Houston Methodist. Leading Medicine.
Houston Methodist. Leading Medicine

4 Pillars of Surgical Excellence

The 4 Pillars of Surgical Excellence

Core Knowledge

The Four Pillars of Surgical Excellence

Most of the core knowledge you need, you will have acquired during your 5 years of surgical residency. For those areas that are new to you or, where you have gaps in your knowledge, we will try to provide you with that knowledge.

Fellows are also expected to supplement their knowledge base through continued self-study. We will provide the standard texts frequently used by residents and fellows. In addition, a copy of the current SESAP materials will be available to assist fellows in studying for the boards. Plenty of time is available for study.

Surgical Skills Mastery

This is the core component of your training at TMH. No surgeon in clinical practice can be at the top of his or her profession if they lack the skill sets needed to perform the surgeries that their patients need and desire, unless they can perform these surgeries with the highest levels of skill. In today's world, this means that the surgeon must master minimally invasive surgery. Laparoscopic skills such as: laparoscopic suturing with a free hand needle, mastery of the Endostitch device, the use of endomechanical devices, such as endoscopic staplers, proper anatomic dissection, and the use and understanding of energy devices will all be mastered by the fellows. Both Drs. Reardon and Dunkin utilize reduced numbers and sizes of ports. Dr. Reardon has successfully performed over 1200 laparoscopic cholecystectomies utilizing 2 mm ports, instrumentation and laparoscopes. The use of 2 mm and 3 mm ports, instruments and laparoscopces will be achieved by the fellows.

Operating Room

Like every aspect involving patient care here at TMH, the operating rooms are designed to help us to achieve excellence in surgical care. We have numerous Karl Storz OR 1 integrated minimally invasive surgery suites. These high definition suites are designed to help us maximize our surgical outcomes, improve efficiency and promote training. We have complete capacity to capture or stream multiple channels of video in high definition, store these to a central server and retrieve them later for editing. Fellows will learn about the function of all of the equipment, controlling the equipment and troubleshooting the equipment. Correct positioning of the laparoscopic equipment is a critical element of all surgeries and fellows will be trained in this area.

Operation Details

Our fellows will be expected to learn, and independently recall, the step-by-step details of how to perform the various advanced laparoscopic procedures that they are exposed to in a faculty-specific manner. These include: correctly positioning the patient, correctly positioning the equipment, the choice of instruments and tools, port placement, anatomic dissection, and accurate, step-by-step reproduction of procedures as performed by the individual faculty. The goal is to have the fellows be able to accurately reproduce the operation and, thereby, accurately reproduce the good outcomes achieved by their faculty.