IngentaConnect Reduction in varicose vein services: impact on operative training

Authors: Bajwa, A.¹; Magee, T.R.¹; Galland, R.B.¹

Source: Annals of The Royal College of Surgeons of England, Volume 89, Number 8, November 2007 , pp. 789-791(3)

Publisher: The Royal College of Surgeons of England

Abstract:

INTRODUCTION: This study examines the impact of rationing varicose vein operations on operative training on a general surgical unit with a vascular interest.

PATIENTS AND METHODS: Log-books of middle-grade surgeons were analysed for 3-month periods before and after a decision by the local Primary Care Trust to ration varicose vein referrals. Number, intermediate equivalents and type of operations were recorded, whether they were general or vascular cases and whether the trainee had carried out or assisted with the operation.

RESULTS: There was a slight fall in the total number of operations in which the middle-grade surgeons were involved (208 to 186). There was a significant increase in general surgical cases with the fall in number of varicose vein operations (P < 0.0001). The fall in case-load and work-load operative training in vascular surgery was compensated by an increase in general surgical cases (P = 0.0003). This was largely due to increased number of hernia repairs (P = 0.0035).

CONCLUSIONS: From the point of operative training, a vascular unit in a district general hospital would not be sustainable following withdrawal of varicose vein services. However, this can be off-set by increasing general surgical case-load to fill the gap created.

Keywords: VASCULAR UNIT; OPERATIVE TRAINING; DISTRICT GENERAL HOSPITAL; VARICOSE VEIN

Document Type: Research article

DOI: 10.1308/003588407X232125

Affiliations: 1: Department of Vascular Surgery, Royal Berkshire Hospital, Reading, UK