Operative evaluation form open radical nephrectomy. Resident PGY: 4 Demonstrates Competence. 2 Needs Improvement

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1 open radical nephrectomy Procedure: OPEN RADICAL NEPHRECTOMY knows preoperative evaluation of renal mass (including imaging results) knows indications for open nephrectomy knows the AUA guidelines for antibiotic prophylaxis for kidney surgery knows incisions and potential complications including plueral injury etc. understand how to place rectactor for kidney surgery, protect bowel vessels and adjacent organs (spleen, liver) knows how to position the patient supine and flank positions including the display of relevant radiologic images right side anterior approach including kocherizing duodenum right side expose IVC left side anatomic relationships including pancreas, spleen, gonadal and adrenal vein with renal vein etc. identifies and ligates ureter identifies and ligates renal vein identifies and ligates renal artery identifies adrenal gland understands hemostatic principles (sealants) and how to repair IVC etc? appropriate choice of suture for wound closure can instruct patient about outpatient post-op care

2 lap radical nephrectomy Procedure: LAP RADICAL NEPHRECTOMY knows preoperative evaluation of renal mass (including imaging results) knows indications for lap nephrectomy knows the AUA guidelines for antibiotic prophylaxis for kidney surgery knows port placement and potential complications including plueral injury etc. knows how to place Handport understand how to place rectactor for kidney surgery, protect bowel vessels and adjacent organs (spleen, liver) knows how to position the patient supine and flank positions including the display of relevant radiologic images right side anterior approach including kocherizing duodenum right side expose IVC left side anatomic relationships including pancreas, spleen, gonadal and adrenal vein with renal vein etc. identifies and ligates ureter identifies and ligates renal vein identifies and ligates renal artery identifies adrenal gland understands hemostatic principles (sealants) and how to repair IVC etc? appropriate choice of suture for port closure

3 can instruct patient about outpatient post-op care

4 lap radical prostatectomy Procedure: LAP RADICAL PROSTATECTOMY knows preoperative evaluation of prostate cancer knows indications for lap prostatectomy knows the AUA guidelines for antibiotic prophylaxis for prostate surgery knows port placement and potential complications understands proper positioning and safe retraction techniques find and expose the posterior compartment (pouch of Douglas) identify Denonvillier's fascia expose endopelvic fascia identify and ligate the dorsal venous complex identify and divide the bladder neck ensure prostatic pedicle control extricate the prostate from rectal bed (check for rectal injury) perform interrupted vesicourethral anastomosis with M knot extract prostate and close umbilical incision appropriate choice of suture for wound closure can instruct patient about outpatient post-op care

5 percutaneous renal surgery Procedure: PCNL knows preoperative evaluation of renal stone (including imaging results) knows indications for pcnl knows the AUA guidelines for antibiotic prophylaxis for kidney surgery knows tract creation and complications including plueral injury etc. understands how to use fluoroscopy safely knows how to position the patient in prone position with proper padding including the display of relevant radiologic images identifies collecting system landmarks understands principles and uses of different lithotriptors understands different types of nephrostomy drains understands hemostatic principles (balloon tamponade) can instruct patient about outpatient post-op care

6 Vaginal Surgery Procedure: urethral sling prolapse repair knows preoperative evaluation of incontinence / prolapse is able to interpret urodynamic data can obtain informed consent and is familiar with reasonable risks is able to select proper technique and select proper product knows how to position the patient knows the AUA guidelines for antibiotic prophylaxis for vaginal surgery knows surgical incisions for vaginal surgery is able to perform hydrodissection of vaginal wall can identify pelvic anatomic landmarks can instruct patient about post-operative care

7 Cystectomy and diversion Resident PGY: Procedure: Cystectomy and diversion Positions the patient supine, SCDs placed, lithotomy if urethrectomy required in male or if patient female. Recognizes layers of anterior abdominal incision and urachus with peritoneal reflections Able to set up bookwalter or similar retractor system and able to pack small bowel to reveal cul de sac/pouch of Douglas Is able to develop space of Retzius Able to incise posterior peritoneum and identify ureters Able to dissect ureters and trace distally to detrusor hiatus Able to incise posterior peritoneum and develop plane between bladder and rectum Able to identify superior vesical pedicles of bladder. Able to identify lateral pedicles of bladder and ligate with either suture ligature or endo-gia vascular stapler device Able to identify limits of standard pelvic lymph node dissection to include obturator, hypogastric, and external iliac nodes. Steps of Competency for Urinary Diversion (Ileal Conduit/Ileal Neobladder) Able to appropriately mark stomal site for ileal conduit Able to identify the terminal ileum and recognize the need for preserving terminal ileum for B12 absorption Able to isolate segment of ileum without devascularizing harvested segment Able to reanastomose side- to side using stapling devices. Able to tunnel left ureter below sigmoid mesentery. Able to spatulate ureter and create a tension free, water-tight, anastomosis Able to pass stent through conduit and kidney atraumatically Able to create a stoma with everted rose bud appearance and tension free Able to form neobladder pouch using harvested segment of bowel as described above Able to identify dependent portion of neobladder and create urethro-intestinal anastomosis Able to properly place suprapubic tube through skin, abdominal wall, and neobladder Able to atraumatically place JP drains without damaging epigastric vessels and securing in place at skin level

8 vasectomy Resident PGY: Procedure: Vasectomy The resident demonstrates: Knowledge of procedure Obtaining appropriate informed consent Perform time out Able to obtain local anesthesia Able to localize the vas Ablility to effectively divide and secure vas Instructs patient appropriately about postoperative course

9 ureteroscopy Procedure: URS knows preoperative evaluation of renal stone (including imaging results) knows indications for urs knows the AUA guidelines for antibiotic prophylaxis for kidney surgery knows ureteral access techniques and complications including perforation understands how to use fluoroscopy safely knows how to position the patient in lithotomy position with proper padding including the display of relevant radiologic images identifies collecting system landmarks understands different properties in guide wire selection understands principles and uses of different lithotriptors understands proper stent selection and positioning can instruct patient about outpatient post-op care

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