The changes in operative gynecology in the past decades have been dramatic in terms of shifting strategies.For example there has been a shift not only from ultraradical techniques such as exenterations,which were firs...The changes in operative gynecology in the past decades have been dramatic in terms of shifting strategies.For example there has been a shift not only from ultraradical techniques such as exenterations,which were first proposed by Brunschwig in 19481 and used in gynecologic oncology by Felix Rutledge in 1974,2 to minimally invasive techniques such as endoscopic or robotic surgery,but also the level of training in terms of anatomical and surgical skills,which are significantly influenced by medico-legal aspects(i.e.,legal regulations).Thus there has been a significant reduction of personal expertise and a changing attitude towards life goals.Moreover,with the European Working Time Directive leading to a reduction in working hours and expansion of the number of trainees,surgical training in areas such as operative experience,patient management,communication,and teaching skills has been getting worse.展开更多
文摘The changes in operative gynecology in the past decades have been dramatic in terms of shifting strategies.For example there has been a shift not only from ultraradical techniques such as exenterations,which were first proposed by Brunschwig in 19481 and used in gynecologic oncology by Felix Rutledge in 1974,2 to minimally invasive techniques such as endoscopic or robotic surgery,but also the level of training in terms of anatomical and surgical skills,which are significantly influenced by medico-legal aspects(i.e.,legal regulations).Thus there has been a significant reduction of personal expertise and a changing attitude towards life goals.Moreover,with the European Working Time Directive leading to a reduction in working hours and expansion of the number of trainees,surgical training in areas such as operative experience,patient management,communication,and teaching skills has been getting worse.
