Surgery Research
Emergency Medicine
Professor Ardagh heads the Emergency Medicine and Nursing Research Group in the Emergency Department. This group includes Dr Martin Than and PhD student Sandra Richardson (the only Emergency Nurse Researcher in New Zealand). Their research includes diagnostic decision-making research, in collaboration with the Respiratory Medicine and Cardioendocrine Research Groups and the ethics of resuscitation medicine.
General Surgery
The department has considerable expertise in clinically-based research, as well as translational research from laboratory based research programs. The collaborations this department has with other clinicians and researchers from New Zealand’s hospitals and universities are one of the strengths of their research program.
Clinical trials
- ALCCaS RCT. Australasian laparoscopic colon cancer study, a randomized controlled multi-centre trial of laparoscopic versus open surgery for colorectal cancer.
- A multicentre RCT on colonic stents versus open operation for stage 4 colorectal cancers
- A multicentre RCT of laparoscopic versus open surgery for rectal prolapse.
Clinical studies
- Colorectal function following spinal injuries.
- Various aspects of inflammatory bowel disease in a population-based IBD cohort, including the characteristics of resectional surgery and surgery for perianal disease.
- Management of rectal cancer.
- Prospective studies of elective gastrointestinal operations and outcomes.
- Randomised controlled trial comparing tailored vs standard sphincterotomy for idiopathic fissure in ano.
- The outcome of computed tomography diagnosed intussusception in adults.
- Outcome of surgery for bowel obstruction in recurrent ovarian malignancy.
- The utility of anorectal manometry and ultrasound in the management of faecal incontinence.
- Examine enhanced recovery (fast track management) after surgery pathway for both laparoscopic and open colorectal procedures
Laboratory-based research
- Selected Ion Flow Tube Mass Spectrometry “supernose” Technology Technology (R. Allardyce), breath test diagnosis, including breath testing children, renal dialysis, transplant and respiratory patients.
- The role of outer membrane vesicles in modulation of intestinal function by gram-negative bacteria (J Keenan in collaboration with the Departments of Physiology and Medicine, University of Otago).
- Genetic and environmental influences on inflammatory bowel diseases (J Keenan in collaboration with Departments of Pathology and Medicine, University of Otago, Christchurch).
- A study of host iron levels and H. pylori pathogenesis (J Keenan).
- Foods to prevent or treat H. pylori infection (in collaboration with Crop and Food Research).
Ophthalmology
The Ophthalmology Department currently has funding from the Health Research Council (NZ) to study “Retinopathy of Prematurity.”
Oral and Maxillofacial Surgery
This department is involved in a number of research projects, including:
- Demographics of Facial Fractures
- Influence of Alcohol in Facial Injuries
- Facial Injuries in Neurosurgical admissions
- Facial Laser Scanning
- Oral Epithelial Dysplasia
- Orofacial Dystonia
- Bisphosphonate induced Jaw Necrosis
- Trial of New Delivery System in Management of Xerostomia
Otolaryngology - Head & Neck Surgery
The clinical research in this Department encompasses General Otolaryngology, Rhinology, Head and Neck Surgery, Otology, and Neurotology and includes randomised controlled trials (RCT) investigating postoperative analgesia and bolus obstruction of oesophagus (the latter in conjunction with Emergency Medicine and Gastroenterology.)
Dr Phil Bird has a particular interest in outcomes research relating to cochlear implantation and otology, specifically the protection of inner ear function during medical and surgical treatment using corticosteroids delivered directly into the middle ear with diffusion into the inner ear (in collaboration with Evan Begg, Clinical Pharmacology). He is also involved in a RCT on prevention of hearing loss, both in patients undergoing Cisplatin chemotherapy and in attempted hearing preservation in cochlear implantation. Another research interest is eustachian tube dysfunction, especially in children and young adults with refractory middle ear disease, and the particular role of the adenoid pad. This is a long term project and will involve a combination of basis science and clinical research.
Paediatric Surgery
Professor Spencer Beasley has a longstanding research interest in studying the effects of Adriamycin on the fetus, and refining the rodent model of the VATER association, as a means of investigating various aspects of oesophageal atresia and related congenital structural abnormalities.
More recently the role of Sonic Hedgehog in both normal development of the foregut and hindgut, and in abnormal development has been studied and related to the development of malignancies in children, particular hepatoblastoma and neuroblastoma.
Clinical research in Pediatric Surgery includes a study of the factors that predict outcome and complications after herniotomy and orchidopexy, the relationship between the operative appearance of the hernial sac at herniotomy and prediction of a contralateral hernia, quality of life after laparoscopic ACE procedure, predictors of outcome following laparoscopic appendicectomy in children and the outcomes following laparoscopic fundolplication in infants <10kg.
Other current research includes a study of the parameters of operative experience that predict progress in surgical trainees (surgical education), the use of the operative logbook as a tool to measure the characteristics of accredited training posts (surgical education), trends and complications of a variety of minimally invasive surgical procedures, the effect of the paediatric surgical outreach programme on improving outcome for children.
An additional project investigates a possible solution to the difficult problem of "short gut syndrome", where there is inadequate length of small bowel for effective absorption to occur. This happens in a variety of situations, including Crohn disease, embolic or vascular disease, closed loop obstruction, malrotation with volvulus, gastroschisis with atresia, necrotizing enterocolitis, CIIPS, extensive aganglionosis (Hirschsprung disease), Microvillus inclusion and polyposis. Currently, therapeutic options are limited, and range from TPN until adaption occurs for less severe situations, to small bowel transplantation with its associated problems of rejection. We are investigating techniques of tissue-engineering bowel using the Yamanaka et al. technique in which induced pluripotent stem cells (iPS) dedifferentiated from somatic fibroblasts by retroviral transduction of four transcription factors, are encouraged to differentiate into cells normally found in the gut. This technology using iPS cells overcomes the ethical problem of using fertilized eggs, obviates the need for immunosuppression, and has the potential to restore functional gut in those with "short gut syndrome". We are refining the technique to differentiate iPS cells more reliably into components of the gut, including smooth muscle, with the longer term goal of employing tissue engineering techniques to rebuild gut using the patients’ own cells. The value of these new technologies is that ultimately they may dispense with the need for small bowel transplantation, and allow patients who have inadequate gut for absorption to "grow" their own small bowel.
Cardiomyocytes
Cardiomyocytes 2
Peristalsis Sheet
Peristalsis Sheet 2
Gut Components
Plastic Surgery
Research in this department includes an ongoing collaboration with the Departments of Plastic Surgery and Dermatology at Addenbrookes Hospital, Cambridge and includes melanoma SSG donor site, management of atypical fibroxanthoma, and aspects of free tissue reconstruction following breast cancer..
Clinical research within Plastic Surgery currently includes an evaluation of the long term results of bilateral breast reconstruction, data collection on the growth of non-melanoma skin cancer and quantification of split skin graft shrinkage and a study of nodal metastases of cutaneous malignant melanoma.
Other collaborative research projects include a study of non-melanoma skin cancer in renal transplant recipients (with Renal, Vascular departments and the Angiogenesis research group), laparotomy scar outcome (with General Surgery) and tetraplegic upper limb surgery (with Orthopaedics).
Urology
Clinical research is undertaken outside of the University, with support from the privately-funded Urology Trust.
Vascular Endovascular and Transplant Surgery (VETS)
VETS members are engaged in clinical and laboratory-based research, in collaboration with established research groups at University of Otago, Christchurch, and the University of Canterbury.
Clinical research themes include prioritisation for surgery, vascular audit and continuous quality improvement, clinical decision modelling in vascular surgery (focussed around abdominal aortic aneurysm), and wound management (in collaboration with Nurse Maude.)
Their laboratory-based research includes a collaborations with the University of Canterbury Centre for Bioengineering (Prof Tim David) and Biological Sciences (Dr Steve Gieseg) ["The Growth Dynamics of Atherosclerotic Plaque"] and the Angiogenesis Research Group (University of Otago, Christchurch) and the Department of Plastic Surgery [“Skin cancers in renal transplant recipients" ].