The Society of American Gastrointestinal Endoscopic Surgeons (SAGES) endorses the following concepts for training in laparoscopic surgery.
1) Laparoscopic operations are integral components of general surgery.
2) Training of general surgeons in the foundations of laparoscopic surgery should occur within the general surgery residency. Training and certification in the Fundamentals of Laparoscopic Surgery is a part of this foundation.
3) General surgical training includes a defined number of basic1 laparoscopic operations and the minimum numbers set by the RRC serve as a reference point for basic laparoscopy exposure.
4) General surgical training also includes a defined number of advanced2 laparoscopic operations and the minimum numbers set by the RRC serve as a reference point for advanced laparoscopy exposure.
5) While all residents should meet the RRC requirements for advanced laparoscopy and endoscopy, Program Directors may be flexible and tailor the residency experience in advanced laparoscopic surgery for those individuals who are committed to a career in general surgery.
6) The RRC also requires 85 flexible endoscopy procedures, of which 50 should be colonoscopies.
(1) Basic laparoscopic surgery is comprised of: diagnostic laparoscopy, laparoscopic cholecystectomy, and laparoscopic appendectomy.
(2) Advanced laparoscopic surgery consists of all other laparoscopic operations. Specifically, the RRC considers the following procedures advanced laparoscopy:
Laparoscopic Gastrostomy and Feeding Jejunostomy placement
Laparoscopic Inguinal and Incisional Herniorrhaphy
Laparoscopic Bariatric Procedures
Laparoscopic Anti-reflux/esophageal Procedures
Laparoscopic Enterolysis
Laparoscopic Small and Large Bowel procedures
Laparoscopic Renal and Adrenal surgery
Laparoscopic Donor Nephrectomy
Laparoscopic Splenectomy
This document was prepared and reviewed by the Resident Education Committee. It was originally prepared by an ad hoc task force on Residency Integration in 1997 and approved in 2003 and in 2010 by the SAGES Board of Governors.
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Guidelines for clinical practice are intended to indicate preferable approaches to medical problems as established by experts in the field. These recommendations will be based on existing data or a consensus of expert opinion when little or no data are available. Guidelines are applicable to all physicians who address the clinical problem(s) without regard to specialty training or interests, and are intended to indicate the preferable, but not necessarily the only acceptable approaches due to the complexity of the healthcare environment. Guidelines are intended to be flexible. Given the wide range of specifics in any health care problem, the surgeon must always choose the course best suited to the individual patient and the variables in existence at the moment of decision.
Guidelines are developed under the auspices of the Society of American Gastrointestinal and Endoscopic Surgeons and its various committees, and approved by the Board of Governors. Each clinical practice guideline has been systematically researched, reviewed and revised by the guidelines committee, and reviewed by an appropriate multidisciplinary team. The recommendations are therefore considered valid at the time of its production based on the data available. Each guideline is scheduled for periodic review to allow incorporation of pertinent new developments in medical research knowledge, and practice.