1. Developments in Laparoscopic Colorectal Surgery

2. Technology appraisal TA105 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 Recommends laparoscopic surgery as an alternative to open surgery for people with colorectal cancer if:

5. CSCG 3 rd Bowel Cancer Report Apr 2005 – March 2007

7. 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

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

9. 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

10. 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

11. 36/45 80% response rate no plans to start want to start off and running ready to teach

12. 4 3 1 2 2 4 3 1 1 2

13. Should be part of MDT discussion? Yes26/3770% No5/3714% No answer6/3716%

14. What % patients realistically are suitable?

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

16. Current Consultants Teams Future Consultants

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

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

19. Future consultants Self sufficient in Wales for training Expect laparoscopic colorectal training by CCST Technique not a speciality

20. BSS Course Core skills Laparoscopy

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

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

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