Does the Experience Level of Surgeons and Assistants Influence the Rate of Complications Following Appendicectomy?

Background Appendicectomies are the most frequently performed acute general surgery. The risk of complications depends on several factors, including patient age, American Society of Anesthesiologists (ASA), duration of symptoms, serum inflammatory markers, and the grade of inflammation. Prior research failed to demonstrate a relationship between the rate of complications and the surgeon's level of experience. It is unclear if the assistant's level of experience influences complication rates. Methods We conducted a retrospective cohort study to investigate the relationship between the surgeon's and assistant's position and the rate of complications following appendicectomy. We also explored whether more experienced staff were involved in higher-risk cases and their relationship with resource utilization. Results There was no significant difference in total complication rates based on the surgeon's and assistant's position (p = 0.48 and p = 0.99, respectively). Post-operative bleeding was the only complication that correlated with the assistant's level of experience (p = 0.002). More experienced surgeons performed faster appendicectomies (p =0.002), while the assistant's position had no influence (p = 0.47). There was no statistically significant relationship between the surgeon's and assistant's position, and post-operative length of admission, or risk factors for complications as measured by age, days of abdominal pain, white blood cell count (WCC), C-reactive protein (CRP), ASA, radiographic and intra-operative American Association for the Surgery of Trauma (AAST). Conclusion Experienced surgeons performed faster appendicectomies. There was a trend toward higher rates of post-operative bleeding with less experienced assistants. Otherwise, there was no relationship between the surgeon's experience level and post-appendicectomy complication rates, length of post-operative stay, or patient risk factors for complications.