Abstract
The first laparoscopic nephrectomy performed in 1990 heralded a new era in urological surgery. Since then there has been an exponential increase in the number of laparoscopic cases being performed each year with over 4000 laparoscopic nephrectomies performed in England in 2013. With increasing surgical experience the indications for minimally access approaches have also expanded to include even more complex procedures such as radical prostatectomy and cystectomy. Whilst this changing landscape brings significant patient benefits it is accompanied by very real challenges for surgical trainers. Recent changes to training mean that trainees must acquire these new and demanding technical skills during a shortened training programme. As a result we must carefully consider how surgeons learn new skills and incorporate these principles into laparoscopic training. A curriculum for learning advanced laparoscopy should include appropriate simulation, mentorship and assessment of competence.
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References
Shah J. Endoscopy through the ages. BJUI. 2002;89:645–52.
Clayman RV, Kavoussi LR, Soper NJ, et al. Laparoscopic nephrectomy: initial case report. J Urol. 1991;146:278–82.
Ljungberg B, Bensalah K, Bex A, et al. Guidelines on renal cell carcinoma. European Association of Urology. Eur Urol. 2013;67(5):913–24.
Finkelstein J, Eckersberger E, Sadri H, et al. Open versus laparoscopic versus robot-assisted laparoscopic prostatectomy: the European and US experience. Rev Urol. 2010;12(1):35–43.
Schon D. Preparing professionals for the demands of practice p3 in educating the reflective practitioner. San Francisco: Jossey-Bass Inc Publishers; 1987.
Department of Health. Hospital Doctors: training for the future. The Report of the Working Group on Specialist Medical Training. London: Department of Health; 1993.
Cresswell B, Marron C, Hawkins W, et al. Optimising working hours to provide quality in training and patient safety a position statement by The Association of Surgeons in Training. 2009.
Chikwe J, deSouza AC, Pepper JR. No time to train the surgeons. BMJ. 2004;328(7437):418–9.
Ericsson KA. Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Acad Med. 2004;79(10):S70–81.
Davenport K, Timoney AG, Keeley Jr FX, Joyce AD, Downey P. A 3-year review of the British Association of Urological Surgeons Section of Endourology Laparoscopic Nephrectomy Audit. BJUI. 2006;97:333–7.
Department of Health. ‘The NHS Plan’ Department of Health, London; 2000.
Joint Committee on Surgical Training. Guidelines for the award of a CCT in Urology. 2012. http://www.jcst.org/quality-assurance/documents/cct-guidelines/urology-cct-guidelines.
Imamura M, McLennan S, Lapitan MC, et al. The UCAN Systematic Review Reference Group and the EAU Guideline Group for renal cell carcinoma. Systematic review of clinical effectiveness of surgical management for localized renal cell carcinoma. 2011. University of Aberdeen, Academic Urology Unit: www.uroweb.org/.
Stolzenberg J, Rabenalt R, do M, Horn LC, Liatsikos EN. Modular training for residents with no prior experience with open pelvic surgery in endoscopic extraperitoneal radical prostatectomy. Eur Urol. 2005;49:491–500.
Kneebone R. Evaluating clinical simulations for learning procedural skills: a theory-based approach. Acad Med. 2005;80(6):549–53.
Vygotsky LS. Thought and language. Cambridge, MA: Harvard University Press; 1962.
Wood D. How children think and learn. 2nd ed. Oxford: Blackwell; 1998.
BAUS Section of Oncology, Analyses of Nephrectomy Dataset Jan 1st – 31st Dec 2013. June 2014.
BAUS Section of Oncology, Analyses of Prostatectomy Dataset Jan 1st – 31st Dec 2012. June 2013.
BAUS Section of Oncology, Analyses of Cystectomy Dataset Jan 1st – Dec 31st. June 2014.
Gill IS, Martin SF, Desai MM, et al. Comparative analysis of laparoscopic versus open partial nephrectomy for renal tumours in 200 patients. J Urol. 2003;170(1):64–8.
Keeley FX, Rimington P, Timoney AG, McClinton S. BAUS laparoscopic mentorship guidelines. BAUS. 2007;100(2):247–8.
Stewart GD, Phipps S, Little B, et al. Description and validation of a modular training system for laparoscopic nephrectomy. J Endourol. 2012;26(11):1512–7.
Stolzenburg J, Schwaibold H, Bhanot SM, et al. Modular surgical training for endoscopic extraperitoneal radical prostatectomy. BJUI. 2005;96:1022–7.
Martina GR, Giumelli P, Scuzzarella S, et al. Laparoscopic extraperitoneal radical prostatectomy – learning curve of a laparoscopy naive urologist in a community hospital. Urology. 2005;65:959–63.
Miller G. The assessment of clinical skills/competence/performance. Acad Med. 1990;65(9):S63–7.
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Sweeney, C., McNeill, A. (2015). Teaching Advanced Laparoscopic Skills in Urological Surgery. In: Francis, N., Fingerhut, A., Bergamaschi, R., Motson, R. (eds) Training in Minimal Access Surgery. Springer, London. https://doi.org/10.1007/978-1-4471-6494-4_8
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DOI: https://doi.org/10.1007/978-1-4471-6494-4_8
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