The Christie NHS FT Annual Report & Accounts 2019-20

Anae4sthetics, Theatre & Surgery

skin malignancy. This includes the provision of the Cheshire and Greater Manchester Sentinel Lymph Node Biopsy (SLNB) service, undertaking approximately 180 SLNBs per year. This element of the plastic surgery service encompasses block lymph node dissections of the head and neck, axillary, inguinal and ileoinguinal regions, undertaken for skin cancer. The latter is performed as part of a multidisciplinary minimally invasive surgery team, in order to minimise morbidity and optimise recovery and discharge. The team have also continued to look to expand the lymphedema service in conjunction with the physiotherapy team. In addition, the team supports and liaises closely with the specialist pelvic MDT, to provide reconstructive solutions for difficult cases which would be otherwise inoperable or leave patients with suboptimal results or debilitating/chronic wounds. The plastic surgery team operates on approximately 45-50 such cases per year, including reconstruction of vulval defects utilising local or pedicled flaps, pelvic obturation and perineal closure following total pelvic clearance or abdominoperineal resection, pelvic brim resections and abdominal wall reconstructions, abdominolipectomy to aid pelvic access and optimise wound healing. As part of the overall provision of reconstructive services, the team performs microvascular free tissue transfers, allowing reconstruction of large or complex defects by the provision of tissue from distant donor sites.

the gynaecology surgeons also provide supra radical exenterative surgery, cytoreductive surgery and complex reconstructive surgery. In 2018, the team undertook 50 joint procedures with surgical colleagues. The team is highly regarded for its educational activities and is recognised as a training centre for gynaecological robotic surgery. The service is delivered in a networked (hub and spoke) manner ensuring that regular attendances for outpatients and diagnostics are provided closer to home, with specialist cancer surgery being delivered on a central site. Plastic Surgical Service The plastic surgery team ensures we can provide integrated cancer surgery and oncological care in a multidisciplinary, one site service. The team is co located with surgical and non-surgical oncology teams, often working in parallel or shared clinics for the provision of one stop, comprehensive cancer management with dedicated nurse specialists working across specialties for continuity of patient care. This year we have moved outpatient clinics and local anaesthetic daycase procedures to the new Integrated Procedures Unit. This allows for the most efficient and effective care, whilst optimising the patient experience. The plastic surgery team provide two main models for delivery of care. By far, the more significant part of our practice includes comprehensive surgical management of melanoma and non melanoma skin cancer, sarcoma and breast reconstruction. We are one of the few departments in the UK that provides a comprehensive range of surgical options for melanoma treatment. We also deliver the reconstructive procedures for the other three surgical specialities. Similar to 2018, we have delivered almost 2,000 treatment episodes this year and over 10,000 outpatient consultations. We undertake primary resections and reconstructions for patients with

14