Basic Laparoscopic Skills

The UW General Surgery Basic Laparoscopic Skills Curriculum is based on the Fundamentals of Laparoscopic Surgery program developed by SAGES (Society of Gastrointestinal and Endoscopic Surgeons) and adopted by the American College of Surgeons. It is the most studied and best validated program in surgical simulation and will form the core of your laparoscopic skills training.

FLS certification (cognitive test and skills test) is considered a ‘high stakes exam’ due to its rigorous validation and is required for Board Certification by the American Board of Surgery (ABS). You will need to pass the FLS tests before February of your R4 year in order to have a completed application for ABS Certification (mailed in April of your Chief year)

Fundamentals of Laparoscopic Surgery has two parts: a didactic module and technical skills training. During your EVATS rotations you should review the FLS didactic content. This includes information on safe laparoscopy, and is critical information to review prior to your first laparoscopic case.

The technical skills training consists of five tasks:

• Peg transfer
• Circle cutting
• Endoloop
• Suturing with extracorporeal knot tying
• Suturing with intra-corporeal knot-tying

Demonstrations of each of these tasks are also on the FLS website.

Dr. Khandelwal has also developed an excellent laparoscopic suturing module: https://sites.uw.edu/uwgensurgtechskills/laparoscopic-suturing/

FLS has developed a proficiency-based curriculum based on the time and errors to complete each task, available through the ACS/APDS Phase I Basic Laparoscopic Skills Curriculum. The proficiency-based goals are also posted on the wall above the FLS trainer box in WISH.

The goal times may seem aggressive, but they have been nationally validated as proficiency metrics. If it seems difficult to match these times, remember that they were were set by 1^st year medical students.

At the R1 level you must meet the criteria for the Peg Transfer and Circle Cutting tasks. The remaining tasks are optional at the R1 level but required at the R2-5 levels. Additionally, the Endostitch device is not part of the formal FLS curriculum but it is used frequently at the UW. You should meet the target metrics for intracorporeal suturing and knot tying while using the endostitch rather than the laparoscopic needle drivers

FLS Target Metrics:

You will need to obtain supplies from the WISH techs. There are FLS boxes in WISH HMC and WISH UWMC