Our Summary

This research paper looks into how the experience level of junior pediatric surgeons impacts the outcomes of appendectomy surgeries. Appendectomies, or surgeries to remove the appendix, have traditionally been seen as a good training opportunity for young surgeons. However, with more and more surgeries being done laparoscopically (using small incisions and a camera), there is concern about the ability of less experienced surgeons to perform these procedures.

The study looked back at patients who had appendectomies between 2018 and 2021, and grouped them by the experience level of the surgeon who performed the surgery. They looked at factors like the rate of complicated cases, the length of the operation, and any complications after the surgery. They also compared results between traditional “open” surgeries and the newer laparoscopic technique.

The results showed that nearly all the surgeries were performed by junior surgeons in their first five years of training. They found that as the surgeons gained more experience, the rate of complicated cases increased slightly, although not significantly. The ratio of laparoscopic to open surgeries also increased as the surgeons gained more experience. The length of the surgeries decreased significantly with more experience, in both types of surgeries. There were no significant differences in complications after surgery, regardless of the surgeon’s experience or the type of surgery.

The conclusion is that appendectomy surgeries can be safely performed by junior pediatric surgeons from their first year of training, no matter which type of surgery is used.

FAQs

  1. Does the experience level of junior pediatric surgeons affect the outcome of appendectomy surgeries?
  2. How does the rate of complicated cases and length of operation vary with the surgeon’s experience level?
  3. Can appendectomy surgeries be safely conducted by junior surgeons in their first year of training?

Doctor’s Tip

One helpful tip a doctor might give a patient about appendectomy is to make sure to follow all pre-operative instructions provided by the surgical team. This may include fasting before the surgery, taking any prescribed medications as directed, and preparing for a hospital stay if necessary. By following these instructions, patients can help ensure a successful surgery and smooth recovery process.

Suitable For

Patients who are typically recommended appendectomy are those who are experiencing symptoms of appendicitis, such as abdominal pain, nausea, vomiting, and fever. In some cases, imaging tests may be done to confirm the diagnosis before surgery is recommended. Patients who have a ruptured appendix or severe complications of appendicitis may also be recommended for an appendectomy. Overall, appendectomy is a common and relatively safe procedure for patients of all ages, and this study suggests that even junior surgeons can perform it effectively with good outcomes.

Timeline

Before the appendectomy:

  1. Patient experiences symptoms of appendicitis such as abdominal pain, nausea, vomiting, and fever.
  2. Patient visits a doctor or emergency room for evaluation and diagnosis.
  3. Diagnostic tests such as physical examination, blood tests, and imaging studies (such as ultrasound or CT scan) are performed to confirm appendicitis.
  4. Patient is scheduled for surgery and given instructions for pre-operative preparation, such as fasting.

After the appendectomy:

  1. Patient undergoes the appendectomy surgery, either through open surgery or laparoscopic surgery.
  2. Recovery time in the hospital typically ranges from 1-2 days for laparoscopic surgery and 2-4 days for open surgery.
  3. Patient is monitored for post-operative complications, such as infection, bleeding, or bowel obstruction.
  4. Patient is discharged from the hospital with instructions for at-home care, including wound care, pain management, and activity restrictions.
  5. Follow-up appointments are scheduled with the surgeon to monitor healing and address any concerns or complications.
  6. Patient gradually resumes normal activities and diet as instructed by the surgeon, with full recovery expected within 2-4 weeks.

What to Ask Your Doctor

Some questions a patient should ask their doctor about appendectomy include:

  1. What type of appendectomy surgery do you recommend for me (laparoscopic or open)?
  2. How experienced are you in performing appendectomy surgeries?
  3. How many appendectomy surgeries have you performed in the past year?
  4. What is your complication rate for appendectomy surgeries?
  5. What is the typical recovery time and expected outcomes for this surgery?
  6. Are there any alternative treatment options for my condition?
  7. What are the potential risks and complications associated with this surgery?
  8. Will I need any follow-up appointments or tests after the surgery?
  9. What can I do to prepare for the surgery and improve my recovery?
  10. Are there any specific restrictions or limitations I should be aware of after the surgery?

Reference

Authors: Delgado-Miguel C, Miguel-Ferrero M, San Basilio M, Ramírez C, Camps J, Hernández Oliveros F. Journal: Pediatr Surg Int. 2023 Apr 7;39(1):168. doi: 10.1007/s00383-023-05453-7. PMID: 37029305