Abstract
Objective: To determine the current state of training of urology residents in Spain in laparoscopic surgery and robotic urologic surgery Methods: At the Department of Urology of the Clinico San Carlos Hospital in Madrid these methods were surveyed and directed to Spanish residents, during the period between 2011 and May 2012. We designed a survey that was disseminated through the website (www.seclaendosurgery.com) of the Spanish Society of Laparoscopic and Robotic Surgery (SECLA) to all intern doctors at any Spanish hospital Results: Of a total of 384 residents in Urology, 36 responded to the survey (9.3%). The data related to endoscopic procedures showed that 25% of respondents have never participated in the placement of a percutaneous nephrostomy (n=36), or expected to. By contrast, 77% say that they have done it as surgeons in ureteroscopy (n=36) and 25% did it in more than ten procedures. The 54’4% of respondents have participated as surgeons in percutaneous nephrolitectomy (n=28) and 79% expected to do it. The participation of residents in assisted procedures with the da Vinci robot is low. Laparoscopic procedures are of great interest and participation is reduced on increasing the complexity of the procedure. 41.6% of respondents think that their training is adequate while 58.3% think it is not. 88% think that their training could be improved with courses and seminars and by gaining more responsibility in the operating room and 50% that their training could be supplemented with external rotations and/or fellowships Conclusion: It is necessary to define what the best ways are to start in laparoscopy surgery and to improve participation in basic laparoscopic procedures to improve the residents’ skills and to get the right training in more difficult surgeries. The participation in endoscopic procedures is acceptable.
Highlights
The rapid development of minimally invasive surgery coupled with the complexity of the different techniques is a challenge when training new specialists, especially if you consider that formed urologists have not completed their learning curve yet
The increase of urology residency positions, offered by government agencies, even in centres where there is no chance of getting training in these techniques, resulting in a diversification of surgical treatment of different pathologies and heterogeneous ways in the manner of treating
This causes a decrease of the number of minimally invasive surgeries achievable by a resident physician, being undermined by the quality of their training [1,2]
Summary
The rapid development of minimally invasive surgery coupled with the complexity of the different techniques is a challenge when training new specialists, especially if you consider that formed urologists have not completed their learning curve yet. The increase of urology residency positions, offered by government agencies, even in centres where there is no chance of getting training in these techniques, resulting in a diversification of surgical treatment of different pathologies and heterogeneous ways in the manner of treating. This causes a decrease of the number of minimally invasive surgeries achievable by a resident physician, being undermined by the quality of their training [1,2]. This is the case of simulation, proper animal legal requirements, courses, seminars, rotations and fellowships could lead to fill the gaps we face today [3]
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