First of all you need to be a board-certified general surgeon to do this procedure. It's done laparoscopically, so with a minimally invasive surgery.
We have some of the basic skills, but because it is a new procedure, we are mentored by a surgeon who has performed over 1,000 of these procedures. There's a systematic mentorship program. In our case it was Dr. Steve Miller from Drummondville, Quebec. He came to Lakeview. He showed us how to do the first few procedures. Then he assisted, and then he stepped aside and watched us perform the procedure. After approximately 25 cases, he certified us and felt we were safe to perform these alone.
It's much like a pilot who's learning to fly a new airplane. He still has the fundamental skills of flying, but he will have to learn the idiosyncrasies of a specific procedure. It's an excellent question.