1.
Identify different types of instruments and suture (needle drivers, scissors, pickups) required for intestinal and vascular anastomosis
2.
Learn how to appropriately load a needle on the appropriate driver (e.g. Castroviejo) and handle vascular and intestinal tissue with said instruments
3.
Master needle transfer within tissue (needle placement and preparation from stitch to stitch, including appropriate angles)
4.
Master knot tying on braided and monofilament suture of variable thickness when used in an anastomosis (ranging from 2-0 to 6-0)
1.
Learn the definition and technique for Lembert suturing (sero-muscular, non-mucosal bites)
2.
Identify the different types of arterio-venous fistulae and grafts for dialysis access, including description of the course of the major arterial and venous anatomy of the arm (radiocephalic, brachiocephalic, basilic vein transposition, DRIL procedure)
3.
Set up an end to end (heel to toe), end to side (bypass graft-heel to toe), and side to side
(Brescia-Cimino) vascular anastomosis
4.
Identify the different types of gastrointestinal stapling devices (open and laparoscopic) and utilize said devices for the creation of a side-to-side, functional end-to-end intestinal anastomosis (including guiding principals of non-tension, anti-mesenteric, staggered staple lines)
1.
Specifically identify sources of autogenous materials versus exogenous materials (bovine, PTFE) for creation of vascular anastomosis along with appropriate timing and dosing of heparinization, describe and perform a parachuted end-to-end vascular anastomosis and the circumstances under which such an anastomosis is performed
2.
Identify what depth of staple load is used for the following tissue: vascular, stomach, small intestine, colon, rectum
3.
Describe succinctly (with surgical semantics) the exposure for the Zone 1 great vessels of the abdomen: a.
supramesocolic (suprarenal aorta, celiac axis, proximal SMA, proximal renal artery) b.
inframesocolic (infrarenal abdominal aorta, IVC)
*Specifically describe approach for IVC injury at level of renal veins and at common iliac vein confluence
4.
Set up a single layer and two layer hand sewn side-to-side bowel anastomosis (both isoperistaltic and antiperistaltic), incorporating interrupted Lembert, running, and Connell suturing techniques
1.
Set up a single layer and two layer hand sewn end-to-end bowel anastomosis
2.
Set up a stapled end to end anastomosis, including an understanding and description of how to chose EEA size, techniques utilized in securing proximal anvil, and techniques used in placin g the EEA stapler in the rectum

3.
Describe succinctly (with surgical semantics) the exposure and techniques (including type of anastomosis and graft size) how to perform the following vascular procedures: carotid endarterectomy, open infrarenal AAA repair, open juxta/suprarenal AAA repair, aorto-bifemoral bypass, femoral-popliteal bypass, femoral-distal bypass
4.
Describe the type of bowel anastomosis (number of layers and orientation) used in the following operations: esophago-jejunostomy, ileo/colo rectostomy, choledochoduodenostomy, choledocojejunostomy, duodenojejunostomy, pancreatojejunostomy