BERKELEY, CA (UroToday.com) - The aim of the present review was to study factors influencing training and the maintenance of skills in performing ureteroscopy (URS).
We searched on the following keywords in the Medline, Embase and Cochrane databases: renal or ureteric stone; ureteroscopy; endourology; educational; training; learning curve; expertise; skill; residency; practice; simulator; and robotics. We have defined, when possible, levels and grades of evidence, based on 2009 recommendations of the Oxford Centre for Evidence-Based Medicine. We found that technological advancement and surgeon experience is a predictive factor for success or complications of URS. Experience may be related to special endourology training, time passed after basic training and the number of procedures performed. Studies suggest that a resident must perform a certain amount of cases to gain proficiency with URS, but there is still a need for well designed studies for the learning curve of URS to be accurately defined. Training models may be useful for training in URS and stone disintegration. Stone centres that provide all the endoscopic treatment options seem to provide the best conditions to ensure a sufficient volume of patients required. Defining minimum requirements for training in URS and for maintaining certification is a major challenge, as is defining the learning curve in URS. Careful curriculum design in highvolume stone centres may be the key to optimizing URS training...View or save the full text Mini Review as a .pdf file
Andreas Skolarikos, Stavros Gravas*, M. Pilar Laguna,† Olivier Traxer,‡ Glenn M. Preminger§ and Jean de la Rosette¶
Athens Medical School, Second Department of Urology, Sismanoglio Hospital, *University of Thesaly, Department of Urology, Athens, Greece, †Department of Urology, AMC University Hospital, Amsterdam, The Netherlands, ‡Department of Urology, Pierre et Marie Curie University Paris VI, Paris, France, §Comprehensive Kidney Stone Center, Department of Urology, Duke University Medical Center, Durham, NC, USA, and ¶Department of Urology, AMC University Hospital, Amsterdam, The Netherlands
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