title: Medical students impact laparoscopic surgery case time.
abstract: BACKGROUND
  Medical students (MS) are increasingly assuming active roles in the operating room. Laparoscopic cases offer unique opportunities for MS participation. The aim of this study was to examine associations between the presence of MS in laparoscopic cases and operation time and postoperative complication rates.
  
  
  METHODS
  Data from the American College of Surgeons National Surgical Quality Improvement Program were linked to operative records for nonemergent, inpatient, and laparoscopic general surgery cases at our institution from January, 2009-January, 2013. Cases were grouped into eight distinct procedure categories. Hospital records provided information on the presence of MS. Demographics, comorbidities, intraoperative variables, and postoperative complication rates were analyzed.
  
  
  RESULTS
  Seven hundred laparoscopic cases were included. Controlling for wound class, procedure group, and surgeon, MS were associated with an additional 28 min of total operative time. The most significant increase occurred between the skin incision and skin closure. No significant association between the presence of MS and postoperative complications was observed.
  
  
  CONCLUSIONS
  This is the first retrospective analysis to examine the effect of MS presence during laparoscopic procedures. Increase in the operation time associated with the presence of MS should be examined further, to optimize the educational experience without incurring increased cost due to increased operation time.
authors.affiliation: Department of Surgery, Emory University School of Medicine, Emory University, Atlanta, Georgia.
authors.forename: Makoto
authors.initials: M
authors.lastname: Mori
authors.affiliation: Department of Surgery, Emory University School of Medicine, Emory University, Atlanta, Georgia.
authors.forename: Albert
authors.initials: A
authors.lastname: Liao
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Hagopian
authors.affiliation: Department of Surgery, Emory University School of Medicine, Emory University, Atlanta, Georgia.
authors.forename: Sebastian D
authors.initials: SD
authors.lastname: Perez
authors.affiliation: Department of Surgery, Emory University School of Medicine, Emory University, Atlanta, Georgia.
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Pettitt
authors.affiliation: Department of Surgery, Emory University School of Medicine, Emory University, Atlanta, Georgia. Electronic address: jfsween@emory.edu.
authors.forename: John F
authors.initials: JF
authors.lastname: Sweeney
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004504:Education, Medical, Undergraduate / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000193:education* / Q000706:statistics & numerical data; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States
keywords: Laparoscopic surgery; Medical students; Operating rooms; Operative time; University hospitals