Top Gun 3


Top Gun Level 3:

Laparoscopic Anastomosis Course


Course Description:
Once surgeons have become adept at basic laparoscopic suturing techniques using the Rosser method for intracorporeal knot tying, they are ready to move on to the next level of training. The Top Gun Level 2 course is designed to empower surgeons with the proper techniques and skills necessary to place a uniform, structurally sound anastomosis. With an emphasis on peer review and self-analysis, surgeons will become proficient at identifying obstacles before they happen, thereby allowing them to deploy the appropriate countermeasures and avoid leakage.


Course Objectives:
Initially, the surgeons will be put through a short preliminary course to evaluate their Level 1 skills, using the scientifically validated drills designed by Dr. Rosser and utilized in the Level 1 course. This includes Cobra Rope, Slam Dunk, Terrible Triangle, and intracorporeal suturing on animate tissue. This will be followed by a short refresher course on intracorporeal suturing, in which Dr. Rosser will review his suturing algorithm with participants and allow them to practice.

Next is a lecture series detailing the correct procedure for placement of an intracorporeal anastomosis, complete with CD-ROM demonstration, lecture, photo review, and a detailed explanation of the criteria for evaluation of an anastomosis. Once students have become familiar with the methodology, the real challenge begins. Participants are first separated into teams of two, and must cooperate in the placement of an anastomosis on inanimate tissue, which must have no less than eight interrupted sutures on the back wall and a running anastomosis on the front wall. Surgeons will then be instructed in Dr. Rosserís principles regarding optical correctness, port placement, and overall preparation. The participants must then perform the anastomosis on a section of pig bowel, which is much more difficult to work with than inanimate tissue. Once the anastomosis has been completed, it is then examined by instructors using strict grading criteria such as: proper length and depth, uniformity of sutures, placement, knot integrity, ability to work as a team, and overall anastomosis integrity.

  •    To view the course itinerary, please click here.
  •    To view the course brochure, please click here.

  • For more information, please call 212-844-1413.