The development of gynecological laparoscopy in The Netherlands is slow. Laparoscopic training needs more emphasis during residency training. The laparoscopic simulator needs to be officially... Show moreThe development of gynecological laparoscopy in The Netherlands is slow. Laparoscopic training needs more emphasis during residency training. The laparoscopic simulator needs to be officially implemented into residency curriculum guidelines and incorporated into practice. Simulator training should be structured and mandatory, as a training tool, as well as a skills assessment tool. In order for residents to obtain a sufficient and uniform level of skills, their surgical skills need to be measured individually and objectively by means of the simulator. In addition, experts' level on the simulator can be set as performance standards for residents and should be reached by residents before performing live laparoscopic surgery. Assisting during laparoscopic hysterectomy should be added to the requirements for graduation in the curriculum guidelines. To accomplish these recommendations, skilled laparoscopic gynecologists are required in every teaching hospital. Besides the beneficial aspects for residency training, a skilled laparoscopic gynecologist is needed to establish an internal referral system for procedures such as laparoscopic hysterectomy. For the other advanced laparoscopic procedures a regional or national referral system can be created. Show less
