da Vinci Application form - Urology · competence in urologic robotic surgery including discussing...

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Transcript of da Vinci Application form - Urology · competence in urologic robotic surgery including discussing...

Mr

ApplicationForm

ROBOTICUROLOGYCADAVERICCOURSE22-23May2018TheUrologyFoundationCentreofRoboticTrainingNewcastleSurgicalTrainingCentreFreemanHospital,NewcastleUponTyne

NewcastleSurgicalTrainingCentredeliversover170advancedtrainingcoursesfromregional,nationalandinternationalsurgeonsrepresentingmultispecialties.Collaborationwithnationalandinternationalfacultydrivesagreaterunderstandingofsurgicaltechniquesdeliveringimprovedpatientcare.www.nstcsurg.org

Thiscourseisdesignedforsurgeons,urologists,andmulti-disciplinaryteamstogainsystemknowledgeanddevelopaworkingunderstandingofthedaVinci

andlearntechnicalskillsusefulintheoperatingtheatre.Thedesiredresultfromthiseventisthatthelearnerincreasesorenhanceshisknowledgeandcompetenceinurologicroboticsurgeryincludingdiscussingthesurgical

techniqueforsafeandeffectiveroboticsurgery,indicationsandcontraindications,andmethodstomanagecomplications.

• DISSECTORS:ACCESSTOCLINICALLECTURESANDCADAVERICPROCEDURES

• NONDISSECTORS:-CLINICALLECTURESANDACCESSTOSIMULATORONLY

• AVAILABLETOALLUROLOGYTRAININGGRADES/CONSULTANTS

FACULTYProfessorNaeemSoomro–CourseDirector

ConsultantUrologistNewcastleUponTyneHospitals

AdditionalFacultytobeconfirmed

FurtherinformationForfulldetailsandregistrationinformationvisit

www.nstcsurg.org

Orcontact:LouiseSoreFreemanHospital,NewcastleuponTyne

Tel:(+441912138589Email:louise.sore@nuth.nhs.uk

NewcastleSurgicalTrainingCentre www.nstcsurg.org

SPECIALFEATURESOFTHECOURSE

• Intensivetwo-daycourse• Highfaculty-to-participantratio• NumberofDISSECTORSlimitedto8• InteractiveclassroomandHandson

ProceduresONFRESHFROZENSPECIMENS

• Coursedinnerandallrefreshmentsincluded

Coursecertificate-CPDPENDING

COURSEAIMSANDOBJECTIVES

TobecomefamiliarwiththefunctionandoperationofthedaVinci®SurgicalSystemTobecomefamiliarwiththeergonomicsofthedaVinci®SurgicalSystemrobotandtheavailableroboticinstrumentationTounderstandtheselectionprocessforpatientposition,daVincisurgicalteampositionandroboticsurgicalapproachesTobecomefamiliarwiththetechniqueofroboticsurgeryintracorporealsuturingandknottyingTolearn"tricksofthetrade"tomakeroboticsurgicalproceduresmoreefficientwithoutmuchcomplication.Tolearnrobotictissuedissectiontechniquesusingmonopolarbipolar,harmonicandplasmakineticenergyinroboticsurgery.TolearnintracorporealsuturingandknottingtoperformroboticsurgeryTolearnscientificportpositiontodoproperdockingduringroboticsurgeryTolearnbaseballdiamondconceptofportpositionofroboticsurgeryTolearnergonomicprincipleofroboticsurgeryforproperandtroublefreesurgery.TolearnbowelanastomosisandtremorfreepyeloplastydaVincirobot

FRESHFROZENCADAVERS

PROCEDURESINCORPORATE:

ROBOTICASSISTEDCYSTECTOMY,ROBOTICSASSISTEDLYMPHNODEDISSECTION

ROBOTICASSISTEDPROSTATECTOMY,ROBOTICASSISTEDNEPHRECTOMY

Surname: Title:(Mr /Mrs /Miss /Ms )Forenames:

JobTitle:

GRADE::

HospitalAddress:

Postcode:

MobileTelephone: Email:

FurtherdetailsHowdidyouhearaboutthiscourse? TrustWebsite Mailing OtherPleasestateanyspecialdietaryrequirements:Signed: Date:

DAVINCIROBOTICUROLOGYCADAVERICCOURSE

DATE:22-23May2018Delegatefee:£1200□OBSERVERS:£300(ACCESSTOLECTURESANDSIMULATOR)

Pleasenote:Thecoursefeewillincludelunchandrefreshments.PaymentcanbemadeviaBACS(automaticbanktransfer)bycreditcard,orby cheque,payable toNewcastleuponTyneHospitalsNHSTrust.Fulldetailsandregistrationinformationcanbefoundatwww.nstcsurg.org

Pleasenote,paymentisdueatregistrationtosecureyourplaceandattendanceonthecourseisconditionaluponadvancepaymentbeingreceived.Refundscannotbegivenintheeventofyourcancellationwithintwoweeksofthecoursedate.NSTCcannotacceptliabilityforcostsincurredintheeventofacoursehavingtobecancelledasaresultofcircumstancesbeyonditsreasonablecontrol.Thereisanadministrationchargeof10%(or£50,whichever isgreater)ofthetotalcoursefee.However,withinfourweekspriortothestartdateofthecourse,thetotalcoursefeewillbechargedunlessinexceptionalcircumstancesatthediscretionoftheNSTC.Whilewemakeeveryefforttoruncoursesasadvertised,wereservetherighttochange the timetableand/or the teaching staffwithoutpriornoticeand to cancel any courseswithout liability (inwhich case therewillbea fullrefund of course fees to participant). Note that any consequential losses (e.g. travel or accommodation costs) incurred in such cases remain theresponsibilityofthebooker,andconsiderationshouldbemadetotakingoutappropriatetravelinsuranceforanynon-refundablecosts.

CardholderName

CARDNumber ______________________________________________________________________

ExpirationDate _____________________________________________________________________

Validfromdate

Securitynumber(3digitnumberonbackof

Visa/MasterCard

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Accounttype:Visa�MasterCard�Discover�WEDONOTACCEPTDINERSCLUB,AMEXORAMERICANEXPRESSCARDS