Laparoscopic Cholecystectomy in Day Care Unit: An Underutilized Training Opportunity

8^th International Conference on Surgeons

October 28, 2022 | Webinar

A Ammar, F Anis, B Khateeb

University Hospitals of Derby UK

Scientific Tracks Abstracts: J Surg

Abstract :

Introduction: Surgical Training in the UK is facing unprecedented challenges following the COVID-19 pandemic amongst other pressures, with many trainees struggling to meet their required competency. Laparoscopic cholecystectomy (LC) operation has been regarded as gateway to developing key surgical skills.We aim to audit the utilisation of laparoscopic cholecystectomy training opportunities in day case surgical unit (DCU) and assess the impact of COVID-19 pandemic on training. Methods: All elective LC operations performed on DCU were collected from the Operative Room information System (ORMIS) between April 2018 and March 2022. Data collected included: Operating surgeons, Procedure performed, Procedure time (PT), rates of successful same-day discharge, readmission and death rates within 30 days. Data was compared before and after March 2020. Results: 611 LC operations were performed. Majority were performed pre-pandemic (467 cases) making up 76% of total LCs. The percentages of consultant-led and trainee-led operations were 54.5% and 45.5% respectively. Consultants’ median time of completion of the procedure was 65 minutes (52 , 82) compared to the trainee procedure time of 69 minutes (59 , 85) (p=0.002). The median procedure time for laparoscopic cholecystectomies performed during the pandemic was 74 mins (62, 93) and 65 mins (53, 80) before the pandemic (p<0.001). Consultants had an 80.8% successful same-day discharge rate compared to 79.1% successful same-day discharge rate for trainees(p=0.220). The readmission rate to hospital within 30 days of the procedure between consultants and trainees was 5.70% and 5.75% respectively (p=0979). There were no reported mortalities within 30 days of the operation for any of the patients. Conclusion: There was a significant reduction in utilised day case LC training opportunities during the pandemic compared with the pre- pandemic period with no significant differences in procedure time, rates of successful same day discharge, readmission or death rates within 30 days of the operation between consultants and trainees. Day case surgery remains an important opportunity for trainees to develop key laparoscopic skills. Accounting for dedicated training lists when planning the post-pandemic recovery could help increase utilisation of DCU and help accelerate the development of key surgical skills.

Biography :

Mr Ahmed Ammar is working form University Hospitals of Derby and Burton NHS Foundation Trust.