Editorial

In experienced hands…: the current challenges of laparoscopic education Minimal surgical invasiveness should translate into minimal peri-operative morbidity. Based on this assumption and encouraged by the report of the first total laparoscopic hysterectomy in 1990 (Reich, 2007), endoscopic surgery has undergone a remarkable development. Laparoscopy has demonstrated its technical ability to perform gynaecological and abdominal surgery for most benign and malignant conditions (Canis et al., 2001; Walsh et al., 2009). Advances in image quality, surgical instruments and energy generation have allowed to perform more complex procedures in the fields of pelvic floor repair, deep endometriosis and oncology. In this context, adequate radicality is reported while reduced post-operative pain, intra-operative blood loss and hospital stay are noted (Galaal et al., 2012). After a fourth of a century of an exciting surgical journey, one must admit that laparoscopy has come to a paradoxical status. While the limits of the endoscopic approach are pushed further everyday by some experts practicing in specialized surgical centres (Ferron et al., 2012), the proportion of patients treated by laparoscopy for even standard procedures has remained steadily low over the last decades. In France, where many of the laparoscopic operations have been pioneered, only 8000 of the 60000 patients (13%) undergoing a hysterectomy