ASiT and ALSGBI have teamed up to deliver a laparoscopic skills course for specialty trainees
The ASiT ALSGBI Intermediate Laparoscopic Skills Course was held on 5 April as one of 13 pre-conference courses, which also included the ASiT Core Laparoscopic Skills Course, held during the 2013 ASiT International Conference.
The course was organised by ASiT Vice-president, Mr Jonathan Wild and supported by the ALSGBI and was the inaugural external course held at the newly opened, and well-equipped, Manchester Surgical Skills and Simulation Centre (MSSSC), which provided the perfect setting for this event.
Places were restricted to 12 delegates which, with six consultant surgeon faculty members, meant a 2:1 tutor to participant ratio. It was aimed at ST3/4 trainees with laparoscopic suturing experience and a novel feature of this skills course was the utilisation of a team of medical student volunteer camera operators, enabling ample opportunity for hands-on practise whilst being under direct supervision.
Aside from a short welcome and introduction, the rest of the day was dedicated to practical sessions with brief demonstrations followed by hands-on practice. This began with extra-corporeal knot tying. Although this skill is touched upon during core laparoscopic skills courses it was useful to revisit this and discuss its various applications, including to the appendix stump and to the cystic duct during appendicectomy and cholecystectomy, respectively. Next, we were taken through laparoscopic suturing and the tumbled square knot with a practical demonstration by Mr Peter Sedman, ALSGBI Director of Education and faculty lead, who broke this skill down into its component parts in such a way that we were able to practise them immediately, focusing on the set-up of the suture inside the abdomen. Using a cadaveric porcine small bowel, we created and subsequently closed enterotomies.
Later sessions included Heller’s myotomy and perforated duodenal ulcer repair, again on a porcine model. There was opportunity to familiarise ourselves with endoscopic linear stapling devices, which we subsequently used to perform side-to-side small bowel anastomoses, on bovine bowel, together with laparoscopic suturing to close the final enterotomy.
The course concluded with a laparoscopic cholecystectomy and common bile duct exploration on a cadaveric bovine model, with peppercorns placed in the CBD to simulate stones. Provision was made for use of a choledochoscope, which in addition to gaining experience of this novel skill also afforded more opportunity to consolidate skills gained earlier in the course, including sharp and blunt dissection and extra-corporeal knot tying whilst gaining familiarity with the anatomy of Calot’s triangle first-hand.
Overall, this was an intensive, highly enjoyable and valuable course taught by a friendly and approachable expert faculty, covering a range of applicable skills to general surgical practice. For only £95 including refreshments and lunch, transport to and from the conference venue, and a drinks reception, this course offered excellent value for money and I would recommend it to peers and colleagues.
Mr Ashok Gunawardene