Surgical Sciencs

Faculty of Life Sciences & Medicine School of Bioscience Education

6BBYS301 SURGICAL SCIENCES

Module Handbook 2018 - 2019

30 Credits - Level 6 SURGICAL SCIENCES COURSE BOOKLET 2018-19

PROGRAMME LEADS

Mr. Kamran Ahmed Senior Lecturer and Hon. Consultant Urological Surgeon [email protected]

Professor Prokar Dasgupta Chair for Robotic Surgery & Urological Innovation and Consultant Urological Surgeon [email protected]

Prof. Muhammad Shamim Khan

Professor of Urology and Surgical Education and Consultant Urological Surgeon [email protected]

Dr. Abdullatif Aydin Simulation Research Fellow [email protected]

MRC Centre for Transplantation, School of Immunology & Microbial Sciences

SURGICAL SCIENCES COURSE BOOKLET 2018-19

INTRODUCTION

This course aims to provide you with an over-view of fundamental components of surgical sciences and technology by integrating both theoretical and practical aspects of surgery.

The course is delivered through a dynamic range of lectures given by leaders in the ﬁeld, from surgeons and academics alike. Modules covered include introduction to research methods, core and specialist principles of surgery and surgical technology, which will add focus on the modernisation of surgical practice through innovative technology such as robotic and laparoscopic surgery.

The course will feature heavily on practical aspects of surgery and hands on experience. Technical skills sessions will be held at the Olympus Simulation Centre at Guy’s Hospital and Weston Education Centre at King’s College Hospital, where you will have access to the latest simulation technology in surgery. There will be opportunities to observe live surgery, including robot-assisted, and enjoy operating theaters and surgical simulation environments. Aside from the technical aspects of surgery, we aim to provide you with an overview of non-technical skills such as communication, team working and surgical decision making, leadership and management.

There are plenty of opportunities to gain research experience during the course. The programme leads and course providers will fully support you in learning how to plan, conduct and present your own research. There are opportunities for publication for exceptional work.

Pre-requisites for course: Students must have completed MBBS Phases 1-2 and passed MBBS part 2 (or equivalent) exams at first attempt (50% pass mark) and have passed all Student Selected Components (SSCs) or equivalent. Cases of academic misconduct such as plagiarism may be taken into account when deciding an offer. Students from MBBS phases 3-4 are expected to have achieved the same level of performance as Phase 1-2 students and pass their end of year MBBS (or equivalent) examinations and SSCs at first attempt. SURGICAL SCIENCES COURSE BOOKLET 2018-19

MODULE AIMS

FUNDAMENTALS OF RESEARCH 1. To gain an understanding of the fundamentals of surgical research including literature search techniques, types of studies, critical appraisal, composing original research for publication and the fundamentals of grant writing. 2. Be familiar with evidence-based medicine, be able to critically analyse scientific literature and use it to justify arguments and draw conclusions. 3. Develop self directed learning skills and learn to independently search and evaluate scientific papers and other literature to consolidate learning in lectures and as evidence of wider reading in written examinations. 4. Develop the skills to communicate and present scientific data orally and in written format.

PRINCIPLES OF SURGERY (CORE) 1. To understand the core theoretical and practical principles of surgical science, including pre and postoperative management of surgical patients, surgical complications and their management, basics of anaesthesia, recovery and wound healing. 2. To gain a basic understanding of the dynamics of the operating theatre through formal lectures and observation of the operating theatre environment. 3. To gain a basic understanding of the practical aspects of surgery such as instrumentation and basic surgical techniques. Develop basic surgical skills through practical sessions and workshops and training in simulated environments with advanced surgical technologies. 4. To gain an over-view of the issues surrounding patient safety and measures taken to ensure patient safety in the surgical environment.

PRINCIPLES OF SURGERY (SPECIALTIES) 1. To gain a basic understanding of what diﬀerent surgical specialties entail 2. To understand the science behind major concepts in key surgical specialties.

SURGICAL TECHNOLOGY 1. To gain a basic understanding of innovations in surgery such as endoscopic, laparoscopic and robotic surgery – stages of evolution, application, equipment and evidence-based practice. 2. To gain a basic understanding of other minimally invasive techniques including microsurgery and LASERs – stages of evolution, application, equipment and evidence-based practice. SURGICAL SCIENCES COURSE BOOKLET 2018-19

TEACHING METHODS

Lectures: There are normally 3-4 lectures per week, covering an overview of different aspects of surgical science and technology. The course is divided into five main components and these will be delivered as follows: Semester 1: Principles of Surgery (Core & Specialties) Semester 2: Surgical Technology You are expected to consolidate learning in lectures through independent study of wider literature.

Technical & Non-technical Skills Sessions: There are a variety of opportunities to develop basic surgical skills such as suturing, knot tying through practical workshops and, also, laparoscopic skills. The simulation centre at Guy’s Hospital is well equipped to allow you to explore more advanced simulation programmes in minimally invasive modalities such as endoscopy, laparoscopic and robot-assisted surgery. This component will be delivered in the following order: • Semester 1: Basic Surgical Skills • Semester 2: Laparoscopic Surgical Skills Furthermore, students will receive the following specialty skills workshops: • Orthopaedic Skills - Plastering and Fracture Fixation • Core Skills in Microsurgery Students will also receive a half-day workshop on the role of Non-technical Skills in surgical practice, where you will learn about the importance of communication, team-work, leadership and decision making in surgery.

Research: The Fundamentals of Research component of the course will provide students the opportunity to become involved in research, leading to potential publications, as many of the course lecturers are actively involved in research and are happy to supervise enthusiastic students.

Conferences: As part of Fundamentals of Research, students may be registered for a scientific meeting running on the module day. In previous years, students were attended the European Robotic Surgery Symposium and the Richard Tiptaft Visiting Professorship to give students a feel of how research is disseminated.

Observation in Theatres: Students will be given the opportunity to observe live surgery, should they wish to, in specialties of their interest.

Workshops: Students will receive career workshops on how to prepare a Surgical Portfolio and pursue an interest in a surgical specialty, academia and entrepreneurship. SURGICAL SCIENCES COURSE BOOKLET 2018-19

PUBLICATIONS FROM STUDENT WORK

Many of our students have been very successful on producing outstanding pieces of work for their in-course essays. With the support of our faculty, many of these have been published (examples as below):

(1) Quirke K, Aydin A, Brunckhorst O, Bultitude M, Khan M, Dasgupta P, Sarica K, Ahmed K. Learning Curves of Urolithiasis Surgery: A Systematic Review. J Endourol. 2018 Jul 24. [Epub ahead of print] PMID: 30039711 (2) Ounounou E, Aydin A, Brunckhorst O, Khan MS, Dasgupta P, Ahmed K. Nontechnical Skills in Surgery: A Systematic Review of Current Training Modalities. J Surg Educ. 2018 Aug 16.[Epub ahead of print] PMID: 30122636 (3) Jamshaid F, Froghi S, Di Cocco P, Dor FJ. Novel non-invasive biomarkers diagnostic of acute rejection in renal transplant recipients: A systematic review. Int J Clin Pract. 2018 Jul 16:e13220. [Epub ahead of print] Review. PMID: 30011113 (4) Sharma SC, Raison N, Khan S, Shabbir M, Dasgupta P, Ahmed K. Male circumcision for the prevention of human immunodeficiency virus (HIV) acquisition: a meta-analysis. BJU Int. 2018 Apr;121(4):515-526. PMID: 29232046 (5) Ridgley J, Raison N, Sheikh MI, Dasgupta P, Khan MS, Ahmed K. Ischaemic priapism: A clinical review. Turk J Urol. 2017 Mar; 43(1):1-8. PMID: 28270944 (6) Wallace L, Raison N, Gumman F, Moran A, Khan MS, Dasgupta P, Ahmed K. Cognitive training: How can it be adapted for surgical education? Surgeon. 2017 Aug;15(4):231-239. PMID: 27658665 (7) Wood TC, Raison N, Haldar S, Brunckhorst O, McIlhenny C, Dasgupta P, Ahmed K. Training Tools for Nontechnical Skills for Surgeons-A Systematic Review. J Surg Educ. 2017 Jul - Aug;74(4):548-578. PMID: 28011262 (8) Morgan M, Aydin A, Salih A, Robati S, Ahmed K. Current Status of Simulation-based Training Tools in Orthopedic Surgery: A Systematic Review. J Surg Educ. 2017 Jul - Aug;74(4):698-716. PMID: 28188003 (9) Mullen E, Ahmed K, Challacombe B. Systematic review of open versus laparoscopic versus robot-assisted nephroureterectomy. Rev Urol. 2017;19(1):32-43. PMID: 28522928 (10) Rees T, Raison N, Sheikh MI, Jaffry Z, Madaan S, Challacombe B, Ahmed K, Dasgupta P. Is extended pelvic lymph node dissection for prostate cancer the only recommended option? A systematic over-view of the literature. Turk J Urol. 2016 Dec;42(4):240-246. Review. PMID: 27909616 (11) Ross T, Ahmed K, Raison N, Challacombe B, Dasgupta P. Clarifying the PSA grey zone: The management of patients with a borderline PSA. Int J Clin Pract. 2016 Nov;70(11):950-959. PMID: 27672001 (12) Singh A, Ahmed K, Aydin A, Khan MS, Dasgupta P. Fournier’s Gangrene: A Clinical Review. Arch Ital Urol Androl. 2016 Oct; 88(3):157-64. PMID: 27711086 (13) Iqbal MH, Aydin A, Brunckhorst O, Dasgupta P, Ahmed K. A review of wearable technology in medicine. J R Soc Med. 2016 Oct;109(10):372-380. PMID: 27729595 (14) Aydin A, Shafi AM, Khan MS, Dasgupta P, Ahmed K. Current Status of Simulation and Training Models in Urological Surgery: A Systematic Review. J Urol. 2016 Aug;196(2):312-20. PMID: 27016463 (15) Lobo N, Dupré S, Sahai A, Thurairaja R, Khan MS. Getting out of a tight spot: an overview of ureteroenteric anastomotic strictures. Nat Rev Urol. 2016 Aug;13(8):447-55. PMID: 27349367 (16) Mishra A, Ahmed K, Froghi S, Dasgupta P. Systematic review of the relationship between artificial sweetener consumption and cancer in humans: analysis of 599,741 participants. Int J Clin Pract. 2015 Dec;69(12):1418-26. PMID: 26202345 (17) Whittaker G, Abboudi H, Khan MS, Dasgupta P, Ahmed K. Teamwork Assessment Tools in Modern Surgical Practice: A Systematic Review. Surg Res Pract. 2015;2015:494827. PMID: 26425732 (18) Jayakumar N, Brunckhorst O, Dasgupta P, Khan MS, Ahmed K. e-Learning in Surgical Education: A Systematic Review. J Surg Educ. 2015 Nov-Dec;72(6):1145-57. PMID: 26111822 (19) Chou E, Abboudi H, Khan MS, Dasgupta P, Ahmed K. Surgical outcomes: Pros and cons – should they be published? J R Soc Med. 2015 Apr;108(4):127-35. PMID: 25899023 (20) Lovegrove C, Ahmed K, Challacombe B, Khan MS, Popert R, Dasgupta P. Systematic review of prostate cancer risk and association with consumption of fish and fish-oils: analysis of 495,321 participants. Int J Clin Pract. 2015 Jan;69(1): 87-105. PMID: 25495842 (21) Fisher RA, Dasgupta P, Mottrie A, Volpe A, Khan MS, Challacombe B, Ahmed K. An over-view of robot assisted surgery curricula and the status of their validation. Int J Surg. 2015 Jan;13:115-23. PMID: 25486264 (22) Fonseka T, Ahmed K, Froghi S, Khan SA, Dasgupta P, Khan MS. Comparing robotic, laparoscopic and open cystectomy: A systematic review and meta-analysis. Arch Ital Urol Androl. 2015 Mar 31;87(1):41-8. PMID: 25847896 (23) Brunckhorst O, Challacombe B, Abboudi H, Khan MS, Dasgupta P, Ahmed K. Systematic review of live surgical demonstrations and their effectiveness on training. Br J Surg. 2014 Dec;101(13):1637-43. PMID: 25312488 (24) Pervez A, Ahmed K, Thompson S, Elhage O, Khan MS, Dasgupta P. Image guided robotic surgery: current evidence for effectiveness in urology. Arch Ital Urol Androl. 2014 Dec 30;86(4):245-8. PMID: 25641443 (25) Patel J, Ahmed K, Guru KA, Khan F, Marsh H, Shamim Khan M, Dasgupta P. An overview of the use and implementation of checklists in surgical specialities - a systematic review. Int J Surg. 2014 Dec;12(12):1317-23. PMID: 25448652 (26) Khan F, Ahmed K, Lee N, Challacombe B, Khan MS, Dasgupta P. Management of ureteropelvic junction obstruction in adults. Nat Rev Urol. 2014 Nov;11(11):629-38. PMID: 25287785 SURGICAL SCIENCES COURSE BOOKLET 2018-19

(27) Michael M, Abboudi H, Ker J, Shamim Khan M, Dasgupta P, Ahmed K. Performance of technology-driven simulators for medical students--a systematic review. J Surg Res. 2014 Dec;192(2):531-43. PMID: 25234749 (28) Rourke W, Khan SA, Ahmed K, Masood S, Dasgupta P, Khan MS. Painful bladder syndrome/interstitial cystitis: aetiology, evaluation and management. Arch Ital Urol Androl. 2014 Jun 30;86(2):126-31. PMID: 25017594 (29) Shepherd W, Arora KS, Abboudi H, Shamim Khan M, Dasgupta P, Ahmed K. A review of the available urology skills training curricula and their validation. J Surg Educ. 2014 May-Jun;71(3):289-96. PMID: 24797842 (30) Hay D, Khan MS, van Poppel H, van Cleynenbreugel B, Peabody J, Guru K, Challacombe B, Dasgupta P, Ahmed K. Current Status and Effectiveness of Mentorship Programmes in Urology - A Systematic Review. BJU Int. 2015 Sep;116(3):487-94. PMID: 24571359 (31) Aydin A, Ahmed K, Zaman I, Khan MS, Dasgupta P. Recurrent urinary tract infections in women. Int Urogynecol J. 2015 Jun; 26(6):795-804. PMID: 25410372 SURGICAL SCIENCES COURSE BOOKLET 2018-19

LECTURE OBJECTIVES FUNDAMENTALS OF RESEARCH

Literature search Techniques, Levels of Evidence and Critical Analysis Mr. Saied Froghi Students will be able to: • Evaluate different modes of experimental design • Assess and appreciate levels of evidence • Critique a scientific paper relating to surgery • Develop skills in presenting scientific data in a clear and concise manner and demonstrate this during relevant parts of the course • Develop the necessary IT skills to communicate scientific information

How to write an article: Basic principles Dr. Abdullatif Aydin Students will be able to: • Understand the process of scientific writing including style, format and structure and be able to demonstrate this during their Semester 1 assessments • Gain skills in structuring a paper, organising data, citing references, developing a suitable writing style and will be expected to demonstrate this during the course assessments

Systematic reviews and Meta-analyses: A beginner’s guide Dr. Oliver Brunckhorst Students will be able to: • Formulate a search strategy for a systematic review of the literature • Extract relevant data from the available literature • Explain different available methods to assess study quality • Present data for a review, either narratively or statistically • Understand the structure of a systematic review or meta-analysis manuscript

Fundamentals of grant writing, looking for funding Dr. Peter Lovell Students will be able to: • Understand the process of funding for scientific research • Gain an insight into the different sources of funding • Gain skills in grant writing, including writing style, structure and format. SURGICAL SCIENCES COURSE BOOKLET 2018-19

PRINCIPLES OF SURGERY (CORE)

Pre-operative preparations for surgery Mr. Arun Sahai Students will be able to: • Explain the patient pathway in surgery in the pre-operative phase leading up to the surgery • Understand the importance of dealing with patients’ ideas and expectations and explain the significance of effective communication between patient, surgeon, anaesthetist, physician and other healthcare staff • Explain the importance of gaining informed consent and weighing risk vs. benefits • Understand the role of pre-operative general system examinations and investigations, and the use of checklists in pre-operative assessment to prevent non-technical errors

General & basic principles of post operative care Mr. Oussama Elhage Students will be able to: • Explain the systemic response to surgery • Explain the handover of patients from surgery to recovery for post-operative care • Understand the basic principles of post-operative care such as nutrition, pain control, mobility • Explain post-operative care on general wards, intensive care unit and for day surgery • Explain possible post-operative complications and how these are prevented • Specify care of the critically ill patients following surgery

Inflammation, wound healing and management Mr. Oussama Elhage Students will be able to: • Explain the mechanism and stages of wound healing and specify local and systemic factors affecting the process • Explain and justify management as part of post-operative care • Specify classification of wounds and ways of optimizing wound healing • Understand and explain the concept of pathological wound healing

Surgical complications and their management principles Mr. Oussama Elhage Students will be able to: • Explain the main surgical complications in major abdominal surgery and their management • Explain how complications arise and how can they be prevented? • Understand and explain the role of the multidisciplinary team in the care and prevention of peri-operative and postoperative complications

Enhanced recovery after surgery (ERAS) Mr. Nicholas Raison Students will be able to: • Explain the importance of various factors such as mobility, nutrition etc. in the recovery of surgical patients. • Explain components of enhanced recovery after surgery and how patient care is delivered in the recovery phase and the roles of the multidisciplinary team SURGICAL SCIENCES COURSE BOOKLET 2018-19

• Specify what ERAS means for Primary Care?

Nutritional support in surgical patients Mr. Nicholas Raison Students will be able to: • Explain malnutrition in surgery: Pathophysiology, Types and consequences of malnutrition • Compare metabolism of short and long fasts and of the insult • Explain assessment of nutritional state • Explain the approaches to calculating the energy and protein needs for the patient • Explain the concepts of parenteral and enteral nutrition: administration routes, indications, techniques, complications, pros and cons

Common infections related to surgery and use of Antibiotics Miss Francesca Kum Students will be able to explain: • Sepsis and its causes • Ventilator induced lung injury • Prophylaxis of infection in surgery • Asepsis and antisepsis. • Infection of the surgical wound including deep infections • Types of surgery according to degree of contamination: clean, clean-contaminated, contaminated and dirty • Effect of the host in infection. Surgery in patients with viral disease. • Treatment of infections in the surgical patient

Fluid and electrolyte management in surgical patients Mr. Alan Salih Students will be able to explain: • Normal losses of the body • Losses due to different digestive secretions in different clinical situations • Most common clinical situations that alter the water-electrolyte balance in surgery • Diagnosis and treatment in the pre- and post-operative period • Composition of different solutions

Pain management in surgical patients Mr. Alan Salih Students will be able to: • Explain mechanisms of pain production and transmission pathways; types of acute pain • Describe biological and psychological factors in pain perception • Specify appropriate drugs and pathways for pain management • Explain the role of accurate assessment in pain management and analgaesic efficacy • Explain the undesired effects and complications associated with methods of postoperative analgesia • Appreciate the importance of a biopsychosocial approach in the management of pain SURGICAL SCIENCES COURSE BOOKLET 2018-19

Basics of anaesthesia for surgical patients Dr. Richard Morey Students will be able to: • Appreciate the important relationship between anaesthesia and surgery • Explain physiology and pharmacology of anaesthesia and understand the basic mechanism of local and general anaesthetics. • Compare and contrast the differences between anaesthetic techniques and criteria for choosing the right technique • Explain stages of anaesthesia • Specify the main agents of inhalator anaesthesia and Pharmacokinetics • Explain IV induction anaesthesia - Pharmacokinetics, forms of administration • Specify local anaesthetics and types of solution administered • Compare different techniques of local and regional anaesthesia - indications and complications • Appreciate the importance of anaesthesia and pain control in pre-operative assessment and postoperative management of surgical patients.

Care of critically ill surgical patient – fundamental principles Mr. Saied Froghi Students will be able to: • Define the criteria for critically ill patients • Explain the initial assessment and management of these patients • Explain pathways of management, HDU / ITU care • Specify the differences between HDU / ITU • Explain the basic principles of management • Appreciate the role of inter-disciplinary communication • Gain basic insight into higher levels of care, indications for transfer and principles of management

Basics of patient safety (Concept, clinics, wards, theatres) Mr. Saied Froghi Students will be able to: • Explain the importance of maintaining patient safety in surgery and what measures are taken to prevent breaches in patient safety • Explain how patient safety may be compromised at different levels of care • Understand that all members of staff involved the patient’s care have a duty to maintain patient safety and how this is achieved at different levels of care. SURGICAL SCIENCES COURSE BOOKLET 2018-19

PRINCIPLES OF SURGERY (SPECIALTIES)

Transplantation and immunosuppression Mr. Nicos Kessaris Students will be able to explain: • Types of transplant: autograft, isograft, allograft, and xenograft • Characteristics of organ donors • Organ preservation, legal regulations of organ transplantation and omplications • Basic principles of prophylaxis and treatment of organ rejection • Indications for the most common organ transplants and their general characteristics

Cardiothoracic surgery: basics and common operations Mr. Duncan Steele Students will be able to: • Explain the basics principles of cardiothoracic surgery • Gain insight into common operations performed in CTS

Introduction to and management of vascular surgical emergencies Mr. Bijan Modarai • Students will be able to explain common vascular surgical emergencies and their management

Management of common Gastrointestinal emergencies TBC • Students will be able to explain common GI emergencies and their management

Management of Urological emergencies Ms. Rhana Zakri • Students will be able to explain common urological emergencies and their management

Management of Pediatric emergencies Mr. Ashish Desai • Students will be able to explain common paediatric surgical emergencies and their management

An overview of gynecological surgery Mrs. Ruth Cochrane • Students will be able to explain common gynaecological operations: indications, steps

Burns and other Plastics emergencies Mrs. Jenny Geh Students will be able to: • Classify burns: depth and extension • Predict the prognoses and explain admission criteria • Explain the initial treatment of large burns including local treatment • Specify special characteristics of electrical and chemical burns, lesions due to radiation • Explain cold lesions: hypothermia and frostbite • Explain other common Plastics emergencies SURGICAL SCIENCES COURSE BOOKLET 2018-19

Grafts and flaps Mrs. Jenny Geh Students will be able to: • Explain the concept of grafts: histology, types and applications • Explain the concept of flaps: histology, types and applications in surgery • Discriminate between types of cutaneous ulcers: vascular, pressure or positional

The multiple trauma patient Mr. Shibby Robati Students will be able to: • Explain the concept of multiple trauma • Explain the general approach to the damage in different systems • Specify the diagnostic & treatment aspects of trauma patients from the perspective of different specialties • Describe and explain basic principles in the treatment of the multiple trauma patient • Explain reanimation, assessment and priorities

Bone remodelling, fractures and their management Mr. Shibby Robati Students will be able to: • Understand and explain principles of fracture healing • Classify different fractures and explain their management • Discriminate between the pros and cons of conservative versus operative treatments • Appreciate basic plastering applications and uses

Principles of Surgical Oncology Mr. Oussama Elhage Students will be able to: • Explain the key concepts of : Oncongenes, Tumour suppressor genes, Growth factors and receptors, Cell cycle, Apoptosis • Explain the surgical principles behind Curative intent, Palliative surgery, Metastectomy, Debulking surgery • Explain the staging and grading of tumours

Eye emergencies and common ophthalmological operations Mr. Omar Mahroo • Students will be able to explain common eye emergencies and their management • Students will be able to gain insight into common ophthalmological operations

Emergencies and common operations in Oral & Maxillofacial surgery Dr. Rizwan Mahmood • Students will be able to explain common Maxillofacial emergencies and their management • Students will gain insight into common Oral & Maxillofacial surgical operations

Introduction to Neurosurgery Mr. Agbolahan Sofela • Students will be able to explain common neurosurgical emergencies and operations SURGICAL SCIENCES COURSE BOOKLET 2018-19

Basics of ENT & Head & Neck surgery and management of common emergencies TBC • Students will be able to explain common ENT emergencies and their management • Students will gain insight into common ENT and Head & Neck operations SURGICAL SCIENCES COURSE BOOKLET 2018-19

SURGICAL TECHNOLOGY

Introduction to operating theatre equipment Mr. Ben Challacombe Students will be able to: • Gain insight into the operating theatre environments, equipments and instruments • Explain the use of basic operating theatre equipment in different types of surgical procedures

Introduction to laparoscopic surgery (Stages of evolution) Mr. Ben Challacombe Students will be able to: • Explain the historical development of laparoscopic technology and its introduction into modern day surgery • Specify the stages of evolution of laparoscopic surgery and its evolution over time • Explain the role laparoscopic surgery in different surgical specialties, its advantages and future developments

Equipment, camera systems and Instruments Mr. Ben Challacombe • Students will be able to integrate basic knowledge of operating theatre equipment with advanced knowledge of equipment and camera systems in surgery

Fundamental principles and applications of endoscopic surgery Mr. Oussama Elhage Students will be able to: • Explain the history and evolution of endoscopic surgery • Explain how endoscopic surgery is used in different specialties • Explain how endoscopic surgery has led to the development of minimally invasive technology has impacted surgery in general

Advances in therapeutic endoscopy Mr. Amyn Haji Students will be able to: • Explain the main principles of therapeutic endoscopy and its current evidence-base • Gain insight into advances in therapeutic endoscopy

Laparoscopy in Urological Surgery Mr. Christian Brown Students will be able to: • Explain the history and evolution of laparoscopic technology in urological surgery • Explain the different applications of laparoscopy in modern urological surgery • Compare and contrast laparoscopic surgery over open and robotic surgery

The use of lasers in urology: current evidence-base Ms. Rhana Zakri Students will be able to: • Explain the history and evolution of laser technology in urological surgery • Evaluate current alternatives in laser technology • Explore the advantages and disadvantages of each laser modality • Appreciate current developments in laser technology SURGICAL SCIENCES COURSE BOOKLET 2018-19

Minimally Invasive Gynaecological Surgery Ms. Lisa Story Students will be able to: • Explain the history and evolution of laparoscopic technology in gynaecological surgery • Explain the different applications of laparoscopy in modern gynaecological surgery • Compare and contrast laparoscopic surgery over open and robotic surgery

Laparoscopy in General Surgery Mr. James Gossage Students will be able to: • Explain the history and evolution of laparoscopic technology in general surgery • Explain the different applications of laparoscopy in general surgery • Compare and contrast laparoscopic surgery over open and robotic surgery

Minimal access liver Surgery Mr. Saied Froghi Students will be able to: • Appreciate the application of minimal access in liver surgery • Compare and contrast laparoscopic surgery over open and robotic surgery • Critique the current evidence-base for minimal access liver surgery

Single site & natural orifice surgery (NOTES) Mr. Jonathan Makanjuola Students will be able to: • Define and explain the evolution of LESS, its principles and current use in surgical specialties • Comment on the practicality, safety and efficacy of LESS • Define NOTES and explain the development and evolution • Comment on the use of NOTES and explore its practicality, safety and efficacy is modern surgery

Technology in Orthopaedic Surgery and Application Mr. Alan Salih Students will be able to: • Explain the use of technology in orthopedic surgery, and use of minimally invasive techniques • Explain the evolution of arthroscopy in orthopaedic surgery and its current application • Explain how arthroscopy is used in orthopaedic surgery and compare to open surgery

Evolution of robotics and tele-mentoring Mr. Ben Challacombe Students will be able to: • Explain the stages of evolution of robotic technology in teaching and mentoring in surgery • Explain the current application of these technologies and predict possible future directions • Comment on the practically, effectiveness and safety of these robotic technologies Robotics in Urological Surgery Mr. Rick Catterwell Students will be able to: • Explain the historical development of robotic technology in urological surgery • Learn about the application of this technology in modern surgery and how it is used in urological procedures SURGICAL SCIENCES COURSE BOOKLET 2018-19

• Explore the practicality, safety and efficacy of this technology and compare it to other surgical approaches such as open and laparoscopic surgery.

Complications of laparoscopic & robotic surgery Mr. Fahd Khan Students will be able to: • Compare the advantages and disadvantages of laparoscopic surgery with other methods such as open surgery • Explain the pre-requisites and stages of laparoscopic surgery • Describe the different insufflants and explain methods of insufflation • Explain the pathophysiology of the Pneumoperitoneum

The future of Robotics Prof. Kaspar Althoefer Students will be able to: • Explain the evolution and development of current robotic systems in surgery • Evaluate the practicality, safety and efficacy of the proposed systems up-to-date • Gain insight into current developments in Robotic technology and predict their outcomes in clinical practice

Technology in Plastic surgery: Microsurgery and Robotics Mrs. Jenny Geh Students will be able to: • Explain the role and significance of microsurgery in plastic surgery • Explain the use of robotics in plastic surgery and explore its practicality, safety and efficacy

Technology in ophthalmology: Lasers and Microsurgery Mr. Omar Mahroo Students will be able to: • Explain the use of lasers in ophthalmological surgery and explore its origins and evidence-base • Explain the role and significance of microsurgery in ophthalmological surgery

Technology in ENT / Head&Neck Surgery Mr. Christopher Skilbeck Students will be able to: • Explain the use of technology in ENT and head & neck surgery, and use of minimally invasive techniques • Explore the practicality, safety and efficacy of these techniques compared to other surgical approaches

Technology in Oral & Maxillofacial Surgery Dr. Rizwan Mahmood Students will be able to: • Explain the use of technology in Oral and maxillofacial surgery, and use of minimally invasive techniques • Explore the practicality, safety and efficacy of these techniques compared to other surgical approaches Technology in Neurosurgery Mr. Agbolahan Sofela Students will be able to: • Explain the use of technology in neurosurgery, and use of minimally invasive techniques • Explore the practicality, safety and efficacy of these techniques compared to other surgical approaches SURGICAL SCIENCES COURSE BOOKLET 2018-19

Technology in Cardiothoracic Surgery Mr. David McCormack Students will be able to: • Explain the use of technology in cardiothoracic surgery, and use of minimally invasive techniques • Explain the use of the cardiopulmonary bypass, diagnostic devices, valves and assist devices

Interventional radiology and endovascular surgery Mr. Adam Gwozdz Students will be able to: • Explain the development and introduction of minimally invasive technology in IR and endovascular surgery • Explain the basic principles and predict the future directions in endovascular surgery • Explain the different types of modalities and their applications • Critique the practicality, safety and efficacy of these technologies

Use of clinical imaging and image guided systems Dr. Steve Thompson Students will be able to: • Explain the importance of imaging in medicine and surgery and have a basic idea of the different types of imaging modalities • Explain the role of clinical imaging such as diagnostic and interventional purposes

Healthcare technology: Safe implementation and assessment Mr. Nicholas Raison Students will be able to: • Explain the concept “health technologies” and the steps involved in safely introducing new technologies in healthcare • Know the basic principles of validation of new technologies and what is involved in the process • Understand that new healthcare technology must be assessed and evaluated before implementation • Explain the evolution of healthcare technology assessment through rigorous scientific research

Introduction to training and simulation technology Dr. Abdullatif Aydin Students will be able to: • Explain the concept of professional competence and list its major components • Define technical (procedural) and non-technical (communication, decision making, team-working) skills and understand how the two interact in the surgical setting. • Explain how these skills are acquired, applied and assessed in the surgical settings • Explain the basic structure of surgical training programmes and how they are designed and run • Explain how progress is assessed in surgery and the importance of continuing professional development • Explain that periodic assessment of knowledge and skills is vital for professional development and patient safety SURGICAL SCIENCES MODULE HANDBOOK 2018-19

SURGICAL SKILLS

The purpose of this component of the module is to expose students to skills which they may require should they wish to pursue a career in surgery. The introductory level sessions and assessments are based at the level of the medical students and are not intended to be a qualiﬁcation to conduct these skills in clinical practice and students will be expected to follow up on these skills in clinical practice either by their medical schools or their educational/clinical supervisors at the consent of patients.

Basic Skills Sessions: Students will be taught basic open surgical skills in Semester 1, including: 1. Instrument handling 2. Knot-tying: Reef and surgical knots 3. Suturing: Simple interrupted and continuous sutures

Faculty: Dr. Abdullatif Aydin, Mr. Nicholas Raison, Miss Francesca Kum, Dr. George Whittaker, Dr. Rebecca Fisher, Dr. M. Husnain Iqbal

Laparoscopic Skills Sessions: Students will be taught basic laparoscopic surgical skills in Semester 2, including: 1. Object manipulation using laparoscopic tools 2. Basic laparoscopic suturing 3. Laparoscopic dissection

Faculty: Dr. Abdullatif Aydin, Dr. Ali Bahsoun, Mr. Nicholas Raison, Miss Francesca Kum

Assessment: Assessment is aimed at the level expected of a medical student having attended the course. Students will be assessed by the session leads and subsequently awarded a grade, contributing to 10% of their module outcome. Students will only be assessed on Basic Surgical and Laparoscopic skills (as above). Students are recommended to follow up sessions with further practice.

Introduction to Orthopaedic Skills: Students will receive two half-day workshops on orthopaedic plastering (Semester 1) and fracture ﬁxation (Semester 2). Faculty: Mr. Shibby Robati, Mr. Alan Salih

Core Skills in Microsurgery: Students will receive a half-day workshop on plastics microsurgery training. Faculty: Miss Pari-Naz Mohanna, Ms. Nadine Hachach-Haram, St. Thomas’ Hospital Plastics Team SURGICAL SCIENCES MODULE HANDBOOK 2018-19

Further opportunities will be available through contact with lecturers and students are highly recommended to spend time in theatres. Students can also gain training in endoscopic, laparoscopic and robotic surgical skills through various virtual-reality simulators, available at the Olympus Sim Lab.

Non-Technical Skills Sessions: Students will also receive a half-day session on Non-technical skills training (in two groups). Students will be able to: • Explain the main principles of Non- technical skills and how the multidisciplinary team communicate and work together as a unit in a surgical setting • Critique some of the core issues of Non-technical skills: surgical decision making and leadership in surgery

Faculty: Mr. Amir Darakhshan, Mr. James Brewin

Sessions are conducted at the Sherman Education Centre, 4th Floor Southwark Wing, Guy’s Hospital (unless otherwise stated)

*In the case that students miss or are unable to attend sessions, due to extenuating circumstances, they should email [email protected] prior to the session. SURGICAL SCIENCES MODULE HANDBOOK 2018-19