Training in laparoscopic surgery--have we got it right yet?

Training in laparoscopic surgery started with short two to three-day courses, frequently unstructured and unaccredited, in a rush to provide surgeons with supposedly adequate training in laparoscopic techniques before performing laparoscopic cholecystectomy in patients. The high incidence of complications with this situation led to guidelines on training, credentialling and auditing being drawn up by several responsible professional bodies. Almost a decade after the introduction of laparoscopic cholecystectomy, the situation with training in laparoscopic surgery is still unresolved in many countries. This article reviews the current opinion on training in laparoscopic surgery, and presents the various teaching models and techniques employed to facilitate this process. Training in laparoscopic surgery should form part of the general surgery training programme, and should involve a combination of short introductory courses with hands-on animal models, and a period of preceptorship following this.