Training, proctoring, credentialing in endoscopic surgery

SummaryAlthough the procedures of endoscopic surgery are in many ways, simply a new way of approaching old, familiar problems, certain technical aspects are sufficiently different enough from the common experience of the general surgeon so as to require special training and certification for competency. The introduction of laparoscopic cholecystectomy worldwide showed that many aspects of endoscopic surgery deserved emphasis in training. These include the unique instruments, equipment, and techniques associated with videoendoscopic procedures and, perhaps of even greater importance, the differences in anatomic exposure and perspective afforded by the laparoscope [1–4]. Surgeons used to working in a three-dimensional environment with extensive tactile sensation were forced to learn to operate at a distance from the target tissue using instruments that provided much less feel for the tissues. Direct visualization of the operative field was replaced by a narrow field of view and a magnified, two-dimensional ...