Learning internal iliac artery ligation and pelvic ureter course through cadaveric dissections

Authors

  • Arun R. Mahale Department of Obstetrics and Gynecology, MIMSR Medical College, Latur, Maharashtra, India
  • Anjali G. Gosavi Department of Anatomy, Ashwini Rural Medical College and Hospital, Solapur, Maharashtra, India
  • Mahesh S. Ugale Department of Anatomy, MIMSR Medical Collge, Latur, Maharashtra, India
  • Chaya V. Diwan Department of Anatomy, SC Govt Medical College, Nanded, Maharashtra, India
  • Shivaji B. Sukre Department of Anatomy, Govt Medical College, Aurangabad, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20184499

Keywords:

Cadaveric dissection, Internal iliac artery ligation, Surgical anatomy Ureter course

Abstract

Background: Few surgical procedures, although vital, are not learnt and mastered during postgraduate courses in Obstetrics and Gynecology. Internal iliac artery ligation and tracing course of ureter are few of such surgical procedures. Cadaveric dissection sessions organized during postgraduate courses and as CME sessions (continued medical education) have proved useful in learning such unlearnt procedures. This article shares experiences from teaching internal iliac artery ligation, pelvic ureter course tracing and principles of many other unusual gynaecological surgical procedures to Obstetrics and Gynecology specialists and postgraduate students through CME programs involving cadaveric dissection.

Methods: This involved organizing and conducting four cadaveric dissection CME workshops at three different teaching institutions. The components of these CMEs were lectures with power point presentations and two-way audio-visual interactive sessions while pelvic anatomy was demonstrated on cadavers through live dissections. Each CME was concluded by tactile experience to each delegate by handling the dissected cadavers; this was made possible by limiting delegate registration to 50 at each CME.

Results: The surgical skills of internal iliac artery ligation and tracing course of pelvic ureter, which are not adequately and confidently learnt in routine postgraduate tenure, could be effectively transferred through cadaveric dissection.

Conclusions: Revisiting anatomy dissection halls helps in learning rare but lifesaving surgical techniques. This can be achieved by arranging cadaveric dissection CMEs for practicing specialists. Such CMEs should be organized regularly and should be integrated into postgraduate curriculum.

References

Joshi V, Otiv S, Majumder R, Nikam Y, Shrivastava M. Internal iliac artery ligation for arresting postpartum haemorrhage. BJOG 2007; 114(3):356-61.

Papp, Z; Tóth-Pál, E; Papp, C; Sziller, I; Gávai, M; Silhavy, M; Hupiczi, P. Hypogastric artery ligation for intractable pelvic hemorrhage. Obstet Gynecol Survey. 2006;61(4):224-6.

Wagaarachchi P.T, Fernando L. Fertility following ligation of internal iliac arteries for life-threatening obstetric haemorrhage: Case report. Human Reproduct 2000;15(6):1311-3.

Burchell RC. Physiology of internal iliac artery ligation. BJOG. 1968;75(6):642-51.

Ali A, Khan ZN, Konczalik W, Coughlin P, El Sayed S. The perception of anatomy teaching among UK medical students. Bul R Coll Surg Engl. 2015;97(9):397-400.

Charles M. Maliska, John W. Carter, John Blebea, Jeanne E. Gillert, Carmen Ruiz. Focused cadaveric dissection in surgical resident education. J Am Coll Surg. 2015;221(4):S52-3.

J Gilbody, AW Prasthofer, K Ho, ML Costa. The use and effectiveness of cadaveric workshops in higher surgical training: a systematic review. Ann R Coll Surg Engl 2011;93(5):347-52.

CL Gelder, S Paterson-Brown. The role of anatomy in surgical training and the use of cadaveric training courses. Bullet Royal Coll Surg England 2015;97(3):123-6.

Memon I. Cadaver Dissection Is Obsolete in Medical Training! A Misinterpreted Notion. Med Princ Pract 2018;27(2):201-10.

Reddy R, Iyer S, Pillay M,1 Thankappan K,2 Ramu J. Soft embalming of cadavers for training purposes: Optimising for long-term use in tropical weather. Indian J Plast Surg. 2017; 50(1):29-34.

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Published

2018-10-25

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Section

Original Research Articles