Participants also had questions about whether ISTCs should have a decentralized, technique-based focus in which one procedure is taught at multiple sites, or a centralized, site-based focus in which the comprehensive surgical needs of a site are addressed. For a decentralized approach, participants mentioned that it could allow for diversity and smaller, more manageable tasks. For a centralized approach, participants felt that it could streamline ISTCs and allow for all of those involved to take on a more organized integrated approach.