LAPAROSCOPIC APPENDECTOMY - A TRAINEES PERSPECTIVE

Minimally invasive surgery is rapidly becoming an integral part of gen eral surgery. Many general surgeons have been trained to undertake lap aroscopic cholecystectomy. It has been recommended that laparoscopic a ppendicectomy should be the training operation for junior surgeons. Th e aim of our study was to assess whether laparoscopic appendicectomy t raining can safely be introduced to junior surgeons in a district gene ral hospital. During the 11 month study period, 27 laparoscopic and 38 open appendicectomies were performed. The median anaesthetic time was 80 min for laparoscopic and 52.5 min for open appendicectomies. Lapar oscopic appendicectomies cost, on average, pound 618 and open appendic ectomies pound 770 per case. The complication rate between the two pro cedures was equal. We therefore showed that laparoscopic appendicectom y by junior surgeons is both safe and cost-effective. Although the reg istrar did most of the laparoscopic appendicectomies, with resultant l ess operating for the SHO, laparoscopic appendicectomy provided the SH O with training in diagnostic laparoscopy and laparoscopic dissection. We conclude that basic laparoscopic training should be introduced ear ly in surgical training, after which laparoscopic appendicectomy is a safe procedure for surgical trainees.