Appendix 1 – Useful surgical resources for trainees
The British Society for Gynaecological Endoscopy
European Society for Gynaecological Endoscopy
American Association of Gynecolgic Laparoscopists
Online university of IRCAD (surgical videos)
Appendix 2 – Set-up costs of a new simulation hub
Equipment |
Cost per unit £/number needed |
Total cost £* |
Laparoscopic simulation boxes including screens |
300-600*/10 |
3000-6000 |
Maryland graspers |
50 – 144/10 |
500 - 1440 |
Johan graspers |
50 – 144/10 |
500 - 1440 |
Laparoscopic scissors |
50 – 144/10 |
500 - 1440 |
Laparoscopic needle holders |
60 – 222/10 |
600-2220 |
Suture pad |
42/10 |
420 |
|
Total |
5520 - 12960 |
*costs researched June 2022
*some laparoscopic simulators can be purchased as a pack with instruments, suturing pads, sutures etc all included in the price
Appendix 3 – Model Hub and curriculum example
Basic
- ST1-2
- 5 face-to-face sessions
- Receive box trainer and consumables
Intermediate
- ST3-7
- 5 face-to-face sessions
Advanced
- ST6-7 (Gynae ATSMs)
- 5 face-to-face sessions
- Trainee numbers – 100
- Core faculty – 5 including regional simulation lead
- Hub located centrally within deanery.
- Total faculty – 30
- All trainees receive a box trainer and consumables on commencing the programme.
Lectures to cover:
Basic:
- The laparoscopic stack and camera skills
- Instruments and ergonomics
- Laparoscopic entry and port insertion – part 1
- Introduction to pelvic anatomy and systematic laparoscopy
- Electrosurgery – part 1
- Salpingectomy and salpingostomy
- Ovarian cystectomy
- Oophorectomy
- Anaesthetic consideration in laparoscopy
- Patient considerations and consent
- Tissue extraction techniques
- Introduction to suturing and techniques
- Introduction to surgical complications – bladder, bowel and vascular
Intermediate:
- Theatre Setup and ergonomics
- Laparoscopic entry and port insertion – part 2
- Patient considerations and consent
- Retroperitoneal anatomy
- Ectopic pregnancy
- Ovarian pathology
- Adnexal Surgery
- Electrosurgery – part 2
- Suturing techniques
- Dissection techniques
- Surgical complications
Advanced:
- Advanced pelvic anatomy – retroperitoneal and nuero-anatomy
- Ectopic pregnancy including interstitial and scar ectopics
- Suturing – needleholders, sutures, setup
- Suturing – types of knots
- Total laparoscopic hysterectomy – step by step
- Tips for the challenging hysterectomy
- Subtotal hysterectomy – step by step
- Laparoscopic myomectomy
- In-bag morcellation and tissue extraction
- Management of PID
- Endometriosis surgery – a structured approach
- Ureterolysis – step by step
- Surgical consent
- Patient considerations and consent