acs booklet
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Surgical SkillSCurriculum for Residents
acS/aPDS: SuRgiCal SkillS CuRRiCulum foR ReSidentS
Contents:
Asepsis and Instrument Identification: TraumaMan System
Knot tying: Basic Open Surgical Skills (BOSS)
Suturing: Basic Open Surgical Skills (BOSS)
Airway Management: TraumaMan System
Chest tube and Thoracentesis: TraumaMan System & Thoracentesis Model
Arterial and Venous Catheterization: CentraLineMan & FemoraLineMan
Laparotomy Opening and Closure: Laparotomy Model
Introduction to inguinal anatomy: Hernia Model
Hand sewn anastomosis: Laparotomy Model
Stapled anastomosis: Laparotomy Model
Laparoscopic/Open Bile Duct Exploration: CBDE Model
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MOD1: aSePSiS & inStRument identifiCation
objeCtives:
> Correct prepping and draping for maintaining a sterile field
stations:
> Gowning and Gloving> Prepping and Draping> Instrument Identification and Handling
simulatorneeded:torsomodel
TraumaMan System (TPP–10): This simulator can be used for teaching students how to correctly prep and drape a patient to maintain a sterile field
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MOD2: knot tying
objeCtives:
> Tie a series of 10: two handed square knots
> Tie a series of 10: two handed square knots at depth
> Tie a series of 10: one handed square knots
> Tie a series of 10: one handed square knots at depth
> Tie a series of 4: instrument tied square knots
simulatorneeded:Knottyingboard
Basic Open Surgical Skills (BOSS–10): This trainer provides a flexible platform for basic surgical skill development, including knot tyingStudent Tissue Pack (BTP–10): Includes Tissue Model, Complex Tissue Model, Large Intestine, Tissue Suture Pad, and an Injectable Tissue Pad
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MOD3: SutuRing and SutuRing teChniqueS
objeCtives:
> Demonstrate a simple interrupted stitch
> Demonstrate a simple running stitch
> Demonstrate a running subcuticular stitch
> Demonstrate vertical and horizontal mattress stitches
stations:
> Simple Interrupted and Running Stitch
> Running Subcuticular Stitch> Vertical Mattress Stitch> Horizontal Mattress Stitch
simulatorneeded:tissuemodels
Basic Open Surgical Skills (BOSS–10): This trainer provides a flexible platform for basic surgical skill development, including suturingStudent Tissue Pack (BTP–10): Includes Tissue Model, Complex Tissue Model, Large Intestine, Tissue Suture Pad, and an Injectable Tissue Pad
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MOD7: aiRway management
objeCtives:> Demonstrate the ability to perform
a cricothyroidotomy
> Demonstrate the ability to perform the tracheostomy portion of a percutaneous tracheostomy
stations:
> Surgical Cricothyroidotomy> Percutaneous Tracheostomy
simulatorneeded:maniKinwithairwaysystem
TraumaMan System (TPP–10): This simulator includes a complete airway system powered by a portable ventilator, provides an airway response to the operative sites
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MOD8: CheSt tube and thoRaCenteSiS
objeCtives:> Demonstrate the ability to place
a decompressive needle
> Demonstrate the ability to place a chest tube
> Demonstrate the ability to perform thoracentesis
stations:
> Needle Decompression> Chest Tube Insertion> Thoracentesis
simulatorneeded:torsomodel
> TraumaMan System (TPP–10): This simulator includes an anatomically correct torso, complete airway system - providing a platform for performing chest tube insertion and needle decompression
> Thoracentesis Model (THM–10): This simulator provides a realistic platform for performing thoracentesis
Thoracentesis Replaceable Tissue (THMT–10)
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MOD9: aRteRial and VenouS CatheteRization
objeCtives:> Identify the anatomic landmarks to
safely place arterial and central venous catheters
> Develop an algorithm to maximize safety in placement of arterial and central venous lines
> Demonstrate a working knowledge to the use of the “Site Rite” ultrasound for the placement of central venous catheters
simulatorneeded:vasCularaCCesstrainers
> CentraLineMan System (CLM–20): This simulator can be used for teaching students how to insert a central venous line - both the jugular and subclavian approach
CentraLineMan Replaceable Tissue (CLMT–20)
> RadiaLineMan System: Under Development
> FemoraLineMan System (FLM–20): This simulator can be used for teaching students how to insert a femoral arterial line
FemoraLineMan Replaceable Tissue (FLMT–20)
stations:
> Central Venous Line - Jugular Approach> Central Venous Line - Subclavian
Approach> Radial Arterial Line > Femoral Arterial Line
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MOD12: laPaRotomy oPening and CloSuRe
objeCtives:> Demonstrate the ability to safely
make a midline incision, correctly identifying all layers of the abdominal wall, and preventing any injury to intra-abdominal structures
> Demonstrate the ability to close the abdominal wall in the midline in the appropriate layered fashion
stations:
> Midline Laparotomy Opening> Midline Laparotomy Closure
(Interrupted Technique)> Midline Laparotomy Closure
(Continuous Technique)
simulatorneeded:laparotomymodel
Laparotomy Model (LPM–10): This simulator includes a partial abdomen with replaceable abdominal tissue cover that includes skin, subcutaneous fat, fascia, preperitoneal fat, and peritoneumLaparotomy Replaceable Tissue (LPMT–10)
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MOD14: intRoduCtion to inguinal anatomy
objeCtives:> Identify pertinent external landmarks of
the inguinal region for use in herniorrhaphy
> Identify the components of the inguinal canal and spermatic cord
> Describe the etiology of groin hernias by defining potential weak areas of the inguinal and femoral regions
> Describe the anatomic basis for hernia repair
stations:
> Anatomy Dissection> Anatomy Demonstration
simulatorneeded:herniamodel
Hernia Model (HTM–30): This simulator includes an anatomically correct pelvis with necessary landmarks
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objeCtives:> Demonstrate a functional end-to-
end intestinal anastomosis using sutures
> Perform side-to-side bypass enteroenterostomy using sutures
MOD19: hand Sewn anaStomoSiS
simulatorneeded:laparotomymodelandlargeintestine
Laparotomy Model (LPM–10): This simulator includes a partial abdomen with replaceable abdominal tissue cover that includes skin, subcutaneous fat, fascia, preperitoneal fat, and peritoneum; and the Large Intestine is a reinforced bowel section for anastomosisLaparotomy Replaceable Tissue (LPMT–10)
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objeCtives:> Demonstrate a functional end-to-end
intestinal anastomosis using enteric staplers
> Perform side-to-side bypass enteroenterostomy using stapler technique
MOD20: StaPled anaStomoSiS
simulatorneeded:laparotomymodelandlargeintestine
Laparotomy Model (LPM–10): This simulator includes a partial abdomen with replaceable abdominal tissue cover that includes skin, subcutaneous fat, fascia, preperitoneal fat, and peritoneum; and the Large Intestine is a reinforced bowel section for anastomosisLaparotomy Replaceable Tissue (LPMT–10)
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objeCtives:> Learn necessary steps for
laparoscopic and open common bile duct explorations
> Become proficient wiht the specialized laparoscopic equipment
> Perform laparoscopic and open common bile duct exploration using transcystic and choledochotomy approaches
> Perform choledochoscopy
MOD5: Common bile duCt exPloRation (PhaSe ii)
simulatorneeded:Cbdemodel
CBDE Model (LCD–10): This anatomically correct model includes a soft tissue base with anatomical landmarks. It is ideal for practicing laparoscopic transcystic common bile duct exploration (LAPTC-CBDE), laparoscopic choledochotomy for common bile duct exploration (LAP C-CBDE), or open CBDE. CBDE Replaceable Tissue (LCD–20)
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