Gloucestershire Hospitals - Anaesthesia for Major General Surgery
We are delighted to offer a high-volume, high-complexity Stage 3 Specialist Interest Area (SIA) placement in Anaesthesia for Major General Surgery, with a focus on colorectal and urological surgery. This post is designed in line with the 2021 RCoA curriculum to support development of perioperative leadership, advanced clinical decision-making, and the management of major surgical cases in both elective and emergency settings.
Colorectal Surgery – Gloucester Royal Hospital (GRH) & Cheltenham General Hospital (CGH)
Gloucestershire is one of the busiest colorectal cancer resection centres in the UK, undertaking around 300 major resections per year. With our upcoming reconfiguration, all major colorectal resections will soon be centralised at GRH, offering enhanced training continuity.
Training opportunities include:
- A wide range of resections: right, left, sigmoid & colectomies, anterior resections, and abdomino-perineal excision of the rectum.
- Advanced salvage surgery for complex and recurrent anal cancer cases (regional centre).
- Predominantly laparoscopic surgery, with open and robotic approaches available.
- Emergency laparotomy exposure at one of the busiest units nationally.
- Advanced IBD surgery, including ileoanal pouch formation.
- Tertiary service for early rectal cancer (TEMS) at CGH.
- Day-case coloproctology and opportunities for enhanced recovery collaboration.
- Weekly theatre sessions: Mon (3 lists), Tues (half day), Wed (2), Thurs (2), Fri (2).
Upper GI Surgery – GRH & CGH
Our Upper GI unit provides anaesthetic exposure to a wide range of elective and emergency procedures, excluding hepatopancreatobiliary (HPB) resections. With over 700 cholecystectomies performed annually, as well as high-volume complex oesophagogastric and robotic cases, this is a valuable training opportunity for senior anaesthetists interested in major abdominal surgery.
Training opportunities include:
- Oesophagectomy (30–40/year)
- Total and partial gastrectomy (10–20/year)
- Hiatal hernia repair and antireflux procedures – both laparoscopic and robotic (≈50/year)
- GIST excision (20/year)
- Heller’s myotomy (10/year)
- Elective and emergency cholecystectomy including bile duct exploration (700–800/year)
Weekly theatre activity includes:
- Monday: all-day list (GRH)
- Tuesday: cancer list + additional afternoon session (GRH); 2 x all-day lists (CGH)
- Wednesday: 2 x all-day lists (GRH); 1 x all-day list (CGH)
- Thursday: UGI cancer MDT and departmental cancer pathway meeting (AM)
- Friday: 2 x all-day lists (GRH)
The Upper GI Cancer MDT meets Thursday 11:30–13:30 (F8, Redwood Education Centre, GRH), and anaesthetic trainees are welcome to attend for insight into perioperative planning and multidisciplinary discussions.
Gynaecological Surgery – CGH & GRH
Trainees on this placement will benefit from exposure to both benign and malignant gynaecological surgery, with high volumes of laparoscopic, open, and robotic procedures. The Gynae-Oncology team serves Gloucestershire, Herefordshire, and Worcestershire, offering some of the most complex pelvic surgeries in the region.
Gynae-Oncology (CGH):
- Monday: all-day list (50% extended) – robotic and radical ovarian cancer surgery
- Tuesday: all-day list – laparoscopic, radical vulval and exenterative surgery
- Thursday: all-day list (50% extended) – robotic and complex oncological procedures
- Friday: all-day list – early-stage endometrial cancer surgery (robotic and laparoscopic)
Benign Gynaecology:
- Day-case surgery at CGH (Mon–Thurs)
- Inpatient lists at GRH (Mon–Wed)
Training opportunities include:
- Radical and laparoscopic hysterectomies
- Robotic-assisted pelvic surgery
- Debulking and exenterative procedures for advanced malignancy
- Enhanced recovery pathways and perioperative care for high-risk oncological patients
- MDT exposure: Gynae-Oncology MDT (Wednesdays PM, CGH); Regional MDT participation with Hereford (Mon lunchtime) and Worcester (Thurs AM)
Urological Surgery – CGH, GRH & Community Sites
Led by an experienced surgical team, the urology department offers a broad spectrum of major procedures across the county, including significant exposure to minimally invasive and robotic techniques.
Training opportunities include:
- Cystectomy (50/year)
- Prostatectomy (250/year)
- Nephrectomy – open, laparoscopic, and robotic (55/year)
- Percutaneous nephrolithotomy (15/year)
- TURP (350/year) and TURBT (330/year)
- Aquablation (60/year) – cutting-edge BPH treatment
- Ureteroscopy, scrotal and penile surgery
- Paediatric urology list (weekly at GRH)
- Weekly MDT: Fridays 15:00–17:00
Why choose Gloucestershire for your SIA?
- Extensive case mix: from routine to highly complex tertiary procedures
- Laparoscopic, open, and robotic surgical environments
- Multidisciplinary team working in both elective and emergency contexts
- Opportunities to develop new Enhanced Recovery After Surgery (ERAS) protocols, with several QIP/management projects available
- Supervised autonomy in delivering anaesthesia for high-risk patients
- Access to colorectal and urology MDTs to broaden understanding of the perioperative pathway
This placement is ideal for senior anaesthetic trainees seeking broad-based major general surgical exposure with opportunities to develop subspecialty interests and refine complex perioperative care skills.
SIA module leads:
Dr Natalie Constable, natalie.constable1@nhs.net
Dr Tom Knight, tom.knight5@nhs.net