title: Laparoscopic colorectal fellowship training programme : a 6-year experience in a university colorectal unit.
abstract: BACKGROUND
  The aim of this study was to evaluate a structured training programme for laparoscopic colorectal surgery in a university colorectal unit over a 6-year period.
  
  
  METHODS
  Data on patients who underwent laparoscopic colectomy between November 2004 and October 2010 were analyzed. Operations were performed either by the consultant colorectal surgeons or colorectal fellows. The effectiveness and safety of our structured training programme were evaluated.
  
  
  RESULTS
  During the study period, 813 patients (478 men) with a median age 69 years (range 22-93) underwent laparoscopic colectomy. A total of 370 cases (45.5 %) were performed by four colorectal fellows. Overall, 674 patients (82.9 %) were classified as ASA I or II. The conversion rate was 3.7 %. The conversion rate, intra-operative blood loss, number of lymph nodes retrieved and post-operative recovery were similar between the two groups. When comparing with consultant group, the patients operated by fellows were: (1) significantly older; (2) more were operated on as emergency cases; (3) had pathologically less advanced tumours; (4) less patients with low rectal cancers. There were two surgical mortalities in this series. The morbidities between the two groups were similar. At the end of 3 years of training, the fellows had performed more than 85 cases of laparoscopic colectomies. The level of supervision decreased with increased experience. Finally, experienced fellows were able to supervise more junior colleagues on laparoscopic colectomies.
  
  
  CONCLUSIONS
  Our results confirmed a structured training programme for laparoscopic colectomy is safe and effective. Reasonable results were achieved even though a high volume of cases were performed by surgical fellows.
authors.affiliation: Department of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China. jimmylicm@hotmail.com
authors.forename: Jimmy C M
authors.initials: JC
authors.lastname: Li
authors.forename: Tony W C
authors.initials: TW
authors.lastname: Mak
authors.forename: Sophie S F
authors.initials: SS
authors.lastname: Hon
authors.forename: Dennis K Y
authors.initials: DK
authors.lastname: Ngo
authors.forename: Simon S M
authors.initials: SS
authors.lastname: Ng
authors.forename: Janet F Y
authors.initials: JF
authors.lastname: Lee
authors.forename: Ka Lau
authors.initials: KL
authors.lastname: Leung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003107:Colorectal Surgery / Q000009:adverse effects / Q000193:education*; D003710:Demography; D005257:Fellowships and Scholarships; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000193:education*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012017:Referral and Consultation; D016896:Treatment Outcome; D014495:Universities; D055815:Young Adult