There is every need for the trainee in surgery to be trained in laparoscopic surgery . Dr Pravin John, Dr John Thanakumar

1. INTRODUCING LAP SURGERY TO
THE TRAINEE-THE NEED OF THE
HOUR
Dr Pravin John
Dr John Thanakumar
ANURAG HOSPITAL, COIMBATORE
www,anuraghospital.com

2. Goal
• To provide surgical trainee an opportunity
to learn the fundamentals of laparoscopic
surgery
• Consistent, scientifically accepted format
• Improve cognitive, surgical decision-
making, and technical skills, all with the
goal of improving the quality of patient
care.

3. Who should benefit
• Designed for surgical residents, fellows
• Practicing surgeon to learn and practice
laparoscopic skills
• Measure and document those skills..
• Master surgeon Learns newer skills – SILS,
etc

4. Endorsement
• By IAGES
• By Dr MGR University
• MCI
• Standardizes
• Helps later on

5. • Foundation to supplement to any current
MAS curriculum
• Appropriate learning tool for disciplines
including as gynecology ,urology, VATS,
pediatric surgery

6. Why train?
• Skills in laparoscopic surgery can be
increased by virtual reality simulator
training.
• The performance was increased to
experienced laparoscopists and
• Operation time was halved.
• Simulator training should be considered
before trainees carry out laparoscopic
procedures.Effect of virtual reality training on laparoscopic surgery: randomised controlled
trial
BMJ 2009; 338 doi: 10.1136/bmj.b1802 (Published 14 May 2009)
Cite this as: BMJ 2009;338:b1802

7. Training Models
• Surgical trainers,
• Animal models,
• Virtual reality trainers, or
• Other simulated operating conditions
before the trainee performs these
procedures in the operating room on
patients.

8. Skills learnt
• Accurate instrument targeting
• Two-handed manipulation, dissection,
• Non Dominant hand Dextrity
• Intracorporeal suturing, and
• Intra- and extracorporeal knot tying.
• Ergometrics

9. Basic Course
• 1 or 2 day course
• Didactic lectures
• Hands-on laboratory experience with
inanimate objects
• Wet lab with tissues
• Animal Lab

10. ADVANCED LAP TRAINING
• Hiatal Surgery
• Colorectal Surgery
• VATS
• Solid organ and Endocrine Surgery
• Bariatric Surgery
• Suturing
• Hernia Surgery

11. • Skills Labs: The creation of inanimate and
animal training facilities by individual
programs initially
• Supplement by advanced program
• IAGES

12. Other forms of training
• Endoscopy
• Colonoscopy
• Operative ultra sound
• NOTES
• Single incision Lap surgery
• Robotics

13. Certified course
• Repeat prn
• Repeat course for
different systems
• Repeat course for
newer techniques
• Issue Cerificate
• Keep up with
advances

14. • Training is not the end
• ……. But the means to the end