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World J Surg (2017) 41:106107 DOI 10.1007/s00268-016-3741-5
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Total Extra-peritoneal Hernia Repair: Residency Teaching Program and Outcome Evaluation
Danny Rosin1,2
Published online: 13 October 2016 Socit Internationale de Chirurgie 2016
There is an inherent problem in modern surgical education: The more advanced, specialized, complex and technology-dependent surgery becomes, the less it includes teaching residents as an integral and natural part of the profession. Laparoscopy is often blamed for this change, with its infamous learning curves, but it is only part of the problem.
Highly complex procedures, such as robotic surgery, rarely involve residents as the rst operators (funny, when robotic surgery is advertised as making the operation easier for the surgeon). Even simpler procedures, such as breast surgery, became part of such a highly specialized discipline that patients are often treated solely by a dedicated breast surgeon, with minimal involvement of residents. Add to that the hour-limit rules of residency programsand the crisis in surgical teaching becomes obvious. While in the past, hernia and breast surgery were considered residents cases, and surgical residency produced a relatively mature and independent surgeon, almost no surgeon nowadays can become procient enough without a dedicated fellowship period, which is simply an extension of the training.
Hernia surgery has transformed as well in the last two decades, going in the same direction to become a specialized...