National uptake of laparoscopic colorectal resection in England following implementation of a National Training Programme: F21


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Abstract

Aim:Laparoscopic colorectal surgery (LCS) is becoming ubiquitous. In 2006 the UK government instituted a National Training Programme (NTP) in LCS for consultant colorectal surgeons. The aims of this study were to assess (1) the uptake of LCS since the NTP inception, (2) theproficiency gainprocess of trainees and (3) clinical outcomes within the NTP.Method:Data were analysed from the National Hospital Episode Statistics registry (HES). Proportions of LCS versus open surgery performed were compared. An online structured global assessment score form was completed for each LCS case by both trainer and trainee. Clinical outcomes were recordedprospectively.Results:The NTP currently holds 147 registered trainees who performed 694 training cases. Between 2007 and 2009 theproportion of LCS nationally has increased from 12% to 23%. Educational assessment data indicates that competent performance is achieved after 20-25 cases. Clinical outcomes of patients within the NTP are excellent with a conversion rate of 4.4%, 12.3% morbidity and 0.5% in-hospital mortality.Conclusion:Theproportion of colorectal resections undertaken laparoscopically has increased since the inception of the NTP. It is ensuring that the skills deficit in existing surgeons in England is safely corrected in a way that is unprecedented.

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