Training in Laparoscopy

ObjectiveTraining in laparoscopy is still a challenge for the urologic community. Surgeons in training must learn the laparoscopic techniques, possibly without having ever performed the conventional procedure. In the present study, we provide a nonstructured literature review pertaining to laparoscopic training and discuss the training design and the modular concept.MethodsA thorough literature search was performed with the Medline database and different training procedures were analysed.ResultsDue to increasing time constraints, cost, stress, and ethical considerations, the modern operating room is not the ideal learning environment. Various simulators and models for laparoscopic training in urology and general surgery with different levels of validity and reliability are available. Wide acceptance of the use simulators has been hampered by the lack of standard and valid methods to measure and certify competence in basic psychomotor skills. Besides, it is unclear if trainees have enough access to these programmes and if they are sufficient enough to develop the required skills. Whether complex urologic procedures can be performed by beginners without open surgical expertise and whether experience in open surgery is definitely required before mastering laparoscopic techniques are still matters of issue.ConclusionThe lack of a standardised, evaluated training procedure needs to be overcome. Structured training programmes and transference of gained experience into daily practice are essential to provide urology with expert laparoscopists.