Top Gun Level 1

Laparoscopic Anastomosis Course


Day 1:

7:00 – 7:30       Registration and Breakfast
7:30 – 7:45       Introduction
7:45 – 8:15       Review “The Art of Laparoscopic Suturing” CD-ROM
8:15 – 8:45       Cognitive Test
8:45 – 9:30       Skill Test I - Cobra Rope, Bean Drop, Terrible Triangle
                       - Each participant will be required to perform three trials of each drill
                       - Time and error will be recorded throughout each drill
                       - Each participant must demonstrate skill level of 70th percentile or better

9:30 – 12:00     Skill Test II – Intracorporeal Suturing on Animate Tissue
                       - Each participant will perform ten intracorporeal suture placement on animate                           tissue
                       - Time and error will be recorded through each round
                       - Each participant must perform in the 70th percentile or better
12:00 -- 1:00    Lunch
1:00 – 1:45       Maximum Knot Tying Drill (Dominant Hand, Animate Tissue)
                       - Three 5 minutes trials
                       - Place as many square knots as possible
                       - Record # of knots, # of errors
1:45 – 3:00      RKY Drill (Non-Dominant Hand, Foam)
                       - Three trials
                       - Arrange eight 4” sutures outside trainer
                       - Pass needle/suture complex through eight pre-designated marks (1cm apart)
                       - Failure to pass needle through target, as determined by instructors, will result in                        an error. The suture will then be removed and properly/more accurately place.
                       - Time and error will be recorded through each round
3:00 – 5:00      Non-Dominant Hand Suturing on Foam
                       - Placement of ten simple interrupted intracorporeal sutures on foam using the                          standard Top Gun knot (surgeons knot followed by two alternating half hitch                          square knots)
                       - Each knot will be timed and errors will be recorded

5:00                 End of Day 1

Day 2:

8:00                 Breakfast
8:30 – 9:30       Trocar Placement and Room Set-up Lecture and Test
9:30 -- 12:00     Non-Dominant Hand Suturing on Animate Tissue
                       - Placement of ten simple interrupted intracorporeal sutures on animate tissue                          using the standard Top Gun knot (surgeons knot followed by two alternating                          half hitch square knots)
                       - Each knot will be timed and errors will be recorded.
12:00 – 1:00     Needle Recovery Drill (Dominant Hand, Animate Tissue)
                       - Acquisition of needle from four predetermined positions within the GRIP device                          (see needle positions below). Pass needle through tissue and perform the                          standard Top Gun Knot (Surgeons knot followed by two alternating half hitch                          square knots)
                       - Time and errors will be recorded
1:00 – 2:00      Lunch
2:00 – 2:15      Tutorial – Extracorporeal Knot Tying: The “Fisherman’s Knot”
2:15 – 3:30      Fisherman’s Knot Exercise (10 trials timed)
                       - Using 36” length of twine, practice placement of a fisherman’s knot
                       - Perform 10 fisherman’s knots in a row without error, timing each individual                          knot
3:30 – 5:00      Extracorporeal Suturing Drill (Dominant Hand, Animate Tissue)
                       - This drill will require an additional trochar to be placed directly over the                           operative site. This port will be used for introduction of needle/suture complex,                           as well as for seating your knot with an Ethicon knot-pusher.
                       - 1st trial as practice
                       - Trial 2&3 will be timed and errors recorded
5:00 – 5:15      Course Evaluations
5:15                End of Day 2/Course

For more information, please call 212-844-1413.