A comprehensive program for resident training in operative laparoscopy

Abstract

A comprehensive program for resident training in operative laparoscopy is presented in outline as an educational template. We understand that placing such concepts into action can be formidable. Strategies for implementation critically depend on identifying available methodologies that can help actualize each educational component. Both conceptual and visual-motor objectives can be satisfied by collectively matching with explanatory text, instruction manuals, inanimate exercises and practice, animate porcine correlates, and companion videotapes (both in vitro and in vivo) as necessary. Methods for validating the effectiveness of this program are in the process of development. Standardized neuropsychologic tools will be used to establish and monitor behavioral and psychometric benchmarks. Visiospatial benchmarks will be ascertained for motor processing using conventional in vitro exercises assessed by rate and efficiency. Ultimately, a properly oriented preceptor will assess benefits translated as improved surgical skills. After this training cascade, most technical achievements are realized after performing enough cases through level III, which contains types of laparoscopic surgeries that are realistically available and can be accomplished in most training institutions. Although some programs may provide the opportunity to experience the skill sets and procedures of levels IV and V, these levels are delineated for experienced and highly skilled laparoscopic surgeons and as content for fellowship programs for advanced laparoscopic surgery.