- Email: [email protected]
1216 Novel Laparoscopic Simulation Platform
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Abstracts / Journal of Minimally Invasive Gynecology 26 (2019) S98−S231
Interventions: All patients were diagnosed as CSD by TVS and/or MRI. Measurements and Main Results: The potential risk factors for CSD were investigated with multivariable logistic regression analysis. The TVS and MRI were performed for CSD measurements, including residual myometrium thickness, depth, length and width of CSD. The association between CSD size through TVS/MRI and symptoms were evaluated respectively. The operation time of CS ≥85min, peripartum fever or infection, retroflexed uterine were risk factors for CSD. And age at time of last CS < 30 years old, intraoperative blood loss <150ml, double-layer closure were protective factors for CSD. Prolonged menstruation, dysmenorrhea, chronic pelvic pain and infertility are main clinical manifestation. Women with larger size of CSD presented with more prolonged menstruation. Compared with TVS, measurements by MRI shows a better prediction of clinical symptoms of CSD. Conclusion: Multi-factors contribute to development of CSD. Prevention of peripartum infection, shortening operation time, reducing blood loos and a more careful uterine closure are needed to decrease the risk of developing CSD. MRI is a reliable method for diagnosis and measurement of CSD and can be utilized in clinical practice.
Study Objective: To compare uterine weights (UW) and surgical outcomes for all routes of hysterectomies completed by generalist Ob-Gyns, minimally-invasive gynecologic surgeons (MIGS), and urogynecologists (Urogyn). Design: Retrospective descriptive study. Setting: A tertiary urban academic teaching hospital. Patients or Participants: All patients receiving a hysterectomy from May 2015 to April 2019 as recorded in a single-institution REDCap database. Interventions: N/A Measurements and Main Results: Over a four-year period, 1177 hysterectomies, including total and supracervical hysterectomies, were performed and entered into a database. Routes of surgery: (1) laparotomy (n=222, 18.9%), (2) total laparoscopic (TLH) (n=274, 23.3%), (3) roboticassisted (raTLH) (n=529, 44.9%), (4) vaginal (TVH) (n=148, 12.6%), and (5) laparoscopic-assisted vaginal (LAVH) (n=4, 0.3%). Majority of hysterectomies (n=905, 81.1%) were minimally invasive. Additional prolapse and/or incontinence procedures were performed by Urogyn. Average UW were: 1142.5g for laparotomy, 237.0g for TLH, 458.2g for raTLH, 127.9g for TVH, and 332.3g for LAVH. In all routes, MIGS had the highest average UW (562.5g), followed by generalists (397.8g), then Urogyn (87.5g). Average UW and BMI overall were 493.8g and 29.0. Complication rates (inclusive of 21 extensive variables both minor and major) and average EBL were: 15.3%, and 553.5mL for laparotomy, 4.4% and 141.3mL for TLH, 6.4% and 149.4mL for raTLH, 5.4% and 211.2mL for TVH, and 0% and 332.3mL for LAVH. Overall complication rate of 7.5% (n=1177). Length of surgery (LOS) is comparable in all routes (3:09 with laparotomy, 3:04 with TLH, 3:44 with raTLH, 3:29 for TVH, 3:22 for LAVH). Conclusion: Within a single urban academic center, hysterectomies were performed by a wide-range of providers with various trends observed. MIGS performed all routes of hysterectomy more frequently and with greater UW. Urogyn performed more vaginal procedures. With a high average departmental UW (>450g), a laparoscopic or robotic-assisted approach is a safe and appropriate option. EBL and LOS are proportionally lower with MIGS when accounting for increased average UW.
Virtual Poster Session 2: Basic Science/Research/Education (1:30 PM − 1:40 PM) 1:30 PM: STATION R 2198 New Laparoscopic Entry Port for Previous Surgery Cases: Jain Point Jain DN*. Obs. & Gynae, Vardhman Trauma and Laparoscopy Centre Pvt.Ltd, Muzaffarnagar, India *Corresponding author. Study Objective: Laparoscopy in previous surgery cases is a challenge due to risk of encountering adhesions during the first blind trocar entry. This study demonstrates the technique, and relative benefits of a new entry point. Design: It is a retrospective study undertaken at a high volume tertiary care referral center for advanced gynecological laparoscopic surgery. Setting: Tertiary Care Centre Patients or Participants: The total number of patients from January 2011 to March 2019. Total 6830 laparoscopic cases were done between January 2011 to March 2019. In 1948 patients there was a history of previous abdominal surgeries. Interventions: Working over the years we found that post surgical adhesions are encountered usually in the midline or right side. The left side is spared as the colon adheres at the pelvic brim and stomach and spleen lie higher up at T 10 level. So we developed a point which is at L4 level and on the left side. It is at the level of umbilicus on a straight line drawn vertically upwards from a point 2.5 cm medial to the anterior superior iliac spine. We first introduce the veress needle perpendicular to the abdomen and then the 5mm telescope from this point, and optimize the 10 mm telescope entry. Jain Point port doubles up as the main working port in due course of surgery. Measurements and Main Results: All of the 6830 cases were entered by the Jain Point in an identical manner. Out of these 1948 case were of previous one or multiple surgeries. Conclusion: Jain Point offers an alternate safe entry point in previous surgery cases, applicable to upper, mid and lower abdominal scars. Virtual Poster Session 2: Basic Science/Research/Education (1:30 PM − 1:40 PM) 1:30 PM: STATION S 2681 Impact of Surgical Specialization on Size of Uterus and Subsequent Route of Hysterectomy Arora C,* Han ES, Kim J.H.J, Advincula AP. Obstetrics and Gynecology, Columbia University Medical Center, New York, NY *Corresponding author.
Virtual Poster Session 2: Basic Science/Research/Education (1:30 PM − 1:40 PM) 1:30 PM: STATION T 1216 Novel Laparoscopic Simulation Platform Ulrich AP,1,* Cho M,1 Lerner V2. 1OB/GYN (Minimally Invasive Gynecologic Surgery), Montefiore Hospital/Albert Einstein College of Medicine, Bronx, NY; 2OBGYN, Montefiore Medical Center Albert Einstein College of Medicine, Bronx, NY *Corresponding author. Video Objective: With the requirement for the Fundamentals of Laparoscopic Surgery certification amongst graduating OBGYN residents there has been increased interest in utilization of simulation to practice and improve laparoscopic skills. Currently FLS box trainers for practice and testing of FLS manual skills tasks are being sold. We aimed to create a low-cost, easy-to-make, and versatile laparoscopic training platform and studied its usability at our institution. Setting: Academic Hospital, OBGYN Residency program Interventions: A rectangular piece of sheet wood was used as a platform and a blueprint based on the official FLS box trainer dimensions was created with corresponding placement of ports and the camera on the board. A drill is used to create holes for the metal pegs with eyehooks that function as ports. Velcro is applied to the board to provide stability for FLS inserts. This model can be used for any laparoscopic set up including models for hysterectomy or colpotomy. Open design of the model allows for complex task breakdown to allow learners to master skills. Total cost of one model was $15-25 per platform and took 30 minutes to build. Conclusion: A usability and acceptability survey was administered to a convenient sample of faculty and trainees. Trainees and faculty responded favorably to the model. 70% (7/10) residents and 86% (6/7) of attendings
Abstracts / Journal of Minimally Invasive Gynecology 26 (2019) S98−S231
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agreed the platform was easy to use. 100% (10/10) of residents and attendings (6/6) agreed the laparoscopic platform is useful for improving and practicing laparoscopic skills. 100% of attendings felt that the laparoscopic platform is useful for assessing the learners ability to perform laparoscopic skills prior to live surgery. 88% (8/9) of residents/fellows and 86% (6/7) of attendings felt that it closely simulated the feel of performing laparoscopy in live surgery. Novel laparoscopic platform model is an innovative low-cost teaching tool to add to the gynecologic surgical education armamentarium.
accelerates proficiency by correlating laparoscopic/robotic experience with simulator skills acquisition Design: Prospective cohort study Setting: Urban academic center with active COEMIG designation Patients or Participants: 2017-2018 Gynecology residents(PGY1-4) Interventions: Voluntary participants were instructed to complete 10 repetitions of 5 exercises (pegboard-1, energy dissection-1, energy switching1, ring&rail-2, tubes) on the dV-TrainerÒ robotic simulator. After a 4month hiatus, residents were asked to repeat the protocol. Residents were surveyed regarding prior surgical experience and perceptions regarding simulation utility. Measurements and Main Results: 25 of 28(89%) residents participated. Performance was captured using M-scoresÒ (aggregate quality, efficiency, risk, and safety measure). With all exercises, M-scoresÒ increased with repetitions among all levels (mean§SD 58.9§19.1 repetition 1 versus 82.0§13.6 repetition 10, p<0.001); however, after one round, many trainees failed to attain the pre-determined passing score of 80%. Across all participants, mean scores by exercise were 82.5§15.6, 78.0§15.8, 72.6§ 17.9, 62.7§19.4, 60.1§22.1 (p<0.001). Neither PGY level nor prior surgical experience correlated with higher scores: repetition-1 scores were 61§ 12.8, 54.0§11.2, 59.4 §19.7, and 59.8§10.6 for PGY-1 through -4 participants, p=0.51; repetition-10 scores were 80§3.9, 82§9.3, 86.5§9.3, and 84.9§9.0, p=0.79, respectively. Self-reported prior surgical experience reflected graduated responsibility: only PGY-4 participants reported console exposure, with most describing 1-5 cases performed. Retention of skills at 4 months negatively correlated with difficulty, suggesting challenging skills require more repetitions to master. Poor compliance hindered data interpretation. The majority of trainees believed simulation is valuable. Conclusion: Robotic simulation may be useful for development/maintenance of robotic skills in Gynecology trainees. M-scoreÒ may be insufficiently sensitive; additional metrics should be explored. Robotic simulation is valued by trainees, however, not a milestone established by the ACGME. Protected time with incorporation into curricula would be needed to maximize utility.
Virtual Poster Session 2: Basic Science/Research/Education (1:40 PM − 1:50 PM) 1:40 PM: STATION A 3005 Resident Versus Program Director Opinions on the Fundamentals of Laparoscopic Surgery Exam Requirement To JK,* Zong W. OB/GYN, Flushing Hospital Medical Center, Flushing, NY *Corresponding author. Study Objective: To determine opinions of both residents and program directors regarding the new American Board of Obstetrics and Gynecology Fundamentals of Laparoscopic Surgery (FLS) exam requirement Design: Survey Setting: Nation-wide Patients or Participants: All OB/GYN residents and program directors (PD’s) in the United States Interventions: Nation-wide survey Measurements and Main Results: 91 residents completed the survey while 27 program directors completed it. 71% of residents felt that they never used their simulation lab while 59% of PD’s thought that residents used it 1-2 times a week. Of answers that scored the highest, 49% of residents felt that the main obstacle to simulation training was their resident work, while 31% of PD’s felt that it was due to resident initiative. 75.4% of residents agreed with FLS requirement, whereas only 44.4% of PD’s agreed. The majority of both residents and PD’s agreed that the programs should pay for the test. Additionally, both residents and PD’s equally felt that residents would be adequately prepared without additional resources (64.9% and 59.3% respectively). Conclusion: Understanding both resident and PD viewpoints may be helpful in developing FLS residency curriculums. Virtual Poster Session 2: Basic Science/Research/Education (1:40 PM − 1:50 PM) 1:40 PM: STATION B 2519 Training, Education for Robotic Performance with Simulation (Terps): A Valuable Tool For Gynecologic Surgeons In Training Helou CM,1,* Seal PM,2 Sanses TV,3 Morozov VV,4 Roque DM5. 1 Minimally Invasive Gynecology, Vanderbilt University Medical Center, Nashville, TN; 2General Obstetrics and Gynecology, Palmetto Health University of South Carolina School of Medicine, Columbia, SC; 3Female Pelvic Medicine & Reconstructive Surgery Urogynecology, Howard University School of Medicine, Washington, DC; 4Minimally Invasive Gynecologic Surgery, Medstar Washington Hospital Center, Georgetown University Washington District of Colombia, Washington, DC; 5Division of Gynecologic Oncology, University of Maryland School of Medicine, Baltimore, MD *Corresponding author. Study Objective: To evaluate the role of robotic simulation in training OBGYN residents by determining an optimal number of exercise repetitions prior to clinical debut; To assess whether clinical exposure
Virtual Poster Session 2: Basic Science/Research/Education (1:40 PM − 1:50 PM) 1:40 PM: STATION C 1866 The Role of Microrna-424/503-Wee1 Axis in Ovarian Cancer Stem Like Cells Na YJ,1,* Lee HJ,2 Yoon HJ,2 Kwon BS2. 1Department of Obstetrics and Gynecology, Pusan National University School of Medicine, Busan, Korea, Republic of (South); 2Department of Obstetrics and Gynecology, Pusan National University School of Medicine, and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea, Republic of (South) *Corresponding author. Study Objective: We investigated the role of miR-424/503-WEE1 axis in ovarian cancer and its potential utility as a therapeutic target. Design: To determine whether miR 424/503-WEE1 axis is associated with the generation of CSCs, we up/down-regulated miR 424/503-WEE1 axis in ovarian cancer sphere cells. Setting: This study was performed in Pusan National University Hospital, Busan, Korea Patients or Participants: The human epithelial ovarian cancer cell lines OVCAR3, SKOV3, and OVCAR429 were obtained from the Korean Cell Line Bank. Ovarian cancer cells were maintained in MEM (Life Technologies, Inc., Grand Island, NY, USA) supplemented with 10% fetal bovine serum and 100 mg/ml streptomycin in a humidified 5% CO2 incubator. Interventions: In order to assess spheroid formation, approximately 5 £ 103 cells were suspended in 10 mL of serum-free DMEM-F12,
Abstracts / Journal of Minimally Invasive Gynecology 26 (2019) S98−S231
Interventions: All patients were diagnosed as CSD by TVS and/or MRI. Measurements and Main Results: The potential risk factors for CSD were investigated with multivariable logistic regression analysis. The TVS and MRI were performed for CSD measurements, including residual myometrium thickness, depth, length and width of CSD. The association between CSD size through TVS/MRI and symptoms were evaluated respectively. The operation time of CS ≥85min, peripartum fever or infection, retroflexed uterine were risk factors for CSD. And age at time of last CS < 30 years old, intraoperative blood loss <150ml, double-layer closure were protective factors for CSD. Prolonged menstruation, dysmenorrhea, chronic pelvic pain and infertility are main clinical manifestation. Women with larger size of CSD presented with more prolonged menstruation. Compared with TVS, measurements by MRI shows a better prediction of clinical symptoms of CSD. Conclusion: Multi-factors contribute to development of CSD. Prevention of peripartum infection, shortening operation time, reducing blood loos and a more careful uterine closure are needed to decrease the risk of developing CSD. MRI is a reliable method for diagnosis and measurement of CSD and can be utilized in clinical practice.
Study Objective: To compare uterine weights (UW) and surgical outcomes for all routes of hysterectomies completed by generalist Ob-Gyns, minimally-invasive gynecologic surgeons (MIGS), and urogynecologists (Urogyn). Design: Retrospective descriptive study. Setting: A tertiary urban academic teaching hospital. Patients or Participants: All patients receiving a hysterectomy from May 2015 to April 2019 as recorded in a single-institution REDCap database. Interventions: N/A Measurements and Main Results: Over a four-year period, 1177 hysterectomies, including total and supracervical hysterectomies, were performed and entered into a database. Routes of surgery: (1) laparotomy (n=222, 18.9%), (2) total laparoscopic (TLH) (n=274, 23.3%), (3) roboticassisted (raTLH) (n=529, 44.9%), (4) vaginal (TVH) (n=148, 12.6%), and (5) laparoscopic-assisted vaginal (LAVH) (n=4, 0.3%). Majority of hysterectomies (n=905, 81.1%) were minimally invasive. Additional prolapse and/or incontinence procedures were performed by Urogyn. Average UW were: 1142.5g for laparotomy, 237.0g for TLH, 458.2g for raTLH, 127.9g for TVH, and 332.3g for LAVH. In all routes, MIGS had the highest average UW (562.5g), followed by generalists (397.8g), then Urogyn (87.5g). Average UW and BMI overall were 493.8g and 29.0. Complication rates (inclusive of 21 extensive variables both minor and major) and average EBL were: 15.3%, and 553.5mL for laparotomy, 4.4% and 141.3mL for TLH, 6.4% and 149.4mL for raTLH, 5.4% and 211.2mL for TVH, and 0% and 332.3mL for LAVH. Overall complication rate of 7.5% (n=1177). Length of surgery (LOS) is comparable in all routes (3:09 with laparotomy, 3:04 with TLH, 3:44 with raTLH, 3:29 for TVH, 3:22 for LAVH). Conclusion: Within a single urban academic center, hysterectomies were performed by a wide-range of providers with various trends observed. MIGS performed all routes of hysterectomy more frequently and with greater UW. Urogyn performed more vaginal procedures. With a high average departmental UW (>450g), a laparoscopic or robotic-assisted approach is a safe and appropriate option. EBL and LOS are proportionally lower with MIGS when accounting for increased average UW.
Virtual Poster Session 2: Basic Science/Research/Education (1:30 PM − 1:40 PM) 1:30 PM: STATION R 2198 New Laparoscopic Entry Port for Previous Surgery Cases: Jain Point Jain DN*. Obs. & Gynae, Vardhman Trauma and Laparoscopy Centre Pvt.Ltd, Muzaffarnagar, India *Corresponding author. Study Objective: Laparoscopy in previous surgery cases is a challenge due to risk of encountering adhesions during the first blind trocar entry. This study demonstrates the technique, and relative benefits of a new entry point. Design: It is a retrospective study undertaken at a high volume tertiary care referral center for advanced gynecological laparoscopic surgery. Setting: Tertiary Care Centre Patients or Participants: The total number of patients from January 2011 to March 2019. Total 6830 laparoscopic cases were done between January 2011 to March 2019. In 1948 patients there was a history of previous abdominal surgeries. Interventions: Working over the years we found that post surgical adhesions are encountered usually in the midline or right side. The left side is spared as the colon adheres at the pelvic brim and stomach and spleen lie higher up at T 10 level. So we developed a point which is at L4 level and on the left side. It is at the level of umbilicus on a straight line drawn vertically upwards from a point 2.5 cm medial to the anterior superior iliac spine. We first introduce the veress needle perpendicular to the abdomen and then the 5mm telescope from this point, and optimize the 10 mm telescope entry. Jain Point port doubles up as the main working port in due course of surgery. Measurements and Main Results: All of the 6830 cases were entered by the Jain Point in an identical manner. Out of these 1948 case were of previous one or multiple surgeries. Conclusion: Jain Point offers an alternate safe entry point in previous surgery cases, applicable to upper, mid and lower abdominal scars. Virtual Poster Session 2: Basic Science/Research/Education (1:30 PM − 1:40 PM) 1:30 PM: STATION S 2681 Impact of Surgical Specialization on Size of Uterus and Subsequent Route of Hysterectomy Arora C,* Han ES, Kim J.H.J, Advincula AP. Obstetrics and Gynecology, Columbia University Medical Center, New York, NY *Corresponding author.
Virtual Poster Session 2: Basic Science/Research/Education (1:30 PM − 1:40 PM) 1:30 PM: STATION T 1216 Novel Laparoscopic Simulation Platform Ulrich AP,1,* Cho M,1 Lerner V2. 1OB/GYN (Minimally Invasive Gynecologic Surgery), Montefiore Hospital/Albert Einstein College of Medicine, Bronx, NY; 2OBGYN, Montefiore Medical Center Albert Einstein College of Medicine, Bronx, NY *Corresponding author. Video Objective: With the requirement for the Fundamentals of Laparoscopic Surgery certification amongst graduating OBGYN residents there has been increased interest in utilization of simulation to practice and improve laparoscopic skills. Currently FLS box trainers for practice and testing of FLS manual skills tasks are being sold. We aimed to create a low-cost, easy-to-make, and versatile laparoscopic training platform and studied its usability at our institution. Setting: Academic Hospital, OBGYN Residency program Interventions: A rectangular piece of sheet wood was used as a platform and a blueprint based on the official FLS box trainer dimensions was created with corresponding placement of ports and the camera on the board. A drill is used to create holes for the metal pegs with eyehooks that function as ports. Velcro is applied to the board to provide stability for FLS inserts. This model can be used for any laparoscopic set up including models for hysterectomy or colpotomy. Open design of the model allows for complex task breakdown to allow learners to master skills. Total cost of one model was $15-25 per platform and took 30 minutes to build. Conclusion: A usability and acceptability survey was administered to a convenient sample of faculty and trainees. Trainees and faculty responded favorably to the model. 70% (7/10) residents and 86% (6/7) of attendings
Abstracts / Journal of Minimally Invasive Gynecology 26 (2019) S98−S231
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agreed the platform was easy to use. 100% (10/10) of residents and attendings (6/6) agreed the laparoscopic platform is useful for improving and practicing laparoscopic skills. 100% of attendings felt that the laparoscopic platform is useful for assessing the learners ability to perform laparoscopic skills prior to live surgery. 88% (8/9) of residents/fellows and 86% (6/7) of attendings felt that it closely simulated the feel of performing laparoscopy in live surgery. Novel laparoscopic platform model is an innovative low-cost teaching tool to add to the gynecologic surgical education armamentarium.
accelerates proficiency by correlating laparoscopic/robotic experience with simulator skills acquisition Design: Prospective cohort study Setting: Urban academic center with active COEMIG designation Patients or Participants: 2017-2018 Gynecology residents(PGY1-4) Interventions: Voluntary participants were instructed to complete 10 repetitions of 5 exercises (pegboard-1, energy dissection-1, energy switching1, ring&rail-2, tubes) on the dV-TrainerÒ robotic simulator. After a 4month hiatus, residents were asked to repeat the protocol. Residents were surveyed regarding prior surgical experience and perceptions regarding simulation utility. Measurements and Main Results: 25 of 28(89%) residents participated. Performance was captured using M-scoresÒ (aggregate quality, efficiency, risk, and safety measure). With all exercises, M-scoresÒ increased with repetitions among all levels (mean§SD 58.9§19.1 repetition 1 versus 82.0§13.6 repetition 10, p<0.001); however, after one round, many trainees failed to attain the pre-determined passing score of 80%. Across all participants, mean scores by exercise were 82.5§15.6, 78.0§15.8, 72.6§ 17.9, 62.7§19.4, 60.1§22.1 (p<0.001). Neither PGY level nor prior surgical experience correlated with higher scores: repetition-1 scores were 61§ 12.8, 54.0§11.2, 59.4 §19.7, and 59.8§10.6 for PGY-1 through -4 participants, p=0.51; repetition-10 scores were 80§3.9, 82§9.3, 86.5§9.3, and 84.9§9.0, p=0.79, respectively. Self-reported prior surgical experience reflected graduated responsibility: only PGY-4 participants reported console exposure, with most describing 1-5 cases performed. Retention of skills at 4 months negatively correlated with difficulty, suggesting challenging skills require more repetitions to master. Poor compliance hindered data interpretation. The majority of trainees believed simulation is valuable. Conclusion: Robotic simulation may be useful for development/maintenance of robotic skills in Gynecology trainees. M-scoreÒ may be insufficiently sensitive; additional metrics should be explored. Robotic simulation is valued by trainees, however, not a milestone established by the ACGME. Protected time with incorporation into curricula would be needed to maximize utility.
Virtual Poster Session 2: Basic Science/Research/Education (1:40 PM − 1:50 PM) 1:40 PM: STATION A 3005 Resident Versus Program Director Opinions on the Fundamentals of Laparoscopic Surgery Exam Requirement To JK,* Zong W. OB/GYN, Flushing Hospital Medical Center, Flushing, NY *Corresponding author. Study Objective: To determine opinions of both residents and program directors regarding the new American Board of Obstetrics and Gynecology Fundamentals of Laparoscopic Surgery (FLS) exam requirement Design: Survey Setting: Nation-wide Patients or Participants: All OB/GYN residents and program directors (PD’s) in the United States Interventions: Nation-wide survey Measurements and Main Results: 91 residents completed the survey while 27 program directors completed it. 71% of residents felt that they never used their simulation lab while 59% of PD’s thought that residents used it 1-2 times a week. Of answers that scored the highest, 49% of residents felt that the main obstacle to simulation training was their resident work, while 31% of PD’s felt that it was due to resident initiative. 75.4% of residents agreed with FLS requirement, whereas only 44.4% of PD’s agreed. The majority of both residents and PD’s agreed that the programs should pay for the test. Additionally, both residents and PD’s equally felt that residents would be adequately prepared without additional resources (64.9% and 59.3% respectively). Conclusion: Understanding both resident and PD viewpoints may be helpful in developing FLS residency curriculums. Virtual Poster Session 2: Basic Science/Research/Education (1:40 PM − 1:50 PM) 1:40 PM: STATION B 2519 Training, Education for Robotic Performance with Simulation (Terps): A Valuable Tool For Gynecologic Surgeons In Training Helou CM,1,* Seal PM,2 Sanses TV,3 Morozov VV,4 Roque DM5. 1 Minimally Invasive Gynecology, Vanderbilt University Medical Center, Nashville, TN; 2General Obstetrics and Gynecology, Palmetto Health University of South Carolina School of Medicine, Columbia, SC; 3Female Pelvic Medicine & Reconstructive Surgery Urogynecology, Howard University School of Medicine, Washington, DC; 4Minimally Invasive Gynecologic Surgery, Medstar Washington Hospital Center, Georgetown University Washington District of Colombia, Washington, DC; 5Division of Gynecologic Oncology, University of Maryland School of Medicine, Baltimore, MD *Corresponding author. Study Objective: To evaluate the role of robotic simulation in training OBGYN residents by determining an optimal number of exercise repetitions prior to clinical debut; To assess whether clinical exposure
Virtual Poster Session 2: Basic Science/Research/Education (1:40 PM − 1:50 PM) 1:40 PM: STATION C 1866 The Role of Microrna-424/503-Wee1 Axis in Ovarian Cancer Stem Like Cells Na YJ,1,* Lee HJ,2 Yoon HJ,2 Kwon BS2. 1Department of Obstetrics and Gynecology, Pusan National University School of Medicine, Busan, Korea, Republic of (South); 2Department of Obstetrics and Gynecology, Pusan National University School of Medicine, and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea, Republic of (South) *Corresponding author. Study Objective: We investigated the role of miR-424/503-WEE1 axis in ovarian cancer and its potential utility as a therapeutic target. Design: To determine whether miR 424/503-WEE1 axis is associated with the generation of CSCs, we up/down-regulated miR 424/503-WEE1 axis in ovarian cancer sphere cells. Setting: This study was performed in Pusan National University Hospital, Busan, Korea Patients or Participants: The human epithelial ovarian cancer cell lines OVCAR3, SKOV3, and OVCAR429 were obtained from the Korean Cell Line Bank. Ovarian cancer cells were maintained in MEM (Life Technologies, Inc., Grand Island, NY, USA) supplemented with 10% fetal bovine serum and 100 mg/ml streptomycin in a humidified 5% CO2 incubator. Interventions: In order to assess spheroid formation, approximately 5 £ 103 cells were suspended in 10 mL of serum-free DMEM-F12,