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Laparoscopic Cholecystectomy Performed by Residents: A Retrospective Study on 569 Patients

DOI: 10.1155/2014/912143

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Abstract:

Introduction. Aim of this study was to evaluate the safety of laparoscopic cholecystectomy performed by residents. Materials and Methods. We retrospectively reviewed 569 elective laparoscopic cholecystectomies. Results. Duration of surgery was min for residents versus?? ?min for staff surgeons, . Rate of conversion was 3.2% for residents versus 2.7% for staff surgeons, . There was no difference in the rates of intraoperative and postoperative complications for residents (1.2% and 3.2%) versus staff surgeons (1.5% and 3.1%), and . Postoperative hospital stay was days for residents versus?? days for staff surgeons, . One death in patients operated by residents (1/246) and one in patients operated by staff surgeons (1/323) were found, . No difference in the time to return to normal daily activities between residents ( days) and staff surgeons ( days) was found, . Shorter duration of surgery when operating the senior residents ( minutes) than the junior residents ( minutes), . Conclusion. Laparoscopic cholecystectomy performed by residents is a safe procedure with results comparable to those of staff surgeons. 1. Introduction Since Philippe Mouret performed the first laparoscopic cholecystectomy in 1987 [1], considerable progress has been made in the field of surgical instruments and equipment, and a great deal of experience in performing the laparoscopic cholecystectomy was acquired around the world. One of the great advantages of laparoscopy is the possibility for the entire surgical team to see with the eyes of the surgeon. For the surgeon in training, this is an important educational opportunity than the open surgery in which, in some steps of the operation, his vision is severely restricted. Despite this advantage, there are some limitations of the laparoscopic surgery which are represented by the lack of tactile feedback, 2-dimensional vision, limited degree of movement of the instruments, and loss of natural hand-eye coordination. The teaching of laparoscopic surgery should be based not just on knowledge of the anatomy and the steps of operation but also on the learning of gestures and tricks of surgical technique which in some cases may be different from the laparotomy surgery. The primary aim of our study was to analyze whether the laparoscopic cholecystectomy performed by surgeons in training is a safe procedure by comparing the same operation performed by trainees and staff surgeons. The secondary aim was to analyze the possible differences within the group of surgeons in training with the progress of their learning-curve. 2. Materials and

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