The Trauma Program at Montreal General Hospital is conducting a Definitive Surgical Trauma

Care (DSTC®) course and the Advanced Surgical Skills for Exposure in Trauma (ASSET®) course

from September 15th to 17th, 2025.

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REGISTRATION IS NOW OPEN!

Link: https://forms.gle/ezJJ68rqtZhBDagX7

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For registration, general information and inquiries about the courses

please contact: Timothy Lan, Course Coordinator, Trauma Program, Montreal General Hospital

Email: traumacourses.muhc@gmail.com

 

Introduction to DSTC

Trauma is a growing problem worldwide.

The Advanced Trauma Life Support (ATLS®) Course of the American College of Surgeons has had a

dramatic effect in improving outcome of patients by standardising their resuscitation and initial

assessment and providing one safe simple way for the initial care of such patients. However, ATLS®

makes very little provision for care beyond the “Golden Hour”.

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The standard general surgical training received in the management of trauma is often deficient, partly

because traditional surgical training is more and more organ specific, concentrating on

“superspecialties” such as vascular, hepatobiliary or endocrine surgery, and partly because in most

developed training programs, there is limited exposure to the range of injured patients. It is not enough

to be a good operator. The effective practitioner is part of a multidisciplinary team that plans for, and

is trained to provide, the essential medical and surgical response required in the management of the

injured patient.

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Planning the response requires an understanding of:

• The causation of injuries produced in the local population. An urban population with

motorways will have a different spectrum of injury to an armed inner-city population.

• The emergency, pre-hospital and emergency room care of the patient. The condition in which

the patient is delivered to the hospital and subsequently to the operating room will be

determined by the emergency response, and in many respects will determine outcome.

• The resources, both physical and intellectual within the hospital, and the ability to anticipate

the specific problems associated with the patient with multiple injuries.

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The International Association for Trauma Surgery and Intensive Care (IATSIC) is a founding component

of the Société International de Chirurgie (International Surgical Society) – ISS. Under the patronage and

supervision of IATSIC, the Definitive Surgical Trauma Care (DSTCTM) Course has been developed for

surgeons who may be faced with the definitive care of a patient with multiple injuries. By the beginning

of 2014, more than 300 Courses have been delivered in over 26 countries. It is gratifying that

Anaesthesiologists and Operating Room Scrub Nurses are integrated into the DSTCTM Team.

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The DSTCTM Course is designed for surgeons and surgical trainees, by surgeons. Many situations require

specialist trauma surgical expertise, yet because of local conditions this is simply not available. Its

intention is not to duplicate ATLS®, nor to provide an in-depth course in surgery, but rather to teach

those techniques particularly applicable to the patient who requires surgery and intensive care for

major trauma, in a setting where such care is not commonly practised or even necessarily available. At

the same time, Trauma Care is changing all the time, and this course also serves as an update of

knowledge and information in the field of Trauma Care.

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- About the course

The course is a mixture of lecture-based learning, case discussion, and surgical skills, demonstrated and

practiced, and involves.

• Probabilities of organ injury

• Technical surgical strategies

• Decision making in trauma surgery

• Group discussions drawing on the experience of the course Faculty

• Practical sessions training the skills required

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The uniqueness of the DSTCTM course, relates to its ability to link trauma surgical decision making with

surgical techniques. There is an integral relation in the course between the probability of organ injury

and the decision-making process resulting, and these two philosophies must be reflected in the talks and

interactions. It is important that talks and surgical technique relate only to technique and avoid the

reintroduction of injury pattern and demographics, as these must be confined to the area of talk.

Of fundamental importance is the faculty member’s’ ability to overcome personal issues and

egocentricities to ensure that the lecture is relevant to the audience, and reproducible. While the course

will need to be modified philosophically for each centre in which it is run, the core curriculum must

remain the same and avoidance of the teaching of personal philosophies by individual faculty members

must be upheld at all times.

The key philosophies are:

• Probabilities

• Decision Making

• Surgical Techniques

• Pitfalls

DSTC has been developed in many continents under the umbrella of IATSIC, International Association for

Trauma Surgery and Intensive Care. Increasingly it is being recognized that DSTC is an outstanding

educational event meeting the very real needs of surgeons caring for the injured.

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COURSE STRUCTURE

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Strategic Thinking and Decision-Making Topics:

• Damage Control in Trauma

• Blunt and Penetrating Thoracic Injuries

• Penetrating Injuries to the Neck

• Abdominal Injuries

• Pelvic Fractures

• Vascular Injuries

• Head Injuries

Operative Approaches and Surgical Techniques:

• Thoracotomy and Sternotomy

• Laparotomy and Packing

• Fasciotomy

• Craniotomy

• Splenectomy and Splenorrhaphy

• Liver packing

• Medial Visceral Rotation

• Duodenal and Pancreatic Repairs

• Vascular Repairs

• Cardiac and Pulmonary Repairs

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This session will provide hands-on exposure to operative techniques in a small group with a high

faculty/participant ratio.

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ASSET – About the course

The ASSET course uses human cadavers to teach surgical exposure of anatomic structures that when

injured may pose a threat to life or limb. It is an excellent progression from the DSTC course.

A course manual is distributed to participants prior to taking the course to provide an overview of key

surgical exposures in five key anatomic areas: neck, chest, abdomen and pelvis, extremities, upper and

lower. The one day cadaver-based course follows this modular, body region approach. Each section begins

with a short case-based overview, followed by a hands-on exposure performed by students under the

guidance of faculty. The student to faculty ratio is low, allowing extensive faculty guidance and interaction

with students. The student assesses his or her ability to perform each exposure independently and is

evaluated on knowledge and technical skills. In other words, the course allows one to perform all the

vascular and visceral exposures one would need to know in open management major trauma. The course

has four participants per cadaver, led by an instructor.

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TARGET AUDIENCE

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The intended audience includes senior surgical residents, trauma and acute care surgical fellows, and any

surgeon who wishes a review of this anatomy.

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OBJECTIVES

• The student will demonstrate knowledge of key anatomical exposures for the care of injured and

acutely ill surgical patients.

• The student will demonstrate his or her technical ability to expose important structures that may

require acute surgical intervention to save life or limb.

• The student will gain confidence in performing anatomic exposures independently.

• Faculty assessment of the student’s ability to independently perform anatomical exposures will

be satisfactory.