INTRODUCTION: Advanced minimal access surgical training is an important component of training in gynecological oncology (GO). Europe-wide data on this topic are lacking. We present data on availability and trainee experience of advanced laparoscopic surgical (ALS) and robotic surgical (RS) training in GO across Europe. METHOD: A prospective web-based anonymized survey of European GO trainees was sent to the European Network of Young Gynaecological Oncologists members/trainees. It included sociodemographic information and specific questions pertaining to training experience or satisfaction in laparoscopic and robotic surgery. χ2 test was used for evaluating categorical variables and Mann-Whitney/Kruskal-Wallis (nonparametric) tests for continuous variables between 2 and more independent groups. RESULTS: A total of 113 GO trainees from 29 countries responded. The mean (standard deviation) age was 35.2 (6.1) years, 59.3% were men, 40.7% were women, and 46% were in accredited training posts. The ALS and RS training was offered in only 43% and 23% of institutes respectively, and 54% and 23% of trainees had undergone some form of formal or informal training in ALS and RS respectively. A total of 62.4% felt that RS should be a formal component of GO training programs. A total of 61% and 35% planned to go outside their institute for ALS or RS training respectively. Trainees rating (1-5 scale) of their open surgery and ALS or RS skills (3.3/2.6/1.9) and training experience (3.5/2.8/2.1), respectively, were higher for open surgery than ALS or RS (P < 0.0005). Accredited posts were more likely than nonaccredited posts to offer ALS training (60%/31%, P = 0.002), formal training schedules (27.9%/4.4%, P = 0.003), and use of logbooks (46%/23%, P = 0.035). CONCLUSIONS: Training and experience in ALS and RS are poorly rated by GO trainees across Europe, and only few centers offer this. There is an urgent need to expand and harmonize training opportunities for ALS and RS. Most trainees want RS included as a formal component of their training.

14 Department of Women's Cancer EGA Institute of Women's Health University College London London United Kingdom

Department of Gynaecological Oncology Royal London Hospital Whitechapel London United Kingdom 2 Department of Obstetrics and Gynecology University of Freiburg Freiburg Germany 3 Comprehensive Cancer Center South Location Catharina Hospital Eindhoven The Netherlands 4 2nd Medical Faculty of the Charles University Prague Czech Republic 5 1st Department of Obstetrics and Gynecology Gynecologic Oncology Unit Alexandra Hospital Athens Greece 6 Gynaecologic Oncology Unit La Paz University Hospital Madrid Spain 7 Department of Gynecology European Competence Center for Ovarian Cancer Charite University Medicine of Berlin Berlin Germany 8 Medical Faculty University of Belgrade Department of Obstetrics and Gynecology Clinical Center of Serbia Belgrade Serbia 9 Clinic of Obstetrics and Gynecology Medical Faculty University of Duisburg Essen Germany 10 Oncogynecological Centre Charles University Hospital Prague Czech Republic 11 Paoli Calmettes Institute Marseille France 12 Division of Surgical and Oncological Gynaecology University Medical Center Utrecht Utrecht The Netherlands 13 Barts Cancer Institute Queen Mary University of London

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