J P Wallace, MD1, Vernon D Horst, MD1, Joshua S Brandner, DDS, MD1, Hetal D Patel, MD2, Stan C Hewlett, MD1, Greg L Bearden, MD1. 1Brookwood Baptist Health System, Department of Surgery, Birmingham, AL, 2University of Kentucky, Department of Surgery, Division of Cardiothoracic Surgery, Lexington, KY
INTRODUCTION – The objective of this study was to evaluate general surgery resident competency at our institution through a relatively common surgical procedure (laparoscopic cholecystectomy). The objective was also to demonstrate the effectiveness of our institution’s minimally invasive training program, including both laparoscopic and robotic procedures.
METHODS – We performed a chart review of all laparoscopic and robotic cholecystectomies from January 1, 2014 – December 31, 2015 performed at Princeton Baptist Medical Center. Over 160 cases were performed by attending physicians and chief surgery residents (PGY5). Statistical significance was determined by Student’s t-test.
RESULTS – We analyzed operative time between attending physicians and chief residents in laparoscopic as well as robotic cholecystectomy. We found no significant difference in operative between attending physicians vs. PGY5 residents in laparoscopic or robotic cholecystectomy times (see Table).
| Laparoscopic Time (min) | Robotic Time(min) | P value | |
|---|---|---|---|
| Attending | 76.44 | 53.97 | 0.0119 |
| PGY-5 | 72.65 | 56.87 | 0.0002 |
| P value | .05322 | 0.3927 |
CONCLUSION – ACGME case requirements for surgical training include basic and advanced laparoscopic cases. Competence in operative technique is often subjective, with little objective data. No statistically significant difference exists at our program between chief resident and attending surgeon operative time on a common minimally invasive operation, in both laparoscopic and robotic approaches. Training in robotic surgery during surgical residency is important in preparing today's trainee general surgeon. Establishing a standardized curriculum for robotic surgery during residency is an effective tool for developing this new skill. Robotic assistance increased overall operative time by an average of 21.5 and 15.8 minutes for attending surgeons and chief residents, respectively. Our mean operative times match or are superior to published mean operative times. Competence in performing basic laparoscopic operations can be assessed by recording and tracking operative times. Our robotic curriculum is effective in training residents to competently perform a common general surgery operation by the PGY-5 year.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80017
Program Number: P287
Presentation Session: Poster (Non CME)
Presentation Type: Poster
