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Logistics and Sponsor:
Held on 3/20/25 from 8-12 am at: Science Care Arizona Lab 3836 E Watkins St, Phoenix, AZ 85034.
Sponsor: Ethicon
EPAs Addressed:
#2 Evaluate and manage a patient with the acute abdomen.
#4 Evaluate a patient with right lower quadrant pain and manage appendicitis.
# 6 Evaluate and manage a patient with benign or malignant colon disease.
#10 Evaluate and manage a patient with gallbladder disease.
# 17 Evaluate and manage a patient with thyroid and parathyroid disease.
#18 Evaluation and initial management of a patient presenting with blunt or penetrating trauma.
Materials Required:
Instruments
Scalpels (#10 and #15)
Metzenbaum scissors and Mayo scissors (standard and long versions)
DeBakey forceps and Adson forceps
Small needle drivers
Fine-tip needle drivers (for delicate work in pelvic and vascular areas)
Self-retaining retractors (Weitlaner, thyroid retractors)
Longer retractors (Army-Navy, Richardson)
Balfour or Bookwalter retractors for laparotomy
Rib spreader (Finochietto) and heavy Mayo/rib shears
Lung retractors or sponge sticks
Vascular clamps (bulldogs, angled clamps, DeBakey, Satinsky)
Right-angle clamps
Vessel loops
Basic vascular instruments for small vessel control
Gynecologic instruments (e.g., Heaney clamps) if performing hysterectomy
Liver resection instruments (Kelly clamps, energy-compatible tools)
CBD exploration set (duct dilators, Fogarty catheters)
Patch materials (harvested vein graft, PTFE patch, or makeshift options like Penrose drains)
Sutures
Sutures
3‑0 and 4-0 Vicryl
3‑0 and 4-0 Monocryl
3‑0 or 4‑0 Silk or Prolene sutures
3-0 or 4-0 barbed sutures for anastomosis closures
#1 barbed sutures for fascial closure
2‑0 or 3‑0 silk ties for ligating mesenteric and other small vessels
5‑0 or 6‑0 Prolene for delicate arterial repairs (e.g., carotid/subclavian)
Devices (Energy & Stapling)
Devices (Energy & Stapling)
Energy Devices
Small vessel sealers
Monopolar electrocautery
Stapling Devices
Linear stapler (GIA or curved options for esophageal and bowel transections)
Circular stapler (EEA) for colorectal anastomosis
Goals and Objectives
Goals and Objectives
Goals:
Provide additional, safe exposure to complex operations for senior level residents
Objectives:
Refine Surgical Anatomy
Gain a deeper understanding of regional anatomy for neck, thoracic, abdominal, and pelvic operations.
Identify critical structures (e.g., major vessels, nerves, ducts, organ boundaries) accurately and consistently.
Practice Safe and Efficient Exposure
Develop systematic approaches to gaining surgical exposure in challenging operative fields (e.g., subclavian artery, thoracic esophagus, infrarenal aorta).
Use appropriate retraction, mobilization techniques, and tissue-handling skills to minimize the risk of iatrogenic injury.
3. Enhance Technical Proficiency
Perform key operative maneuvers (e.g., vascular control, anastomosis, resection, reconstruction) with precision.
Utilize advanced devices (e.g., energy instruments, staplers) correctly and safely in a controlled environment.
4. Improve Intraoperative Decision-Making
Recognize normal vs. variant anatomy and adapt the surgical plan accordingly.
Develop the judgment to determine the best surgical approach (e.g., hand-sewn vs. stapled anastomosis, open vs. minimally invasive) based on patient factors and operative findings.
5. Build Confidence for Complex Procedures
Reduce the learning curve by rehearsing high-risk operations in a cadaveric model.
Strengthen residents’ comfort level before performing or assisting in similar cases on live patients.
Cadaver Lab Stations:
Instructional Resources
Instructional Resources
UA Access Surgery
(log in with your UA account through the library website, or log in through here https://accesssurgery.mhmedical.com):
Zollinger’s Atlas of Surgical Operations, 11e by E. Christopher Ellison, Robert M. Zollinger, Jr., Timothy M. Pawlik, Patrick S. Vaccaro, Marita Bitans, Anthony S. Baker
Chapter 7: Arterial Blood Supply to the Upper Abdominal Viscera
Chapter 8: Venous and Lymphatic Supply to the Upper Abdominal Viscera
Chapter 9: Anatomy of the Large Intestine
Chapter 10: Anatomy of the Abdominal Aorta and Inferior Vena Cava
Chapter 11: Thoracic and Pulmonary Anatomy
Chapter 12: Laparotomy
Chapter 17: Thoracotomy Incision
Chapter 54: Surgical Anatomy for Resection of the Colon and Rectum
Chapter 59: Colon Anastomosis, Stapled
Chapter 60: Colectomy, Right
Access surgery video: Right Open Hemicolectomy (Access Surgery > Video & Audio > Right Open Hemicolectomy)
Chapter 66: Low Anterior Resection
SAGES Video: 'Open' total mesorectal resection for rectal cancer
Chapter 74: Open Cholecystectomy
Chapter 75: Common Bile Duct Exploration, Open
SAGES Video: Open CBDE < Excellent Discussions
Chapter 80: Roux-en-Y Hepaticojejunostomy
Chapter 97: A Gynecologic Procedures Overview
Chapter 98: Total Abdominal Hysterectomy
Chapter 99: Salpingectomy—Oophorectomy
Chapter 102: Ureteral Injury Repair
Chapter 119: Thyroidectomy, Subtotal
Access surgery video: Right Thyroid Lobectomy (Access Surgery > Video & Audio > Right Thyroid Lobectomy)
Mayo Video: Thyroid lobectomy
Chapter 120: Parathyroidectomy
Access surgery video: Right Thyroid Lobectomy (Access Surgery > Video & Audio > Right Thyroid Lobectomy)
Mayo Video: Parathyroidectomy for Parathyroid Adenoma
Trauma, 9e, by David V. Feliciano, Kenneth L. Mattox, Ernest E. Moore
Videos are found under Access Surgery > Trauma 9e > View All Videos (under "Features" on the right had side of the page)
Anatomic Exposures in Trauma: Carotid Artery
Anatomic Exposures in Trauma: Subclavian Vessels
Anatomic Exposures in Trauma: Axillary Vessels
Anatomic Exposures in Trauma: Cervical Esophagus
Anatomic Exposures in Trauma: Mediastinal Vessels
Anatomic Exposures in Trauma: Sternotomy and Cardiac Repair
Anatomic Exposures in Trauma: Duodenum
Anatomic Exposures in Trauma: Inferior Vena Cava
Anatomic Exposures in Trauma: Iliac Vessels
Checklists
Checklists
Act professional and respect the cadavers.
Compete the station procedures as listed.
If there is extra time, rotate stations to gain additional exposure.
Clean up and thank the reps for their time and donation to your education.
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