Surgical skills education and training in fetoscopy and fetal surgery

Abstract Introduction Surgical education must constantly evolve to align with the most current methods of surgical practice. This paper presents our experience organizing ten international editions of a training course in fetoscopic surgery. We have developed various inanimate training models and a sheep-animal model for fetal surgery training and research, which are both practical and reproducible. Methods Various practices and surgical sessions are developed during training: Knowledge of sheep anatomy and physiology as a model of pregnancy, introduction to basic fetoscopy equipment, exploration of the uterine cavity, use of the Nd-YAG laser for photocoagulation of placental vessels, resolution of fetal and amniotic constriction bands, and endoscopic balloon tracheal occlusion (for the treatment of severe CDH). Results Fetoscopic surgery is technically challenging, and learning new skills in a clinical setting can be risky. Successful performance requires acquiring a new set of technical skills and familiarity with specific surgical procedures. Understanding how to use the fetoscope, learning intrauterine vessel orientation, and becoming familiar with laser coagulation before operating on patients can reduce surgical complications. This training can shorten the learning curve for new surgeons and reinforce practice among experts as fundamental skills are developed using realistic tissue models and surgical simulators. Conclusion The sequential skill acquisition programme using a simulator and animal model is transferable to human patients and shortens the learning curve for new specialists, although expert consultation is recommended in the initial phase to minimize potential complications.