Learning internal iliac artery ligation and pelvic ureter course through cadaveric dissections (original) (raw)
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Impact of a gynecologic oncology cadaveric dissection course for surgical training
Anatomy, 2019
The aim of this study was to measure the educational efficacy of a gynecologic oncology cadaveric dissection course on fellows and specialists. Methods: After the radical and reconstructive vulvar and abdominal gynecologic cancer surgery cadaveric course, a post-course survey was applied to evaluate the improvement in topographic surgical anatomy and the effect on broadening the surgical experience. Results: Totally 10 and 16 participants attended to the vulvar cancer surgery cadaveric dissection course and abdominal gynecologic cancer surgery cadaveric dissection course, respectively. All participants stated that they had an improvement in topographic surgical anatomy and they found the cadaveric workshop beneficial to broaden the surgical experience. All participants suggested this kind of courses to learn the proper techniques of a surgical procedure in a comfortable and non-stressful setting and improve the surgical skills for rare and complicated surgeries. Conclusion: Cadaveric dissection courses in the field of gynecologic oncology tailor the surgical anatomy education and improve the training.
With the inclusion of various technologies, teaching anatomy to medical students is in the midst of a transition in medical schools. The traditional anatomy curriculum based on topographical structural anatomy taught by didactic lectures and complete dissection of the body with personal instruction, has been replaced by a multiple range of special study modules, problem-based workshops, computer based education, plastic models, just to name a few of teaching tools employed. Most new tools in the literature are descriptive and lack efficacy data. In this study we compared an internet-based anatomy module with traditional methods taught to the 3 rd year medical students. During 2008-2014, pelvic anatomy was taught to 3 rd year medical students using dissection-based (DB) and internet-based (IB) methods. This module was composed of 30 minutes of a lecture with PowerPoint, 30 minutes of anatomy videos, 30 minutes of dissection lab, and a post-test at the conclusion. The 30 min of anatomy video course consisted of 30 minutes session designed to address the perineal external and internal anatomy, perineal muscles and neurovasculature, caudad view of levator ani muscle, lateral view of pelvic organs and vasculature, cephalad view of pelvic organs and nerves, and cephalad view of the levator ani muscle. The same course material and the PowerPoint presentations used were converted to digital format and taught as an internet-based (IB) module without inclusion of a dissection lab. We compared the students' performance at final assessment between DB vs. IB groups. Comparison between DB and IB groups revealed significantly (P<0.0001) higher mean score for the IB group in all learning objectives except perineal Internal Anatomy (P= 0.431). 3 rd year medical students demonstrated higher pelvic floor anatomy scores after completing an internet-based module compared to a traditional dissection based course.
Laparoscopic Dissection of the Pelvic Ureter: Rules of Engagement
Journal of minimally invasive gynecology, 2018
To point out the relevant anatomy of the ureter and to demonstrate its rules of dissection. An educational video to explain how to use ureteral relevant anatomy and the principle of dissection to perform safe ureterolysis during laparoscopic procedures. A tertiary care university hospital and endometriosis referential center. Anatomic keynotes of the ureter and examples of ureterolysis. This video shows the feasibility of laparoscopic ureteral dissection and provides safety rules to perform ureterolysis. Identification and dissection of the ureter should be part of all gynecologic surgeons' background to reduce the risk of complications [1]. Knowledge of anatomy plays a pivotal role, allowing the surgeon to keep the ureter at a distance and minimizing the need for ureterolysis. Unfortunately, the need for ureteral dissection is not always predictable preoperatively, and gynecologic surgeons need to master this technique, especially when approaching more complex procedures such a...
Clinical Anatomy and Surgical Skills Training for Gynecology and Urology Residents
Journal of Pelvic Medicine and Surgery, 2009
Objectives: We developed a curriculum for urogynecological procedures and problem-solving for senior residents in obstetrics/gynecology and urology. Methods: The clinical anatomy and surgical skills training senior program was developed with collaboration between faculty from multiple medical centers and surgical disciplines. The format used a series of workshops with didactics and hands-on sessions with cadavers and bench models to teach anatomy and surgical skills. The curriculum was developed by incorporating a needs assessment from participants and faculty with academic principles of educational objectives. Written pre and posttests were administered to evaluate the knowledge of the participants. Results: Thirty-nine residents from 4 Gynecology, 1 Urology residency programs participated in the program. Although the majority of residents felt adequately prepared for endoscopy and vaginal surgery, most of the participants responded that they had inadequate skills for identification of urologic surgical complications (67%) or bowel injury (33%). Very few responded that they had adequate knowledge for advanced surgical procedures such as colposuspension or midurethral sling or displayed adequate knowledge of these procedures and anatomy involved. The satisfaction survey found mean satisfaction scores of 4.0 to 4.8 of 5.0. Conclusion: The results of the questionnaires indicate the need for further educational efforts to teach these advanced surgical skills. The satisfaction scores show that this format is highly regarded by the participants as an effective teaching tool. The results of this program can be used in future sessions for curricular development at which time we plan to evaluate participant performance as well as knowledge enhancements.
The Dissected Pelvis: A Classroom Tool to Help Students Discover the Pelvic Cavity and Perineum
HAPS Educator, 2016
For beginning anatomy students, the pelvis of a prosected cadaver is one of the most mystifying and confusing areas of the body to learn and understand. While the connections between the pelvis and the abdomen, the pelvis and the anterior thigh, and the pelvis and the gluteal region are clear in prosections, the relationships among organs, nerves, and blood vessels in the pelvic cavity and perineum are harder to see and therefore more difficult to assess and fully appreciate. Although pelvic models offer a solution to this dilemma, most models focus on just one area, making it difficult to visualize muscles, nerves, and vessels in the gluteal and anterior abdominal regions, pelvic cavity, and perineum simultaneously. In this study, we further dissected the pelvis of a male and female cadaver prosections and placed the female pelvis in acrylic to preserve it as a model. We bisected the male pelvis and are currently using this specimen as a teaching aid in human anatomy labs. We are currently evaluating student performance after introduction of the pelvic model in order to test if the model is helpful in improving student understanding of this difficult material.
A Novel Approach to Gross Dissection of the Human Pelvis and Perineum
Anatomical Sciences Education, 2019
Progressive curricular changes in medical education over the past two decades have resulted in the diaspora of gross anatomy content into integrated curricula while significantly reducing total contact hours. Despite the development of a wide range of alternative teaching modalities, gross dissection remains a critical component of medical education. The challenge posed to modern anatomists is how to maximize and integrate the time spent dissecting under the current curricular changes. In this study, an alternative approach to the dissection of the pelvis and perineum is presented in an effort to improve content delivery and student satisfaction. The approach involves removal of the perineum en bloc from the cadaver followed by excision of the pubic symphysis, removal and examination of the bladder and associated structures, examination and bisection of the midline pelvic organs in situ, and midsagittal hemisection of the pelvis for identification of the neurovasculature. Results indicate that this novel dissecting approach increases the number of structures identified by 46% ± 14% over current dissecting methods. Survey results indicate that students were better able to integrate lecture and laboratory concepts, understand the concepts, and successfully identify more structures using the new approach (P < 0.05). The concept of anatomic efficiency is introduced and proposed as a standard quantitative measure of gross dissection proficiency across programs and institutions. These findings provide evidence that innovative solutions to anatomy education can be found that help to maintain critical content and student satisfaction in a modern medical curriculum.