicectomy,f ound that the number of open appendicectomies performed by the SHOs after the introduction of the programme fell by 50%. 3 We hypothesised that the growing popularity of laparoscopic appendicectomy is having ad eleterious effect on the operative experience of SHOs. The aim of this study was to test this hypothesis by examining recent trends with respect to the use of laparoscopic appendicectomy and SHO appendicectomies at one district training hospital. Patients and MethodsWe undertook ar etrospective review of all cases of appendicectomies performed in one district hospital over a 7-year period from August 1999 to August 2006. The operation details for all the patients are entered into a computerised data collection system at the day of the operation. These data were downloaded and used to obtain GENERAL Ann RC oll Surg Engl 2008; 90:5 77-580

Offene Appendektomie

“…Die Rate von Appendektomien durch junge Chirurgen ist mit der Einführung der LA zurückgegangen und sank in der Folgezeit um bis zu 50% [25]. Erst mit der wachsenden Erfahrung der Oberärzte konnte das Wissen auch an junge Chirurgen weitergegeben werden [26]. Die anfängliche Befürchtung, dass nur noch erfahrene Chirurgen eine Appendektomie durchführen werden, scheint widerlegt zu sein.…”