FALS Guidelines (Except Proctology)
FALS Guidelines
(Fellowship of Advanced Laparoscopic Surgery)
About FALS Fellowship Course
- This course is to train senior or advanced laparoscopic surgeons and to keep the members abreast with recent advancements in advanced laparoscopic procedures. FALS courses are organized in various sub- specialties such as hernia, bariatric surgery, upper gastrointestinal surgery, colorectal surgery and oncology, HPB and robotic surgery except FALS Proctology.
A. FELLOWSHIP CATEGORY
Eligibility Criteria:
IAGES MEMBERSHIP IS MUST.
- Those who are not members may apply for membership online. See the website www.iages.in for more details
- Members of collaborating associations who have signed MOU with IAGES are also eligible. They are expected to get their application endorsed by the respective collaborating association prior to joining the course.
- FALS courses can be taken under following subspecialty
- Upper GI
- Colo-rectal
- Oncology
- Hernia
- Bariatric surgery
- Robotic Surgery
- HPB
- Non-Examination category
- Surgeons who have been doing laparoscopic surgery in the chosen field for 10 or more years are eligible for Non-Examination Category.
- Candidates should have performed more than 100 laparoscopic surgeries in the chosen subspecialty and need to submit a logbook to substantiate the claim.
- All the candidates will be interviewed by the IAGES board for final assessment before the award of fellowship
- Surgeons who have been doing laparoscopic surgery in the chosen field for 10 or more years are eligible for Non-Examination Category.
- Examination Category
- All surgeons with a minimum of three years experience Post MS /DNB in General Surgery.
- The applicant should have performed over 25 laparoscopic procedures in the chosen specialty either jointly or independently.
- All the candidates would appear for MCQ assessment and Viva by the IAGES FALS board for final assessment during the forthcoming annual national conference before awarding the fellowship
- All surgeons with a minimum of three years experience Post MS /DNB in General Surgery.
B. Non-Fellowship Category
- FALS course is also open to Non-members and all surgical postgraduates and interested surgeons across the globe, under the non-Fellowship category wherein they are eligible to take this course and receive the Certificate of completion of FALS course.
- They could register and participate in the annual national conference as Postgraduates or Non-member category
Logbook
- Age/Sex/Surgery/Role/Post-op course/Complication/Remarks
- Role – Assisted/undersupervision/Independent (as drop down)
- Post-op course – Uneventful / Eventful (as drop down)
- Complications – Infection, Bleeding, Leak, Stricture, Obstruction, Others (type if others) as drop down
Remarks – Type the outcome of the event, if patient has been conservatively managed, Recovered, Diseased, Transferred, etc
FALS UPPER GI FELLOWSHIP COURSE MODULES
| S.no | Topics |
|---|---|
| 1 | The Surgical anatomy of GE Junction & Esophagus – An MIS Perspective |
| 2 | The Functional assessment of the esophagus |
| 3 | Antireflux Surgery for GERD |
| 4 | Surgical Management of Achalasia Cardia |
| 5 | MIS for Paraesophageal Hernia |
| 6 | Revision Surgery following Hellers Myotomy |
| 7 | Approach to Boerhaave Syndrome |
| 8 | MIS for Benign Tracheooesophageal fistula &Esophageal Diverticula |
| 9 | Role of Endoscopy and Endotherapy for Benign Esophageal Dissorders – Achalasia & GERD |
| 10 | MIS for Benign Esophageal Tumour |
| 11 | Perioperative Complications and Management During Functional esophageal Surgery |
| 12 | Current Status on role of revision Surgery Following Fundoplication |
| 13 | Transthoracic Esophagectomy: Step by Step |
| 14 | Robotic Esophagectomy: How do I Perform? |
| 15 | The Role of Transhiatal Esophagectomy in 2020 |
| 16 | Enteral Feeding PEG, MIS Options |
| 17 | Stents in Foregut Disorders |
| 18 | Perioperative Complications and Management during Malignant Oesophageal Surgery |
| 19 | Endo Laparoscopic Resections – GIST |
| 20 | Surgery for Peptic Ulcer Disease (Truncal Vagotomy +GJ, HSV) |
| 21 | MIS For Benign Perforations in Stomach and Duodenum |
| 22 | Gastric Volvulus |
| 23 | MIS Total D2 Gastrectomy |
| 24 | Robotic D2 Gastrectomy |
| 25 | Complicationsfollowing Gastric Surgeries |
| 26 | Diaphragmatic Hernia |
| 27 | MIS for Duodenal NET +. MIS for Duodenal cancer |
| 28 | Panel Discussion on video demonstrations of Bariatric surgery |
| 29 | Panel Discussion on complications of Bariatric surgery |
| 30 | Current management of Portal Hypertension |
| FALS Colo Rectal Fellowship Course Modules | |
| S.No | Topics |
|---|---|
| 1 | Colorectal Anatomy |
| 2 | Role of Colonoscopy for Surgeons |
| 3 | Enhanced Recovery After Surgery (ERAS) in Colorectal Surgery |
| 4 | Pathology Specimen and Role of Pathologist in Colorectal Cancer and its Impact on Outcome |
| 5 | Bowel preparation for colorectal surgery and antibiotic prophylaxisReview of literature |
| 6 | Evidence based management of Haemorrhoids and Evaluation of ODS |
| 7 | VAAFT |
| 8 | Laparoscopic management of complete rectal prolapse |
| 9 | Surgical management of Diverticulitis |
| 10 | Acute Left sided colonic obstruction : Management options |
| 11 | Newer Diagnostic and Therapeutic Approaches for Abdominal Tuberculosis |
| 12 | Prevention and Management of para-stomal hernias |
| 13 | Laparoscopic right hemicolectomy technique |
| 14 | Conventional Versus Minimally Invasive Hartmann Takedown: A Metaanalysis of the Literature. |
| 15 | Role of ICG in assessing LN, Mets and to assess bowel perfusion / anastomosis |
| 16 | Laparoscopic left hemicolectomy techniques- one step at a time – IMV, Splenic flexure and IMA |
| 17 | Lap AR: The Learning Curve! |
| 18 | Laparoscopic Abdominoperineal Resection |
| 19 | Laparoscopic colorectal anastomotic options – Intracorporeal / Extracorporeal / Hand sewn / Side to side/ End to side stapling technique and extraction.? |
| 20 | Transanal Minimally Invasive Surgery (TAMIS) |
| 21 | Roboticsin Colorectal Surgery |
| 22 | How to make an idealstoma and management of stoma |
| 23 | Colonic polyposis syndrome – screening and surgical management |
| 24 | Functional outcomes of sphincter preserving surgeries |
| 25 | Open, Lap, Robotic for Rectal Cancer – Does approach matter? |
| 26 | Imaging in colorectal disease : Anatomy , MRI Assessment for Rectal Cancer – Pre / post NACRT treatment. |
| 27 | Colonic Perforation and Anastomotic Leak |
| 28 | Surgery for ulcerative colitis: Who and when to take the call? How I do it? Video: Laparoscopic restorative proctocolectomy with IPAA |
| 29 | Short vs Long Course RT- Is there still a debate? |
| 30 | Surgeons role in Metastatic Colorectal Cancer & Different options in the treatment of Liver Metastases |
| FALS Oncology Fellowship Course Modules | |
| S.No | Topics |
|---|---|
| 1 | Applied anatomy for thoracic and Lap upper GI Surgery |
| 2 | Case Selection : Who is the Operable Patient |
| 3 | OT Set Up Anesthesia & Port Position in Thoracoscopic Oesophagectomy |
| 4 | Transthoraciac Esophagectomy – Master Video |
| 5 | Other Approaches : Transhiatal Three Field and IVOR Lewis |
| 6 | Complications of Esophagectomy and Gastrectomy> Prevention & Management |
| 7 | Ca Stomach: Case Selection : Who is the Operable Patient |
| 8 | Laparoscopic D2 Gastrectomy – Master Video |
| 9 | Pallitative Procedures in Cancer Stomach |
| 10 | Colorectal Anatomy for the Laparoscopic Surgeon |
| 11 | Evaluation & Case Selection of the Patient for Lap CRC Surgery |
| 12 | Laparoscopic RT Hemicolectomy With CME and CVL : Master Video |
| 13 | Lap APR |
| 14 | Laparoscopic Anterior Resection : Master Video |
| 15 | Special Situations – Colorectal Oncology |
| 16 | Complications of Colorectal Onco Surgery |
| 17 | Is the Time Ripe for MAS Liver Surgery? |
| 18 | Lap Radical Cholecystectomy With Clearance |
| 19 | MAS in Cancer Pancreas- Current Controversies |
| 20 | Laparoscopic Distal Pancreatectomy – Mastervideo Combine With Spleen Preserving |
| 21 | Laparoscopic Whipple Surgery – Mastervideo |
| 22 | Robotic Surgery for Upper GI Cancers |
| 23 | Robotic ISR |
| 24 | Tamis and Tatme Time to Take Notes Again? |
| 25 | Neoadjuvant Therapy – Boon or Bane for the Surgeon? |
| 26 | NACT in HPB |
| 27 | Hipec in GI Onco |
| 28 | Endoscopy in GI Onco More Than Just Diagnosis! ( ESR EMR Stent ) |
| 29 | Interesting Case Capsules in Oncology |
FALS Hernia Fellowship Course Modules
| S.No | Topics |
|---|---|
| Inguinal Hernia & Diaphragmatic Hernia | |
| 1 | History & Evolution of Laparoscopic Hernia Surgery |
| 2 | Endoscopic Anatomy of Inguinal Region |
| 3 | Mesh/Fixators/Sutures & Sealants for Hernia Repair |
| 4 | Laparoscopic Inguinal Hernia Repair- What does the evidence say? |
| 5 | Role of Robotics in Hernia Surgery |
| 6 | Difficult Groin Hernias- Giant, Recurrent, Incarcerated |
| 7 | Complications of Lap Inguinal Hernia Surgery (Except Recurrence) |
| 8 | Chronic Groin Pain – Is It A Myth or Reality? How to Tackle? |
| 9 | Recurrence After Lap Inguinal Hernia- Factors & Solutions |
| 10 | Laparoscopic Management of diaphragmatic – Hernias |
| 11 | Laparoscopic Management of Hiatal Hernia |
| 12 | Laparoscopy in Emergency Hernia Surgery |
| 13 | TAPP- Elucidating the techniques & Key to Success |
| 14 | TEP- Elucidating the techniques & Key to Success |
| 15 | eTEP for Groin hernia |
| Ventral Incisional Hernia | |
| 17 | Abdominal Incision Closure and preventing hernias |
| 18 | Well prepared is half done- Imaging in Hernias |
| 19 | Pneumoperitoneum, Botox |
| 20 | Complications of Laparoscopic Ventral Hernia Repair |
| 21 | e-TEP- RS + TAR |
| 22 | TARM |
| 23 | SCOM, SCOLA, eMILOS |
| 24 | Suprapubic, Epigastric & Sub Costal Hernia Repairs – Problems & solutions |
| 25 | Parastomal Hernia Repair – Tips & Tricks |
| 26 | Lumbar Hernias and denervation bulges |
| 27 | Ventral Hernia Algorithm – Which Procedureis the best in this Patient? |
| 28 | Hernia repair in the morbidly obese |
| 29 | Complex Hernias – Complex Solutions? |
| 30 | Lap. Ventral Hernia Repair (IPOM, IPOM Plus) |
| 31 | Anterior Component Separation – Open & Laparoscopic |
| 32 | Posterior Component Separation. Tips & Tricks |
| Fals Bariatric Surgery Fellowship Course Modules | |
| 1 | History & evolution of bariatric surgery |
| 2 | Setting up of bariatric programme |
| 3 | Bariatric Guidelines – Why they are different for India? |
| 4 | How to prepare the patient for bariatric surgery |
| 5 | Anaesthesia for bariatric surgery – “What is special” |
| 6 | Mechanism(s) of Bariatric surgeries & Outcomes |
| 7 | Evidence Based Procedure Selection – Does an algorithm exists? |
| 8 | Sleeve Gastrectomy – Step by Step “What is going to make it work” |
| 9 | Interesting complications other than leaks in Sleeve & their management-Video based |
| 10 | RyGB – Step by Step of various techniques |
| 11 | Complications of RyGB& their management |
| 12 | OAGB – step by step & technical variations |
| 13 | OAGB Complications & their management |
| 14 | Other Bariatric (non endoscopic) surgeries |
| 15 | Endoscopic weight loss options |
| 16 | Weight regain after bariatric surgery – now what? |
| 17 | Why band a bariatric procedure |
| 18 | Single port/Robotic bariatric surgery – “Where do we stand” |
| 19 | Follow up protocol and nutritional supplementation |
| 20 | Obesity surgery in adolescent & elderly – expectation, safety & outcomes |
| 21 | VTE risk mitigation – assessment & steps |
| 22 | Enhanced recovery after bariatric surgery |
| 23 | Management of ventral hernias in morbidly obese patients |
| 24 | Prediction of Diabetes Remission -“Role of scoring system” |
| 25 | Importance and ways of follow up -“Is it over rated” |
| 26 | Uncommon Complications encountered in bariatric surgery |
| 27 | Safety in bariatric surgery |
| 28 | Hiatus Hernia and Sleeve |
| 29 | Staple line- Reinforcement in Sleeve gastrectomy- options & current status |
| 30 | Conversion of sleeve to “What, When & How” |
| 31 | Sleeve leaks and its Management |
| FALS HPB Fellowship Course Module | |
| Biliary and Vascular surgical anatomy | |
| 1 | Cross-sectional Imaging in Common HPB diseases |
| 2 | Energy sources in HPB surgery |
| 3 | Role of Interventional Radiology in HPB diseases |
| 4 | Diagnostic / Therapeutic EUS in HPB diseases |
| 5 | Robotics in HPB surgery |
| Gallbladder | |
| 6 | Management of Asymptomatic cholelithiasis |
| 7 | Safe Laparoscopic cholecystectomy – step by step |
| 8 | Difficult cholecystectomy – tips and tricks |
| 9 | Cholecystectomy in chronic liver disease |
| 10 | Mirizzi’s syndrome – how I deal with it? |
| 11 | Current trends in the management of carcinoma of gallbladder |
| 12 | Panel Discussion – Unexpected scenarios in Laparoscopic cholecystectomy |
| Bile duct | |
| 13 | Bile-duct Injuries – Classification, Grading and Clinical implications |
| 14 | Laparoscopic CBD exploration |
| 15 | Laparoscopic Choledochal cyst excision and hepaticojejunostomy |
| 16 | Role of Immunofluorescence in Biliary surgery |
| 17 | Role of ERCP in benign CBD strictures |
| 18 | Principles of ERCP and mechanical lithotripsy in management of Choledocholithiasis |
| 19 | Role of Spyglass and laser lithotripsy in Choledocholithiasis |
| Spleen | |
| 20 | Indications and Work-up for Splenectomy |
| 21 | Different surgical approaches in Laparoscopic Splenectomy |
| 22 | Laparoscopic Splenectomy – How I do it? |
| Surgical Anatomy of Liver | |
| 23 | Radiological evaluation of SOL in liver – What a surgeon needs to know? |
| 24 | Histopathology of liver lesions – an overview |
| 25 | Laparoscopic Management of Simple Liver cysts |
| 26 | Hepatic Hydatid cysts – principles of management & laparoscopic excision |
| Liver – 2 | |
| 27 | Laparoscopic Management of Liver abscesses |
| 28 | Chronic Liver disease – Pre-op Optimisation |
| 29 | Principles of anaesthesia in major hepatic resections |
| 30 | Role of Diagnostic Laparoscopy in HPB malignancy |
| 31 | Laparoscopic resection of Colorectal cancer (CRC) liver mets |
| 32 | Laparoscopic liver resections – principles and challenges |
| Pancreas – 1 | |
| 33 | Management of acute pancreatitis – current guidelines |
| 34 | Pancreatic Necrosis – Step-up approach |
| 35 | Endoscopic Management of pancreatic necrosis |
| 36 | Laparoscopic management of infected Walled-off Pancreatic Necrosis (WOPN) |
| 37 | Laparoscopic Spleen – preserving distal pancreatectomy |
| 38 | Laparoscopic management of Chronic Pancreatitis – pancreatic drainage procedures |
| Pancreas – 2 | |
| 39 | Laparoscopic management of pancreatic pseudocyst |
| 40 | Pancreatic cystic neoplasms – an overview |
| 41 | Laparoscopic management of pancreatic cystic neoplasms |
| 42 | Laparoscopic Pancreatico-duodenectomy |
| Live Operating Session | |
| 43 | Laparoscopic difficult cholecystectomy |
| 44 | Laparoscopic liver cyst excision |
| 45 | Laparoscopic CBD exploration |
| 46 | Laparoscopic Subtotal pancreatectomy |
| 47 | Laparoscopic Splenectomy |
| 48 | Laparoscopic Cyst-gastrostomy |
| 49 | Laparoscopic Whipple’s procedure |
| 50 | Laparoscopic Choledochal cyst excision and Hepaticojejunostomy |
| FALS Robotics Fellowship Course Module | |
| S.No | Topics |
|---|---|
| 1 | Essentials in Robotic Surgery |
| 2 | Introduction to various Robotic Systems |
| 3 | Finances in Robotic Surgery |
| 4 | Patient Counselling in RAS |
| 5 | Starting a successful Robotic Surgery Program |
| 6 | Upper GI Session |
| 7 | Hiatus Hernia & Diaphragmatic Hernia |
| 8 | Colo-Rectal Session |
| 9 | Bariatric Surgery Session |
| 10 | Primary Bariatric Surgery |
| 11 | Revision Bariatric Surgery |
| 12 | Cholecystectomy |
| 13 | Hepato-Pancreatico-Biliary Surgery |
| 14 | Splenectomy |
| 15 | Hernia – AWR |
| 16 | Groin Hernia Session – TAPP & ETEP-RS |
| 17 | Ventral Hernia Session – IPOM, TAPP, TARM / TARUP, PETEP, TAPE & ETEP-RS |
| 18 | RoboTAR |
| 19 | Complications in Robotic Surgery |
| 20 | Combined Robotic Surgery |
| 21 | Speciality Robotics: Thoracic, Head – Neck, Urology & Gynecology |
| 22 | Virtual Live Session – Minimally edited Surgeries |
Assessment of FALS fellowship candidates/Exam category
The candidate is expected to know all important facts in Chosen subspecialty in laparoscopic surgery.
➢ Written Paper Timings: 60 minutes
➢ Maximum number of marks: 100
➢ The written paper should have 100 MCQ questions (single best response type).
Practical Examination:
- Interview/assessment for approximately 10 minutes on each candidate. The candidates are divided in to batches and are interviewed by the two or more senior most faculty members of IAGES depending upon the number of candidates. Maximum of 50 marks are allotted for the interview.
- Outcome of written and practical assessment will be prepared by the organizing team and to be signed and to be sent to the President with a copy to Hon Secretary Office and FALS board and results will be published in the IAGES website.
- Successful candidates would be expected to attend the subsequent annual conference and convocation to receive the fellowship certificate. The Fellowship certificate would be posted to the candidate if he /she fails to attend two consecutive annual congress/convocation.
Guidelines about conduct of FALS and selection of faculty:
➢ Topics for lectures have already been finalized and by and large were similar in all the fellowship course held in the past and alteration may be done in forthcoming courses according to the newer developments
➢ The local organizing chairman may bring the changes after discussing with the president, chairman fellowship board and the secretary. The faculty is selected on the basis of their experience and field of interest. Speakers to be selected amongst present and past executive members and other eminent IAGES members
➢ The services of executive committee members both present and past, eminent and senior members can be utilized throughout the fellowship course. They are involved as the speakers, as chairpersons, as faculty in meet the professor session, for performing surgery in work shop, for interviewing the candidates, and for checking the answer sheet.
- Duration of lectures – 20minutes.
- Discussion time – 5 minutes
➢ The speakers are given liberty to prepare the lecture in their own way to cover all the important aspect related to the topic in allotted time. The text should be evidence based, authentic and well documented and should help in enhancement of basic understanding of subject. It is to be delivered expressively with support of excellent slides and video. Since the large number of delegates are new in the field of laparoscopic surgery, the importance to be safe and to prevent complications should be highlighted whenever required.
➢ Speakers and chairpersons have to stick to the timeline. Only one liner introduction of speakers and chair persons will save time for the lecture.
➢ Chairpersons have to ensure that there is no encroachment on other speaker or discussion time and they have to facilitate interaction between speaker and audience and which should be to the point.
➢ All speakers and topic of their lecture should be finalized at least 1 to 2 months in advance by the local organizing committee in consultation and knowledge of the president, chairman-fellow ship board or any consigned officer. Alternative replacement has to be made for any last-minute withdrawal due to unavoidable circumstances.
➢ The Feedback assessment form is given to all the delegates for their comments and suggestions.
➢ Presentation of mementos to be avoided on the stage since lots of time is wasted and time scheduled is disturbed and delayed. It is preferable to place it in the registration bag.