Dr. Greg Marchand is the Program Director of a fully accredited fellowship in Minimally Invasive and Robotic Gynecologic Surgery, offered through the Marchand Institute for Minimally Invasive Surgery in affiliation with HonorHealth Four Peaks Medical Center. The program holds full accreditation through the Society of Laparoscopic & Robotic Surgeons (SLS).
Fellows operate directly with Dr. Marchand, train in ultra-minimally invasive and single-port technique, and publish. Applications are reviewed annually and are encouraged prior to February 1st.
The Program
The fellowship trains surgeons in both laparoscopic and robotic techniques across the full range of minimally invasive gynecologic surgery, with a particular focus on ultra-minimally invasive and single-port laparoscopic technique — the area in which the Institute holds world records, issued patents and a substantial published literature.
The program is accredited by SLS and listed on the society’s fellowship register. Full details of the accredited program are available on the SLS website.
Applications are reviewed annually and are encouraged prior to February 1st.
Program Director
Greg J. Marchand, MD, FACS, FACOG, FICS — Fellowship-trained and ABOG Focused Practice Designated in Minimally Invasive Gynecologic Surgery; first surgeon in the United States to receive the Surgical Review Corporation’s Master Surgeon designation in MIGS; holder of three world records for minimally invasive procedures; inventor on three issued United States patents.
View Dr. Marchand’s full curriculum vitae · Biography
Program Goals
The overall goal is to train surgeons who can practise minimally invasive surgery in any environment they choose — from full-service OB/GYNs who wish to offer minimally invasive surgery to their own patients, through to tertiary specialists in regional centers receiving referrals from other gynecologic surgeons.
Although complications with minimally invasive procedures performed by competent surgeons are rare, a significant portion of training is devoted to the identification and treatment of surgical complications. Simulation and structured discussion sessions keep complication recognition a constant theme despite its low prevalence in practice. Substantial emphasis is placed on correct patient selection, on the limitations of each surgical modality, and on appropriate patient counselling and the documentation of that counselling. Every graduate leaves as an expert in minimally invasive entry techniques to the complicated abdominal cavity.
Research Training
Fellows join an active, high-output research program. The Institute publishes systematic reviews and meta-analyses continuously, registers protocols prospectively with PROSPERO, and reports to PRISMA standards using Cochrane RoB 2 appraisal. Fellows are trained in protocol development, structured searching, dual independent screening, risk-of-bias assessment and random-effects synthesis, and are credited authors on the work they contribute to under ICMJE authorship criteria.
Fellows routinely present at the AAGL Global Congress and SLS Minimally Invasive Surgery Week, with abstracts published in the Journal of Minimally Invasive Gynecology. See our research methodology and the publications database.
Applicant Requirements
- Applicants must be board certified or board eligible OB/GYN physicians, able to be licensed in the State of Arizona with an unrestricted license, and able to obtain hospital privileges at our affiliated hospital system.
- Applicants must be legal United States residents with the legal right to work in the United States. This program does not sponsor J-1 visas.
- Applicants must be committed to the advancement of minimally invasive gynecologic surgery and to bringing these advancements to all women in the United States regardless of nationality, economic class or ability to pay.
Rotations
1. Office-based (outpatient) counselling for minimally invasive surgical procedures
During the office-based gynecology rotation the fellow learns to become an effective counsellor and communicator while functioning as a consultant to other specialties. Fellows see patients in an office environment and either personally perform ultrasound or interpret ultrasound performed by sonographic staff. Based on clinical presentation and radiologic findings, the fellow counsels the patient on appropriate options including minimally invasive approaches, and counsels extensively on the risks of surgical intervention. Fellows then follow these patients through surgery, including technique selection, choice of minimally invasive modality and postoperative care.
Elective cases arranged from the office environment are mandatory for fellows throughout the fellowship regardless of current rotation, excepting surgeries that conflict with protected academic or research time, or where another fellow or resident is taking the primary learning role. This rotation emphasises the fundamentals of laparoscopic, vaginal and robotic surgery, and requires fellows to develop confidence in technique and to articulate the scenarios in which a change of technique is warranted. Sufficient OB/GYN coverage is in place so that fellows are not required to perform gynecologic surgeries unrelated to minimally invasive surgery, although they remain responsible for counselling patients about the availability of those procedures. Fellows must understand the limits of minimally invasive surgery and may attend laparotomy or other non-minimally invasive surgery where the patient and physician choose that option.
2. Hospital-based (emergent) minimally invasive surgical patient management
In hospital-based rotations the fellow functions as a consultant in minimally invasive surgery, performing inpatient minimally invasive procedures as needed and exercising specialist judgement about which scenarios permit or require a minimally invasive approach. Fellows must be able to counsel patients effectively before surgery and discuss the limitations of minimally invasive procedures performed emergently. Specific scenarios are addressed in depth, including emergency surgery resulting in loss of fertility, and hysterectomy performed on an inpatient basis.
All rotations include electively scheduled cases from all attendings and providers unless emergency situations preclude attendance.
Laparoscopic and Robotic Simulation Laboratory
The Institute hosts one of the most advanced laparoscopic simulation laboratories in Arizona, available exclusively to our fellows, residents and students:
- CAE Healthcare LapVR virtual reality laparoscopy system — full haptic feedback with gynecologic and general surgery modules.
- Mimic Simulation dV-Trainer — virtual reality da Vinci robotic training simulator with three- and four-arm simulations covering the full range of robotic surgical skill.
The laboratory is also a testing ground for newly developed surgical techniques, which can be simulated before being attempted in the operating room. An in-house study is underway developing a rapid protocol for assessing innate surgical ability in medical students and prospective medical students, using validated Dreyfus-scale testing protocols, and aiming to produce both a faster protocol for robot-assisted surgery and the first described testing protocol for straight-stick laparoscopy.
How to Apply
Applications are encouraged prior to February 1st for the following program year. To request an application packet or to discuss the program, contact the Fellowship Program Coordinator:
Maria A. Sainz — Fellowship Program Coordinator
maria@marchandobgyn.com · (480) 999-0905
Inquiries can also be sent through our inquiries page using the subject line FELLOWSHIP.
Preceptorships and Short Courses
Practicing surgeons who wish to observe or train in single-port and ultra-minimally invasive technique without committing to a full fellowship year may enquire about a preceptorship. Contact Maria Sainz for the preceptee application and the Specialized Minimally Invasive and Robotic Surgery Program Manual.