General surgery residents at Sinai participate in both a laparoscopic and endoscopic skills curriculum beginning in their junior years. The laparoscopic curriculum is designed as an integrated experience with didactics, hands-on sessions, and basic and advanced simulation. Didactics include lectures focused on physiology, complications and up-to-date evidence for minimally invasive surgery. Our own faculty and distinguished speakers are invited to give these lectures. We also have annual “hands-on sessions” in the operating room to go over various equipment including graspers, staplers and energy devices.
The endoscopic curriculum follows the American Board of Surgery Flexible Endoscopy Curriculum with a focus on lectures, simulation, clinical exposure, and evaluation of knowledge and proficiency. Didactics focus on physiology and pathophysiology of common GI disorders. We utilize the Simbionix CAE GI Mentor and CAE EndoVR simulators for extended practice on endoscopy. In addition, there is a dedicated Gastroenterology/Endoscopy rotation during the PGY-3 to ensure resident competency in these skills. The typical resident graduates with much higher endoscopy numbers than the required minimum.
As of Spring 2023, our simulation lab has been updated! We now have a larger dedicated simulation lab that holds 3 classrooms, Standard Patient Rooms, a large space with multiple observation beds, a simulation OR, procedure room, ICU room and Emergency Room!
Laparoscopic and Endoscopic Skills Curriculum Outline
I. Basic Laparoscopic Skills
Lectures (with various faculty members)
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“Physiologic Changes During MIS Surgery and Management of Complications”
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“Morbid Obesity Medicine/Surgery State of the Art”
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“MIS Hernia Repair, Abdominal Wall, Inguinal, State of the Art”
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“Minimally Invasive Techniques of Colon and Rectal Surgery: What is the Evidence”
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“Diagnostic Laparoscopy in Trauma”
Annual “Introduction to Laparoscopic Equipment” (three one-hour sessions with Christina Li, M.D.)
Fundamentals of Laparoscopic Skills (Technical) Training at Sinai Hospital Simulation Center
Register and pass the Fundamentals of Laparoscopic Surgery examination
II. Advanced Laparoscopic Skills
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Laparoscopic appendectomy
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Laparoscopic right hemicolectomy
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Laparoscopic left hemicolectomy
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Laparoscopic cholecystectomy
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Laparoscopic sleeve gastrectomy
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Laparoscopic bowel anastomosis
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Laparoscopic lysis of adhesions
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Laparoscopic ventral hernia repair
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Laparoscopic Nissen fundoplication
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Laparoscopic splenectomy
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Laparoscopic inguinal hernia repair
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Endoscopic skills
III. Flexible Endoscopic Skills
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12 web-based, interactive cognitive content chapters
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Task-specific simulation
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Completing Fundamentals of Endoscopic Surgery (FES)
Additional Simulation
Intern Simulations
Once a month for the first year of training, the interns will participate in simulations of commonly encountered patient urgencies/emergencies. Facilitated by faculty and senior residents, this will ensure that our interns are proficient at identifying signs and symptoms that require additional workup and intervention(s).
Trauma Resuscitation Simulations
Done at least quarterly, these simulations are designed to enhance best practices in communication during an emergent situation. The multidisciplinary sim takes place in situ (in the trauma bay) or in the sim lab based on availability.
Giving Bad News
An unfortunate but necessary part of the job of a surgeon is giving bad news. These skills are often not intuitive and take practice. These simulations are designed to teach best practices in communication of bad news and afford the residents an opportunity to practice in a controlled setting.
Surgery Olympics
The inaugural Sinai Surgical Olympics took place in 2022. This gave our trainees opportunity to showcase their technical skills in friendly competition. Residents of all levels were divided into 4 teams, each named after a former Department Chair (Efron, Barbul, Seligman and Gann). The teams competed in 6 events over 2 days – 3 of these tested skills in open surgery, and 3 tested laparoscopic technique. (insert pictures) Team Barbul was the gold medal winner, with Seligman taking the silver and Efron and Gann tied for bronze. We look forward to the next Olympics which will commence in 2023.