Training and mentoring surgeons in lymphatic mapping

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Intraoperative lymphatic mapping and selective lymphadenectomy is a novel surgical technique introduced in the last 12 years for solid malignancies.
• Dissemination of this technique has paralleled the adoption of new laparoscopic procedures.
• Initial literature primarily consists of case series from leading institutions, with subsequent series offering technical refinements.

Purpose of the Study:

• To evaluate the dissemination and training frameworks for intraoperative lymphatic mapping and selective lymphadenectomy.
• To highlight the unique proficiency assessment offered by sentinel node methodology.
• To discuss the role of clinical trials and mentoring in developing structured evaluation for new surgical procedures.

Main Methods:

• Review of surgical literature focusing on case series and technical refinements.
• Analysis of clinical trial data for sentinel lymph node technology.
• Examination of surgeon training and mentoring programs.

Main Results:

• The technique's adoption follows patterns similar to laparoscopic techniques.
• Sentinel node methodology provides a unique proficiency assessment via completion lymphadenectomy.
• Completed clinical trials have established training and mentoring pathways for surgeons.

Conclusions:

• Multi-institutional studies and mentoring programs are crucial initial steps for evaluating new surgical procedures.
• A structured framework is needed for the evaluation of novel surgical techniques like intraoperative lymphatic mapping.
• Sentinel node methodology offers a valuable tool for both assessment and training in oncologic surgery.