Laparoscopic Training in Urology Residency Programs: A Systematic Review. 2019

Tiago Ribeiro de Oliveira, and Ben Van Cleynenbreugel, and Sérgio Pereira, and Pedro Oliveira, and Sandro Gaspar, and Nuno Domingues, and Tito Leitão, and Artur Palmas, and Tomé Lopes, and Hein Van Poppel
Department of Urology, Santa Maria University Hospital, Lisbon, Portugal.

OBJECTIVE Laparoscopy is a widespread surgical approach for many urological conditions. Achieving prof-ciency in laparoscopic surgery requires considerable effort due to the steep learning curve. Several residency programs include standardized laparoscopic training periods in their curricula. Our aim was to systematically analyze the evidence on the current status of training in laparoscopy in different residency programs in urology. METHODS We performed a systematic review of PubMed/Medline and the Cochrane library, in February 2018, according to the Preferred Reporting Items for the Systematic Review and Meta-Analyses Statement. Identified reports were reviewed according to the previously defined inclusion criteria. Eight publications, comprising a total of 985 urology residents, were selected for inclusion in this analysis. RESULTS There was a wide variation between training programs in terms of exposure to laparoscopy. Most residents considered that training in lap-aroscopy was inadequate during residency and had a low degree of confidence in independently performing laparo-scopic procedures by the end of the residency. Only North American residents reported high degrees of confidence in the possibility of performing laparoscopic procedures in the uture, whereas the remaining residents, namely from European countries, reported considerably lower degrees of confidence. CONCLUSIONS There were considerable differences between national urology residency programs in terms of exposure to laparoscopy. Most residents would prefer higher exposure to laparoscopy throughout their residencies.

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