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.    

2018 Central Clinical School Public Lecture

Obesity: a serious disease that deserves serious treatment

You are invited to attend the annual CCS public lecture. This year the lecture will be hosted by the Department of Surgery.

Obesity is the most prevalent disease in Australia affecting 28% of the adult population and has become our most important health care challenge. Prevention would be the ideal. However, for those already suffering effective treatment options are desperately needed. Once a given individual has gained weight it is very difficult to lose and maintain that loss as the body defends its fat mass vigorously. Bariatric (weight loss) surgery is currently the most predictably effective treatment for obesity. These procedures help to manage a person’s appetite and enable them to manage their weight into the long term. Bariatric Surgery also provides an opportunity to better understand the pathways that lead to sustained weight loss. Importantly, with weight loss achieved with bariatric surgery there are significant health gains for the individual and cost savings for the community.

This lecture will review the disease of obesity, describe the role of bariatric surgery as an effective treatment option and potential model for future treatments. Challenges and barriers to providing bariatric surgery at a population level will also be addressed.

Details
Date: Thursday 18 October 2018
Time: 6.30pm for a 7.00pm start. Lecture will be followed by Q&A session
Venue: AMREP Lecture Theatre
Cost: Free
RSVP: Eventbrite registration link

 

About our speaker

Professor Wendy Brown is an Upper GI and Bariatric Surgeon. She is Chair of the Monash University Department of Surgery at the Alfred Hospital, Director of the Monash University Centre for Obesity Research and Education and Clinical Director of the National Bariatric Surgery Registry and Victorian State Upper GI Cancer Registry. Her sub-specialist interests are oesophago-gastric cancer, gastrooesophageal reflux disease and bariatric surgery. Her research interests include health outcomes from bariatric surgery, animal models of bariatric surgery and basic mechanisms underlying satiety. She is Past President of OSSANZ and President of ANZGOSA, Immediate Past Senior Examiner in General Surgery for the RACS, Deputy Chair of the Victorian State Consultative Surgical Council and Chair of the Scientific Committee of the International Federation for Surgery for Obesity and Metabolic Disorders. She was awarded the prestigious RACS John Mitchell Crouch Fellowship for Surgical Research Excellence in 2018.

The John Masterton Public Lecture, “Thyroid Cancer, towards a better paradigm” Mr James Lee

AMREP Lecture Theatre and Foyer, AMREP Education Centre, Alfred Health

5.30 pm                        Drinks and canapes

6.00 pm                        Lecture to begin with Introduction by Mr Roger Wale

Introduction

The incidence of thyroid cancer has almost tripled over the last four decades. In 2017, in Australia, it was the 7^th most commonly diagnosed cancer in females. The true underlying cause of this increase is unclear, but what is clear is that a new treatment paradigm is needed. The behaviour of thyroid cancers varies widely – from extremely indolent to universally lethal. Thankfully, the latter is rare. Due to the wide spectrum of aggressiveness, a personalised treatment plan is the holy grail of thyroid cancer management, striving for that perfect balance between optimal treatment and minimising treatment side-effects. With appropriate treatment, long-term survival can be expected in the majority of patients diagnosed with thyroid cancer. Therefore, ensuring an optimal quality of life post cancer treatment is also a priority. Thyroid cancer is managed with a multi-disciplinary team approach involving surgeons, endocrinologists, pathologists, nuclear medicine physicians, radiologists, nurses, and other allied health staff. However, the mainstay of treatment for thyroid cancer is surgery. Thyroid surgery has undergone dramatic changes over the last 150 years. It has been transformed from a high-risk procedure, once banned by the French Academy of Medicine in the mid-1800’s, to one with very low morbidity and near-zero mortality today.
In this lecture, James will briefly describe the key turning points of interest in the history of thyroid surgery. In addition, the trends in the management of thyroid cancer will be discussed. Finally, James will address 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.

Speaker

MR JAMES LEE, SENIOR LECTURER, SURGERY ALFRED HOSPITAL
James is an academic surgeon, specialising in Endocrine Surgery (of the thyroid, parathyroid and adrenal glands). His public hospital appointments are at The Alfred and Monash Health, and his private practice is based at Epworth Richmond. James is a Senior Lecturer at Monash University, where he currently holds the prestigious Royal Australasian College of Surgeons (RACS) Senior Lecturer Fellowship. James’ research focuses on patient-centred outcomes of thyroid cancer and surgery. He has published numerous papers in this area, both in clinical and basic science research. James also regularly presents his research findings in national and international meetings. His research is supported by Perpetual IMPACT Philanthropy, The Aftershock Foundation, and Epworth Research Institute. James is the Deputy Co-Chair of the RACS Younger Fellows Committee, the Younger Fellows Representative on the Section of Academic Surgery Committee, and a Member of the Victorian Regional Committee. In 2016, James founded the Surgical Research Essentials course, which has enabled aspiring academic surgeons to enter the world of surgical research.

2018 Surgical Research Forum – Innovation for better patient care

Thursday 26 July, 2018
1.30 pm – 5.30 pm
Lecture Theatre, Level 5 Alfred Centre
Purpose: 
To showcase the research activities of the Alfred Hospital Surgical Departments
 
Session 1 – The Hugh Dudley Symposium on Surgical Innovation
Chair – A/Prof Bill Johnson Director of Surgery Alfred Health

Time	Presenter	Topic
1.30 pm	A/Prof Jeremy Grummet	Innovations in the diagnosis of prostate cancer
1.45 pm	Prof Mark Fitzgerald	New tools for streamlining trauma care
2.00 pm	Mr Cheng Lo	Clinical application of cultured epithelial autografts (CEA) in burns injuries
2.15 pm	A/Prof Heather Cleland	Novel ways to achieve skin closure in burns patients
2.30 pm	A/Prof Susan Liew	Custom implants and instruments
2.45 pm	Mr Charles Milne	An integrated approach to the operating room – Hybrid Technology

The Sir Edward Hughes Keynote Lecture
Introduced by Adrian Polglase 

3.00 pm

Prof David McGiffin

Novel ideas to improve therapy for patients with end stage heart disease

3.30 – 3.45 pm Afternoon tea
Session 2 – The Paul O'Brien Younger Surgical Researchers Symposium
This Symposium will highlight the work of our Higher Degree Students and Post Doctoral Fellows
Chair – Professor Wendy Brown Chair, Department of Surgery

Time	Presenter	Topic
3.45 pm	Dr Geraldine Ooi	Improving   liver function through weight loss
4.00 pm	Mr Matt Read	Barretts oesophagus – towards a better future
4.15 pm	Mr Stephen Bell	ADIPOSE trial – the effect of weight loss on Rectal Cancer Surgery - Cabrini
4.30 pm	Dr Rebekah Engel	Organoid research and colorectal cancer - Cabrini
4.45 pm	Rowan Miller	Urology Masters
5.00 pm	Mr Frank Raiola	Osseointegration changing lives
5.15 pm	Mr Charles Pilgrim	IRE – new hope for inoperable Pancreatic Cancer

The John Masterton Public Lecture

"Thyroid Cancer, towards a better paradigm"  Mr James Lee

AMREP Lecture Theatre and Foyer, AMREP Education Centre, Alfred Health
5.30 pm    Drinks and canapes
6.00 pm    Lecture to begin with Introduction by Mr Roger Wale

Enquiries: Dr Daphne Vogiagis daphne.vogiagis@monash.edu
Web: www.monash.edu/medicine/ccs/surgery-alfred