Our Summary

This study surveyed surgical trainees in South Africa to understand their exposure to a specific surgical procedure called laparoscopic appendectomy (removal of the appendix through small incisions). They also sought to understand what might be preventing more widespread use of this procedure. 132 trainees responded to the survey, and many reported they had not been taught how to perform this procedure, had limited experience with it, and lacked confidence in doing it independently. They also expressed interest in learning more about it. The main obstacles they identified were limited resources and time. Some also mentioned that senior surgeons were not keen to teach the procedure. These findings suggest that there is a gap in the surgical training programs in South Africa, which needs to be addressed with innovative solutions.

FAQs

  1. What is the level of exposure of surgical trainees in South Africa to laparoscopic appendectomy?
  2. What are the main obstacles hindering the widespread use of laparoscopic appendectomy in South Africa?
  3. What solutions are suggested to address the gap in the surgical training programs for laparoscopic appendectomy in South Africa?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laparoscopic appendectomy is to follow post-operative care instructions closely, including taking prescribed pain medications as directed, avoiding strenuous activity, and monitoring for signs of infection such as fever or increasing abdominal pain. It is important to attend follow-up appointments with the surgeon to ensure proper healing and recovery.

Suitable For

Patients who are typically recommended for laparoscopic appendectomy include those with uncomplicated appendicitis, as well as those with complicated appendicitis such as perforated appendicitis or appendiceal abscess. Laparoscopic appendectomy is generally considered safe and effective for most patients, with faster recovery times and lower rates of complications compared to traditional open surgery. However, the decision to recommend laparoscopic appendectomy may depend on the individual patient’s condition and the surgeon’s experience and expertise in performing the procedure.

Timeline

Before laparoscopic appendectomy:

  1. Patient experiences abdominal pain, usually starting around the belly button and moving to the lower right side of the abdomen.
  2. Patient may also experience nausea, vomiting, loss of appetite, and fever.
  3. Patient visits a healthcare provider who performs a physical exam, orders blood tests, and possibly imaging tests like ultrasound or CT scan to confirm appendicitis.
  4. Once appendicitis is confirmed, patient undergoes surgery for appendectomy, either laparoscopic or open.

After laparoscopic appendectomy:

  1. Patient is prepared for surgery and given anesthesia.
  2. Surgeon makes small incisions in the abdomen and inserts a laparoscope to view the appendix.
  3. Appendix is removed through the small incisions.
  4. Patient is monitored in the recovery room and may stay in the hospital for a day or two for observation.
  5. Patient is given pain medication and instructions for post-operative care, including diet and activity restrictions.
  6. Patient may experience some discomfort, bloating, or shoulder pain from the gas used during the procedure.
  7. Patient gradually resumes normal activities and typically recovers faster compared to open appendectomy.
  8. Patient follows up with the healthcare provider for a check-up to ensure proper healing and recovery.

What to Ask Your Doctor

  1. How experienced are you in performing laparoscopic appendectomies?
  2. What are the benefits of a laparoscopic appendectomy compared to a traditional open surgery?
  3. What are the potential risks and complications associated with a laparoscopic appendectomy?
  4. How long is the recovery time for a laparoscopic appendectomy compared to an open surgery?
  5. Will I have any restrictions or limitations after the surgery?
  6. What type of anesthesia will be used during the procedure?
  7. Will I have any scarring or visible marks after the surgery?
  8. How many laparoscopic appendectomies have you performed successfully?
  9. Are there any alternative treatment options for appendicitis?
  10. How long will the surgery take and how soon can I return to normal activities?

Reference

Authors: Naidoo M, Kong VY, Clarke DL, Conradie B. Journal: S Afr J Surg. 2022 Dec;60(4):300-304. doi: 10.17159/2078-5151/SAJS3739. PMID: 36477062