LAPAROSCOPY

Minimal Access Surgery Fellowship

This course in the Department of Surgery of Rasoul Akram Hospital has been launched.

This course is also named in other famous university around the world as below:

Minimally Invasive Surgery (MIS)
Minimal Access Surgery (MAS)
Endoscopic Surgery

This course which helps the general surgeon to improve their skill to perform various endoscopic procedure .more over the other goals of this course earn the necessary ability for education and research in this field . Duration of this course is about 1.5 year (18 mounths) , that has been defined by the ministry of health , which is as long as the other famous university program .
fields related to this course is general and thoracic surgery. intraoperative sonography interferes with this course , so the education of this field is instructed by radiology department .

Director : Dr. Abdolreza Pazouki

History of this Program at the reputable around the world

Although the first laparoscopic surgery performed in 1987 ,the academic traning of endoscopic surgery has been stated recently among the literatures , MIS fellowship course was began at the Texas university and Stanford university in 2000 and 2002 respectively.
Duration of endoscopic fellowship course in the other famous universities around the world are as follows:

Complete educational programs in this field in Mayo Clinic center in the USA is defined as follows:

Clinical Education

Include : endocrine, Gastro eantestynal, Colorectal, Renal and rotational to other practices such as GI endoscopy , Interventional Radiology.

Research

trainees' of endoscopic fellowship course will be expected to participate in prospect and retrospect research activities .

Working conditions

Mayo Clinic provide opportunities for endoscopic fellowship.
Complete educational programs at Texas University in the USA is defined as below :
Every fellowship should participate about 350 operation at the end of one year , include :
Cholecystectomy: %5
Appendectomy: %5
Inguinal hernia: %5
Fundoplication:% 5
incisional hernia : %2
paraesophagenal hernia : %3
colectomy : %4
splenectomy : %1
Adrenalectomy: %1
Nephrectomy: %2
open bariatric : %2
Total Colectomy: %1
Radiofrequency ablation : %1
Gastric Bounding: %14
Gastric Bypass: %27
EGD: %12
Pancreas: %1
colonscopy : %7
liver resection : %1

Benefits of establishing this course in order to increase of medical education:

1. Economize in foreign exchange resources
2. Updating the knowledge of general surgery in Iran
3. maximize the clinical skills of our surgeons
4. minimize the bad results of mortality and morbidity among patients because of absence of classic educations.

Benefits of establishing this course in order to maximize the patient care quality

1. better ability to recognize because of good power of visualization and approach to all parts of peritoneal and thoracic space concerning the use of telescope in spite of little incisions on skin
2. magnification by lens that increases the exactness during surgery
3. less need of dissection and therefore less tissue damage ( no need to use retractor in most cases)
4. less intestine adherence ( this is one of laparatomy results and maximize the risk of obstruction)
5. less wound infection
6. less immunosuppression
7. rapid come back to work and daily life for patient
8. less ileus
9. less pain
10. less post operation complications (wound complication, absence of healing in sternum , etc.)
11. best cosmetic results

Educational purposes in this course

1. Orientation with advantage and disadvantages of insightful surgery
2. Orientation and get skills of equipments in this field
3. Orientation with physiologic and clinical results of this kind of surgery
4. Orientation with patient selection, indications and contraindications
5. Get ability to do this surgery
6. Do several researches about this method
7. Orientation with documentation about educational and studios issues

Content of program ( Core curriculum )

Educational program in all cases are as below:

1. patient select
2. indications and contraindications
3. equipments
4. techniques
5. documentations
6. pre-op and post-op cares
7. patient follows
8. results
9. results and ways of managing them
10. evaluation of the course by review the films of cases
11. train on pelvic trainers or models
12. practice the surgeries by animal surgeries
13. multimedia education by review of films
14. urologic laparoscopic procedures (Nephrectomy or Varicocel)
15. Gyn. Laparoscopic procedures ( EP, Ovarian Cystectomy)
16. Upper & Lower GI Endoscopy

It should be noted that each one of these courses in related wards are done with special groups of university and each course maximum is 1 month that will be added to the whole period of training course. Theory issues like : patient select , indication & contra indications , j.club & etc. will be done in ward .practical issues like animal surgeries and in follow the whole procedure on human ( observer , assistant , etc ) will be done independently.

Method of trainee evaluation during training course

1. Evaluation forms to monitor the results of practical exercises
2. Monitoring of films of surgeries that done by trainee
3. Paper exams in 3-6 months periods

Method of trainee evaluation in final

1. Evaluation and grading of logbook that has been written by professors In order to evaluate theory ability :
2. Final paper exam
3. Publishing minimum 2 articles in related and valid magazines
4. Publishing or continues 2 proposals in Minimally invasive surgery research center

Curriculum monitoring procedure in this course

Direct supervision by manager that will be done each 3 months and in this case educational managers and professors will have deep co operations and educational institute of university and its managers will take part in final exam.

Board members of program

Related and necessary space and equipments that are intended for this course are listed as below:

Class for theory sessions , and educational meetings ( j.club , conference , etc) , library that is equipped with internet access , audiovisual facilities , trainer , animal lab with related facilities , clinic, wards , OR ( equipped with related tools)

References & Library

Qualification needs and methods

1. To have General Surgery Board
2. Qualifying entering exam
3. Not take part in any other educational, therapeutic or executive activity during period of course
4. Other qualification factors that are needed to take part in fellow ship , authorized by MOH

Trainee duties during this course

1. All duties un fellowship statute , authorized by MOH
2. All duties that are intended for a General Surgeon
3. Regular appearance in ward from 7am to 4pm , on Thursday up to 1pm
4. Appearance in emergency surgeries if needed
5. Associate in education of residents, nurses and personnel in wards
6. Associate in short time training courses
7. Take part in research method workshop and get the certificate maximum up to 1st 6months of course
8. Create and manage of data base about 2 diseases up to completeness of data base
9. Do the studios related to MAS under supervision of professors
10. Publishing minimum 2 article in valid magazines
11. Obey the ethical regulations during whole procedures
12. Publishing or continues 2 proposals in Minimally invasive surgery research center

Minimal conditions for qualifying & qualifiers

1. Qualify in final exam and publish 2 article in magazines
2. Do minimum 100 basic ( cholecystectomy , appendectomy) & 100 advanced ( others) laparoscopic surgeries and confirm the logbook by professors
3. Publishing or continues 2 proposals in Minimally invasive surgery research center

workplace after qualification (education)

1. Ward & Clinic
2. OR with related equipments