Course 1:

Complications in Pelvic Surgery – Avoidance Strategies and Minimally Invasive Treatment Options  

Sunday, March 26, 2017 - 8:00 AM - 5:00 PM

UT Health Science Center at San Antonio
Hands-on Course - Limited to first 32 registrants
All participants should arrive to the course in scrubs.

Course Directors: Elizabeth Mueller MD and Andrew Sokol MD

Course Faculty: Jonathon Solnik MD, Kevin Stepp MD, Karl Jallad MD, Kimberly Kenton MD, Olga Ramm MD, Lee Richter MD

The course is designed for gynecologic surgeons interested in improving their ability to avoid and treat complications during pelvic surgery in a minimally invasive fashion. The workshop will utilize a combination of didactic and hands-on instruction to enable participants to prevent injury, laparoscopically repair cystotomy, place ureteral stents, and interpret lower urinary tract imaging. Laparoscopic suturing trainers will be utilized to both practice suturing and then repair cystotomy in porcine bladders. Cadavers will be utilized for stent placement. 

Learning Objectives

At the conclusion of this course, the participant will be able to:
1) Improve laparoscopic suturing and knot-tying skills
2) Reproducibly perform a laparoscopic cystotomy repair
3) Employ a systematic approach to intra-operative ureteral obstruction
4) Demonstrate a basic understanding of ureteral stent placement
5) Interpret normal and abnormal intraoperative fluoroscopy images

Course Outline:

08:00 am                     Bus leaves La Cantera for UT Health Science Center in San Antonio
8:20 am - 8:50 am       Continental Breakfast
8:50 am - 9:00 am       Welcome - Drs. Mueller and Sokol
9:00 am - 9:20 am       Basic Cystoscopy Mechanics and Dynamics – Kimberly Kenton, MD
9:20 am - 9:40 am       Fundamentals of laparoscopic suturing - Jonathon Solnik, MD
9:40 am - 10:00 am     Advanced Cystoscopic Mechanics and Dynamics – Elizabeth Mueller, MD
10:00 am - 12:00 pm - Morning Hands-on Lab Sessions

Participants will be divided into two groups of 16. Each group will spend an hour in each lab session.

LAB 1 - 3D-Med trainers
Suture pad practice of:
1. Loading needles
2. Placing and retrieving needles through tissue
3. Extracorporeal knot tying with open knot pusher
4. Extracorporeal knot tying with closed knot pusher
5. Intracorporeal knot tying
6. Running barbed suture

LAB 2 - 4 stations (15 minutes each)
AREA 1: Hands on equipment- working bridges/lens/painting the bladder
AREA 2: Retrogrades (2 cadavers)
AREA 3: Interpreting images
AREA 4: Cystoscopy and passing a wire/double open-ended catheter (2 cadavers)


12:00 pm- 12:30 pm -  Lunch
12:30 pm - 12:45 pm   No jet, now what (Intraoperative assessment of ureteral injury)– Lee Richter, MD
12:45 pm - 01:15 pm   Minimally invasive management of lower urinary tract injury during GYN surgery – Kevin Stepp, MD
01:15 pm - 01:30 pm   Post-operative assessment of lower urinary tract injury - Elizabeth Mueller, MD
01:30 pm - 03:30 pm    Afternoon Hands-on Lab Session

Participants will be divided into two groups of 16. Each group will spend an hour in each lab session.

LAB 3 - 3D-Med trainers with each participant working on an intact porcine bladder (1 hour)
Practice 2 layer closure of cystotomy
Intracorporeal knot tying and using barbed suture
LAB 4 - 4 stations (15 minutes each = 1 hour total)
AREA 1: Flexible cystoscopy
AREA 2: Passing stents with 30 degree and 70 degree lens (2 cadavers)
AREA 3: Bladder Irrigation Techniques, Advanced Urethral Catheter
AREA 4: Retropubic anatomy, bladder mobilization and ureter reimplantation concepts (2 cadavers)
3:30 pm - 4:00 pm - Wrap Up
4:00 pm - Bus Leave to Return to La Cantera Resort & Spa