Most findings indicate that residents can perform some index general surgery procedures safely. An important caveat to operative independence of residents lies in the judgment of their teaching attending customer reviews (16). Factors involved in an attending��s decision to allow a resident to perform, like first operator, any surgical intervention include, among others, the skill and ability of the resident, the complexity of the patient and his/her disease, the resources of the hospital, and the urgency of the case (2, 17). The Italian residency program states that a resident must perform in his teaching development at least 80 procedures including either the more easy outpatient surgical procedure or most difficult procedures such as colectomy or gastrectomy.

In order to master most difficult surgical procedure, a resident need to reach several skills and the outpatient procedures could be useful to obtain this target (18, 19). However the outcomes should not get worse in a good residency program. The results, obtained by resident or attending surgeon, should be similar in order to ensure safety and efficacy of each surgical intervention. Thus a resident should reach several skills step-by-step. In this setting, our findings demonstrate that inguinal hernia repair and pilonidal sinus excision comparing to others surgical procedures evaluated in our study, can be the ideal teaching operation for a resident surgeon. More in details, the study demonstrates that the occurrence of complications after inguinal hernia repair and excision and primary closure of pilonidal sinus were similar either if performed by a resident or by an attending surgeon.

At variance, the results obtained after safenectomy and hemorrhoidectomy were worse if performed by a resident surgeon. However in a separate analysis we have demonstrated that the results obtained by senior resident or attending surgeon were similar among all surgical interventions. Whereas outpatient surgical procedures have to be taken into consideration as the ideal training for young surgeon in a residency program, saphenectomy and hemorrhoidectomy should be considered safe only if performed by a senior resident surgeon. Thus hernia repair and excision and primary closure of pilonidal sinus have to be considered the ideal teaching procedure in a residency program, giving to the young surgeon the opportunity of reach several skills that he need to master most difficult surgical procedures.

Breast Reduction (BR) is a common procedure around the world. Patients are screened for incidental carcinoma preoperatively by mammography Batimastat or ultrasonography and BR specimens are sent for pathologic examination postoperatively. Since the incidence of incidental carcinoma is very low, no consensus exist regarding efficiency of pathologic examination.