Role of ELSA in Training
ELSA being the professional society representing Asia in the field of endoscopic and laparoscopic surgery, has the responsibility to set standards on the practice and training of endoscopic and laparoscopic surgery that are agreeable by all the country members. This set standards will be the guide to member countries in its practice and training in minimally invasive surgery. Since how one practice is heavily dependent on the training that the surgeon has received before he / she applies his / her skills, a guideline on training of minimally invasive surgery will be the key to the standard of care provided by the surgeons.
However, the guidelines on training promulgated by ELSA should also reflect the practical situations in each country in Asia. A uniform guideline to be applied to each country will be difficult due to the widely varied economic, political, professional situations. But a set of principles of guidelines on training that is agreed by all countries will be useful to the development of minimally invasive surgery in the member countries.
Accreditation of Training as a means to attain acceptable standard
While it is important to lay down guidelines on practice and standard of care for surgeons to follow, those guidelines are already easily available from other international organizations and each country should adapt those international standards to suit their need. On the other hand, recommendation on guidelines on practice should be updated all the time to reflect new developments. We feel that it should be the responsibility of the professional or governmental organizations of individual country in the monitor of the practice of surgeons in minimally invasive surgery. However, what ELSA can do at this stage is to promulgate its guidelines on how people should be trained in minimally invasive surgery so that people would acquire knowledge and skills in minimally invasive surgery in the proper manner so that certain standards can be achieved. These guidelines are meant to be recommendations for corresponding professional organizations to follow. If the ELSA guidelines on training can be more explicit and concrete, they will represent the standard of minimally invasive surgery training in Asia that is transparent to all concerned parties and stakeholders. In so doing, the ELSA guidelines will be more credible and through proper accreditation process, facilities that meet the prerequisite criteria can be labeled as ELSA accredited training centers and this will facilities the development of minimally invasive surgery in Asian countries and at the same time safeguards the acceptable standards are being met.
It is important to have centers or facilities that meet certain criteria and are deemed adequate in the ability to provide training in minimally invasive surgery and be accredited as ELSA training centers. It does not mean that training provided by centers other than ELSA centers are not acceptable. This label of ELSA centers only mean that those centers have attained certain standards that the ELSA has endorsed.
ELSA training centers should be institutions where adequate training facilities are available for training and regular training courses are provided. Training courses can be in form of fellowship programs, courses in basic and advanced laparoscopic and endoscopic surgery and hands-on training opportunities on animate and / or inanimate models.
Training facilities should include
- facilities for classroom teaching
- facilities for hand-on training on animate and / or inanimate needs
- training resources such as videos, books, journals and electronic access to publications
- structured training courses or programs that are delivered regularly to trainees
- The training centers should also be centers where laparoscopic and endoscope works are regularly performed and audits on those works were regularly carried out to ensure acceptable outcomes are achieved. Centers may be classified according to the major laparoscopic or endoscopic work done in the centre and types of training programs delivered.
Examples -- laparoscopic cholecystectomy
Advanced laparoscopy (in subspecialties)
As many centers may have more interest in some kinds of advanced laparoscopic work and not others, it may be useful to classify them according to the subspecialty the centers are most experienced in
Examples -- advanced laparoscopic surgery in
Good trainers are the key to success of every training program. Trainees very often follow what their trainers or mentors do when they practice independently. Therefore given the training facilities are adequate, the quality of trainers should be safeguarded with explicit rules stating their qualifications, experience in minimally invasive surgery and ability in coaching others. Although appointing qualified trainers are so important, it is difficult for ELSA as an international body to govern who should be able to train others in minimally invasive surgery and this job should be left to the individual countries’ professional organizations. However, the ELSA can keep a list of qualified minimally invasive surgery trainers as recommended by the individual country professional organization as a reference that can be a useful resource for trainees seeking training opportunities.
Procedures for Accreditation
Application sent to ELSA secretariat by interested centers
Application passes to Accreditation Board
Secretary General to organize Inspection Team
Inspection of Center (if deemed appropriate)
Report of inspection and recommendation to Accreditation Board for approval
Endorsement by President of ELSA
Endorsed Training Center List
Center of Excellence for Minimal Access Surgery Training (CEMAST)
Chinese University of Hong Kong Jockey Club Minimally Invasive Surgical Skills Centre
Prince of Wales Hospital, Shatin, Hong Kong
Indonesian Endo-Laparoscopic Training Centre
Minimally-Invasive Laparo-endoscopic Surgery (MILES) Training Centre
Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
Minimal Access Surgery Training Centre
Pamela Youde Nethersole Eastern Hospital, Hong Kong
Minimally Invasive Surgery Development Centre
United Christian Hospital, Hong Kong
Minimally Invasive Surgical Centre
National University Hospital, Singapore
Philippine Center for Advance Surgery (PCAS)
Cardinal Santos Medical Center, Metro Manila, Philippines