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Minimally invasive techniques in common surgical procedures: Implications for training

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Abstract

Background Laparoscopic techniques are increasingly used in common surgical procedures. Many of these procedures are used to teach basic surgical trainees (BST) and therefore introduction of these techniques may have implications for training.

Aims To establish whether the introduction of laparoscopic techniques reduced the opportunity of BSTs to perform surgical procedures.

Methods Patients undergoing hernia repair or appendicectomy in 1991 (when laparoscopy was first introduced) and 1997 (when laparoscopy was readily available) were identified using the Hospital In-Patient Enquiry (HIPE) database. The principal operator and whether the procedure was open or laparoscopic were identified by chart review.

Results The data showed a 50% reduction in the number of appendicectomies performed by BSTs following the introduction of laparoscopic techniques. The number of hernia repairs performed by BSTs has been preserved but the proportion by BSTs fell from 10 to 6%. The proportion of BST-performed procedures carried out laparoscopically has been reduced compared with the registrar-performed group.

Conclusions The use of minimally invasive techniques has had a negative effect on surgical training. Appropriate measures must be taken to minimise this and such measures should include a structured approach to laparoscopic training and greater access to laparoscopic training facilities.

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Authors and Affiliations

  1. Department of Surgery, Adelaide and Meath, incorporating the National Children’s Hospital, Dublin, Ireland

    PH McCormick, WA Tanner, FBV Keane & S Tierney

Authors
  1. PH McCormick
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  2. WA Tanner
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  3. FBV Keane
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  4. S Tierney
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Correspondence to S Tierney.

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McCormick, P., Tanner, W., Keane, F. et al. Minimally invasive techniques in common surgical procedures: Implications for training. Ir J Med Sci 172, 27–29 (2003). https://doi.org/10.1007/BF02914782

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  • DOI: https://doi.org/10.1007/BF02914782

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