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AAGL 2017 Registration is now online! Click here to register now for the 46th AAGL Global Congress


 

Laparoscopic Hysterectomy:
Amalgamation of Value and Versatility

Produced & Presented By
Course Faculty:
Jon I. Einarsson, MD, Ted T.M. Lee, MD
 
Estimated time of Completion: 199 minutes
Release Date:
September 30, 2016
Expiration Date:
October 1, 2017

This course is free for all physicians to watch. If you would like to earn Continuing Medical Education (CME) credit, you may log in using your AAGL membership account, or you may purchase access to the CME modules by clicking here.

Description

Using nothing more than old-fashioned Kleppinger bipolar forceps and laparoscopic needle holders, Dr. Harry Reich performed the first laparoscopic hysterectomy in 1988. Since that time, technological advances, including clearer visualization with improved video technology, and predictable thermal spread with advanced vessel sealing technology, have made the procedure safer and more efficient. Furthermore, the incorporation of anatomy-based strategies and techniques have taken laparoscopic hysterectomy to a different level. Considering its versatility in dismantling nearly all pelvic pathologies, as well as its cost effectiveness, laparoscopic hysterectomy is perfectly suited to thrive in the environment of value-based healthcare.

Over the years, two major schools of gynecologic laparoscopic surgery have evolved. These two schools are defined by their difference in port placement. Some gynecologic surgeons like to operate with their hands on two ipsilateral ports, while others use their dominant hand in the suprapubic/midline port and non-dominant hand on a lateral port. While the steps and strategies for a laparoscopic hysterectomy may be similar in both schools, the techniques and mechanics are likely different. This two-part webinar will explore laparoscopic hysterectomy in a step-by- step fashion from the perspective of surgeons from both schools of laparoscopy. In addition, anatomy-based strategies and techniques on difficult hysterectomy will be reviewed. The webinar will end with a cadaveric pelvic retroperitoneal dissection, focusing on techniques for identification and dissection of the ureter, in addition to common approaches to isolation of uterine artery from its origin. The cadaveric dissection will also include a total laparoscopic hysterectomy.

Learning Objectives

  1. Discuss the differences and similarities between the ipsilateral and suprapubic schools of laparoscopy and their step-by-step approaches to laparoscopic hysterectomy.
  2. Demonstrate medial and lateral approaches to laparoscopic ureteral identification and dissection.
  3. Demonstrate posterior/pararectal and anterior/median umbilical approaches to ligating the uterine artery at its origin.
  4. Discuss various dissection techniques to maximize surgical efficiency and minimize complications.
  5. Articulate strategies for difficult laparoscopic hysterectomy.

Target Audience

This educational activity is developed to meet the needs of surgical gynecologists in practice and in training, as well as other healthcare professionals in the field of gynecology.

The AAGL is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

*The AAGL designates this enduring material for a maximum of 3.50 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

 

Disclosures

In accordance with the Standards for Commercial Support issued by the Accreditation Council for Continuing Medical Education (ACCME), AAGL requires resolution of all conflicts of interest to ensure CME activities are free of commercial bias.

PLANNER DISCLOSURE

The following members of AAGL have been involved in the educational planning of this workshop (listed in alphabetical order by last name).

Art Arellano, Professional Education Manager, AAGL*

Edward Betcher*

Amber Bradshaw
Speakers Bureau: Myriad Genetics Lab
Other: Proctor: Intuitive Surgical

Sarah L. Cohen
Consultant: Olympus

Erica Dun*

Jon I. Einarsson*

Joseph (Jay) L. Hudgens
Contracted Research: Gynesonics

Ted T.M. Lee
Consultant: Ethicon Endo-Surgery

Frank D. Loffer, Medical Director, AAGL*

Suketu Mansuria
Speakers Bureau: Covidien

Linda Michels, Executive Director, AAGL*

Karen C. Wang*

Johnny Yi*

 

FACULTY DISCLOSURE

The following have agreed to provide verbal disclosure of their relationships prior to their presentations. They have also agreed to support their presentations and clinical recommendations with the “best available evidence” from medical literature (in alphabetical order by last name).

Jon I. Einarsson*

Ted T.M. Lee
Consultant: Ethicon Endo-Surgery

Content Reviewer has nothing to disclose.

Asterisk (*) denotes no financial relationships to disclose.

 

This CME activity was produced by AAGL and the information in this educational activity is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition. The viewpoints expressed in this CME activity are those of the authors/faculty. They do not represent an endorsement by AAGL. In no event will AAGL be liable for any decision made or action taken in reliance upon the information provided through this CME activity.

https://www.aagl.org/cme/policy-on-enduring-materials/

How to Obtain AMA PRA Category 1 Credit(s)

  1. Log into your AAGL membership account or enter your personal details.
  2. Watch the webcast.
  3. Take the CME posttest (each question must be answered correctly).
  4. Select the number of CME hours for which you are applying for this activity.
  5. You will receive your personalized CME certificate by email.

Technical Requirements

This site is best viewed using Internet Explorer 7 and higher, or Firefox 3.0 and higher. A broadband Internet connection with a minimum speed 1024Kbps is suggested, although the webcast is still viewable on slower connections with a significant buffering delay.

All CME webcast activities feature audio and you must have a sound card and speakers or headphones to listen to the audio portion of the program.

The streaming video portion of the webcast requires Adobe Flash, Version 9.0 or later. You can download and install Adobe Flash Player by visiting

http://get.adobe.com/flashplayer/


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Access to this Webinar for non-AAGL Members

AAGL is pleased to offer Laparoscopic Hysterectomy: Amalgamation of Value and Versatility to non-members for just $40. By purchasing CME access to this course, you will be able to earm AMA PRA Category 1 Credit(s)TM for the modules in the course. You may also watch the video series for free, but you will not be able to claim CME credit unless you purchase CME access.


 
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Course Outline

Step-by-Step Approach to Laparoscopic Hysterectomy
  • Port Placement
  • Round Ligament Incision and Development of a Bladder Flap
  • Management of Upper Pedicles (Utero-Ovarian and Infundibulopelvic Ligaments)
  • Securing Uterine Artery and Cardinal Ligament
  • Colpotomy
  • Vaginal Cuff Closure
T.T.M. Lee, J.I. Einarsson
Strategies and Techniques for a Dense C-Section ScarT.T.M. Lee
Strategies and Techniques for Large FibroidsJ.I. Einarsson
Cadaveric Demonstration: Laparoscopic Hysterectomy
Port Placement
Pelvic Retroperitoneal Dissection
  • Developing Pelvic Spaces
  • Medial and Lateral Approach to Ureteral Identification and Dissection
  • Anterior/Median Umbilical and Posterior/Pararectal Approaches to Isolating Uterine Artery at Its Origin
J.I. Einarsson, T.T.M. Lee
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Video Main Menu

Step-by-Step Approach to Laparoscopic Hysterectomy
  • Port Placement
  • Round Ligament Incision and Development of a Bladder Flap
  • Management of Upper Pedicles (Utero-Ovarian and Infundibulopelvic Ligaments)
  • Securing Uterine Artery and Cardinal Ligament
  • Colpotomy
  • Vaginal Cuff Closure
T.T.M. Lee, J.I. Einarsson
Watch w/CME
Watch Now
Strategies and Techniques for a Dense C-Section ScarT.T.M. Lee
Watch w/CME
Watch Now
Strategies and Techniques for Large FibroidsJ.I. Einarsson
Watch w/CME
Watch Now
Cadaveric Demonstration: Laparoscopic Hysterectomy

Port Placement

Pelvic Retroperitoneal Dissection
  • Developing Pelvic Spaces
  • Medial and Lateral Approach to Ureteral Identification and Dissection
  • Anterior/Median Umbilical and Posterior/Pararectal Approaches to Isolating Uterine Artery at Its Origin
J.I. Einarsson, T.T.M. Lee
Watch w/CME
Watch Now

Back to Main Menu

 

About Our Faculty


Dr. Jon I. Einarsson, M.D., Ph.D, MPH

Director, Division of Minimally Invasive Gynecologic Surgery, Brigham and Women's Hospital
Associate Professor, Harvard Medical School
Boston, MA

Dr. Ted T.M. Lee, M.D., FACOG

Director of Minimally Invasive Gynecologic Surgery
Magee-Women's Hospital, UPMC
Pittsburgh, PA

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