12 Training and regulation for endoscopic surgery

Abstract

As the use of endoscopic surgery in gynaecology develops, endoscopic techniques represent a larger proportion of the practised surgical techniques. Therefore there is a need for good training and regulation in endoscopic surgery for the benefit and well-being of our patients (Semm and Mettler, 1980; Semm, 1982; Ruckdeschel and Semm, 1988). Gynaecological endoscopic surgery (pelviscopy) has been the pacesetter for the change from the mainly organ-resecting gynaecological laparotomy to organ-preserving operative surgery. This stands for general surgical technologies as well. Minimally invasive surgery is still at the very beginning of its development as the major surgical technique practised and requires special training and regulation. Although we gynaecological have performed these surgical procedures for 20 years, we still lack guidelines for training and regulation of standards. Every patient requiring an endoscopic surgical procedure is prepared for a laparotomy and has to sign a consent form for a possible change from laparoscopy to laparotomy; if she wakes up with a laparotomy, she will understand that in her case laparotomy was the best procedure. Under these premises, this chapter tries to provoke the establishment of training and regulation in all countries.