Open Appendicectomy and the Surgical Trainee in Ireland. The Experience of a University Teaching Hospital

Introduction: Both societal changes and technological advancements in recent decades have resulted in an evolutionary time for both surgical trainees and their mentors. A reduction in the amount of available working hours and the introduction of minimally invasive surgery has resulted in a need for an innovative approach to training our surgical trainees. This innovative approach should be in the form of simulated surgical training. Methods: The Hospital Inpatient Enquiry (HIPE) database was used to identify laparoscopic and open appendicectomies performed during a 6 year period, from January 2009 to December 2014. The rates of laparoscopic and open appendicectomy performed during the first three years (20092011) were compared with those in the second three years (20122014). Results: Of 1072 appendicectomies performed over the six year period, 62% were Laparoscopic. The median patient age, length of hospital stay, and the male to female ratio did not differ between the two time periods studied. The open appendicectomy rate fell from 54% during the first half of the study to 22.5% during the second half (p< 0.001). A significant increase in laparoscopic appendicectomy rates were noted in both male and female patients, as well as in paediatric (8-16 years) and adult (≥16 years) patients. Only 25(14.1%) open appendicectomies were performed in 2014. Conclusion: Simulated surgical training provides a risk free and safe learning environment for surgical trainees and should be utilised more in the National Surgical Training Programme in Ireland.