Professor Julian Smith appointed Editor-in-Chief of ANZ Journal of Surgery

Professor Julian Smith, Head of Department of Surgery at the School of Clinical Sciences at Monash Health has been appointed the new Editor-in-Chief of the prestigious ANZ Journal of Surgery.

Professor Smith, who is also Head, Department of Cardiothoracic Surgery at Monash Health, will take up the position in January 2019, becoming the thirteenth editor of the journal that was established at the first meeting of the Royal Australasian College of Surgeons’ council held in Dunedin in 1927.

As Editor-in-Chief, Professor Smith’s duties include determining the editorial content and overseeing the production of the online and print versions of the journal, initiating and overseeing the review process of manuscripts, and making appointments to the Editorial Board.

Professor Smith has served on the Editorial Board of the ANZ Journal of Surgerysince 1998, firstly as Specialty Editor for Cardiothoracic Surgery, then as Senior Editor and recently as Deputy Editor-in-Chief.  Other positions include him serving as Chairman of the Cardiothoracic Board of Studies, Senior Examiner in Cardiothoracic Surgery and a Fellowship Elected Councillor.

His exceptional publication record includes four books, 35 book chapters and over 250 papers in peer-reviewed journals.

What’s new in Research – across the campuses 2018

Peninsula Health
Recently the research being conducted by the surgical team at Peninsula Health was showcased, at the annual Surgical Symposium.
Medical students, medical interns, registrars and residents presented research they have done over the last year, to be considered for the Professor Jonathan Serpell Prize for Excellence in Surgical Research and Endeavour and the Frankston Orthopaedic Research Prize.
Congratulations to everyone who presented their work at the symposium.

July 2017 to June 2018 saw over 39 papers published within the Department of Surgery at peninsula Health.  We currently have several students completing a range of projects within our Honours, Masters PhD and Doctorate programs.

Significant Publication:
Cosmetic breast augmentation in Australia: a cost of complication study
Miller GS, Robinson S, Reid CM, Hunter-Smith DJ. C
2018 Australasian Journal of Plastic Surgery
Article View

Monash Health
It has been an exciting and productive year for our department both on the clinical research and also the simulation-based educational one. Ram Nataraja and Maurizio Pacilli have been leading the research streams and in total the department has had 16 peer-reviewed publications and 18 international abstract presentations at various international conferences. Damir Ljuhar our simulation fellow received the prize for the best presentation at the Victorian Simulation Alliance conference for our work in Myanmar.

We have also completed recruitment for 4 of our randomised controlled trials and are in the process of data analysis, as well as, completing one more. We have had 2 BMedSci students, Nic Ensor and Kirby Qin in the department who have excelled and become one of the MCH Surgical family. We also welcomed Simon Nguyen who is a co-supervised engineering PhD student this year to the department.
We have conducted 4 successful simulation-based educational courses in Myanmar with MCHI and our colleagues at Yangon Children’s and Yankin Children’s Hospital in Yangon and have more planned for 2019.


We have the pleasure of welcoming two new members of the team to the surgical simulation department; Iris Pilares our technician and Andrea Wallace our facilitator. With their arrival we have now become operational and have started to host simulation-based educational local and national courses. These have included courses designed by MCH Sim for the General Surgeons of Australia, Monash Newborn, Monash Hear, Monash Ed and also the Department of Urology. All of these courses have been a great success and it’s a great privilege to work in such amazing facilities.

We have also received a grant for augmented mixed reality headsets (HoloLensTM) and are in the process of setting up various new research stream using this novel technology. We are all looking forward to all the great opportunities that 2019 will bring improving the evidence base for paediatric surgery and surgical simulation!

Eastern Health

The Eastern Health surgical community has had a busy 2018. The introduction of surgical grand rounds and regular research collaborative meetings have provided a focus for inter-disciplinary interaction that has been invaluable.

The urology unit has opened a number of clinical trials, with others currently in the pipeline. A Below-the-Belt research grant from the ANZUP clinical trials group is supporting the development of a pilot study of water irrigation for bladder tumour resection. The unit was one of 2 Australian centers to contribute to the UK-led Identify study of haematuria investigation. The appointment of a dedicated trial co-ordinator recently and the enrolment of two Masters students for 2019 will help further support these activities.

The colorectal unit has completed two randomised clinical trials and have two further in varying stages of implementation. The upper GI unit has seen two Masters students complete their theses, with anticipation of successful completion shortly.

Other units, including Breast surgery, Orthopaedics and Plastic surgery have also continued to develop research interests. Overall, there have been more than 20 publications and conference presentations form Eastern Health surgeons this year. 

Cabrini Health

It has been another productive and busy year for Cabrini researchers.  We have successfully published 5 papers and have a further 3 manuscripts under review.  Our Department has presented at 4 national and international conferences and we have had grant success of up to $60,000

Our research has been recognised with awards at Cabrini research week. Dr. Christine Koulis our Postdoctoral Research Fellow at the Cabrini Monash University Department of Surgery, won two awards for her research on Tissue Microarrays including the 'Best Cancer Poster Award’ by the Monash Partners Comprehensive Cancer Consortium and the ‘People’s Choice Poster Award’.  

Also, Dr. Rebekah Engel who is part of the research team at the Cabrini Monash University Department of Surgery, received the Monash BDI Award for Outstanding Achievement in Science Communication and Community Engagement.

Ms Karen Oliva our Departmental Data Manager, won a Cabrini Research Week Poster Award for her work on ‘When to resect? Management of patients with adverse histopathological features post colonoscopic polypectomy’ and Mr Ali Baqar our clinical colorectal fellow was awarded a Cabrini Research Week Poster prize for his work on ‘The impact of double stapled anastomotic technique in colorectal cancer surgery.

 Let’s Beat Bowel Cancer supported this year’s AL Polglase Visiting Professorship in November at Cabrini Institute and Hospital in Malvern.  Professor Antonio De Lacy travelled from Barcelona, Spain to be our 2018 visiting professor and the three days were jam packed for our special guest. Professor Antonio De Lacy presented an insightful and entertaining lecture on the future of education in surgery and how technology will change how our medical staff interact and learn in the future. Overall the visit was an extremely successful one and greatly contributed to the ongoing professional development of Cabrini’s colorectal surgeons.

We have also made great strides in fundraising this year with Let’s Beat Bowel Cancer having a successful Golf Classic corporate fundraiser, raising over $100,000.

The Alfred

Professor Wendy Brown presented the 2018 Central Clinical School Public Lecture on 18 October 2018: “Obesity: a serious disease that deserves serious treatment.”  In this lecture Prof Brown reviewed the disease of obesity, and described the role of bariatric surgery as an effective treatment option and potential model for future treatments.  She also addressed challenges and barriers to providing bariatric surgery at a population level.  This lecture was attended by 100 people and can be viewed here: https://www.youtube.com/watch?v=QXln6_fQJ4Y

Our second Surgical Research Forum took place on 26 July 2018 and was designed to showcase the research activities of the Alfred Hospital Surgical Departments.  The forum was focused on Innovation for better patient care.  Operating theatres were cancelled for the event and this led to the attendance of 80 surgical unit members and included invited guests.  Some of the past Professors of the Department were acknowledged for their outstanding contributions and now have a keynote lecture or a symposium named in their honour.

The Hugh Dudley Symposium on Surgical Innovation

The Paul O’Brien Younger Surgical Researchers Symposium

The Sir Edward Hughes Keynote Lecture

https://www.monash.edu/medicine/ccs/surgery-alfred/education/2018-surgical-research-forum

The forum was followed by the John Masterton Public Lecture which was presented by Mr James Lee on, “Thyroid cancer: Towards a better paradigm.”

In this lecture Mr Lee addressed the challenges and potential strategies in achieving a new management paradigm that is necessary to meet the dramatic rise in the incidence of thyroid cancer diagnosis https://www.youtube.com/watch?v=2fSOtPlz3mw

Funding Wendy Brown was awarded $4.144M in funding from the Commonwealth Government for the National Bariatric Surgery Registry.

                                                                                                                                            

NHMRC Grant  Discovery and validation of biomarkers for nonalcoholic steatohepatitis 

and liver fibrosis. Watt M, Montgomery M, Burton P, Brown W, Roberts S, Kemp W. 

$772,521 over 3 years                                                                                                                                      

Significant Publication 

Obesity Drives STAT-1-Dependent NASH and STAT-3-Dependent HCC        

Grohmann M, Wiede F, Dodd GT, Gurzov EN, Oooi GJ, Butt T, Rasmiena AA, Kaur S, Gulati T, Goh PK, Treloar AE, Archer S, Brown WA, Muller M, Watt MJ, Ohara O, MsLean CA, Tiganis T.

2018 CELL https://doi.org/10.1016/j.cell.2018.09.053                                                                                                                                  

                                                                                

Message from the Chair of MUSAG - Professor Julian Smith

Monash medical graduate Professor Hutson receives an Honorary Fellowship of the American College of Surgeons

Professor John M. Hutson AO, Chair of Paediatric Surgery at the University of Melbourne and Consultant Paediatric Urologist at the Royal Children’s Hospital, Melbourne and Joint Group Leader, Surgical Research Group at the Murdoch Children’s Research Institute, Melbourne was one of 12 international surgeons awarded an Honorary Fellowship of the ACS. He has been an international leader in basic and clinical research on the reproductive and intestinal tracts. John M. Hutson, AO, BS, MD(Melb), MD(Monash), DSc(Melb), FRACS, FAAP(Hon), FCAPS(Hon), is chair, paediatric surgery, University of Melbourne; consultant paediatric urologist, The Royal Children’s Hospital; and joint group leader, surgical research group, Murdoch Children’s Research Institute, Melbourne, Australia. Dr. Hutson is known worldwide for his basic and clinical research on the reproductive and intestinal tracts. He has advanced our understanding of undescended testis, disorders of sexual differentiation, and colonic dysmotility. His research has been extensively funded by the National Health and Research Council of Australia and through a number of trusts and private donations.
A full citation for Professor Hutson appears below and in the November 2018 issue of the Bulletin of the American College of Surgeons: Professor John Hutson Citation

 Prof. John M. Hutson is chair of paediatric surgery at the University of Melbourne (UMelb), Australia, where he has practiced pediatric surgery since 1984 and has a leadership role at the Murdoch Children’s Research Institute. Educated at Monash Medical School, his extensive research training included study with Patricia Donahoe, MD, FACS, at Massachusetts General Hospital, Boston. Professor Hutson has three doctorates—MD, UMelb; MD, Monash; and DSc, UMelb—in sexual development. He was honored as an Officer of the Order of Australia in 2007, an award established to recognize Australian citizens and other persons for achievement or meritorious service. Professor Hutson is known worldwide for his basic and clinical research on the reproductive and intestinal tracts. He has advanced our understanding of undescended testis, disorders of sexual differentiation, and colonic dysmotility. His research has been extensively funded by the National Health and Research Council of Australia, and a number of trusts and private donations. Professor Hutson’s passion and enthusiasm to “figure things out” and improve patient care is infectious. He has been extremely productive in investigative science, including the supervision of at least 81 students for advanced degrees, and 329 publications in peer-reviewed journals. He has been an invited speaker at 169 seminars and an overseas guest at 81 additional venues. He has won numerous prizes and awards during his professional life. He continues to travel internationally, where he provides on-site teaching  and lectures, particularly in Asia. Together with his wife, Susan, the personal mentorship of his four now successful and grown children served as a model for success in his professional life; his students and residents were extensions of his family and were all made to feel welcome and embraced for their individual intellect and contributions. Professor Hutson has acted as an intellectual ambassador who has always been willing to share his knowledge and insight in an interdisciplinary and collegial manner.

Professor Kumud Dhital Director of Cardiothoracic Surgery & Transplantation at The Alfred

Professor Kumud Dhital has recently joined the Alfred Hospital as the Director of Cardiothoracic Surgery & Transplantation as well as Program Director of Alfred Heart & Lung.

Following a science degree in Physiology and Biochemistry with a subsequent PhD in Anatomy at the University of London, Kumud Dhital qualified in medicine at the University of Oxford with Cardiothoracic surgical training in the UK at various institutions including John Radcliffe Hospital in Oxford, the Royal Brompton and Guy’s & St Thomas’ Hospitals in London, before a transplant fellowship at Papworth Hospital, Cambridge.

Between 2003-2005, he worked for the University of Pittsburgh Medical Centre (UPMC, USA) as Assistant Professor of Surgery and the Director of a new Heart & Lung Transplant program which he helped to establish in Palermo, Italy for the Mediterranean Institute for Advanced Therapies (IsMeTT). He subsequently returned to Papworth Hospital as a consultant cardiothoracic & transplant surgeon and Director Lung Transplantation. In 2009 he moved to a similar position at St Vincent’s Hospital, Sydney, Australia. In Sydney, he was an Associate Professor of Surgery at the University of New Wales and on the Faculty at the Victor Chang Cardiac Research Institute (VCCRI). Together with Prof Peter Macdonald, the Director of Heart Transplantation, they developed the donation after circulatory death (DCD) heart transplant program.  In July 2014, Prof Dhital performed the world’s first heart transplant with a distantly procured DCD heart. He was the lead surgeon for the St Vincent's Hospital's DCD heart transplant program which to date has performed 28 successful transplants from this donation pathway.

Beyond his interest in surgery for cardio-pulmonary failure, he provides a comprehensive cardiac and thoracic surgical practice including pulmonary endarterectomy for Chronic Thromboembolic Pulmonary Hypertension. Prof Dhital has also had significant teaching responsibilities for medical students and junior surgeons. This has been complemented with a basic and translational research program with supervision of higher degree research students as co-director of the Transplant Laboratory at the Victor Chang Cardiac Research Institute.

James Lee Awarded “The Aftershock Foundation Research Grant”

Recently I have had the honour of being awarded The Aftershock Foundation Research Grant Award – a philanthropic grant valued at AUD$120,000. The Aftershock is a not-for-profile, start-up organisation with the mission to raise funds and awareness of high-mortality rate and rare cancers. It was founded by Suzanne Neate, who had recently experienced the tragic loss of her mother, Theresa Neate, to metastatic medullary thyroid cancer. The organisation prides itself in transparency and accountability, with every dollar raised going towards supporting the intended research.

The incidence of thyroid cancer is on the rise. It is now the 7th most commonly diagnosed cancer in women, and 3rd in women between 24 and 49 years of age. While this phenomenon is multifactorial and likely contributed significantly by detection bias, but the fact remains, a rapidly increasing number of patients will carry the diagnosis of thyroid cancer. While clinicians continue to debate the clinical significance of this, or the threshold to warrant further treatment, patients are seeking second opinions and dealing with the anxiety associated with their cancer diagnosis. In addition, the rate of indeterminate FNA cytology results continue to be reported between 20 to 25 % of all FNA samples from clinically significant nodules. This further plays into both the patients’ anxiety and clinicians’ uncertainty if surgery was not performed.

Molecular profiling of thyroid FNA (needle biopsy) samples continues to hold the promise to at least reduce, if not eliminate that preoperative uncertainty. Several commercialised products are currently available in the USA, with the promise to significantly improve the diagnostic accuracy of thyroid FNA. However, not only are none of these currently available in Australia, the published evidence also casts doubt in the utility of these diagnostic adjuncts in their current status. We believe that with further research, the potential of FNA molecular testing will be realised.

It has been shown that the true utility and the eventual gain in diagnostic accuracy depend on the prevalence of the disease as well as the frequency of indeterminate results in FNA samples of the specific region. Therefore, it is important for such research to take place locally here in Victoria. As the technique matures and clinical outcome information becomes available in time, it is envisaged that the clinical benefit of pre-operative molecular testing would be beyond the initial diagnostic phase, but also be able to inform clinicians on the prognosis.

There is no doubt that precision medicine with molecular techniques is the next frontier. Whether it is to inform on diagnosis, prognosis or likely response to treatment, the careful integration of pre-operative molecular testing should aim to streamline and optimise management of patients with thyroid nodules or malignancy. Patients with rare cancers such as thyroid cancer have much to gain from such cutting-edge technology, especially when there is significant heterogeneity in its clinical course. The ability to better predict clinical behaviour from molecular information will enhance the clinician’s confidence in recommending the appropriate level of treatment right from the outset, thus avoiding over- and under-treatment on an individual basis.

The support of philanthropic foundations such as The Aftershock is vital in our endeavours in the research and development of new techniques here in Victoria. The pilot data and studies will allow us to leverage more funding support from government agencies. As a rare cancer, research in thyroid cancer are ideally conducted in multicenter studies, and non-institutional seed funding affords the researcher freedom to be collaborative. Therefore, this Aftershock grant will contribute to establishing collaborations of multiple Melbourne institutions, including Alfred Health, Monash Health, and Epworth HealthCare.

Only one year into their existence, The Aftershock is already making a significant contribution to the medical research of rare cancers here in Victoria. Further funds have been pledged for both thyroid and brain cancers in the coming years. We are grateful for their work. We look forward to ongoing collaborations with The Aftershock, and draw much inspiration from their phenomenal fund-raising efforts.

For more information on The Aftershock, go to www.theaftershock.org

2019 Surgery Public Lecture

Professor Steven Boyce: Tissue engineering of skin for burns, and regenerative medicine for wound care

You are invited to attend a public lecture by Professor Steven Boyce, hosted by the Department of Surgery, Central Clinical School, Alfred Centre and the Victorian Adult Burns Service at Alfred Health.

In his seminar, Dr Boyce will identify wound closure as a limiting factor for survival and recovery after life-threatening burn injuries, and describe design considerations and current models of tissue-engineered skin to address this limitation.  He will also summarize results from preclinical characterizations, and clinical trial of autologous Engineered Skin Substitutes (ESS) in full-thickness burns ranging from 50-95% of the body surface.  The seminar will focus on the clinical benefits realized to date by burn survivors from this investigative therapy, and prospective benefits that are the subjects of continuing preclinical studies.  The remainder of the presentation will distinguish the capabilities of tissue engineering of skin from regenerative medicine for skin wounds that promises to restore the full, uninjured anatomy and physiology of skin without scar.  The principles for development of new cell therapies for repair and regeneration of skin are broadly applicable to most, if not all, of the tissues and organs in the human body.

Details

Date: Thursday 7 March 2019
Time: 5.30pm refreshments for 6.00pm start. 
Venue: Alfred Research Alliance Lecture Theatre (formerly AMREP lecture theatre) is adjacent to the Baker Institute at 75 Commercial Road, Melbourne 3004, 200 metres east of the main Alfred Hospital entrance
Cost: Free
RSVP: Link
Enquiries: E daphne.vogiagis@monash.edu or alison.clough@monash.edu

About our speaker
Steven Boyce, PhD, serves currently as Professor emeritus in the Departments of Surgery and Biomedical Engineering at the University of Cincinnati, and as Senior Investigator in the Research Department of the Shriners Hospitals for Children - Cincinnati.  He trained in the Department of Molecular, Cellular and Developmental Biology at the University of Colorado, and spent his post-doctoral years in the Department of Surgery at the University of California San Diego.  With interests and expertise in engineering of model systems for anatomy and physiology of human skin, Dr. Boyce has designed, characterized and tested engineered skin substitutes consisting of autologous human skin cells and degradable biopolymer scaffolds for closure of severe burns, reconstructive surgery, and chronic wounds.  Continuing investigations with advanced models of engineered skin are focused on restoration of cutaneous pigmentation, and regeneration of hair and glands after grafting of full-thickness wounds.