Time for evidence-based minimal access surgery training—simulate or sink

Excerpt

As minimal access surgery (MAS) has become a significant component of routine surgical practice, the need for structured education and training in MAS techniques is evident. For surgical residents, training in MAS procedures is becoming increasingly of paramount importance and has to be regarded as an integral component of the surgical training curriculum. For those surgical trainees who, for whatever reason, have limited opportunity to acquire the necessary skills for MAS during their training (a temporary self-limiting situation, we hope), an even greater need exists for an efficient system of regional postgraduate specialist training and assessment in MAS to overcome this deficiency. The patient-directed increased demand for advanced MAS procedures in the treatment of morbid obesity, colonic resections, surgery for solid organ pathology, and many other operations requires the acquisition by the next generation of surgeons of a necessary level of proficiency to execute these operations competently. The acquisition of the component skills underpinning this operative competence, such as suturing and intra- and extracorporeal knot tying, safe anastomotic techniques, and safe deployment of energized dissection systems, is the best safeguard to quality execution and quality assurance that we can pass on to the next generation of endoscopic surgeons. This operative competence, together with the necessary humanistic skills, which we must not overlook, is the only way that will guarantee optimal clinical outcome of patients in years to come—our best and only legacy. …