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FULL DAY: How Do You Measure Up? ASSESS Your Skills

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FULL DAY: How Do You Measure Up? ASSESS Your Skills FULL DAY: How Do You Measure Up? ASSESS Your Skills PROGRAM CHAIR Ernest G. Lockrow, DO Angela Chaudhari, MD Grace Chen, MD Susan G. Dunlow, MD Joseph M. Gobern, MD, MBA Candice Jones-Cox, MD Leslie D. Kammire, MD Malcolm W. Mackenzie, MD Douglas Miyazaki, MD Jamal Mourad, DO Brent E. Seibel, MD Sangeeta Senapati, MD M. Jonathon Solnik, MD Sabrina Whitehurst, MD AAGL acknowledges that it has received support in part by educational grants and equipment (in-kind) from the following companies: 3-Dmed, Applied Medical, Boston Scientific, CooperSurgical, Ethicon US, LLC, Marina Medical, Medtronic, Olympus America, Inc., Karl Storz Endoscopy-America, Inc., Symmetry Surgical Sponsored by Advancing MinimallyAAGL Invasive Gynecology Worldwide Professional Education Information Target Audience This educational activity is developed to meet the needs of residents, fellows and new minimally invasive specialists in the field of gynecology. Accreditation AAGL is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AAGL designates this live activity for a maximum of 7.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. DISCLOSURE OF RELEVANT FINANCIAL RELATIONSHIPS As a provider accredited by the Accreditation Council for Continuing Medical Education, AAGL must ensure balance, independence, and objectivity in all CME activities to promote improvements in health care and not proprietary interests of a commercial interest. The provider controls all decisions related to identification of CME needs, determination of educational objectives, selection and presentation of content, selection of all persons and organizations that will be in a position to control the content, selection of educational methods, and evaluation of the activity. Course chairs, planning committee members, presenters, authors, moderators, panel members, and others in a position to control the content of this activity are required to disclose relevant financial relationships with commercial interests related to the subject matter of this educational activity. Learners are able to assess the potential for commercial bias in information when complete disclosure, resolution of conflicts of interest, and acknowledgment of commercial support are provided prior to the activity. Informed learners are the final safeguards in assuring that a CME activity is independent from commercial support. We believe this mechanism contributes to the transparency and accountability of CME. Table of Contents Course Description ........................................................................................................................................ 1 Disclosure ...................................................................................................................................................... 2 Laparoscopic Hysterectomy S. Senapati .................................................................................................................................................... 3 Complications of Laparoscopy E.G. Lockrow ............................................................................................................................................... 12 Vaginal Hysterectomy M.J. Solnik .................................................................................................................................................. 21 Retropubic Slings D. Miyazaki ................................................................................................................................................. 28 Cultural and Linguistics Competency ......................................................................................................... 35 SKIL-700 FULL DAY: How Do You Measure Up? ASSESS Your Skills Presented in affiliation with the American College of Obstetricians and Gynecologists (ACOG) Ernest G. Lockrow, Chair Faculty: Angela Chaudhari, Grace Chen, Susan G. Dunlow, Joseph M. Gobern, Candice Jones-Cox, Leslie D. Kammire, Malcolm W. Mackenzie, Douglas Miyazaki, Jamal Mourad, Brent E. Seibel, Sangeeta Senapati, M. Jonathon Solnik, Sabrina Whitehurst This course was developed in collaboration with the ACOG Simulations Consortium and is specifically designed to assess gynecologic surgeons in all levels of training on various gynecologic surgeries. The modules used from the Advanced Surgical Simulation and Endoscopic Surgical Simulation (ASSESS) Course include: Vaginal Hysterectomy, Laparoscopic Hysterectomy and Retropubic Slings. Whether you are a current expert in the field of gynecologic surgery or have not been able to perform minimally invasive surgical procedures such as vaginal hysterectomy, laparoscopic surgery or retropubic slings, this course will afford you the opportunity to assess your current level of expertise in gynecologic surgery. This is a hands-on course utilizing moderate fidelity simulation models from industry that you will be able to perform an actual vaginal hysterectomy, laparoscopic hysterectomy and retropubic sling. The course is an ABOG Maintenance of Certification (MOC) approved simulation course that will afford the participants credit during their MOC cycle. Learning Objectives: At the conclusion of this course, the clinicians will be able to: 1) Assess their skills in performing laparoscopic hysterectomy; 2) assess their skills in performing vaginal hysterectomy; and 3) assess their skills in performing retropublic slings. Course Outline 7:00 Welcome, Introductions and Course Overview E.G. Lockrow 7:15 Laparoscopic Hysterectomy S. Senapati 7:45 Complications of Laparoscopy E.G. Lockrow 8:30 Questions & Answers All Faculty 8:45 Break 9:00 LAB I: Using the Limbs and Things Model: Group A Performs Laparoscopic Hysterectomy, Group B Performs Laparoscopic Suturing Skills 10:50 Questions & Answers 11:00 Adjourn/Lunch 12:30 Vaginal Hysterectomy M.J. Solnik 1:15 Retropubic Slings D. Miyazaki 2:00 Questions & Answers All Faculty 2:15 Break 2:30 LAB II: Using the MIYA Model: Group A Performs Vaginal Hysterectomy, Group B Performs Retropubic Slings 4:15 Wrap-Up 4:30 Adjourn 1 PLANNER DISCLOSURE The following members of AAGL have been involved in the educational planning of this workshop and have no conflict of interest to disclose (in alphabetical order by last name). Art Arellano, Professional Education Manager, AAGL* Amber Bradshaw Speakers Bureau: Myriad Genetics Lab Other: Proctor: Intuitive Surgical Erica Dun* Frank D. Loffer, Medical Director, AAGL* Linda Michels, Executive Director, AAGL* Johnny Yi* SCIENTIFIC PROGRAM COMMITTEE Arnold P. Advincula Consultant: Intuitive Royalty: CooperSurgical Sarah L. Cohen* Jon I. Einarsson* Stuart Hart Consultant: Covidien Speakers Bureau: Boston Scientific, Covidien Kimberly A. Kho Contracted/Research: Applied Medical Other: Pivotal Protocol Advisor: Actamax Matthew T. Siedhoff Other: Payment for Training Sales Representatives: Teleflex M. Jonathon Solnik Consultant: Z Microsystems Other: Faculty for PACE Surgical Courses: Covidien FACULTY DISCLOSURE The following have agreed to provide verbal disclosure of their relationships prior to their presentations. They have also agreed to support their presentations and clinical recommendations with the “best available evidence” from medical literature (in alphabetical order by last name). Angela Chaudhari* Grace Chen* Susan G. Dunlow* Joseph M. Gobern* Candice Jones-Cox* Leslie D. Kammire* Ernest G. Lockrow* Malcolm W. Mackenzie Consultant: Olympus Douglas Miyazaki* Jamal Mourad* Brent E. Seibel* Sangeeta Senapati Consultant: Emmi M. Jonathon Solnik Consultant: Z Microsystems Other: Faculty for PACE Surgical Courses: Covidien Sabrina Whitehurst* Asterisk (*) denotes no financial relationships to disclose. 2 Laparoscopic Hysterectomy: A Review of the Basics • Consultant: Emmi Sangeeta Senapati, MD Northshore University HealthSystem Evolution of Hysterectomy • Approximately 600,000 hysterectomies • Explain the rationale for a laparoscopic performed each year in U.S. approach to hysterectomy • $5 Billion • Discuss options for instrumentation and key • By age 60, 1 in 3 women in U.S. will have had a technical components hysterectomy • 90% performed for elective benign indications • Describe a technique for conventional – Fibroids laparoscopic hysterectomy – Abnormal uterine bleeding • Review variations of laparoscopic – Endometriosis hysterectomies – Chronic pelvic pain Carlson et al N Engl J Med 1993 Epidemiology • Age range ‐ median 44‐45 yrs1 • Ethnicity ‐ 69% Caucasian, 17% African‐ American, 10.5% Hispanic2 • LOS ‐ median 2‐3 days1 • Complication rates ‐ 1‐3%2 • Transfusion rates ‐ 1‐3%3 1Farquhar CM & Steiner CA Ob Gyn2002; 2Campbell ES et al JRM 2003; 4Meikle SF et al Ob Gyn 19973 3 Evolution of Hysterectomy Laparoscopic Hysterectomy Classification • Total abdominal & vaginal hysterectomy (TAH, TVH) • Laparoscopic‐assisted vaginal hysterectomy, introduced by Reich in late 1980s (LAVH) • Laparoscopic supracervical hysterectomy (LSH) • Total laparoscopic hysterectomy (TLH) 66% of all hysterectomies performed in the U.S. are abdominal Wu et al, Ob Gyn 2007 Laparoscopic Hysterectomy Criteria Classification • A non‐vaginal hysterectomy candidate who by traditional methods would have undergone hysterectomy abdominally There are no absolute contraindications, just relative: surgeon experience, anatomical operating field, anesthesia, abdominal entry issues… Potential
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