Education is a high priority of the McGill Minimally Invasive Surgical Program.
An annual course has been developed for residents in general surgery and has been run by Dr. Gabriela Ghitulescu. This involves a series of two-hour didactic teaching sessions including both slides and videos covering the basic physiology, surgical principles and description of specific procedures. This is accompanied by a manual skills component utilizing the facilities of our minimally invasive surgical skills laboratory on the 19th floor of the Montreal General Hospital. This facility allows residents access to six physical simulators and four different types of virtual reality simulators. This skills training is based on a criterion-based model whereby residents are required to achieve a target level of performance in a simulator before operating on patients. This curriculum is being evaluated with both a pre-test and a post-test as a way of demonstrating its effectiveness. This course has also been offered also to gynecology and urology residents since 2003.
The McGill MIS simulation lab has also been extensively used by practicing surgeons in general surgery, gynecology, urology, and otolaryngology to develop and enhance their fundamental skills in video-endoscopic surgery.
Nursing education is a prominent responsibility of our Centre. Under the leadership of Donna Stanbridge a series of seminars, in-service programs, and skills lab training are used to advance nurses’ knowledge and skills in minimally invasive surgery.
The McGill MIS team participates in monthly videoconference rounds with a number of North American Centres. These rounds provide a fertile forum for discussion of clinical problems and innovative approaches to patient care.
New MIS operating rooms at the Montreal General Hospital site have added the capabilities of telestration and video-conferencing to augment the educational resources of our program. Digital recordings in the operating room can be synthesized into practical educational resources for resident and continuing medical education programs.
We maintain a large multimedia library of MIS texts, journals, and videos for the use of our residents and fellows.
The McGill Laparoscopic Inguinal Hernia Simulator (MLIHS)
The MLIHS was created from low cost, readily available materials. It is an anatomically accurate representation of the inguinal anatomy that can be used to simulate both transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) hernia repairs. Experienced surgeons found the simulator very useful for training and assessment.
The Hernia Simulator instruction kit:
Surgical Abdominal Wall (SAW)
The surgical abdominal wall model is used to simulate laparoscopic ventral hernia repair (LVHR). It is made from low-cost, readily available material, and is easy to assemble. The simulator aims to educate learners on anatomical relationships, procedural steps, and mesh sizing and fixation techniques.
Colonoscope Training Model
A Japanese Colonoscope Training Model is a physical simulator designed by Kyoto Kagaku. The training model allows for realistic colonoscopy insertion and withdrawal techniques. This model can be adjusted to the needs of the learner for different challenges and sensitivity variations.
Fundamentals of Laparoscopic Surgery (FLS)
The FLS program teaches technical skill exercises to surgical residents and surgeons with the goal of improving laparoscopic ability. Our team at McGill has developed the manual skills component, called MISTELS. It consists of 5 tasks performed in a physical simulator that were proven to correlate with improved intraoperative performance. The system has been shown to be valid and reliable, and is now widely used across North America.
Fundamentals of Endoscopic Surgery (FES)
Fundamentals of Endoscopic Surgery (FES) is a program developed by SAGES in collaboration with our team at McGill. It aims to assess knowledge and skills in flexible gastrointestinal endoscopy. The technical skills component uses the Simbionix GI Mentor II virtual reality simulator that can simulate upper GI endoscopies.
The LapSim laparoscopic surgical simulator (Immersion Medical, Gaithersburg, MD) is a virtual reality simulator that includes a template with two endoscopic handles. The tasks are displayed in 2-dimensional representations on a computer screen. The simulator can be used to practice basic laparoscopic skills, cholecystectomy, and gynecological procedures.
ProMIS, designed by Haptica, is the first hybrid laparoscopic simulator. The trainer can assess the learner by evaluating the time taken, the path length, and the efficiency of movements. Feedback is offered immediately after each task.
Low-Cost Simulator for Training and Evaluation of Flexible Endoscopic Skills
This low-cost simulator is designed (by David Berger Richardson) to allow surgical trainees to develop the fundamental skills of flexible endoscopy. These skills include retroflexion, navigation and loop reduction, mucosal evaluation and instrumentation.