Evaluating the Feasibility of Single Incision Laparoscopic Appendectomy Performed by a Resident Based on Propensity Score Matching

Safety and feasibility of single-port laparoscopic appendectomy as a training procedure for surgical residents

Background:

Single-port laparoscopic appendectomy (SPLA) is one of the most commonly performed single-port surgeries worldwide. This study aimed to determine whether the performance of SPLA by residents without sufficient experience as operators of conventional LA (CLA) is safe and feasible.

Patients and Methods:

Records of patients who underwent LA between March 2017 and February 2018 at a hospital in Korea were retrospectively analysed. Patients aged <18 years or >80 years were excluded from the study. SPLA and CLA were performed by two 2^nd-year residents (junior group) and three 3^rd-year residents (senior group). Demographic data, perioperative variables and surgical outcomes were compared.

Results:

During the study period, 154 patients underwent LA (104 SPLA and 50 CLA) performed by surgical residents. No differences were found between the SPLA and CLA groups in demographic data or perioperative variables, except for the drain insertion rate. The SPLA group had significantly shorter mean operation times than did the CLA group. No significant difference was observed between the junior and senior groups in the mean operation time for LA. Perioperative outcomes were not significantly different between groups. Fewer women underwent SPLA performed by 2^nd-year residents compared with SPLA performed by 3^rd-year residents. However, there were no differences in other general characteristics or perioperative outcomes.

Conclusions:

SPLA was safe and feasible when performed by junior residents. Surgical residents with sufficient experience as assistants during laparoscopic appendectomies could perform SPLA safely. Furthermore, SPLA could serve as a teaching procedure for surgical residents.