Advanced Hysteroscopic Surgery Training
Identifieur interne : 002093 ( Pmc/Curation ); précédent : 002092; suivant : 002094Advanced Hysteroscopic Surgery Training
Auteurs : Mark M. Erian ; Glenda R. Mclaren ; Anna-Marie ErianSource :
- JSLS : Journal of the Society of Laparoendoscopic Surgeons [ 1086-8089 ] ; 2014.
Abstract
Hysteroscopic surgery is pivotal in management of many gynecological pathologies. The skills required for performing advanced hysteroscopic surgery (AHS), eg, transcervical hysteroscopic endometrial resection (TCRE), hysteroscopic polypectomy and myomectomy in the management of menorrhagia, hysteroscopic septulysis in fertility-related gynecological problems and hysteroscopic removal of chronically retained products of conception and excision of intramural ectopic pregnancy ought to be practiced by contemporary gynecological surgeons in their day-to-day clinical practice. AHS is a minimally invasive procedure that preserves the uterus in most cases. Whilst the outcome is of paramount importance, proper training should be adopted and followed through so that doctors, nurses, and institutions may deliver the highest standard of patient care.
Url:
DOI: 10.4293/JSLS.2014.00396
PubMed: 25392678
PubMed Central: 4216174
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Advanced Hysteroscopic Surgery Training</title><author><name sortKey="Erian, Mark M" sort="Erian, Mark M" uniqKey="Erian M" first="Mark M." last="Erian">Mark M. Erian</name></author><author><name sortKey="Mclaren, Glenda R" sort="Mclaren, Glenda R" uniqKey="Mclaren G" first="Glenda R." last="Mclaren">Glenda R. Mclaren</name></author><author><name sortKey="Erian, Anna Marie" sort="Erian, Anna Marie" uniqKey="Erian A" first="Anna-Marie" last="Erian">Anna-Marie Erian</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25392678</idno><idno type="pmc">4216174</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4216174</idno><idno type="RBID">PMC:4216174</idno><idno type="doi">10.4293/JSLS.2014.00396</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">002093</idno><idno type="wicri:Area/Pmc/Curation">002093</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Advanced Hysteroscopic Surgery Training</title><author><name sortKey="Erian, Mark M" sort="Erian, Mark M" uniqKey="Erian M" first="Mark M." last="Erian">Mark M. Erian</name></author><author><name sortKey="Mclaren, Glenda R" sort="Mclaren, Glenda R" uniqKey="Mclaren G" first="Glenda R." last="Mclaren">Glenda R. Mclaren</name></author><author><name sortKey="Erian, Anna Marie" sort="Erian, Anna Marie" uniqKey="Erian A" first="Anna-Marie" last="Erian">Anna-Marie Erian</name></author></analytic><series><title level="j">JSLS : Journal of the Society of Laparoendoscopic Surgeons</title><idno type="ISSN">1086-8089</idno><idno type="eISSN">1938-3797</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Hysteroscopic surgery is pivotal in management of many gynecological pathologies. The skills required for performing advanced hysteroscopic surgery (AHS), eg, transcervical hysteroscopic endometrial resection (TCRE), hysteroscopic polypectomy and myomectomy in the management of menorrhagia, hysteroscopic septulysis in fertility-related gynecological problems and hysteroscopic removal of chronically retained products of conception and excision of intramural ectopic pregnancy ought to be practiced by contemporary gynecological surgeons in their day-to-day clinical practice. AHS is a minimally invasive procedure that preserves the uterus in most cases. Whilst the outcome is of paramount importance, proper training should be adopted and followed through so that doctors, nurses, and institutions may deliver the highest standard of patient care.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Lethaby, A" uniqKey="Lethaby A">A Lethaby</name></author><author><name sortKey="Penninx, J" uniqKey="Penninx J">J Penninx</name></author><author><name sortKey="Hickey, M" uniqKey="Hickey M">M Hickey</name></author><author><name sortKey="Garry, R" uniqKey="Garry R">R Garry</name></author><author><name sortKey="Marjoribanks, J" uniqKey="Marjoribanks J">J Marjoribanks</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tonguc, Ea" uniqKey="Tonguc E">EA Tonguc</name></author><author><name sortKey="Var, T" uniqKey="Var T">T Var</name></author><author><name sortKey="Batioglu, S" uniqKey="Batioglu S">S Batioglu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Golan, A" uniqKey="Golan A">A Golan</name></author><author><name sortKey="Dishi, M" uniqKey="Dishi M">M Dishi</name></author><author><name sortKey="Shalev, A" uniqKey="Shalev A">A Shalev</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wu, Pj" uniqKey="Wu P">PJ Wu</name></author><author><name sortKey="Han, Cm" uniqKey="Han C">CM Han</name></author><author><name sortKey="Wang, Cj" uniqKey="Wang C">CJ Wang</name></author><author><name sortKey="Lee, Cl" uniqKey="Lee C">CL Lee</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Litta, P" uniqKey="Litta P">P Litta</name></author><author><name sortKey="Bartolucci, C" uniqKey="Bartolucci C">C Bartolucci</name></author><author><name sortKey="Saccardi, C" uniqKey="Saccardi C">C Saccardi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mccormick, Ph" uniqKey="Mccormick P">PH McCormick</name></author><author><name sortKey="Tanner, Wa" uniqKey="Tanner W">WA Tanner</name></author><author><name sortKey="Kean, Fb" uniqKey="Kean F">FB Kean</name></author><author><name sortKey="Tierney, S" uniqKey="Tierney S">S Tierney</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Rackow, Bw" uniqKey="Rackow B">BW Rackow</name></author><author><name sortKey="Solnik, Mj" uniqKey="Solnik M">MJ Solnik</name></author><author><name sortKey="Tu, Ff" uniqKey="Tu F">FF Tu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Arendas, K" uniqKey="Arendas K">K Arendas</name></author><author><name sortKey="Posner, Gd" uniqKey="Posner G">GD Posner</name></author><author><name sortKey="Singh, Ss" uniqKey="Singh S">SS Singh</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="De Wilde, Rl" uniqKey="De Wilde R">RL De Wilde</name></author><author><name sortKey="Hucke, J" uniqKey="Hucke J">J Hucke</name></author><author><name sortKey="Kolmorgen, K" uniqKey="Kolmorgen K">K Kolmorgen</name></author><author><name sortKey="Tinneberg, H" uniqKey="Tinneberg H">H Tinneberg</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Einarsson, Ji" uniqKey="Einarsson J">JI Einarsson</name></author><author><name sortKey="Sangi Haghpeykar, H" uniqKey="Sangi Haghpeykar H">H Sangi-Haghpeykar</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hiemstra, E" uniqKey="Hiemstra E">E Hiemstra</name></author><author><name sortKey="Kolkman, W" uniqKey="Kolkman W">W Kolkman</name></author><author><name sortKey="Le Cessie, S" uniqKey="Le Cessie S">S le Cessie</name></author><author><name sortKey="Jansen, Fw" uniqKey="Jansen F">FW Jansen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bodle, Jf" uniqKey="Bodle J">JF Bodle</name></author><author><name sortKey="Duffy, Sr" uniqKey="Duffy S">SR Duffy</name></author><author><name sortKey="Binney, Dm" uniqKey="Binney D">DM Binney</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Morozov, V" uniqKey="Morozov V">V Morozov</name></author><author><name sortKey="Nezhat, C" uniqKey="Nezhat C">C Nezhat</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Munro, Mg" uniqKey="Munro M">MG Munro</name></author><author><name sortKey="Storz, K" uniqKey="Storz K">K Storz</name></author><author><name sortKey="Abbott, Ja" uniqKey="Abbott J">JA Abbott</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bahar, R" uniqKey="Bahar R">R Bahar</name></author><author><name sortKey="Shimonovitz, M" uniqKey="Shimonovitz M">M Shimonovitz</name></author><author><name sortKey="Benshushan, A" uniqKey="Benshushan A">A Benshushan</name></author><author><name sortKey="Shushan, A" uniqKey="Shushan A">A Shushan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Berman, Jm" uniqKey="Berman J">JM Berman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Olive, Dl" uniqKey="Olive D">DL Olive</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nisolle, M" uniqKey="Nisolle M">M Nisolle</name></author><author><name sortKey="Delbecque, K" uniqKey="Delbecque K">K Delbecque</name></author><author><name sortKey="Perrier D Hauterive, S" uniqKey="Perrier D Hauterive S">S Perrier D'Hauterive</name></author><author><name sortKey="Firquet, A" uniqKey="Firquet A">A Firquet</name></author><author><name sortKey="Chantraine, F" uniqKey="Chantraine F">F Chantraine</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Macchi, V" uniqKey="Macchi V">V Macchi</name></author><author><name sortKey="Munari, Pf" uniqKey="Munari P">PF Munari</name></author><author><name sortKey="Brizzi, E" uniqKey="Brizzi E">E Brizzi</name></author><author><name sortKey="Parenti, A" uniqKey="Parenti A">A Parenti</name></author><author><name sortKey="De Caro, R" uniqKey="De Caro R">R De Caro</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Munro, Mg" uniqKey="Munro M">MG Munro</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Stamatopoulos, Cp" uniqKey="Stamatopoulos C">CP Stamatopoulos</name></author><author><name sortKey="Mikos, T" uniqKey="Mikos T">T Mikos</name></author><author><name sortKey="Grimbizis, Gf" uniqKey="Grimbizis G">GF Grimbizis</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Maia, H" uniqKey="Maia H">H Maia</name></author><author><name sortKey="Haddad, C" uniqKey="Haddad C">C Haddad</name></author><author><name sortKey="Casoy, J" uniqKey="Casoy J">J Casoy</name></author><author><name sortKey="Maia, R" uniqKey="Maia R">R Maia</name></author><author><name sortKey="Pinheiro, N" uniqKey="Pinheiro N">N Pinheiro</name></author><author><name sortKey="Coutinho, Em" uniqKey="Coutinho E">EM Coutinho</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Munro, Mc" uniqKey="Munro M">MC Munro</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Berg, A" uniqKey="Berg A">A Berg</name></author><author><name sortKey="Sandvik, L" uniqKey="Sandvik L">L Sandvik</name></author><author><name sortKey="Langebrekke, A" uniqKey="Langebrekke A">A Langebrekke</name></author><author><name sortKey="Istre, O" uniqKey="Istre O">O Istre</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sinha, M" uniqKey="Sinha M">M Sinha</name></author><author><name sortKey="Hegde, A" uniqKey="Hegde A">A Hegde</name></author><author><name sortKey="Sinha, R" uniqKey="Sinha R">R Sinha</name></author><author><name sortKey="Goel, S" uniqKey="Goel S">S Goel</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="De Freitas Fonseca, M" uniqKey="De Freitas Fonseca M">M De Freitas Fonseca</name></author><author><name sortKey="Andrade, Cm" uniqKey="Andrade C">CM Andrade</name></author><author><name sortKey="De Mello, Mj" uniqKey="De Mello M">MJ de Mello</name></author><author><name sortKey="Crispi, Cp" uniqKey="Crispi C">CP Crispi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Birdsell, Dc" uniqKey="Birdsell D">DC Birdsell</name></author><author><name sortKey="Mattatall, F" uniqKey="Mattatall F">F Mattatall</name></author><author><name sortKey="Rosengarten, Am" uniqKey="Rosengarten A">AM Rosengarten</name></author><author><name sortKey="Watson, Sd" uniqKey="Watson S">SD Watson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wortman, M" uniqKey="Wortman M">M Wortman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bergeron, Me" uniqKey="Bergeron M">ME Bergeron</name></author><author><name sortKey="Ouellet, P" uniqKey="Ouellet P">P Ouellet</name></author><author><name sortKey="Bujold, E" uniqKey="Bujold E">E Bujold</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sammarco, Mj" uniqKey="Sammarco M">MJ Sammarco</name></author><author><name sortKey="Youngblood, Jp" uniqKey="Youngblood J">JP Youngblood</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chen, I" uniqKey="Chen I">I Chen</name></author><author><name sortKey="Bajzak, Ki" uniqKey="Bajzak K">KI Bajzak</name></author><author><name sortKey="Guo, Y" uniqKey="Guo Y">Y Guo</name></author><author><name sortKey="Singh, Ss" uniqKey="Singh S">SS Singh</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Manning, N" uniqKey="Manning N">N Manning</name></author><author><name sortKey="Phillips, A" uniqKey="Phillips A">A Phillips</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Di Spiezio Sardo, A" uniqKey="Di Spiezio Sardo A">A Di Spiezio Sardo</name></author><author><name sortKey="Taylor, A" uniqKey="Taylor A">A Taylor</name></author><author><name sortKey="Tsirkas, P" uniqKey="Tsirkas P">P Tsirkas</name></author><author><name sortKey="Mastrogamvrakis, G" uniqKey="Mastrogamvrakis G">G Mastrogamvrakis</name></author><author><name sortKey="Sharma, M" uniqKey="Sharma M">M Sharma</name></author><author><name sortKey="Magos, A" uniqKey="Magos A">A Magos</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Van Dongen, H" uniqKey="Van Dongen H">H Van Dongen</name></author><author><name sortKey="Kolkman, W" uniqKey="Kolkman W">W Kolkman</name></author><author><name sortKey="Jansen, Fw" uniqKey="Jansen F">FW Jansen</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Kim, Ww" uniqKey="Kim W">WW Kim</name></author><author><name sortKey="Gagner, M" uniqKey="Gagner M">M Gagner</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hasson, Hm" uniqKey="Hasson H">HM Hasson</name></author><author><name sortKey="Getzels, J" uniqKey="Getzels J">J Getzels</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Janse, Ja" uniqKey="Janse J">JA Janse</name></author><author><name sortKey="Pattij, To" uniqKey="Pattij T">TO Pattij</name></author><author><name sortKey="Eijkemans, Mj" uniqKey="Eijkemans M">MJ Eijkemans</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Theroux, R" uniqKey="Theroux R">R Theroux</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Stovall, Tg" uniqKey="Stovall T">TG Stovall</name></author><author><name sortKey="Ling, Fw" uniqKey="Ling F">FW Ling</name></author><author><name sortKey="Lipscomb, Gh" uniqKey="Lipscomb G">GH Lipscomb</name></author><author><name sortKey="Summitt, Rl" uniqKey="Summitt R">RL Summitt</name></author><author><name sortKey="Beckmann, Cr" uniqKey="Beckmann C">CR Beckmann</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Di Spiezio Spardo, A" uniqKey="Di Spiezio Spardo A">A Di Spiezio Spardo</name></author><author><name sortKey="Bettocchi, S" uniqKey="Bettocchi S">S Bettocchi</name></author><author><name sortKey="Spinelli, M" uniqKey="Spinelli M">M Spinelli</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wortman, M" uniqKey="Wortman M">M Wortman</name></author><author><name sortKey="Daggett, Af" uniqKey="Daggett A">AF Daggett</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Feldman, Ls" uniqKey="Feldman L">LS Feldman</name></author><author><name sortKey="Hagarty, Se" uniqKey="Hagarty S">SE Hagarty</name></author><author><name sortKey="Ghitulescu, G" uniqKey="Ghitulescu G">G Ghitulescu</name></author><author><name sortKey="Stanbridge, D" uniqKey="Stanbridge D">D Stanbridge</name></author><author><name sortKey="Fried, Gm" uniqKey="Fried G">GM Fried</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jensen, A" uniqKey="Jensen A">A Jensen</name></author><author><name sortKey="Milner, R" uniqKey="Milner R">R Milner</name></author><author><name sortKey="Fisher, C" uniqKey="Fisher C">C Fisher</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lashbrook, Dl" uniqKey="Lashbrook D">DL Lashbrook</name></author><author><name sortKey="Frazier, Lm" uniqKey="Frazier L">LM Frazier</name></author><author><name sortKey="Horbelt, Dv" uniqKey="Horbelt D">DV Horbelt</name></author><author><name sortKey="Stembridge, Tw" uniqKey="Stembridge T">TW Stembridge</name></author><author><name sortKey="Rall, Mj" uniqKey="Rall M">MJ Rall</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Blanchard, Mh" uniqKey="Blanchard M">MH Blanchard</name></author><author><name sortKey="Amini, Sb" uniqKey="Amini S">SB Amini</name></author><author><name sortKey="Frank, Tm" uniqKey="Frank T">TM Frank</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dimick, Jb" uniqKey="Dimick J">JB Dimick</name></author><author><name sortKey="Pronovost, Pj" uniqKey="Pronovost P">PJ Pronovost</name></author><author><name sortKey="Cowan, Ja" uniqKey="Cowan J">JA Cowan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Peterson, Ed" uniqKey="Peterson E">ED Peterson</name></author><author><name sortKey="Coombs, Lp" uniqKey="Coombs L">LP Coombs</name></author><author><name sortKey="Delong, Er" uniqKey="Delong E">ER DeLong</name></author><author><name sortKey="Haan, Ck" uniqKey="Haan C">CK Haan</name></author><author><name sortKey="Ferguson, Tb" uniqKey="Ferguson T">TB Ferguson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Koperna, T" uniqKey="Koperna T">T Koperna</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bridges, M" uniqKey="Bridges M">M Bridges</name></author><author><name sortKey="Diamond, Dl" uniqKey="Diamond D">DL Diamond</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Levie, M" uniqKey="Levie M">M Levie</name></author><author><name sortKey="Chudnoff, Sg" uniqKey="Chudnoff S">SG Chudnoff</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pascual Pedre O, A" uniqKey="Pascual Pedre O A">A Pascual-Pedreño</name></author><author><name sortKey="Perez Medina, T" uniqKey="Perez Medina T">T Perez-Medina</name></author><author><name sortKey="Brouard Urkiaga, I" uniqKey="Brouard Urkiaga I">I Brouard Urkiaga</name></author><author><name sortKey="Fernandez Parra, J" uniqKey="Fernandez Parra J">J Fernández-Parra</name></author><author><name sortKey="Sobreviela Laserrada, M" uniqKey="Sobreviela Laserrada M">M Sobreviela-Laserrada</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lipscomb, Gh" uniqKey="Lipscomb G">GH Lipscomb</name></author><author><name sortKey="Stovall, Tg" uniqKey="Stovall T">TG Stovall</name></author><author><name sortKey="Ling, Fw" uniqKey="Ling F">FW Ling</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Wolfe, Wm" uniqKey="Wolfe W">WM Wolfe</name></author><author><name sortKey="Levine, Rl" uniqKey="Levine R">RL Levine</name></author><author><name sortKey="Sanfilippo, Js" uniqKey="Sanfilippo J">JS Sanfilippo</name></author><author><name sortKey="Eggler, S" uniqKey="Eggler S">S Eggler</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ng, Yw" uniqKey="Ng Y">YW Ng</name></author><author><name sortKey="Fong, Yf" uniqKey="Fong Y">YF Fong</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kingston, A" uniqKey="Kingston A">A Kingston</name></author><author><name sortKey="Abbott, J" uniqKey="Abbott J">J Abbott</name></author><author><name sortKey="Lenart, M" uniqKey="Lenart M">M Lenart</name></author><author><name sortKey="Vancaillie, T" uniqKey="Vancaillie T">T Vancaillie</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Levinson, Cj" uniqKey="Levinson C">CJ Levinson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Macedonia, Cr" uniqKey="Macedonia C">CR Macedonia</name></author><author><name sortKey="Gherman, Rb" uniqKey="Gherman R">RB Gherman</name></author><author><name sortKey="Satin, Aj" uniqKey="Satin A">AJ Satin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lim, F" uniqKey="Lim F">F Lim</name></author><author><name sortKey="Brown, I" uniqKey="Brown I">I Brown</name></author><author><name sortKey="Mccoll, R" uniqKey="Mccoll R">R McColl</name></author><author><name sortKey="Seligman, C" uniqKey="Seligman C">C Seligman</name></author><author><name sortKey="Alsaraira, A" uniqKey="Alsaraira A">A Alsaraira</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lim, F" uniqKey="Lim F">F Lim</name></author><author><name sortKey="Brown, I" uniqKey="Brown I">I Brown</name></author><author><name sortKey="Mccoll, R" uniqKey="Mccoll R">R McColl</name></author><author><name sortKey="Seligman, C" uniqKey="Seligman C">C Seligman</name></author><author><name sortKey="Alsaraira, A" uniqKey="Alsaraira A">A Alsaraira</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Niitsu, H" uniqKey="Niitsu H">H Niitsu</name></author><author><name sortKey="Hirabayashi, N" uniqKey="Hirabayashi N">N Hirabayashi</name></author><author><name sortKey="Yoshimitsu, M" uniqKey="Yoshimitsu M">M Yoshimitsu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Adrales, Gl" uniqKey="Adrales G">GL Adrales</name></author><author><name sortKey="Donnelly, Mb" uniqKey="Donnelly M">MB Donnelly</name></author><author><name sortKey="Chu, Ub" uniqKey="Chu U">UB Chu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bajka, M" uniqKey="Bajka M">M Bajka</name></author><author><name sortKey="Tuchschmid, S" uniqKey="Tuchschmid S">S Tuchschmid</name></author><author><name sortKey="Streich, M" uniqKey="Streich M">M Streich</name></author><author><name sortKey="Fink, D" uniqKey="Fink D">D Fink</name></author><author><name sortKey="Szekely, G" uniqKey="Szekely G">G Székely</name></author><author><name sortKey="Harders, M" uniqKey="Harders M">M Harders</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Burchard, Er" uniqKey="Burchard E">ER Burchard</name></author><author><name sortKey="Lockrow, Eg" uniqKey="Lockrow E">EG Lockrow</name></author><author><name sortKey="Zahn, Cm" uniqKey="Zahn C">CM Zahn</name></author><author><name sortKey="Dunlow, Sg" uniqKey="Dunlow S">SG Dunlow</name></author><author><name sortKey="Satin, Aj" uniqKey="Satin A">AJ Satin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lentz, Gm" uniqKey="Lentz G">GM Lentz</name></author><author><name sortKey="Mandel, Ls" uniqKey="Mandel L">LS Mandel</name></author><author><name sortKey="Lee, D" uniqKey="Lee D">D Lee</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mccloy, R" uniqKey="Mccloy R">R McCloy</name></author><author><name sortKey="Stone, R" uniqKey="Stone R">R Stone</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Berguer, R" uniqKey="Berguer R">R Berguer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bajka, M" uniqKey="Bajka M">M Bajka</name></author><author><name sortKey="Tuchschmid, S" uniqKey="Tuchschmid S">S Tuchschmid</name></author><author><name sortKey="Fink, D" uniqKey="Fink D">D Fink</name></author><author><name sortKey="Szekely, G" uniqKey="Szekely G">G Székely</name></author><author><name sortKey="Harders, M" uniqKey="Harders M">M Harders</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gallagher, Ag" uniqKey="Gallagher A">AG Gallagher</name></author><author><name sortKey="Satava, Rm" uniqKey="Satava R">RM Satava</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hiemstra, E" uniqKey="Hiemstra E">E Hiemstra</name></author><author><name sortKey="Kolkman, W" uniqKey="Kolkman W">W Kolkman</name></author><author><name sortKey="Jansen, Fw" uniqKey="Jansen F">FW Jansen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Aydeniz, B" uniqKey="Aydeniz B">B Aydeniz</name></author><author><name sortKey="Gruber, Iv" uniqKey="Gruber I">IV Gruber</name></author><author><name sortKey="Schauf, B" uniqKey="Schauf B">B Schauf</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Anne Claire, J" uniqKey="Anne Claire J">J Anne-Claire</name></author><author><name sortKey="Denis, Q" uniqKey="Denis Q">Q Denis</name></author><author><name sortKey="Patrick, D" uniqKey="Patrick D">D Patrick</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Szekely, G" uniqKey="Szekely G">G Szekely</name></author><author><name sortKey="Bajka, M" uniqKey="Bajka M">M Bajka</name></author><author><name sortKey="Brechbuhler, C" uniqKey="Brechbuhler C">C Brechbuhler</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Brunner, Wc" uniqKey="Brunner W">WC Brunner</name></author><author><name sortKey="Korndorffer, Jr" uniqKey="Korndorffer J">JR Korndorffer</name></author><author><name sortKey="Sierra, R" uniqKey="Sierra R">R Sierra</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Erian, M" uniqKey="Erian M">M Erian</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chudnoff, Sg" uniqKey="Chudnoff S">SG Chudnoff</name></author><author><name sortKey="Liu, Cs" uniqKey="Liu C">CS Liu</name></author><author><name sortKey="Levie, Md" uniqKey="Levie M">MD Levie</name></author><author><name sortKey="Bernstein, P" uniqKey="Bernstein P">P Bernstein</name></author><author><name sortKey="Banks, Eh" uniqKey="Banks E">EH Banks</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Harders, M" uniqKey="Harders M">M Harders</name></author><author><name sortKey="Steinemann, D" uniqKey="Steinemann D">D Steinemann</name></author><author><name sortKey="Gross, M" uniqKey="Gross M">M Gross</name></author><author><name sortKey="Szekely, G" uniqKey="Szekely G">G Székely</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Panel, P" uniqKey="Panel P">P Panel</name></author><author><name sortKey="Bajka, M" uniqKey="Bajka M">M Bajka</name></author><author><name sortKey="Le Tohic, A" uniqKey="Le Tohic A">A Le Tohic</name></author><author><name sortKey="Ghoneimi, Ae" uniqKey="Ghoneimi A">AE Ghoneimi</name></author><author><name sortKey="Chis, C" uniqKey="Chis C">C Chis</name></author><author><name sortKey="Cotin, S" uniqKey="Cotin S">S Cotin</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">JSLS</journal-id><journal-id journal-id-type="iso-abbrev">JSLS</journal-id><journal-id journal-id-type="hwp">jsls</journal-id><journal-id journal-id-type="pmc">jsls</journal-id><journal-id journal-id-type="publisher-id">JSLS</journal-id><journal-title-group><journal-title>JSLS : Journal of the Society of Laparoendoscopic Surgeons</journal-title></journal-title-group><issn pub-type="ppub">1086-8089</issn><issn pub-type="epub">1938-3797</issn><publisher><publisher-name>Society of Laparoendoscopic Surgeons</publisher-name><publisher-loc>Miami, FL</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25392678</article-id><article-id pub-id-type="pmc">4216174</article-id><article-id pub-id-type="publisher-id">JSLS-D-13-00396</article-id><article-id pub-id-type="doi">10.4293/JSLS.2014.00396</article-id><article-categories><subj-group subj-group-type="heading"><subject>Scientific Papers</subject></subj-group></article-categories><title-group><article-title>Advanced Hysteroscopic Surgery Training</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Erian</surname><given-names>Mark M.</given-names></name><degrees>MD</degrees><aff>Teaching and Research Department, Royal Brisbane and Women's Hospital, Herston, Australia.</aff></contrib><contrib contrib-type="author"><name><surname>McLaren</surname><given-names>Glenda R.</given-names></name><degrees>MD</degrees><aff>University of Queensland and Mater Mothers Hospital, Brisbane, Australia.</aff></contrib><contrib contrib-type="author"><name><surname>Erian</surname><given-names>Anna-Marie</given-names></name><degrees>MD</degrees><aff>Caboolture General Hospital Brisbane, Brisbane, Australia.</aff></contrib></contrib-group><author-notes><corresp>Address correspondence to: Mark Erian, MD, <addr-line>Teaching and Research Department, Royal Brisbane and Women's Hospital, Sixth Floor, Ned Hanlon Building, Herston, Queensland 4029, Australia</addr-line>. Telephone <phone>(+61) 4 3832 7399</phone>; Fax: <fax>(+61) 7 3398 1491</fax>; E-mail: <email>m.erian1@uq.edu.au</email></corresp></author-notes><pub-date pub-type="ppub"><season>Oct-Dec</season><year>2014</year></pub-date><volume>18</volume><issue>4</issue><elocation-id>e2014.00396</elocation-id><permissions><copyright-statement>© 2014 by JSLS, Journal of the Society of Laparoendoscopic Surgeons.</copyright-statement><copyright-year>2014</copyright-year><copyright-holder>Society of Laparoendoscopic Surgeons, Inc.</copyright-holder><license license-type="open-access"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc-nd/3.0/us/">http://creativecommons.org/licenses/by-nc-nd/3.0/us/</ext-link>), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way.</license-p></license></permissions><self-uri xlink:title="pdf" xlink:type="simple" xlink:href="jls00414396001.pdf"></self-uri><abstract><p>Hysteroscopic surgery is pivotal in management of many gynecological pathologies. The skills required for performing advanced hysteroscopic surgery (AHS), eg, transcervical hysteroscopic endometrial resection (TCRE), hysteroscopic polypectomy and myomectomy in the management of menorrhagia, hysteroscopic septulysis in fertility-related gynecological problems and hysteroscopic removal of chronically retained products of conception and excision of intramural ectopic pregnancy ought to be practiced by contemporary gynecological surgeons in their day-to-day clinical practice. AHS is a minimally invasive procedure that preserves the uterus in most cases. Whilst the outcome is of paramount importance, proper training should be adopted and followed through so that doctors, nurses, and institutions may deliver the highest standard of patient care.</p></abstract><kwd-group><kwd>Hysteroscopir surgery</kwd><kwd>Transcervical</kwd><kwd>Polypectomy</kwd><kwd>Myomectomy</kwd><kwd>Training</kwd></kwd-group></article-meta></front><body><sec sec-type="intro"><title>INTRODUCTION</title><p>Hysteroscopic surgery is pivotal in the management of many gynecologic pathologies. The skills required to perform advanced hysteroscopic surgery (AHS)—for example, transcervical hysteroscopic endometrial resection (TCRE), hysteroscopic polypectomy, and myomectomy in the management of menorrhagia<sup><xref rid="B1" ref-type="bibr">1</xref></sup>; hysteroscopic septolysis in patients with fertility-related gynecologic problems<sup><xref rid="B2" ref-type="bibr">2</xref></sup>; hysteroscopic removal of chronically retained products of conception (placenta accreta)<sup><xref rid="B3" ref-type="bibr">3</xref></sup>; and excision of intramural ectopic pregnancy<sup><xref rid="B4" ref-type="bibr">4</xref></sup>—ought to be practiced by contemporary gynecologic surgeons in their day-to-day clinical practice. AHS is a minimally invasive procedure that preserves the uterus in most cases.<sup><xref rid="B5" ref-type="bibr">5</xref></sup> We suggest a logarithm of training in workshops, including virtual reality (VR), before embarking on operations in the operating room (<bold><xref ref-type="fig" rid="F1">Figure 1</xref></bold>).</p><fig id="F1" position="float"><label>Figure 1.</label><caption><p>Logarithm showing progression of new techniques from conception in workshop to implementation in operating theaters. VR = virtual reality.</p></caption><graphic xlink:href="jls9991434330001"></graphic></fig></sec><sec><title>TRAINING</title><p>Good training is conducive to sound clinical practice; this is particularly true in AHS because the margin for error is rather narrow. There is a learning curve; the operating time decreases as one goes through the learning curve so that, ultimately, the gynecologic surgeon will grasp knowledge, manual dexterity, and training to enable him or her to perform AHS competently in both emergency and elective settings to the benefit of the patient.<sup><xref rid="B6" ref-type="bibr">6</xref></sup></p></sec><sec><title>REGISTRAR TRAINING</title><p>The term <italic>registrar</italic> in Australia and United Kingdom is a synonym of <italic>resident</italic> in the United States, that is, a trainee in the obstetrics and gynecology integrated training program accredited by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists.<sup><xref rid="B7" ref-type="bibr">7</xref></sup> Many aspects of the integrated training program in Australia are shared by other countries in the Western world because there is a constant effort to internationalize and update the integrated professional training programs in Australia.<sup><xref rid="B8" ref-type="bibr">8</xref><xref ref-type="bibr" rid="B9">–</xref><xref rid="B10" ref-type="bibr">10</xref></sup></p><p>Hysteroscopic operations are a primary component of gynecologic surgery in many teaching hospitals around the world. However, opportunities to perform advanced hysteroscopic procedures vary widely among gynecologic training programs, as well as trainees.<sup><xref rid="B9" ref-type="bibr">9</xref>,<xref rid="B11" ref-type="bibr">11</xref></sup> The required skills are not more difficult to acquire during registrar (residency) training than conventional surgical procedures.<sup><xref rid="B12" ref-type="bibr">12</xref>,<xref rid="B13" ref-type="bibr">13</xref></sup></p><p>It is the duty of the consultant (specialist) gynecologist to be in the operating room to personally monitor the progress of the operation and demonstrate leadership skills in the operating room in a teaching capacity.<sup><xref rid="B14" ref-type="bibr">14</xref></sup> Failure to do so may enhance the risk of litigation if the patient sustains any intraoperative or postoperative complications.<sup><xref rid="B15" ref-type="bibr">15</xref>,<xref rid="B16" ref-type="bibr">16</xref></sup></p><p>Before contemplating AHS, the registrar has to be familiar with assembling the elements of the operative hysteroresectoscope; with the power sources, as well as their effects and limitations; and with the use of uterine distending fluids and their possible complications, in addition to being on the alert for any intraoperative or postoperative complications.<sup><xref rid="B17" ref-type="bibr">17</xref></sup> Being aware of the registrar's own limits is important. Technically difficult operations such as division of intractable intrauterine synechiae (adhesions),<sup><xref rid="B18" ref-type="bibr">18</xref></sup> excision of intramural myomata,<sup><xref rid="B19" ref-type="bibr">19</xref></sup> and hysteroscopic excision of abnormally invasive placenta residuals<sup><xref rid="B20" ref-type="bibr">20</xref></sup> should be carried out only by an experienced gynecologic endoscopist.</p></sec><sec><title>MAIN EDUCATIONAL COMPONENTS</title><p>The main educational components are as follows:
<list list-type="order"><list-item><p>Anatomy of the female pelvis.<sup><xref rid="B21" ref-type="bibr">21</xref></sup></p></list-item><list-item><p>Thorough knowledge, both theoretical and practical, regarding hysteroscopic use of energy sources, as well as their physics and different effects on human cells and tissues.<sup><xref rid="B22" ref-type="bibr">22</xref></sup></p></list-item><list-item><p>Pathophysiology of disease and diagnoses including differential diagnoses, for example, recognizing myomata and adenomyosis as causes of menorrhagia and uterine enlargement; obtaining magnetic resonance imaging preoperatively to differentiate among the different pathologies<sup><xref rid="B23" ref-type="bibr">23</xref></sup>; and understanding that adenomyosis may decrease the amenorrhea rate after TCRE.<sup><xref rid="B24" ref-type="bibr">24</xref></sup></p></list-item><list-item><p>Operative indications, contraindications, limitations, and possible complications of every AHS, together with full knowledge of the prevention, early recognition, and management of complications.<sup><xref rid="B25" ref-type="bibr">25</xref><xref ref-type="bibr" rid="B26">–</xref><xref rid="B31" ref-type="bibr">31</xref></sup></p></list-item><list-item><p>The relative advantages and disadvantages of AHS as opposed to conventional laparotomy and vaginal approaches.</p></list-item></list></p></sec><sec><title>SKILLS</title><p>There are skills required to perform both simple hysteroscopic surgery and AHS. These skills are often acquired by attending 2- or 3-day courses that comprise didactic lectures and hands-on components.<sup><xref rid="B32" ref-type="bibr">32</xref></sup> However, registrar training has at least 2 main problems pertaining to training and its adequacy or otherwise in training programs: First, there is often limited AHS teaching in operating rooms during residency and sometimes at the level of fellowship training.<sup><xref rid="B33" ref-type="bibr">33</xref><xref ref-type="bibr" rid="B34">–</xref><xref rid="B35" ref-type="bibr">35</xref></sup> Second, there are no universally accepted standards to accredit registrars.<sup><xref rid="B32" ref-type="bibr">32</xref></sup> A well-planned structured training program is probably superior to ad hoc opportunity.<sup><xref rid="B9" ref-type="bibr">9</xref>,<xref rid="B36" ref-type="bibr">36</xref><xref ref-type="bibr" rid="B37">–</xref><xref rid="B45" ref-type="bibr">45</xref></sup></p><p>Perusal of the aforementioned and other teaching principles in gynecologic endoscopy and related specialties will inevitably lead to the question, Which is the best program? This is a good question to which there is no easy answer.<sup><xref rid="B9" ref-type="bibr">9</xref>,<xref rid="B36" ref-type="bibr">36</xref></sup></p><p>One way around this problem is for each hospital's accreditation committee to set several realistic criteria of training and accreditation, in accordance with the broad recommendations of professional bodies, such as the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, and recognized conclusions of risk management in national and international settings.<sup><xref rid="B37" ref-type="bibr">37</xref></sup></p></sec><sec><title>WHAT SKILLS NEED TO BE LEARNED AND WHERE?</title><sec><title>Advanced Level</title><p>Satisfactory performance of AHS, such as combined hysteroscopic myomectomy and endometrial resection, hysteroscopic septolysis, and excision of pathologically adherent placenta (accrete), requires the expertise and manual dexterity of an experienced endoscopic surgeon. The logical sequence of events is that one has to crawl before he or she can walk; basic skills need to be performed well and practiced before one contemplates performing AHS. However, advanced hysteroscopic skills are required for most advanced procedures, and experience in a specific operation enhances the acquisition of skills necessary to perform others. Hence it is the combined experience in advanced procedures that should be emphasized during training rather than the excellent command of any one individual procedure.<sup><xref rid="B38" ref-type="bibr">38</xref></sup></p><p>Hasson and Getzels<sup><xref rid="B39" ref-type="bibr">39</xref></sup> suggested a workable and easy-to-implement system of credentialing physicians in AHS. Physicians are certified by the Accreditation Council for Gynecologic Endoscopy on receipt of completed documentation and proctorship. The system has stood the test of time and is practicable, and many units worldwide adopt the same.</p></sec><sec><title>Where</title><p>Training in operating theaters is a feasible option because it allows interaction with valuable one-to-one practical tuition in real-life situations. For example, a simple procedure may be chosen (eg, laparoscopic sterilization), and different aspects, alternatives (eg, hysteroscopic sterilization), indications, complications, and technical aspects of occlusive device application may all be tested. Trainees' learning curve for hysteroscopic tubal sterilization showed a shorter procedure time in the operating room.<sup><xref rid="B40" ref-type="bibr">40</xref></sup> The procedure offered a high efficacy.<sup><xref rid="B41" ref-type="bibr">41</xref></sup> It has been concluded that knowledge of a specific gynecologic endoscopic procedure can be measured and that a carefully calculated and structured learning package can be effective.<sup><xref rid="B42" ref-type="bibr">42</xref></sup> Office hysteroscopy includes, but is not limited to, TCRE under local infiltration anesthesia and hysteroscopic sterilization.<sup><xref rid="B43" ref-type="bibr">43</xref>,<xref rid="B44" ref-type="bibr">44</xref></sup></p><p>Supervision and subjective assessment by the consultant endoscopist in the operating room have their perceived problems:
<list list-type="order"><list-item><p>There is a discrepancy between subjective in-training evaluations of surgical performance and an objective assessment using a simulation.<sup><xref rid="B45" ref-type="bibr">45</xref></sup></p></list-item><list-item><p>In a busy gynecology unit, the registrar may be temporarily sleep deprived and this may be perceived to negatively affect his or her surgical endoscopy performance. However, short-term sleep deficits do not appear to hinder the acquisition of endoscopy skills, even after registrars have been on call the night before.<sup><xref rid="B46" ref-type="bibr">46</xref></sup></p></list-item><list-item><p>Pregnancy during gynecologic registrar training does not seem to have a negative impact on the surgical experience, especially when the attending endoscopist is supportive of the registrar and her pregnancy status.<sup><xref rid="B47" ref-type="bibr">47</xref></sup></p></list-item><list-item><p>With the gradual implementation of “safe working hours” of junior doctors in public hospitals in the Western world, our trainees have incurred a decrease in the number of gynecologic endoscopy operations they have performed.<sup><xref rid="B48" ref-type="bibr">48</xref></sup> Morbidity and mortality rates are lowest when procedures are performed by physicians who perform the procedures frequently and in centers that have large volumes of these procedures.<sup><xref rid="B49" ref-type="bibr">49</xref>,<xref rid="B50" ref-type="bibr">50</xref></sup> The clinical and educational implications of these changes in working hours for registrars to gain experience need to be further elucidated. However, there is evidence that teaching registrars in the operating room is expensive in terms of operating time and financial cost.<sup><xref rid="B51" ref-type="bibr">51</xref>,<xref rid="B52" ref-type="bibr">52</xref></sup> What then is the alternative?</p></list-item></list></p></sec></sec><sec><title>PREPARATION FOR OPERATING ROOM TEACHING</title><sec><title>Workshops</title><p>Workshops with objective goals of improving theoretical knowledge, enhancing clinical judgment, and initiating and up-scaling manual dexterity must be an integral part of professional development of the trainer and trainee alike in gynecologic endoscopic surgery in any teaching hospital with a respected national and international standing.<sup><xref rid="B53" ref-type="bibr">53</xref>,<xref rid="B54" ref-type="bibr">54</xref></sup></p><p>The theoretical knowledge of registrars may surpass that of the practicing gynecologic endoscopist.<sup><xref rid="B55" ref-type="bibr">55</xref></sup> This is a serious drawback that may well negate the value of registrars' learning curve. One possible explanation for this may be that busy practicing gynecologists have very little time available to them to update their professional knowledge because they would rather concentrate on practical aspects of patient care. By so doing, their current knowledge may “decay” at an exponential rate, hence the crucial importance of continuous professional development strenuously advocated by major professional bodies worldwide (eg, Royal Australia and New Zealand College of Obstetricians and Gynaecologists<sup><xref rid="B56" ref-type="bibr">56</xref></sup>).</p></sec><sec><title>Animal Laboratory</title><p>Animal laboratory teaching is best performed on inanimate tissue and readily available animal tissue (eg, sow uterus<sup><xref rid="B57" ref-type="bibr">57</xref></sup> or pig bladder<sup><xref rid="B58" ref-type="bibr">58</xref></sup>). Eye-hand-foot coordination can be developed and assessed in this setting.<sup><xref rid="B59" ref-type="bibr">59</xref></sup> However, this approach does not exactly simulate the in vivo human condition in that there is little demonstration of injury, such as that shown by bleeding.<sup><xref rid="B60" ref-type="bibr">60</xref></sup></p></sec><sec><title>Visual Reality Simulators</title><p>Simulations have been used by the airline industry and military, as well as our colleagues in other medical specialties, to educate, evaluate, and prepare for life-threatening scenarios.<sup><xref rid="B61" ref-type="bibr">61</xref></sup> The gynecologist goes through specific training to develop a different level of psychomotor skills than that required for conventional (laparotomy and vaginal) surgery.<sup><xref rid="B62" ref-type="bibr">62</xref></sup></p><p>To reduce the need for experimental animals and the more expensive operating-room hands-on learning, bench models were introduced to improve not only endoscopic skills from the technical standpoint but also the operative performance of trainees.<sup><xref rid="B63" ref-type="bibr">63</xref></sup> Objective structured assessment of technical skills is a multistation performance-based examination of surgical skills.<sup><xref rid="B64" ref-type="bibr">64</xref></sup> It uses visual reality (VR) simulators and has been successfully used in many institutions worldwide to objectively score candidates.<sup><xref rid="B65" ref-type="bibr">65</xref></sup> These tools serve to objectively validate teaching methodologies.<sup><xref rid="B66" ref-type="bibr">66</xref></sup> The findings of these programs could well be used in the selection of appropriate training methodologies.<sup><xref rid="B66" ref-type="bibr">66</xref>,<xref rid="B67" ref-type="bibr">67</xref></sup></p><p>VR simulations are valuable not only in education but in objectively assessing the trainee's learning curve with good reliability, validity, and cost-effectiveness.<sup><xref rid="B68" ref-type="bibr">68</xref><xref ref-type="bibr" rid="B69">–</xref><xref rid="B70" ref-type="bibr">70</xref></sup> VR simulation is a feasible system that the trainee may choose to use regularly. However, many current, qualified advanced hysteroscopic surgeons have not been taught the fundamentals through an organized curriculum that included VR training.<sup><xref rid="B62" ref-type="bibr">62</xref></sup></p><p>Endoscopic surgical competency may be judged by gynecologists experienced in the field of operative endoscopy. Because the definitive criteria for assessing competence in gynecologic endoscopy remain elusive, attempts to streamline the objectivity of assessment were made. Trainees were tested on multiple tasks, involving clinical judgment, dexterity, serial/simultaneous complexity, and spatial orientation. The assessors then assessed overall subject competence for each procedure on simulation. Point-biserial correlational analysis and cluster analysis were performed to ascertain the relationships among the different scales. The cluster analysis showed that the surgeon assessors shared a common perception of competence.<sup><xref rid="B65" ref-type="bibr">65</xref>,<xref rid="B71" ref-type="bibr">71</xref></sup> However, VR provides a more objective means for evaluating the psychomotor skills needed to perform endoscopic surgery.<sup><xref rid="B72" ref-type="bibr">72</xref></sup> In addition, medicolegal and financial constraints of training and evaluation in operating rooms have enhanced the use of VR endoscopic surgery.<sup><xref rid="B73" ref-type="bibr">73</xref></sup></p><p>Hysteroscopic surgery is a relatively new technique used to surgically manage uterine pathology in many leading centers of gynecologic endoscopy worldwide.<sup><xref rid="B74" ref-type="bibr">74</xref></sup> It requires special surgical skills for handling the operating hysteroscope and remote instrument control.</p><p>In general, VR simulators seem to enrich education in gynecologic endoscopy, in addition to clinical education and active learning in operating rooms.<sup><xref rid="B75" ref-type="bibr">75</xref></sup> Nevertheless, these systems have been criticized as not being able to lend themselves to the realistic surgical environment.<sup><xref rid="B76" ref-type="bibr">76</xref></sup> It has been suggested that this method lacks standards defining performance-based endpoints, with neither a predetermined training duration nor an arbitrary number of repetitions of tasks being adequate to ensure endoscopic proficiency after simulator training.<sup><xref rid="B77" ref-type="bibr">77</xref></sup> However, the Royal College of Obstetricians and Gynaecologists, London, has recommended that surgical training systems, such as VR hysteroscopy, be evaluated, piloted, and introduced into basic surgical skills courses.<sup><xref rid="B78" ref-type="bibr">78</xref></sup> In addition, skills acquired during VR operative hysteroscopy sessions can be effectively transferred to the patient's care in the operating room.<sup><xref rid="B79" ref-type="bibr">79</xref><xref ref-type="bibr" rid="B80">–</xref><xref rid="B81" ref-type="bibr">81</xref></sup> International multicenter studies objectively comparing VR systems and their potential impact on the practice of gynecologic endoscopic surgery are awaited with interest.</p></sec></sec><sec><title>RECOMMENDATION</title><p>Before operating on patients, trainees should be assessed in workshops, including animal laboratories if available; during VR simulation exercises; and in the operating theater. The results of objective assessments are recorded in trainees' log books.</p></sec></body><back><ref-list><title>References</title><ref id="B1"><label>1.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lethaby</surname><given-names>A</given-names></name><name><surname>Penninx</surname><given-names>J</given-names></name><name><surname>Hickey</surname><given-names>M</given-names></name><name><surname>Garry</surname><given-names>R</given-names></name><name><surname>Marjoribanks</surname><given-names>J</given-names></name></person-group>. <article-title>Endometrial resection and ablation techniques for heavy menstrual bleeding</article-title>. <source>Cochrane Database Syst Rev</source>. <year>2013</year>;<volume>8</volume>;<fpage>CD001501</fpage><pub-id pub-id-type="pmid">23990373</pub-id></mixed-citation></ref><ref id="B2"><label>2.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Tonguc</surname><given-names>EA</given-names></name><name><surname>Var</surname><given-names>T</given-names></name><name><surname>Batioglu</surname><given-names>S</given-names></name></person-group>. <article-title>Hysteroscopic metroplasty in patients with a uterine septum and otherwise unexplained infertility</article-title>. <source>Int J Gynaecol Obstet</source>. <year>2011</year>;<volume>113</volume>(<issue>2</issue>):<fpage>128</fpage>–<lpage>130</lpage><pub-id pub-id-type="pmid">21392763</pub-id></mixed-citation></ref><ref id="B3"><label>3.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Golan</surname><given-names>A</given-names></name><name><surname>Dishi</surname><given-names>M</given-names></name><name><surname>Shalev</surname><given-names>A</given-names></name><etal></etal></person-group>. <article-title>Operative hysteroscopy to remove retained products of conception: novel treatment of an old problem</article-title>. <source>J Minim Invasive Gynecol</source>. <year>2011</year>;<volume>18</volume>(<issue>1</issue>):<fpage>100</fpage>–<lpage>103</lpage><pub-id pub-id-type="pmid">21195960</pub-id></mixed-citation></ref><ref id="B4"><label>4.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Wu</surname><given-names>PJ</given-names></name><name><surname>Han</surname><given-names>CM</given-names></name><name><surname>Wang</surname><given-names>CJ</given-names></name><name><surname>Lee</surname><given-names>CL</given-names></name></person-group>. <article-title>Early detection and minimally invasive management of intramural pregnancy</article-title>. <source>J Minim Invasive Gynecol</source>. <year>2013</year>;<volume>20</volume>(<issue>1</issue>):<fpage>123</fpage>–<lpage>126</lpage><pub-id pub-id-type="pmid">23312255</pub-id></mixed-citation></ref><ref id="B5"><label>5.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Litta</surname><given-names>P</given-names></name><name><surname>Bartolucci</surname><given-names>C</given-names></name><name><surname>Saccardi</surname><given-names>C</given-names></name><etal></etal></person-group>. <article-title>A typical endometrial lesions: hysteroscopic resection as an alternative to hysterectomy</article-title>. <source>Eur J Gynaecol Oncol</source>. <year>2013</year>;<volume>34</volume>(<issue>1</issue>):<fpage>51</fpage>–<lpage>53</lpage><pub-id pub-id-type="pmid">23590001</pub-id></mixed-citation></ref><ref id="B6"><label>6.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>McCormick</surname><given-names>PH</given-names></name><name><surname>Tanner</surname><given-names>WA</given-names></name><name><surname>Kean</surname><given-names>FB</given-names></name><name><surname>Tierney</surname><given-names>S</given-names></name></person-group>. <article-title>Minimally invasive techniques in common surgical procedures: implications for training</article-title>. <source>Ir J Med Sci</source>. <year>2003</year>;<volume>172</volume>(<issue>1</issue>):<fpage>27</fpage>–<lpage>29</lpage><pub-id pub-id-type="pmid">12760460</pub-id></mixed-citation></ref><ref id="B7"><label>7.</label><mixed-citation publication-type="webpage"><article-title>Royal Australian and New Zealand College of Obstetricians and Gynaecologists Web site</article-title>. <comment>Available at: <ext-link ext-link-type="uri" xlink:href="http://www.ranzcog.edu.au">www.ranzcog.edu.au</ext-link></comment></mixed-citation></ref><ref id="B8"><label>8.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Rackow</surname><given-names>BW</given-names></name><name><surname>Solnik</surname><given-names>MJ</given-names></name><name><surname>Tu</surname><given-names>FF</given-names></name><etal></etal></person-group>. <article-title>Deliberate practice improves obstetrics and gynecology residents' hysteroscopy skills</article-title>. <source>J Grad Med Educ</source>. <year>2012</year>;<volume>4</volume>(<issue>3</issue>):<fpage>329</fpage>–<lpage>334</lpage><pub-id pub-id-type="pmid">23997877</pub-id></mixed-citation></ref><ref id="B9"><label>9.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Arendas</surname><given-names>K</given-names></name><name><surname>Posner</surname><given-names>GD</given-names></name><name><surname>Singh</surname><given-names>SS</given-names></name></person-group>. <article-title>Managing expectations of surgical training: a national perspective on gynaecologic endoscopy practice</article-title>. <source>J Obstet Gynaecol Can</source>. <year>2013</year>;<volume>35</volume>(<issue>7</issue>):<fpage>640</fpage>–<lpage>646</lpage><pub-id pub-id-type="pmid">23876642</pub-id></mixed-citation></ref><ref id="B10"><label>10.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>De Wilde</surname><given-names>RL</given-names></name><name><surname>Hucke</surname><given-names>J</given-names></name><name><surname>Kolmorgen</surname><given-names>K</given-names></name><name><surname>Tinneberg</surname><given-names>H</given-names></name></person-group>, <collab>Gynecologic Endoscopy Working Group of the German Society of Obstetrics and Gynecology</collab>. <article-title>Recommendations by the Gynecologic Endoscopy Working Group of the German Society of Obstetrics and Gynecology for the advancement of training and education in minimal-access surgery</article-title>. <source>Arch Gynecol Obstet</source>. <year>2011</year>;<volume>283</volume>(<issue>3</issue>):<fpage>509</fpage>–<lpage>512</lpage><pub-id pub-id-type="pmid">21225275</pub-id></mixed-citation></ref><ref id="B11"><label>11.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Einarsson</surname><given-names>JI</given-names></name><name><surname>Sangi-Haghpeykar</surname><given-names>H</given-names></name></person-group>. <article-title>Perceived proficiency in minimally invasive surgery among senior OB/GYN residents</article-title>. <source>JSLS</source>. <year>2009</year>;<volume>13</volume>(<issue>4</issue>):<fpage>473</fpage>–<lpage>478</lpage><pub-id pub-id-type="pmid">20202386</pub-id></mixed-citation></ref><ref id="B12"><label>12.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hiemstra</surname><given-names>E</given-names></name><name><surname>Kolkman</surname><given-names>W</given-names></name><name><surname>le Cessie</surname><given-names>S</given-names></name><name><surname>Jansen</surname><given-names>FW</given-names></name></person-group>. <article-title>Are minimally invasive procedures harder to acquire than conventional surgical procedures?</article-title><source>Gynecol Obstet Invest</source>. <year>2011</year>;<volume>71</volume>(<issue>4</issue>):<fpage>268</fpage>–<lpage>273</lpage><pub-id pub-id-type="pmid">21196689</pub-id></mixed-citation></ref><ref id="B13"><label>13.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Bodle</surname><given-names>JF</given-names></name><name><surname>Duffy</surname><given-names>SR</given-names></name><name><surname>Binney</surname><given-names>DM</given-names></name></person-group>. <article-title>Patient satisfaction with outpatient hysteroscopy performed by nurse hysteroscopists</article-title>. <source>Int J Gynaecol Obstet</source>. <year>2008</year>;<volume>103</volume>(<issue>2</issue>):<fpage>116</fpage>–<lpage>120</lpage><pub-id pub-id-type="pmid">18760412</pub-id></mixed-citation></ref><ref id="B14"><label>14.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Morozov</surname><given-names>V</given-names></name><name><surname>Nezhat</surname><given-names>C</given-names></name></person-group>. <article-title>Proposal of a formal gynecologic endoscopy curriculum</article-title>. <source>J Minim Invasive Gynecol</source>. <year>2009</year>;<volume>16</volume>(<issue>4</issue>):<fpage>416</fpage>–<lpage>421</lpage><pub-id pub-id-type="pmid">19406690</pub-id></mixed-citation></ref><ref id="B15"><label>15.</label><mixed-citation publication-type="journal"><collab>American College of Obstetricians and Gynecologists</collab>. <article-title>Technology assessment No. 7: hysteroscopy</article-title>. <source>Obstet Gynecol</source>. <year>2011</year>;<volume>117</volume>(<issue>6</issue>):<fpage>1486</fpage>–<lpage>1491</lpage><pub-id pub-id-type="pmid">21606772</pub-id></mixed-citation></ref><ref id="B16"><label>16.</label><mixed-citation publication-type="journal"><collab>AAGL Advancing Minimally Invasive Gynecology Worldwide</collab>, <person-group person-group-type="author"><name><surname>Munro</surname><given-names>MG</given-names></name><name><surname>Storz</surname><given-names>K</given-names></name><name><surname>Abbott</surname><given-names>JA</given-names></name><etal></etal></person-group>. <article-title>AAGL practice report: practice guidelines for the management of hysteroscopic distending media: (replaces hysteroscopic fluid monitoring guidelines. J Am Assoc Gynecol Laparosc. 2000;7:167–168)</article-title>. <source>J Minim Invasive Gynecol</source>. <year>2013</year>;<volume>20</volume>(<issue>2</issue>):<fpage>137</fpage>–<lpage>148</lpage><pub-id pub-id-type="pmid">23465255</pub-id></mixed-citation></ref><ref id="B17"><label>17.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Bahar</surname><given-names>R</given-names></name><name><surname>Shimonovitz</surname><given-names>M</given-names></name><name><surname>Benshushan</surname><given-names>A</given-names></name><name><surname>Shushan</surname><given-names>A</given-names></name></person-group>. <article-title>Case-control study of complications associated with bipolar and monopolar hysteroscopic operations</article-title>. <source>J Minim Invasive Gynecol</source>. <year>2013</year>;<volume>20</volume>(<issue>3</issue>):<fpage>376</fpage>–<lpage>380</lpage><pub-id pub-id-type="pmid">23453765</pub-id></mixed-citation></ref><ref id="B18"><label>18.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Berman</surname><given-names>JM</given-names></name></person-group>. <article-title>Intrauterine adhesions</article-title>. <source>Semin Reprod Med</source>. <year>2008</year>;<volume>26</volume>(<issue>4</issue>):<fpage>349</fpage>–<lpage>355</lpage><pub-id pub-id-type="pmid">18756412</pub-id></mixed-citation></ref><ref id="B19"><label>19.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Olive</surname><given-names>DL</given-names></name></person-group>. <article-title>The surgical treatment of fibroids for infertility</article-title>. <source>Semin Reprod Med</source>. <year>2011</year>;<volume>29</volume>(<issue>2</issue>):<fpage>113</fpage>–<lpage>123</lpage><pub-id pub-id-type="pmid">21437825</pub-id></mixed-citation></ref><ref id="B20"><label>20.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Nisolle</surname><given-names>M</given-names></name><name><surname>Delbecque</surname><given-names>K</given-names></name><name><surname>Perrier D'Hauterive</surname><given-names>S</given-names></name><name><surname>Firquet</surname><given-names>A</given-names></name><name><surname>Chantraine</surname><given-names>F</given-names></name></person-group>. <article-title>Hysteroscopic resection of abnormally invasive placenta residuals</article-title>. <source>Acta Obstet Gynecol Scand</source>. <year>2013</year>;<volume>92</volume>(<issue>4</issue>):<fpage>451</fpage>–<lpage>456</lpage><pub-id pub-id-type="pmid">23331051</pub-id></mixed-citation></ref><ref id="B21"><label>21.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Macchi</surname><given-names>V</given-names></name><name><surname>Munari</surname><given-names>PF</given-names></name><name><surname>Brizzi</surname><given-names>E</given-names></name><name><surname>Parenti</surname><given-names>A</given-names></name><name><surname>De Caro</surname><given-names>R</given-names></name></person-group>. <article-title>Workshop in clinical anatomy for residents in gynecology and obstetrics</article-title>. <source>Clin Anat</source>. <year>2003</year>;<volume>16</volume>(<issue>5</issue>):<fpage>440</fpage>–<lpage>447</lpage><pub-id pub-id-type="pmid">12903067</pub-id></mixed-citation></ref><ref id="B22"><label>22.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Munro</surname><given-names>MG</given-names></name></person-group>. <article-title>The evolution of uterine surgery</article-title>. <source>Clin Obstet Gynecol</source>. <year>2006</year>;<volume>49</volume>(<issue>4</issue>):<fpage>713</fpage>–<lpage>721</lpage><pub-id pub-id-type="pmid">17082669</pub-id></mixed-citation></ref><ref id="B23"><label>23.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Stamatopoulos</surname><given-names>CP</given-names></name><name><surname>Mikos</surname><given-names>T</given-names></name><name><surname>Grimbizis</surname><given-names>GF</given-names></name><etal></etal></person-group>. <article-title>Value of magnetic resonance imaging in diagnosis of adenomyosis and myomas of the uterus</article-title>. <source>J Minim Invasive Gynecol</source>. <year>2012</year>;<volume>19</volume>(<issue>5</issue>):<fpage>620</fpage>–<lpage>626</lpage><pub-id pub-id-type="pmid">22935303</pub-id></mixed-citation></ref><ref id="B24"><label>24.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Maia</surname><given-names>H</given-names></name><name><surname>Haddad</surname><given-names>C</given-names></name><name><surname>Casoy</surname><given-names>J</given-names></name><name><surname>Maia</surname><given-names>R</given-names></name><name><surname>Pinheiro</surname><given-names>N</given-names></name><name><surname>Coutinho</surname><given-names>EM</given-names></name></person-group>. <article-title>Effect of a hormone-releasing intrauterine system (Mirena) on aromatase and Cox-2 expression in patients with adenomyosis submitted or not, to endometrial resection</article-title>. <source>Int J Womens Health</source>. <year>2012</year>;<volume>4</volume>:<fpage>175</fpage>–<lpage>183</lpage><pub-id pub-id-type="pmid">22532781</pub-id></mixed-citation></ref><ref id="B25"><label>25.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Munro</surname><given-names>MC</given-names></name></person-group>. <article-title>Complications of hysteroscopic and uterine resectoscopic surgery</article-title>. <source>Obstet Gynecol Clin North Am</source>. <year>2010</year>;<volume>37</volume>(<issue>3</issue>):<fpage>399</fpage>–<lpage>425</lpage><pub-id pub-id-type="pmid">20674783</pub-id></mixed-citation></ref><ref id="B26"><label>26.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Berg</surname><given-names>A</given-names></name><name><surname>Sandvik</surname><given-names>L</given-names></name><name><surname>Langebrekke</surname><given-names>A</given-names></name><name><surname>Istre</surname><given-names>O</given-names></name></person-group>. <article-title>A randomized trial comparing monopolar electrodes using glycine 1.5% with two different types of bipolar electrodes (TCRis, Versapoint) using saline, in hysteroscopic surgery</article-title>. <source>Fertil Steril</source>. <year>2009</year>;<volume>91</volume>(<issue>4</issue>):<fpage>1273</fpage>–<lpage>1278</lpage><pub-id pub-id-type="pmid">18371962</pub-id></mixed-citation></ref><ref id="B27"><label>27.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Sinha</surname><given-names>M</given-names></name><name><surname>Hegde</surname><given-names>A</given-names></name><name><surname>Sinha</surname><given-names>R</given-names></name><name><surname>Goel</surname><given-names>S</given-names></name></person-group>. <article-title>Parotid area sign: a clinical test for the diagnosis of fluid overload in hysteroscopic surgery</article-title>. <source>J Minim Invasive Gynecol</source>. <year>2007</year>;<volume>14</volume>(<issue>2</issue>):<fpage>161</fpage>–<lpage>168</lpage><pub-id pub-id-type="pmid">17368250</pub-id></mixed-citation></ref><ref id="B28"><label>28.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>De Freitas Fonseca</surname><given-names>M</given-names></name><name><surname>Andrade</surname><given-names>CM</given-names><suffix>Jr</suffix></name><name><surname>de Mello</surname><given-names>MJ</given-names></name><name><surname>Crispi</surname><given-names>CP</given-names></name></person-group>. <article-title>Effect of temperature on fluidity of irrigation fluids</article-title>. <source>Br J Anaesth</source>. <year>2011</year>;<volume>106</volume>(<issue>1</issue>):<fpage>51</fpage>–<lpage>56</lpage><pub-id pub-id-type="pmid">21051494</pub-id></mixed-citation></ref><ref id="B29"><label>29.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Birdsell</surname><given-names>DC</given-names></name><name><surname>Mattatall</surname><given-names>F</given-names></name><name><surname>Rosengarten</surname><given-names>AM</given-names></name><name><surname>Watson</surname><given-names>SD</given-names></name></person-group>. <article-title>Vulvar burn: a complication of hysteroscopic endometrial ablation</article-title>. <source>J Obstet Gynaecol Can</source>. <year>2010</year>;<volume>32</volume>(<issue>11</issue>):<fpage>1021</fpage>–<lpage>1022</lpage><pub-id pub-id-type="pmid">21176312</pub-id></mixed-citation></ref><ref id="B30"><label>30.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Wortman</surname><given-names>M</given-names></name></person-group>. <article-title>Sonographically guided hysteroscopic myomectomy (SGHM): minimizing the risks and maximizing efficiency</article-title>. <source>Surg Technol Int</source>. <year>2013</year>;<volume>23</volume>:<fpage>181</fpage>–<lpage>189</lpage><pub-id pub-id-type="pmid">24081849</pub-id></mixed-citation></ref><ref id="B31"><label>31.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Bergeron</surname><given-names>ME</given-names></name><name><surname>Ouellet</surname><given-names>P</given-names></name><name><surname>Bujold</surname><given-names>E</given-names></name><etal></etal></person-group>. <article-title>The impact of anesthesia on glycine absorption in operative hysteroscopy: a randomised controlled trial</article-title>. <source>Anesth Analg</source>. <year>2011</year>;<volume>113</volume>(<issue>4</issue>):<fpage>723</fpage>–<lpage>728</lpage><pub-id pub-id-type="pmid">21788316</pub-id></mixed-citation></ref><ref id="B32"><label>32.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Sammarco</surname><given-names>MJ</given-names></name><name><surname>Youngblood</surname><given-names>JP</given-names></name></person-group>. <article-title>A resident teaching program in operative endoscopy</article-title>. <source>Obstet Gynecol</source>. <year>1993</year>;<volume>81</volume>(<issue>3</issue>):<fpage>463</fpage>–<lpage>466</lpage><pub-id pub-id-type="pmid">8437806</pub-id></mixed-citation></ref><ref id="B33"><label>33.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Chen</surname><given-names>I</given-names></name><name><surname>Bajzak</surname><given-names>KI</given-names></name><name><surname>Guo</surname><given-names>Y</given-names></name><name><surname>Singh</surname><given-names>SS</given-names></name></person-group>. <article-title>A national survey of endoscopic practice among gynaecologists in Canada</article-title>. <source>J Obstet Gynaecol Can</source>. <year>2012</year>;<volume>34</volume>(<issue>3</issue>):<fpage>257</fpage>–<lpage>263</lpage><pub-id pub-id-type="pmid">22385669</pub-id></mixed-citation></ref><ref id="B34"><label>34.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Manning</surname><given-names>N</given-names></name><name><surname>Phillips</surname><given-names>A</given-names></name></person-group>. <article-title>The “cost” of surgical training</article-title>. <source>J Ark Med Soc</source>. <year>2013</year>;<volume>109</volume>(<issue>13</issue>):<fpage>271</fpage><pub-id pub-id-type="pmid">23808091</pub-id></mixed-citation></ref><ref id="B35"><label>35.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Di Spiezio Sardo</surname><given-names>A</given-names></name><name><surname>Taylor</surname><given-names>A</given-names></name><name><surname>Tsirkas</surname><given-names>P</given-names></name><name><surname>Mastrogamvrakis</surname><given-names>G</given-names></name><name><surname>Sharma</surname><given-names>M</given-names></name><name><surname>Magos</surname><given-names>A</given-names></name></person-group>. <article-title>Hysteroscopy: a technique for all? Analysis of 5,000 outpatient hysteroscopies</article-title>. <source>Fertil Steril</source>. <year>2008</year>;<volume>89</volume>(<issue>2</issue>):<fpage>438</fpage>–<lpage>443</lpage><pub-id pub-id-type="pmid">17482613</pub-id></mixed-citation></ref><ref id="B36"><label>36.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Van Dongen</surname><given-names>H</given-names></name><name><surname>Kolkman</surname><given-names>W</given-names></name><name><surname>Jansen</surname><given-names>FW</given-names></name></person-group>. <article-title>Hysteroscopic surgery: perspectives on skills training</article-title>. <source>J Minim Invasive Gynecol</source>. <year>2006</year>;<volume>13</volume>(<issue>2</issue>):<fpage>121</fpage>–<lpage>125</lpage><pub-id pub-id-type="pmid">16527714</pub-id></mixed-citation></ref><ref id="B37"><label>37.</label><mixed-citation publication-type="webpage"><collab>Clinical Risk Management Activity Reflection Worksheet</collab>. <comment><ext-link ext-link-type="uri" xlink:href="http://www.ranzcog.edu.au/riskmanagement">www.ranzcog.edu.au/riskmanagement</ext-link></comment></mixed-citation></ref><ref id="B38"><label>38.</label><mixed-citation publication-type="book"><person-group person-group-type="author"><name><surname>Kim</surname><given-names>WW</given-names></name><name><surname>Gagner</surname><given-names>M</given-names></name></person-group>. <article-title>Training and credentialing in laparoscopic surgery</article-title>. In: <source>Laparoscopic Surgery</source>. <publisher-loc>New York, NY</publisher-loc>: <publisher-name>McGraw-Hill</publisher-name>; <year>2003</year>:<fpage>53</fpage>–<lpage>62</lpage></mixed-citation></ref><ref id="B39"><label>39.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hasson</surname><given-names>HM</given-names></name><name><surname>Getzels</surname><given-names>J</given-names></name></person-group>. <article-title>A system of credentialing physicians in advanced gynecologic endoscopy</article-title>. <source>J Am Assoc Gynecol Laparosc</source>. <year>2001</year>;<volume>8</volume>(<issue>2</issue>):<fpage>214</fpage>–<lpage>217</lpage><pub-id pub-id-type="pmid">11342727</pub-id></mixed-citation></ref><ref id="B40"><label>40.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Janse</surname><given-names>JA</given-names></name><name><surname>Pattij</surname><given-names>TO</given-names></name><name><surname>Eijkemans</surname><given-names>MJ</given-names></name><etal></etal></person-group>. <article-title>Learning curve of hysteroscopic placement of tubal sterilization microinserts in 15 gynecologists in the Netherlands</article-title>. <source>Fertil Steril</source>. <year>2013</year>;<volume>100</volume>(<issue>3</issue>):<fpage>755</fpage>–<lpage>760</lpage><pub-id pub-id-type="pmid">23768989</pub-id></mixed-citation></ref><ref id="B41"><label>41.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Theroux</surname><given-names>R</given-names></name></person-group>. <article-title>The hysteroscopic approach to sterilization</article-title>. <source>J Obstet Gynecol Neonatal Nurs</source>. <year>2008</year>;<volume>37</volume>(<issue>3</issue>):<fpage>356</fpage>–<lpage>360</lpage></mixed-citation></ref><ref id="B42"><label>42.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Stovall</surname><given-names>TG</given-names></name><name><surname>Ling</surname><given-names>FW</given-names></name><name><surname>Lipscomb</surname><given-names>GH</given-names></name><name><surname>Summitt</surname><given-names>RL</given-names><suffix>Jr</suffix></name><name><surname>Beckmann</surname><given-names>CR</given-names></name></person-group>. <article-title>A model for resident surgical training in laparoscopic sterilization</article-title>. <source>Obstet Gynecol</source>. <year>1994</year>;<volume>83</volume>(<issue>3</issue>):<fpage>470</fpage>–<lpage>472</lpage><pub-id pub-id-type="pmid">8127545</pub-id></mixed-citation></ref><ref id="B43"><label>43.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Di Spiezio Spardo</surname><given-names>A</given-names></name><name><surname>Bettocchi</surname><given-names>S</given-names></name><name><surname>Spinelli</surname><given-names>M</given-names></name><etal></etal></person-group>. <article-title>Office operative hysteroscopy: an update of the evidence (2002–2009)</article-title>. <source>J Minim Invasive Gynecol</source>. <year>2009</year>;<volume>16</volume>:<fpage>S85</fpage></mixed-citation></ref><ref id="B44"><label>44.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Wortman</surname><given-names>M</given-names></name><name><surname>Daggett</surname><given-names>AF</given-names></name></person-group>. <article-title>Operative hysteroscopy in an office-based setting: a review of patient and satisfaction in 414 cases</article-title>. <source>J Minim Invasive Gynecol</source>. <year>2012</year>;<volume>19</volume>:<fpage>S106</fpage></mixed-citation></ref><ref id="B45"><label>45.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Feldman</surname><given-names>LS</given-names></name><name><surname>Hagarty</surname><given-names>SE</given-names></name><name><surname>Ghitulescu</surname><given-names>G</given-names></name><name><surname>Stanbridge</surname><given-names>D</given-names></name><name><surname>Fried</surname><given-names>GM</given-names></name></person-group>. <article-title>Relationship between objective assessment of technical skills and subjective in-training evaluations in surgical residents</article-title>. <source>J Am Coll Surg</source>. <year>2004</year>;<volume>198</volume>(<issue>1</issue>):<fpage>105</fpage>–<lpage>110</lpage><pub-id pub-id-type="pmid">14698317</pub-id></mixed-citation></ref><ref id="B46"><label>46.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Jensen</surname><given-names>A</given-names></name><name><surname>Milner</surname><given-names>R</given-names></name><name><surname>Fisher</surname><given-names>C</given-names></name><etal></etal></person-group>. <article-title>Short-term sleep deficits do not adversely affect acquisition of laparoscopic skills in a laboratory setting</article-title>. <source>Surg Endosc</source>. <year>2004</year>;<volume>18</volume>(<issue>6</issue>):<fpage>948</fpage>–<lpage>953</lpage><pub-id pub-id-type="pmid">15095080</pub-id></mixed-citation></ref><ref id="B47"><label>47.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lashbrook</surname><given-names>DL</given-names></name><name><surname>Frazier</surname><given-names>LM</given-names></name><name><surname>Horbelt</surname><given-names>DV</given-names></name><name><surname>Stembridge</surname><given-names>TW</given-names></name><name><surname>Rall</surname><given-names>MJ</given-names></name></person-group>. <article-title>Pregnancy during obstetrics and gynecology residency: effect on surgical experience</article-title>. <source>Am J Obstet Gynecol</source>. <year>2003</year>;<volume>189</volume>(<issue>3</issue>):<fpage>662</fpage>–<lpage>665</lpage><pub-id pub-id-type="pmid">14526288</pub-id></mixed-citation></ref><ref id="B48"><label>48.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Blanchard</surname><given-names>MH</given-names></name><name><surname>Amini</surname><given-names>SB</given-names></name><name><surname>Frank</surname><given-names>TM</given-names></name></person-group>. <article-title>Impact of work hour restrictions on resident case experience in an obstetrics and gynecology residency program</article-title>. <source>Am J Obstet Gynecol</source>. <year>2004</year>;<volume>191</volume>(<issue>5</issue>):<fpage>1746</fpage>–<lpage>1751</lpage><pub-id pub-id-type="pmid">15547558</pub-id></mixed-citation></ref><ref id="B49"><label>49.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Dimick</surname><given-names>JB</given-names></name><name><surname>Pronovost</surname><given-names>PJ</given-names></name><name><surname>Cowan</surname><given-names>JA</given-names><suffix>Jr</suffix></name><etal></etal></person-group>. <article-title>Variation in postoperative complication rates after high-risk surgery in the United States</article-title>. <source>Surgery</source>. <year>2003</year>;<volume>134</volume>(<issue>4</issue>):<fpage>534</fpage>–<lpage>540</lpage>; <comment>discussion 540–541</comment><pub-id pub-id-type="pmid">14605612</pub-id></mixed-citation></ref><ref id="B50"><label>50.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Peterson</surname><given-names>ED</given-names></name><name><surname>Coombs</surname><given-names>LP</given-names></name><name><surname>DeLong</surname><given-names>ER</given-names></name><name><surname>Haan</surname><given-names>CK</given-names></name><name><surname>Ferguson</surname><given-names>TB</given-names></name></person-group>. <article-title>Procedural volume as a marker of quality for CABG surgery</article-title>. <source>JAMA</source>. <year>2004</year>;<volume>291</volume>(<issue>2</issue>):<fpage>195</fpage>–<lpage>201</lpage><pub-id pub-id-type="pmid">14722145</pub-id></mixed-citation></ref><ref id="B51"><label>51.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Koperna</surname><given-names>T</given-names></name></person-group>. <article-title>How long do we need teaching in the operating room? The true costs of achieving surgical routine</article-title>. <source>Langenbecks Arch Surg</source>. <year>2004</year>;<volume>389</volume>(<issue>3</issue>):<fpage>204</fpage>–<lpage>208</lpage><pub-id pub-id-type="pmid">14557883</pub-id></mixed-citation></ref><ref id="B52"><label>52.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Bridges</surname><given-names>M</given-names></name><name><surname>Diamond</surname><given-names>DL</given-names></name></person-group>. <article-title>The financial impact of teaching surgical residents in the operating room</article-title>. <source>Am J Surg</source>. <year>1999</year>;<volume>177</volume>(<issue>1</issue>):<fpage>28</fpage>–<lpage>32</lpage><pub-id pub-id-type="pmid">10037304</pub-id></mixed-citation></ref><ref id="B53"><label>53.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Levie</surname><given-names>M</given-names></name><name><surname>Chudnoff</surname><given-names>SG</given-names></name></person-group>. <article-title>A comparison of novice and experienced physicians performing hysteroscopic sterilization: an analysis of an FDA-mandated trial</article-title>. <source>Fertil Steril</source>. <year>2011</year>;<volume>96</volume>(<issue>3</issue>):<fpage>643</fpage>–<lpage>648.31</lpage><pub-id pub-id-type="pmid">21782168</pub-id></mixed-citation></ref><ref id="B54"><label>54.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Pascual-Pedreño</surname><given-names>A</given-names></name><name><surname>Perez-Medina</surname><given-names>T</given-names></name><name><surname>Brouard Urkiaga</surname><given-names>I</given-names></name><name><surname>Fernández-Parra</surname><given-names>J</given-names></name><name><surname>Sobreviela-Laserrada</surname><given-names>M</given-names></name></person-group>. <article-title>Practice of endoscopic gynecologic surgery: a survey of Spanish gynecologists</article-title>. <source>Eur J Obstet Gynecol Reprod Biol</source>. <year>2013</year>;<volume>169</volume>(<issue>1</issue>):<fpage>64</fpage>–<lpage>68</lpage><pub-id pub-id-type="pmid">23434402</pub-id></mixed-citation></ref><ref id="B55"><label>55.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lipscomb</surname><given-names>GH</given-names></name><name><surname>Stovall</surname><given-names>TG</given-names></name><name><surname>Ling</surname><given-names>FW</given-names></name></person-group>. <article-title>Basic laparoscopic knowledge among gynecologic laparoscopists</article-title>. <source>Am J Obstet Gynecol</source>. <year>1994</year>;<volume>171</volume>(<issue>6</issue>):<fpage>1455</fpage>–<lpage>1457</lpage>; <comment>discussion 1457–1459</comment><pub-id pub-id-type="pmid">7802053</pub-id></mixed-citation></ref><ref id="B56"><label>56.</label><mixed-citation publication-type="webpage"><article-title>Continuing professional development (CPD) overview</article-title>. <comment><ext-link ext-link-type="uri" xlink:href="http://www.ranzcog.edu.au/cpd">www.ranzcog.edu.au/cpd</ext-link>. Last updated August 14, 2012</comment></mixed-citation></ref><ref id="B57"><label>57.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Wolfe</surname><given-names>WM</given-names></name><name><surname>Levine</surname><given-names>RL</given-names></name><name><surname>Sanfilippo</surname><given-names>JS</given-names></name><name><surname>Eggler</surname><given-names>S</given-names></name></person-group>. <article-title>A teaching model for endoscopic surgery: hysteroscopy and pelviscopic surgery</article-title>. <source>Fertil Steril</source>. <year>1988</year>;<volume>50</volume>(<issue>4</issue>):<fpage>662</fpage>–<lpage>664</lpage><pub-id pub-id-type="pmid">3169289</pub-id></mixed-citation></ref><ref id="B58"><label>58.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ng</surname><given-names>YW</given-names></name><name><surname>Fong</surname><given-names>YF</given-names></name></person-group>. <article-title>Get “real” with hysteroscopy using the pig bladder: a “uterine” model for hysteroscopy training</article-title>. <source>Ann Acad Med Singapore</source>. <year>2013</year>;<volume>42</volume>(<issue>1</issue>):<fpage>18</fpage>–<lpage>23</lpage><pub-id pub-id-type="pmid">23417587</pub-id></mixed-citation></ref><ref id="B59"><label>59.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kingston</surname><given-names>A</given-names></name><name><surname>Abbott</surname><given-names>J</given-names></name><name><surname>Lenart</surname><given-names>M</given-names></name><name><surname>Vancaillie</surname><given-names>T</given-names></name></person-group>. <article-title>Hysteroscopic training: the butternut pumpkin model</article-title>. <source>J Am Assoc Gynecol Laparosc</source>. <year>2004</year>;<volume>11</volume>(<issue>2</issue>):<fpage>256</fpage>–<lpage>261</lpage><pub-id pub-id-type="pmid">15200786</pub-id></mixed-citation></ref><ref id="B60"><label>60.</label><mixed-citation publication-type="book"><person-group person-group-type="author"><name><surname>Levinson</surname><given-names>CJ</given-names></name></person-group>. <article-title>Training and credentialing</article-title>. In: <person-group person-group-type="editor"><name><surname>Kavic</surname><given-names>MS</given-names></name><name><surname>Levinson</surname><given-names>CJ</given-names></name><name><surname>Wetter</surname><given-names>PA</given-names></name></person-group>, eds. <source>Prevention and Management of Laparoendoscopic Surgical Complications</source>. <publisher-loc>Miami, FL</publisher-loc>: <publisher-name>Society of Laparoendoscopic Surgeons</publisher-name>; <year>1999</year>:<fpage>223</fpage>–<lpage>227</lpage></mixed-citation></ref><ref id="B61"><label>61.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Macedonia</surname><given-names>CR</given-names></name><name><surname>Gherman</surname><given-names>RB</given-names></name><name><surname>Satin</surname><given-names>AJ</given-names></name></person-group>. <article-title>Simulation laboratories for training in obstetrics and gynecology</article-title>. <source>Obstet Gynecol</source>. <year>2003</year>;<volume>102</volume>(<issue>2</issue>):<fpage>388</fpage>–<lpage>392</lpage><pub-id pub-id-type="pmid">12907117</pub-id></mixed-citation></ref><ref id="B62"><label>62.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lim</surname><given-names>F</given-names></name><name><surname>Brown</surname><given-names>I</given-names></name><name><surname>McColl</surname><given-names>R</given-names></name><name><surname>Seligman</surname><given-names>C</given-names></name><name><surname>Alsaraira</surname><given-names>A</given-names></name></person-group>. <article-title>A visual graphic/haptic rendering model for hysteroscopic procedures</article-title>. <source>Australas Phys Eng Sci Med</source>. <year>2006</year>;<volume>29</volume>(<issue>1</issue>):<fpage>57</fpage>–<lpage>61</lpage><pub-id pub-id-type="pmid">16623222</pub-id></mixed-citation></ref><ref id="B63"><label>63.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lim</surname><given-names>F</given-names></name><name><surname>Brown</surname><given-names>I</given-names></name><name><surname>McColl</surname><given-names>R</given-names></name><name><surname>Seligman</surname><given-names>C</given-names></name><name><surname>Alsaraira</surname><given-names>A</given-names></name></person-group>. <article-title>Hysteroscopic simulator for training and educational purposes</article-title>. <source>Conf Proc IEEE Eng Med Biol Soc</source>. <year>2006</year>;<volume>1</volume>:<fpage>1513</fpage>–<lpage>1516</lpage><pub-id pub-id-type="pmid">17946898</pub-id></mixed-citation></ref><ref id="B64"><label>64.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Niitsu</surname><given-names>H</given-names></name><name><surname>Hirabayashi</surname><given-names>N</given-names></name><name><surname>Yoshimitsu</surname><given-names>M</given-names></name><etal></etal></person-group>. <article-title>Using the Objective Structured Assessment of Technical Skills (OSATS) global rating scale to evaluate the skills of surgical trainees in the operating room</article-title>. <source>Surg Today</source>. <year>2013</year>;<volume>43</volume>(<issue>3</issue>):<fpage>271</fpage>–<lpage>275</lpage><pub-id pub-id-type="pmid">22941345</pub-id></mixed-citation></ref><ref id="B65"><label>65.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Adrales</surname><given-names>GL</given-names></name><name><surname>Donnelly</surname><given-names>MB</given-names></name><name><surname>Chu</surname><given-names>UB</given-names></name><etal></etal></person-group>. <article-title>Determinants of competency judgments by experienced laparoscopic surgeons</article-title>. <source>Surg Endosc</source>. <year>2004</year>;<volume>18</volume>(<issue>2</issue>):<fpage>323</fpage>–<lpage>327</lpage><pub-id pub-id-type="pmid">14691715</pub-id></mixed-citation></ref><ref id="B66"><label>66.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Bajka</surname><given-names>M</given-names></name><name><surname>Tuchschmid</surname><given-names>S</given-names></name><name><surname>Streich</surname><given-names>M</given-names></name><name><surname>Fink</surname><given-names>D</given-names></name><name><surname>Székely</surname><given-names>G</given-names></name><name><surname>Harders</surname><given-names>M</given-names></name></person-group>. <article-title>Evaluation of a new virtual-reality training simulator for hysteroscopy</article-title>. <source>Surg Endosc</source>. <year>2009</year>;<volume>23</volume>(<issue>9</issue>):<fpage>2026</fpage>–<lpage>2033</lpage><pub-id pub-id-type="pmid">18437471</pub-id></mixed-citation></ref><ref id="B67"><label>67.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Burchard</surname><given-names>ER</given-names></name><name><surname>Lockrow</surname><given-names>EG</given-names></name><name><surname>Zahn</surname><given-names>CM</given-names></name><name><surname>Dunlow</surname><given-names>SG</given-names></name><name><surname>Satin</surname><given-names>AJ</given-names></name></person-group>. <article-title>Simulation training improves resident performance in operative hysteroscopic resection techniques</article-title>. <source>Am J Obstet Gynecol</source>. <year>2007</year>;<volume>197</volume>(<issue>5</issue>):<fpage>542.e1</fpage>–<lpage>542.e4</lpage><pub-id pub-id-type="pmid">17980203</pub-id></mixed-citation></ref><ref id="B68"><label>68.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lentz</surname><given-names>GM</given-names></name><name><surname>Mandel</surname><given-names>LS</given-names></name><name><surname>Lee</surname><given-names>D</given-names></name><etal></etal></person-group>. <article-title>Testing surgical skills of obstetric and gynecologic residents in a bench laboratory setting: validity and reliability</article-title>. <source>Am J Obstet Gynecol</source>. <year>2001</year>;<volume>184</volume>(<issue>7</issue>):<fpage>1462</fpage>–<lpage>1468</lpage>; <comment>discussion 1468–1470</comment><pub-id pub-id-type="pmid">11408869</pub-id></mixed-citation></ref><ref id="B69"><label>69.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>McCloy</surname><given-names>R</given-names></name><name><surname>Stone</surname><given-names>R</given-names></name></person-group>. <article-title>Science, medicine and the future. Virtual reality in surgery</article-title>. <source>BMJ</source>. <year>2001</year>;<volume>323</volume>(<issue>7318</issue>):<fpage>912</fpage>–<lpage>915</lpage><pub-id pub-id-type="pmid">11668138</pub-id></mixed-citation></ref><ref id="B70"><label>70.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Berguer</surname><given-names>R</given-names></name></person-group>. <article-title>Surgery and ergonomics</article-title>. <source>Arch Surg</source>. <year>1999</year>;<volume>134</volume>(<issue>9</issue>):<fpage>1011</fpage>–<lpage>1016</lpage><pub-id pub-id-type="pmid">10487599</pub-id></mixed-citation></ref><ref id="B71"><label>71.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Bajka</surname><given-names>M</given-names></name><name><surname>Tuchschmid</surname><given-names>S</given-names></name><name><surname>Fink</surname><given-names>D</given-names></name><name><surname>Székely</surname><given-names>G</given-names></name><name><surname>Harders</surname><given-names>M</given-names></name></person-group>. <article-title>Establishing construct validity of a virtual-reality training simulator for hysteroscopy via a multimetric scoring system</article-title>. <source>Surg Endosc</source>. <year>2010</year>;<volume>24</volume>(<issue>1</issue>):<fpage>79</fpage>–<lpage>88</lpage><pub-id pub-id-type="pmid">19551434</pub-id></mixed-citation></ref><ref id="B72"><label>72.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Gallagher</surname><given-names>AG</given-names></name><name><surname>Satava</surname><given-names>RM</given-names></name></person-group>. <article-title>Virtual reality as a metric for the assessment of laparoscopic psychomotor skills. Learning curves and reliability measures</article-title>. <source>Surg. Endosc</source>. <year>2002</year>;<volume>16</volume>(<issue>12</issue>):<fpage>1746</fpage>–<lpage>1752</lpage><pub-id pub-id-type="pmid">12140641</pub-id></mixed-citation></ref><ref id="B73"><label>73.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hiemstra</surname><given-names>E</given-names></name><name><surname>Kolkman</surname><given-names>W</given-names></name><name><surname>Jansen</surname><given-names>FW</given-names></name></person-group>. <article-title>Skills training in minimally invasive surgery in Dutch obstetrics and gynecology residency curriculum</article-title>. <source>Gynecol Surg</source>. <year>2008</year>;<volume>5</volume>(<issue>4</issue>):<fpage>321</fpage>–<lpage>325</lpage><pub-id pub-id-type="pmid">21841942</pub-id></mixed-citation></ref><ref id="B74"><label>74.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Aydeniz</surname><given-names>B</given-names></name><name><surname>Gruber</surname><given-names>IV</given-names></name><name><surname>Schauf</surname><given-names>B</given-names></name><etal></etal></person-group>. <article-title>A multicenter survey of complications associated with 21,676 operative hysteroscopies</article-title>. <source>Eur J Obstet Gynecol Reprod Biol</source>. <year>2002</year>;<volume>104</volume>(<issue>2</issue>):<fpage>160</fpage>–<lpage>164</lpage><pub-id pub-id-type="pmid">12206931</pub-id></mixed-citation></ref><ref id="B75"><label>75.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Anne-Claire</surname><given-names>J</given-names></name><name><surname>Denis</surname><given-names>Q</given-names></name><name><surname>Patrick</surname><given-names>D</given-names></name><etal></etal></person-group>. <article-title>S.P.I.C. pedagogical simulator for gynecologic laparoscopy</article-title>. <source>Stud Health Technol Inform</source>. <year>2000</year>;<volume>70</volume>:<fpage>139</fpage>–<lpage>145</lpage><pub-id pub-id-type="pmid">10977527</pub-id></mixed-citation></ref><ref id="B76"><label>76.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Szekely</surname><given-names>G</given-names></name><name><surname>Bajka</surname><given-names>M</given-names></name><name><surname>Brechbuhler</surname><given-names>C</given-names></name><etal></etal></person-group>. <article-title>Virtual reality based surgery simulation for endoscopic gynaecology</article-title>. <source>Stud Health Technol Inform</source>. <year>1999</year>;<volume>62</volume>:<fpage>351</fpage>–<lpage>357</lpage><pub-id pub-id-type="pmid">10538385</pub-id></mixed-citation></ref><ref id="B77"><label>77.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Brunner</surname><given-names>WC</given-names></name><name><surname>Korndorffer</surname><given-names>JR</given-names><suffix>Jr</suffix></name><name><surname>Sierra</surname><given-names>R</given-names></name><etal></etal></person-group>. <article-title>Laparoscopic virtual reality training: are 30 repetitions enough?</article-title><source>J Surg Res</source>. <year>2004</year>;<volume>122</volume>(<issue>2</issue>):<fpage>150</fpage>–<lpage>156</lpage><pub-id pub-id-type="pmid">15555611</pub-id></mixed-citation></ref><ref id="B78"><label>78.</label><mixed-citation publication-type="book"><person-group person-group-type="author"><name><surname>Erian</surname><given-names>M</given-names></name></person-group>. <source>Discussion Document on Further Training for Doctors in Difficulty</source>. <publisher-loc>London</publisher-loc>: <publisher-name>Royal College of Obstetricians and Gynaecologists</publisher-name>; <year>2002</year></mixed-citation></ref><ref id="B79"><label>79.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Chudnoff</surname><given-names>SG</given-names></name><name><surname>Liu</surname><given-names>CS</given-names></name><name><surname>Levie</surname><given-names>MD</given-names></name><name><surname>Bernstein</surname><given-names>P</given-names></name><name><surname>Banks</surname><given-names>EH</given-names></name></person-group>. <article-title>Efficacy of a novel educational curriculum using a simulation laboratory on resident performance of hysteroscopic sterilization</article-title>. <source>Fertil Steril</source>. <year>2010</year>;<volume>94</volume>(<issue>4</issue>):<fpage>1521</fpage>–<lpage>1524</lpage><pub-id pub-id-type="pmid">19782357</pub-id></mixed-citation></ref><ref id="B80"><label>80.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Harders</surname><given-names>M</given-names></name><name><surname>Steinemann</surname><given-names>D</given-names></name><name><surname>Gross</surname><given-names>M</given-names></name><name><surname>Székely</surname><given-names>G</given-names></name></person-group>. <article-title>A hybrid cutting approach for hysteroscopy simulation</article-title>. <source>Med Image Comput Comput Assist Interv</source>. <year>2005</year>;<volume>8</volume>(<issue>Pt 2</issue>):<fpage>567</fpage>–<lpage>574</lpage><pub-id pub-id-type="pmid">16686005</pub-id></mixed-citation></ref><ref id="B81"><label>81.</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Panel</surname><given-names>P</given-names></name><name><surname>Bajka</surname><given-names>M</given-names></name><name><surname>Le Tohic</surname><given-names>A</given-names></name><name><surname>Ghoneimi</surname><given-names>AE</given-names></name><name><surname>Chis</surname><given-names>C</given-names></name><name><surname>Cotin</surname><given-names>S</given-names></name></person-group>. <article-title>Hysteroscopic placement of tubal sterilization implants: virtual reality simulator training</article-title>. <source>Surg Endosc</source>. <year>2012</year>;<volume>26</volume>(<issue>7</issue>):<fpage>1986</fpage>–<lpage>1996</lpage><pub-id pub-id-type="pmid">22234594</pub-id></mixed-citation></ref></ref-list></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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