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Advanced Workshop on Retroperitoneal Surgical Anatomy

The Solution to Difficult Surgery: Navigate, Dissect, Do No Harm

May 24 - 25, 2019

Register Now! https://events.eply.com/Retroperitoneal-Surgical-Anatomy-Workshop

Fariba Mohtashami, Chair, University of British Columbia

International Faculty

Kate O’Hanlan, Laparoscopic Institute for Gynecology & Oncology, California, USA Stephen Jeffrey, University of Cape Town, South Africa

Afshin Fazel, Lariboisière Hospital, Paris, France Joseph (Jay) L. Hudgens, University of Virginia, USA

Samar Nahas, University of California, USA Craig J. Sobolewski, Duke University, North Carolina, USA

Canadian Faculty

John Thiel, University of Saskatchewan Ally Murji, University of Toronto

Chandrew Rajakumar, University of Calgary

Local Faculty: University of British Columbia Geoffrey Cundiff, Mohamed Bedaiwy, Mina Wesa, Michael Suen, Merry Gong

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Course Description

Anatomy is the foundation of surgery. Gynecologic surgeons operate in one of the most complex anatomic environments of the human body from different perspectives such as vaginal, abdominal and laparoscopic. Hence a deep knowledge and understanding of the three-dimensional relationship of pelvic structures is the key to competency and successful outcomes. This course provides 8 hours of hands-on practice on pelvic anatomy with only three participants per station where they will operate, assist and observe in a rotational fashion. Strategic approach to pelvic anatomy including pelvic viscera, vasculature, nerves, ligaments and structural landmarks will be demonstrated using a multitude of lectures and highly selected surgical videos. There will be emphasis on the retroperitoneal spaces and commonly encountered scenarios in pelvic surgery where a practical knowledge of surgical anatomy makes all the difference. The faculty are not only proficient pelvic surgeons, but more importantly they are experienced mentors with ability to guide learners in complex learning environments such as OR. Concomitant emphasis will be made on dissection techniques, surgical planes and tissue handling. Knowledge of anatomy is the road map and dissection is the vehicle that moves the surgeon toward the destination. One needs both for a safe journey. An optional laparoscopic suturing workshop, at no extra cost, with comprehensive lectures and hands on practice on box trainers will be offered on May 23rd from 2-5 pm. This is for those registrants aiming to master suturing skills in advance and prepare for the anatomy lab. A dry lab with dedicated faculty will run alongside the anatomy lab on May 24-25. This includes box trainers for laparoscopic suturing, high fidelity pelvic modules for Sacrospinous Ligament Suspension (Capio), Retropubic and Transobturator Midurethrtal Slings (TVT & TOT), hysteroscopic resection of submucosal fibroids and fluid management system, and office hysteroscopy.

Course Objectives At the conclusion of this activity, the participant will be able to:

1. Identify, isolate and dissect visceral, vascular and neurologic components of the pelvic side wall

2. Distinguish retroperitoneal spaces and strategies for laparoscopic dissection in the surgical planes

3. Apply principles of laparoscopic suturing to measurable improvement in tissue reapproxiamtion and knot tying

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Course Outline

Thursday: May 23, 2019: Fundamentals of Laparoscopic Suturing 1:45 Welcome, Introductions and Course Overview F. Mohtashami / K. O’Hanlan 2:00 Needle Handling & Tissue reapproximation J. Hudgens/M. Wesa 2:15 Suture Management & Running Suturing C. Rajakumar 2:30 Intracorporeal & Extracorporeal knot tying M. Gong/M. Suen 2:45 Hands-on Lab DRY LAB Laparoscopic Suturing (1 participant/Box Trainer) All Faculty 5:00 Adjourn Friday: May 24, 2019: Advanced Workshop on Retroperitoneal Surgical Anatomy

7:30 Breakfast 7:55 Welcome, Introductions and Course Overview F. Mohtashami 8:00 Electrosurgery: Practical Application C. Rajakumar 8:30 Laparoscopic Dissection Techniques: The Devil Lies in Details F. Mohtashami 9:00 OR Ergonomics & Safe Entry: Well Begun is Half Done S. Nahas 9:30 Retroperitoneal spaces & Pelvic Vasculature J. Hudgens 10:10 Questions & Answers All Faculty Refreshment Break 10:45 Pelvic Side Wall & Ureter: Charming the Snake in the Grass C. Sobolewski 11:15 Hysterectomy from A-Z K. O’Hanlan 12:00 Lunch 1:00-5:00 Hands-on Lab WET LAB Pelvic side wall Dissection

Pelvic Vasculature: From Aortic Bifurcation to Obliterated Umbilical Artery Ureter: From Pelvic Brim to Bladder Retroperitoneal Spaces: Pararectal, Paravaginal, Obturator Laparoscopic Suturing: Bladder & Bowel Injury, Uterosacral Ligament Suspension

DRY LAB: Sacrospinous Ligament Suspension (Capio), TVT and TOT on Pelvic Modules Laparoscopic Suturing on Box Trainers

Hysteroscopic Resection of Fibroids & Aquilex Fluid Control System Office Hysteroscopy

05:00 Adjourn

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Saturday: May 25, 2019 Advanced Workshop on Retroperitoneal Surgical Anatomy 7:30 Breakfast 8:00 Laparoscopic Approach to Apical Prolapse & Stress Urinary Incontinence: Sacrocolpopexy, Uterosacral Ligament Suspension, Burch S. Jeffrey 8:30 Frozen Pelvis: Anatomical Approach to Obliterated Cul-de-Sac M. Bedaiwy 9:00 Pelvic Neuroanatomy: Avoiding the Nervous Breakdown A. Fazel 9:30 Laparoscopic Myomectomy A. Murji 10:00 Questions and Answers All Faculty Refreshment Break 10:30 Urinary & Gastrointestinal Injury: Prevention, Diagnosis, Treatment C. Sobolewski 11:00 Major Vascular Injury: Prevention, Diagnosis, Treatment S. Nahas 11:30 Laparoscopic Complications J. Thiel 12:00 Lunch 01:00-5:00 Hands-on Lab – Continued WET LAB: Retroperitoneal Dissection

Presacral Space, Hypogastric Plexus, Retzius Space Burch and Paravaginal Repair Pelvic Nerves: Ilioinguinal, Genitofemoral, Obturator, Pudendal, Femoral, Sciatic Laparoscopic Suturing: Ureteral Injury, Sacrocolpopexy

DRY LAB: Sacrospinous Ligament Suspension (Capio), TVT and TOT on Pelvic Modules Laparoscopic Suturing on Box Trainers Hysteroscopic Resection of Fibroids (Myosure)

Aquilex Fluid Control System Office Hysteroscopy

05:00 Adjourn Registration Fee Suturing Workshop /Lectures/Dry Lab/Anatomy Lab CAD 2,400

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Accreditation statement The University of British Columbia Division of Continuing Professional Development (UBC CPD) is fully accredited by the Committee on Accreditation of Continuing Medical Education (CACME) to provide study credits for continuing medical education for physicians. This activity is an Accredited Simulation Activity (Section 3) as defined by the Maintenance of Certification Program (MOC) of the Royal College of Physicians and Surgeons of Canada, and has been approved by UBC CPD for up to 18.0 MOC Section 3 Simulation hours (credits are automatically calculated). Each physician should claim only those credits he/she actually spent in the activity. Workshop Location The workshop will be held at the Life Sciences Institute, Gross Anatomy Lab:

University of British Columbia, Point Grey Campus Life Sciences Institute 2350 Health Sciences Mall Vancouver, BC, Canada, V6T 1Z3 Accommodation: Accommodation arrangements are to be made individually. For convenience in taxi pooling we suggest the Granville Island Hotel: Granville Island Hotel | Official Site. Book Direct. Or call direct: Kim Dodge – Operations Manager The Granville Island Hotel Tel: 236 521 1772 kim@gihotel.net

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Optional Sunset Cruise Dinner to Mix Informally with all Faculty The conference has organized a group dinner cruise leaving down town Vancouver, cruising around Stanley Park, under the Lions Gate Bridge, past Granville Island and up False Creek. Friday May 24: Strict departure at 19:00, return at 21:30

Boarding starts at 1830 at 501 Denman Street. Departure time is strict—the boat does not wait. Tickets: $140 per person which includes a dual-entree West Coast styled buffet (salmon and slow-roasted beef), table wine and live music. Cancellation The Conference Organizers and their agents, including UBC CPD, reserve the right to cancel a course thirty (30) days prior to the course date. Each registrant will be notified by telephone, with written notification and a full refund following. The University of British Columbia is not responsible for any costs, including, but not limited to, airline or hotel penalties. No refunds or transfers, unless you cancel IN WRITING by May 01, 2019 for a $125 fee. Freedom of Information and Protection of Privacy Personal Information is collected on this registration form pursuant to section 26 of the Freedom of Information and Protection of Privacy Act, RSBC 1996c. 165. The information will be used for the purposes of facilitating the conference and producing aggregate statistics. For questions, please contact UBC CPD at 604-875-5101.

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Faculty Dr. Mohtashami is Clinical Associate Professor and Head of the Division of General Gynecology and Obstetrics at the University of British Columbia. She is passionate about surgical education with emphasis on fundamentals of surgery such as 1- Anatomy, 2- Dissection, 3- Electrosurgery and 4- Suturing. Dr. Mohtashami is a Fundamental of Laparoscopic Surgery (FLS) Certified Proctor. She is a regular chair and faculty at a variety of international workshops in North America, Europe, and South Africa. She has received several awards including Dr. Mike Turko Surgical Teaching Award for outstanding surgical teaching in the UBC Residency Program; Carl Nimrod Award for Surgical Mentorship from the Association of Academic Professionals in Obstetrics and Gynecology of Canada (APOG) and also the APOG Best Preceptor Award at the Annual APOG Minimally Invasive Surgery Workshop.

Dr. O’Hanlan has performed over 3,000 Total and Radical laparoscopic hysterectomies from her practice in the Bay Area of California. She likes to call herself a laparoscopic oncologist. Dr. O’Hanlan teaches surgical skills internationally with 27 of her 60+ journal publications focused on TLH and laparoscopic oncologic surgery. In 2006, Dr. O’Hanlan founded the Laparoscopic Institute for Gynecology and Oncology (LIGO), providing training for oncologists and generalists in minimally invasive techniques. Today, LIGO is considered the “boot camp” for skill building and advancing MIS skills.

Dr. Jeffery is Head of the Department of Urogynaecology and Pelvic floor Reconstruction at the University of Cape Town, South Africa, and in private practice the Urogynaecology and Laparoscopy Clinic in Cape Town. He is a Royal College (London) accredited subspecialist urogynaecologist and completed a three-year fellowship in urogynaecology at St. George’s Hospital in London. Dr. Jeffrey is a high-volume pelvic surgeon with a broad interest in laparoscopic and vaginal approaches to pelvic floor dysfunction. He travels widely teaching and demonstrating surgery and has trained surgeons from the USA, UK, Ghana, Pakistan, India, UAE, Kenya, Philippines, Germany, Nepal, Mozambique, and Mauritius. He was previously on the International Advisory Board of IUGA and was the IUGA meeting chair in 2016.

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Dr. Fazel is Assistant Professor in the Department of Gynecology and Obstetrics at the Hospital Lariboisière, Paris, France. He finished his residency in France where he was trained in Laparoscopic Surgery by Dr. Denis Querleu, one of the pioneers of MIS in oncology. He then completed a fellowship in Minimally Invasive Gynecologic Surgery at Columbia University, New York. Dr. Fazel’s area of interest includes Oncology and Deep Infiltrating Endometriosis with nerve preservation and he has trained over 150 residents and fellows. He is an active member of AAGL, ESGE and SLS. He is regular chair and faculty in advanced MIS workshops and a researcher at INSERM (French National Institute of Scientific and Medical Research). His interests lie in Drug Delivery Systems and diagnostic tools for uterine malignancies. He is the Principal Investigator of an international multicenter study for a diagnostic test for endometriosis.

Dr. Nahas, is Clinical Assistant Professor of Gynecology and Oncology at the University of California, Riverside School of Medicine. She completed her OBGYN residency at the University of British Columbia, followed by a fellowship in gynecologic oncology at the University of Manitoba. She then completed a second fellowship in Advanced Laparoscopic and Robotic Surgery in Gynecologic Oncology at the Mayo Clinic and earned her Masters Degree in Public Health from Johns Hopkins University. Dr. Nahas is a member of the Society of Gynecologic Oncology of Canada, the American College of Obstetrics and Gynecology, the Royal College of Physician and Surgeons of Canada. She is regular faculty and chair at several advanced workshops organized by the Laparoscopic Institute of Gynecologic Oncology (LIGO) and AAGL. She has a special interest in innovative surgical techniques and teaching minimally invasive surgery.

Dr. Hudgens is Associate Professor, Vice Chair of Gynecological Services, Director of Advanced Gynecological Surgical Center at the University of Virginia, USA. He graduated from University of Arkansas Medical School, completed his specialty training in Obstetrics and Gynecology followed by a Fellowship in Minimally Invasive Gynecology at the University of Louisville School of Medicine. Dr. Hudgens is a board certified fellow from the American College of Obstetrics and Gynecology. He is regular chair and faculty in a variety of advanced workshops at AAGL. His clinical interests include complex pelvic surgery for advanced endometriosis, minimally invasive hysterectomy for large fibroids, laparoscopic myomectomy, infertility surgery, pelvic ultrasound, and evaluation of refractory pelvic pain.

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Dr. Sobolewski is Assistant Professor of Obstetrics and Gynecology and Chief, Division of Minimally Invasive Gynecologic Surgery at Duke University. He received his M.D. from the Ohio State University and completed his OBGYN residency at Penn State University where he served as the OB/GYN Residency Program Director and Chief of Gynecology. Dr. Sobolewski joined the faculty at Duke University in 2003. His clinical expertise lies in advanced laparoscopic and hysteroscopic procedures. He has received several awards for his skills as an educator including the Duke University Distinguished Faculty Award, the APGO Excellence in Teaching Award, and the CREOG National Faculty Award. He is a regular faculty in international workshops and has authored several publications and book chapters. He served on the Board of Trustees of the AAGL from 2010 to 2012.

Dr. Thiel is Clinical Professor and the Provincial Head of Obstetrics and Gynecology in the Saskatchewan Health Authority and at the University of Saskatchewan. He received his followed by his OBGYN residency at the University of Saskatchewan. He founded the postgraduate fellowship program in Minimally Invasive Gynecology in Regina in 2006 and remains the fellowship director, currently training the 14th fellow in the program.

Dr. Thiel is a founding member of the Canadian Society for the Advancement of Gynecologic Excellence (CanSAGE) and is the current president of the organization.He has been awarded both the CREOG and APGO Excellence in Teaching Awards for resident teaching and the 2010 Golden Hysteroscope Award for best hysteroscopy paper at the 39th Global Congress of MIS. His clinical and research interests include intra-operative evaluation, hysteroscopic tubal sterilization, alternatives for fibroid management, endometrial ablation and chronic pelvic pain.

Dr. Rajakumar is the Section Head of Minimally Invasive Gynecologic Surgery at the University of Calgary. He received his bachelor degree in Chemical/Biochemical Engineering followed by MD and OBGYN residency at the University of Western Ontario. He then completed a 2-year fellowship in Minimally Invasive Gynecologic Surgery with a special focus on endometriosis and chronic pelvic pain as well as a fellowship in Simulation and Medical Education at the University of Ottawa. Dr. Rajakumar’s focus is complex surgery performed endoscopically, endometriosis, uterine disorders and chronic pain. Additionally, he manages the outpatient hysteroscopy and minor surgery program at South Health Campus and is the Major Gyn/Benign Gyn Lead for the Enhanced Recovery After Surgery program for the province of Alberta.

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Dr. Murji is Assistant Professor of Obstetrics & Gynecology at the University of Toronto. He is part of the Generalist Division at Mt Sinai Hospital. Dr. Murji graduated from the OBGYN residency program at University of Toronto. He then completed a two-year fellowship in minimally invasive gynecologic surgery at McMaster University. His training was focused on advanced laparoscopy, hysteroscopy, endometriosis and outpatient procedures. He also completed a Masters in Public Health from Harvard University. He has a keen interest in outcomes research and quality improvement.

Dr. Cundiff is Professor and Head of the Department of Obstetrics and Gynecology at the University of British Columbia. His clinical practice, based at the Centre for Pelvic Floor Competence, is dedicated to the diagnosis and treatment of pelvic floor disorders. Dr. Cundiff is also a research scientist with active trials in reconstructive surgery and obstetrics. His research interests are broad-based including epidemiology of pelvic floor disorders, surgical education, and prevention of maternal obstetrical trauma, although he is best known for outcomes research for pelvic floor disorders. He has published 6 books, and more than 140 peer reviewed publications including, surgical and non-surgical treatments, and has led several multi-centered randomized trials. He has been a pioneer in advocating patient-based outcomes measures and has worked to develop and validate such measures.

Dr. Bedaiwy is Professor and Head of Division of Reproductive Endocrinology and Infertility at the University of British Columbia. He received his MD from Egypt, OBGYN residency and REI fellowship as well as MIS Fellowship from Cleveland Clinic, Ohio. In Canada he completed a fellowship in Reproductive Sciences at the University of Toronto and received his PhD from the University of Maastricht, the Netherlands and has over 350 peer reviewed publications. He received several international awards for surgical and research excellence at different societies from Egypt, Jordan, Australia, Canada and USA. He has an interest in minimally invasive surgery and fertility preservation and is regular chair and faculty at workshops held by ASRM, WCE and the AAGL. He is on the editorial of the Journal of Minimally Invasive Gynecology and was the Associate Editor of the Human Reproduction Journal (2012-2016). His research is focused on advancing basic and clinical knowledge about endometriosis, infertility, ART and early pregnancy complications.

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Dr. Wesa is Clinical Assistant Professor in the Department of Obstetrics & Gynecology at the University of British Columbia. She completed her undergraduate and medical education at the University of British Columbia and graduated from the UBC OBGYN residency program in 2013. Dr. Wesa completed a fellowship in Minimally Invasive Gynecologic Surgery at the University of Ottawa and joined the faculty at Royal Columbian Hospital. Her areas of interest include Advanced Laparoscopic Surgery, Uterine Fibroids and Endometriosis.

Dr. Suen is Clinical Assistant Professor in the Department of Obstetrics & Gynecology at the University of British Columbia. He completed his MD and OBGYN residency at UBC. This was followed by a two-year Fellowship in Minimally Invasive Surgery through the AAGL at the University of Ottawa, concurrently with a second Fellowship through the Department of Innovation in Medical Education and Simulation. Dr. Suen is a Clinical Assistant Professor at the University of British Columbia; his practice is in New Westminster and his main hospital appointments are at Royal Columbian Hospital and Eagle Ridge Hospital. His interests include complex benign gynecologic cases and medical education.

Dr. Gong is Clinical Assistant Professor in the Department of Obstetrics and Gynecology at the University of British Columbia. She completed both medical school and her specialty training in Obstetrics and Gynecology at UBC. She is currently completing a fellowship in Female Pelvic Medicine and Reconstructive Surgery (FPMRS) at St. Paul’s Hospital. Dr. Gong’s clinical practice is focused on the prevention, diagnosis and treatment of pelvic floor disorders. She is actively engaged in research with specific interests in the prevention and management of obstetrical pelvic floor trauma.

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