Advanced laparoscopic skills acquisition: the case of laparoscopic colorectal surgery.

Acquisition of advanced technical skills requires commitment, time, patience, and discipline (eg, the 10-year rule). Dabbling is not a recipe for success. Despite the value of all other teaching methods, guided practice with feedback is essential to develop the high level of visuospatial perceptual ability (observation and performance with feedback) that is necessary for advanced MIS. The necessary ingredients to skill acquisition for advanced MIS procedures (laparoscopic colorectal surgery) for a practicing surgeon include introduction through short courses, access to skill stations, and access to preceptorship or mini-sabbatical. For residents in training, there is no better alternative than an MIS fellowship. In an ideal world where there are enough trainers, the residency environment should provide this training. Comprehensive strategies of knowledge transfer for practicing surgeons should be designed with the input of experts in knowledge transfer.