Skip to main content

Military Health System

METC improves surgical tech training with new laparoscopy standard

Image of Surgical team in operating room. Navy Petty Officer 1st Class Wesley Middleton (left) and Navy Petty Officer 2nd Class Domenick Llanda (right), instructors in the Medical Education and Training Campus Surgical Technologist program, conduct a mock laparoscopic procedure while Navy Petty Officer 1st Class Forest Stewart (center), also an instructor, assists the team. (Photo by Lisa Braun, Medical Education and Training Campus Public Affairs.)

Recommended Content:

Health Readiness & Combat Support | Health Readiness & Combat Support | Research and Innovation | Health Care Technology | Education & Training | Medical Education and Training Campus

Army, Navy and Air Force Surgical Technologist (ST) students at the Medical Education and Training Campus (METC) located aboard Joint Base San-Antonio-Fort Sam Houston in Texas are becoming more familiar with laparoscopic procedures thanks to a curriculum update and new laparoscopic equipment that was added to the surgical training simulators.

A laparoscopy is a low-risk, non-invasive surgical procedure used to examine organs inside the abdomen and repair or remove tissue. It requires only small incisions and utilizes an instrument called a laparoscope, a long, thin tube with a high-intensity light and a high-resolution camera at the front. The surgeon inserts the laparoscope through an incision in the abdominal wall and views the images on a video monitor while conducting the procedure.

Laparoscopic surgery was introduced to the METC ST program in May 2020 to familiarize all students with the procedures and equipment as part of the program’s consolidated Phase I, or didactic, training. Army Sgt. 1st Class Merle Nalder, the program director, explained how it was time to move away from the open appendectomy surgery that had been the standard used to evaluate students for roughly 25 years.

“The open appendectomy is not the standard out in the surgical world anymore,” stated Nalder. “More and more they’re going to laparoscopic procedures. Even in the military field environment we’re moving toward laparoscopies. The military medical services all recognized the need to change.”

Nalder explained that all ST students receive blocks of instruction on the minimally invasive laparoscopic surgery. At the culmination of Phase I, students are evaluated on their ability to perform, from start to finish, an exploratory laparotomy, or open belly case, which is a low-fidelity simulated surgery.

Updates were made to convert a simulated general operating room, previously used for mock open appendectomies, into a laparoscopic simulator by adding a laparoscopic tower, which includes a camera and light source, specialized laparoscopic instruments, and reusable devices.

Surgical team in operating room
Navy Petty Officer 1st Class Wesley Middleton (left) removes a "liver" during a mock laparotomy assisted by Navy Petty Officer 2nd Class Domenick Llanda (right).  (Photo by Lisa Braun, Medical Education and Training Campus Public Affairs.)

Also added were sophisticated mannequins which provide more realism to the mock open laparotomy and laparoscopy cases, helping to better prepare the students. The mannequins can support up to 50 different types of laparoscopic procedures and allow for life-like scenarios. “The parts are a little more realistic, the skin feels much more realistic, and they have a blood pump which causes blood to flow throughout the mannequin’s system,” explained Nalder. “The blood fills the cavity very quickly and the flow will then actually rupture a blood vessel or artery, depending on the scenario, lending that realism to the simulation.”

With the blood pump, Nadler said, instructors can simulate different types of situations causing organ damage or distress, whereas in the past they could only simulate one type of procedure with the open appendectomy.

“Our new curriculum requires us to evaluate our students on an open laparotomy, and with these mannequins we can choose which cases we want the students to experience,” stated Nalder. “This gives instructors the latitude to expose students to multiple types of surgeries in comparison to what we had before.”

Nalder said that aspect has changed this portion of the training from a passive to an active type of learning where students are more involved. “I feel that the students appreciate it more and they get more out of it rather than the simple step by step open appendectomy scenario.”

Not only has the standard surgical procedure been updated in the consolidated portion of the training, but the Navy has updated its service-specific training as well.

“We updated the curriculum based on direct feedback from the fleet to ensure the training courses align with fleet requirements,” stated Navy Lt. Cmdr. Rachel Bradshaw, the program’s Navy service lead.

Twenty-one hours of laparoscopic surgery training was added to the Navy-specific curriculum.  The training includes a mock laparoscopic surgery and a didactic test which are not part of the consolidated training.

Navy students may good candidates to receive the additional training because enlisted sailors arrive with prior medical training. “Before they arrive in the Surgical Technologist program, or any enlisted medical program, Navy students have to go through the METC Hospital Corpsman Basic program where they learn basic medical knowledge consisting of pre-hospital, inpatient and outpatient medical care,” Bradshaw explained.

Navy students are taught how to assemble and process complex laparoscopic instruments, recognize thoracic surgery pathologies, and safely prepare for minimal invasive clinical procedures.

According to Bradshaw, the added benefit of implementing the new curriculum is that the students are exposed to laparoscopic surgery prior to entering the clinical portion of the program. “This exposure allows for our students to enter the operating room with some familiarity to laparoscopic procedures, to include the equipment and setup.

“Additionally,” she continued, “adding the laparoscopic curriculum is in line with the Navy Surgeon General's 2020 priorities of optimizing our people, platforms, performance, and power; specifically performance, because we are very much ensuring that we are meeting and exceeding military medical knowledge, skill, and ability standards in order to use data driven decisions to optimize a medically ready force and prepare a ready medical force.” 

You also may be interested in...

Joint Medical Asset Repository (JMAR)

Fact Sheet
8/12/2022

JMAR provides 24/7 access to medical asset information for users, on any computer

Recommended Content:

Medical Logistics | Health Care Technology | Solution Delivery Division

Theater Enterprise-Wide Logistics Systems (TEWLS)

Fact Sheet
8/12/2022

TEWLS consolidates numerous military logistics functions into a single application and database.

Recommended Content:

Health Care Technology | Solution Delivery Division

AHLTA 3.3

Fact Sheet
8/12/2022

AHLTA 3.3, a major component of the military’s electronic health record, is the primary clinical information system used by the military’s medical community to help generate, maintain, store and securely access data for 9.5 million beneficiaries.

Recommended Content:

Health Care Technology | Solution Delivery Division

Military Health System Research Program Notice of Funding Opportunity

Fact Sheet
3/31/2022

This flyer describes the process for applying for and receiving funding by the Military Health System Research Program.

Recommended Content:

Military Health System Research Branch | Research and Innovation

Key Themes Digital Health Ethics

Fact Sheet
11/24/2021

This document outlines key themes and topics for providers applying ethics to the use of digital health technology in clinical practice.

Recommended Content:

Health Care Technology

Digital Health Competency Resource

Fact Sheet
7/23/2021

This reference provides information and links to online tools to aid MHS providers in maintaining competency in using digital health technology in clinical practice.

Recommended Content:

Health Care Technology

Cultural Humility for Providers

Fact Sheet
6/25/2021

This one page tip sheet provides cultural humility tips for MHS care providers.

Recommended Content:

Health Care Technology

Patient Accessible Notes Support Tool

Fact Sheet
5/26/2021

Clinical support tool to aid MHS providers in developing clinical notes that are understandable by patients.

Recommended Content:

Health Care Technology

Tactical Combat Casualty Care All Service Member Master Trainer Course FAQs

Fact Sheet
4/7/2021

Additional information about the TCCC ASM CM course for potential students to review.

Recommended Content:

Health Readiness & Combat Support | Defense Medical Readiness Training Institute | DMRTI Course Information | Tactical Combat Casualty Care Course (TCCC)

Key Themes in Digital Ethics

Fact Sheet
2/16/2021

This fact sheet provides an overview of key themes in ethics related to the use of digital health in clinical practice.

Recommended Content:

Health Care Technology | Mobile Apps

Mobile Health Device Privacy and Security

Fact Sheet
2/16/2021

Tips and techniques for maintaining privacy and security of health information stored on mobile devices.

Recommended Content:

Health Care Technology | Mobile Apps

Solution Delivery Division

Fact Sheet
1/21/2021

The mission of Solution Delivery Division (SDD) is enhancing Health Service Delivery through exceptional Information and Technology.

Recommended Content:

Health Care Technology

DMRTI_EWSC Student Criteria

Fact Sheet
1/8/2021

A reference for potential EWSC students.

Recommended Content:

Emergency War Surgery Course (EWSC) | Defense Medical Readiness Training Institute | Health Readiness & Combat Support

TRICARE Online Patient Portal

Fact Sheet
12/21/2020

TRICARE Online Patient Portal (TOL) is the Department of Defense (DOD) online patient portal providing eligible beneficiaries access to military hospital and clinic appointing, prescription (Rx) refill, DOD PP Health Record personal health data, Secure Messaging, Service Separation/Retirement and Nurse Advice Line.

Recommended Content:

Health Care Technology

Essentris®

Fact Sheet
10/26/2020

The military’s inpatient electronic health record is used in acute hospital environments, providing point-of-care data capture at the patient’s bedside for physiological devices, fetal/uterine devices, ventilators and other patient care machines.

Recommended Content:

Health Care Technology | Solution Delivery Division
<< < 1 2 3 > >> 
Showing results 1 - 15 Page 1 of 3
Refine your search
Last Updated: July 20, 2022
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on Twitter Follow us on YouTube Sign up on GovDelivery