National survey of surgeons' attitudes to laparoscopic surgical training in South Africa.

Abstract

Laparoscopic surgery forms an integral component of modern surgical practice. The perception exists that laparoscopic training in South Africa has been unplanned and under-resourced. This study set out to assess the opinions of surgeons and surgical trainees with regard to the various facets of laparoscopic surgical training. A national survey was conducted, using a questionnaire distributed to surgical staff of all academic surgical centres. Multiple variables were assessed, predominantly using the following numerical scoring system: 5--strongly agree; 4--agree; 3--neutral; 2--disagree; 1--strongly disagree. There were 122 respondents: 77 trainees and 45 consultants. The majority strongly agreed that laparoscopic training is essential for local surgical registrars. Current laparoscopic training was assessed as being average. Cholecystectomy, diagnostic laparoscopy, antireflux surgery and appendicectomy were the laparoscopic procedures deemed most important in training. The average number of laparoscopic cholecystectomies respondents thought were required for competency was 24. The major hurdle to training was lack of equipment and equipment shortages, and the majority felt that laparoscopic skills facilities and laparoscopy seminars would optimally augment training. Surgeons and trainees in academic units recognise the importance of laparoscopic training, but feel that it is currently not optimal. Consensus exists on appropriate procedures and what the hurdles are to training in our context. This knowledge can be applied to improve laparoscopic surgical training in South Africa.