Abstract

ABSTRACT:
BACKGROUND:
From the start of era of laparoscopic surgery the debate starts regarding the best time for laparoscopic training and in most developed countries the training is part of residency program nowadays; the safety of surgeons performing laparoscopic cholecystectomy assessed by results of surgery in addition to different scoring systems( like GOALS and Thomas R Eubanks).
OBJECTIVE:
The purpose of this study is to evaluate the safety of elective laparoscopic cholecystectomy done by postgraduate trainees under supervision and the introduction of proper training program of laparoscopic surgery in postgraduate residency programs in Iraq. The safety of the procedure performed was determined using The Global Operative Assessment of Laparoscopic Skills (GOALS) and Thomas R. Eubank scoring systems which were designed for evaluation of resident and surgeon in training laparoscopic performance .
PATIENTS AND METHODS:
This prospective study includes 200 consecutive cases underwent laparoscopic cholecystectomy for symptomatic cholelithiasis, conducted in AL-Jumhoori Teaching Hospital in Mosul city - Iraq during the period from (October 2010 to October 2011). These laparoscopic cholecystectomies were performed by(5th&4th year) postgraduate trainees under supervision of senior laparoscopic surgeons.
RESULTS:
Among 200 cases, there were 45 (22.5 %) males and 155 (77.5 %) females. The age of patients ranged from 18-65 years. All cases were done by 4th and 5th post graduate trainees with minimal complications. The results and observations were made for the operating time, difficulty in dissection, open conversion rate and early complications, The mean operating time was 40 minutes. The open conversion was 3%. and gut injury was 0.5% with no mortality.
CONCLUSION:
laparoscopic cholecystectomy can be performed safely by resident postgraduate trainees according to the outcome data , "Global Operative Assessment of Laparoscopic Skills" (GOALS) and Thomas R Eubanks scoring system and this proves the effectiveness of the suggested training program