Ceh. Scottconner et al., THE INTEGRATION OF LAPAROSCOPY INTO A SURGICAL RESIDENCY AND IMPLICATIONS FOR THE TRAINING ENVIRONMENT, Surgical endoscopy, 8(9), 1994, pp. 1054-1057
Although laparoscopic cholecystectomy is now an accepted part of resid
ent training, the impact of operative laparoscopy (OL) upon the reside
ncy environment has not been examined in detail. We reviewed the first
3 years' experience with OL and the process by which it was introduce
d into our residency program. Data were obtained from our prospective
computerized surgical laparoscopic registry as well as from a survey c
onducted midway in this experience. At that time, a questionnaire was
sent to current residents in the program and residents who graduated a
fter the inception of the OL program were interviewed by telephone. OL
cases increased each year and comprised a progressively greater perce
ntage of total cases. Residents performed over 97% of cases, with atte
nding surgeons as first assistants. Initially, only senior-level resid
ents participated as surgeons; however, after the first year we noted
a significant tendency for cases to filter down the ranks. Junior-leve
l residents have already participated in more laparoscopic than open c
holecystectomies and expressed considerable concern about training in
open procedures. Graduated residents without exception were able to ob
tain privileges to perform OL without additional training. They did no
t feel that resident education was compromised by the advent of laparo
scopy. Both current and graduated residents considered didactic sessio
ns including animal laboratories and simulators an important part of t
raining. With appropriate use of didactic sessions, simulators, and an
imal laboratories, a radically new procedure (OL) can be successfully
introduced into a surgical residency program and subsequently taught t
hrough conventional means.