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Lookup NU author(s): Paul Gallagher
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Background: Laparoscopic appendicectomy offers potential advantages, but its use seems variable and perhaps related to the enthusiasm of individual trainees. There is limited opportunity in many hospitals for consultants to do and teach laparoscopic appendicectomy because of the way emergency work is organised. Methods: This study investigated the use and teaching of laparoscopic appendicectomy in two health regions, by a questionnaire sent to all specialist registrars (SpRs) in general surgery and completed by 78% (56 of 72). Results: Of the responding SpRs, 43% had performed a laparoscopic appendicectomy (with an average of 2.5 supervised by a consultant and 7.5 with a more junior assistant). Of these, 92% had been taught by a consultant, but only 31% (33 of 108) of the consultants for whom they were currently working had done appendicectomy laparoscopically, and laparoscopic appendicectomy was only being performed on 14% of the SpRs current firms (47% with upper gastrointestinal and 40% with colorectal specialist interest). Some 5-30% of patients on those firms were treated laparoscopically, mostly at the preference of the SpR. Conclusions: Dedicated consultant time for emergencies would facilitate teaching of laparoscopic appendicectomy but theatre time, costs of disposable instruments, and the inexperience of many consultants in this operation are likely to continue limiting its use. Further debate is needed on its place in the treatment of appendicitis.
Author(s): Noble H, Gallagher P, Campbell WB
Publication type: Article
Publication status: Published
Journal: Annals of the Royal College of Surgeons of England
ISSN (print): 0035-8843
ISSN (electronic): 1478-7083
Publisher: The Royal College of Surgeons of England
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