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gynaecology

Under UK GMC Guidance, doctors wishing to undertake training in Obstetrics & Gynaecology, undergo a minimum seven years training as a Specialist Trainee (ST1 - ST7 Approved Specialty Curriculum and Associated Assessment System 2010). The examinations and training involved are undertaken through The Royal College of Obstetrics & Gynaecology (for information, see the curriculum & the profession)

 

Some consultants offering advanced laparoscopic procedures underwent "apprenticeship" type gynaecological training to gain their surgical skills and competencies (continued and further developed in their specialised consultant roles). Due to changing training practices and the European Working Time Directive, recent specialists in a particular Gynaecological field undertake Advanced Training Skill Modules (ATSM) (or subspecialist training options, via competitive entry). Consultants offering advanced laparoscopic surgery should be able to fulfil requirements for their individual special interest, regardless of their training pathway.

 

Current ATSM's open to selected trainees who wish to specialise in Gynaecology, include the following surgical training options for specific skills, relevent to their special interests (curriculum and syllabus via hyperlinks):

 

Those who wish to subspecialise further in gynaecological surgical fields have the following options (limited entry only) to achieve competencies required to practise in the relevant gynaecological fields:

 

A number of consultants and trainees are now achieving "accreditation" by undertaking the MSc in Advanced Gynaecological Endoscopy (via the Postgraduate School of Medicine, Guildford, University of Surrey), in effect an advanced laparoscopic surgery fellowship scheme.

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Gynaecological Specialties //

Gynaecological "keyhole" operations //

There are many "keyhole" operations  for women:

 

Operative hysteroscopy procedures

Salpingo-oophorectomy

Ovarian cystectomy

Adhesiolysis

Myomectomy & Morcellation of fibroids

Laparoscopically Assisted Vaginal Hysterectomy (LAVH)

Laparoscopically assisted subtotal hysterectomy (LASH)

Total Laparoscopic Hysterectomy (TLH)

Surgery for endometriosis

Sacro-colpopexy

OTHER operations

 

Information about the types can be found in subsequent sections & pages

BENIGN ABDOMINAL SURGERY (from RCOG)

The modern surgical gynaecologist is able to perform a range of safe and effective surgery within their area of specialization. With the reduction in volume of major abdominal gynaecological surgery, a focused and methodical approach is required, with attention to the place of laparoscopic, hysteroscopic and open surgical techniques. It is now possible to perform many therapeutic procedures with laparoscopic visualization, avoiding large scars and enhancing recovery rates (e.g. Laparoscopic Hysterectomy). Combining open surgical, hysteroscopic and laparoscopic skills enables the modern gynaecologist to choose the most appropriate approach for the care of each patient. Pre-operative planning ensures a clear understanding of conditions where it is appropriate to refer on more complex cases to other specialists.

UROGYNAECOLOGY & VAGINAL SURGERY (from RCOG)

Consultants manage women with pelvic floor disorders (such as vaginal or uterine prolapse) and urinary symptoms (such as incontinence). These problems are common and often distressing. The two conditions are often interrelated and management by a multi-professional, multi-disciplinary team may be required. It is important to ensure the correct type of surgery is performed, although surgery is not always needed to alleviate symptoms.

gynaecology

SUBFERTILITY & REPRODUCTIVE HEALTH (from RCOG)

The field of subfertility and reproductive endocrinology continues to face rapid developments in clinical practice and basic and translational research. Multidisciplinary teamwork is central to the management of many individuals. Consultants with special interest in this area have undergone a recognized structured training programme, lead the provision of fertility care services within a hospital and liaise with professionals working in tertiary referral centres.

ENDOMETRIOSIS SURGERY

Endometriosis is a condition in which cells from the lining of the uterus (endometrium) appear and flourish outside the uterine cavity, commonly on the ovary and the membrane which lines the abdominal cavity, the peritoneum. The most common symptoms are various manifestations of pain. It may be associated with infertility. Surgical treatment involves the excision of this benign disease, which in the worst cases causes considerable distortion of pelvic anatomy. This type of surgery may be complex and often requires high-level advanced laparoscopic surgical skills. Again it may involve multi-professional, multi-disciplinary teams. Some of the surgery may be performed in tertiary centres (including “endometriosis centres”).

OUTPATIENT AMBULATORY SURGERY

This type of surgery involves advanced level skills in diagnostic and operative hysteroscopy (inspection and treatment of conditions within the uterine cavity). This practice is also known as “Office Gynaecology” as it is set in the outpatient clinic. It is used for management of menstrual disorders, post-menopausal bleeding and some conditions related to infertility. Some of the procedures performed now include destruction (ablation) of the lining of the uterine cavity or endometrium and correction of distorted uterine cavity. Sterilisation can also be performed by ambulatory hsyteroscopic techniques.

GYNAECOLOGICAL CANCER

Please see sub-section.

gynaecology

Pre-operative Imaging //

Gynaecology, Gynaecologists, laparoscopy, hysterectomy

Many surgical procedures will need radiological imaging before gynaecological surgery is planned and performed.

 

This includes ultrasound scans, CT Scan, MRI Scan. Some gynaecologists perform ultrasound scans themeselves.

 

It is important the radiologist reporting CT & MRI images, is used to interpreting gynaecological scans. Many  work with the gynaecologist to plan management within a Multi-Disciplinary setting. Your gynaecologist will advise you on this.

gynaecology

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