455: Hemostatic Dissection: The Missing Link to Surgical Mastery

Sunday, November 15, 2026
2:00 pm - 3:00 pm

Room: RM312

Chair: William Kondo

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

Description:

Contemporary surgical education emphasizes anatomy and disease processes, with comparatively little formal attention to the mechanical principles governing safe and efficient tissue separation. This advanced surgical tutorial focuses on the mechanics of dissection using pelvic sidewall dissection, parametrectomy, and ureterolysis in stage IV endometriosis as a common operative challenge.

Four internationally recognized laparoscopic and robotic surgeons will present narrated operative videos demonstrating their individual approaches to this complex dissection. Each video will be followed by commentary from another faculty member, creating an opportunity to compare operative decisions, technical styles, instruments, and energy platforms while examining the underlying principles shared by expert surgeons.

The educational framework is the interdependent triad of Space, Tissue Tension, and Speed. Blunt dissection and traction–countertraction create space and expand the margin of safety for energy application. Appropriate tissue tension also creates space by facilitating tissue separation. Differential tissue tension between adjacent structures helps define and develop the intended plane, while appropriate tension accelerates tissue separation. Controlled instrument speed reduces energy dwell time and can minimize collateral thermal spread.

By comparing different approaches to the same operative challenge, participants will examine not only what expert surgeons do, but why they make particular decisions. The goal is to make the often implicit mechanical skills of surgical mastery visible, understandable, and transferable 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, and speed during complex pelvic dissection; 2) Analyze how blunt dissection, traction–countertraction, and differential tissue tension facilitate plane development and expand the margin of safety; 3) Apply principles of tissue tension and instrument speed to optimize energy dwell time and minimize collateral thermal spread during ureterolysis and parametrial dissection; and 4) Compare laparoscopic and robotic dissection strategies to identify transferable mechanical principles for safe, efficient, and reproducible surgery.

COURSE OUTLINE
2:00 PM Welcome, Introductions and Course Overview: The Mechanics of Hemostatic Dissection and the Space–Tissue Tension–Speed Triad
W. Kondo

2:03 PM Narrated Video: Pelvic Sidewall Dissection and Ureterolysis: Laparoscopic Techniques and Energy Modality Selection
M. Malzoni

2:11 PM Commentary on Pelvic Sidewall Dissection and Ureterolysis: Laparoscopic Techniques and Energy Modality Selection
T. Lee

2:14 AM Narrated Video: Pelvic Sidewall Dissection and Ureterolysis: The Robotic Approach
A. Advincula

2:22 PM Commentary on Pelvic Sidewall Dissection and Ureterolysis: The Robotic Approach
M. Malzoni

2:25 PM Narrated Video: Pelvic Sidewall Dissection and Ureterolysis: Mechanical Principles Across Energy Modalities
T. Lee

2:33 PM Commentary on Pelvic Sidewall Dissection and Ureterolysis: Mechanical Principles Across Energy Modalities
W. Kondo

2:36 PM Narrated Video: Pelvic Sidewall Dissection and Ureterolysis: Ultrasonic and Alternative Energy Strategies
W. Kondo

2:44 PM Commentary: Pelvic Sidewall Dissection and Ureterolysis: Ultrasonic and Alternative Energy Strategies
A. Advincula

2:47 PM Moderated Comparative Discussion and Audience Questions
All Faculty

3:00 PM Adjourn