The Need for a Laparoscopic Skills Training Programme for Junior Surgeons

A Phaily, MBBS¹, J Thomas, MBBS², A Ali, MBBS, MRCS¹, A Robinson¹. ¹Ashford and St. Peter’s Hospitals NHS Foundation Trust, ²University Hospital of Wales

Background: 
Surgery has been revolutionised by the introduction of minimally invasive procedures such as laparoscopy. The rapid spread and dissemination of these procedures has left many surgical education programmes struggling to catch up to the advances, especially in the face of nascent robotics technology. Currently, there is exists no generally accepted laparoscopy training programme for junior surgical trainees in the United Kingdom. This article assesses the feasibility of such a programme and highlights its benefits and drawbacks.

Methods: 
A literature review and analysis of current international laparoscopic surgery curricula and their merits. A discussion of medical education theories, acquisition of practical skills and cost implications for healthcare trusts and Local Education and Training Boards (LETBs). Assessment of current and future models of technological innovation as applied to surgery.

Results: 
Current programmes such as the Fundamentals of Laparoscopic Surgery (FLS) and the Danish model focus heavily on formative assessment and certification. An outline of a novel laparoscopic surgery training programme is proposed. By the end of the programme, improvements will be seen in the following domains: spatial awareness, hand to eye co-ordination, efficiency of movement and tissue handling. Initial cost implications will be offset by development of the minimally invasive simulation suite and training courses for external applicants as a source of funding.

Conclusions: 
As advances in technology and its applications in surgery are accelerating, early formal training in new surgical techniques is not only recommended but necessary. Early training and adoption will enable surgeons to better adapt to future innovations in minimally invasive surgery.