Impact of Fellowship During Single-Incision Laparoscopic Cholecystectomy

Background and Objectives: Minimally invasive surgery fellowship programs have been created in response to advancements in technology and patient’s demands. Single-incision laparoscopic cholecystectomy (SILC) is a technique that has been shown to be safe and feasible, but this appears to be the case only for experienced surgeons. The purpose of this study is to evaluate the impact of minimally invasive surgery fellow participation during SILC. Methods: We reviewed data from our experience with SILC during 3 years. The cases were divided in two groups: group 1 comprised procedures performed by the main attending without the presence of the fellow, and group 2 comprised procedures performed with the fellow present during the operation. Demographic characteristics, comorbidities, indication for surgery, total surgical time, hospital length of stay, and complications were evaluated. Results: The cohort included 229 patients: 142 (62%) were included in group 1 and 87 (38%) in group 2. No differences were found in demographic characteristics, comorbidities, and indication for surgery between groups. The total surgical time was 34.4 11.4 minutes for group 1 and 46.8 16.0 minutes for group 2 (P .001). The hospital length of stay was 0.89 0.32 days for group 1 and 1.01 0.40 days for group 2 (P .027). No intraoperative complications were seen in either group. There were 3 postoperative complications (2.1%) in group 1 and none in group 2 (P .172). Conclusion: Adoption of SILC during an established fellowship program is safe and feasible. A longer surgical time is expected during the teaching process.