Optimizing outcomes in laparoscopic urologic training: toward a standardized global consensus.

Area of Science:

• Urology
• Surgical Education
• Minimally Invasive Surgery

Background:

• Laparoscopic urologic surgery (LUS) is a rapidly expanding surgical subspecialty.
• LUS demands high technical skill with limited room for error.
• Ethical, medicolegal, and economic factors complicate LUS training.

Purpose of the Study:

• To review current LUS training programs.
• To identify core components of an optimal LUS training program.
• To propose training models based on evidence and current trends.

Main Methods:

• Comprehensive literature search of major medical databases (MEDLINE, PubMed, CINAHL, EMBASE, Cochrane, Google Scholar) from 1970-2006.
• Inclusion of abstracts from key urological society meetings (AUA, EAU, WCE) from 1996-2006.
• Focus on publications related to laparoscopic surgical training in urology.

Main Results:

• No global consensus on optimal LUS training programs was identified.
• Several training models were found, with some successful minifellowship applications.
• Clear guidelines for optimal LUS training are currently lacking.

Conclusions:

• Optimal LUS training programs require tailoring to specific institutional resources, including economics, mentor availability, and caseload.
• Further research is necessary to establish global minimum standards for LUS training.
• Individualized program development is recommended in the absence of universal guidelines.