The Royal Brisbane & Women’s Hospital is a major tertiary referral centre for colorectal disease. The Colorectal Unit has a special interest in the application and development of laparoscopic techniques for colorectal disorders.
The RBWH is the major centre for complex inflammatory bowel disease cases and there is thus considerable exposure to laparoscopic total colectomies for acute severe colitis and the subsequent restorative ileal pouch procedures. The unit has a strong philosophy of combined Gastro/surgical consultation. Early surgery in ileal Crohn’s disease is an area of interest and thus there is considerable exposure to laparoscopic surgery for Crohn’s disease. There is also considerable experience in the treatment of functional disorders including sacral nerve stimulation and laparoscopic surgery for prolapse. An exenteration unit has been started and headed by Dr David Taylor and Dr Craig Harris. Dr Carina Chow has completed a robotic fellowship and models are been developed to implement its use. Colorectal cancer is well represented and the trans-anal approach to rectal diseases is currently under evaluation. Brisbane is a major teaching centre for the binational workshops in TaTME.
The Colorectal Unit also has a second training Fellow from overseas who has similar operative experience and logbook numbers as the TBCRS Fellow. Both Fellows are intimately involved in the 3 day workshop in laparoscopic colorectal surgery which is held every 8 weeks. The workshop has been a regular fixture since 2001. The Fellow is supported by 2 advanced training registrars, a principle house officer and 3 interns. There is a dedicated unit nurse co-ordinator.
Data has been prospectively collected on laparoscopic surgery since 1991 and over 4500 patients are now on the database. A further comprehensive database is separately maintained for inflammatory bowel disease. The unit has a newly appointed research co-ordinator.
Hospitals involved in programme:
• Royal Brisbane and Women’s Hospital
• St Vincent’s Private Hospital Northside
• Wesley Hospital, Brisbane
• St Andrew’s Private Hospital
University affiliation
• Department of Surgery, University of Queensland
• Fellow’s are appointed as Clinical Lecturers
Colorectal Surgeons:
• Prof Andrew Stevenson - Head of Unit, Chair of TBCRS
• Prof David Clark - Director of Training, Member CSSANZ
• Dr Damien Petersen - CSSANZ Councillor, Member CSSANZ
• Dr Carina Chow- Member CSSANZ
• Dr David Taylor - Member CSSANZ
• Dr Craig Harris - Member CSSANZ
Operative Exposure per Year for the Fellow (approximate figures):
• Major colorectal resections 530
• Laparoscopic Resections 400
• Prolapse surgery 70
• Minor anorectal procedures 320
• Rectal Cancer / TME 100
• Major IBD & Pouches 25 -30
Diagnostic Exposure:
• Colonoscopy: 1 list per week, approximately 40/year
• Anorectal manometry, pudendal nerve studies and endoanal/endorectal ultrasound: fully equipped laboratory at St Andrew’s Private Hospital - up to 900 patients per year having anorectal physiology studies available to Fellow depending on level of interest.
Research:
• Accredited TBCRS
• Clinical research in laparoscopic colorectal surgery, pouch surgery, colorectal cancer and incontinence. Unit members have been principal investigator and co-investigators in the ALCCaS and ALaCarte trials.
• Supported by dedicated research co-ordinator
Method of Funding:
• Senior registrar RBWH, half time
• Private assisting
• On call payments as fellow
Expected "on call" Roster Commitments:
• One in five weekends and weekday ward cover
Other strengths of unit:
This is a very collegiate unit. Fellows and their families are warmly welcomed.
David A Clark
Training Director