Gynecologic, GYN-ONC, ColoRectal
Anatomy and Surgery Course:
A Workshop with Cadavers at GBMC Women’s
Pavilion. January 14,2012
Course Overview
This postgraduate workshop has been designed for the
surgeon with advanced laparoscopic skills who desires to
master the retroperitoneal spaces, Space of Retzius, and
surgeries of the deep pelvic floor. The AM session will be
focused on anatomy dissection of the pelvic spaces. The
afternoon session will focus on procedures which will include
LSH, TLH, TVT/TOT, Vaginal Meshes, Single Port BSO, Single
Port Cholycystectomy , uterosacral suspensions, Trans- anal
Single Port for the colorectal surgeon and laparoscopic
suturing.
The workshop will achieve these goals with a series of
focused didactic lectures on anatomy and technique, followed
immediately with hands on practice using unenbalmed female
cadavers. Three participants will be assigned to each cadaver
and will be closely supervised by experienced faculty
instructors.
The 4-hour morning session will cover the anatomy and
surgical technique of dissecting the pelvic sidewall and deep
pelvic floor. The paravesical and pararectal spaces will be
identified and dissected concomitantly with ureterolysis.
Exploring the Space of Retzius and suture techniques of
uterosacral suspension will be performed in the second half of
the morning.
The 4-hour afternoon session will cover technical tricks for
various procedures: laparoscopic hysterectomies, Single Port
procedures, vaginal meshes and suburethral slings. Time
remaining will focus on laparoscopic suturing. Gyn Onc will be
performing a Total Pelvic Exenteration through out the day
which will have live video feed into the Simulation Room for all
to view. Breakout groups will rotate through cadavers
assigned for TVT/TOT/Miniarc and Single Port procedures.
There will be an optional break out session during the lunch
break to observe a pudendal nerve dissection approached from
the buttock. After lunch this cadaver will be used for
placement of meshes and suburethral sling to accentuate the
neuronal vaginal anatomy of the deep pelvic floor structures.
During each session of the hands-on experience with the
cadavers, each participant will operate, assist and observe.
With this rotational format, participants learn pelvic anatomy
and laparoscopic suturing skills in an applicable manner.
Faculty members will lead participants through these multiple
procedures.
Breakout sessions will be designed into the morning and
afternoon for participants to work with instructors on
laparoscopic suturing techniques on the Stryker Simulators.
Course Objectives
After completion of this two-day course of lectures and handson-dissection of human, fresh frozen cadavers, the participants
will:
 Increase their applied knowledge of female pelvic
anatomy.
 Improve their surgical skills through hands-on dissection
of retroperitoneal spaces and pelvic sidewall.
 Improve their anatomic knowledge and laparoscopic
skills in performing advanced operative laparoscopic
procedures.
 Reinforce their laparoscopic suturing skills and learn new
ones.
 Learn how to perform TVT/TOT/Miniarc procedures.
 Learn how to implement Single Port technologies into
common GYN and colorectal procedures.
 Observe the technique of Laparoscopic Total Pelvic
Exenteration.
Program Agenda
7:30- 8:00 Registration and Breakfast
8:00 Introduction and Course Overview
8:05 Anatomy of pelvic sidewall & technical dissection tricks
8:20 Pelvic Floor Anatomy Overview
8:35 Energy Modalities in Laparoscopic Surgery
8:50 Q&A
9:00-12:00 Cadavers
 Review anatomy and technologies
 Dissect retroperitoneal spaces: Paravesical/Pararectal
 Review vessels/nerves in dissection
 Basics of Ureterolysis
 Dissection of Space of Retzius
 Uterosacral suspension techniques
12:00-1:00 Lunch Break
Optional Breakout: Dissection of Pudendal Nerve
And Hands on Suturing Stations
1:00 Technical tricks for hysterectomies
1:10 Slings and Mesh applications
1:20 Single Port options
1:30 Suturing techniques and devices
1:50 Q&A
2:00-3:30 Cadavers
GYN A
 Anatomy and Techniques of Hysterectomy
 Laparoscopic Suturing
 Single Port BSO
Gen Surg
 Single Port Cholycystectomy
GYN B
 TVT/TOT/Mini Arc/Meshes
3:30- 5:00
GYN A
 TVT/TOT/MiniArc /Meshes
GYN B
 Single Port BSO
 Anatomy and Techniques of Hysterectomy
 Laparoscopic Suturing
5:05 Wrap up.
CME Credit
All Participants Must Complete a Course Evaluation in order to
receive a CME Certificate Accreditation Statement and
Designation of Credits. This activity has been planned and
implemented in accordance with the Essential Areas & Elements
of the Accreditation Council for Continuing Medical Education
(ACCME) through the sponsorship of The Minimally Invasive
Center at GBMC. GBMC is accredited by the ACCME to provide
continuing medical education for physicians. GBMC designates
this educational activity for a maximum of 8.00 AMA Category 1
Credits™. Physicians should only claim credit commensurate with
the extent of their participation in the activity.
Faculty Disclosure
GBMC CME Courses have a policy that requires course faculty to
disclose all financial relationships with any company producing
health care goods or services, consumed by or used on patients. It
is not assumed that these financial interests or affiliations will
have an adverse impact on faculty presentations; they are simply
provided to fully inform participants. Faculty financial disclosures
are on file at GBMC and full disclosure of faculty relationships will
be made at the conference. The content of this CME activity was
planned to be balanced, objective, and scientifically rigorous.
Occasionally, faculty may express opinions that represent their
own viewpoint. Conclusions drawn by participants should be
derived from objective analysis of scientific data. GBMC has
informed all faculty that if any presentations include discussion of
off label or investigational use of a commercial product, therapy
or medical device, full disclosure must be made to the course
participants.
Faculty
Instructors have been selected for their outstanding teaching
abilities and extensive surgical experience with the procedures
and techniques that will be presented at this conference.
Course Director:
Carol E Ritter, MD. Director of Women`s Minimally Invasive
Surgery at Greater Baltimore Medical Center.
Conference Faculty
Francis Grumbine, MD –Chairman of Dept of Gynecology and Gyn
Oncology, Greater Baltimore Medical Center
James Henderson Dorsey, MD – Professor, Dept of Gynecology
Greater Baltimore Medical Center
Joan Blomquist, MD – Division of Urogynecology and Pelvic
Surgery, Greater Baltimore Medical Center. Director
Urogynecology Fellowship
John Yacoub, MD – Director of Minimally Invasive Surgery, St
Agnes Hospital, Baltimore , Maryland
Michael Vietz, MD – Director of Minimally Invasive Surgery,
Carroll County Hospital, Westminster, Maryland
Richard Marvel, MD- Gyn Pain Specialist, Center for Pelvic Pain,
Anne Arundel Hospital, Annapolis, Maryland
Amanda Nickels-Fader, MD- Associate Director Gyn Onc. Director
of Residency Training Program GBMC, Director of Gyn Robotic
Surgery, GBMC
Dr George Apostolides, MD- Division of ColoRectal Surgery at
Greater Baltimore Medical Center
Commercial Support
This activity may be supported by unrestricted educational grants
from commercial sources. Any grants received will be disclosed to
the participants according to the ACCME Standards for
Commercial Support. All grants are provided with the
understanding that the supporter will not exert any influence on
the content or educational development of this activity as a
condition of the gift; nor will they take, or have taken any role in
the selection of topics, speakers, or audience for this activity. This
activity is for educational purposes and not for the purpose of
promoting any product. Promotional activities will not be
allowed in the meeting room and this activity will be presented
with objectivity and balance. Commercial supporters may have
representatives on hand to answer questions you may have
related to their therapies, products, and/or technologies. We
encourage you to talk with these representatives during the
scheduled break sessions to obtain information that can be a
valuable resource to your practice.
Vendor Support is greatly appreciated from the following
companies:
Covidien, Ethicon, Applied Medical, AMS, Cooper Surgical,
Storz, Stryker, Endoevolution, Conmed, Olympus
Carol Ritter, M.D.
MIS Program Director,
GBMC Baltimore MD
Location: GBMC PPW Suite 100
6567 North Charles St
Towson, Md, 21204
First Floor Physician Pavillion West
Sponsored by: GBMC and The MIS Simulation Center