Summary

■ With carefully planned strategies and proper balance between the complexity of procedures and the experience of the surgeon, advanced urologic laparoscopy in a community setting can yield results comparable to major academic centers.

■ A nonexclusive, but constant and unyielding full-time commitment is crucial to develop laparoscopic ability while practicing general urology.

■ To develop specific technical aspects, didactic lectures, live case observation, videos, animate and inanimate labs are valuable methods. For the inexperienced laparoscopist, a preceptor or mentor should be mandatory prior to delving into any advanced case. Videotaping procedures for future self-review or review by an experienced laparoscopist can be helpful, particularly when matched with patient outcome.

■ Specific technical modifications are often appropriate for the community urologist.

■ Technical nuances of surgical equipment can be found in laparoscopic periodicals, trade shows, and Internet sites.

■ Reliable teamwork can be achieved creating a laparoscopic team founded on mutual respect, which encourages the same personnel to be present for all laparoscopic cases.

■ To a large degree, laparoscopy markets itself. However, one must take care to promote accurate expectations. The best approach to marketing exists in the form of education. Sources for patients include a practice web site, brochures, prior patients, and community-targeted talks. The smallest marketing opportunity can yield dividends in the future.

■ Keys to successful laparoscopy in the community setting include the balance between complexity and ability, tools and technique, technology and personnel, and most importantly, workload and enjoyment.

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