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The Programme Structure


The LTO is a two tier programme for trainees in Obstetrics and Gynaecology wishing to extend their laparoscopic experience and improve their skills in laparoscopic suturing.

This means that there are two LTO programme tiers, LT1 and LT2. You are recommended to complete the LT1 programme tier during your ST1 to ST4 years and the LT2 programme tier during your ST5 to ST7 years. Each LTO programme tier is 12 weeks long. Each LTO programme tier comprises of seven modules.

Each delegate will be provided with a laparoscopic box trainer package by the Deanery for the duration of the LTO programme tier they are allocated to and will be expected to attend all seven Zoom based online modules of the programme tier and complete the web based tasks by online video submission. 


The LTO programme recognises that the RCOG Matrix of Progression for the year 2021 has the following requirements with regards to Laparoscopic Surgery in Gynaecology:

No requirements pertaining to laparoscopic skills

No requirements pertaining to laparoscopic skills

No requirements pertaining to laparoscopic skills

Competence in diagnostic laparoscopy

Competence in simple operative laparoscopy (laparoscopic sterilisation or simple adnexal surgery e.g. adhesiolysis / ovarian drilling)

No specific requirements pertaining to laparoscopic skills

Competence in laparoscopic management of ectopic pregnancy and ovarian cystectomy (open or laparoscopic)

The Deanery LTO programme tiers, LT1 and LT2 are developed with respect to these requirement at its core.

ThE LT1 and LT2

The LT1 tier comprises the following modules:

  1. Understanding laparoscopy - laparoscopic entry techniques and set up

  2. The basics of laparoscopic surgery and suturing

  3. Laparoscopic anatomy and the course of the ureter

  4. Simple adnexal surgery including sterilisations, adhesiolysis and ovarian drilling

  5. Salpingotomies, salpingostomies and salpingectomies

  6. Ovarian cysts and cystectomies

  7. Energy sources in laparoscopic surgery

The LT2 tier comprises the following modules:

  1. New concepts in laparoscopic suturing techniques

  2. Tubal surgery, salpingotomies, salpingostomies and salpingectomies

  3. Suturing of the vaginal cuff

  4. Total and sub-total laparoscopic hysterectomies

  5. Ovarian cysts and endometriomas

  6. Simplifying the laparoscopic myomectomy

  7. Energy sources in laparoscopic surgery


The necessary overlap of modules pertaining to adnexal surgery, ensures that the step up from ST4 through to ST6 is a smooth and confident transition.

Each module attended will generate a Certificate of Attendance and these Certificates can be mapped to CiP 6, 9 and 11 of the core curriculum on the RCOG ePortfolio. As well as the following ATSM CiPs:​

  • AGEP CiP 2

  • ALAP CiP 1

  • ALAP CiP 3

  • BASOL CiP 1

  • BASOL CiP 3

  • O CiP 2

  • SRH CiP 1

  • SRH CiP 2

  • SRH CiP 4


It is only after you attend all seven modules of an LTO programme tier that you will get a Certificate of Completion for that tier. It is not mandatory to attend all the modules, however it is recommended that the trainee at least completes LT1 before CCT.  

CiP mapping guidance will be available at all times from your faculty and your allocated mentors. 

WHAT are you waiting for?

Please note: you can only register for a Deanery LTO programme if you have been instructed by your Deanery, TPD or ES to register for it.

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