Outcome of patients in laparoscopic training courses compared to standard patients.
OBJECTIVE
Current Laparoscopic simulators have limited usefulness and patients have been used for training since the dawn of surgery. NUGITS (Northumbrian Upper Gastro Intestinal Team of Surgeons) Laparoscopic Skills courses utilise hands-on experience with simulators moving to live operating on volunteer patients. It is vital to know that the volunteer patient is not disadvantaged by greater surgical risk.


METHODS
This was a case-controlled prospective comparison of patients undergoing both Laparoscopic Cholecystectomy (LC) [n=51] and Laparoscopic Inguinal Hernia (LIH) [n=62] during NUGITS training courses. They are compared with a matched (age, sex and ASA grade) control group LC (n=51) and LIH (n=62) operated on by consultants. The outcome measures were surgical peri-and post-operative complications, post-operative hospital stay, readmission and early recurrence of inguinal hernia (<6 months).


RESULTS
In the LC cohort, there was no significant difference in the length of hospital stay (p=0.07) or readmission (p=0.16) in both the groups. The mean operating time was higher in the trainee compared to the control group (p=0.001). There was no difference in the post-operative morbidity or mortality in either group. In LIH cohort, the mean operating time was higher in the trainee compared with the control group. There was no significant difference in post-operative complications (p>0.05) and early post-operative recurrence of hernia (p>0.05).


CONCLUSIONS
The post-operative outcomes of patients undergoing laparoscopic surgery during laparoscopic training courses are similar to consultant-operated patients. Thus, it is acceptable and safe to encourage patients to volunteer for laparoscopic training courses.
Kanakala
V
V
Department of General and Upper G I Surgery, North Tyneside General Hospital, Northumbria Healthcare NHS Foundation Trust, Rake Lane, North Shields, Tyne & Wear, NE29 8NH, UK. ven.kanakala@gmail.com
Bawa
S
S
Gallagher
P
P
Woodcock
S
S
Attwood
S E
SE
Horgan
L F
LF
Seymour
K
K
D002764:Cholecystitis / Q000601:surgery; D002983:Clinical Competence; D004502:Education, Medical, Continuing / Q000592:standards*; D006552:Hernia, Inguinal / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome