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Measey Surgical Skills Suite

PGY1 Curriculum - BLOCK 3
DAY 1
Morning Session
Overview Tools Objectives References
Stapled GI Anastomosis

Powerpoint

Covidien Staplers

Foam Bowel model

Understand the advantages of stapled bowel anastomosis vs hand-sewn anastomosis

Review the differences between a TA, GIA, and EEA

Perform a functional end-to-end bowel anastomosis using staplers

  1. Mortensen NJ, Ashraf S. ACS Surgery principles & Practice: Intestinal Anastomosis. Available at here.
  2. Meade B, moran B. Reducing the incidence and managing the consequences of anastomotic leakage after rectal resection. Acta Chir Lugos 2004; 51(3): 19-23.

Shock

PA Catheters

Powerpoint

Edwards® Swan Catheters

Understand the different types of shock

Understand the indications for PA catheter placement

Familiarize with the insertion technique for Swan catheters

  1. Holcroft JW, Anderson JT, Sena MJ. ACS Surgery principles & Practice: Shock. Available at here.
  2. Silvestry, F. UpToDate: Pulmonary Artery catheterization: Interpretation of Tracings. August 2010.
 
DAY 1
Afternoon Session
Overview Tools Objectives References
Colonoscopy

PowerPoint

Simbionix® GI Mentor
Immersion Endoscopy AccuTouch® System

Understand the basic handling of a colonoscope

Perform a colonoscopy and flexible sigmoidoscopy

  1. Gordon PH, Nivatvongd S. Principles and Practice of Surgery for the Colon, Rectum and Anus: Colonoscopy. Pgs 112-124.
 
DAY 2
Morning Session
Overview Tools Objectives References

Carotid Stenosis

Peripheral Vascular Disease

PowerPoint

Mentice® VIST trainer

Understand the pathophysiology of Carotid Stenosis

Recognize the surgical indications for an open CEA vs carotid stenting

Perform an Internal Carotid balloon angioplasty and stenting

  1. Wang G, Fairman R. Gowned and Gloved Surgery: Carotid Endarterectomy and Carotid Stenting. Saunders Elsevier 2009. Pgs 210-216.
  2. Aburahma AF, Stone PA. ACS Surgery principles & Practice: Asymptomatic Carotid Bruit & Carotid Stenosis. Available at www.acssurgery.com
 
DAY 2
Afternoon 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

FLS box

FLS

Train residents on the basic laparoscopic www.FLSprogram.org
 
DAY 3
Morning Session
Overview Tools Objectives References
Central Line Removal PowerPoint

Recognize potential complications of CVC removal

Familiarize with the management of air embolisms

  1. Morgan B. London Health Sciences CenteR: procedure for Removal of CVC. Nov 2000. Available at here.
  2. O'Dowd, Kelly MA. UpToDate: Air Embolism. Available here.
Appendicitis

PowerPoint

Surgical Science® LapSim trainer

Understand the pathophysiology of appendicitis

Identify the open vs laparoscopic operative techniques for an appendectomy

Perform a laparoscopic appendectomy using a stapler

  1. Rodriguez JA, Roses R, Braslow B. Gowned and Gloved Surgery: Appendectomy. Saunders Elsevier 2009. Pgs 123-130.
  2. So HS. ACS Surgery principles & Practice: Appendectomy. Available at here.
  3. Sauerland S, Neugebauer EAM, Lefering R. Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Review 2002; 1: CD001546.
 
DAY 3
Afternoon Session
Overview Tools Objectives References

Cholecystitis

Complications of Gallbladder Surgery

PowerPoint

Surgical Science® LapSim trainer

Simbionix® Lap Mentor

Identify the triangle of Calot and understand the importance of the "critical view of safety"

Identify steps to reduce complications associated with laparoscopic and open cholecystectomy

Perform a laparoscopic cholecystectomy

  1. Paulson EC, Roses R, Morris J. Gowned and Gloved Surgery: Laparoscopic Cholecystectomy. Saunders Elsevier 2009. Pgs 92-101.
  2. Scott-Conner C. Chassin's Operative Strategy in General Surgery: Cholecystectomy, 3rd Edition. Springer 2002. Pgs 572-585.
  3. Way LW, Stewart L, Gantert W. Causes and prevention of laparoscopic bile duct injuries: Analysis of 252 cases from human factors and cognitive psycology perspective. Ann Surg 2003; 237: 460-469.
 
DAY 4
Morning Session
Overview Tools Objectives References
OR Team Training

Simulated OR

Laerdal® SimMan 3G

Respond to a simulated OR emergency  
Gastric Cancer

Powerpoint

Double-layer synthetic bowel

Familiarize with the most common gastric tumors

Identify steps to reduce complications associated with vagotomy, pyloroplasty, and gastrectomy

  1. Newman A, Spitz F. Gowned and Gloved Surgery: Gastrectomy. Saunders Elsevier 2009. Pgs 55-67.
  2. Dempsey DT, Pathak A. Operative Techniques in General Surgery: Antrectomy. 2003, vol 5(2): 86-100.
 
DAY 4
Afternoon Session
Overview Tools Objectives References
Carotid Endarterectomy

PowerPoint

CEA training models

Perform a carotid endarterectomy
  1. Wang G, Fairman R. Gowned and Gloved Surgery: Carotid Endarterectomy and Carotid Stenting. Saunders Elsevier 2009. Pgs 210-216
  2. Aburahma AF, Stone PA. ACS Surgery principles & Practice: Asymptomatic Carotid Bruit & Carotid Stenosis. Available at here.
Critical Care

Simulated Critical Care Unit

Laerdal® SimMan 3G

Manage a RRT scenario in the floor

Familiarize with how to manage an unstable patient in the ICU

Understand the principles of early goal directed therapy in septic shock

  1. Moore LJ, Moore FA. ACS Surgery principles & Practice: Early management of sepsis, severe sepsis, and septic shock in the surgical patient. Available at here.
  2. Society of Critical care Medicine. Fundamental Critical Care Support Manual, 4th Edition. Ch 7: Diagnosis and Management of Shock.
  3. Rivers E, Nguyen B, Havstad S. Early Goal-Directed Therapy in the Treatment of Severe Sepsis and Septic Shock. N Engl J Med 2001; 354: 1368-1377.
 
DAY 5
Morning Session
Overview Tools Objectives References
Percutaneous Gastrostomy Tubes (PEGs)

PowerPoint

Olympus® Scopes

PEG trainer model

Simbionix® GI Mentor

Immersion Endoscopy AccuTouch® System

Understand the basic handling of the upper endoscope

Understand how to minimize complications after PEG tube insertion

Perform a PEG tube insertion

Perform an EGD

  1. Herdrich B, Morris J. Gowned and Gloved Surgery: Enteral Access Procedures. Saunders Elsevier 2009. Pgs 77-84.
 
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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