Program Coordinator: Raul Rosenthal, MD

Duration: 4 weeks
Availability: Year round
No. of Students: 1
Time: Full time

Prerequisite

Satisfactory completion of third year medicine and surgery rotations.

Objectives

To provide students with clinical and surgical exposure to the diagnosis and treatment of patients of minimally invasive surgery such as:

  • Surgery of the foregut:
    It will focus on benign and malignant disease of the foregut. Morbid obesity and gastroesophageal reflux disease, as well as associated swallowing disorders will be specifically addressed. We will focus on minimally invasive techniques for gastric bypass, gastric banding, Nissen's fundoplication, Heller's myotomy, etc.
  • Surgery of the biliary tree, liver and solid organs:
    We will concentrate in the performance of laparoscopic cholecystectomies, common bile duct exploration as well as the routine use of cholangiogram and intraoperative ultrasound to detect abnormalities of the liver and biliary tract. Excision and cryoablation of liver lesions, splenectomy or palliative bypass procedures for malignant outlet obstructions of the biliary tree will also be performed.
  • Endoscopic endocrine surgery:
    Endoscopic approaches to diseases of the adrenal glands as well as diseases of the pancreas will be implemented.
  • Abdominal wall hernias:
    Incisional as well as inguinal hernias will be approached through the laparoscope. Students will be able to identify the indications when to use the open or laparoscopic approach as well as to be familiar with the different techniques that can be used in each area.
  • Morbid obesity:
    We perform basic and advanced surgical procedures to treat obesity and metabolic syndrome.
  • Emergency and diagnostic procedures:
    When appropriate the laparoscopic approach will be used to stage patients with malignancies or assess and/or treat patients with acute diseases of the gastrointestinal tract.

Description

The rotation will focus on three main aspects patient care, teaching, and research.

  • Patient Care:
    Students will be supervised by attendings in all their activities. The presence of fellows will improve the quality of care and communications with patients and nursing staff. They will be involved in the pre-, peri- and postoperative care of our patients allowing us to clarify and recognize potential problems as well as early detect and manage complications. Their activities will be divided in daily morning rounds, conferences, operating room experience, outpatient clinic and data collection and analysis. The student will become familiar with handling of endoscopic instrumentation and equipment, indications and contraindications for endoscopic procedures as well as with the different surgical techniques. We may divide our outpatient work in sub specialized clinics that will concentrate on special disorders, e.g. heartburn clinic, hernia clinic, spine clinic, morbid obesity, etc. This may allow us to improve the quality of care and data collection.
  • Teaching:
    Students will be actively involved in case presentations, morbidity and mortality conferences, radiological conferences, etc. They will participate in the preparation and presentation of lectures for conferences to be given to CCF nursing and attending staff, non-staff nurses and physicians as well as sales and marketing industry personnel. This will give our fellows a comprehensive practical and teaching experience. At the same time this will facilitate the unit to offer on a regular basis courses that will update our nurses and physicians in state of the art endoscopic surgery. The student will also participate in the education program of house staff, medical students and residents.
  • Research:
    We have implemented a research program in endoscopic surgery, which will keep our unit in the forefront of basic science and technology. We welcome supporting grants from the industry in order to finance the below mentioned research program. We encourage our fellows to help develop and perform animal and human research projects. A wide variety of research protocols involving the participation of the departments of medicine, radiology, gastroenterology, pediatrics, etc. are being developed. We concentrate our efforts in two main research sites. Students are encouraged to participate in research activities and be co-authors in those papers.
  • Endoscopic surgical techniques and skills laboratories:
    Together with the industry we are developing animal protocols that will allow us to improve and develop new techniques and instrumentation in endoscopic surgery. We promote participation of our fellows as trainees and later as preceptors in animal laboratory sessions. This will help fellows, residents and attending staff to acquire and refine their ability to perform specific endoscopic procedures. We envision that this skills laboratory will become a prestigious site that will grant continuing medical education.

Evaluation

The staff physicians to whom the student is assigned perform evaluations. A report will be given to deans and phase coordinators upon request.