Efforts Underway to Increase MIS in Gynecology

Educational programs help expand expertise

By Rosanne M. Kho, MD

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The Ob/Gyn & Women’s Health Institute has made a concerted effort to increase minimally invasive gynecological surgery (MIGS) training, awareness and adoption both for our own staff and colleagues around the world.

We implemented a comprehensive series of hands-on teaching modules in MIGS with simulation for residents. In our Benign Gynecology Section, a formalized teaching program schedule provides opportunities for residents and staff members to become aware of latest evidence and expand their expertise. A master’s course in MIGS (March 2018) will offer hands-on learning in the simulation lab as another effort to increase MIS adoption among Cleveland surgeons.

At local, national and international levels, we offered a CME program entitled “Controversies in Endometriosis, Adenomyosis and Fibroids” for the first time. The well-attended conference provided up-to-date material on how to best manage these complex benign conditions. Our own experts along with invited international faculty offered didactic and interactive instructive sessions covering a variety of complex cases.

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Clinical pathway developed

One of our objectives as an institute is to decrease the number of open abdominal hysterectomies. To achieve this goal, we developed and implemented a clinical pathway that sets appropriate parameters and provides specific guidelines to help colleagues understand exactly when it is appropriate to refer patients to an MIS surgeon. Imaging protocols for endometriosis and fibroids, developed in close collaboration with our radiology colleagues, have also been implemented to improve preoperative diagnosis and the treatment planning process for our patients with these conditions.

We also work closely with the Center for Endometriosis and the Chronic Pelvic Pain Clinic. Together, our areas are dedicated to advancing care for patients with benign gynecological conditions.

Further reading:
Breaking Tradition in Teaching Gynecologic Surgical Skills to Residents
Management of Endometriosis and Pelvic Pain

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Dr. Kho is Head, Section of Benign Gynecology, and Director, Benign Gynecologic Surgery, at Cleveland Clinic.