title: [Appendectomy in surgical residency. What has changed over the past 10 years?].
abstract: BACKGROUND
  Surgical residents need to train laparoscopic skills for minimally invasive procedures at an early stage. The aim of this study was the investigation and assessment of appendectomy carried out at a university medical center over the previous decade regarding the frequency of operations by residents in training and the type of surgical technique used (laparoscopic vs. open).
  
  
  METHODS
  A retrospective analysis of appendectomies carried out from 2005 to 2014 at the clinic for general, visceral and transplant surgery was performed. Operators were stratified into two groups (group 1: residents and group 2: fellows/attending surgeons). Surgery was classified as laparoscopic or open appendectomy.
  
  
  RESULTS
  Out of 1,587 appendectomies analyzed 946 were performed laparoscopically (59.6 %). The percentage of laparoscopic appendectomies increased significantly over the decade analyzed (p < 0.001) and reached 94.4 % in 2014. From 2005 until 2007 the rate of appendectomies by residents was 17.9 % (77 out of 430). Laparoscopic appendectomy was performed in 5.8 % and was only performed by fellows or attending surgeons. From 2008 to 2014 the rate of surgeries by residents significantly increased (p < 0.001) and accounted for 57.6 % (range 19.4-66.9 %).
  
  
  CONCLUSIONS
  Regardless of the surgical technique used, appendectomy is still a primary training operation for surgical residents. An early and focused training of minimally invasive visceral surgery in the new regulations for continuing medical education starts with laparoscopic appendectomy.
authors.affiliation: Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Huber
authors.affiliation: Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Paschold
authors.affiliation: Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: Bartsch
authors.affiliation: Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland.
authors.forename: H
authors.initials: H
authors.lastname: Lang
authors.affiliation: Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland. werner.kneist@unimedizin-mainz.de.
authors.forename: W
authors.initials: W
authors.lastname: Kneist
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000368:Aged; D001062:Appendectomy / Q000193:education* / Q000706:statistics & numerical data; D001064:Appendicitis / Q000601:surgery*; D003479:Curriculum / Q000639:trends; D005257:Fellowships and Scholarships / Q000639:trends; D005260:Female; D005544:Forecasting; D005858:Germany; D006801:Humans; D007396:Internship and Residency / Q000639:trends*; D010535:Laparoscopy / Q000193:education* / Q000706:statistics & numerical data / Q000639:trends*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education; D008875:Middle Aged; D061646:Operative Time; D012086:Reoperation; D012189:Retrospective Studies; D014600:Utilization Review; D055815:Young Adult
keywords: Appendectomy; Laparoscopy; Minimally invasive surgery; Surgical residents; Surgical training