Advanced Minimal Access Hernia Surgery

Learning Outcomes

Understand Instrumentation and Setup:

For minimal access surgery
Enhance proficiency in scope and instrument handling, dissection, knotting, clipping and electrosurgery.
Compare the advantages and disadvantages of various hernia repair techniques, including TEP and TAPP
Properly and safely use laparoscopic instruments, ensuring regular maintenance.
Apply step-by-step procedural knowledge in simulated environments for eTEP, TAPP & Ventral hernia repair.
Execute intracorporeal suturing, stapling, mesh handling and placement with precision.

Course Description

This comprehensive three-day course is designed to equip participants with foundational knowledge, practical skills, and advanced techniques in laparoscopic hernia surgery. Combine interactive lectures, hands-on simulation exercises, and case-based discussions, the program fosters a robust understanding of laparoscopic instruments, procedural steps, and trouble shooting strategies in minimal access surgery for hernia. Participants will gain a thorough understanding of hernia repair techniques, mesh handling and intracorporeal suturing, culminating in a practical assessment to validate their proficiency.

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Course Duration:

3 Days

Webinars, panels and small group discussions
Equipment, instrument and procedure demonstrations
Dry laboratory training on all technical aspect of MAS
Live demonstrations/master videos of various surgical procedures
Wet lab for hands-on experience during selected courses

Curriculum

Knowledge

Delivered through online lectures

Skills

Delivered through 3-day contact course at Apollo Simulation Centre

Assessment

For both knowledge and skills

Observership

Optional

Mentorship

Optional

Online Modules

All didactic lectures will be available as online modules for candidates 2 weeks prior to the contact course to prepare for the course well in advance. All the required theory knowledge will be learnt through web platform. There will be a Q&A section available after each lecture to interact with the faculty for any additional doubts to be clarified. Completing online modules is mandatory for certification

S. No	Topic
1	Introduction to laparoscopy
2	Laparoscopic instruments
3	Basic principles
4	Energy sources
5	Access techniques
6	Tissue approximation
7	Equipment maintenance
8	Anaesthetic considerations
9	Troubleshooting
10	Robotic surgery
11	EndoHernia anatomy and radiology
12	Prosthesis and fixators
13	Optimising patients for surgery
14	Approach to groin hernias
15	Approach to abdominal wall hernia
16	Abdominal wall reconstruction
17	Emergency hernia management
18	Difficult and revisional hernias
19	Recent advances and future
20	Setting up a lap unit

Contact Course

The three-day contact course is aimed at providing practical knowledge about everything that one needs to know about minimal access hernia surgery. This is achieved by way of 50% of time spent on panel discussions, live surgical demonstrations and 50% time on hands on training including dry and simulation laboratory.

Day 1: ASC

Time	Event	Location	Comment
08:45	Registration and pairing	Lounge	Welcoming of participants
09:00	D1: Instruments/Prosthesis	EndoSuite	Image chain, lap trolley
09:45	D2: Basic principles	EndoSuite	Ergonomics of set-up and access
10:30	D3: Access techniques	EndoSuite	Creation of working space
11:00	Coffee/Tea – Lounge
11:15	H1: Access and dexterity	Skills Lab	Dissection and scissors exercise
12:00	H2: Knotting and suturing	Skills Lab	Technique and steps
12:30	Lunch – Lounge
13:30	P1: Which hernia repair?	Skills Lab	Advantages and disadvantages
14:00	P2: Hernia master videos	Skills Lab	Tips and tricks
15:00	Coffee/Tea – Lounge
15:15	H3: Extracorporeal knotting	Skills Lab	Endoloop, torn sac looping
16:15	H4: Intracorporeal suturing	Skills Lab	Needle handling, suturing
16:45	Summary	Lounge	Views, recap and group photo
17:00	End of the Course

Day 2: ASC

Time	Event	Location	Comment
08:45	Overview	Lounge	Pairing
09:00	H5: Mesh handling	Skills lab	Technique and steps
09:45	H6: Mesh placement	Skills lab	Technique and steps
11:00	Coffee/Tea
11:15	H7: Mesh fixation	Skills lab	Technique, steps
11:45	H8: Mesh suturing	Skills lab	Technique, steps
12:30	Lunch
13:30	P3: Controversies and problems	Board room	How to overcome difficulties
14:00	P4: Mishap videos	Board room	Complications, troubleshooting
15:00	Coffee/Tea
15:15	E1: OSCE	Skills Lab	Practical exam
16:30	E2: Results and certification	Skills Lab	Analysis of performance
16:45	Summary and feedback	Lounge	Views and recap

Day 3: ASC/EISE

Time	Event	Location	Comment
08:45	Overview	OT Lounge	Pairing
09:00	S1: TAP/TEP inguinal hernia	OT	Technique, steps
10:30	Coffee/Tea
11:00	S2: e-TEP ventral hernia	OT	Step by step approach
12:30	Lunch
13:30	S3: AWR (Lap/Robotic)	OT	Step by step approach
15:00	Coffee/Tea
16:30	Summary	OT Lounge	Views and feedbacks
17:00	End of the Course

Observership program

Observership includes a short 3-day period of attachment with the respective speciality unit to witness live surgeries and ward rounds of various surgeries as per availability in the respective speciality.

Mentorship program

Mentorship involves a much longer 3-week period of clinical attachment to the speciality unit, with the possibility of surgeon shadowing through managing outpatient/inpatient services and assisting procedures/surgeries.

Objective Structured Clinical Examination (OSCE)

Skills and technique assessment will be done through OSCE at the end of the contact course. Each student will be performing various tasks like dissection, suturing, stapling, mesh placement, tacker application, etc. which we objectively assessed through scoring key. The number of stations will vary between 8 and 12. At the end of the examination, a cumulative score of 70% will be required to clear the assessment.