MTP2.05 Surgical confidence in performing an emergency appendicectomy: a cross-sectional survey of surgical registrars and SHOs at a DGH

Aims This study aims to investigate confidence and experience in performing emergency appendicectomy among surgical registrars and senior house officers (SHOs) at a district general hospital, highlighting areas for improvement, particularly in open appendicectomy. Methods A retrospective survey consisting of 13 anonymised questions was distributed to all surgical registrars and SHOs between January and February 2024 via email and social media. Subgroup analysis was conducted to compare responses based on seniority, confidence in performing open and laparoscopic appendicectomy, and managing complications across pre-operative, intra-operative, and post-operative stages on a 1-10 scale. Results 19 responses were received from the general surgical team, including 11 registrars (1 locum) and 8 SHOs. Of these, 15.8% (3) were ST3-ST4 trainees, 42.1% (8) were non-trainee registrars, and 42.1% (8) were SHOs. While 63.2% (12/19) reported >90% confidence in performing pre-operative assessments for both laparoscopic and open appendicectomy, only 42.1% (8/19) were similarly confident with laparoscopic appendicectomy. Just 21% (4/19) expressed >90% confidence in performing open appendicectomy or managing intra-operative complications. Conclusions This study highlights significant variation in confidence among surgical registrars and SHOs in performing laparoscopic and open appendicectomies, with most lacking experience in open. Experience and seniority likely influencing these differences. The rise in minimally invasive techniques explains the decline in open surgery exposure. Addressing this gap is essential to safeguard patient care and safety. We recommend local trainers introduce consultant led teaching sessions or courses and encourage observation and teaching opportunities during challenging cases requiring conversion to open appendicectomy.