POSSIBILITIES OF TEACHING INTERNS ENDOSCOPIC SURGICAL SKILLS IN GYNECOLOGY
One of the most important stages of training surgical interns is mastering practical skills of operative technique. In recent decades, operations in the abdominal surgery using laparoscopic access are increasingly used, and therefore the optimization of the process of laparoscopic surgery teaching has become one of the most important methodological issues in the system of postgraduate professional education of doctors.The purpose of this work is to acquaint interns with the possibilities of mastering basic practical skills of endoscopic surgery in the course of their training in internship in gynecology.In Obstetrics and Gynecology Department of Donetsk City Central Clinical Hospital, which is a base for internship training of relevant speciality, a programme of mastering basic practical skills of endoscopic surgery has been established. This programme includes theoretical preparation, work with endoscopic isolation ward, watch ing live surgery, the analysis of the course of operative measures in videos as well as participation in endoscopic surgical operations. Theoretical preparation began with test control of initial level of topographical anatomy knowledge, operational surgery knowledge, features of laparoscopic equipment and types of energies used. By the results of incoming control, interns were recommended to study the themes independently so that they could write papers, based on the themes and be ready to discuss them.Work with endoscopic isolation ward consisted of perfecting speciﬁ c laparoscopic skills, which include camera navigation, coordination of vision and movements of surgeon’s hands and coordination of both hands actions. Laparoscopic camera navigation provides the ability to control it correctly, overcoming the optical limitings of endoscopic surgery. At the second stage, the coordination of eyesight and hand movements were mastered, providing the ability to use the dominant and non-dominant hands for navigating the camera with one hand and manipulating the endoscopic instrument with the other hand. The following stage was movement coordination of the surgeon’s both hands - bimanual coordination, which provides the surgeon’s ability to manipulate laparoscopic tools together with dominant and not dominant hands.Along with theoretical preparation and mastering endoscopic skills, interns were involved in practical surgical activities in clinic as surgical assistants. Thus, the introduction of the programme for mastering laparoscopic skills for interns proves the possibility of obtaining a basic level of preparation, which results in psychological, theoretical and technical ability to perform a standard laparoscopic intervention.