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Training in Urological laparoscopic surgery
Posted in Lectures on 10 April 2019

Dr. Francisco M. Sánchez Margallo (Scientific Director)
Dr. Javier Sánchez-Fernández (Training Coordinator)
Minimally Invasive Surgery Centre Jesús Usón (Cáceres, Spain)

Urology is becoming increasingly dependent on interdisciplinary cooperation between different areas of knowledge, technology and innovation. Thus, to meet new challenges, the current skills training and certification system requires permanent revision.

Laparoscopic surgery (LS) in urology has developed rapidly in recent decades. Considering the benefits of LS over conventional surgery, it is reasonable to increase the number of surgeries through this technique. However, this should imply an ongoing process of improvement in the provision of health services and also in the training of surgeons.

The design of a training program, in structured segments and with progressive complexity, provides adequate guidance to transfer the acquired skills to a real scenario with the appropriate safety levels for the patient. Therefore, simulators and animal models are essential tools as a follow-up to clinical training. In addition, ongoing training is crucial to update and renew knowledge and, in a field such as laparoscopy, mandatory.

In addition to the evident advances in robotics, there are many other developments that are emerging within the Urology field, in which urologists must necessarily be trained, such as portable technology and the development of medical imaging techniques, in collaboration with other specialists.

The traditional method of surgical training with a clear focus on motor skills and theoretical knowledge is still prevalent. However, non-technical skills should also be considered. Training programmes should provide a curriculum that covers not only this, but also communication, cognitive and non-technical expertise. However, most urologists do not receive a formal education and adequate training in these disciplines.

Similarly, current evaluation is often limited to theoretical knowledge rather than specific skills. We understand that assessment is an integral component of training, and the solid foundation upon which to base its accreditation. By establishing the use of a valid and objective tool, under clearly defined criteria, we will be able to ensure a thorough and rigorous evaluation that guarantees surgical training.

The technological revolution in which Urology also participates must be adequately reflected in the training plans for urologists. However, training in new techniques, approaches and technology cannot ignore training in conventional surgery, which should continue in a structured manner, with an effective ongoing training programme throughout the surgeon’s professional career. Finally, the evaluation of any given surgeon’s skills, and the analysis of health outcomes, is the ideal tool to validate the effectiveness of a training program.