SIMULATION EXERCISES AND SURGICAL LABS


Obstetric Simulation Drills

During every rotation on Obstetrics, the resident team will participate in a half-day simulation with faculty, nurses, and members of the Anesthesiology Department. The resident will gain experience in the proper team approach to managing shoulder dystocia, postpartum hemorrhage, eclampsia, maternal cardiac arrest, and the difficult airway.

Gynecology Surgery Labs

During every rotation on Gynecology, the resident team participates in a hysteroscopy lab and two laparoscopy labs. During the hysteroscopy lab, the residents are trained in the proper performance of hysteroscopic tubal occlusion, hysteroscopic resection procedures, and global endometrial ablation techniques, as well as the hysteroscopic fluid management system. Details of the laparoscopy labs are described below. In addition, while on the Gynecologic Surgery Subspecialties rotation, residents will receive one-on-one instruction in the correct methods for performing mid-urethral slings. Also, our department has a subscription to the International Academy of Pelvic Surgery video series so residents can view videos of various surgical procedures at any time.

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Laparoscopic Training Labs

The department offers a structured curriculum for laparoscopic skills labs. The program consists of eight sessions per year, two during each gynecology rotation. Each team of residents completes two dedicated laparoscopy labs per quarter, supervised by two faculty members.  One-on-one laparoscopic training sessions are arranged as needed during the gynecology rotation. Incoming PGY 1 residents each receive a laparoscopic training tool that incorporates a webcam and laparoscopic instruments for regular practice.

In addition to training on the basics of laparoscopic surgery, laparoscopic tower, camera handling, and instrumentation, the dry lab curriculum incorporates the Fundamentals of Laparoscopic Surgery (FLS) skills (http://www.flsprogram.org/), including the following:

  1. Peg transfer
  2. EndoLoop application
  3. Precision (circle) cutting
  4. Laparoscopic suturing skills, with extracorporeal and intracorporeal knot-tying.

In addition to structured, hands-on laparoscopy labs, dedicated core lectures are provided on surgical anatomy, electrosurgery, and laparoscopic hysterectomy techniques.

Robotic Surgery Training Labs

While on the Oncology rotation, all residents participate in a robotic surgery training program. The program consists of on-line training modules, an orientation to the robot by the da Vinci representative, and one-on-one instruction on the robot simulator from an Oncology faculty member. Residents who complete the program and perform the required number of robotic cases (10 as assistants, 20 as primary surgeons) receive a Training Equivalency Certificate from da Vinci Surgery that they can use to obtain robotic privileges after graduation. Motivated residents have no difficulty meeting the requirements for the training certification.

We firmly believe in building a strong foundation of basic vaginal, laparoscopic, and open surgical skills for our residents. In addition, the structured robotic training curriculum is integrated into our minimally invasive surgery teaching to ensure that, upon graduation, our residents are equipped to perform surgery by any route.