Minimal invasive surgical training (MIST) was established to promote minimal invasive advanced surgical training.
What is Minimal Invasive Surgery?
Minimally invasive surgery entail performing surgical procedures that limit the size of incisions needed resulting in reduced pain, quicker recovery times and fewer complications. There are various approaches to minimal invasive surgery. Most evolving approaches amongst these are laparoscopic and robotic surgery.
Minimal Invasive Surgery (MIS) is one of the most significant advances in history of surgery. The change has revolutionised the approach to surgical procedures. MIS role in cancer surgery has significant advantages over open approach for patients in terms of significantly reduced pain and early recovery without compromise in oncological safety. Introduction of laparoscopic surgery in 1990s was a phenomenal first step in newly evolving approach to surgery. The approach was adapted with hesitation in modern world as change is not easily accepted but the approach made its way because of significant advantages over open approach. Governments invested hugely in training the surgeons. Despite of massive investment current status of UK is that only 70% patients receive minimal invasive surgery in bowel cancer more than two decades since introduction of the surgical approach.
World has now recognised the minimal invasive surgery as a standard of care for cancer patients. Most of the world is still very far behind in this area.
Technique has evolved and now becoming a dominant approach in gastrointestinal and other visceral benign and oncologysurgical conditions with figures reaching approximately 70% all over UK. Gulf, some parts of Europe, South Asia and Africa are far behind in terms of adapting the approach to deal with surgically correctable conditions.
Who we are?
We are group of surgeons trained in minimal invasive surgery where technique was developing. We have not only adapted the technique but also trained to a very high level. We developed syllabus for minimal invasive surgery. We standardised the approach by simplifying it into various modules. We then decided to take this to rest of the world and transferred our skills. We developed our training program focussed to train full time consultant surgeons as well as the trainee surgeons. We developed curriculum, training modules for MIS and standardised our training program. We also developed assessment tools to assess post training competency. We developed training methods based on latest evidence. Training qualifications and fellowships were introduced. Training system was tested and validated.
We have developed an extensive portfolio in minimal invasive training. Our master trainer is one the pioneers in minimal invasive surgery training in United Kingdom. He contributed to skill the full-time consultants to help them adapt the modern era of minimal invasive surgery. He developed a team which then extended its portfolio beyond borders into Europe. We have laid foundation of minimal invasive surgery in Germany, HK and Czech Republic. We developed the training program for minimal invasive training in Serbia. We also developed the similar training program in Russia, Iran and south Asia. We founded European Academy of Robotic Colorectal Surgery (EARCS) which overseas advanced minimal invasive surgery all over the world.
Our moto is to train as many surgeons as possible to highest standards and make this technique as a standard for the rest of the world. We also wish to train the trainers to assist them transfer our skills to younger generation.
MIST programme will improve the outcomes of oncology surgery internationally, thereby improving patient outcomes. This will also result in financial benefits resulting in savings from occupied bed days, intensive care and complications.
Training programme will impact the surgical practice in following ways:
Introduction ofMultiple Disciplinary Team (MDT) approach to cancer surgery:
We understand and take every individual diagnosed with colon and rectal cancer as very important. The standard recommended method of providing specialist care to a newly diagnosed cancer patient is planned and individualised as per MDT discussion. This is the first principle of cancer treatment and we will implement this for every patient.
- MDT comprises of specialists from oncology, radiology, pathology and surgery. These are coordinated by specialist nurses and facilitated by cancer nurse practitioners. Hands on training will be given in workshops and emphasis will be given on adapting MDT approach which is considered as the best way to deal with cancer patients.
- Role of enhanced recovery and peri-operative care
- Demonstration and familiarization with operative techniques
In reach Training would involve:
- Up to 20 cases under direct supervision in the base hospital
- Teaching and training of the team with anaesthesiologists, radiologists and pathologists
- Training mapped with real time Global assessment Scores (GAS).
Research & Education
BMIST will become an integral part of surgical mainstream education, thereby raising standards on par with the western European standards.
The wealth of data gathered from MIST will translate to international presentations and publications, thereby impacting on translational research.
MIST will provide a streamlined, structured training programme, in association with EARCS. This will deliver a University diploma which is recognized around the world.
Pathway for training would include selection of centre and surgeons locally by the local stake holders. Some of the modules planned would encompass:
- Module 1 – Introduction to surgical oncology
- Module 2 – Surgical anatomy for Colo-rectal cancers
- Module 3 – Minimally invasive surgical principles
- Module 4 – Human factors: Decision making, risk communication, patient safety and health outcomes
The following tasks would need to be completed in consensus with all the stake holders:
- MCQ exams
- Video assessments
- 2 unedited videos for right and left colon performed by the trainees would be assessed blindly by the faculty using L-CAT forms
- Final certification and feedback
Infrastructure & resources required by each participating center
- Operative tables compatible with Laparoscopy
- High definition Laparoscopic stack – with a master and slave
- Laparoscopic instruments – Bowel graspers Johan’s long and short tip/ Endo Babcock / Laparoscopic needle holders
- Energy sources (Hormonic scalpel / Ligature – 5 mm device)
- Staplers – Laparoscopic Linear cutter / Echelon or endo GIA
- Circular stapling devices / CDH 28 – 30
- Hem-o-lock clips – various sizes
- Would protectors
- Patient immobilizers – Bean bag / Lloyd Davies boots
- Other consumables