By 2006, Dr. O'Hanlan saw that laparoscopic technology could be used to perform 98% of benign and most (but not all) gynecologic cancer conditions; but even with such well-documented benefits, there was a slow uptake in the mainstream use of these procedures in the early 21st century. She thus founded the Laparoscopic Institute for Gynecologic Oncology (LIGO) and wrote the course in 2006, certified by the American College of Obstetrics and Gynecology and the American Board of Obstetrics and Gynecology, teaching minimally invasive surgeries, using both cadavers and pelvic simulators.

The LIGO course was unique in that it was the first course to use evidence as a basis for structured training. The course’s hands on laparoscopic training embodied the findings from the surgical training research showing what minimum number of sutures needed to have been placed, knots to have been tied, incisions to have been closed that brought a surgeon to a plateau of ability and performance that translated to OR skill improvements. Dr. O’Hanlan reported on the course effectiveness to the members of the American Association of Gynecologic Laproscopists: Evaluation of an evidence-based educational strategy using a novel simulated suture and knot-tying challenge, the "holiotomy".