SURGICAL SKILLS FOR COMPLEX CAESAREAN SECTION: PRACTICAL & THEORY COURSE

We are delighted to introduce a new surgical course, held for the first time in the United Kingdom, organised by the GEFOG Health Foundation and Professor Asma Khalil, in collaboration with Professors José M. Palacios Jaraquemada and Albaro J. Nieto Calvache.

This full-day, hands-on course is designed for obstetricians and maternal–fetal medicine specialists, with a strong emphasis on reproducible surgical techniques to manage challenging situations such as placenta accreta spectrum (PAS), postpartum haemorrhage, and uterine dehiscence. Through interactive lectures, simulation training, and expert-guided case discussions, participants will gain practical insights into advanced yet safe surgical approaches that can be readily implemented in clinical practice.

Learning Objectives

By the end of the course, participants will be able to:

• Identify pelvic vascular anatomy and access safe surgical planes.
• Perform haemostatic techniques of the lower and upper uterine segments.
• Apply conservative surgical approaches in PAS management.
• Use internal aortic compression and uterine tamponade techniques.
• Recognise sonographic signs of PAS and uterine dehiscence.
• Establish intraoperative decision-making strategies in complex cases.
• Master volume-preserving haemostatic interventions.
• Determine appropriate surgical techniques to avoid myometrial defects during caesarean section.

Course Structure

Module 1: Theoretical Component (Morning)
A concise and clinically-focused set of presentations, covering essential topics such as vascular control, conservative surgery, and haemostatic management in PAS and postpartum haemorrhage. Includes interactive case-based discussions.

• Describe the areas and vascular pedicles of the female genital system.
• Represent the pelvic spaces and their safe access.
• Describe and perform hemostasis of the lower uterine segment.
• Repair the dehiscent uterine segment.
• Describe and perform internal aortic compression.
• Describe the ultrasound signs of placenta accreta and other conditions of a complex cesarean section (uterine dehiscence, placenta previa, etc.).
• Establish a therapeutic algorithm for the incidental finding of placenta accreta.
• Describe therapeutic options for placenta accreta.
• Perform operative staging in myometrial dehiscence with or without placental intrusion.
• Perform uterine hemostatic procedures without volume loss.
• Describe and perform a hemostatic procedure for different uterine segments.
• Perform a high hysterotomy during cesarean operation to prevent myometrial defects.

Module 2: Simulation Workshops (Afternoon)
Small-group practical training using high-fidelity simulation models. Techniques include uterine compression, tamponade, tourniquet application, and conservative resection and repair.

• Uterine conservation in placenta accreta
• Hemostasis of the upper uterine segment (body) and lower uterine segment
• Modified subtotal hysterectomy (placenta accreta with vesicouterine fibrosis)
• Manual compression of the aorta
• Vaginal compression of the uterine arteries
• Pelvic packing with compresses, artisanal subatmospheric pressure system
• Uterine tourniquet
• Uterine bandage
• Uterine tamponade with Bakri balloon during cesarean section
• Uterine tamponade by suction after cesarean section

Module 3: Clinical Case Review & Decision-Making (Late Afternoon)
Video-based reviews of complex obstetric surgeries led by expert faculty, with a focus on real-life decision-making in challenging scenarios such as multiple caesarean sections, placenta praevia, and broad ligament haematoma.

• OSCS. One step conservative surgery
• IMAC. Internal manual aortic compression
• MSTH. Modified Subtotal hysterectomy

• LUCS. Lower uterine compression sutures

Course Fees and Registration

• Fee: £ 379,90 for one day of in-person attendance
• Capacity: Limited to 50 participants to ensure an optimal learning experience
• Certificate of completion: All participants will receive an official certificate upon completing the course successfully.
• Help centre: education@gefoghealthfoundation.org

Please note: This is an on-site only course. Online access and recordings will not be available.

Join us for this comprehensive training course and gain hands-on expertise in the surgical management of complex caesarean sections, under the guidance of leading international experts.