Training postgraduate urologists in laparoscopic surgery: the current challenge

Area of Science:

• Urology
• Surgical Education
• Minimally Invasive Surgery

Background:

• Traditional training for laparoscopic urological surgery has limitations.
• Pelvic trainers and animal laboratory courses offer foundational skills but lack clinical application.
• Practicing urologists require a bridge to independent laparoscopic surgery.

Purpose of the Study:

• To establish and evaluate a novel mini-fellowship training model for practicing urologists in laparoscopic urological surgery.
• To provide a learning experience that extends beyond basic simulation to direct clinical mentorship.
• To facilitate the safe and rapid adoption of laparoscopic techniques in community urology practices.

Main Methods:

• A three-phase mini-fellowship was developed: 1) a 2-3 day hands-on course (pelvic trainers, animal model), 2) observation of 6+ major renal laparoscopic cases by a mentor, and 3) performance of 6+ major renal procedures under direct mentorship.
• Trainees obtained temporary privileges to perform procedures on patients.
• The model was piloted with two community urologists.

Main Results:

• Following the mini-fellowship, one urologist performed 30 laparoscopic procedures within 8 months, including radical nephrectomies and cyst ablations.
• The second urologist performed 10 laparoscopic procedures within 3 months post-training.
• Both trainees demonstrated successful application of learned laparoscopic skills in clinical practice.

Conclusions:

• The mini-fellowship model offers a clinically relevant and effective teaching experience for urologists learning new surgical concepts.
• This approach facilitates a rapid and safe dissemination of laparoscopic urological surgery to community urologists.
• The model provides a framework for establishing centers of excellence to train urological communities in advanced surgical skills.