New & Revised Course

The London WIPS program is now widely regarded as the World’s premier Surgical Skills Workshop for Vaginal Surgery. Obviously, all Obstetrics and Gynaecology graduates receive basic training in vaginal surgery, sufficient to remove a prolapsing uterus or to do the now obsolete operations of anterior and posterior colporrhaphy. However, such basic training is well short of the skill set needed to remove a large, nondescending uterus or to perform definitive cystocoele and rectocoele repair from below. As intra-abdominal surgery shifted its emphasis from laparotomy to laparoscopy, gynaecologists had to acquire advanced endoscopic skills, over and above what was taught in residency. In a similar vein, mastering difficult vaginal hysterectomy and acquiring the ability to perform vaginal paravaginal repair or vaginal sacrocolpopexy also requires that advanced vaginal skills be learned.

In establishing the WIPS program, we have always emphasized the five key ingredients of skilled reparative surgery. Namely:

  • Complete familiarity with the surgical anatomy of the pelvis including the sidewall.
  • The ability to consistently operate within the relatively bloodless planes, and to effectively manage whatever intra-operative problems that arise.
  • Awareness of the exact location of the pelvic ureter at all times.
  • A sophisticated knowledge of pelvic support anatomy and the patterns of damage that cause pelvic organ prolapse.
  • A fundamental understanding of the host immune response to the various surgical implants now being used on the prolapse repair
  • Unfortunately, biomaterials are regularly being implanted by practitioners who only have a rudimentary understanding of the principles of prosthetic repair.

These surgical skills are taught against a background of site-specific repair. However, the skills are generic and are applicable to any form of pelvic surgery.

Given that the WIPS program is fundamentally a Skills Workshop (rather than an annual scientific update), we have sought to retain the essential elements from year to year. However, the program has evolved, as we modified the Course content in response to constructive criticism from the delegates. The most consistent request has been for more surgical film. This year, we have doubled the surgical film, and will provide every delegate with a 2 hour DVD setting out key elements.

The expanded film sessions come at the cost of reduced discussion of some important theory. To redress this shift in focus, we will mail relevant syllabus material, as pre-reading. New additions to the 2010 program include:

  • Comprehensive discussion of how good quality imaging and urodynamic imaging and urodynamic assessment can materially refine pre-operative decision making.
  • A greater emphasis on the surgical anatomy underlying urinary tract and bowel injuries. There is also a 1 hour breakout session dealing with such complications.
  • A much expanded gallery of mesh morbidity and in depth discussion on how to both avoid and manage mesh morbidity.
  • Brief anatomic films illustrating the anatomic alteration underlying the pathogenesis of anterior and posteroapical prolapse.
  • Detailed explanation (with multiple illustrative surgical films) of the technique for sacrocolpopexy via the transvaginal route.
  • Greatly expanded film sessions to teach vaginal paravaginal repair, including a demonstration of how the Autosuture and Capio push catch devices facilitate placement of the necessary stay sutures.

We also welcome four new faculty members: Professor Peter von Theobald (from the University Hospital of Caen, France), Dr Chris Harmston (a British colorectal surgeon, trained at West Midlands and John Radcliffe Hospitals), Dr Ami Shukla ( a British gynaecologist from Kettering General Hospital, Northamptonshire) and Mr Alistair Duncan (Gynaecologist Oncologist from the Northamptonshire Cancer Centre).

Accreditation

UK Gynaecologists: This course has been carefully designed to ensure that the programme is of great educational value. Please note that you will receive a certificate of attendance at the end of this course. It is your responsibility to assess the educational value of the programme.

Gynaecologists from Other Countries: Application has been made to the American College of Surgeons and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists to have this Workshop accepted as a Category A meeting, whereby eligible Fellows will earn 40 cognate points for Continuing Medical Education.

WIPS reserves the right to change the programme and/or the faculty.