This post was edited on Feb 13th, 2012. See footnote note in red.
Are you looking to advance your surgical skills in Gynecological laparoscopy?
Medicine is evolving at a fast pace. It is important to stay up to date and to offer our patients the most advanced and least invasive options available.
Hysterectomy is the second most common surgery performed on womyn in USA and Canada, Cesarean delivery being the first. There are different routes to performing a hysterectomy: Laparoscopic (LH), Vaginal (VH), and Abdominal (AH) among others.
Here is a comparison from The American College of Obstetricians and Gynecologists (ACOG) Committee Opinion #444, November 2009:
Here is The American Association of Gynecologic Laparoscopists (AAGL) position statement in 2010:
It is the position of the AAGL that most hysterectomies for benign disease should be performed either vaginally or laparoscopically and that continued efforts should be taken to facilitate these approaches. Surgeons without the requisite training and skills required for the safe performance of vaginal or laparoscopic hysterectomies should enlist the aid of colleagues who do or should refer patients requiring hysterectomy to such individuals for their surgical care.
In other words: VH should always be your first choice. When VH is not feasible, the patient should be offered LH. A surgeon should make every effort to avoid AH by either improving her/his laparoscopic skills or referring the patient.
Surgeon’s experience should no longer be a factor that influences route of hysterectomy unless referral of the patient, or access to a training course is not a viable option.
There are plenty of advanced surgical courses that are scheduled annually. in 2010, I attended Harvard’s Minimally Invasive Gynecologic Surgery conference in Boston, Massachusetts, USA. In 2011, I attended the Laparoscopic Institute for Gynecologic Oncology LIGO’s Surgical Masters’ Course in Total Laparoscopic Hysterectomy in San Francisco, California, USA.
In comparison, the LIGO course provides a larger opportunity for hands-on training with multiple simulated laparoscopy stations and one-on-one guidance from a mentor.
I enjoyed the intense nature of the course. Day 1 starts at 7 AM and adjourns at 9 PM. Day 2 starts at 7 AM and adjourn that 5PM. This provides ample time to explore the beautiful city of San Francisco.
Another success point for the course is that it is “newbie-friendly”. Even though the course teaches advanced skills, the training is usually tailored to your level of expertise. If you have not trained to do Laparoscopic hysterectomies the course will prepare you to start performing them.
It was pleasant to meet Dr. O’Hanlan and her partner Leoni Walker. I learned about Dr. O’Hanlan as an authority on lesbian health issues. I read her studies/articles during my literature review for my lesbian health research. It is impressive that she is an authority in two different medical fields.
Besides all the education, the course was fun. The Heliotomy Challenge was a laparoscopic suturing contest in a very laid back atmosphere. It was the perfect way to conclude the course. With alcohol being served, the contest turned into a nice evening to unwind among pleasant people, and spending the last hours of the course laughing and cheering for contestants.
- Like LIGO Surgical Masters’ Courses on Facebook.
- Follow @LapInstGynOnc on Twitter.
- Register for upcoming LIGO course
(Always in San Francisco)
You might be interested in reading a similar post: Bigger surgeries. Smaller incisions! Oct. 26th 2010
P.S. This blog post was transcribed by Siri after I broke my arm, and recently edited for posting.
Footnote (Added Feb 13th 2012): This blog post was dictated and transcribed shortly after the LIGO course I attended in Sept. 2011. I recently edited and posted it before I receive an official invitation from the Laparoscopic Institute of Gynecologic Oncology to join them in Atlanta as a LIGO preceptor. After the invitation no content was changed in the above post besides removing the following phrase “Always in San Francisco” as indicated above.
Categories: Health
There are many drawback of Laparoscopic surgery also like restricted vision, the difficulty in handling of the instruments (new hand-eye coordination skills are needed), the lack of tactile perception and the limited working area are factors which add to the technical complexity of this surgical approach. For these reasons, minimal Access surgery has emerged as a highly competitive new sub-specialty within various fields of surgery. Surgical residents and junior consultant who wish to focus on this area of advanced surgery gain additional laparoscopic training after completing their basic surgical residency.
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It is very difficult to become proficient at Minimally Invasive Surgery in Gynecology in 4 years of residency. You have to take the lead and find the proper venue to train, other than doing a Fellowship.
As a preceptor with LIGO, I highly recommend this course over others I’ve attended. Dr. Kate O’Hanlan’s course is vibrant, fun, highly educational and very much hands on.
Let me welcome you to San Francisco this spring !
Luis A. Gonzalez, MD, FACOG
LIGO Preceptor
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Thank you Dr. Gonzalez for reading and your insight.
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