LapPass

Launched at the 2015 ALSGBI ASM in Southport in the Arthrex Mobile Training Lab

Laparoscopic surgery is technically demanding and the skills required for proficiency are difficult to acquire. It is not for everyone. However, perhaps more than for any other branch of surgery, simulator training lends itself for practising and perfecting laparoscopic technical skills and from Autumn 2015 the ALSGBI has formally recognised those trainees who are able to demonstrate proficiency in a defined set of 5 laparoscopic tasks. These are not easy skills to perfect and the possession of the passport is a badge of proficiency which will be recognised nationwide and will mark out those who are serious laparoscopic surgeons. In turn, it is anticipated that trainers will recognise that those in possession of the LapPass® will be suitable for accelerated operative training. The 5 skills include camera holding (which will be assessed intra-operatively) and 4 technical skill tasks which will be demonstrated and assessed in training jigs.

LapPass® aims to provide trainees with the opportunity to improve their laparoscopic skills, and ultimately assess them in being competent at the LapPass® tasks. This certification serves as an indicator of trainees’ capabilities and skills, allowing them to prove their level of proficiency to supervisors as they move around hospitals or regions. The LapPass® group are working towards rolling out LapPass® internationally, setting up courses across the country and nationwide; ensuring it is accessible, standardised, affordable and consistent.

Click here for a list of members who have passed the LapPass® skills assessment

Click here to read about the experience of the first person to pass

Featuring Satish Kolli

Featuring Charutha Senaratne, Nicholas Ting and India Jacklin-Chatha

Please click HERE to download your LapPass® pre-course guide, HERE for instructions on how to set up a LapPass® course, authored by Grace Bennett and Mike Kelly, and HERE for the National LapPass® Handbook

The Academy LapPass® group lead is Grace Bennett.

Regional Training Courses

 

Anglian

Organiser: Mr Neil Keeling

The next assessment will be held on Wednesday 17th May 2023 at the West Suffolk Hospital. FREE for ALSGBI members (refundable deposit). Please click HERE for further details.

Ireland

Organiser: Mr Graeme Macaulay

The last course took place on Friday 3rd June 2022 at the RCSI, 26 York Street, Dublin. The course fee was only 100 Euros for members (200 Euros for non-members).

Click here for flyer & registration instructions

Midlands

Organiser: Mr Jawad Ahmad

North Thames

Organiser: Mr Marco Adamo

North West & Mersey

Organiser: Mr Chelliah Selvasekar

The next course will take place on Friday 19th April 2024 at Whiston Hospital, Warrington Road, Cheshire, Prescot L35 5DR. The course fee is only GBP 60 for members (GBP 120 for non-members).

Click here for listing & registration instructions

Northern & Yorkshire

Organiser: Professor YKS Viswanath

The next course will take place on 22nd May 2023 at the Hull Surgical Skills Training Centre, Suite 22, Castle Hill Hospital, Castle Road, Cottingham, East Yorkshire HU16 5JQ. The course fee is only GBP 100 for members (GBP 125 for non-members).

Click HERE for further details and booking

Oxford & Wessex

Organiser: Professor Jim Khan

The last course took place on Wednesday 9th March 2022 at the Karl Storz Endoscopy (UK) facility in Slough. The course fee was only GBP 50 and is for members only.

Click here for flyer & registration instructions

Scotland

Organiser: Professor Irfan Ahmed

South Thames

Organiser: Mr Iain Jourdan

South and West

Organiser: Mr Simon Higgs

The next course will take place on 18th August 2023 at the Education Centre, Cheltenham General Hospital, Sandford Road, Cheltenham GL53 7AN. The course fee is only GBP 50 for members (GBP 150 for non-members).

Click here for flyer & registration instructions

Trent

Organiser: Mr Imran Bhatti

Wales

Organiser: Mr Graham Whiteley

The next course will take place on 20th December 2023 in the IT Room, Medical Institute at Wrexham Maelor Hospital, Croesnewydd Road, Wrexham, LL13 7TD. The course is free for members (GBP 100 for non – members).

Please click here for further information & registration instructions

ASSESSORS and ASSESSMENT

We hope you will enjoy acquiring the LapPass®. The tasks set are challenging but the skills required are very much clinically relevant and for most people not intuitive. They will require practice, probably over many hours at home or in the lab. They do not intend in any way to avoid the need for courses but much like the Driving Test: lessons will help speedy acquisition of the required proficiency and promote good habits but on the day you still have to pass the Test itself with or without formal lessons.

We expect to run assessments at the Annual Scientific Meeting each year and in addition there are the regional training days as above. Please watch the website and newsletter for further information. The tasks are designed to be able to be conducted on low fidelity jigs and we would encourage practice in this way.

To invite one or more of our Assessors below to your course, please contact Jenny Treglohan at jtreglohan@alsgbi.org :

Assessors:

Mr Marco Adamo Mr Petre Ichim Mr James Olivier
Professor Irfan Ahmed Mr Iain Jourdan Professor Bijen Patel
Mr Jawad Ahmad Mr Neil Keeling Mr Rikesh Patel
Professor Tan Arulampalam Mr Jim Khan Miss Jo Reed
Mr Altaf Awan Mr Satish Kolli Mr Manel Rivera
Mrs Grace Bennett Mr Javed Latif Professor Tim Rockall
Mr Imran Bhatti Mr Paul Leeder Mr Pater Sedman
Mr Nick Davies Mr Graham Macaulay Mr Chelliah Selvasekar
Mr Andrew Day Mr David Mahon Ms Shafaque Shaikh
Mr Simon Dexter Mr Stuart Mercer Ms Emma Upchurch
Mr Steven Dixon Miss Tamsin Morrison Mr Mark Vipond
Professor Nader Francis Mr Sreedutt Murali Professor YKS Viswanath
Mr Ewen Griffiths Mr Ahmad Nassar Mr Martin Wadley
Mr Simon Higgs Mr Colm O’Boyle Mr Graham Whiteley

ASSESSMENT FORMS

Once completed, please email these forms to Jenny Treglohan at jtreglohan@alsgbi.org at the ALSGBI office

Click here to download practical skills assessment form

Click here to download camera holding assessment form

 

2019 SURVEYS

Click here for ALSGBI Trainees Retrospective Survey 2019

Click here for ALSGBI Trainees Prospective Survey Part I 2019

Click here for ALSGBI Trainees Prospective Survey Part II 2019

Click here for ALSGBI Trainees Evaluation Survey 2019

Click here for ALSGBI Lap Pass Sign Off 2019

Click here for ALSGBI Trainers Survey 2019

 

PURCHASING LAPPASS® TRAINING KITS

We are delighted and excited to announce our appointment of Inovus Medical as the official manufacturer and supplier of the new LapPass® training kits.

The tasks can be used with all of the Inovus Medical laparoscopic box trainers. The 5 key laparoscopic skills can be practised in line with the LapPass® certification requirements and adding real value to the certification, the newly designed kits from Inovus have been developed to meet the key requirements of the existing LapPass® curriculum whilst adding improved realism and standardisation to the fully validated laparoscopic skills curriculum.

The LapPass® kit comes complete with a range of interchangeable elements including: hoops, pegs, 20cm of blue thread, foam block, Penrose drains, suturing skins and cutting skins allowing you to practise all of the key skills required to work towards your LapPass® certification.

If you are interested in purchasing the LapPass® kit or any other Inovus Medical products then visit the Inovus website.

Special note: Trainee Surgeon Members will receive a 10% discount as you will see if you click here.

LapPass Tasks

TASK 1

Basic grasping and manipulation of polo mints

EQUIPMENT
3 posts
3 polo mints
1 piece of string/cord 15cm in length
2 Johannes forceps

TASK
Transfer 3 polo mints from post to post from a start and finish position in the floor of the simulator with the polo writing face up.
From base to post 1: Using left hand only
From post 1 to post 2: Use right hand only remove from post one and place on post two upside down
From post 2 to post 3: Remove from post two with one hand, transfer in mid air to grasper in other hand then place on post 3
From post 3 to finish: Remove from post three and in mid air pass over the cord such that the polo mint does not touch the floor of the simulator. The mint is then placed back at the starting position.

ESSENTIAL ELEMENTS
Grasping and manipulation
Spatial awareness
Pronation and supination
Tactile feedback from graspers
Smooth performance.

CLOCK STARTS: As soon as the first polo mint is touched
CLOCK STOPS: As soon as the third polo mint is placed back at the starting point.
TARGET TIME: 4 minutes

COMMENTS
If a polo mint is dropped it is placed back at the starting position and the cycle is repeated for that individual polo mint.

TASK 2

TYING EXTRACORPOREAL ROEDER KNOTS AND PLACING THEM TO SIMULATE APPENDICECTOMY

EQUIPMENT
Partially inflated glove with 4 lines at 1cm intervals along one digit.
Long length of braided suture material
Johannes or knot pusher
Laparoscopic scissors

TASK
Create and place three Roeder knots, 2 proximally in zone 1, one distally in zone three and divide in zone two. Glove must not deflate

ESSENTIAL ELEMENTS
Demonstration of accurate and effective Roeder knot.
Precision placement of endoloop
Precision cutting

CLOCK STARTS: As soon as first endoloop is passed into the simulator
CLOCK STOPS: When tip of glove is separated from main glove and the last endoloop has been cut
TARGET TIME: 8 mins

COMMENTS
The first endoloop may be constructed outside the simulator before the exercise begins and is done in front of the assessor to confirm that the knot is being accurately constructed. There is no time limit on this stage. The technique of Roeder knot formation is available on the ALS website courtesy of the Royal College of Surgeons.
Inaccurate loops must be repeated. Inaccurate division of the tip of the glove or immediate (< 1 minute) deflation of the body of the glove disqualifies the exercise which must then be repeated in its entirety.

Click for a powerpoint file with step-by-step instructions to create a Roeder knot

TASK 3

CUTTING A SHAPE

EQUIPMENT
Solid circular line on glove or chamois leather with inner and external parallel dotted lines 0.5 cm away. Diameter of circle must be at least 5 cm.
Laparoscopic scissors and graspers.
Target circle

TASK
To precisely cut a circular shape without deviation from the line on excision and without damaging underlying tissue

ESSENTIAL ELEMENTS
Precision cutting
Grasping and manipulation
Placing the tissue under tension to facilitate the exercise

CLOCK STARTS: As the first instrument is placed into the simulator
CLOCK STOPS: As the shape is confirmed to be fully excised
TARGET TIME: 3 mins

COMMENTS
Touching or breaching either dotted line disqualifies the exercise. Scissors may be used in either hand and may be used interchangeably

TASK 4

SUTURING

EQUIPMENT
Flexible pad with two pairs of dots drawn in
Braided suture
Needle driver
Johannes/ second needle holder
LLaparoscopic scissors.

TASK
To place two accurate sutures and tie them securely to draw tissue under tension

ESSENTIAL ELEMENTS
Loading of needle drivers. Accurate suturing. Precise and secure knot tying with appropriate tension. The two target spots must be touching (outer dotted lines) on completion of the excercise.

CLOCK STARTS: As soon as suture material is inserted into simulator
CLOCK STOPS: With division of the suture material after second suture
TARGET TIME: 6 minutes

COMMENTS
Acceptable knot types: Szabo knot (secure reef knot with additional throw), may be tied using two hand technique (“C” and “D” loops) or (for advanced practitioners) tied single handedly, Surgeon’s knot. Precision and tension mandatory

CAMERA HOLDING SKILLS

Minimum of 6 cases each at least 30 mins long
Sole camera holder
Forewarn operator that this is an assessable task
At least 3 cases using 30 degree laparoscope

SKILLS TO BE DEMONSTRATED
Camera precision: Target to be maintained within the centre of the image for the majority of the time and to the satisfaction of the operator
An appropriate distance from the target tissue to be maintained and to demonstrate proactive dynamism with “zooming in” for precise tasks and “zooming out” for general views and instrument exchanges
An understanding of the principles of the 30 degree laparoscope with demonstration of orientation whilst maintaining the horizon
Appropriate teamworking skills

How to make your own Laparoscopic Box Trainer