All anatomy of complications workshop programmes are divided into four discrete but integrated and related modules, each of which is of half a day’s duration. Prior to attending the workshop all participants receive a teaching DVD demonstrating the various procedures to be performed during the practical surgical sessions. They also receive an anatomy CD which is a copy of the material presented at the interactive anatomy lecture during the first module of  the workshop. It is crucial that these materials are reviewed by participants prior to attendance at the workshop.

The four modules are:

1. Anatomy
2. Surgical Skills
3. Live Animal surgery
4. Case Presentations

Participants work in pairs that are allocated by the workshop organizers. All participants rotate through six different pairings in order to maximize interaction and to allow for the different skill and speed of participants.

At the conclusion of the workshop each participant completes a formal structured evaluation questionnaire. This gives valuable feedback to the course organizers and allows for continued improvement in the quality and content of the workshop.

View standard programme for Obstetrics and Gynaecology workshop

We have developed 3 variations of the workshop programme:

• Workshop for Urology trainees [Click here for details] 
  Following the success of the Urology Trainees workshop in November 2003, we have been invited to run a further Workshop for Urology trainees in 2006. This will be for all of the 3rd year trainees in the Urology training program of the RACS. It will be held in Perth and the date for this workshop will be announced in 2005.

  View programme for Urology workshop

  
  

• Workshop for Gynaecologic Oncology subspecialty trainees and subspecialists [Click here for details]
  The next workshop will be held in September 2004,. It is anticipated that a further workshop for Gynaecologic Oncology subspecialty trainees will be held in September 2006. Details of the 2006 workshop will be available in late 2005. 

  View programme for Gynaecologic Oncology workshop

  
  

• Workshop for Urogynaecology trainees and subspecialists [TBA]
  We will be working with the relevant craft groups to develop the curriculum for this workshop, but the basic aim is the improvement in performance in all participants and an understanding of the principles of prevention and management of complications in pelvic surgery. Details of this workshop will be available in late 2004.

Anatomy

• To demonstrate and learn the pelvic surgical anatomy relevant to obstetric and gynaecological surgery.
• 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.

Anatomy review in the St John of God Interactive Seminar Room - Learners are seated in the front row! Cadaver dissection in progress with facilitator Examination of prosected specimens

This session is aimed at revising and improving the participants’ knowledge and understanding of clinically relevant pelvic anatomy.

The first part of this session is an interactive review of pelvic anatomy facilitated by Ian Hammond and John Taylor. Active participation by the learners and all facilitators is encouraged during this review process.

Following the anatomy review, Paul McMenamin introduces and supervises the practical anatomy session including cadaver dissection and examination of prosected specimens that includes self directed learning materials. The practical anatomy session takes place in the Hill International Surgical Workshop which is next door to the seminar room.

This session requires satisfactory completion of a number of tasks during the cadaver dissection, as outlined below:

• Dissect ureter from pelvic brim to the bladder.
• Note anatomical relationships to vessels, muscles, nerves and viscera.
• Dissect the vessels of the pelvic side wall.
• Common iliac
• External iliac
• Internal iliac.
• Branches of anterior division of internal iliac.
• Uterine artery.
• Dissect the obturator fossa and contents.
• Identify obturator internus muscle.
• Identify the obturator artery, vein & nerve.
• Identify the ischial spine, pudendal vessels and levator ani muscle.

Surgical skills

• To demonstrate, practice and learn the various surgical skills which may be needed to deal with unexpected intraoperative injury to bowel, bladder or ureter.

John Taylor demonstrating ureteric repair Session in progress: Hill Int'l Surgical Workshop: Hand-sewn bowel anastomosis

This session lasts 4 hours and takes place in the Hill International Surgical Workshop at the Clinical Training & Education Centre (CTEC).

Participants work in pairs. After watching a demonstration of the surgical procedures to be learned (as seen on the workshop DVD), each participant then performs and assists at this procedure. We use porcine gut, bladder, ureter and aorta for this practical session.

Polysorb, Caprosyn, Biosyn, and Surgipro sutures are donated to the workshop by Tyco Healthcare.
Double-J (JJ) ureteric stents are donated to the workshop by COOK.

The following procedures are carried out by all the participants under supervision by facilitators:

• Repair of enterotomy
• Repair of cystotomy
• Bowel anastomosis
• Repair of divided ureter over JJ stent
• Repair of aortic laceration

Live Animal Surgery

Live animal surgery at CAST Two operating tables in ‘sterile’ surgical theatre at CAST John Newnham welcoming gynaecologic oncology trainees to the September 2002 workshop

• To demonstrate the pelvic anatomy in the ewe.
• To confidently dissect the ureter and major pelvic vessels.
• To perform a 'safe' hysterectomy.
• To repair injury to bowel, bladder and ureter.
• To practice the technique of internal iliac artery ligation.
• To reimplant a ureter into bladder.
• To raise a colostomy
• To repair vascular injury
• To be knowledgeable about these procedures and to understand their place in the management of intraoperative injury.

During this session a number of surgical procedures will be performed by all participants with the supervision of experienced facilitators.

These procedures are listed below:

• Open abdomen via midline incision
• Identify pelvic organs
• Dissect ureter
• Perform hysterectomy (long cervix)
• Dissect vessels of pelvic side wall
• Perform internal iliac artery ligation
• Ureteric reimplantation into bladder
• Psoas hitch, Boari flap
• Bowel resection (using large bowel) and anastomosis
• Raise ‘colostomy’ or ‘ileostomy’
• Vascular damage and repair:
• Arteriotomy and Venotomy & repair

Case Presentations: Prevention & Management of Complications

• To present and discuss common clinical situations occurring during and after obstetric and gynaecological surgery.
• To understand the principles of safe management of injury to bowel, bladder, ureter and major vessels.
• To understand and learn approaches which lead to a reduction in surgical injury.

Case presentation by participant in the Geoff Bird Clinical Staff Lounge

This is the final session and is held at King Edward Memorial Hospital for Women in the Geoff Bird Clinical Staff Lounge.

Prior to attendance, all participants are required to submit one case for presentation. This case would usually describe a surgical complication, or a difficult management decision. The presentation is given using Microsoft Power Point  with a maximum of four slides. Each case is allocated 15 minutes to include presentation and discussion.

This session is facilitated by Ian Hammond and John Taylor, and is controlled so that the discussion is constructive and non-threatening. During this session the other participants and facilitators are asked to provide ‘micro- summaries’ of the case under consideration. At the end of each presentation and discussion the group is asked to define the ‘learning points’ from the case.

This has proved to be a most popular and valuable session; allowing for integration of all the workshop modules.

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