Do trainee surgeons really take that much longer when operating in day-case surgery?

Abstract

s / International Journal of Surgery 10 (2012) S53–S109 S76 ABSTRACTS 0610: DO TRAINEE SURGEONS REALLY TAKE THAT MUCH LONGER WHEN OPERATING IN DAY-CASE SURGERY? Ahmed M. El-Sharkawy, Elena Theophilidou, John W. Quarmby. Royal Derby Hospital, Derby, UK Aim: Theatre time pressures may prevent trainees from taking the lead when operating and this can impact on their training. We aim to assess the operating time taken by trainee surgeons in the Day-Case Surgical Unit (DSU). Method: Operative Room Management Information System records for DSU were reviewed between December 2007-2008 and 2010-2011 at the Royal Derby Hospital. Data was collected on operating times for general surgical cases and compared between consultants, associate specialists (AS) and trainees. Results: The total number of open hernia procedures performed was 772 by consultants, 398 by AS and 97 by trainees. The mean time for all open hernia surgery in minutes was 38.8 for consultants, 34.2 for AS and 41.2 for trainees. Sub-group analysis demonstrated similar trends. Furthermore, operative time in minutes for excision of benign lesions was 18.5 for consultants, 13.5 for AS and 21.5 for trainees. Similar results were demonstrated when comparing other day-case procedures including laparoscopic cholecystectomy. Conclusions: The results show that there are little differences in operating times, particularly when trainees perform appropriately selected cases. DSU provides the perfect setting for trainees to perform appropriately selected procedures on relatively uncomplicated patients in order to develop and practice their operative skills. 0616: THE IMPORTANCE OF CONSULTANT-LED SUPERVISION AND TRAINING IN EMERGENCY COLOSTOMY FORMATION Pritesh Morar, Riaz Agha, John Meyrick-Thomas. West Hertfordshire NHS Trust, Vicarage Road, Watford, Hertfordshire, UK Aim: We performed an audit systematically analysing the early incidence of problematic stomas at our district general hospital. The aim of the audit was to quantify our incidence of problematic stomas, attribute causative factors, highlight awareness and implement change. Method: The standard* showed 66% of stomas were healthy and 34% were problematic nationwide. A problematic stoma was defined by complications within 3 weeks of surgery, requiring one or more accessories. Retrospective evaluation of 41 patients’ notes over a six month period yielded the following data: the type of operation; elective or emergency; consultant or trainee performed; and stoma-related outcome. Results: Of the 16 end colostomies produced: 25% were healthy and 75% were problematic. Retraction compromised 75% of problematic end colostomies; problematic stomas were noted in trainee (79%) verses consultant (30%) constructions, emergency (65%) verses elective (29%) constructions, with Hartmann's procedures (50%) in the presence of diverticular disease (80%). Conclusion: In conclusion, a higher incidence of end colostomy retraction following Hartmann's procedures performed by unsupervised trainees in the emergency setting exists. Consultant supervision in such settings is vital, providing additional experience in tension-free stoma formations. *Standard from National Audit of Stoma Complications within 3 weeks of Surgery, (Cottam and Richards 2006) 0619: ARE MEDICAL TRAINEES FOLLOWING BEST PRACTICE GUIDELINES WHEN PERFORMING ARTERIAL BLOOD GAS SAMPLING ON ACUTE SURGICAL PATIENTS? MATHURI SAKTHITHASAN, MICHAEL MAGRO , AKLAK CHOUDHURY, ROBERT FOWLERQUEEN'S HOSPITAL. BARKING, HAVERING AND REDBRIDGE UNIVERSITY HOSPITALS NHS TRUST, ROMFORD, UNITED KINGDOM Mathuri Sakthithasan, Michael Magro, Aklak Choudhury. Queens Hospital,