General Surgery PGY-2


This curriculum aims to provide the participant with the essential simulation assignments needed to acquire the skills and core competencies for General Surgery PGY-2 training.

Proficiency-Based Training

Training within a proficiency-based virtual reality curriculum may reduce errors during real surgical procedures. The basic skills and laparoscopic cholecystectomy training within this curriculum is based on Development of a Virtual Reality Training Curriculum for Laparoscopic Cholecystectomy (Darzi et al. British Journal of Surgery 2009; 96: 1086–1093). The aim of the training curriculum is for an individual to acquire skills and reach a predetermined level of proficiency before progressing to more challenging cases.

The course components include:

  1. Basic Laparoscopic Skills Training
  2. Basic Laparoscopic Skills – Demonstration of Proficiency
  3. Laparoscopic Cholecystectomy Tasks Training
  4. Laparoscopic Cholecystectomy Tasks – Demonstration of Proficiency
  5. Laparoscopic Cholecystectomy Procedure (Basic Level)
  6. Laparoscopic Cholecystectomy Procedure (Advanced Level)

Basic Skills

Enables the trainee to acquire basic-level skills essential to building confidence and ease with laparoscopic techniques. Exercises in a non-anatomic setting provide a relaxed environment outside of the operating room for both individuals and teams, aimed at improving orientation, eye hand coordination and manual skills.

Laparoscopic Cholecystectomy Tasks

Didactic procedural tasks provide a step-by-step tutorial of the Lap Chole procedure.

Each task focuses on one critical step of the procedure: Achieving the critical view of the cystic duct and artery, safe clipping and cutting and dissection of gallbladder from the liver bed. Instructions on safe procedure performance are applied to the anatomical setting. This module helps surgeons identify the visual cues associated with traction/counter-traction of tissue as well as identifying areas requiring additional practice.

Laparoscopic Cholecystectomy Procedure Training

Different patient cases with easy to difficult anatomical variations to the cystic duct and positions of arteries, which may otherwise not be experienced during a training period. This course component enables free-style training using different techniques, alternative approaches, and acquisition of the skills and knowledge necessary to safely cope with possible complications.

  • To practice and acquire competence in basic laparoscopic skills: Clipping and grasping; Two-handed maneuvers; Cutting; Electrocautery.
  • To practice the skills and techniques essential for the laparoscopic cholecystectomy procedure in a simulated environment.
  • To familiarize with the pitfalls of easy to difficult anatomical variations to the cystic duct and positions of arteries.
Target Audience

General Surgery PGY-2


Prerequisite: Completed basic laparoscopic skills training.

Suggested Time Length

12 hours


The Basic Skills and Laparoscopic Cholecystectomy modules were developed in collaboration with:

  • Amir Szold, MD, Medical Director, Assia Medical Group, Assuta Hospital, Tel Aviv, Israel.
  • Jeffrey L. Ponsky, M.D., Oliver H. Payne Professor and Chairman, Department of Surgery, CWRU School of Medicine, Surgeon in Chief, University Hospitals, Case Medical Center, Cleveland, Ohio.
  • Rajesh Aggarwal MD PhD MA FRCS, Instructor in Gastrointestinal Surgery, University of Pennsylvania.