WTP7.5 The shift in practice Toward Laparoscopic emergency surgery over period of 7 years in a district hospital

Abstract

Abstract Aim Many studies showed the advantages of laparoscopic surgery when compared to open surgery both in elective and emergency surgery. The Aim of this study is to compare Laparoscopic and open surgical procedures in managing Emergency surgery in a district hospital over a period of 7 years. Methods We reviewed 1776 emergency cases in 2015 and 1836 cases in 2022 in the emergency theatre register. We included all the abdominal emergency surgeries that qualifies for the NELA inclusion/ exclusion criteria. We excluded all non-general surgery cases. We also excluded Appendectomies, Hernia repair and Laparoscopic cholecystectomies. Results We included 207 in 2015 and 234 in 2022. There was significant increase in Laparoscopic surgery performed between 2015 and 2022 (63%Vs40%). Less open surgeries were performed (46%Vs24%) and no change in the conversion rate (13%vs12%). Operating time was (89min) for Laparoscopic cases. Compared to open procedures (119min) and converted cases (141min). Conclusion There has been more than 50 % increase in laparoscopic cases. However, there was no significant reduction in conversion rate. The laparoscopic surgery time was significantly less when compared to open or converted cases, however this might simply be sure to the complexity of those cases rather than the advantage of laparoscopic surgery. Key statement There has been significant shift toward laparoscopic surgery over the last few years due to better understanding of the benefit of laparoscopic surgery and increase confidence in performing laparoscopic surgery. There is a room of improvement in case selection to decrease the conversion rate avoiding unnecessary increase of operating time.