Neonatal Colorectal 20 14 Level 4 surgery Repair of neonatal 25 15 Level 4 Inguinal hernia General Surgery of 250 130 Childhood totals Circ, inguinal hernia etc 200 100 Level 4 Repair of 10 5 4 epigastric/umbilical hernia etc Pyloromyotomy 20 10 Level 4 (open/closed) Appendicectomy (see 20 15 Level 4 laparoscopic group also) Thoracic totals 25 12 Chest drain insertion 12 6 Level 4 Pleural debridement for 8 4 empyema (open or thoracoscopic) Lung biopsy/resection 5 2 etc (open or thoracoscopic) Urology totals 160 80 Cystourethroscopy etc 26 15 Level 4 Ureteric access STING, 11 6 – stent Hypospadias repair 20 6 Level 4 Nephrectomy/partial 6 3 Level 4 nephrectomy (open or laparoscopic) Nephrostomy 3 0 (open/perc) Pyeloplasty (open or 8 3 Level 4 laparoscopic) Reimplantation of ureter 3 0 Bladder augmentation 4 0 ACE 5 0 Mitrofanoff 4 0 Orchidopexy 60 40 Peritoneal dialysis Level 3 catheter ( insertion or removal ) Surgery for impalpable 10 7 UDT (open or laparoscopic) Signature Date
Neonatal Colorectal surgery 20 14 Level 4 Repair of neonatal Inguinal hernia 25 15 Level 4 General Surgery of Childhood totals 250 130 Circ, inguinal hernia etc 200 100 Level 4 Repair of epigastric/umbilical hernia etc 10 5 4 Pyloromyotomy (open/closed) 20 10 Level 4 Appendicectomy (see laparoscopic group also) 20 15 Level 4 Thoracic totals 25 12 Chest drain insertion 12 6 Level 4 Pleural debridement for empyema (open or thoracoscopic) 8 4 Lung biopsy/resection etc (open or thoracoscopic) 5 2 Urology totals 160 80 Cystourethroscopy etc 26 15 Level 4 Ureteric access – STING, stent 11 6 Hypospadias repair 20 6 Level 4 Nephrectomy/partial nephrectomy (open or laparoscopic) 6 3 Level 4 Nephrostomy (open/perc) 3 0 Pyeloplasty (open or laparoscopic) 8 3 Level 4 Reimplantation of ureter 3 0 Bladder augmentation 4 0 ACE 5 0 Mitrofanoff 4 0 Orchidopexy 60 40 Peritoneal dialysis catheter ( insertion or removal ) Level 3 Surgery for impalpable UDT (open or laparoscopic) 10 7 Signature Date
arcp-6-checklist--paeds-2017-final.docx