HPB SIA at PHNT
Overview
The HPB SIA runs for a minimum of 6 months.
You will work directly with consultant anaesthetists with a regular commitment to HPB surgery as well as HPB consultant surgeons, delivering 5 full days operating per week. The service delivers a wide range of open and laparoscopic liver and pancreatic resections as well as small bowel tumour resections. Having a dedicated theatre allows an excellent culture of teamwork and it is anticipated an advanced trainee would become integral to the running of that team.
We do not perform liver transplants at PHNT however we encourage you and can help facilitate organisation of an observer role at a liver transplant unit for 1-2 weeks to gain exposure and insight into anaesthesia for transplant surgery as outlined in the curriculum.
Clinical Activity
By the end of your SIA in HPB, you will be expected to deliver anaesthetic services at a consultant level, working independently with distant consultant supervision. You will develop a full range of anaesthetic skills, to include:
- attendance at hepatobiliary pre-assessment clinics, assessing patients for major cancer work affecting the liver and pancreas. This includes CPET and shared decision-making discussions and can lead to accreditation in CPET.
- anaesthetic representation at the weekly HPB MDT meeting.
- Deliver anaesthesia for a wide range of cases including lap and open liver resections, pancreatic surgery – PPPD, Whipple’s, distal pancreatectomy and splenectomy; understand the differences in techniques and the risks associated for the patient.
- management of high-risk patients.
- management of major blood loss.
- understand thrombo-elastography (ROTEM/TEG).
- vascular access, goal directed fluid therapy and regional analgesic techniques.
- gain an understanding of neuroendocrine and adrenal tumours, such as phaeochromocytomas where experience is available.
- management of portal hypertension with an emphasis on provision of anaesthesia or monitored anaesthesia care for trans jugular intrahepatic portosystemic shunt (TIPS) procedure.
- liver transplantation – risks/ benefits/assessment.
Teaching
You will be expected to be involved teaching, in a supervisory role for trainees on intermediate and higher HPB modules.
QI/Research/Management
As a large university teaching hospital there will be ample opportunity to become involved in research activities. You would be fully expected and supported to engage in quality improvement activity aligned with local and national priorities in HPB surgery including the development of guidelines and policies related to management of patients for HPB surgery. Any work undertaken should be of such a standard as to be suitable for publication or presentation at local, national or international specialist meetings. Opportunities for management and leadership activities will be identified and are encouraged. To support you in these ambitions you can negotiate dedicated non-clinical sessions during your working week.
Any questions please contact: Dr Louise Schonborn, Consultant Anaesthetist.