455: Hemostatic Dissection: The Missing Link to Surgical Mastery

Sunday, November 15, 2026
11:00 am - 12:00 pm

Room: RM304

Chairs: William Kondo

Faculty: Arnold P. Advincula, Ted T. Lee, William Kondo, Mario M. Malzoni

Description: Internationally recognized laparoscopic and robotic surgeons demonstrate their techniques using diverse energy modalities. Despite stylistic differences, all rely on a single, interdependent triad:

Space – Tissue Tension – Speed

Space: Blunt dissection and traction–countertraction create operative space, expanding the margin of safety and allowing tissues to separate with reduced energy requirements.
Tissue Tension: Tension defines planes and accelerates separation. Differential tension between adjacent structures is a critical principle — planes are easier to develop when one tissue is tensioned relative to its neighbor, guiding safe and efficient dissection.
Speed: Instrument motion across a tensioned plane determines energy dwell time; efficient speed minimizes lateral thermal spread and preserves critical structures.

These variables function dynamically; modification of one inherently affects the others. Blunt dissection establishes safe space for energy application, tissue tension (including differential tension) accelerates plane development, and controlled speed optimizes hemostasis while protecting adjacent structures.

Through high-definition laparoscopic and robotic footage, slow-motion analysis, and moderated discussion, this session demonstrates how expert surgeons continuously recalibrate the triad — including the strategic application of differential tissue tension — in real time. The emphasis is not on the device or platform but on reproducible mechanical principles that make complex dissection controlled, hemostatic, and safe across platforms.

Learning Objectives: At the end of this course, the participant will be able to:

1. Describe the interdependent relationship between space, tissue tension (including differential tension), and speed during pelvic sidewall dissection and ureterolysis in advanced endometriosis;
2. Analyze how blunt dissection, traction, and differential tension create safe planes and reduce energy dependence in complex parametrial surgery; and Apply principles of tension modulation, differential tension, and dwell time management to minimize thermal spread and optimize surgical precision across laparoscopic and robotic platforms. Integrate triad-based decision-making, including differential tension, into advanced endometriosis surgery to improve reproducibility and operative efficiency.
3. Integrate triad-based decision-making, including differential tension, into advanced endometriosis surgery to improve reproducibility and operative efficiency.

COURSE OUTLINE

11:00 AM Welcome, Introduction and Course Overview

W. Kondo

11:05 AM TBD

A. Advincula

11:15 AM TBD

T. Lee

11:25 AM TBD

W. Kondo

11:35 AM TBD

M. Malzoni

11:45 AM Discussion Questions & Answers

12:00 PM Adjourn