Category: Video Spotlight
COURSE DESCRIPTION: This live surgery demonstrates an early method of total laparoscopic hysterectomy (TLH) without the use of vaginal manipulators. Hysterectomy is the most commonly performed surgery and every lap surgeon should be able to perform a TLH. This method includes using a myoma screw, which is advantageous for large uteri and other challenging cases. The advantages of performing TLH with this method will be discussed, as well as the use of newer energy sources which reduce ureteric injury and prevent vaginal cuff complications.
LEARNING OBJECTIVES: At the conclusion of this course, the participant will be able to: 1) Describe a simple, standardized method of TLH for large uterus; 2) discuss the advantages of using myoma screw as a manipulator instead of using vaginal manipulators; and 3) explain the advantages of newer energy sources in TLH for large uterus.
Live Telesurgery – “Resection of Deep Infiltrative Endometriosis Plus/Minus Segmental Resection If Indicated” with Mario Malzoni, M.D.
COURSE DESCRIPTION: This course provides a live surgical demonstration of a laparoscopic assisted bowel segmental resection for deep infiltrating endometriosis. This is a very effective technique in symptomatic patients in terms of reduced pain and restored bowel function. It can be considered feasible and safe, with low complication rates, but being a highly complex surgery, requiring specific skills in laparoscopic urologic and colorectal procedures, it is advisable to be performed only in specialized high volume centers by high volume surgeons. This session demonstrates surgical technique, discusses appropriate candidates for this procedure, and shows tips and tricks to overcome the difficulties related to disruption of pelvic anatomy due to severe infiltrating endometriosis.
LEARNING OBJECTIVES: At the conclusion of this course, the participant will be able to: 1) Explain and apply key points of pelvic anatomy essential in performing severe pelvic deep endometriosis surgery; 2) implement laparoscopic assisted bowel segmental resection as a stepwise technique; and 3) discuss indications to segmental bowel resection and/or other different surgical approaches to bowel endometriosis nodulectomy.
COURSE DESCRIPTION: This pre-recorded surgery demonstrates a laparoscopic posterior sling for uterocervical prolapse in women who desire preservation of the uterus and normal child bearing function. The sling restores the uterus to its original position without altering the pelvic anatomy and its relation to the adjacent pelvic organs. The uterosacral ligaments are strengthened bilaterally using a mersilene tape with a detour on the left arm through a psoas pulley to accommodate and protect the recto sigmoid function.
The course discusses the evolution of this technique, its efficacy through multiple labors, failures, probable complications, and use in cases of recurrent prolapse with a follow-up over 18 years.
This easily reproducible anatomical sling integrates with the anatomy around the lateral pelvic wall and the dissection around the sacral promontory, safe guarding vital structures. It also can be used for recurrent uterine prolapse.
LEARNING OBJECTIVES: At the conclusion of this course, the participant will be able to: 1) Demonstrate a conservative procedure for young patients with uterocervical prolapse who desire preservation of menstrual and child bearing function; 2) discuss the advantages of restoring uterocervical pelvic anatomy, which allows the dynamics of multiple pregnancies and labor to proceed unchanged; and 3) discuss how advantages of laparoscopy make a conventional time-tested, but technically challenging procedure easily reproducible.
Live Telesurgery – “Complex Laparoscopic Total Hysterectomy in the Setting of Multiple Prior Surgeries for Endometriosis” with Nicholas Leyland, M.D.
COURSE DESCRIPTION: This course provides a live surgical demonstration of a total hysterectomy and BSO (TLH BSO). This technique holds the advantage of eliciting a reduced level of wound pain compared with conventional laparoscopy, with better cosmetic results. This course will demonstrate the technique of TLH BSO, ureterolysis, and ureteric stent placement, discuss appropriate candidates for this procedure, and show tips and tricks to overcome the difficulties related to prior surgical interventions, pelvic adhesions and anatomic distortion.
LEARNING OBJECTIVES: At the conclusion of this course, the participant will be able to: 1) Develop a retroperitoneal anatomic strategy to manage hysterectomy in the setting of multiple prior conservative surgeries for endometriosis; 2) recognize the value of lighted ureteric stents in this surgical scenario; and 3) understand a standardized stepped approach to the pelvic anatomic distortion typically found in endometriosis cases (cul de sac obliteration, deeply infiltrative endometriosis, adhesive disease).
COURSE DESCRIPTION: This case provides a systematic approach to surgical treating and staging endometrial cancer. Para aortic node dissection, hysterectomy and pelvic node dissection will be demonstrated with a focus on anatomic boundaries and a step wise approach in order to maximize efficiency and minimize complications. In addition, the DaVinci Xi surgical platform will be used in order to highlight the current advantages and advancements of the latest robotic surgical platform.
LEARNING OBJECTIVES: At the conclusion of this course, the participant will be able to: 1) Identify the anatomic boundaries of pelvic and para-aortic node dissection; 2) describe a systematic approach to perform nodal dissection and hysterectomy; and 3) explain an approach for using the Xi robotic platform for treating endometrial cancer.
AAGL 2015 Presidential Address – “Gynecologic Surgery, Technology and Sisyphus” with Dr. Arnold Advincula
Dr. Advincula is a leader in minimally invasive surgical techniques and one of the world’s most experienced gynecologic robotic surgeons. He has published and taught extensively in the area of minimally invasive surgery as well as developed surgical instruments in use worldwide. Dr. Advincula is a board certified obstetrician- gynecologist and a fellow of the American College of Surgeons.
After graduating with honors from Temple University School of Medicine, Dr. Advincula completed an ob-gyn residency and a minimally invasive surgery fellowship at the University of North Carolina – Chapel Hill. He went on to spend 10 years at the University of Michigan where he rose to the rank of Professor. During his tenure there he served as Director of the Minimally Invasive Surgery Division and Fellowship. He also founded the Endometriosis Center at Michigan. In 2009, Dr. Advincula joined Florida Hospital Celebration Health as Director of the Center for Specialized Gynecology. While in Florida, he served as the Director of the Celebration Health Endometriosis Center and established an AAGL accredited Fellowship in Minimally Invasive Surgery. He was also Medical Director of Gynecologic Robotics at Florida Hospital, as well as Professor of Obstetrics & Gynecology at the University of Central Florida College of Medicine. Additionally, Dr. Advincula was the Education Institute Director of the Nicholson Center, an advanced medical and surgical simulation training facility in Celebration, Florida.
In 2014, Dr. Advincula accepted the position of Levine Family Professor, Vice-Chair of Women’s Health & Chief of Gynecology at the Sloane Hospital for Women, Columbia University Medical Center/New York Presbyterian Hospital. Dr. Advincula brings more than 16 years of clinical expertise, innovation and leadership to the position. In addition to his departmental responsibilities, he also serves as Co-director of the AAGL accredited Fellowship in Minimally Invasive Surgery. Dr. Advincula is also Medical Director of the Simulation Center for Columbia University College of Physicians & Surgeons/New York Presbyterian Hospital. Despite his busy clinical and administrative schedule, Dr. Advincula continues to train residents, fellows and physicians worldwide in advanced surgical techniques.
On July 24, 2015 at 9am PDT / 12 noon EDT, Dr. Mario E. Castellanos presented a live webcast on “When Surgery Fails To Relieve Pain” live on SurgeryU HD. Click on the link above to watch a replay of the event.
Chronic pelvic pain is a highly prevalent but challenging diagnosis that affects 15% of women. With over 40% of gynecologic laparoscopies performed for chronic pelvic pain, it is important to understand and work up patients for various origins. This course provides a guide to approaching patients who continue to have pelvic pain despite undergoing operative laparoscopy or resection of endometriosis. It will focus on the most common causes of chronic pelvic pain associated with endometriosis including bladder pain syndrome, hypertonic pelvic floor disorders, and irritable bowel syndrome.
At the conclusion of this activity, the participant will be able to: 1) Identify common causes of persistent chronic pelvic pain that is not alleviated after gynecologic surgery; 2) Implement a diagnostic process for evaluation of theses causes, and; 3) Recommend appropriate treatment options.
On November 20, 2014, AAGL/SurgeryU presented “Stainless Steel Surgeon – Live at the 43rd AAGL Global Congress on Minimally Gynecology.” This live, interactive session featured three cadaveric demonstrations of vaginal, laparoscopic, and robot-assisted hysterectomy, and was presented before a live audience at the Vancouver Convention Center. We are pleased to present this session for on-demand viewing here on AAGL.org. ( READ MORE )
AAGL is pleased to present this live telesurgery on Laparoscopic Myomectomy with Enclosed Morcellation that took place at AAGL 2014. This course provided a live surgical demonstration of a Laparoscopic myomectomy with enclosed morcellation. This course demonstrated the procedural technique and showed tips and tricks for performing key portions of the procedure such as high volume infiltration of dilute vasopressin, secure multilayer myometrial closure with barbed suture and enclosed tissue morcellation in a safe and efficient manner.