P177: Training general surgery residents in pediatric surgery: Analysis of time and cost

Abstract

Background: Resident participation in the pediatric surgery service is essential to their training. The impact with regard to operative time and hospital cost is not well-defined. Hypothesis: Training general surgery residents in pediatric surgery significantly increases operative time and hospital cost. Methods: A retrospective analysis of operative times was performed for three common pediatric operations: unilateral inguinal herniorraphy, bilateral inguinal herniorraphy, and open pyloromyotomy. All cases occured between July 2004 and July 2006. In Group 1 all operations were performed by a single attending pediatric surgeon. Group 2 involved the same attending surgeon directing a 3rd -year general surgery resident through the operations. Operative time was defined as the time from skin incision to placement of the final dressing. Surgery schedules and a cost analysis were also analyzed for the 2 groups. Statistical analysis was performed using student t-test. Results: Demographics between the two groups were similar. Mean operative time was shorter in Group 1 with respect to unilateral and bilateral herniorraphy. Mean operative time for pyloromyotomy was similar between the 2 groups. No perioperative complications or recurrent hernias occured in either group. Surgery schedules (number of operations per day) were similar between the 2 groups. Furthermore, decreased time in performing herniorraphy without surgery residents would not lead to more operative cases performed per day, thus hospital cost and surgeon fees are similar between the 2 groups. Conclusion: Training general surgery residents in pediatric surgery increased operative time with respect to unilateral and bilateral herniorraphy. There was no increase in operative with respect to pyloromyotomy. Increased operative time to train general surgery residents did not influence surgical scheduling, thus there was no increase in cost to the hospital or surgeon. Tabled 1Operative time (minutes) between the 2 groups Group 1 Group 2 p Unilateral herniorraphy 31.2 ± 10.4 (n=41) 40.1 ± 15.2 (n=35) 0.003 Bilateral herniorraphy 44.9 ± 13.4 (n=30) 54.0 ± 16.6 (n=20) 0.04 Pyloromyotomy 32.9 ± 9.6 (n=10) 34.6 ± 7.4 (n=15) 0.61 Open table in a new tab