Introduction: The ideal approach to teach general surgery residents laparoscopic colectomy is not well established. This study demonstrates the impact of a unique advanced laparoscopic mentorship rotation on residents ability to perform laparoscopic sigmoid colectomy for diverticular disease.
Methods: All attempted laparoscopic sigmoid resections for diverticular disease by senior or chief residents assisted by a single colorectal surgeon from 1999-2005 were included. Residents at our institution participate in a three month mentorship with an advanced laparoscopic surgeon before or after their colorectal clerkship. The operating resident's exposure to this mentorship dictated which group each patient was assigned to.
Results: There were 88 patients who underwent LSR by previously mentored resident's (MR) and 63 patients by those resident's who had not completed the laparoscopic rotation (R). There was no difference in patient demographics or indication for surgery. There was a statistically significant difference in operative time favoring MR (MR 115 min (65-175) vs R 161 min (105-205); p= <.01). Complications were similar in the two groups (MR 17% vs, R 15%) as well as length of hospital stay (MR 4.2 days (2-9) vs R 4.4 days (3-10); p= 0.73. There were fewer conversions in the mentored group (MR 4.5% vs. R 13%; p< 0.01).
Conclusions: A ten week advanced laparoscopic mentorship rotation improves general surgery residents ability to perform straight laparoscopic colectomy as demonstrated by both decreased operative times and a lower conversion rate.