Does laparoscopic colorectal surgery reduce training opportunity?: P070


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Abstract

Aim:The uptake of Laparoscopic Colorectal Surgery in the U.K. has been slow. Steep learning curve, controversies with regard to oncological safety and small number of randomised trials are amongst the reasons cited for such delay. This indirectly affected training opportunity in laparoscopic colorectal surgery. The aim of this study is to review our experience in laparoscopic colorectal surgery over the last 8 years.Method:Retrospective review of laparoscopic colorectal resections for benign and malignant disease between May 2001 and December 2009. Training opportunities was identified during this period.Results:A total of 478 laparoscopic colorectal resections, 206 were for benign disease (slow transit constipation, inflammatory bowel disease, diverticular disease and rectalprolapse) and 272 for malignant disease. There were 101 rectal resections of which 12 required a defunctioning loop ileostomy. Overall rate of anastomotic leak was 6%. The mean number of mesenteric lymph nodes retrieved was 15. Surgical trainees performing theprocedure as first or second surgeon rose from 0 to 40%. From 2007 all trainees attended at least one laparoscopic colorectal course.Conclusion:Our experience does indicate that there is a steep learning curve when performing laparoscopic colorectal surgical resection. However, with wider use of animal labs, cadaveric courses and targeted approach improvement in training is feasible.

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