TOTAL LAPAROSCOPIC HYSTERECTOMY TRAINING COURSE FOR THE SIMBIONIX LAP MENTOR

Description

Hysterectomy, removal of the uterus, is the second most common major operation among women in the United States. Approximately 600,000 hysterectomies are performed yearly in the United States at a cost of nearly $5 billion, according to the Centers for Disease Control and Prevention.

While studies indicate that many hysterectomies can safely and successfully be performed using laparoscopic techniques, the majority of these surgeries are performed abdominally through an “open” laparotomy incision. Despite laparoscopic surgery’s advantages in appropriately selected patients – less postsurgical pain, quicker recovery times and smaller scars — OB/GYN’s have lagged behind other fields in adopting this minimally-invasive approach.

There is a great need for scientifically-validated, advanced surgical simulation training that will assist practicing OB/GYN’s in the transfer of surgical skills from the “open” abdominal hysterectomy approach to the laparoscopic approach, as well as train residents and fellows in the latest techniques for laparoscopic hysterectomy.

The following training curriculum for Total Laparoscopic Hysterectomy provides repetitive practice of surgical skills required for the Total Laparoscopic Hysterectomy procedure, in a safe and reproducible environment.

The course is intended for practicing OB-GYN surgeons, as well as residents and fellows, who are familiar with basic laparoscopic skills and gynecological procedures. Refer to ‘Basic Laparoscopic Gynecology Skills and Procedures Course’ for comprehensive basic skills and basic gynecological procedure training.

Prior to participating in the hysterectomy course, the participant should demonstrate a minimal skill level for two basic laparoscopic tasks in the basic course referenced above. The required skill levels are derived from the Development of a Virtual Reality Training Curriculum for Laparoscopic Cholecystectomy (Darzi et al. British Journal of Surgery 2009; 96: 1086–1093).

In the second course component the participant performs a total laparoscopic hysterectomy procedure using the LAP Mentor simulator. Participants train in the key components of the procedure: Uterine manipulation, superior pedicle division, bladder mobilization, exposure and division of the uterine vessels and performance of a colpotomy. The course of the ureters may be visualized transperitoneally, or through a retroperitoneal dissection. Either salpingo-oophorectomy or preservation of the adnexa may be performed.

Included in this curriculum are a variety of complications and emergency situations that may occur during the key steps of the procedure including: Ureteral injuries, injury to the bladder or bowel and uterine artery bleeding. The simulation also provides the surgeon with flexibility to determine the extent of bladder mobilization, identification of the course of the ureters, and recognition of the cervico-vaginal margin during colpotomy. All the key decision points of the actual procedure are incorporated into a realistic surgical environment. The curriculum provides a complete educational solution, including videos of individual steps of the real procedure, step-by-step procedural guidance and comprehensive objective performance metrics.