Report by Dr Emily Fairclough, Warrell Unit, Manchester Foundation Trust
The collaboration between London Medical Education Academy, the cadaveric surgical training laboratory at Manchester University Medical School and the clinicians from the Warrell Unit, Manchester Foundation Trust created a wonderful learning environment for pelvic floor surgeons. Surgeons of all experience levels benefited from the unique learning experiences of this course.
Operating on cadaveric specimens offered the ability to operate in a bloodless, risk-free environment. It provides educational benefits that differ from simulator training, and from operating on patients in theatre. Working with the cadavers gave the ability to operate beyond the normal confines of a surgical procedure; surgeons were able to explore the surrounding anatomy, to assess limits of dissection, to open organs to check correct placement of sutures, and to practice both repairing organs and different methods of closing the peritoneum. They were able to repeat the same procedure multiple times, and also to perform multiple operations on one specimen within a short period of time.
This was an intensive, two-day course with plenty of time spent operating under the direct supervision of experienced surgeons. The focus of the first day was on laparoscopic surgery, covering laparoscopic colposuspension, sacrohysteropexy and sacrocolpopexy. Although it is possible to learn the basics of intra-corporeal suturing using a simulator, there are other fine motor skills that really can only be replicated within the body. The cadaveric lab allowed surgeons to practice the subtle angulation of needle placement required in placing colposuspension and sacrocolpopexy sutures. Surgeons were able to open the bladder to check correct suture placement. In addition, surgeons were able to dissect the ureters from the pelvic sidewall and observe their course in relation to the surgeries being performed.
The second day gave the opportunity to develop skills in open surgery, performing fascial slings, colposuspension and two types of urethral bulking procedures. The faculty were very flexible in their teaching methods and were able to modify the course to each individual’s learning needs.
The opportunity to attend a cadaveric surgical training course is something everyone should embrace, no matter what your training level or experience; even those who have been operating for decades gained new knowledge from the experience. Currently the Urogynaecology speciality faces an urgent need to update and develop surgeons’ skills in non-mesh incontinence surgeries. The Masterclass environment creates an option to progress surgeons’ learning curves in these operations before they enter the operating theatre.
Next Course 7-8 March 2019: http://www.lmedac.com/courses/