Accomplishing the leap from camera person to laparoscopic surgeon is daunting for any surgical trainee. Laparoscopic skills have become a core skill set for many surgical specialities. However, laparoscopic skills often comprise a small portion of basic surgical skills courses which, juxtaposed with restricted working hours, limits opportunity to develop these skills. Core Skills in Laparoscopic Surgery is a two day course designed to bridge the gap between holding the camera and performing laparoscopic surgery. By the end of the course all participants had accomplished the skills to perform simulated diagnostic laparoscopy, laparoscopic appendicectomy and laparoscopic cholecystectomy.
Who is it for and when did you take the course?
The course is designed for surgical trainees wishing to develop basic skills in laparoscopic surgery. I took the course as a Core Surgical Trainee (CST) 1. Most of the participants on my course were CST1 to CST3 but more senior trainees wishing to refresh their skills are also welcome.
Where did you do it?
The course is run in the state-of –the-art DIHS atNinewellsHospital,Dundee.
How much did it cost?
The two day course costs £520.
Why did you do it?
I took the course as I wanted to consolidate my “on the job” training in laparoscopic surgery and maximise my learning during theatre sessions. I felt this would help me progress in my training by enhancing my core laparoscopic surgical skills.
How much preparation is required?
Once you have registered you have access to ten short online modules to read through. These cover some of the theory and safety issues around laparoscopic surgery. This maximises the time spent on the course acquiring practical skills on simulators.
Basic Format?
The two day course begins with practical sessions on access, insufflation, and camera use before moving on to ergonomics, sharp and blunt dissection and clipping. After lunch the focus moves to electrosurgery and use of hook and scissors before moving on to use of endoloops, tissue extraction and port closure. Each practical session is preceded by a concise lecture and DVD demonstration of the tasks to be accomplished on the simulators. Day one finishes with each participant utilising all the skills learned during the day to perform a simulated diagnostic laparoscopy.
Day two starts with a DVD demonstration on how to perform a laparoscopic appendicectomy before each participant then performs this operation on a simulator. This is followed by the “Objective laparoscopic skills assessment” where participants have a set time to perform the skills learned in day one. This is followed by a brief DVD demonstration on how to perform laparoscopic cholecystectomy, and a discussion about errors and complications of this operation.
The course culminates in each participant consolidating all the skills they have learned over the duration of the course by performing a laparoscopic cholecystectomy on a sample of pig liver and gallbladder.
Is there an assessment?
There is no official assessment. Tutors are on hand throughout the entirety of the course to give feedback on how to improve technique when performing simulated tasks. On the second day you pair up with another participant and informally assess each other during the “Objective laparoscopic skills assessment” session. Learning is encouraged by observing and helping each other as well as developing skills of assessing and providing feedback to colleagues.
Pros and Cons:
One of the best aspects of the course was the combined use of animal, synthetic and computer simulators. This complemented the format of the course which took participants from developing basic skills through abstract tasks to performing simulated operations. It builds confidence to see yourself progress from stacking sugar cubes to performing a laparoscopic cholecystectomy on a sample of pig liver in just two days! This provides a huge stepping stone, making you feel ready to bring your newly acquired skills away from the simulators and into the real world.
The course is intense and can be tiring but moves at as efficient pace. You will feel that you have achieved a lot over two days without being over whelmed with information.
Top tips:
Book early as courses are popular.
Read the course information before attending to maximise time spent developing practical skills on simulators.
Author name, job title and address
Alison Bradley, CST1, NHS Grampian
Michael D Gale, ST 4 General Surgery, NHS Grampian