Laparoscopic splenectomy does the training of minimally invasive surgical fellows affect outcomes?
BACKGROUND
The training of surgeons and residents in laparoscopic surgery has become an important issue. The purpose of this study is to determine if the training of a laparoscopic fellow affects outcomes in patients undergoing laparoscopic splenectomy (LS).


METHODS
Data were obtained from a prospectively collected database of patients who underwent LS from August 1994 to November 1999. Outcomes of the last 25 cases, performed by fellows under supervision, were compared to 25 cases performed by staff surgeons prior to the introduction of fellows.


RESULTS
Patient demographics, preoperative platelet count, and splenic size were similar for the two groups. Outcome measures comparing the staff and the fellows group including operative time (151 vs 178 min, p = 0.055), blood loss (214 vs 162 ml, p = 0.40), intraoperative complications (3 vs 2, p = 1.0), need for transfusion (2 vs 3, p = 1.0), conversions (1 vs 0, p = 1.0), length of hospital stay (3.3 vs 2.5 days, p = 0.13), and postoperative complications (1 vs 2, p = 1.0) were similar for the two groups.


CONCLUSIONS
When performed by a fellow under supervision, LS has the same outcomes as when the procedure is performed by the teaching staff surgeon.
Pace
D E
DE
The Centre for Minimally Invasive Surgery, St. Michael's Hospital, The University of Toronto, 30 Bond Street, Toronto, Ontario, Canada M5B 1W8. eric.poulin@utoronto.ca
Chiasson
P M
PM
Schlachta
C M
CM
Mamazza
J
J
Poulin
E C
EC
D000293:Adolescent; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D002170:Canada; D003625:Data Collection; D016208:Databases, Factual; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D007432:Intraoperative Period; D010535:Laparoscopy / Q000009:adverse effects / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013156:Splenectomy / Q000009:adverse effects / Q000706:statistics & numerical data*; D016896:Treatment Outcome