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Use of the self-reported critical view of safety in laparoscopic cholecystectomy during residency

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Abstract

Background

Even though the goal of safely performing cholecystectomy is already a priority in general surgical training programs, we aimed to study how many residents and attendings reached the critical view of safety (CVS) in laparoscopic cholecystectomy.

Materials and methods

Retrospective review of prospectively collected data of all patients with biliary surgical conditions, which underwent laparoscopic cholecystectomy and their corresponding postoperative notes with self-reported CVS from May 2019 to May 2020 in an academic hospital. Comparisons of operative variables between postgraduate year and attendings were made.

Results

Laparoscopic cholecystectomy was performed in 126 elective cases (62.6%) and 75 (37.3%) emergency cases. On 105 (83.3%) of the elective cases and on 54 (66.7%) emergency cases, a CVS was successfully performed. PGY3 and PGY5 had higher odds of achieving CVS compared to attendings OR 6.09 (95% CI 2.05 to 8.07) and 4.51 (95% CI 1.0 to 10.20), respectively. Overall, attendings had decreased odds ratio of achieving CVS of 0.488 when compared to all residents. Elective procedures had increased odds ratios of achieving CVS of 3.44 (95% CI 1.52 to 7.74). On elective cases, attendings performed significantly faster procedures when compared to PGY2–4, but not PGY5. No differences were seen between operative speeds between PGY. Third-year residents were identified as having the highest frequency of CVS; however, these differences were not statistically significant. In emergency cases, blood loss, operative time, CVS, and bile duct injuries revealed non-significant differences between operators.

Conclusion

CVS was reached significantly more often in elective than in emergency surgeries. There is still a lack of residents and attending surgeons who still failed to complete CVS during LC, highlighting the need for further education. Future studies should be attempted to repeat this study with a larger sample size and multiple coaching sessions to determine long-term efficacy.

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Acknowledgements

This paper is dedicated to the memory of Dr. Morris E. Franklin Jr. Renowned laparoscopic surgeon, educator, and mentor of many latin american surgeons.

Funding

This research did not receive any specific Grant from funding agencies in the public, commercial, or not-for-profit sector.

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Authors and Affiliations

  1. Tecnologico de Monterrey, School of Medicine and Health Sciences, Dr. Ignacio Morones Prieto O 3000, 64710, Monterrey, NL, México

    Mauricio Gonzalez-Urquijo, David E. Hinojosa-Gonzalez, Mario Rodarte-Shade, Gerardo Gil-Galindo & Javier Rojas-Mendez

  2. Tecnologico de Monterrey, School of Engineering and Science, Av. Eugenio Garza Sada 2501 Sur, Tecnológico, 64849, Monterrey, NL, Mexico

    Eduardo Flores-Villalba

Authors
  1. Mauricio Gonzalez-Urquijo
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  2. David E. Hinojosa-Gonzalez
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  3. Mario Rodarte-Shade
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  4. Gerardo Gil-Galindo
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  5. Eduardo Flores-Villalba
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  6. Javier Rojas-Mendez
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Corresponding author

Correspondence to Mauricio Gonzalez-Urquijo.

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Disclosures

Mauricio Gonzalez-Urquijo, David Eugenio Hinojosa Gonzalez, Mario Rodarte Shade, Gerardo Gil Galindo, Eduardo Flores-Villalba, and Javier Rojas Mendez have no conflicts of interest or financial ties to disclosure.

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Written informed consent was obtained from the patients for publication of this case series. A copy of the written consent is available for review by the Editor-in-Chief of this journal on request.

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Gonzalez-Urquijo, M., Hinojosa-Gonzalez, D.E., Rodarte-Shade, M. et al. Use of the self-reported critical view of safety in laparoscopic cholecystectomy during residency. Surg Endosc 36, 3110–3115 (2022). https://doi.org/10.1007/s00464-021-08612-w

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  • DOI: https://doi.org/10.1007/s00464-021-08612-w

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