General Surgery PGY-5


This curriculum aims to provide the participant with the essential simulation assignments needed to acquire the skills and core competencies for General Surgery PGY-5 training.

The course components include:

  1. FLS Training
  2. Suturing & Knot Tying
  3. Laparoscopic Cholecystectomy Procedure (Advanced Level)
  4. Sigmoidectomy

FLS Training

Tasks include peg transfer, pattern cutting and placement of ligating loop.

Suturing and Knot Tying

Practice knot tying techniques such as ligature and surgeon`s knot and performing interrupted and continuous suture and suturing in a curved suture line angle. Tasks are illustrated by instructional videos. Real suturing handles enable realistic training.

Laparoscopic Cholecystectomy Procedure (Advanced Level)

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.


The module provides an environment in which to perform a wide range of tasks from vessel isolation through creation of the anastomosis before encountering them in the operating room. Trainees learn to determine the best approach to the procedure, practicing real-time clinical decision-making and working safely to prevent complications and respond to injuries. An anatomical 3D map, on-demand real-life videos, procedural instructions and trocar placements complete this exceptional training module.

  • To become accustomed with the fulcrum effect, laparoscopic depth perception and eye hand coordination.
  • To practice coordinated hand movements.
  • To accurately and efficiently grasp objects and transfer them to designated areas.
  • To train on the use of laparoscopic scissors for cutting.
  • To become familiarized with the method of placing a ligating loop.
  • To become familiarized with different knot tying techniques such as half knot, square knot, and ligature and surgeon`s knot.
  • To perform interrupted and continuous suture.
  • To practice suturing in difficult suture line angles.
  • To familiarize with the pitfalls of easy to difficult anatomical variations to the cystic duct and positions of arteries.
  • To practice the skills and techniques essential for the laparoscopic cholecystectomy procedure in a simulated environment.
  • To practice the skills and techniques essential for the laparoscopic sigmoidectomy procedure in a simulated environment.
Target Audience

General Surgery PGY-5


Prerequisite: Completed basic laparoscopic skills training and basic laparoscopic procedure training.

Suggested Time Length

14 hours


The Essential Tasks, Suturing and Laparoscopic Cholecystectomy and Sigmoidectomy modules were developed in collaboration with:

  • Amir Szold, MD, Medical Director, Assia Medical Group, Assuta Hospital, Tel Aviv, Israel.
  • Conor P Delaney M.D., MCh, PhD, FRCSI, FACS Professor of Surgery, Case Western Reserve University, Chief, Division of Colorectal Surgery, Vice-Chairman, Department of Surgery, Director, Institute for Surgery and Innovation, University Hospitals of Cleveland, Case Medical Center.
  • Masahiko Watanabe, M.D., Ph.D., Professor & Chairman, Department of Surgery, Kitasato University School of Medicine.
  • Yukihito Kokuba, M.D., Ph.D., Associate Professor, Department of Laparoscopic Surgery for Digestive Disease, Kyoto Prefectural University.
  • 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.
  • Yaron Munz, MD, Senior Surgeon, Dept. of General Surgery, Rabin Medical Center, Golda Campus – Hasharon. Director of Surgical Simulation, The Israel Centre for Medical Simulation, Sheba Medical Centre, Tel Hashomer.