Venkata Seelamanthula, Elizabeth V and B Kirkby
Caboolture Hospital, Australia
Introduction: Appendicitis is the most common General Surgical presentation to Emergency. Laparoscopic and open appendicectomy is the commonest emergency surgical procedure performed in Australia. The level of consultant supervision of trainees is considered to be an important component of surgical education and training. During early training, trainees need close supervision to facilitate advice and tuition on technical aspects of operative surgery. Equally a high level of consultant involvement in decision making of non-operative management and intraoperative management is important in achieving low negative appendicectomy rates.
Methodology: Retrospective review of data from theatre software was retrieved and analysed. The aim of the study was to assess the level of Supervision of trainees during their Acute General Surgery oncall. All patients who underwent appendicectomy during Apr 2017 to Mar 2018 were included in the study. Histology of all appendicectomies performed were reviewed using pathology software.
Results: During Apr 2017 to March 2018, 189 appendicectomies were performed for clinically suspicious appendicitis. 72 appendicectomies were performed out of hours between 1630- 0730. Negative appendicectomy rate performed after hours was 29% vs 9% when performed during working hours. Overall negative appendicectomy rate was 16.9 % for appendicectomies performed during one-year period.
Conclusion: Direct consultant involvement in preoperative decision making decreases the amount of negative appendicectomy and further decrease in operation related morbidity.
Venkata Seelamanthula is a Surgical Registrar at Caboolture Hospital, Queensland, Australia. He is actively involved in teaching medical students. He is a member of the Royal college of Surgeons, Edinburgh. He graduated from Kathmandu Medical college, Nepal. He published his research work in Annals of Surgeons. Presented papers in scientific meetings in Australia and international conferences.
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