WBAMC becomes only laparoscopic surgery test site in region

By Marcy SanchezMarch 1, 2019

William Beaumont Army Medical Center was recently reaccredited as a testing site for The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES)' Fundamentals of Laparoscopic Surgery (FLS), the only medical facility to be designated as such in nearly a 400-mile radius.

The designation allows Graduate Medical Education (GME) residents to complete required courses of study for GME programs at WBAMC, and prepare for assignments elsewhere. Additionally, FLS aims to improve the quality of care for patients undergoing laparoscopic surgery while providing a validated tool to measure fundamental knowledge and skills necessary for laparoscopic surgery.

"The American Board of Surgery requires FLS certification for all graduating general surgery residents, so every graduating resident across the country needs to have FLS certification," said Lt. Col. Eric Ahnfeldt, chief of General Surgery Residency Program at WBAMC. "(Surgeons) can only get certified at an accredited FLS testing center. That accreditation process is pretty rigorous, they make sure the site has the right equipment, very specialized equipment, make sure the proctors are trained to administer the tests and the hands-on portion."

According to SAGES, hands-on testing includes evaluating dexterity and psychomotor skills through simulated laparoscopic manipulation including instrument navigation, coordination, and cutting / knot-tying. A total of five hands-on tasks must be completed within prescribed time limits, and with no errors.

Prior to the designation, general surgeons and residents in the El Paso area wishing to test for FLS would need to travel about 400 miles before reaching the next test center. Thanks to the WBAMC Simulation Center's efforts, not only do WBAMC Graduate Medical Education residents avoid a long trip but, through a memorandum of agreement, other local, non-military medical residents are afforded FLS opportunities at WBAMC as well.

"It's a great turnaround investment," said Ahnfeldt, who also championed FLS accreditation at WBAMC. "We send our residents out every year and they go all over the country (specifically for FLS designation). Now we're able to train them here and are proud to be able to test them here."

"Laparoscopic Surgery has been an evolving technology for many years," said Dr. John Schriver, director of Graduate Medical Education at WBAMC. "The acceptance of minimally invasive surgery began a rapid advancement and technological improvement in the 1990's. Today it has become a standard of care for many procedures and is recognized as a surgical subspecialty."

The minimally invasive surgical technique has spread beyond general surgery to other specialties such as obstetrics and gynecology, becoming a requirement for those residents just last year.

"(FLS) establishes an additional objective measure that all U.S. Surgery Residents and Obstetricians and Gynecologists applying for primary specialty certification must meet," said Schriver. "The goal is to assure residents have an opportunity to learn the fundamentals of laparoscopic surgery in a consistent, scientifically accepted format and to test cognitive, surgical decision-making and technical skills, all with the goal of improving the quality of patient care."

The process for designation consisted of agreements with local health science centers and residency programs, to maximize the value the program will have in the Texas Borderland.

"This is one of those many times that we came together as an institution to make something extraordinary occur," said Thomas Soto, simulation administrator, WBAMC Simulation Center.

According to Schriver, the six-year-long General Surgery Program admits four residents per year, with eight additional residents located in local residency programs. The FLS designation will allow those medical residents the opportunity to test locally, avoiding the time and expense of long travels to other testing sites.

"The FLS is also leading us to great partnerships with local hospitals for residents to use our simulators for their certification," said Ahnfeldt.

The center was also recently recertified as a test center for the Fundamentals of Endoscopic Surgery (FES), by SAGES, another prestigious designation for medical centers.