A standardized resident training program in endoscopic surgery in general and in laparoscopic totally extraperitoneal...

The need for acquisition of specific laparoscopic skills has emphasized the role of a preclinical laboratory-training program. However, for laparoscopic inguinal hernia repair with a steep learning curve, especially for totally extraperitoneal repair, preclinical skill training remains a challenge. A standardized preclinical resident training program in endoscopic surgery is described. Also, a standardized clinical training program is proposed with systematic dissection in 10 different consecutive steps for totally extraperitoneal inguinal hernia repair. Continuous mentoring by an expert is an absolute prerequisite to the success of this training program. In this way, the learning period may be drastically reduced to approximately 30 procedures, in whom the resident progressively performs more and more of the different steps, and ultimately the complete procedure. Validation studies at different institutions are starting up to demonstrate the additional value of this training program.