技術認定制度のこれまでとこれから

The past and future of the Endoscopic Surgical Skill Qualification System of the Japan Society for Endoscopic Surgery

◆要旨：手術技量を未編集の手術動画を用いて評価する技術認定制度は2004年度に開始され20年余が経過した．当初は内視鏡外科の安全な普及が主目的であったが，現在ではそれに加えて指導者たる技量が問われるようになっている．2023年度までに3,491名の合格者を輩出し，技術認定医の指導医としての意義を示すエビデンスも見られるようになった．これまで審査の枠組みに大きな変更はないものの，時代に合わせて細かな改訂が加えられてきており，最近ではロボット支援手術の技術認定にも迅速に対応した．今後この制度のあるべき姿として，特に若手外科医の手術手技習得に対するモチベーション向上につなげていくことが重要だと考えている．

　The Endoscopic Surgical Skill Qualification System of the Japan Society for Endoscopic Surgery was launched in 2004 to evaluate surgical skills using unedited surgery videos, and more than 20 years have passed since its inception. Initially, the primary goal was to promote the safe adoption of endoscopic surgery. However, today, the certification also assesses the proficiency required of instructors. As of 2023, 3,491 individuals have been certified, and there is now evidence showing the value of certified surgeons as trainers. Although the overall assessment framework has remained largely unchanged, minor revisions have been made over the years to stay current, including a recent, swift adaptation for robot-assisted surgery certification. Going forward, it is important for this system to focus on motivating young surgeons in acquiring surgical skills, shaping its role to best support this goal.