TPW 4.07 Laparoscopic Appendicectomy as a Training Procedure: An Analysis of Outcomes by Surgeon Grade

Abstract Aims Laparoscopic appendicectomy (LA) is a core emergency general surgical procedure and a key training operation for developing laparoscopic skills. Its high case volume and typically low patient comorbidity make it a valuable target for evaluating surgical training outcomes. This study analyses whether surgeon training grade influences postoperative outcomes following LA. Methods A single-centre retrospective analysis was conducted of 229 LAs performed by consultants (n=32), registrars (n=109), and senior house officers (SHOs) (n=88) between June-December 2025. Outcomes were compared between training grades to determine whether surgical experience affected enhanced recovery after surgery. Primary outcomes included 30-day re-presentation rates, re-admission rates, and postoperative complication severity classified using the Clavien–Dindo (CD) system. Results Re-presentation rates were highest in consultant-performed cases (15.6%), followed by registrars (13.0%) and SHOs (9.1%). Overall re-admission rates were low, with the highest rate observed in registrar cases (7.4%), compared with consultants (3.1%) and SHOs (1.1%). Postoperative outcomes were excellent across all groups, with CD grade 0 being the most common outcome. CD grade 0 occurred most frequently in SHO-performed procedures (92.0%), followed by registrar (80.7%) and consultant (75.0%) cases. Higher-grade complications (up to CD IIIb) were observed only in registrar and consultant groups. Conclusions LA is a safe and effective training procedure for junior surgeons, with excellent postoperative outcomes observed in SHO-performed cases. Higher complication rates in senior-performed cases likely reflect appropriate allocation of more complex appendicitis to experienced surgeons. The findings from this centre support continued trainee involvement in LA with appropriate case selection and supervision.