TRAINING AND PRIVILEGING FOR NEW PROCEDURES

Hands-on training for advanced laparoscopic procedures is more difficu lt to obtain than for basic laparoscopy, but because morbidity and mor tality rates for these technically demanding procedures are higher, ad equate training is essential and obtained, ideally, through a formal f ellowship in advanced laparoscopy. Shorter preceptorships can provide adequate training but are more difficult to find. Few advanced laparos copic procedures are experimental, but the safety of each must be ensu red before a hospital awards privileges for their performance. Vigilan ce regarding local and national outcomes of these new procedures is es sential in this rapidly evolving field.