EndoSURG Mentorship Program

September 25, 2024

Victoria Conference Centre – Level One, Saanich 1 (Lectures) and 2 (Lab)

Schedule and Learning Objectives

Overall Activity Learning Objectives
Following the completion of this activity the participant shall be able to:
1) Obtain a detailed endometriosis-specific history and correlate to appropriate targeted imaging in a pain patient;
2) Provide individualized medical management options in endometriosis care;
3) Identify those patients who should or should not undergo surgical intervention and timing of intervention or alternative strategies to deal with pain;
4) Perform appropriate patient positioning, selection of instrumentation, safe peritoneal entry and initial pelvic survey and photo-documentation with correlation of the OR note for excision in mild endometriosis;
5) Execute and approach for excision of mild endometriosis through hands on learning.

CanSAGE EndoSURG Mentorship Co-Chairs
Dr. Liane Belland and Dr. Michael Suen

0800 – 0830     Breakfast, introductions and housekeeping

0830 – 1210     Lectures by Faculty:

Dr. Catherine Allaire
Dr. Liane Belland
Dr. Olga Bougie
Dr. Fady Mansour
Dr. Darrien Rattray

Disclosures of Conflicts of Interest for Faculty (PDF)

SESSION 1:     0830 – 0900
Dr. Olga Bougie
History Taking and Imaging in Endometriosis and Pain
Upon completion of this session the participant shall be able to:
1) Identify key questions to ask on history when endometriosis is suspected;
2) Recognize findings that raise suspicion or concern on the physical exam;
3) Ask for critical elements reported on an US or MRI to help in the diagnosis of endometriosis;
4) Determine which patients require immediate referral to a MIGS specialist for ongoing care.

SESSION 2:     0900 – 0930
Dr. Fady Mansour
Medical Management of the Endometriosis/Pain Patient
Upon completion of this session the participant shall be able to:
1) List the categories of endometriosis-specific and nonspecific medications and understand how to individualize care based on patients’ experiences;
2) Recognize common side effects of commonly used medications and apply practical tips to address these;
3) Identify those patients who require surgical intervention along with medical management;
4) Plan for postoperative medical management and incorporate medical management modifications in the surgical theatre.

0930 – 0950     Health Break

SESSION 3:     0950 – 1030
Dr. Catherine Allaire
When Not to Operate. And When to Operate Again
Upon completion of this session the participant shall be able to:
1) Identify elements of a history and physical exam that are concerning for a pain syndrome versus endometriosis;
2) Recommend complementary strategies beyond medical management for pain patients;
3) Recognize when a patient should not be taken to the OR and when to involve a pain specialist/clinic;
4) Describe risk of and options to mitigate recurrence after surgery;
5) Determine when to offer a repeat surgery to a patient with confirmed/presumed endometriosis.​

SESSION 4:     1030 – 1100
Dr. Liane Belland
Intraoperative Preparation and Organization
Upon completion of this session the participant shall be able to:
1) Replicate proper patient positioning for laparoscopic excision;
2) Identify all equipment necessary to execute a successful excision;
3) Perform a systematic pelvic survey with photo-documentation with focus on trocar placement;
4) Identify the 4 I’s in the approach to excision and correlate to an informative operative note.

1100 – 1120     Break

SESSION 5:     1120 – 1210
Dr. Darrien Rattray
Excising Endometriosis and Managing Complications
Upon completion of this session the participant shall be able to:
1) Review equipment options to perform excision of endometriosis and advantages of each;
2) State alternative approaches to entering the retroperitoneal space;
3) Identify relevant retroperitoneal anatomy and techniques to avoid structural trauma;
4) Recognize available hemostatic agents and situations when to use them;
5) Confidently apply an approach to and execute a simulated excision of mild endometriosis.

SESSION 6:     1300 – 1500
Simulation lab excision of endometriosis

Different hands-on stations with electrosurgical instruments, as demonstrated by faculty. Please note these tools are not a commercial aspect, but rather an integral part of the overall educational event to demonstrate tools and procedures to participants.

• Olympus Thunderbeat
• Hologic CoolSeal
• Ethicon Harmonic Scalpel
• Medtronic Ligasure
• Baxter Floseal and Coseal
• Others

Upon completion of this session the participant shall be able to:
1) Review equipment options to perform excision of endometriosis and advantages of each;
2) State alternative approaches to entering the retroperitoneal space;
3) Identify relevant retroperitoneal anatomy and techniques to avoid structural trauma;
4) Recognize available hemostatic agents and situations when to use them;
5) Confidently apply an approach to and execute a simulated excision of mild endometriosis.

SESSION 7:     1500 – 1640
Case Based Discussion
Upon completion of this session the participant shall be able to:
1) Consolidate knowledge gained from sessions;
2) Extrapolate knowledge onto case examples

1640     Conclusion, wrap-up, evaluation

Accreditation:
This activity is an Accredited Simulation Activity (section 3) as defined by the maintenance of certification program of the Royal College of Physicians and Surgeons of Canada and approved by the SOGC. You may claim a maximum of 6.75 hours (credits are automatically calculated).

Networking Reception Following the Course:
EndoSURG participants and faculty are invited to a Networking Reception from 5-7pm.