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Measey Surgical Skills Suite

PGY1 Curriculum - BLOCK 4
DAY 1
Morning Session
Overview Tools Objectives References
Principles of Robotic Training Mimic® dV Robotic Trainer

Familiarize with the robot console

Perform basic tasks on the robotic trainer

  1. da Vinci Online
Chest Tubes

PowerPoint

ACS videos

Chest Tube training model

Understand the indications for needle thoracentesis and chest tube placement

Understand potential complications of thoracentesis and chest tube placement

Insert a chest tube using a safe technique

  1. Sola K, Lillemoe K, Chen H. Manual of Common bedside Surgical Procedures. Williams and Wilkins 1995. Pgs 106-115.
  2. ACS Committee on Trauma: Advanced Trauma Life Support Manual. ACS, Chicago 2003.
Bronchoscopies

Powerpoint

Immersion Endoscopy AccuTouch® System

Familiarize with the bronchoscope

Understand the bronchial anatomy

Perform a bronchoscopy

  1. Diagnostic flexible bronchoscopy and accessory techniques. Rev Port Pneumol 2012, Feb 6. In press.
  2. Wilson K. Flexible bronchoscopy: Indications and contraindications. UpToDate November 2010.
    Available at here.
 
DAY 2
Morning Session
Overview Tools Objectives References
Endovascular Surgery

PowerPoint

Aortic AAA Glass trainer

Understand the pathophysiology that originates AAAs and TAAs

Understand the indications for an EVAR versus and open AAA repair

Understand the indications for a TEVAR versus and open Thoraco-abdominal repair

  1. Fernandez N, Rhee R. ACS Surgery principles & Practice: Descending and Thoracoabdominal Aortic Aneurysms: Open and Endovascular Repair. Available at here.
 
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 surgery (FLS)

FLS box

FLS materials, suture and laparoscopic instruments

Train residents on the basic laparoscopic exercises www.FLSprogram.org
 
DAY 3
Morning Session
Overview Tools Objectives References
Surgical Nutrition PowerPoint

Understand the indications for nutritional Intervention

Identify which are the daily nutritional requirements and special cases in which they need to be modified

  1. Dietary reference intakes: The essential guide to nutrient requirements. Washinton, DC: The Natuional Academies Press 2006.
  2. Ryan JA, Page CP, Babcock L. Early postoperative jejunal feeding of elemental diet in GI surgery. Am Surg 1981; 47:393.
 
DAY 3
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 4
Morning Session
Overview Tools Objectives References
OR Team Training Simulated OR
Laerdal® SimMan 3G
Respond to a simulated OR emergency  
Neuroendocrine Tumors PowerPoint

Familiarize with some common NE tumors such as insulinoma, glucagonoma, pheochromocytoma

Understand the management of neuroendocrine tumors

  1. Elaraj D, Sturgeon C. ACS Surgery principles & Practice: Neuroendocrine Tumors of the Pancreas.
    Available at here.
 
DAY 4
Afternoon Session
Overview Tools Objectives References
AAA

Simulated OR

AAA training model

Understand the basic principles of an open AAA repair

Perform a AAA repair

  1. Fernandez N, Rhee R. ACS Surgery principles & Practice: Descending and Thoracoabdominal Aortic Aneurysms: Open and Endovascular Repair. Available at here.
 
DAY 5
Morning Session
Overview Tools Objectives References
Gastric Bypass

PowerPoint

Mimic® dV Robotic Trainer

Simbionix® Lap Mentor

Understand the nutritional physiologic changes associated with a GBP

Familiarize with the GBP surgical technique

Perform a laparoscopic GBP

  1. Lewis R, Williams N. Gowned and Gloved Surgery: Gastric Bypass. Saunders Elsevier 2009. Pgs 68-76.
Nissen Fundoplication

PowerPoint

ACS videos

Describe the steps in a laparoscopic Nissen fundoplication and errors commonly seen with each step

Perform a laparoscopic Nissen fundoplication

  1. Cuenca-Abente F, Oelschlanger BK, Pellegrini CA. Principles of Successful Surgical Antirefluc Procedure. Managing Failed Antireflux Therapy. Springer-Verlag 2006.
  2. Cuenca-Abente F, Oelschlanger BK, Pellegrini CA. Principles of Successful Surgical Antirefluc Procedure. Managing Failed Antireflux Therapy. Springer-Verlag 2006.
  3. Cuenca-Abente F, Oelschlanger BK, Pellegrini CA. Principles of Successful Surgical Antirefluc Procedure. Managing Failed Antireflux Therapy. Springer-Verlag 2006.
 
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 algorithm

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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