Surgical Skills Laboratory

Surgical Skills Laboratory

Guthrie’s Clinical Skills Laboratory and Simulation Center offers a resource for residents and surgeons pursuing technical expertise in line with the ACS curriculum.

The lab provides an appropriate setting outside the operating room for residents and surgeons to gain proficiency with, or brush up on, a variety of techniques. For surgical residents, this represents a departure from traditional “see one, do one, teach one” methodology, instead offering hands-on training prior to a patient encounter. The skills lab hosts lectures, laboratory sessions and scheduled training.

The Clinic Skills and Simulation Laboratory hosts residents and staff from various departments and specialties such as: surgery, cardiology, neurosurgery, gastroenterology, respiratory, anesthesiology, and orthopedics. Training topics have included: stapled and sutured bowel anastomosis, vascular anastomosis, creation of ostomy, opening and closure of the abdomen, vascular access, central line and chest tube insertion, endoscopic vein harvest, skin suturing, joint injection/aspiration, and interventional vascular techniques. Basics like, skin suture, scrubbing, gowning, gloving, and draping are also offered.

Facilities:

  • State-of-the-art lecture areas, equipped with 80” interactive white-board monitors provide a convenient space to conduct conferences, didactic training or even vendor training for devices.
  • Four additional training rooms house high, medium and low fidelity simulators and training devices to provide training opportunities for the General Surgery, Internal Medicine and Family Medicine residencies as well as nursing and ancillary departments. 
  • A team training room that can be configured for multi-specialty simulation, such as code training, allowing staff to conduct interventions as they would in patient care areas. 
  • Video and audio recordings that allow for post training debriefing and review of interventions.

High Fidelity Options:

  • Immersion Medical Endoscopy Simulator allows for virtual reality imaging with colonoscopes and bronchoscopes.
    • Colonoscopy with or without biopsy and polypectomy.
    • Bronchoscopy for diagnostics as well as EBUS (endobronchial ultrasound) and TBNA (trans bronchial needle aspiration)
  • Noelle Birthing Trainer, a customizable trainer mannequin capable of being programmed to present a variety of birthing scenarios and complications.
  • Wireless newborn mannequin also tablet controlled for neonatal resuscitation practice.
  • Vimedix Echo and sonography simulator, giving virtual reality, beating heart, imaging for trans-thoracic echo, trans-esophageal echo and an abdominal ultrasound probe for abdominal pathology and FAST exams (focused assessment with sonogram for trauma). 
  • Simbionix-3D Lap Mentor laparoscopic simulator providing training from basic skills, laparoscopic appendectomy, laparoscopic cholecystectomy, laparoscopic hernia repair up to advanced procedures such as gastric bypass, laparoscopic colectomy and thoracoscopic lobectomy.
  • Simbionix-3D GI/Bronch Mentor
    • GI modules for colonoscopy and upper endoscopy incorporating basic skills training up to advanced procedures to include Colonic Biopsy, Gastric Bleeding, ERCP, and EUS
    • Bronchoscopic training from basic skills to EBUS and TBNA

Medium Fidelity Options

  • Laerdal ALS mannequin with SimPad controller for code practice and defibrillation/cardioversion training.  This trainer also has its own vital sign display to facilitate team training.
  • Laerdal pediatric mannequins with SimPad controllers for PALS training and pediatric code review.

Low Fidelity options:

  • TraumaMan, a simulator for surgical skills training, including cricothyroidotomy, chest tube insertion, pericardiocentesis, diagnostic peritoneal lavage, and IV cutdown.
  • CentraLineMan, a venous simulator to train surgeons on subclavian, supraclavicular and internal jugular central line access. CentraLineMan also allows the user to utilize ultrasound guidance and imaging during central line catheter placement.
  • Laparoscopic box trainers are utilized to practice the skills that comprise the Fundamentals of Laparoscopic Surgery (FLS) program, developed by SAGES and jointly supported by the ACS. FLS is a comprehensive educational module designed to teach the physiology, fundamental knowledge and technical skills required in basic laparoscopy.

While low fidelity tools are not intended to closely approximate a living subject, their components are anatomically true. Repetitive use of low fidelity tools helps residents gain an understanding of procedure and appropriate situational response.

Wet Labs:

  • Human cadaveric specimens are utilized to practice specific procedures not readily able to be simulated, such as fasciotomies, amputations and skin grafts.
  • Porcine aortas are also utilized to practice vascular anastomosis.