General, Urological and Gynaecological Surgery

General, urological and gynaecological surgery – Core Learning Outcomes

* To gain knowledge, skills and experience of the perioperative anaesthetic care of patients requiring elective and emergency general, urological andgynaecological surgery
* To gain understanding of the perioperative management of patients requiring intra-abdominal laparoscopic surgery and the particular issues related to anaesthetic practice, demonstrating the ability to manage such straightforward cases in adults under distant supervision
* To be able to recognise and manage the perioperative complications associated with intra-abdominal surgery that are relevant to anaesthesia
* To gain understanding of special peri-operative needs of elderly, frail patients

Core clinical learning outcomes:

* Deliver safe perioperative anaesthetic care to uncomplicated ASA 1-3 adult patients requiring elective and emergency surgery such as body surface surgery,appendicectomy and non-complex gynaecological surgery under distant supervision
* Manage a list with uncomplicated ASA 1-3 adults for similar elective surgery under distant supervision


  • GMP GU_BK_01 Outlines the principles of preoperative assessment of patients undergoing major and minor surgery, including guidelines on the appropriateness of simple tests [i.e. NICE guidelines]
  • GU_BK_02 Describes the anaesthetic management of straightforward common surgical procedures and their complications, including but not limited to:
    • * Body surface surgery including breast procedures and thyroid surgery
    • * Urological procedures including TURP and its management [including the TURP syndrome] and procedures on the kidney and urological tract
    • * Laparoscopic surgery including but not exclusively: – Diagnostic laparoscopy – Laparoscopic and open cholecystectomy
    • * Intra-abdominal major general surgery procedures including but not exclusively: – Elective colorectal resection – Elective and emergency surgery for peptic ulcer disease
    • * Endoscopic procedures on the GI and GU tracts including, but not exclusively: – OGD; flexible and rigid – Sigmoidoscopy, Colonoscopy – Cystoscopy
    • * Gynaecology – Elective laparoscopic and open procedures on the uterus – Elective and Emergency procedures in patients in early pregnancy such as ERPC and salpino-oophrectomy for ectopic pregnancy
  • GU_BK_03 Explains the physical and physiological effects of laparoscopic surgery including the effects of positioning [e.g Trendelenberg / reverse Trendelenberg, specifically in the setting of laparoscopic surgery]
  • GU_BK_04 Describes the principles of the anaesthetic management of patients with renal failure for non-transplant surgery, including care of shunts
  • GU_BK_05 Describes the principles of management of non-fasted patients requiring emergency surgery for whatever reason
  • GU_BK_06 Explains transfusion issues in different surgical procedures
  • GU_BK_07 Recalls/describes the management of major haemorrhage
  • GU_BK_08 Recalls/explains the relevance of metabolism and nutrition in the perioperative period
  • GU_BK_09 Explains the specific problems of anaesthesia for non-obstetric surgery in the pregnant patient
  • GU_BK_10 Recalls the factors associated with regurgitation and airway protection during common surgical procedures
  • GU_BK_11 Recalls/describes the anaesthetic implications of abnormal body weight, including morbid obesity
  • GU_BK_12 Describes the NCEPOD classifications and explains the importance of these in delivering surgical care to patients
  • GU_BK_13 Recalls/describes the peri-operative care of the elderly


  • GU_BS_01 Demonstrates the ability to form an appropriate perioperative management plan for ASA 1-3 surgical patients requiring all types of surgery
  • GU_BS_02 Demonstrates the ability to recognise when more complex perioperative assessment and /or optimisation is required
  • GU_BS_03 Demonstrates the ability to identify the high risk emergency surgical patient and initiate early management/optimisation
  • GU_BS_04 Demonstrates the ability to deliver safe perioperative anaesthetic care to ASA 1-3 patients for straightforward surgical procedures e.g. body surface surgery, appendicectomy, ERPC
  • GU_BS_05 Demonstrates the ability to manage an elective surgical list with uncomplicated ASA 1-3 adults for straightforward body surface and lower abdominal surgery under distant supervision [Examples of such cases on lists would be:
    • * General surgical: hernia repair; ‘superficial lumps/bumps’; non-complex appendicetomy
    • * Gynaecology: non-complex total abdominal hysterectomy; hysteroscopy; minor superficial surgery
  • GU_BS_06 Demonstrates sensitive handling of patients with cognitive disturbances/communication problems
  • GU_BS_07 Shows sensitive handling of patient with cognitive impairment