Established surgeons will have to work for a certificate of competence before they can practise keyhole surgery. The move follows growing numbers of cases of patients injured or even killed by surgeons who have wanted to try out the new procedure.
Few surgeons have any training in minimally invasive surgery which involves delicate micro instruments, including a laparoscope which transmits images of the organs onto a video screen (see WDDTY, vol 4, no 12).
As a result of these concerns, the senate of the royal surgical colleges of Great Britain and Ireland has introduced new quality assurance levels, including certification for competence. Training, assessment and certification will become mandatory, especially in the new technique.
Trainees found "inept or physically unable to use any particular techniques" will not receive certification and will be unable to carry out the procedure, a statement from the senate explains.
Monitoring and training would continue even after certification has been given.
However, the measures do not go far enough for Michael Silverman, who has mounted a one man campaign for better training after his wife died following keyhole surgery. He wants surgeons to attend nationally approved training programmes before they receive certification.
As a result of his campaign, the government may look at state controlled training for surgeons specifically on keyhole surgery instead of having self regulation and monitoring by the medical profession.