摘要：The introduction of a certification / diploma program in Minimal Invasive Surgery (MIS) is expected to improve
surgical performance, patient’s safety and outcome. The Gynaecological Endoscopic Surgical Education and
Assessment programme (GESEA) and the ESHRE Certification for Reproductive Endoscopic Surgery (ECRES)
provides a structured learning path, recognising different pillars of competence. In order to achieve a high level
of competence a two steps validation is necessary: (a) the individual should be certified of having the appropriate
theoretical knowledge and (b) the endoscopic psychomotor skills before entering in the diploma programme
reflecting the surgical competence. The influence of such an educational and credentialing path could improve
safety and offer financial benefits to the hospitals, physicians and healthcare authorities. Moreover the medicolegal
consequences can be important when a significant amount of surgeons possess the different diplomas. As the
programs are becoming universally accessible, recognised as the best scientific standard, included in the continuous
medical education (CME) and continuous professional development (CPD), it is expected that a significant number
of surgeons will soon accomplish the diploma path. The co-existence and practice of both non-certified and certified
surgeons with different degrees of experience is unavoidable. However, it is expected that national health systems
(NHS), hospitals and insurance companies will demand and hire doctors with high and specific proficiency to
endoscopic surgery. When medico-legal cases are under investigation, the experts should be aware of the limitations
that individual experience provides. The court first of all examines and then judges if there is negligence and decides
accordingly. However, lack of certification may be considered as negligence by a surgeon operating a case that
eventual faces litigation problems. Patients’ safety and objective preoperative counselling are mandatory, directly
connected to MIS certification while eliminating any dispute of surgeons’ credibility.
