Queen Elizabeth Hospital, Gateshead
Module lead: Andy Bracewell (email)
This module offers the opportunity to gain experience in a range of major surgery, predominantly colorectal (including laparoscopic) and gynaecological oncology (gynae-onc) surgery. As well as involvement in the intraoperative care of these patients, trainees will also expect to gain experience in high risk anaesthesia assessment clinics and Cardiopulmonary Exercise Testing (CPET).
The department runs 3-4 CPET clinics per week. All of these are Consultant led, “one-stop shop” clinics, where patients are tested, results are analysed and the patient given the results and counselled about the risks of surgery. In addition to this there are three “High Risk” Anaesthetics Assessment Clinics per week, which are all Consultant-led. Trainees will be expected to attend both CPET and “High Risk” clinics, and should expect to gain a good understanding of the conduct of CPET testing, and the results generated. There is much opportunity for audit/research within the scope of CPET.
In terms of theatre experience, trainees should expect to gain a large amount of experience in anaesthesia for both major colorectal (both laparoscopic and open) and gynae-onc surgery. QE Gateshead has a world-renowned gynae-oncology service and is the Tertiary referral centre for the North of England. Gynae-onc surgery performed includes major laparoscopic procedures as well as prolonged, extensive open intra-abdominal surgery, with bowel resection, splenectomy, diaphragmatic surgery and liver resection, in addition to the “gynaecological” component of the surgery. There is potential for massive blood loss and fluid shifts. Peri-operative management of these patients is challenging and trainees will gain valuable experience with development of new and transferable skills.
What trainees would be expected to achieve during Advanced module:
- Experience of major colorectal and gynae-onc surgery in supervised and “solo” capacity, including supervising more junior trainees for some procedures.
- Experience of CPET and the running of CPET and High-risk anaesthetics clinics.
- Involvement in teaching, including teaching anaesthetics trainees, medical students, and on the Trust Foundation teaching programme.
- Complete a Quality Improvement project and/or develop a new guideline and/or gain involvement in research.
So far we have had one trainee complete an Advanced Module in major surgery (working on a LTFT basis). In addition to gaining experience in peri-op management of major surgery, the trainee was also able to:
- Develop and co-write peri-operative anaemia pathway/guideline
- Perform an audit of pre-op pneumonia prediction (likely to be submitted for presentation at EBPOM).
- Gain exposure to research with the PREVENTT Trial