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