Benign abdominal cystic tumors are rare. They include retroperitoneal, mesenteric, and omental cysts. Most of these lesions present with vague abdominal pain and nausea. Less commonly they will present with bowel obstruction due to external compression. The diagnosis of these tumors is by abdominal ultrasound or computed tomography. Surgical enucleation is the treatment of choice. Laparoscopic surgical techniques are replacing or complimenting open abdominal surgical procedures. As the indications for these techniques increase, newer applications will arise. Presented here is a case of laparoscopic excision of a mesenteric cyst.
The modular laparoscopic skills center is an integral part of any laparoscopic educational program. It facilitates the acquisition and maintenance of laparoscopic skills.
We describe our early experience with two physicians who successfully completed an obstetrics and gynecology physician reentry program. A 10-step program using an individualized curriculum in a supervised preceptorship is tailored to the candidate's anticipated practice. A reentry curriculum is devised for the candidate based on the advances in the field since they left practice and Accreditation Council for Graduate Medical Education (ACGME) competencies for resident education. The program culminates with an oral boards examination conducted by a panel of obstetrician-gynecologists (ob-gyns). At the completion of the program, the candidate must demonstrate that they are conversant with the field of general obstetrics and gynecology. Both candidates had been part of the medical community, which facilitated their ability to complete the program. One candidate was trained and worked intermittently in obstetrics and gynecology in another country. She used cases from her most recent clinical rotation abroad. The other candidate gathered cases from her future partner and prior colleagues. Both candidates successfully completed the program within 3 months and returned to clinical practice. The first physician practiced as a faculty member for 1 year but had challenges assimilating into a busy resident service while balancing her research duties. We need to enhance opportunities for external reentry candidates to have access to preceptors and their patients. In the future, we will better screen candidates to identify those who are planning to return to active clinical practice. We no longer will accept a case log with cases drawn from other sites. We also will incorporate an assessment of each candidate's surgical skill using surgical simulation.
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