WEDNESDAY, SEPTEMBER 25, 2024:
HANDS-ON SKILLS COURSES:
8:00am – 12:00pm
Suturing Skills Course-Advanced Laparoscopic Suturing – for the Gynecologist, Urologist, and General and Robotic Surgeon:
Participants will learn the uses and limitations of laparoscopic suturing. Suturing with two hands ipsilaterally allows the needle to operate in the sagittal plane, while permitting a restful and relaxed attitude of the elbows, forearms and hands. This course equips all attendees with improved suturing skills and insight into applications during surgery.
Objectives: Course participants will be better able to understand ergonomics, theory and rationale for reproducible and efficient laparoscopic suturing; learn port positions, instruments and tips to minimize fulcrum and maximize efficiency, perform interrupted suturing, continuous suturing, cinch knotting; apply learned skills in relevant surgical situations across specialties; and the prevention and management of bowel, bladder and ureteral complications by appropriate suture repair. A pre-test and post-test will demonstrate improvement in skills.
8:00am – 12:00pm
Mastering Pain Management Before and After Minimally Invasive Surgery Including Office Procedures for Pain (with IPPS)
Peri-operative pain management is essential to good surgical outcomes. Research has identified several risk factors that pre-dispose patients to poor surgical outcomes. This evidence-based course will discuss pre-operative evaluation, down regulation of risk factors, and peri-operative methods for minimizing the risk of persistent pain while maximizing enhanced recovery. Instructors will review abdominal wall and pelvic neuropathies that happen more frequently after surgery, pain anatomy, terminology and management of post operative neuralgias. Lastly, the course will cover office procedures for pain management that every surgeon should know; this review will include procedure protocols, coding, documentation, and billing. This learning activity will be a highly interactive lecture that will also review key factors that influence pain relief and patient satisfaction with care. The session will conclude with a sample case that will be used to: 1) review core principles discussed in the lectures and 2) practice (hands-on) trigger point injections, neural blocks (with and without ultrasound guidance), neuromodulation, and bladder instillations.
Objectives: By the end of this presentation learners will be able to:
- Discuss basic principles of multi-modal treatments for peri-operative pain management
- Review anatomy and management of post-operative neuralgias
- Review office procedures that can be implemented in patients with post operative pain and other associated symptoms
1:00pm – 4:30pm
Hysteroscopy/Office-Based Hysteroscopy Skills Course
This course will introduce diagnostic and operative hysteroscopy and operative hysteroscopic techniques to the participants. This course is designed for clinicians seeking to enhance/update procedural skills as well as for those wishing to add hysteroscopy skills into their armamentarium. Participants will gain hands-on experience with hysteroscopy using virtual reality, wet and dry lab exercises. The expert faculty will instruct the participants on proper technique and tips with emphasis on indications and contraindications for operative and diagnostic hysteroscopy as well as the assembly and functions of the different hysteroscopy instruments.
Objectives: The participants will understand the handling, manipulating and maneuvering of hysteroscopes, and the applications and limitations of these techniques in clinical practice.
DIDACTIC COURSES
8:00am – 12:00p
Challenges and Controversies in Endometriosis – A Multidisciplinary Problem
Endometriosis is an enigmatic disease characterized by the presence of endometrium-like epithelium with or without stroma outside the endometrium and myometrium. It usually results in an associated inflammatory process. Genomic studies have shown significant alteration in gene expression in patients with endometriosis. There is also a multi factorial polymorphic genetic inheritance component to the disease in “familial” cases. Other factors including environmental or autoimmune mechanisms may be at play, making it difficult to precisely determine the etiology of endometriosis. A specific gene associated with a higher risk of endometrioid cancer in an endometrioma has been identified recently. Investigators have found a different patterns of behavior in ovarian endometriosis peritoneal endometriosis or deep infiltrating endometriosis. It can be locally Infiltrative with a severe inflammatory response, causing adhesions and obstructive syndromes in fallopian tubes, ureters, small intestine, colon, or rectum as a result of infiltration into these organs or adhesions. Ectopic endometrial implants have been found on the diaphragm, heart and in the thorax. Intense retroperitoneal fibrosis can occur without symptoms, only to be recognized on routine imaging for other processes. Asymptomatic endometriosis lesions may be found during diagnostic and operative procedures for other pathologies. This course will discuss some of the challenges and controversies in the medical and surgical management of the endometriosis patient.
Objectives:
- To increase understanding about the complexity of the disease and to discuss recent progress in patient management including pharmacologic and surgical options.
- To provide strategies to optimize surgical management of disease and to better understand when to call for help from other disciplines.
- To understand the role for patient referral for radical surgical excision of endometriosis in cases with a preoperative diagnosis of deeply infiltrating endometriosis (DIE).
- To provide clinical and operative vignettes illustrating the management of fibrotic, infiltrative, and obstructive lesions of ureter, bladder, small bowel and colon.
- To encourage surgeons to recognize the possibility of malignancy in patients with endometriosis.
1:00pm – 4:30 pm
Updates in Robotics and Robotically-Assisted Surgery
Robotics represents yet another revolution in the application of minimally invasive techniques to surgery. While conventional videoendoscopic techniques were revolutionary, they were hampered by limited instrument maneuverability and two-dimensional visualization. These technological shortcomings took away the wrist-like motion of the human hand and the depth perception of human eyes and necessitated the design of “new procedures” which were adapted to the technology. Robotics by virtue of wrist-like instrument maneuverability and three-dimensional visualization has returned the advantages of the human wrist and eyes to the field of minimally invasive surgery. A series of presentations by experts in the field will outline the State of the Art in the application of robotics to their specific field in surgery. Robotic technology that is currently available and coming to the marketplace as well as considerations in starting a robotic surgical program and determining what technology is a best fit for the new program or to augment an existing program, as well as considerations for training, credentialing and quality assurance will be discussed.
Objectives: This program will help attendees develop a critical eye to assist them in the adoption of robotics into their practice. Learners will understand the landscape of currently available and soon to be available robotic technology as well as the breadth of applications of these technologies in minimally invasive surgery. Learners will gain insights regarding how to set-up and manage a robotic surgery program, determine what instrumentation best fits their current needs and how to incorporate their first system or additional systems into their program. Learners will gain insights into requirements for education, training, credentialing, and quality assurance, among other topics.
Program is subject to change.