title: Endosurgery and the senior pediatric surgeon.
abstract: BACKGROUND
  Endosurgery is difficult for the senior pediatric surgeon to master because the technique has a steep learning curve, lacks tactile sense, uses elongated instruments, and is ergonomically tiring.
  
  
  METHODS
  The senior author, starting at age 53, has performed more than 300 endoscopic procedures at both children and community hospitals. A full year was required to master laparoscopic Nissen fundoplications. Conversion to open procedures from bleeding and enterotomies were committed in the first year of endosurgery. Facility with endosurgery is gained by performing common and frequent procedures as appendectomies.
  
  
  CONCLUSIONS
  The advantages of endosurgery in pain control and shortened hospitalization make the technique deserving of commitment by the senior pediatric surgeon.
authors.affiliation: Hospital for Infants and Children at Presbyterian/St Lukes Hospital, Denver, CO, USA.
authors.forename: J H
authors.initials: JH
authors.lastname: Chang
authors.forename: S S
authors.initials: SS
authors.lastname: Rothenberg
authors.forename: J F
authors.initials: JF
authors.lastname: Bealer
authors.forename: L A
authors.initials: LA
authors.lastname: Hamby
authors.forename: R W
authors.initials: RW
authors.lastname: Suadi
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D004502:Education, Medical, Continuing / Q000458:organization & administration*; D004724:Endoscopy / Q000191:economics / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data*; D013502:General Surgery / Q000193:education*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control; D010372:Pediatrics / Q000193:education*; D013997:Time Factors