Our Summary

This study looked at the time it took for surgical students at different levels of training to perform a particular type of surgery (laparoscopic cholecystectomy, or gallbladder removal) and how well they did. The surgeries were done at Eastern Health between January 2018 and 2019. The students were divided into three groups: consultants (C), fellows (F), and registrars (R).

The study included 592 patients, with an average age of 54. The average time to complete the surgery was 84 minutes. The less experienced students (SET 2) took significantly longer to complete the surgery compared to the more experienced students and the consultants. Interestingly, when a consultant was helped by a SET student, it took them an average of 15 minutes longer to complete the surgery compared to when they were helped by a non-SET registrar.

The rate of complications was 3.2%, and there was no significant difference between the three groups. There were no deaths during the study period. The rates of patients having to be readmitted to the hospital or return to the operating room were 7.8% and 0.8% respectively, and these were not significantly different between the groups. All conversions from laparoscopic to open surgery were performed by the consultant.

Based on these findings, the study concludes that surgical students can safely perform this type of surgery at all levels of training, under appropriate supervision. While less experienced students take longer, there is a steep but short learning curve. The study suggests that this procedure might be a good way to assess the competency of early-stage surgical students.

FAQs

  1. What was the purpose of the study on laparoscopic cholecystectomy performed at Eastern Health between January 2018 and 2019?
  2. Was there a significant difference in the rate of complications between different levels of surgical students performing laparoscopic cholecystectomy?
  3. Does the study suggest that less experienced surgical students can safely perform laparoscopic cholecystectomy under appropriate supervision?

Doctor’s Tip

One helpful tip a doctor might give a patient about laparoscopic cholecystectomy is to ensure they choose a surgeon who has experience and expertise in performing this procedure. Patients may want to inquire about the surgeon’s level of training and experience with laparoscopic cholecystectomy to ensure they are in good hands.

Suitable For

Patients who are typically recommended for laparoscopic cholecystectomy include those with symptomatic gallstones, acute cholecystitis, biliary dyskinesia, and other gallbladder disorders. This procedure is minimally invasive and offers faster recovery times and less pain compared to traditional open surgery. It is important for patients to discuss their specific condition with their healthcare provider to determine if laparoscopic cholecystectomy is the best option for them.

Timeline

Before laparoscopic cholecystectomy:

  1. Patient presents with symptoms of gallbladder disease such as abdominal pain, nausea, and vomiting.
  2. Patient undergoes diagnostic tests such as ultrasound or CT scan to confirm the diagnosis.
  3. Patient consults with a surgeon to discuss treatment options, including laparoscopic cholecystectomy.

After laparoscopic cholecystectomy:

  1. Patient undergoes the minimally invasive surgery, which typically takes about 1-2 hours.
  2. Patient is discharged from the hospital within 1-2 days after the surgery.
  3. Patient may experience some pain and discomfort at the incision sites, which usually resolves within a few days.
  4. Patient is advised to follow a special diet for a few weeks to allow the bile ducts to adjust to the absence of the gallbladder.
  5. Patient can resume normal activities within 1-2 weeks after the surgery.
  6. Patient follows up with the surgeon for a post-operative visit to ensure proper healing and address any concerns.

What to Ask Your Doctor

  1. What are the risks and potential complications associated with laparoscopic cholecystectomy?
  2. How experienced is the surgical team that will be performing the procedure?
  3. What is the average length of time it takes to complete the surgery?
  4. What is the rate of complications for this type of surgery?
  5. What is the rate of readmission or return to the operating room for patients undergoing this procedure?
  6. What is the conversion rate from laparoscopic to open surgery, and who typically performs these conversions?
  7. How will my pain be managed during and after the surgery?
  8. What is the typical recovery time for patients undergoing laparoscopic cholecystectomy?
  9. Are there any specific guidelines or restrictions I should follow before or after the surgery?
  10. How often will I need to follow up with my doctor post-surgery for monitoring and evaluation?

Reference

Authors: Cheung KT, An V, Sorensen JC, Lin OM, Lie E, Mercier LL, Marguccio SA, Gumulia EN, Goonawardena J, Chan LH, Wong E. Journal: J Surg Educ. 2022 May-Jun;79(3):655-660. doi: 10.1016/j.jsurg.2022.01.008. Epub 2022 Feb 3. PMID: 35123911