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Surgical SkillSCurriculum for Residents

acS/aPDS: SuRgiCal SkillS CuRRiCulum foR ReSidentS

Contents:

Asepsis and Instrument Identification: TraumaMan System

Knot tying: Basic Open Surgical Skills (BOSS)

Suturing: Basic Open Surgical Skills (BOSS)

Airway Management: TraumaMan System

Chest tube and Thoracentesis: TraumaMan System & Thoracentesis Model

Arterial and Venous Catheterization: CentraLineMan & FemoraLineMan

Laparotomy Opening and Closure: Laparotomy Model

Introduction to inguinal anatomy: Hernia Model

Hand sewn anastomosis: Laparotomy Model

Stapled anastomosis: Laparotomy Model

Laparoscopic/Open Bile Duct Exploration: CBDE Model

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MOD1: aSePSiS & inStRument identifiCation

objeCtives:

> Correct prepping and draping for maintaining a sterile field

stations:

> Gowning and Gloving> Prepping and Draping> Instrument Identification and Handling

simulatorneeded:torsomodel

TraumaMan System (TPP–10): This simulator can be used for teaching students how to correctly prep and drape a patient to maintain a sterile field

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MOD2: knot tying

objeCtives:

> Tie a series of 10: two handed square knots

> Tie a series of 10: two handed square knots at depth

> Tie a series of 10: one handed square knots

> Tie a series of 10: one handed square knots at depth

> Tie a series of 4: instrument tied square knots

simulatorneeded:Knottyingboard

Basic Open Surgical Skills (BOSS–10): This trainer provides a flexible platform for basic surgical skill development, including knot tyingStudent Tissue Pack (BTP–10): Includes Tissue Model, Complex Tissue Model, Large Intestine, Tissue Suture Pad, and an Injectable Tissue Pad

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MOD3: SutuRing and SutuRing teChniqueS

objeCtives:

> Demonstrate a simple interrupted stitch

> Demonstrate a simple running stitch

> Demonstrate a running subcuticular stitch

> Demonstrate vertical and horizontal mattress stitches

stations:

> Simple Interrupted and Running Stitch

> Running Subcuticular Stitch> Vertical Mattress Stitch> Horizontal Mattress Stitch

simulatorneeded:tissuemodels

Basic Open Surgical Skills (BOSS–10): This trainer provides a flexible platform for basic surgical skill development, including suturingStudent Tissue Pack (BTP–10): Includes Tissue Model, Complex Tissue Model, Large Intestine, Tissue Suture Pad, and an Injectable Tissue Pad

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MOD7: aiRway management

objeCtives:> Demonstrate the ability to perform

a cricothyroidotomy

> Demonstrate the ability to perform the tracheostomy portion of a percutaneous tracheostomy

stations:

> Surgical Cricothyroidotomy> Percutaneous Tracheostomy

simulatorneeded:maniKinwithairwaysystem

TraumaMan System (TPP–10): This simulator includes a complete airway system powered by a portable ventilator, provides an airway response to the operative sites

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MOD8: CheSt tube and thoRaCenteSiS

objeCtives:> Demonstrate the ability to place

a decompressive needle

> Demonstrate the ability to place a chest tube

> Demonstrate the ability to perform thoracentesis

stations:

> Needle Decompression> Chest Tube Insertion> Thoracentesis

simulatorneeded:torsomodel

> TraumaMan System (TPP–10): This simulator includes an anatomically correct torso, complete airway system - providing a platform for performing chest tube insertion and needle decompression

> Thoracentesis Model (THM–10): This simulator provides a realistic platform for performing thoracentesis

Thoracentesis Replaceable Tissue (THMT–10)

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MOD9: aRteRial and VenouS CatheteRization

objeCtives:> Identify the anatomic landmarks to

safely place arterial and central venous catheters

> Develop an algorithm to maximize safety in placement of arterial and central venous lines

> Demonstrate a working knowledge to the use of the “Site Rite” ultrasound for the placement of central venous catheters

simulatorneeded:vasCularaCCesstrainers

> CentraLineMan System (CLM–20): This simulator can be used for teaching students how to insert a central venous line - both the jugular and subclavian approach

CentraLineMan Replaceable Tissue (CLMT–20)

> RadiaLineMan System: Under Development

> FemoraLineMan System (FLM–20): This simulator can be used for teaching students how to insert a femoral arterial line

FemoraLineMan Replaceable Tissue (FLMT–20)

stations:

> Central Venous Line - Jugular Approach> Central Venous Line - Subclavian

Approach> Radial Arterial Line > Femoral Arterial Line

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MOD12: laPaRotomy oPening and CloSuRe

objeCtives:> Demonstrate the ability to safely

make a midline incision, correctly identifying all layers of the abdominal wall, and preventing any injury to intra-abdominal structures

> Demonstrate the ability to close the abdominal wall in the midline in the appropriate layered fashion

stations:

> Midline Laparotomy Opening> Midline Laparotomy Closure

(Interrupted Technique)> Midline Laparotomy Closure

(Continuous Technique)

simulatorneeded:laparotomymodel

Laparotomy Model (LPM–10): This simulator includes a partial abdomen with replaceable abdominal tissue cover that includes skin, subcutaneous fat, fascia, preperitoneal fat, and peritoneumLaparotomy Replaceable Tissue (LPMT–10)

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MOD14: intRoduCtion to inguinal anatomy

objeCtives:> Identify pertinent external landmarks of

the inguinal region for use in herniorrhaphy

> Identify the components of the inguinal canal and spermatic cord

> Describe the etiology of groin hernias by defining potential weak areas of the inguinal and femoral regions

> Describe the anatomic basis for hernia repair

stations:

> Anatomy Dissection> Anatomy Demonstration

simulatorneeded:herniamodel

Hernia Model (HTM–30): This simulator includes an anatomically correct pelvis with necessary landmarks

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objeCtives:> Demonstrate a functional end-to-

end intestinal anastomosis using sutures

> Perform side-to-side bypass enteroenterostomy using sutures

MOD19: hand Sewn anaStomoSiS

simulatorneeded:laparotomymodelandlargeintestine

Laparotomy Model (LPM–10): This simulator includes a partial abdomen with replaceable abdominal tissue cover that includes skin, subcutaneous fat, fascia, preperitoneal fat, and peritoneum; and the Large Intestine is a reinforced bowel section for anastomosisLaparotomy Replaceable Tissue (LPMT–10)

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objeCtives:> Demonstrate a functional end-to-end

intestinal anastomosis using enteric staplers

> Perform side-to-side bypass enteroenterostomy using stapler technique

MOD20: StaPled anaStomoSiS

simulatorneeded:laparotomymodelandlargeintestine

Laparotomy Model (LPM–10): This simulator includes a partial abdomen with replaceable abdominal tissue cover that includes skin, subcutaneous fat, fascia, preperitoneal fat, and peritoneum; and the Large Intestine is a reinforced bowel section for anastomosisLaparotomy Replaceable Tissue (LPMT–10)

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objeCtives:> Learn necessary steps for

laparoscopic and open common bile duct explorations

> Become proficient wiht the specialized laparoscopic equipment

> Perform laparoscopic and open common bile duct exploration using transcystic and choledochotomy approaches

> Perform choledochoscopy

MOD5: Common bile duCt exPloRation (PhaSe ii)

simulatorneeded:Cbdemodel

CBDE Model (LCD–10): This anatomically correct model includes a soft tissue base with anatomical landmarks. It is ideal for practicing laparoscopic transcystic common bile duct exploration (LAPTC-CBDE), laparoscopic choledochotomy for common bile duct exploration (LAP C-CBDE), or open CBDE. CBDE Replaceable Tissue (LCD–20)

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