The need for training opportunities in advanced laparoscopic surgery

Area of Science:

• Surgical Education
• Minimally Invasive Surgery
• Surgical Training

Background:

• Controversy exists regarding the adequacy of current surgical residency training for advanced laparoscopic procedures.
• General surgery residencies offer limited exposure to complex laparoscopic cases.
• There is increasing interest in specialized, non-accredited fellowships for advanced laparoscopic surgery.

Purpose of the Study:

• To evaluate surgical residents' perspectives on the necessity of advanced laparoscopic surgery training beyond standard general surgery residency.
• To understand residents' perceived training needs for specific advanced laparoscopic procedures.

Main Methods:

• A 15-item questionnaire was distributed to 985 Society of American Gastrointestinal Endoscopic Surgeons (SAGES) members or past course attendees.
• The survey focused on four advanced laparoscopic procedures: Nissen fundoplication, herniorrhaphy, splenectomy, and colectomy.
• Responses were analyzed to gauge perceived training needs and current experience levels.

Main Results:

• A significant majority of respondents (58%) had pursued external advanced laparoscopic surgery courses.
• Residents felt a minimum of eight procedures each was needed for safe practice, yet most had performed three or fewer.
• 65% of residents expressed willingness to undertake an additional year of advanced laparoscopic training if available.

Conclusions:

• Surgical residents strongly perceive a need for enhanced training in advanced laparoscopic surgery.
• Concerns about the impact of advanced laparoscopic surgery fellowships on residency training differ between affiliated and non-affiliated programs.
• Residents in programs without fellowships expressed more apprehension regarding potential interference with their training by fellows.