Accreditation Information: The AAGL is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The AAGL designates this live activity for a maximum of 20.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
ABOG MOC Credits: Diplomates who successfully complete this approved simulation activity are eligible to receive Part IV Practice Improvement credit for the American Board of Obstetrics and Gynecology (ABOG) Maintenance of Certification (MOC) program. Please review the current MOC Bulletin for further information: https://www.abog.org/maintenance-of-certification/bulletins.
ADA Statement: In accordance with the Americans with Disabilities Act (ADA), please contact CMEsupport@aagl.org should you require any special assistance.
The American College of Obstetricians and Gynecologists will recognize this educational activity. In order to apply for cognates, please fax a copy of your certificate to ACOG at (202) 484-1586.
The American Nurses Credentialing Center (ANCC) accepts AMA PRA Category 1 Credits™ toward recertification requirements. Please check with your state licensing board for more information.
The American Academy of Physician Assistants (AAPA) accepts AMA PRA Category 1 Credits™ from organizations accredited by the ACCME. Please check with your state licensing board for more information.
Continuing Medical Education:
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indicates a postgraduate course or session that qualifies for CME credit.
By developing educational courses in minimally invasive gynecology (MIG) we hope to increase the use of MIG and reduce morbidity and complication rates associated with these procedures.
Practice Gap: There is a fundamental lack of minimally invasive gynecological surgical training during physicians’ formal education, and difficulty in acquiring formal training once in medical practice. Gynecologic Surgeons who desire to advance their skills and knowledge in laparoscopic surgery need a forum from which to learn from experts in the field and the opportunity to put newly gained knowledge into practice. Additionally, most gynecologists do not have a sufficient annual volume of benign gynecologic procedures to maintain proficiency. The learning curve for laparoscopic hysterectomy proficiency has been reported to be as high as 75 cases and for robotic hysterectomy proficiency to be as high as 91 cases. Educational forums like the AAGL Annual Global Congress on MIGS provide formal educational and training opportunities, such as surgical tutorials and cadaver labs, which provide access for gynecologists to gain the experience and proficiency needed, post-residency, to perform advanced laparoscopic, robotic, hysteroscopic, abdominal and vaginal surgery for complex, benign gynecologic conditions. These conditions include uterine fibroids, advanced endometriosis, benign ovarian neoplasms, ovarian remnants, and chronic pelvic pain. Best practice would have our learners evaluating and appropriately selecting the appropriate medical and/or surgical treatment plans for women presenting with complex, benign gynecologic conditions such as abnormal uterine bleeding, symptomatic uterine fibroids, chronic pelvic pain, and/or endometriosis. This would include gaining expertise in complex surgical pathology, appropriately managing patients with complicated medical conditions, extensive surgical histories, high BMIs, etc. Minimally invasive techniques have been shown to reduce post-surgical complication rates, reduce hospital length of stay, decrease intraoperative blood loss, reduce postoperative pain, and reduce morbidity and mortality rates associated with traditional procedures.
Gap Analysis: MIG procedures are aimed at preserving the highest possible quality of life for women by using smaller and fewer incisions, reducing pain and trauma to the body, and enabling quicker recovery. Yet, the ability to perform these more patient-friendly procedures requires most gynecologists to commit to post-residency training since they are not routinely taught during formal training. This requires a commitment to lifelong learning to attain specialized skills in pelvic surgery and because of the development of new technologies and instrumentation. Since training varies and is often performed in a manner that is not standardized and subject to bias, it is vital that gynecologists achieve procedural mastery through good surgical coaching and feedback.
Planning the Intervention: The goal of our intervention is that through continuing medical education (CME), organized into didactic and hands-on sessions, gynecologists will acquire and/or advance their skills in MIG. An open forum will follow with discussion designed to stimulate interaction between faculty and learners.
Proposed Method:
I. Create awareness of the role MIG plays and review the current literature relative to MIGS.
II. Host hands-on labs that will allow each participant to practice MIG techniques on cadavers.
III. Offer surgeons with minimally invasive experience the opportunity to refine their skills and technique in both robotic-assisted and traditional laparoscopic surgery.
IV. Review of the fundamentals of laparoscopic suturing, from basic to advanced.
V. Transfer skill to course participants through didactic lectures, video presentations, demonstrations, and supervised wet lab surgeries.
VI. Expectations are that future courses will be organized to spread awareness and transfer skills in MIG to other gynecologists, who are willing to commit to this lifelong process.
VII. To maximize the return of this year’s Congress, upon completion participants will be requested to explain how their newly acquired knowledge and skills will impact their practice.
Objectives: At the conclusion of this activity, the participant will be able to:
I. Apply the latest developments in minimally invasive healthcare for women.
II. Demonstrate the skills needed for proficiency.
III. Employ minimally invasive surgical techniques such as laparoscopic hysterectomy, myomectomy, pelvic floor repair, treatment of endometriosis and advanced hysteroscopic techniques.
IV. Acquire hands-on experience in the anatomy laboratory as well as laboratories focused on laparoscopic suturing, hysteroscopy, robotic surgery, and single-port surgery.
V. Apply the latest advances in research and techniques in the field of minimally invasive gynecologic surgery.
VI. Evaluate data presented to determine the best methods for practice of gynecologic medicine.
VII. Demonstrate and enhance their presentation and publication skills with a hands-on workshop.
VIII. Explore the practice that exists in the intersections between surgical gynecology and other disciplines such as obstetrics, oncology, reproductive medicine, pediatrics, and adolescent medicine.
IX. Identify complications which may occur during minimally invasive surgery in order to better prevent, avoid, and manage complications.
X. Provide culturally, ethnically, and sociologically inclusive clinical care.
Additional Barriers and Possible Solutions: Barrier: MIG is relatively difficult to learn, and all procedures require accurate surgical skills and experience to perform. Therefore, the course participants may not be able to utilize the techniques immediately upon completion of this course.
Possible Solution: Continue to provide physicians with additional education and the resources they need to elevate their practice in gynecology while increasing their skills in minimally invasive gynecology.
Barrier: Literature states that “Racial and ethnic disparities in access to minimally invasive gynecologic surgery for benign pathology exist and these differences are not fully accounted for by patient, socioeconomic, or healthcare infrastructure factors. Initiatives that incentivize hiring surgeons trained to perform complex gynecologic surgery, standardized pathways for route of surgery, quality improvement focused on increased hospital MIS volume, and hospital-based public reporting of MIS volume data may be of benefit for minimizing disparities.”(1)
Possible Solution: “Initiatives to reduce disparities need to address racism, implicit bias, and healthcare structural issues that perpetuate disparities.”(1) AAGL continues to include content to address cultural considerations in care, disparities in care, and implicit bias when planning accredited education with the hope that learners develop and implement strategies to address unintended biases in decision making and health care disparities.
Code of Conduct: AAGL is committed to providing a friendly, safe, supportive, and harassment-free environment during the Congress. AAGL expects Congress participants to respect the rights of others and communicate professionally and constructively, whether in person or virtually, handling disagreement with courtesy, dignity, and an open mind. All participants are expected to observe these rules of conduct in all Congress venues. Organizers will actively enforce this code throughout this event. Violations are taken seriously. If an attendee or participant engages in inappropriate, harassing, abusive or disruptive behavior or language, the AAGL has the right to carry out any action it deems appropriate.
What to Do: If you have any concerns about an individual’s conduct, please go to the AAGL Registration Counter for the procedure to follow to report the incident.
Age Restriction: Children under 16 years of age are not permitted in sessions and workshops but may be allowed into the exhibit hall if accompanied by an adult.
Audio-Visual Recording: Video- and audio-recording of sessions by congress attendees is strictly prohibited. Registration, attendance, or participation in AAGL meetings, Congress, and other activities constitutes an agreement that allows AAGL to use and distribute your image or voice in all media. If you have questions about this policy, please visit the onsite AAGL Registration desk.
Anti-Harassment Statement: AAGL encourages its members to interact with each other for the purposes of professional development and scholarly interchange so that all members may learn, network, and enjoy the company of colleagues in a professional atmosphere. Consequently, it is the policy of the AAGL to provide an environment free from all forms of discrimination, harassment, and retaliation to its members and guests at all regional educational meetings or courses, the annual global congress (i.e., annual meeting), and AAGL-hosted social events (AAGL sponsored activities). Every individual associated with the AAGL has a duty to maintain this environment free of harassment and intimidation.
Reporting an Incident: AAGL encourages reporting all perceived incidents of harassment, discrimination, or retaliation. Any individual covered by this policy who believes that he or she has been subjected to such an inappropriate incident has two (2) options for reporting:
1. By toll free phone to AAGL’s confidential 3rd party hotline: (833) 995-AAGL (2245) during the AAGL Annual or Regional Meetings.
2. By email or phone to: The Executive Director, Linda Michels, at lmichels@aagl.org or (714) 503-6200. All persons who witness potential harassment, discrimination, or other harmful behavior during AAGL sponsored activities are expected to report the incident and be proactive in helping to mitigate or avoid that harm and to alert appropriate authorities if someone is in imminent physical danger. For more information or to view the policy please visit https://cdn.aagl.org/aagl/aagl-anti-harassment-policy-3.6.24.pdf.