IN COLLABORATION WITH

GESEA CERT1 Practical Training Workshop in Cape Town Saturday 1st & Sunday 2nd July 2023

Workshop Description and Objectives

To ensure patient’s safety in laparoscopic surgery, it is clear that future laparoscopic surgeons should possess objective measurable theoretical knowledge and practical skills, prior to undertaking any procedure, even under supervision, in the OR.

As part of its plan to standardize strategies and regulations for training in laparoscopy throughout Europe, the EUROPEAN SOCIETY FOR GYNAECOLOGICAL ENDOSCOPY (ESGE), in collaboration with ESHRE, SERGS and ESGO, has conducted extensive scientific research resulting in a validated programme of exercises for acquiring and testing laparoscopic psychomotor skills.

LASTT1™, SUTT1™ and  HYSTT1™ are validated assessments and certification method which measures and evaluates psychomotor skills in camera navigation, hand-eye and bi-manual coordination.

All exercises are executed in dry-lab set-up, with participants working together in pairs, and under the strict procedural guidance of instructors.

The workshop is open to all delegates interested in laparoscopic surgery; experience level is indifferent.

At the conclusion of the Workshop the clinician will

• be assessed on his/her psychomotor skills level
• be ranked by comparison with benchmark performance data of representative experienced laparoscopic surgeons receiving a red, green or yellow colour code at each test.
• receive a final report of competence in basic laparoscopic psychomotor, suturing and hysteroscopy skills.
• Will have received extensive information off all modalities of the GESEA programme

Workshop Programme

Laparoscopic Psychomotor skill Assessment (LASTT1™)

 Participants are invited to test the basic laparoscopic skills through the LASTT1™ method developed by ESGE. For the first time, a scientific validated method has been defined where, independent of the medical skills, the required psychomotor skills for Laparoscopy are being assessed. Participants will go through an assessment of three exercises, performed in a pelvic trainer box and using the appropriate endoscopic equipment and instruments.

The individual scoring data will be introduced by a GESEA  programme associate into the GESEA On-line Academy Scoring Platform and the individual reports will be printed on location. The reports are part of the final reporting package but will also be available for each individual participant.

General flow

 Dates and Times: (Maximum 18 participants)

Saturday 1st July 2023:                 08h30 to 16h30 (18 Participants)

08h00                          Registration

08h30                          Welcome and introduction

1. Theoretical session (30 min)

During this lecture session participants will be informed on the training possibilities in South-Africa in general and in Cape Town specifically. Furthermore, they will receive an overview of the GESEA training programme, including the laparoscopic and hysteroscopic training models of GESEA Programme. 

Chief Instructor:  TBA

09h00    Gynaecological Endoscopic Surgical Education and Assessment (GESEA) Programme

Chief Instructor:  TBA

2. Practical Sessions

• The Laparoscopic Skills Training and Testing (LASTT1™) method
•  The Laparoscopic Suturing Skills Training and Testing (SUTT1™) method
• The Hysteroscopy Skills Training and Testing (HYSTT1™) method

Chief Instructor:   TBA

Hands-on session LASTT1™ (165 min) The session starts with an introduction of the method by the GESEA Programme Instructor. Participants are invited to go to the workstations in pairs to execute the runs of the first exercise. The workstations are positioned along the walls of the room with a minimum of 1 meter in between.

When the first exercise run is terminated, participants return to the presentation area for the instructive session on the second exercise. And so on, until all three exercises have been completed.

Exercise 1: Introduction:  CAMERA NAVIGATION with a 30° laparoscope                                                        10 minutes

The aim of the first exercise is to navigate the camera with the 30° optic to visualise all important areas of the pelvis.

Instruction exercise 1:            Demonstration by Instructor                                                                                  10 minutes

Session Ex 1:                         Delegates train and practice taking turns alternatively                                         40 minutes

Exercise 2: Introduction:  HAND/EYE CO-ORDINATION with a 0° laparoscope and a curved dissector       5 minutes

The aim of the second exercise is to evaluate the ability to navigate the camera with the non-dominant hand and to handle a forceps with the dominant hand.

Instruction exercise 2:            Demonstration by instructor                                                                                  10 minutes

Session Ex 2:                         Delegates train and practice taking turns alternatively                                          30 minutes

10h45                          Tea

11h00

Exercise 3: Introduction:  HAND/EYE CO-ORDINATION with a 0° laparoscope and a curved dissector and a Matkowicz Grasper

                                                                                                                                                                              10 minutes

Instruction exercise 3:             Demonstration by instructor                                                                                  10 minutes

Session Ex 3:                          Delegates train and practice taking turns alternatively. One delegate does exercise whilst partner                                                           

                                                operates camera/laparoscope                                                                               40 minutes

12h00                          Lunch 

13h00             Suturing session 1           

SUTT1™ – Suturing and knot tying Training and Testing (SUTT1™) method

 The aim of SUTT1™ is to measure the ability of fine and complex psychomotor skills by performing stitches using correct needle handling and intra-corporeal knot tying.  

  SUTT1™ – using a 15 cm 2-0 braided absorbable suture on a 26mm 1/2 circle taper point needle

 Handling a needle in a Laparoscopic Pelvic Trainer

• The anatomy of a needle
• Picking up and manipulating a needle, especially with respect to the angle and cant/slant/tilt of the needle
• The rotation of the needle through the foam model and pulling the suture through
• Skill of positioning the needle and suturing with both left and right hands

Instruction exercise 1:                                                                                                                                       15 minutes                       

Session Ex.1                          Delegates train and practice taking turns alternatively. One delegate does exercise whilst partner operates the camera/ 0° laparoscope                                                                                                                                                                                                                45 minutes                         

   14H00           Suturing session 2

 EXERCISE 2 – Right hand suture – Stitching and knot tying with right hand 

 On a jig with rope:

The technique of tying a surgeon’s knot using string by hand using the C/reverse C technique

The technique of tying a surgeon’s knot using 2 open needle holders

Instruction exercise 2:                                                                                                                                       15 minutes                       

Session Ex.2                          Delegates train and practice individually on a jig                                               15 minutes 

In a laparoscopic pelvic trainer

• Practice trying a knot in the laparoscopic pelvic trainer

Right hand suture and tying a surgeon’s knot

Instruction exercise 2:                                                                                                                                       15 minutes                       

Session Ex.2                          Delegates train and practice taking turns alternatively. One delegate does exercise whilst partner operates the camera/ 0° laparoscope                                                                                                                                                                                                                30 minutes                       

15h15                         Tea 

15h30                        Suturing session 3 

Session Ex.3

 Perform 4 single stitches using your dominant hand and 1  stitch with an intra-corporeal knot

• Pass the suture by entering and exiting precisely within the black dots
• Leave enough thread in the pad for evaluation
• Cut off using laparoscopic scissors

16h30                          Close

Sunday 2nd July 2023:               08h30 to 16h00

08h30                          HYSTT1™ session 1

 The Hysteroscopy Skills Training and Testing method HYSTT1™

HYSTT1™ is a practical test to measure the competence level of an individual in basic hysteroscopic psychomotor skills (HPS) in the uterine environment. These typical skills need to be applied in a ‘key-hole’ situation, such as camera navigation and hand-eye coordination.

HYSTT1  | Exercise 1: Camera Navigation

The aim of the first exercise is to navigate the camera with the 30° optic to visualise all important areas of the uterine cavity.

 Instruction Exercise 1:            Hands-on session HYSTT1™ (30 min) The session starts with an introduction of the method by the Mentor from the GESEA Programme – Video demonstration and model demonstration                                                                                                                               30 min         

Session 2 Exercise 1:              Participants are invited to go to the workstations in pairs to execute the runs of the first exercise. 

                                                                                                                                                                                                30 min

09h30                           session 2

HYSTT1 | Exercise 2: Hand-eye Coordination

The aim of the second exercise of HYSTT1™ is to evaluate the skills of simultaneous camera handling and handling a hysteroscopic forceps, grasping an object and transporting it.

 Instruction Exercise 1:            Hands-on session HYSTT1™ (30 min) The session starts with an introduction of the method by the Mentor from the GESEA Programme – Video demonstration and model demonstration                                                                                                                               30 min         

Session 2 Exercise 2:              Participants are invited to go to the workstations in pairs to execute the runs of the second exercise. 

                                                                                                                                                                                                30 min

10h30                          Tea

11h00                          Suturing session 4

Practice on SUTT1™ pad:

Suture pads – interrupted

Suture pads – continuous

1300                            Lunch

14h00                          Suturing session 5

The Laparoscopic Skills Training and Testing (SUTT1™) TEST

16h00 Conclusion

REGISTER BELOW: (Course subject to a minimum of 16 participants)

Please note that you must have registered for the GESEA e-learning programme before you can register for the workshop – GESEA Level 2MIGS e-learning

Workshop will only take place subject to sufficient number of delegates.

WORKSHOP FULLY BOOKED. For any queries, contact Clive van Geems – clive.vangeems@uct.ac.za