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Appendices

Appendix 1 – Useful surgical resources for trainees

The British Society for Gynaecological Endoscopy

European Society for Gynaecological Endoscopy

American Association of Gynecolgic Laparoscopists

GESEA educational programme

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