Top Gun Level 1:

Laparoscopic Skills and Suturing Program


Course Description:
The purpose of this course is to allow surgeons to acquire advanced laparoscopic skills in both instrument manipulation and laparoscopic suturing. When Dr. Rosser formulated Top Gun in 1990, he started with ten drills, and correlated them to intracorporeal suturing. Only ability to perform the abovementioned drills correlated to success tying intracorporeal sutures, so they were the ones selected for the course (reference Archives 1997). Dr. Rosser has since compiled a database of all course participants, so surgeons are given a percentile ranking, which is indicative of where they rank among their colleagues in the three laparoscopic drills and suturing. The goal of the Top Gun course is to teach surgeons to suture in one and a half days. Every surgeon who has participated in Dr. Rosser’s program has finished with the ability to tie an intracorporeal knot by the end of the course. The Top Gun training method has been featured as part of the ACS since 1996, and SAGES and SLS have also featured it at their annual conventions.


Course Objectives:
The Top Gun Basic Skills and Intracorporeal Suturing Course involves three laparoscopic drills, as well as interrupted suturing on pig bowel. The first drill is the Cobra Rope Drill, during which participants will unwind and pass a string using two graspers, targeting specific colored sections of the rope. Time begins when a participant touches the rope and ends when the last colored section is grabbed. The second drill is the Terrible Triangle Drill, which involves picking up (without seeing the loop used to hook the triangle) and moving five triangles from one circle to another using the non-dominant hand. Time begins when the first triangle is touched and ends when the fifth triangle is dropped in the landing zone circle. An electronic proctor is used to count inaccurate movements, such as bumping the triangle or dragging the triangle on the ground, which completes a circuit and counts an error. The third drill is the Slam Dunk Drill, during which participants move peas into a cup with a 1cm aperture using a grasper in the non-dominant hand. If the participant touches the cup with the grasper, an error is counted. Finally intracorporeal suturing is attempted. The time starts when the suture is touched by one of the instruments and ends when the last knot is tied. If the participant goes outside certain boundaries or takes too deep of a bite with the needle, the electronic proctor counts an error.

   To view the course itinerary, please click here.

   To view the course brochure, please click here.

   To view the course movie trailer, please click here.

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