120 - Total Abdominal Hysterectomy Salpingo-oophorectomy Using Donors Bodies to Teach Reproductive Anatomy and Gynecological Oncology Case Vignette

Poster Board Number: 120
There are separate poster presentation times for odd and even posters.
Odd poster #s – first hour
Even poster #s – second hour

Co-authors:

Rebecca Martinez, MD - Associate Professor, Medical Education, Florida International University Herbert Wertheim College of Medicine; Rakesh Ravikumaran Nair, MD., MPH., MBA - Assistant Professor, Medical Education, Florida International University Herbert Wertheim College of Medicine; Ferdinand Gomez - Assistant Professor, Medical Education, Florida International University Herbert Wertheim College of Medicine

Abstract Body : Introduction

The increase in technology of laparoscopic procedures including robotic laparoscopies, and earlier detection of gynecological cancers have decreased the need for abdominal hysterectomies. This may cause a decrease in the amount of times obstetrics and gynecology residents can participate in abdominal hysterectomies. By allowing 4th-year medical students to conduct a total abdominal hysterectomy bilateral salpingo-oophorectomy (TAH BSO), the students can recognize important anatomical landmarks and practice the proper procedural steps.


Objective

The purpose of this abstract is to understand the female anatomy by performing a TAH BSO, gynecological oncology staging, and utilizing the dissections to teach second-year medical students reproductive anatomy utilizing clinical vignettes.



Materials and Methods

The dissection was completed by a 4th-year medical student and an OBGYN physician. The midline incision was completed. The subcutaneous tissue and muscle were separated. The fascia was separated to reveal the abdominal cavity. The broad ligament, uterus, bilateral fallopian tubes, bilateral ovaries, bladder, and rectum were seen. The aortic bifurcation and para-aortic lymph nodes were visualized. The broad ligament was dissected to reveal the uterine artery located in the retroperitoneum. The uterine arteries were cut bilaterally. The broad ligaments were cut. The Infundibulopelvic (IP) ligaments were identified- within were the ovarian vein, nerves, and artery- and cut. The cardinal ligaments and uterosacral ligaments were visualized. The cardinal ligaments were cut. The cervix and vaginal wall were palpated. The incision was made 1 cm below the cervix to expose the vaginal canal. The uterus was dissected and the cervical os was visualized.


Results

Serial photographs were taken to showcase the steps of the TAH BSO with visualization of the uterus, fallopian tubes, pelvic ligaments, and ovaries.



Conclusion

The TAH BSO required the 4th year medical student to have the anatomical knowledge of the female pelvic structures taught to them in their 2nd year and understand the spatial relationship of the structures and vessels to be able to complete the procedure. The 4th year medical student then taught 2nd year medical students reproductive anatomy and utilized case-based learning to further reinforce their clinical knowledge.



Significance and implications

The anatomy rotation allowed 4th-year medical students to strengthen their knowledge of female anatomy. It allowed them to be more prepared when beginning OBGYN residency. Future implications of using donors to simulate gynecological procedures before a live experience are limited but should be explored to enhance the comfort and increase the anatomical knowledge of students.