Hands-on Workshops

We are in the process of putting together the Pelvic Anatomy and Gynecologic Surgery Symposium (PAGS) program.

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Optional Pre-Conference Hands-on Workshops

December 11, 2019, Encore at Wynn Las Vegas

PAGS Hands-on Workshops are open to PAGS attendees only. Space is limited. We encourage you to register as soon as possible as our workshops will sell out.

Click here for HANDS-ON ENERGY-BASED DEVICES FOR HYSTERECTOMY AND TISSUE EXTRACTION TECHNIQUES WORKSHOP - Workshop A

Click here for HANDS-ON LAPAROSCOPIC SUTURING WORKSHOP – THE "VERTICAL ZONE" (SIMULATION LAB) - Workshop B  

Click here for OFFICE-BASED GYNECOLOGIC PROCEDURES - Workshop C

Click here for TECHNICAL ASPECTS OF VAGINAL HYSTERECTOMY & CYSTOURETHROSCOPY FOR THE GYNECOLOGIST - Workshop D 

 

Workshop A

ENERGY-BASED DEVICES FOR HYSTERECTOMY AND TISSUE EXTRACTION TECHNIQUES WORKSHOP  NEW!

Wednesday, December 11, 2019, 8:30 a.m. - 12:30 p.m., Encore at Wynn Las Vegas

4 CME Credits Available
 

Director: Rosanne M. Kho, MD
Faculty: Andrew I. Brill, MD; Keith B. Isaacson, MD

The objective of this workshop is to provide didactic information, live demonstration and hands-on experience using simulation models for use of energy and tissue extraction at the time of laparoscopic surgery. Important considerations of patient selection and pre-operative evaluation of patients with large fibroids and uteri will be reviewed. Safety concerns with the use of different energy modalities, morcellation techniques and devices will be emphasized. The interactive session will also cover minimally-invasive approaches for morcellation that include vaginal and mini-laparotomy with and without containment. Simulation stations using trainers will allow the participant to practice the use of different energy devices and morcellation techniques.

At the end of this 4-hour hands-on workshop, participants will be able to:

• Articulate the principles underlying different energy devices used in laparoscopy and define appropriate indications for their use;
• Articulate proper patient selection and pre-operative evaluation for patients undergoing surgery for fibroids and large uteri;
• Demonstrate safe techniques using the new FDA-approved power morcellator in a containment system
• Learn efficient and safe alternatives to power morcellation such as manual morcellation through the vaginal and the mini-laparotomy routes.

Program:

8:30 AM	Welcome. Introduction R Kho
8:35 – 9:00 AM	Principles of Appropriate Use of Energy in Laparoscopy A.Brill
9:00 – 9:20 AM	Tissue Morcellation: What’s the Issue? (Aftermath of FDA Statement on Power Morcellation, Vaginal Tissue Extraction technique) R Kho
9:20 - 9:40 AM	Techniques to Fibroid and Uterine Morcellation K Isaacson
9:40 – 10:00 AM	Live Demonstration Laparoscopic containment of tissue Power morcellation Tissue extraction through mini-laparotomy and vaginal routes Faculty
10:15 – 10:30 AM	Break
10:30 AM	Workshop Stations: Energy devices Learning Objectives: Explore methodologies that promote tissue desiccation versus tissue cutting. Tasks: For all instrumentation, formal introduction to energy unit, set-up, any startup algorithms For all instrumentation, formal introduction to device and grasping alternatives Employing non-articulated instrumentation for energy-based surgical skills: Skeletonize and remove chicken skin by lifting and incising the areolar tissue Spark/vaporize/cavitate chicken meat (assigned patterns – circles, trianges/wedges) and inspect thermal margins Alternate contact desiccation with tissue cutting by manipulating energy density For ultrasonics, explore blade dynamics and cavitational effects of tissue traction Bovie Plasmajet Omniguide Harmonic scalpel – open blade Sonocision – open blade Using a perpendicular approach, desiccate, and incise chicken meat using: Best practices with ligating instruments for sealing & incision, inspect thermal margins Harmonic scalpel Sonocision Ligasure (hand and laparoscopic) Enseal (with/without articulation) (hand and laparoscopic) Voyant (hand and laparoscopic) Thunderbeat Tissue Extraction: Placement of large specimen into containment bags Power morcellation Tissue extraction – mini-lap Tissue extraction – vaginal route
12:15 PM	Wrap-up. Q and A. Prize for longest intact specimen
12:30 PM	Adjourn

 

Workshop B
HANDS-ON LAPAROSCOPIC SUTURING WORKSHOP – THE “VERTICAL ZONE” (SIMULATION LAB)

Wednesday, December 11, 2019, 8:30 a.m. - 12:30 p.m., Encore at Wynn Las Vegas

4 CME Credits Available

Director: Charles H. Koh, MD
Faculty: Grace Y. Liu, MD, MSc, FRCSC, FACOG; Leslie Po, MD, MSc, FRCSC; Khai Ling Tan, MD; and Mireille D. Truong, MD  
,

Proficiency in suturing is mandatory in performing advanced operative laparoscopy. The progressive algorithm for laparoscopic suturing as described in the "Vertical Zone" has been taught and tested over many years in national and international courses. This course includes a pre-test and post-test followed by instruction in a controlled setting. Previous results have shown that over 90% of the participants who attend this course achieve tying an intracorporeal knot in less than 3 minutes.

There is strong validity with using the technique described, as the relative hand positions and movements are immediately transferable from the trainer to the operating room. Algorithms from standing on the right and left side of the patient will be taught, with progression from simple interrupted to continuous and cinch knots.

This course equips attendees with improved suturing skills which can be applied in gynecologic surgery. Procedures requiring suturing will be described in videos and related to the drills performed. These include TLH vault closure, colposuspension, sacrocolpopexy, Burch, myomectomy, bowel, bladder, ureteral repair in endometriosis surgery and complications.

Learning Objectives:

At the conclusion of this course, the clinician will be able to:

• Explain the ergonomics, theory, and rationale for reproducible laparoscopic suturing
• Apply the skills learned relevant to gynecologic surgery
• Apply skills acquired to management of bowel, bladder, and ureteral complications by appropriate suture repair
• Demonstrate measurable improvement in laparoscopic suturing skills.

Agenda:

8:30 – 8:35 AM	Welcome, Introductions and Course Overview
8:35 – 9:00 AM	Pre Test (3 minutes)
9:00 – 9:15 AM	Managing Needles, Suture, “Smiley” Knotting
9:15 – 10:15 AM	LAB I: Drills, Intracorporeal Suturing with “Smiley” Needle Technique
10:15 – 10:25 AM	Questions & Answers
10:25 – 10:40 AM	Break
10:40 – 11:00 AM	Expert Knotting, Continuous Suturing and Cinch Knot
11:00 – 12:00 PM	LAB II: Expert Knotting, Continuous and Cinch
12:00 – 12:20 PM	Post Test: Intracorporeal Knot Tying (3 minutes)
12:20 – 12:30 PM	Questions & Answers

 

Workshop C
OFFICE-BASED GYNECOLOGIC PROCEDURES: THE GYNECOLOGIST OF THE FUTURE

Wednesday, December 11, 2019, 8:30 a.m. - 5:30 p.m., Encore at Wynn Las Vegas

8 CME Credits Available

Course Director: Tommaso Falcone, MD

Faculty: Linda D. Bradley, MD; Andrew I. Brill, MD; Mark Dassel, MD; Laura Detti, MD;
Oluwatosin Goje, MD; Keith Isaacson, MD; Mickey Karram, MD; James M. Shwayder, MD, JD

The objective of this workshop is to provide education on the most frequently performed office-based gynecologic procedures including saline infusion sonogram in 2 & 3 D, office diagnostic hysteroscopy, office therapeutic hysteroscopy, vulvar and vaginal biopsies and excisions, botulinum toxin and other injections for chronic pelvic pain, and indications and techniques for energy-based procedures used in the vaginal canal and on the skin of the vulva. The increasing trend to office procedures requires proper patient selection, safe sedation practices, resuscitation equipment, and the ability to deal with emergencies and complications. Lecture series will be followed by extensive lab-based training.

Learning Objectives:

• Describe the analgesia and anesthetics used in the office setting
• Identify patients that are candidates for office-based procedures.
• Understand the technique for performing a 2 D and 3 D saline infusion ultrasound
• Describe different approaches to office-based diagnostic and therapeutic hysteroscopy
• Understand the different trigger point injections and use of botulinum toxin in pelvic floor for chronic pelvic pain
• Describe the techniques of Vulvar Biopsy, Excision or Ablation for vaginal and vulvar disorders
• Describe office-based vulvar and vaginal reconstructive procedures such as labiaplasty
• Discuss indications and techniques for energy-based procedures used in the vaginal canal and on the skin of the vulva.

Agenda:

8:30 AM – 12:45 PM	Part 1 - Lecture Series (20-minute sessions) Led by: Tommaso Falcone, MD
8:30 AM	Anesthesia/Analgesia in the Office Setting Oluwatosin Goje, MD
8:50 AM	Office Set Up: Ensuring Patient Safety Linda D. Bradley, MD
9:10 AM	Saline Infusion Sonogram Laura Detti, MD
9:30 AM	Office Diagnostic Hysteroscopy: Effective Approach Linda D. Bradley, MD
9:50 AM	Disposable Office Hysteroscopes: Any Value? Andrew I. Brill, MD
10:10 AM	Office Operative Hysteroscopy Keith B. Isaacson, MD
10:30 AM	Break
10:50 AM	Management of Vulvo Vaginal Pain: Vulvar Biopsy, Excision, Ablation Oluwatosin Goje, MD
11:10 AM	Trigger Point Injection for Chronic Pain Mark Dassel, MD
11:30 AM	Use of Botulinum Toxin in Pelvic Floor for Chronic Pelvic Pain Mark Dassel, MD
11:50 AM	Use of Energy Sources in the Vaginal Canal and on the Vulva: Indications and Techniques Mickey Karram, MD Jeffrey R. Dell, MD
12:10 PM	Q&A
12:45 PM	Part 1 Concludes
12:45 PM – 1:30 PM	Lunch
1:30 PM - 5:30 PM	Office-Based Gynecologic Procedures continued 8 CME Credits Available (Including morning sessions) Part 2 - All Participant Practicum: all faculty Participants will be divided into 3 groups and will rotate into the separate areas each lasting 60 minutes.
	Vulvar/Vaginal Procedures/ including Energy Sources in the Vaginal Canal and on the Vulva: Injections and Excisions Mark Dassel, MD Oluwatosin Goje, MD Mickey Karram, MD Ultrasound: Saline Infusion Sonogram Laura Detti, MD James M. Shwayder, MD, JD Office Hysteroscopy: Andrew I. Brill, MD Linda D. Bradley, MD Keith Isaacson, MD

 

Workshop D
HANDS-ON TECHNICAL ASPECTS OF VAGINAL HYSTERECTOMY & CYSTOURETHROSCOPY FOR THE GYNECOLOGIST 

Wednesday, December 11, 2019, 1:30 p.m. - 5:30 p.m., Encore at Wynn Las Vegas

4 CME Credits Available

Director: Mickey Karram, MD
Faculty: Rosanne M. Kho, MD, and Doug Miyazaki, MD

This workshop is intended to improve your surgical skills in performing vaginal hysterectomy and diagnostic and operative cystourethroscopy.

Surgical videos as well as unique hands on models will be used to teach the technical aspects performing simple and difficult vaginal hysterectomy.
 

Course Objectives:

• Teach a step by step approach to simple and complicated vaginal hysterectomy with the utilization of extensive video footage as well as the Miyazaki Model
• Discuss indications and techniques for cystourethroscopy, review a variety of pathologic conditions that the gynecologist may encounter when performing cystourethroscopy, and participate in a hands-on cystoscopy lab.

Agenda:

1:30 – 1:45 PM	Introduction Welcome and Review of Objectives Mickey Karram, MD
1:45 – 2:15 PM	Indications for Vaginal Hysterectomy, Including a Review of Current Surgical Trends for Route of Hysterectomy in the United States All Faculty
2:15 – 2:45 PM	Surgical Videofest: Step – by-Step Approach to Simple and Difficult Vaginal Hysterectomy Mickey Karram, MD; Rosanne M. Kho, MD
2:45 – 3:00 PM	Introduction of the Miyazaki Vaginal Hysterectomy Model Doug Miyazaki, MD
3:00 – 3:15 PM	Break
3:15 – 4:15 PM	Hands-on Vaginal Hysterectomy Workshop Utilizing Miyazaki Model
4:15 – 4:45 PM	Didactic Review of Indications and Technique of Cystourethroscopy All Faculty
4:45 – 5:30 PM	Hands-on Cystourethroscopy

 

Register Now for PAGS Workshop(s)