77.07 Medical Students in Laparoscopic Cases: Increased Operative Time and Same Post-Operative Outcomes

M. Mori¹, A. Liao¹, T. Hagopian², S. Perez¹, J. F. Sweeney¹, B. Pettitt^{1  1}Emory University School Of Medicine,Surgery,Atlanta, GA, USA ²University Of Southern California,Plastic And Reconstructive Surgery,Los Angeles, CA, USA

Introduction:
Medical students are increasingly assuming active roles in the operating room (OR) as part of their clerkships. Laparoscopic surgeries offer increasing opportunities for MS participation, including camera driving, teaching through well-visualized operative field, and suturing. The effect of the presence of medical students on the procedure time and post-operative outcomes are unknown. We aimed to characterize the effects of medical student participation in laparoscopic cases.

Methods:
Data from the American College of Surgeons National Surgical Quality Improvement Program was linked to the institutional operative records for non-emergent, inpatient, laparoscopic general surgery cases at our institution from 01/2009 to 01/2013. Cases were grouped into eight distinct procedure categories. Hospital records provided information on the presence of medical students. Demographics, comorbidities, operative time, and postoperative complications were analyzed, using linear regression.

Results:
Of 700 laparoscopic cases reviewed, medical student was present in 38% of the cases. Controlling for wound class, procedure group, and surgeon, multivariate linear regression demonstrated that the presence of medical students in the OR was associated with an additional 30 minutes of total operative time on average (p<0.0001, 95% CI [17-43 mins]). No association between medical students and the number of postoperative complications was observed (0.21 vs. 0.19, p=0.79).

Conclusion:
This is the first study to examine the effect of medical student’s presence during laparoscopic procedures. While it is reassuring that no increase in the complications was observed, the association with increased operative time in laparoscopic cases needs to be examined further, especially given the financial burden incurred by the increased OR time.