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Measey Surgical Skills Suite

PGY1 Curriculum - BLOCK 2
DAY 1
Morning Session
Overview Tools Objectives References
Hand-sewn Bowel Anastomosis

Double-layer synthetic bowel

Surgical Instruments

Covidien suture

Understand the surgical techniques used for hand-sewn bowel anastomosis

Understand the potential complications associated with bowel anastomosis and their management

Perform a Lambert stitch and a Connell stitch

Perform a hand-sewn double-layer bowel anastomosis

  1. Scott-Conner CEH. Small bowel resection and anastomosis. Chassin's Operative Strategy in general Surgery: An Expositive Atlas, 3rd Edition. Springer-Verlag, NY 2002: 331-336.
  2. Mortensen NJ, Ashraf S. ACS Surgery principles & Practice: Intestinal Anastomosis. Available at here.
Thyroid and Parathyroid

PowerPoint

Tracheostomy models

Identify key anatomic structures for safe thyroidectomy and parathyroidectomy

Discussion of a patient with thyroid and parathyroid pathology

Obtain hemostasis with vessel ligation in a deep cervical wound

  1. Gauger PG. Thyroid Gland. Greenfield's Surgery: Scientific Principles and Practice. Lippincott, Williams & Wilkins 2005. Pgs 1289-1309.
  2. Gauger PG, Doherty GM. The Parathyroid Gland. Sabiston Textbook of Surgery. Saunders 2004. Pgs 985-999.
 
DAY 2
Morning Session
Overview Tools Objectives References
Surgery Skills Assessment Surgical skills suite Perform basic surgical tasks and recognize some surgical instruments
Evaluate the participant's baseline surgical technique and skills
 
Fundamentals of laparoscopic surgery (FLS)

FLS box

FLS materials, suture and laparoscopic instruments

Train residents on the basic laparoscopic exercises www.FLSprogram.org
 
DAY 2
Afternoon Session
Overview Tools Objectives References

Colon Cancer

Ileostomies

Colostomies

Double-layer synthetic bowel

Ostomy box trainer

Understand the pathophysiology and risk factors for colorectal canceR

Familiarize with the vascular supply and lymphatic drainage of the colon and rectum

Perform an ileostomy, loop ileostomy, and colostomy

  1. Brenner, B, Ota DM. ACS Surgery principles & Practice: Adenocarcinoma of the colon and rectum. Available at here.
  2. Paulson EC, Mahmoud N. Gowned and Gloved Surgery: Colectomy. Saunders Elsevier 2009. Pgs 131-144.
 
DAY 3
Morning Session
Overview Tools Objectives References
Vascular Anastomosis

ACS videos

Vascular board

PTFE vascular graft

Familiarize with basic vascular anastomosis techniques

Perform and end-to-end and an end-to-side vascular anastomosis

  1. Rutherford RB. Basic vascular surgical techniques. Vascular Surgery Textbook. Elsiever Saunders 2005. Pgs 661-671.
Basic Laparoscopy

Abdominal cavity box trainer

Laparoscopic ports and instruments

Veress Needle

Familiarize with the use of laparoscopic ports and location for different surgical procedures

Recognize the physiologic changes and potential complications of a pneumo -peritoneum

Perform a laparotomy opening and closure

  1. Atlas of Surgical Operations. Zollinger & Zollinger, 7th Edition. Pgs 1-10, 22-29.
  2. Chassin's Operative Strategy in General Surgery, 3rd Edition. Pgs 19-25.
  3. Ceydeli A, Rucinski J, Wise L. Finding the best abdominal closure: An evidence-based review of the literature. Current Surgery 2005; 62(2): 220-225.
 
DAY 3
Afternoon Session
Overview Tools Objectives References
Trauma (ATLS)

Simulated Trauma Bay

Laerdal® SimMan 3G

Familiarize with the Primary and Secondary Survey in the ATLS Protocol

Perform tauma scenariosusing ATLS guidelines

Perform invasive procedures commonly performed in the Trauma Bay

  1. American College of Sugeons Committee on Trauma: Advanced Trauma Life Support Manueal. American College of Surgeons, Chicago, IL: 2003.
 
DAY 4
Morning Session
Overview Tools Objectives References
OR Team Training

Simulated OR

Laerdal® SimMan 3G

Respond to a simulated OR emergency  

EKG

Cardiac Arrhythmias

PowerPoint

EKG exercises

Learn to read an EKG

Recognize the different arrhythmia EKG tracings

Recognize the proper management for each arrhythmia

  1. Basic Rules to Read an EKG. Available at here.
  2. Price D. How To Read an ECG. Part One: Basic Principles of the ECG. SSMJ, Vol 3 Issue 2 May 2010.
  3. EKG exercises. Available at here.
  4. American Heart Association, 2010 ACLS guidelines. Provider's manual.
 
DAY 4
Afternoon Session
Overview Tools Objectives References
Virtual reality simulators

Simbionix® Lap Mentor

Surgical Science® Lap Sim

Mimic® dV Robotic Trainer

SIMENDO® Laparoscopic Trainer

Train residents in basic laparoscopic tasks using high-fidelity simulators

Perform laparoscopic procedures (laparoscopic appendectomy, lap cholecystectomy, lap ventral hernia, lap GBP)

 
 
DAY 5
Morning Session
Overview Tools Objectives References
Ventral Hernia

PowerPoint

Simbionix Lap Mentor

Familiarize with the anatomical layers of the anterior abdominal wall

Assess correctly the size of the fascial defect and perform a safe lysis of adhesions using energy sources

Perform a laparoscopic ventral hernia repair using mesh

  1. Harth K, Rosen M. ACS Surgery principles & Practice: Repair of Ventral Abdominal Wall Hernias. Available at www.acssurgery.com
  2. Cobb WS, Kercher KW, Heniford BT. Laparoscopic repair of incisional hernias. Surg Clin North Am 2005; 85(1): 91-103.
 
DAY 5
Afternoon Session
Overview Tools Objectives References
ACLS

Simulated hospital room

Laerdal® SimMan 3G

Perform ACLS mega- codes using the AHA guidelines

Familiarize with ACLS algorithms

Early detection of unstable patients and prompt activation of RRT

  1. American Heart Association, 2010 ACLS guidelines. Provider's manual.
Knowledge Assessment Score Surgery Questions Evaluate knowledge retention for basic general surgery topics encountered in the ABSITE  
 

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