Training centers: an essential step to developing skills in urolaparoscopy.

Choosing laparoscopy is an important investment for urologists, and it must be learned from basic principles to advance skills through a steep learning curve; the caseload is made of frequent but very demanding procedures. In training centers, scholars are confronted with real-life conditions through large animal models. For about 1500 urologists, the European Institute of Tele Surgery has offered such a program for a decade. We evaluate its impact through a self-administered, Internet-hosted questionnaire. Individual data concern number and type of courses attended, skill level and type of practice before training, and expectations at registration. Personal benefit is evaluated through the delay before starting routine laparoscopy or the major procedures volume facing open counterparts. The ability of this program to meet scholar's expectations is reflected by eventual need for further training or by trainee suggestions. In spite of 85% cumulated satisfaction index, further developments must improve practical training: clear, reproducible stepwise protocols, repeated under supervision in animal models today and hopefully in augmented reality simulators tomorrow. The knowledge transfer and companionship made of theoretical and practical lessons followed by a straight supervised application represent an essential model for gaining proficiency.