AAGL has developed NEW educational materials, “Essentials in Minimally Invasive Gynecologic Surgery (EMIGS) Didactic Program” to assist practicing physicians and subspecialty fellows in the performance of basic and advanced endoscopic surgery.
This 12-module EMIGS Didactic program will help you better understand and learn the fundamentals of endoscopic surgery and minimum standards for cognitive and technical principles used in performing endoscopic gynecologic procedures.
AAGL is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
AAGL designates this enduring material for a maximum of 10.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim the credit commensurate with the extent of their participation in the activity.
For immediate access, click the button below to purchase the program. Once you have purchased the program, a confirmation and link will be sent to you to access the program on AAGL’s educational content website.
Current AAGL Members receive this program at substantially discounted rates!
Non-Member Pricing includes one year membership in the AAGL, including access to the JMIG (Journal on Minimally Invasive Gynecology), SurgeryU and the ListServ.
Module 1: General Endoscopic Principles
Faculty: Nicole M. Donnellan, MD, Gaby N. Moawad, MD, Christopher C. DeStephano, MD, MPH, Sarah L Cohen, MD, MPH, Sangeeta Senapati, MD, Matthew Hopkins, MD, Megan N. Wasson, DO
AAGL designates this enduring material for a maximum of .75 AMA PRA Category 1 Credit(s)™. Physicians should only claim the credit commensurate with the extent of their participation in the activity.
Module 1 training highlights
- Diagnosis and Management of Postoperative Complications – Cardiopulmonary
- General Perioperative Management – Preoperative
- Principles of Equipment, Tissue Extraction and Energy Sources – Bleeding, Benign Adnexal Masses and Benign Uterine Conditions
- Hysteroscopic Procedures – Indications/contraindications
- Operative Laparoscopy – Indications/Contraindications
- Neoplasia – Suspected and Unsuspected (ovarian/uterine/cervical-sections)
- Hemodynamically unstable patient
- Appropriateness for laparoscopic surgery
- Appropriateness for hysteroscopic surgery
- Surgical options for adnexal mass
- Evaluation and management of the patient with complex medical history
- Assessing patients with abnormal uterine bleeding – assess risk pre-ablation, pre-hysterectomy or other high-risk characteristics
Module 2: Principles of Applied Anatomy and Physiology
Faculty: Amy N Broach, MD, MS, Jordan Klebanoff, MD, Sangeeta Senapati, MD, Sarah L. Cohen, MD, MPH, Megan N. Wasson, DO
AAGL designates this enduring material for a maximum of .75 AMA PRA Category 1 Credit(s)™. Physicians should only claim the credit commensurate with the extent of their participation in the activity.
Module 2 training highlights:
- Anatomy of the pelvis and abdomen
- Anatomy pertaining to hysteroscopic procedures
- Anatomy pertaining to laparoscopic procedures
- Description of the course of the ureter at different levels
- Description of the pelvic floor support
- Management of an injury to the bladder trigone and consequences of the repair
- Appropriate management of a functional cyst found during laparoscopy
Module 3: Instrumentation
Faculty: Sangeeta Senapati, MD, Sarah L. Cohen, MD, MPH, Hye-Chun Hur, MD, MPH, Christopher C. DeStephano, MD, MPH, Nicole M. Donnellan, MD, Adela Cope, MD, Megan N. Wasson, DO
AAGL designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim the credit commensurate with the extent of their participation in the activity.
Module 3 training highlights:
- Principles of Equipment, Tissue Extraction and Energy Sources
- Operative Laparoscopy – Surgical Technique
- The utility of the angled scope
- Risk factors for thermal injury during laparoscopy
- Optimizing your laparoscopic image
- Improving visualization during hysteroscopy
- Managing the intra-uterine pressure
- Reducing risk of injury when using uterine manipulators
- Characteristics of CO2 that make it ideal for laparoscopic procedures
- Minimizing fluid absorption
- Appropriate pairing of the energy modality and the distention medium
Module 4: Energy Sources
Faculty: Malcom G. Munro, MD, FACOG, FRCSC, Megan N. Wasson, DO
AAGL designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credit(s)™. Physicians should only claim the credit commensurate with the extent of their participation in the activity.
Module 4 training highlights:
- Principles of Equipment and Energy Sources
- Electrosurgical principles including generator output and relative risks
- Electrosurgical tissue effects
- Principles of energy instrumentation
- Factors affecting the quality of the vessel occlusion with a bipolar device
- Potential complications – direct and capacitive coupling
- Principles of ultrasonic technology and clinical applications
Module 5: Operating Room Set Up and Patient Positioning
Faculty: Sarah L. Cohen, MD, MPH, Megan N. Wasson, DO
AAGL designates this enduring material for a maximum of .25 AMA PRA Category 1 Credit(s)™. Physicians should only claim the credit commensurate with the extent of their participation in the activity.
Module 5 training highlights:
- General Perioperative Management – Intraoperative
- Diagnosis and Management of Postoperative Complications – Neurologic
- Identifying errors in patient positioning
- Identifying ergonomic issues and potential risks
Module 6: Principles of Operative Laparoscopy
Faculty: Matthew Hopkins, MD, Nicole M. Donnellan, MD, Amy N. Broach, MD, MS, Sarah L. Cohen, MD, MPH, Sangeeta Senapati, MD, Megan N. Wasson, DO
AAGL designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credit(s)™. Physicians should only claim the credit commensurate with the extent of their participation in the activity.
Module 6 training highlights:
- Principles of Equipment, Tissue Extraction and Energy Sources
- Operative Laparoscopy – Surgical Technique
- Pneumoperitoneum – Troubleshooting
- Assessing safe laparoscopic entry
- Alternate site primary laparoscopic entry
- Risk factors for primary entry complications
- The factors contributing to the need for fascial closure
- Avoiding injury to the vessels and nerves relating to lateral ports
- Landmarks for safe laparoscopic entry with different BMIs
- Alternate primary laparoscopic entry in patient with previous midline laparotomy of primary entry complications
- Safety principles of laparoscopic tissue extraction
- Appropriate needle/suture sele
Module 7: Principles of Operative Hysteroscopy
Faculty: Sarah L. Cohen, MD, MPH, Jordan Klebanoff, MD, Christopher C. DeStephano, MD, MPH, Megan N. Wasson, DO
AAGL designates this enduring material for a maximum of .50 AMA PRA Category 1 Credit(s)™. Physicians should only claim the credit commensurate with the extent of their participation in the activity.
Module 7 training highlights:
- Hysteroscopic Procedures – Surgical Technique and Fluid Management
- Dosing of local anesthetics, techniques and risks
- Agents used for cervical preparation for pre-menopausal women
- Anatomic landmarks for hysteroscopic entry
- Recognizing and managing uterine perforation during hysteroscopy
- Benefits and risks of cervical vasopressin injections
- Distention media with bipolar and monopolar energy
- Safe techniques for using the resectoscope in different regions of the uterus
Module 8: Laparoscopic Procedures
Faculty: Sangeeta Senapati, MD, Jordan Klebanoff, MD, Sarah L. Cohen, MD, MPH, Gaby N. Moawad, MD, Amy N. Broach, MD, MS, Megan N. Wasson, DO
AAGL designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim the credit commensurate with the extent of their participation in the activity.
Module 8 training highlights:
- Acute, Chronic, Benign Adnexal Masses and Benign Uterine Conditions
- Diagnosis and Management of Postoperative Complications – Genitourinary
- Operative Laparoscopy – Procedures
- Hysterectomy – Complications
- Total Laparoscopic (TLH) – Complications
- Laparoscopic-assisted vaginal (LAVH) – Complications
- Vaginal (VH) – Complications
- Neoplasia – Suspected and Unsuspected (ovarian/uterine/cervical-sections)
- Lysis of adhesions – Safety
- Laparoscopic management and follow-up of ectopic pregnancy
- Surgical steps for laparoscopic management of adnexal masses
- Principles of safe laparoscopic oophorectomy – adnexal mass adhering to the pelvic sidewall
- Management options for young women with ovarian torsion
- Complications of myomectomy
- Minimizing the risk of ureteral injury during hysterectomy
- Indications and contraindications to supra-cervical hysterectomy
- Principles to minimize recurrent pain and recurrent cysts in patients with ovarian endometrioma
Module 9: Hysteroscopic Procedures
Faculty: Amy N. Broach, MD, MS, Jordan Klebanoff, MD, Gaby N. Moawad, MD, Sangeeta Senapati, MD, Megan N. Wasson, DO
AAGL designates this enduring material for a maximum of .50 AMA PRA Category 1 Credit(s)™. Physicians should only claim the credit commensurate with the extent of their participation in the activity.
Module 9 training highlights (drop down):
- Principles of Equipment, Tissue Extraction and Energy Sources – Benign Uterine Conditions
- Hysteroscopic Procedures
- Diagnostic options for focal or diffuse pathology
- Endometrial ablation risks that should be discussed the patient
- Management of uterine fibroids
- Appropriate technique for hysteroscopic polypectomy
Module 10: Laparoscopic Complications
Faculty: Gaby N. Moawad, MD, Nicole M. Donnellan, MD, Amy N. Broach, MD, MS, Stacey A. Scheib, MD, FACOG, Sangeeta Senapati, MD, Jordan Klebanoff, MD, Megan N. Wasson, DO
AAGL designates this enduring material for a maximum of 2.25 AMA PRA Category 1 Credit(s)™. Physicians should only claim the credit commensurate with the extent of their participation in the activity.
Module 10 training highlights:
- General Perioperative Management – Intraoperative and Postoperative
- Diagnosis and Management of Postoperative Complications – Hemorrhage, Gastrointestinal, Genitourinary,
- Cardiopulmonary and Neurologic
- Operative Laparoscopy – Complications
- Hysterectomy – Complications
- Total Laparoscopic Hysterectomy (TLH) – Complications
- Laparoscopic-assisted vaginal (LAVH) – Complications
- Vaginal (VH) – Complications
- Managing injury – patient having a cystoscopy and a hysterectomy and only one ureteric jet seen
- Managing injury – entry injury in the retroperitoneum
- Managing injury – secondary port entry injury
- Managing injury – injury to small bowel at entry or during surgery
- Evaluating bowl integrity with severe endometriosis involving the rectum
- Identifying intraoperative or post-operative signs of bladder injury
- Common areas of injury in laparoscopic procedure
- Managing patients who become asystolic/bradycardic during surgery
- Managing patients with a major vascular intraoperative injury
- Management strategy for patient with thermal bowel injury
- Next steps for a patient becoming hemodynamically unstable at entry or during the surgery
- Identification of workup, management and diagnosis of various scenarios
- Identification of risks and preventative measures for port-site hernia
- Identification of vaginal cuff complications from laparoscopic hysterectomy
- Identification of factors that my decrease the chances of vaginal cuff dehiscence
- Identification of the injured nerve in a neurological presentation
Module 11: Hysteroscopic Complications
Faculty: Nicole M. Donnellan, MD, Christopher C. DeStephano, MD, MPH, Gaby N. Moawad, MD, Jordan Klebanoff, MD, Megan N. Wasson, DO
AAGL designates this enduring material for a maximum of .50 AMA PRA Category 1 Credit(s)™. Physicians should only claim the credit commensurate with the extent of their participation in the activity.
Module 11 training highlights (drop down):
- General Perioperative Management – Intraoperative and Postoperative
- Hysteroscopic Procedures – Fluid Management and Complications (intraoperative and postoperative)
- Management for patients with excessive hypotonic solution absorption
- Management of bleeding for patients with significant bleeding during hysteroscopy
- Management strategy for patients with perforation at myomectomy with an active electrode
- Management of patients having a vasovagal or allergic reaction during an office hysteroscopy
- Management of complications of endometrial ablation
Module 12: Special Considerations
Faculty: Nicole M. Donnellan, MD, Christopher C. DeStephano, MD, MPH, Gaby N. Moawad, MD, Jordan Klebanoff, MD, Megan N. Wasson, DO
AAGL designates this enduring material for a maximum of .50 AMA PRA Category 1 Credit(s)™. Physicians should only claim the credit commensurate with the extent of their participation in the activity.
Module 12 training highlights:
- General Perioperative Management – Preoperative and Intraoperative
- Surgical principles for patients with elevated BMI
- Consideration of laparoscopy on pregnant patients
- Consideration of laparoscopy on patients with comorbidities
Special Thanks
Special thanks to Megan Wasson, DO and Isabel Green, MD, Current and Former EMIGS Didactic Chairs, respectively, and the following members of AAGL listed below who have been involved in the educational planning of this activity.
EMIGS Content Planners:
Amy N. Broach, MD, MPH, Sarah L. Cohen, MD, MPH, Adela G. Cope, MD, Christopher C. Destephano, MD, MPH, Nicole M. Donnellan, MD, Isabel C. Green, MD, Matthew R. Hopkins, MD, Hye-Chun Hur, MD, MPH, Jordan Klebanoff, MD, Gaby N. Moawad, MD, Malcolm G. Munro, MD, FACOG, FRCSC, Stacey A. Scheib, MD, FACOG, Sangeeta Senapati, MD, Maria Victoria Vargas, MD, Megan Wasson, DO