Transferable Competency - PowerPoint Presentation

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Transferable Competency Adominal Wall Surgery

Ferdinand

Köckerling

MD

Professor

of

Surgery

Chairman

Department

of

Surgery

and

Centre

of

Minimally

Invasive

Surgery

Certified

Centre

of

Obesity

Surgery

Certified

Centre

of

Hernia

Surgery

Academic Teaching Hospital

of

Charité Medical School

Vivantes

Hospital Berlin

New Transferable Competency“The trend towards greater specialization is supported by the European Board of Surgery”“The Surgical Scientific Societies are encouraged to develop other new Board denominations”Wolfgang Feil

President

of

the European Board of Surgery

https://uemssurg.org/general/contact

Do we need the Transferable Competency

Abdominal Wall

Surgery

?

Project of the European Hernia Society (EHS)

ACCESS –

Accreditation and Certification requirements for Abdominal Wall Surgery Centers and Surgeons

F. Köckerling, A.J. Sheen, D.

Cuccurullo

, D.

Kopelman

,

R. Fortelny,

F. Berrevoet,

G.Campanelli

, H. Friis-Andersen

,

J.F.

Gillion

, J. Osterberg,

J. Gorjanc, M. Simons, M.

Lopez

Cano

, M.

Smietanski

, W. Reinpold; '

R.K.J.Simmermacher

, S. Morales-Conde, D Weyhe

Do we need the Transferable Competency

Abdominal

Wall

Surgery ?

ACCESS – Project of the European Hernia Society (EHS)

Statement

There

is

a

need

for

accredited

/

certified

abdominal wall

surgery

centers

and

specialists

because

of

the

increasing

complexity

(

availabilities

of

new

techniques

, an

increase

in

surgical

devices

and

the

presence

of

more

complex

cases

requiring

tailored

approach

)

of

abdominal wall

treatment

with

an

increasing

public

awareness

and

expectation

in

treatment

results

.

What is the definition

of

an Abdominal Wall

Surgeon

?

ACCESS – Project of the European Hernia Society (EHS)

Statement

A General

Surgeon

can

be

trained

to

become

an

abdominal wall

surgeon

by

mastering

the

learning

curve

of

all open

and

laparo-

endoscopic

abdominal wall

procedures

that

are

recommended

in

the

Guidelines

and

should

additionally

implement

and

fulfill

the

other

requirements

for

a

abdominal wall

surgery

center

and

perform

a minimal

yearly

case

load

Transferable Competency Abdominal Wall Surgery

Knowledge

Abdominal Wall Surgery (AWS

) is a "transferable competency" which requires the acquisition of "

Knowledge" in basic clinical sciences and operative skills as well as specialized "Knowledge and Skills" in the prevention and treatment of all types of

abdominal

wall

defects

and covers acute, traumatic and non-acute diseases and injuries.

The “transferable competency” AWS provides the “knowledge and skills” for the non-operative and operative management of all types of abdominal wall defects, i.e. prevention, diagnosis, evaluation, decision making, treatment, intensive care, rehabilitation of patients with pathological processes and acute and chronic pain treatment. Transferable Competency

Abdominal Wall

Surgery

Knowledge

Abdominal Wall Surgery (AWS) cooperates with other surgical and medical specialties, e.g. anesthesia and intensive care medicine, emergency surgery, gastroenterology, general surgery, plastic surgery, internal medicine, radiology, neurology, pediatrics, urology and others in the management of patients.Transferable Competency

Abdominal

Wall

Surgery

Knowledge

Transferable Competency Abdominal Wall Surgery

Knowlegde

and

S

kills

Differentiated

use of diagnostic procedures (clinical examination, CT, MRI, Ultrasound)

Indication

for surgery under consideration of the current guidelines

Preoperative

conditioning of patients with risk factors (smoking, obesity, pulmonary diseases)

Prevention

of incisional and

parastomal

hernias following open abdominal procedures by small-bite suture technique and / or prophylactic mesh

Laparo

-endoscopic

and open treatment of all inguinal hernias in the emergency and elective clinical setting according to the guidelines

Surgical

skills for inguinal hernia repair according to the guidelines in Lichtenstein, TEP or TAPP and

Shouldice

techniques

Transferable Competency Abdominal Wall Surgery

Knowlegde

and

S

kills

Tailored

approach in elective inguinal hernia repair under consideration of gender, bi-laterality, recurrence and other factors

Laparo

-endoscopic

and open treatment of all primary ventral hernias (umbilical, epigastric) in the emergency and elective clinical setting under consideration of an additional rectal diastases.

Surgical

skills in laparoscopic IPOM, open suture, open

sublay

, open

onlay

and open component separation techniques for primary ventral hernia repair.

Tailored

approach in primary ventral hernia repair under consideration of obesity, risk factors, patient status and hernia findings.

Laparo

-endoscopic

and open treatment of all types of incisional hernias (primary, recurrent, medial, lateral, “

swiss

-cheese”, “loss of domain”) in the emergency and elective clinical setting.

Transferable Competency Abdominal Wall Surgery

Knowlegde

and

S

kills

Surgical

skills in laparoscopic IPOM, open

sublay

, open IPOM, open

onlay

and open component separation techniques for incisional hernia repair

Tailored

approach in incisional hernia repair under consideration of obesity, risk factors, patient status and findings of the hernia

Complex

ventral and incisional hernia repair in the contaminated surgical field

Treatment

of diaphragmatic hernias

Treatment

of mesh infections

Techniques

for closure of open and burst abdomen

Conservative

and operative management of all postoperative complications

Knowledge

about the characteristics of the used medical technology products in hernia surgery (synthetic, biological and biosynthetic meshes, absorbable and non-absorbable tackers, biologic and synthetic glues.

Treatment

of patients with chronic pain following hernia surgery in cooperation with neurologists and pain experts

The focus is on diagnosis and treatment, which comprises all non-instrumental and instrumental techniques including radiology, sonography, computer tomography and magnetic resonance imaging. The AWS must be capable of employing laparo-endoscopic and open techniques for therapeutic purposes and must have the opportunity to gain knowledge and experience in evolving technological methods. The AWS must be also capable of interpreting all types of surgery-related radiological examinations.The AWS surgical activity covers the pre-, peri- and postoperative period including the principles of enhanced recovery and follow-up of patients. The specialty also includes individual and general preventive activities, rehabilitation, and management of pain.

Transferable

Competency

Abdominal

Wall

Surgery

Knowlegde

and

Skills