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Our aim was to test our laparoscopic simulator for construct validity and for establishing performance standards. The skills of laparoscopic novices (n = 18) and advanced gynaecologists (experts, n = 5) were tested on our inanimate simulator by their performance of five tasks. The sum score was the sum of scores of all five tasks. We calculated the scores by adding completion time and penalty points. After baseline evaluation, the novices were assigned to five weekly training sessions (n = 8, training group) or no training (n = 10, control group). Both groups were retested. The experts were tested once, and their performance was compared with the baseline scores of all novices to establish construct validity. The training group improved significantly in all tasks. The final scores of the trained group were significantly better than those of the control group. The training group reached a plateau within seven trials, except for intra-corporeal knot tying. During final testing, the trained group reached the experts’ level of skills on the simulator. We concluded that our simulation model has construct validity. Novices can reach the experts’ basic laparoscopic skills level on the simulator after a short and intense simulator training course. Experts’ basic skills level on the simulator is an achievable performance standard during residency training.

In 2002, our group introduced an operation to avoid damage to the pelvic autonomous nerves during radical hysterectomy that proved to be feasible, effective and safe. During the last five years, we have adapted our surgical technique to make this procedure easier and safer in terms of radicality. We report on the changes in the surgical approach and the results in the first 15 consecutive patients. The Swift operation is more radical in the area of the uterosacral ligaments than the original operation, and it dissects the hypogastric nerve free under direct vision. In the area of the parametria, it is more radical in the deep lateral part. The vascular parametrial tissue is dissected and separated ventrally from the ureters. From October 2006 to February 2007, 15 consecutive patients with cervical cancer stage IA2 to IB2 underwent the Swift operation. The extra operating time amounted to 20 min, which was similar to the original operation, and with no extra blood loss. The suprapubic catheter was removed after a median of five days. Up until now (February 2008), no recurrences have been seen in these patients. It was concluded that the Swift procedure is easy to perform and that it offers advantages over the original operation in terms of safety and radicality.