Surgical Skills

Objectives:

  • To demonstrate and learn the pelvic surgical anatomy relevant to obstetric and gynaecological surgery
  • To demonstrate, practice and learn the various surgical skills which may be needed to deal with unexpected intraoperative injury to bowel, bladder or ureter

During day 1 participants will work in trios through a variety of clinical scenarios utilising fresh-frozen cadavers. Half of the time is spent dealing with the anatomy and injuries relating to the pelvis, the remainder looking at the retroperitoneum and GI tract.

The module is aimed at revising and improving the participants’ knowledge and understanding of clinically relevant anatomy. The anatomical structures which are commonly involved in surgical injury will be reviewed, in particular the major vessels, nerves, ureter and bladder. The surgical anatomy relevant to urinary incontinence surgery, hysterectomy, ovarian masses and retroperitoneal exploration of the pelvic side wall will be covered.

This session requires satisfactory completion of a number of tasks during the cadaver dissection. The various surgical procedures are carried out by all the participants under supervision by facilitators.

In the course of day 1 participants will:

    • Expose the pararectal and paravesical spaces
    • Perform a ureterolysis and pelvic peritonectomy
    • If time, mobilise bladder and perform cystotomy and repair
    • Perform a lymphadenectomy
    • Expose iliac vessels and branches
    • Expose the obturator nerve
    • Ligate the anterior division of the internal iliac artery
    • Identify pelvic floor muscle and bony pelvis landmarks
    • Identify and dissect along anatomical planes to mobilise colon
    • Identify the blood supply to the bowel
    • Dissect along the interior vena cava and aorta
    • Repair a vessel injury
    • Repair a serosal tear and Veress injury to the small bowel
    • Repair a rectal tear
    • Repair a trocar injury to the stomach
    • Eviscerate and close the abdomen

This session lasts 8 hours and takes place in the Hill Surgical Workshop at the Clinical Training & Education Centre (CTEC) at The University of Western Australia (UWA).

Polysorb, Caprosyn, Biosyn, and Surgipro sutures are donated to the workshop by Medtronic.