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Impact of AITS laparoscopic training center on surgeons’ preference for appendectomy

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Abstract

Background

Acute appendicitis is the most common acute abdomen in general surgery. Show-Chwan Memorial Hospital began an AITS/IRCAD laparoscopic training program in late May 2008. In this retrospective analysis, we surveyed the impact of the AITS training program on surgeons’ preference for open appendectomy (OA) versus laparoscopic appendectomy (LA).

Methods

From January 1, 2004 to July 31, 2009, patients diagnosed with acute appendicitis in Changhua Show-Chwan Memorial Hospital and Chang-Bing Show-Chwan Memorial Hospital were retrospectively analyzed. Demographic data, laboratory examinations, surgical methods, hospital stay, and complication rate data were collected and analyzed. The LA rate and effect of surgeons’ preference before and after AITS were compared.

Results

In all, 1,267 patients (58.2% male and 41.8% female; mean age, 36.6 years) were diagnosed with acute appendicitis during this period. Among them, 78.9% of patients had uncomplicated and 21.1% complicated appendicitis; 784 patients (61.9%) underwent OA, and 465 (36.7%) received LA. In 2004, only 8.1% of patients underwent LA, but the number increased rapidly to 90.4% in 2009 (P < 0.001). The average LA rate before AITS was 21%; however, after AITS, the LA rate increased to 84.6% (P < 0.001). The LA rate increased for all surgeons completing the training course, ranging from 16 to 83%. The overall appendectomy complication rate was 8.4%, with no significant difference between OA (9.7%) and LA (6.5%; P = 0.174). Hospital stay was shorter in the LA group (4.05 ± 1.9 days) compared with the OA group (4.55 ± 3.6; P = 0.006).

Conclusions

Attending the laparoscopic training course significantly increased surgeons’ preference for LA.

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Disclosures

This study was not funded by any foundation or organization. Asian Institute of Telesurgery (AITS) is a nonprofit training center, and this study was performed by objective researchers, who have no attachments with the industry. There are no conflicts of interest in this study. Dr. H-W Lai, S-H Tseng, Y-T Lee, C-H Hsu, D-A Chou, H-S Wu, and M-H Huang have no conflicts of interests or financial ties to disclosure.

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Authors and Affiliations

  1. Division of General Surgery, Department of Surgery, Changhua Christian Hospital, 135 Nanhsiao Street, Changhua, 500, Taiwan, ROC

    Hung-Wen Lai

  2. Division of General Surgery, Department of Surgery, Show-Chwan Memorial Hospital, Changhua, Taiwan, ROC

    Shih-Horng Tseng, Chih-Hung Hsu, Dev-Aur Chou, Hurng-Sheng Wu & Min-Ho Huang

  3. Division of General Surgery, Department of Surgery, Chang-Bing Show-Chwan Memorial Hospital, Lugang, Taiwan, ROC

    Yueh-Tsung Lee & Min-Ho Huang

  4. Asian Institute of TeleSurgery, IRCAD Taiwan Training Center, Changhua, Taiwan, ROC

    Hurng-Sheng Wu & Min-Ho Huang

  5. Department of Research, Changhua Christian Hospital, 135 Nanhsiao Street, Changhua, 500, Taiwan, ROC

    Hung-Wen Lai

  6. Pharmacology Department, School of Medicine, National Yang Ming University, 155, Sec. 2, Linong Street, Taipei, 112, Taiwan, ROC

    Hung-Wen Lai

  7. Tri-Service General Hospital, Taipei, Taiwan, ROC

    Hurng-Sheng Wu

  8. National Defense Medical Center, Taipei, Taiwan, ROC

    Hurng-Sheng Wu

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  1. Hung-Wen Lai
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Correspondence to Hurng-Sheng Wu.

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Lai, HW., Tseng, SH., Lee, YT. et al. Impact of AITS laparoscopic training center on surgeons’ preference for appendectomy. Surg Endosc 24, 2210–2215 (2010). https://doi.org/10.1007/s00464-010-0930-4

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  • DOI: https://doi.org/10.1007/s00464-010-0930-4

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