SRS52 - When risk goes unspoken: an audit of consent documentation for laparoscopic appendicectomy

Abstract Accurate and comprehensive documentation of risks during the consent process is essential to respect patient autonomy and meet national standards set by the General Medical Council (GMC) and Royal College of Surgeons (RCS) England. We conducted a retrospective audit of 68 consent forms for laparoscopic appendicectomy over a three-month period at our institution. Each form was reviewed for documentation of 17 key risks identified through national guidelines and consultant consensus, including common complications such as bleeding, infection, and conversion to open surgery, as well as specific organ injuries and intraoperative contingencies. Overall, only four risks were documented in more than 75% of cases: bleeding (98.5%), infection (95.6%), injury to nearby structures (83.8%), and conversion to open procedure (88.2%). Documentation of specific organ risks was variable, with bowel injury noted in 61.8% of forms, bladder injury in 36.8%, and ureter injury in only 22.1%. Among 46 female patients, documentation of gynecological risks was present in just 30.4%. Other important risks, including hernia formation (63.2%), death (13.2%), and need for reintervention (23.5%) were frequently omitted. These findings reveal poor compliance with GMC and RCS consent guidelines, highlighting a lack of procedure-specific and gender-specific risk documentation. In response, a procedure-specific consent template has been introduced, and a re-audit is planned to evaluate its impact on improving consent quality and compliance. This audit underscores the need for structured consent processes to ensure informed decision-making and medicolegal safety in laparoscopic appendicectomy.