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Surgery Research

Emergency Medicine

The Emergency Medicine and Nursing Research Group in the Emergency Department is chaired by Dr. Martin Than, and includes Professor Mike Ardagh, Dr. Paul Gee, and Dr. Sandra Richardson.

Their research themes include diagnostic decision-making, particularly in relation to the diagnosis of acute coronary syndrome and venous thromboembolism, the health implications of seismic events, toxicology, ethics and emergency nursing.

In addition to grants from the Health Research Council and the Canterbury Medical Research Foundation, the group is supported by the Emergency Care Foundation, a charitable trust dedicated to supporting research, education and innovation in emergency health care.

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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.

Gastroenterology Research Group photo
Gastroenterology Research Group 2016

Clinical trials

  • ALCCaS RCT. Australasian laparoscopic colon cancer study, a randomized controlled multi-centre trial of laparoscopic versus open surgery for colorectal cancer.
  • An individual patient data meta-analysis using the combined databases of major international prospective randomized controlled trials (similar to ALCCaS) to define the patterns of colon cancer disease recurrence following laparoscopic or open surgery.
  • A La CaRT. The Australasian multicentre randomised controlled trial of laparoscopic versus open resection for rectal cancer
  • Cimetidine trial: A multicentre phase3 randomized controlled trial on effect of Cimetidine on outcomes in patients with colorectal cancer.
  • Randomised controlled trial comparing tailored vs standard sphincterotomy for idiopathic fissure in ano.

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, perianal disease and the outcomes of ileal pouch surgery, in particular cost and disability.
  • Management of rectal cancer.
  • Prospective studies of elective gastrointestinal operations and outcomes, including AIN, GIST's, diverticular disease and colorectal cancer.
  • The natural history of diverticulitis and risk factors for recurrence.
  • Multi-national study on the outcomes of patients having surgery for locally recurrent rectal cancer.

Laboratory-based research

  • Toxin-producing strains of enteric bacteria and colorectal cancer (J Keenan)
  • 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).

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Ophthalmology

The Ophthalmology Department currently has funding from the Health Research Council (NZ) to study “Retinopathy of Prematurity.”

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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
  • Patterns of Orbito-zygomatic fractures
  • Evaluation of Cone Beam CT scanning in orbital reconstruction
  • Oral Epithelial Dysplasia
  • Bisphosphonate induced Jaw Necrosis
  • Trial of New Delivery System in Management of Xerostomia

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Otolaryngology - Head & Neck Surgery

Clinical Research in this department covers most areas of the specialty, including General Otolaryngology, Rhinology, Head & Neck Surgery and Otology-Neurotology. Many members of the department undertake clinical research.

Mr Robert Allison leads much of the clinical research on head and neck cancer. Current studies involve a review of the management of laryngeal cancer in Christchurch, outcomes following lateral temporal bone resection for malignancy, a review of patients undergoing surgery for metastatic cutaneous squamous cell carcinoma to the parotid gland (this study is being carried out in conjunction with Waikato Hospital). He is also involved in an ongoing, prospective study examining the effects of pharyngeal pouch surgery on swallowing.

Mr Scott Stevenson is involved in research including rhinology and sleep medicine, he also leads research into general topics, including intervention rates for adenotonsillectomy, postoperative analgesia and bolus obstruction of the oesophagus.

Associate Professor Phil Bird is involved in outcomes research following cochlear implantation. He is also involved in collaborative research looking at the risk to inner ear function from middle ear surgery and cochlear implantation. This is a major collaboration with Dr Greig O’Beirne from the University of Canterbury, involving two PhD students.

There is also collaborative research with Professor Evan Begg from the Department of Clinical Pharmacology, relating to pharmokinetics of steroids when delivered via the intratympanic route. In conjunction with Mr Jeremy Hornibrook from the Otolaryngology Department, he is undertaking research in to intratympanic gadolinium as a marker for endolymphatic hydrops in the inner ear, comparing it with electrocochleography and clinical indicators of Ménière’s Disease.

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Paediatric Surgery

Professor Spencer Beasley has had a longstanding research interest in studying the effects of Adriamycin on the developing foetus, and refining the rodent model of the VATER association, as a means of investigating the embryogenesis of oesophageal atresia and related congenital structural abnormalities. Until the Christchurch earthquakes, this research focussed on the role of Sonic Hedgehog and its downstream genes in both normal development of the foregut and hindgut, and in abnormal organogenesis.

A major clinical research project, recently completed, studied 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. This work included the first comprehensive prospective study of the longterm outcomes after herniotomy in children. A key publication in the British Journal of Surgery provided a benchmark rate for complications of the procedure. Additional clinical studies have included a review of quality of life after laparoscopic ACE procedures, and the predictors of outcome following laparoscopic appendicectomy in children.

Other 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), and the effect of the paediatric surgical outreach programme on improving outcomes for children. The influence of service configuration on clinical outcomes is described in a lead article in the Journal of Pediatric Surgery (2015). The current focus of research interest relates to clarifying the higher cognitive processes around expert clinical judgement and decision-making. Already this work has led to a RACS course on Clinical decision-making for surgical teachers.

Cardiomyocytes

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Cardiomyocytes 2

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Peristalsis Sheet

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Peristalsis Sheet 2

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Gut Components

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Plastic Surgery

Research in this department includes clinical studies concerning wound healing, skin cancer and hand surgery.

Other collaborative research projects include the study of cutaneous squamous cell carcinoma (with the Department of Pathology), and tetraplegic upper limb surgery (with the Department of Orthopaedics).

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Urology

Clinical research is undertaken outside of the University, with support from the privately-funded Urology Trust.

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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 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" ].

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