Buddy operating in gynaecological endoscopy: what should this model of surgical practice look like?

"Buddy operating" is a subtype of dual operating described in the Clark model, where two surgeons of comparable proficiency collaborate during complex procedures. Potential benefits include improved surgical efficacy and safety, shared intraoperative decision making, enhanced skill development, and improved surgeon wellbeing. However, implementation must be justified given resource constraints and potential impacts on surgical training. We propose that buddy operating should be selectively applied to clearly defined complex cases, supported by governance frameworks, structured protocols, and outcome monitoring. Importantly, buddy operating must be distinguished from supervisory training. Future research should evaluate its effects on clinical outcomes, cost-effectiveness, surgeon health, and access to training opportunities.