LSS is a versatile programme that offers a standard for comprehensive performance assessments for training and education in laparoscopic surgery within a multi-level curriculum. LSS focuses on safeguarding the quality of performance in laparoscopic procedures and goes beyond the basic skills. LSS is the first standard that combines criterion-based assessment in the skillslab with clinical assessment of performance on index procedures.

Target Group

LSS is developed for surgeons in training, surgical fellows, practising surgeons and other physicians who perform laparoscopic surgery or would like to acquire laparoscopic skills.

The LSS Assessment


The LSS assessment incorporates a sequence of tests to evaluate a surgeon’s proficiency in cognitive skills, surgical technical skills, and judgment. To this end, web-based study material and examinations are combined with various hands-on simulation modalities, scenario-based assessment, and clinical performance assessment. All LSS assessments are criterion-based and very practice-oriented.

Eligible physicians can enroll for the LSS assessment or an LSS accredited course, in which the LSS assessment is integrated. To enroll for a LSS assessment contact the LSS office.

A multi-level programme

The LSS curriculum is divided into two grades. Grade I is divided into three consecutive levels and includes all basic laparoscopic skills and fundamental laparoscopic procedures. Grade II consists of several separate assessments each focusing on a specific advanced laparoscopic procedure, such as laparoscopic colon surgery or laparoscopic bariatric surgery.

Each level within the LSS curriculum addresses specific index procedures. LSS Grade I Level 1 is aimed at laparoscopic cholecystectomy, laparoscopic appendicectomy, and diagnostic laparoscopy. Grade I Level 2 concentrates on laparoscopic suturing for procedures, with the difficult laparoscopic cholecystectomy, laparoscopic repair of incisional hernia, laparoscopic repair of perforated duodenal ulcer, and common bile duct (CBD) exploration as index procedures. The tasks and procedures in Grade I Level 3 become increasingly more complex with anti-reflux procedures (Nissen fundoplication), laparoscopic incisional hernia repair, common bile duct (CBD) exploration, laparoscopic splenectomy, and laparoscopic inguinal hernia repair as index procedures.



LSS accredited courses

LSS accredited courses are offered in an increasing number of surgical training centres throughout Europe. The LSS accredited courses follow a goal-oriented and criterion-based approach that takes the training needs of each individual participant into account. The LSS assessment is embedded in the LSS accredited course. LSS accredited courses are constructed around a vast amount of deliberate practice on a range of simulation tools and interactive expert discussions. The accredited courses offer a well-balanced mix of theory application and hands-on training.

For more information on how to become a LSS accredited training and/or assessment centre, please contact the LSS office.


The LSS Diploma

To receive the LSS diploma for a specific level the applicant needs to successfully pass all of the tests incorporated in the assessment for that level. All LSS diplomas for the different LSS expertise levels are recognised by the European Association for Endoscopic Surgery (EAES).

Currently, the LSS standard and the LSS diplomas are still in the process of building profile and attaining endorsement and recognition by European national healthcare authorities and local surgical associations. Please check with regional authorities to learn whether they already acknowledge the LSS diploma as accreditation to perform laparoscopic surgical procedures.