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[Training in laparoscopy: from the laboratory to the operating room].

OBJECTIVES
To review all different steps in the process of learning laparoscopic surgery, presenting the guidelines that surgeon and his/her team should follow to successfully complete the process.


METHODS
We describe two levels of training: Basic, that is initiated with handling of instruments in simulators, and Advanced, which culminates with the practice of specific procedures in animal models.


RESULTS
At the basic level eye-hand coordination is acquired through exercises under direct vision in mechanical simulators. Later on, the use of optic and camera will allow to achieve eye-hand-TV monitor coordination. To use experimental and organic tissues permits to practice organic dissection and suture. Training at the advanced level is performed in research animals and makes up team work. Animal species selection, team composition, and anatomical protocol are of utmost importance to successfully complete the second phase.


CONCLUSIONS
Training in laparoscopic surgery is a complex process that implies surgeon's interaction with the rest of the team. Basic and advanced training must be available for all team members in order to assure satisfactory results in the difficult initial phase that should be mentored by an expert in laparoscopic surgery.