Barwon Health Research - General Surgery

General Surgery

The Department of Surgery has a strong research focus and a productive publication output, and constantly strives to improve patient outcomes. The University Department of Surgery collaborates with local and global organisations to ensure patients receive best surgical outcomes. The department strives to embrace new technologies and latest surgical research, promoting and encouraging students to undertake PhD, Masters of Surgery and Honours programs which are supervised by department academics.

Research Areas

Master of Surgical Research

This two year course of study leads to a Masters by Research degree, with the students drawn from qualified medical practitioners, surgeons in training and fellowship-trained surgeons. The program has a primary function in providing doctors with a structured training and experience in independent research, specifically in the surgical specialty.

www.surgical-research.com/copy-of-media

Collaborating Organisations

Royal Australasian College of Surgeons (RACS)	Deakin University	The University of Melbourne	The University of Edinburgh	Victorian Perioperative Consultative Council (VPCC)
Epworth Geelong	Institute for Intelligent Systems Research and Innovation	The Royal Children’s Hospital Melbourne	Safer Care Victoria	Cancer Council Victoria

Research Team

Research Staff

PhD Students

Dr Wendy Crebbin, PhD by Research, Deakin University: Teaching Junior Doctors: How experts think: What impact does it have?
Dr Amelia McGuinnes, PhD by Research, Deakin University: Effect of bowel prep for colonoscopy on intestinal microbiota

Master of Surgical Research Candidates

Dr Louis Scarrold, Characterising the impact of sarcopenia on Colorectal Surgical Outcomes
Dr Hamish Morgan, Geelong Ventral Hernia Repair Audit
Dr Anh Vu, Implementation of robotic-assisted surgery within a regional centre in Australia: has this changed our practice and what can we expect moving
Dr Henry Drysdale, The Impact of COVID-19 on General Surgery in Geelong
Dr John Kefalianos, An evaluation of the Australia and New Zealand Emergency Laparotomy Audit (ANZELA)
Dr Pranav Divakaran, What is the Significance of Side Branch IPMN? A regional Australian Experience

Research News

General Surgery takes out 2020 Barwon Best Care Award for COVID-19 regional response

The response to the coronavirus disease 2019 pandemic required conserving capacity and resources to avoid the health sector being overwhelmed.

To assess Barwon Health’s general surgery response and outcomes, data was collected to compare the first 7 weeks of service delivery during the COVID-19 pandemic (30 March to 17 May 2020) to the corresponding 7 weeks in 2019 (1 April 2019 to 19 May 2019). The study found that:

Elective general surgery decreased by 45.9% but an essential service was maintained by substantially increasing our public in private operating to perform 81 cases.
Despite a 30% decrease in emergency department presentations, general surgery admissions decreased only 6.1% while emergency operations increased 13.9%.
Telehealth was used to conduct 81.3% of outpatient appointments and 61.8% of pre‐operative anaesthetic reviews.
No significant differences were found for overall surgical outcomes, including appendicectomy and laparotomy.
Operative exposure for trainees was maintained.

These results show that Geelong was able to provide a safe and effective general surgery service during the first 7 weeks of the coronavirus disease 2019 pandemic. There are some valuable lessons which could be adopted elsewhere in the event of a surge or second wave of cases.

Project Team: Prof Glenn Guest, Mr Simon Crowley, Dr Henry Drysdale, Dr Will Anderson, Dr Pia Bernardi, Dr Tess Asgill, Dr Elliot Bowden, Dr Jesse Cole, Dr Jordy Dangen, Dr Steve Lau, Dr Ellen McMahon, Dr Yit Leang, Dr Eileen Mary Moore, Mr Sonal Nagra, Dr Sally Ooi, Dr Bushra Othman, Dr Matthew Shears, Dr Sam Pellegrino, A/Prof Douglas Stupart, Dr Kirk Underwood, Prof David Watters.

Featured Publications

Post-operative cognitive dysfunction: An exploration of the inflammatory hypothesis and novel therapies. [NOTE – Abstract only; Barwon Health staff can request full text from Library]. Skvarc DR, Berk M, Byrne LK, Dean OM, Dodd S, Lewis M, Marriott A, Moore EM, Morris G, Page RS, et al. Neuroscience & Biobehavioral Reviews. 2018;84: 116-133.

Cited By Citation in Context

Global surgery 2030: Evidence and solutions for achieving health, welfare, and economic development. Meara JG, Leather AJM, Hagander L, Alkire BC, Alonso N, Ameh EA, Bickler SW, Conteh L, Dare AJ, Davies J, et al. The Lancet. 2015;386(9993): 569-624.

Cited By Citation in Context

Global cancer surgery: Delivering safe, affordable, and timely cancer surgery. [NOTE - Full text for Barwon Health staff; public can view abstract]. Sullivan R, Alatise OI, Anderson BO, Audisio R, Autier P, Aggarwal A, Balch C, Brennan MF, Dare A, D'Cruz A, et al. The Lancet Oncology. 2015;16(11): 1193-1224.

Cited By Citation in Context

Prevalence of bullying, discrimination and sexual harassment in surgery in Australasia. Crebbin W, Campbell G, Hillis DA, Watters DA. ANZ J Surg. 2015;85: 905-909.

Cited By Citation in Context

Perioperative mortality rate (POMR): A global indicator of access to safe surgery and anaesthesia. [NOTE - Full text for Barwon Health staff; public can view abstract]. Watters DA, Hollands MJ, Gruen RL, Maoate K, Perndt H, McDougall RJ, Morriss WW, Tangi V, Casey KM, McQueen KA. World J Surg. 2014;39(4): 856-864.

Cited By Citation in Context

Among vitamin B12 deficient older people, high folate levels are associated with worse cognitive function: Combined data from three cohorts. [NOTE – Abstract only; Barwon Health staff can request full text from Library]. Moore EM, Ames D, Mander AG, Carne RP, Brodaty H, Woodward MC, Boundy K, Ellis KA, Bush AI, Faux NG, et al. J Alzheimer's Dis. 2014;39(3): 661-668.

Cited By Citation in Context

A systematic review of the management and outcome of toxic epidermal necrolysis treated in burns centres. [NOTE - Full text for Barwon Health staff; public can view abstract]. Mahar PD, Wasiak J, Hii B, Cleland H, Watters DA, Gin D, Spinks AB. Burns. 2014;40(7): 1245-1254.

Cited By Citation in Context

Increased risk of cognitive impairment in patients with diabetes is associated with metformin. Moore EM, Mander AG, Ames D, Kotowicz MA, Carne RP, Brodaty H, Woodward M, Boundy K, Ellis KA, Bush AI, et al. Diabetes Care. 2013;36(10): 2981-2987.

Cited By Citation in Context

Cognitive impairment and vitamin B12: A review. Moore E, Mander A, Ames D, Carne R, Sanders K, Watters DA. [NOTE - Full text for Barwon Health staff; public can view abstract]. International Psychogeriatrics. 2012;24(4): 541-556.

Cited By Citation in Context

Cumulative sum techniques for surgeons: A brief review. [NOTE - Full text for Barwon Health staff; public can view abstract]. Yap C, Colson ME, Watters DA. ANZ J Surg. 2007;77(7): 583-586.

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All Publications

2020

Watters DA, Brown W, Hardidge A, Perioperative Expert Working Group; Victorian Perioperative Consultative Council; Victorian Surgical Directors Group. Perspective: Victoria's Perioperative Response to the COVID-19 Pandemic. ANZ Journal of Surgery. doi: 10.1111/ans.16117. [EPub ahead of print]
Lantz A, Holmer H, Finlayson SRG, Ricketts TC, Watters DA, Gruen RL, Johnson WD, Hagander L. Measuring the migration of surgical specialists. Surgery. Jun 2020. doi: 10.1016/j.surg.2020.04.014. [EPub ahead of print]
Watters DA, Tangi V, Guest G, McCaig E, Moate K. Advocacy for global surgery: a Pacific perspective. ANZ Journal of Surgery 2020. [EPub ahead of print]
Stupart D, Beattie J, Lawson M, Watters DA, Fuller L. Medical Students Can Learn Surgery Effectively in a Rural Longitudinal Integrated Clerkship. Journal of Surgical Education. 2020. 10.1016/j.jsurg.2020.04.007 [EPub ahead of print]
Lau S, Mirmilstein G, Wardill D. Enhanced localization of duplicated ureters in robotic Hartmann’s reversal using indocyanin green. ANZ Journal of Surgery. 2020;90(4):634-635. doi: 10.1111/ans.15286. [EPub ahead of print]
Fordyce A, Vorias B, Taranto L, Soares A, Watters D, Saunders C. Breast Disease in Timor Leste. ANZ Journal of Surgery. 2020. doi: 10.1111/ans.15720 [EPub ahead of print]
Lau S, Wardill D. How to do an extended view totally extraperitoneal mesh repair of midline ventral hernia. ANZ Journal of Surgery. 2020;90(6): 1151-1152.
Nagra S, Kaur B, Singh S, Tangi V, McCaig E, Stupart D, Moore EM, Meera J, Guest GD, Watters DA. How will increasing surgical volume affect mortality in the South Pacific. ANZ Journal of Surgery. 2020. doi: 10.1111/ans.15989.
Naresh D, Kefalianos J, Watters DA, Stupart S. Who tolerates early enteral feeding after colorectal surgery? ANZ Journal of Surgery. 2020. doi: 10.111/ans.15979.
Walker H, Liew K, Adams V, Larcombe S, Nagra S, Guest G, Athan E. Medical Education: Necrotising enterocolotis caused by Clostridium perfringens: a life-threatening manifestation of a common foodborne infection. Medical Journal of Australia. 2020. doi: 10.5694/mja2.50568.
Tobin SA, Watters DA. Communication: an enabling competency. ANZ Journal of Surgery. 2020 Jan. doi: 10.1111/ans.15672.
Beasley SW, Smith K, Watters D. What leadership means as a core surgical competence in everyday practice. ANZ Journal of Surgery. doi: 10.1111/ans.15640.
Hennes D, Dragovic A, Sewell J, Yeong Hoh M, Grills R. Primary basal cell carcinoma of the prostate with concurrent adenocarcinoma. IJU Case Reports. 2020. doi: 10.1002/iju5.12143.
Hollands M, et al. One Hundred Up: The Weary Dunlop Boon Pong Scholarship. ANZ Journal of Surgery. 2020; 90:211–214.
Nandoskar P, Coghlan P, Moore MH, Ximenes J, Moore EM, Karnon J, Watters DA. The economic value of the delivery of primary cleft surgery in Timor Leste 2000- 2017. World Journal of Surgery. 2020 Feb. doi: 10.1007/s00268-020-05388-3.

2019

Kim J, Dobson B, Ng CLH, Thong D, Arthur T, Parker D, Quest Collaboration. Can normal inflammatory markers rule out acute appendicitis? The reliability of biochemical investigations in diagnosis. ANZ Journal of Surgery. 2019 Oct. [Epub ahead of print]
Bagguley D, Fordyce A, Guterres J, Soares A, Valadares E, Guest GD, Watters D. Access Delays to Essential Surgical Care Using the Three Delays Framework and Bellwether Procedures at Timor Leste’s National Referral Hospital. BMJ Open. 2019 Aug;9(8):e029812.
Hong MKY, Yeung JM, Watters DAK, Faragher IG. State-Wide Outcomes in Elective Rectal Cancer Resection: Is there a case for centralisation in Victoria? ANZ Journal of Surgery. 2019 Aug;89(12):1642-1646.
Sarfati D, Dyer R, Sam FA, Barton M, Bray F, Buadromo E, Ekeroma A, Foliaki S, Fong J, Herman J, Huggins L, Maoate K, Meredith I, Mola G, Palafox N, Puloka V, Shin HR, Skeen J, Snowdon W, Tafuna'i M, Teng A, Watters D, Vivili P. Cancer Control in Small Island Nations 1. Cancer control in the Pacific: big challenges facing small island states. Lancet Oncology. 2019 Aug;20(9);e475-e492.
Ekeroma A, Dyer R, Palafox N, Maoate K, Skeen J, Foliaki S, Vallely A, Fong J, Hibma M, Mola G, Reichhardt M, Taulung L, Aho G, Fakakovikaetau T, Watters D, Toliman PJ, Buenconsejo-Lum L, Sarfati D. Cancer Control in Small Island Nations 2. Cancer management in the Pacific region: a report on innovation and good practice. The Lancet Oncology. 2019 Aug;20(9):e493-e502.
Ng S, Stupart D, Watters D. Trends in Survival after Colorectal cancer Surgery in an Australian Regional Hospital. World Journal of Colorectal Surgery. 2019 Jun;8(2):40-43.
Ng S, Kong J, Stupart D, Watters D. Is Colonoscopic Surveillance Necessary after Curative Resection of Colorectal Cancer in Elderly Patients? WJCS. 2019 Jun;8(2):24-27.
Roydhouse C, Gannan E, West L, Brandt C, Spokes R. A Rare Case of Primary Multifocal Mucoepidermoid Carcinoma in the Skin of the Breast Masquerading as a Breast Mass. Annals of Clinical Case Reports Open Access. Case Report. 2019 Apr;4:e1649.
Fehlberg T, Rose J, Guest G, Watters D. The Surgical Burden of Disease and Perioperative Mortality in Patients Admitted to Hospitals in Victoria, Australia: a Population-Level Observational Study. British Medical Journal Open Access. 2019 Apr;0:e028671.
Watters DA, Smith JA. Being a better surgeon: a multi-competency challenge. ANZ Journal of Surgery. 2019 Apr;89(5):461-463.
Stevens C, Watters D. Short-term outcomes of pancreaticoduodenectomy in the state of Victoria-Hospital resources are more important than volume. ANZ Journal of Surgery. 2019 Apr;89:1577-1581. doi: 10.1111/ans.15298.
Crebbin W, Beasley S, Tobin S, Guest G, Duviver R, Watters D. Judgement – Clinical Decision Making as a core surgical competency. ANZ Journal of Surgery. 2019 Apr;89:760-763.
Hong M. Murugappen S, Norton S, Moore E, Grills R. Male Urethral Stricture Disease in a Regional Centre: 10 Years of Experience. ANZ Journal of Surgery. 2019 Mar;89:747-751.
Richardson TE, Yanada BA, Watters D, Stupart D, Lamichhane P, Bell C. What young Australians think about a tax on sugar-sweetened beverages. ANZ Journal of Public Health. 2019 Jan;43:63-67.
Coventry AC, Vaska AI, Holland AJA, Read DJ, Ivers RQ. Surgical Procedures Performed by Emergency Medical Teams in Sudden-Onset Disasters: A Systematic Review. World Journal of Surgery. 2019 May;43: 1226-1231.
Watters DA, McCaig E, Nagra S, Kevau I. Surgical training programmes in the South Pacific, Papua New Guinea and Timor Leste. British Journal of Surgery. 2019 Jan;106:e53-e61.
Watters DA, Smith K, Tobin S, Beasley SW. Follow the leader: followership and its relevance for surgeons. ANZ Journal of Surgery. 2019 Jan;89:589-593.
Sakowska M, Cole JAM, Watters DA, Guest GD. Impact of public-private partnership on a regional colonoscopy service. ANZ Journal of Surgery. 2019 Jan;89(5):552-556.
Sebastian A, Stupart D, Watters D. Loop ileostomy reversal after laparoscopic versus open rectal resection. ANZ Journal of Surgery. 2019 Aug;89(3):e52-e55.