Intermediate Surgical Skills
(for Surgeons-in-Training [ISSSiT])
18th and 19th November 2023
College of Physicians and Surgeons of Cardiff, Frazer Building, 126 Bute Street, Cardiff Bay, Cardiff, CF10 5LE
This two-day course is aimed at providing the surgical trainee with a sound overview of the essential principles, core concepts and fundamental skills relevant for a core surgical (CT1 and CT2) trainee and those in the first year of speciality surgical training (ST3 or equivalent). The course comprises of hands-on training in surgical skills using a variety of animal tissue and simulated models, interspersed with structured and focused teaching on the principles behind undertaking common operative procedures and the key notions underpinning the management of different types of trauma. In addition to teaching the skills required to practicesafe operative surgery, the course emphasises the value of being an effective assisting surgeon.
With a high tutor-to-delegate ratio, this course is designed to equip the surgical trainee with the essential surgical skills that will be expected of a coresurgical trainee or an early speciality surgical trainee in the operating theatre or in a trauma setting. The course also includes pertinent discussions on the management of patients presenting with surgical emergencies.
On completion of this course, it is envisaged that a junior surgical trainee at a core training or early speciality training level will be confident in undertaking minor surgical procedures independently and dealing with the immediate intraoperative challenges, being a competent first assistant in major surgical procedures, and being an effective member of a trauma team in the management of surgical emergencies presenting to the Accident and Emergency Department.
A formal assessment will be carried out for award of Certification of Completion of the Course.
- Core Surgical Trainee 1
- Core Surgical Trainee 2
- Core Trainee in Emergency Medicine
- Early Speciality Trainee in Emergency Medicine
- Junior Surgeon Not in a Training Programme (equivalent of CT3, Trust Doctor, Clinical Fellow, Junior Fellow and Non-Trainee awaiting a National Training Number)
- Speciality Trainee in General Surgery, Orthopaedic Surgery, ENT Surgery, Plastic Surgery, Urology, Vascular Surgery, Neurosurgery, Maxillofacial Surgery and Cardiothoracic Surgery (ST3 level or Equivalent)
- Basics of Suture Materials and Surgical Needles
- Surgical Knot-Tying I: Reef; Surgeon's; Tying at Depth
- Surgical Knot-Tying II: Slip Knot; Aberdeen Knot; Instrument Tie
- Correct Handling of Common Surgical Instruments and Disposing of Sharps
- Principles of Safe Infiltration of Local Anaesthesia and Management of Complications
- Suturing Techniques I: Simple Interrupted, Vertical Mattress and Horizontal Mattress
- Suturing Techniques II: Deep Dermal, Simple Continuous and Interlocking Continuous
- Suturing Techniques III: Purse-String Suturing, Intradermal Suturing (anchoring and three-point stitch) and Intradermal Suturing (pull-through technique)
- Figure of '8' Haemostatic Stitch
- Excision of a Simulated Cutaneous Lesion and Closure
- Excision of Puckered Skin (‘dog ears’) and Closure
- Removal of a Simulated Epidermoid Cyst
- Methods of Wound Closure and Reconstructive Ladder
- Full-Thickness Skin Grafting
- Local Flaps: Rhomboid Flap; V-Y Advancement Flap; Rotation Flap
- Draining an Abscess
- Fine Needle Aspiration Cytology
- Lymph Node Biopsy
- Placement of and Securing a Surgical Drain
- Principles of Managing Patients with Trauma
- Needle Cricothyroidotomy
- Surgical Tracheostomy for Airway Management
- Principles of Managing Patients with Shock: Hypovolemic, Cardiogenic, Septic, Neurogenic and Spinal
- Practical Anatomy of Central Vein Cannulation
- Intercostal Nerve Block for Management of Rib Fractures
- Debriding a Traumatic Wound
- Immediate Management of Burns
- Assessing a Hand Injury
- Repairing an Extensor Tendon
- Repairing a Flexor Tendon
- Management of Flexor Tendon Sheath Infection
- Management of Animal and Human Bite Wounds
- Practical Anatomy of Joint Aspirations
- Practical Anatomy of Nerve Blocks
- Midline Laparotomy and Closure
- Mesentery: Ligation in Continuity
- Mesentery: Pedicle Ligation
- Mesentery: Transfixing a Pedicle
- An Overview ofTypes of Colectomies and Stomas
- End-to-End Bowel Anastomosis
- Essential Principles of Vascular Surgery (Bypass and Stents)
- Arteriotomy and Vein Patch
Optional Additional Skills Covered:
- Aseptic Precautions in the Operating Theatre
- Scrubbing and Handwashing Technique
- Closed Method of Gowning and Gloving
- Basic Principles of Surgical Diathermy
- Basics of Laparoscopic Surgery
- Laparoscopic Surgery (stacking)
- Laparoscopic Surgery (cutting)
- Laparoscopic Surgery (threading)
Learning ObjectivesAt the end of this course, asurgical trainee should:
- have gained an appreciation of the different suture materials and surgical needles.
- be able to institute local anaesthesia in a safe and efficient manner, as well as manage any pertinent complications.
- be able to handle surgical instruments correctly and dispose of the sharps safely.
- be able to tie a secure reef knot, surgeon’s knot,slip knot, Aberdeen knot.
- be able to tie a knot at depth and perform an instrument tie.
- be able to execute basic and advanced suturing techniques.
- be able to excise a lesion and close the wound.
- be able to excise a subcutaneous cyst and close the wound.
- be able to perform a fine needle aspiration cytology and a lymph node biopsy.
- have understood the principles behind draining an abscess and planning appropriate wound management.
- have understood the principles of managing patients with trauma.
- have understood the principles of managing patients with different types of shock.
- be able to perform an emergency needle cricothyroidotomy and a surgical tracheostomy.
- be able to perform an intercostal nerve block for rib fractures.
- have understood the principles behind the immediate management of burns.
- have understood the principles behind debriding a traumatic contaminated wound in an effective manner.
- have understood the essential concepts in wound healing and the principles of reconstructive surgery.
- be able to perform a full thickness skin graft and local flaps for reconstruction.
- be able to perform a repair of the extensor and flexor tendons.
- be confident in the principles of treating flexor tendon sheath infections and animal and human bite wounds.
- have understood the anatomical principles behind central vein cannulation, nerve blocks and joint aspirations.
- be able to safely secure a surgical drain.
- be able to perform a laparotomy and close the abdomen.
- be able to appreciate the indications and principles behind colectomies.
- be able to ligate a pedicle in a mesentery and transfix a pedicle.
- be able to perform an end-to-end anastomosis of the bowel.
- have understood the theory behind vascular bypass procedures and the insertion of vascular stents.
- be able to perform an arteriotomy.
- be able to close an arteriotomy incision with a vein patch.
If undertaking the optional additional skills, by the end of the course, the trainee should:
- have understood the main principles of effective surgical scrubbing.
- have appreciated the importance of aseptic precautions in surgery.
- be able to gown in a correct manner.
- be able to carry out the closed method of gloving.
- have understood the principles of surgical diathermy and using it in a safe and efficient manner.
- have understood and appreciated the ergonomics and the skills required in laparoscopic surgery.
|Date||18th and 19th November 2023
|College of Physicians and Surgeons of Cardiff, Frazer Building, 126 Bute Street, Cardiff Bay, Cardiff, CF10 5LE|
|Closing Date||Places will be offered on a first-come-first-served basis and therefore we are unable to provide a precise closing date.|
|No of Places||16|