MINIMALLY
INVASIVE SURGERY SUPPORT PROGRAM
Minimally Invasive
Goals
The overall goal of this program is to establish a standardized
advanced laparoscopic continuing education and support
strategy to assure the penetration of excellence in the
minimally invasive arena by all surgeons in the healthcare
system who are willing to participate in the program.
This organized objective based effort will go a long way
in establishing superior patient outcomes and quality
assurance in an arena that has been plagued with medico-legal
controversy and spotty surgeon participation. The deployment
of this program will allow the surgeons of the system
to stay on the "cutting edge" of the advanced
procedural envelope within a "resource sharing"
educational support system that will be furnished by AMTI/BIMC
Laparoscopy.
Laparoscopic Skill Development
Our laparoscopic skill
curriculum and objective evaluation of the skill capability
of all participating surgeons enables us to rapidly elevate
the baseline abilities of the healthcare system's staff.
Especially, by establishing intracorporeal suturing with
all participating staff. The attending surgeons will then
be capable of participation with the training of the residents
in this arena. Being able to perform this most difficult
of tasks will boost moral and establish solid credibility
of the training effort.
Each course session can accommodate 20 surgeons per outing
and can be held at Beth Israel Medical Center or at the
participating healthcare facility. Following the initial
course sessions, refresher programs of three-hour duration
will be held utilizing videoconferencing.
Cognitive
Development Program
Skill is a very important ingredient for
consistent successful outcomes with minimally invasive
procedures. But, the key to successful procedures lies
with clinical judgment. This can be accomplished with
a foundation of cognitive knowledge and experience. Therefore,
it is essential to have a cognitive and clinical judgment
development program. A yearly schedule of nine tutorials
is suggested.
The establishment of the topics included in these tutorials
will form a core of cognitive knowledge that will lead
to other topics that are more advanced or respond to contemporary
issues.
Remedial Education for Quality
Assurance
The participating healthcare system should purchase and
make available to the surgical staff and residents the
AMTI Laparoscopy CD-ROM series.
The three tutorials are also designed for the nurses and
patients. It is suggested that surgeons review and be
tested on these tutorials during the first year of the
program.
Topics
included in yearly schedule of tutorials: |
AMTI Laparoscopy CD-ROM Series |
1. Difficult Laparoscopic Cholecystectomy
and Avoiding Bile
Duct Injuries
2. Difficult Laparoscopic Cholecystectomy
OCCES
3. Laparoscopic Common Biled Duct Exploration
4. Laparoscopic Nissen Fundoplication
5. Laparoscopic Nissen Fundoplication OCCES
6. Laparoscopic Hernia Repair
7. Laparoscopic Hernia Repair OCCES
8. Laparoscopic Appendectomy
9. Laparoscopic Appendectomy OCCES
*OCCES - Objective Based Clinical Competency Evaluation
Scenario
|
1. Laparoscopic Cholecystectomy
2. Laparoscopic Nissen Fundoplication
3. Laparoscopic Hernia Repair
4. Laparoscopic Cholecystectomy Pre and
Post Operative Tutorials
5. Laparoscopic Nissen Fundoplication
Pre and Post Operative
Tutorials
6. Laparoscopic Hernia Repair Pre and Post
Operative Tutorials
7. Minimally Invasive Approach to the Management
of Common Bile Duct Stones
|
Tactical Leadership Development
It is imperative that we cultivate leaders that are
assimilated into a modern knowledge and skill transfer
program that is intimately associated with the cutting
edge of technology. These leaders will provide tactical
support for the surgeons and nurses at the local level
to help ensure the continuity of the AMTI/BIMC Laparoscopy
Program. This can be established by choosing a select
group of surgeons participate in the AMTI Laparoscopy
Six Week Advanced Minimally Invasive Surgery and Technology
Program.
Nursing Program
A team approach by all surgical team members is essential
for providing a positive outcome for Laparoscopic Surgery.
Success and positive outcomes are closely linked to
the training and experience of the surgical team.
All involved in these procedures need to be knowledgeable
and competent in the following:
1. A basic understanding
of the anatomy and physiology related to teh surgical
procedure.
2. An understandign of
the surgical sequence.
3. Patient preparation.
4. Immediate preoperative
preparation of the surgical site.
5. An understanding of
teh instrumentation and trouble-shooting skills
6. Knowledge of potential
complications and surgical team response.
A basic understanding of the anatomy and physiology
of the surgical approach provides all team members with
guidelines as to the expectations of the surgeon and
desired outcome. This knowledge is essential in providing
decisions around positioning, plan of care for the surgical
patient, pre, intra and immediate postoperative care.
Potential complications can be anticipated and responded
to in a more efficient manner.
Telemedicine
One of the most exciting topics on the medical scene
today is "Telemedicine". It offers a wide
range of possibilities to enhance healthcare delivery.
It is subject matter that administrators and clinicians
alike must be up to date on. It is suggested that a
group of participants representing the healthcare system
attend the AMTI Introduction to Telemedicine Program.
This is a two-day course that establishes both the technical
and application foundation for this new art form. The
program includes a first day of lectures and a second
day of "hands on" laboratory practicals. This
course will provide an excellent foundation to enable
the healthcare system to accurately guide its future.
