Experience and Learning Curve of Laparoscopic Appendectomy and Cholecystectomy of General Surgery Residents in a Latin American Hospital

Introduction: Laparoscopic surgery has revolutionized the surgical management of patients, generating a need for training in the area. Performance in real life is what allows a global determination of the competences in a procedure and establishes a training method. The objective of this study is to describe the evolution in the surgical experience of a group of general surgery residents. Methodology: Observational analytical study of a retrospective cohort at the Hospital Universitario San Ignacio. It included 4191 surgical procedures divided in 1045 laparoscopic appendectomies (LAs) and 3146 laparoscopic cholecystectomies (LCs) performed by a total of 52 residents between January 2008 and December 2014. Results: Both LAs and LCs showed an increase in the number of annual procedures. When comparing the mean times of LA per year of residency training, a decreasing trend in the median was observed, as the resident advanced in his/her training. Intraoperative complications were 0.77% for LA and 1.9% for LC; the most common postoperative complication was surgical site infection (SSI) and mortality was < 0.5%. Conclusion: The results show the need to continue with residency programs that provide adequate training in the laparoscopic approach, possibly with increasingly early exposure to minimally invasive procedures.