Innovation in Surgical Education
UC surgery residents undergo extensive simulation exposure as they progress through their residency education. Structured dry labs include knot tying, basic and advanced suturing, instrument handling, stapling, and advanced surgical equipment handling including the DaVinci robot system. Faculty-taught cadaver labs guide residents through open and laparoscopic hernia repair; hepatobiliary, pancreatic and colon procedures; and the ASSET (Advanced Surgical Skills for Exposure in Trauma) course. Porcine labs provide advanced training in basic and advanced laparoscopy, video-assisted thoracoscopic surgery (VATS), vascular line and tube insertions, cholecystectomy, splenectomy, liver and bowel resection, and re-anastomosis and advanced trauma techniques. Additional training is also provided in collaboration with Ethicon EndoSurgery at their Cincinnati headquarters and training facility.
The Center for Surgical Innovation (CSI)
The Center for Surgical Innovation (CSI), which officially opened in the spring of 2006, is a 3,700 square foot, state-of-the-art core facility that provides unique opportunities for evaluating and validating medical and surgical technologies and supporting training and education. This multipurpose facility continues to develop mutually beneficial collaborations with academic and industrial partners. CSI also has partnered with a number of innovative companies to evaluate and validate technologies and processes in the laboratory environment.
The Edward Woliver Laboratory for Simulation and Education in Surgery
The Edward Woliver Laboratory for Simulation and Education in Surgery includes an array of simulation equipment designed to let surgical residents practice new skills in a safe, faculty-mentored environment outside the operating room. The lab has both low- and high-tech simulation equipment, including simple models to simulate suturing vessels. It also includes sophisticated devices that incorporate haptics (sense of touch) and track a surgeon's performance during the training session.
The UC Department of Surgery recently adopted the Fundamentals of Laparoscopic Surgery (FLS) course to train and evaluate senior residents, fellows, and other surgeons in the basic skills of minimally invasive surgery. The course is conducted in the Center for Surgical Innovation (CSI) facility. The FLS course is an education and skills training module developed by the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) and the American College of Surgeons Division of Education and is rapidly becoming the standard of evaluating basic skills and knowledge for laparoscopy. The course is CME accredited.
The course has two components: (1) a cognitive part designed to teach the basics of laparoscopic surgery, and (2) a set of technical skills to master. It includes several sets of DVDs and a trainer box to allow practice of manual skills. The FLS course is designed to teach the physiology, fundamental knowledge, and technical skills required in basic laparoscopic surgery and to assess cognitive knowledge and manual skills through a two-part, proctored exam. The cognitive component is a timed, multiple-choice exam administered via computer. The manual skills component is a timed, hands-on skills exam administered via the FLS Laparoscopic Trainer Box. FLS provides feedback on performance of both cognitive and technical abilities, and permits learning of minimally invasive techniques in a completely safe environment without putting patients at risk.
The course consists of modules covering Patient Positioning, Anesthesia, Pneumoperitoneum, Trocar Placement, Exiting the Abdomen, Current Laparoscopic Procedures, Diagnostic Laparoscopy, Biopsy, Surgical Injuries, Laparoscopic Suturing, Post-op Care, Closure Complications, and Data Analysis.
The Laparoscopic Trainer Box enables development of psychomotor skills and dexterity required during the performance of basic laparoscopic surgery. It is a portable unit that can be used in the environment of choice. The Trainer Box includes a set of accessories used to simulate specific surgical techniques. The Manual Skills Set test includes Peg Transfer, Precision cutting, Placement and securing of ligating loop, Simple suture with intracorporeal knot, and Simple suture with extracorporeal knot.
Other equipment in the Woliver Lab space includes:
- Symbionix GI-Mentor Endoscopy Simulator
- Fundamentals of Laparoscopic Surgery Trainer Box, which is used to help surgeons practice laparoscopic (minimally invasive) surgery techniques and test learned skills
- Two Mentice VIST mannequin simulators, which will allow residents and fellows to practice inserting catheters, use fluoroscopy (moving X-ray images) to monitor the catheter as it travels up through the body and learn sophisticated manipulations of blood vessels.
Surgical Simulation Experiences:
Surgical Stapling 101
- Knot Tying
- Basic and Advanced Suturing
- Instrument Handling
- Advanced Surgical Instrument Handling
- Cadaver and Porcine Labs
- Introduction to General Surgery
- Hernia Anatomy
- Introduction to Laparoscopy
- Advanced Laparoscopy
- Fundamentals of Laparoscopic Surgery Course
- DaVinci Robot Training
- Video Assisted Thoracoscopic Surgery (VATS)
- Trauma Surgery Simulation
- Vascular Anatomy
- GI Anastomosis
- GI Surgery Simulation
- Hepatobiliary and Pancreatic Surgery
- Laparoscopic Colectomy
- Additional Training at Ethicon EndoSurgery (Cincinnati)