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Developments in Laparoscopic Colorectal Surgery

Developments in Laparoscopic Colorectal Surgery. Technology appraisal TA105. Recommends laparoscopic surgery as an alternative to open surgery for people with colorectal cancer if:. Both laparoscopic and open surgery are suitable for the person and their condition

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Developments in Laparoscopic Colorectal Surgery

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  1. Developments in Laparoscopic Colorectal Surgery

  2. Technology appraisal TA105 Recommends laparoscopic surgery as an alternative to open surgery for people with colorectal cancer if: • Both laparoscopic and open surgery are suitable for the person and their condition • Their surgeon has been trained in laparoscopic surgery for colorectal cancer and performs the operation often enough to keep his or her skills up to date

  3. CSCG3rd Bowel Cancer ReportApr 2005 – March 2007

  4. History of programme • DoH and Cancer Action Team provide money for England • Sept 2007 • 3 preceptors in Wales • WAG agreed funding on scheme administered from WIMAT • 29 Aug 08 appointed Lead Wales • 23 Sept 08 New Lead England

  5. Multiple reservations • Too prescriptive • Credentialling / Accrediation • 5 or 10 years too late • Resentment about equipment • Multiple new appointments • Existing training schemes

  6. Aims of the programme • Ensure that all patients suitable for laparoscopic colorectal cancer resection have access to the choice • Ensure a legacy of laparoscopic colorectal training in Wales

  7. Questionnaire 45 colorectal surgeons Abdullah Appleton Arun Beynon Bhowmick Billings Carr Chamery Davies(1) Davies(2) Delicata Edwards Foster Ghopal Haray Hargest Harries Jackson Jamison Joseph Khot Lala Marsh Masoud Maw McKain Milewski Morgan Phillips Pritchard Radcliffe Rees Rowley Sekeran Shami Shanahan Sheridan Stephenson Swankar Torkington Umughele Whiteley Williams Woodward Young

  8. 36/45 80% response rate no plans to start ready to teach want to start off and running

  9. 3 2 1 1 1 2 3 4 4 2

  10. Should be part of MDT discussion? • Yes 26/37 70% • No 5/37 14% • No answer 6/37 16%

  11. What % patients realistically are suitable?

  12. Barriers to offering more lap surgery to your patients?

  13. Current Consultants Teams Future Consultants

  14. Current Consultants • Bespoke training/support • Non threatening • Not accreditation • Courses • Coordinating preceptorship • Own hospital or host

  15. Team training • Anaesthetist • Scrub nurses • Access to integrated theatre system • Oesophageal doppler • Support group

  16. Future consultants • Self sufficient in Wales for training • Expect laparoscopic colorectal training by CCST • “Technique not a speciality”

  17. BSS Course Core skills Laparoscopy

  18. BSS Course Core skills Laparoscopy Animal Lab Appendix Right Hemi Left side Resection

  19. BSS Course CT1/2 Core Skills Laparoscopy ST3/4 Animal Lab Appendix Right Hemi ST 5/6 Colorectal Trainee Left Side Resection ST 7/8

  20. Administration Contact Kate Creighton Griffiths 02920 71682128 Creighton-griffithsk@cardiff.ac.uk Coordination Teaching Faculty Incl. audit RITA committee

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