Abstract
Background/Objectives: The evolution of minimally invasive techniques has established advanced laparoscopic skills as an increasingly essential component of surgical curricula. However, the feasibility of senior residents performing technically demanding procedures such as Laparoscopic Colorectal Surgery (LCS) remains debated. This study evaluated the perioperative safety, short-term oncologic outcomes, and operative-time implications of supervised Laparoscopic Colorectal Surgery (LCS) performed by senior residents (post-graduate years 3 to 5 of a 5-year program). Methods: A retrospective observational cohort study of 136 patients undergoing curative-intent LCS for primary colorectal malignancy was conducted. Patients were stratified into a Specialist group (n = 102) and a Resident group (n = 34). Residents were senior trainees operating under the direct intraoperative supervision of experienced specialists. Perioperative metrics, patient safety endpoints, and short-term oncologic outcomes were compared. Results: The groups were demographically and pathologically well-matched, demonstrating similar distributions of advanced-stage (T3–T4) tumors and high Body Mass Index. Median operative time was significantly prolonged in the Resident group (340 vs. 290 min; p = 0.023). However, no significant differences were observed regarding the median length of hospital stay (9 vs. 8 days; p = 0.057), the incidence of anastomotic leakage (3.4% vs. 3.8%; p = 1.000), or positive surgical margin rates (5.9% vs. 10.8%; p = 0.517). No statistically significant difference in median lymph node yield was detected between the Resident and Specialist cohorts (17 vs. 16 nodes; p = 0.251). Conclusions: Under direct specialist supervision, resident-performed LCS was associated with no material difference in the measured short-term outcomes within this single-center supervised training model and the eligibility criteria used. The prolongation of operative time associated with resident participation appears to be a safe and acceptable aspect of surgical training.