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Prince of Wales Hospital Upper GI/HPB Unit

ANZHPBA/ANZGOSA Fellowship Prince of Wales Hospital, Randwick, Sydney, Australia.

Overview

Prince of Wales Hospital is a busy tertiary hospital in Sydney’s eastern suburbs with a strong focus on cancer services. The Upper GI unit is a mixed unit encompassing both HPB surgery and upper GI/oesophago-gastric surgery.  There are 4 surgeons on the unit. There is one fellow who works for all consultants on the unit.

One surgeon has a predominantly HPB/transplant workload, two with a mixed practice of both oesophago-gastric and HPB surgery, and the 4th who has a predominantly oesophago-gastric and bariatric focus.
The team also includes at SET trainee registrar, a resident medical officer, and an intern.

Workload

In terms of HPB workload the unit performs approximately 50 pancreatic resections per year including both venous and arterial resection and reconstruction. The unit also performs approximately 80 hepatic resections per year, including many trisectionectomies, re-do resections, second and third stage resections, as well as laparoscopic resections and microwave ablations.

The oesophago-gastric workload involves approximately 10-15 oesophago-gastric resections on top of approximately 40 major procedures for benign disease.

There is further opportunity to be involved in approximately 20 renal transplantations performed each year, with a mixture of living related and cadaveric donors, and both adult and paediatric recipients.
The unit is involved in the care of patients in both Prince of Wales Public and Prince of Wales Private Hospitals.

Operative Experience

The Fellow is involved in all public operating lists, and most private lists throughout the 12 month appointment. This involves on average 5 full operating days per week, with involvement in between 200-300 major cases. The expectation would be that the fellow would be primary operator in around 50% of these cases, depending on the level of experience of the individual. The fellow is also expected to supervise and train the SET trainee registrar on the team in appropriate surgical cases.

The fellow is also expected to take second call on behalf of the unit consultants for weekend call shifts, and be involved in acute surgical emergencies admitted under the unit.

Multidisciplinary Interaction

The unit is also involved in a robust MDT process allowing discussion of these patients and further learning opportunities. This is a weekly meeting to discuss all gastrointestinal malignancies involving Upper GI and colorectal surgical specialists, medical oncologists, radiation oncologists, radiologists, pathologists and palliative care physicians.

There is also a monthly departmental audit meeting with associated journal club. The unit presents all activity data, and morbidity and mortality statistics on a bi-monthly basis.

Perioperative Evaluation

The unit runs a weekly public outpatient clinic which has a wide referral base. This encompasses both simple general surgical presentations, and complex upper GI and HPB referrals. Post operative and long term follow up patients also attend this clinic. The clinic provides opportunity for the pre-operative assessment and work up of upper GI/HPB malignancies under the supervision of the involved consultants.

Education and Training

The fellow attends all departmental and unit meetings, and may be involved in presentations at monthly journal club meetings within the hospital. Attendance at quarterly ANZHPBA journal clubs is also encouraged.

Administration facilities are available with access to an office, computer, internet access and printer.
The unit has strong ties with the University of NSW Medical Faculty, and opportunities for conjoint appointment are available, with associated clinical teaching roles.

Research opportunities are available within the unit, and the fellow can expect to be involved in presentations at national and international conferences, as well as in publication of projects completed during the fellowship year.

Contact

Should you require further information please feel free to contact the ANZHPBA/ANZGOSA supervisor for the hospital Dr Koroush Haghighi via email at surgeon@koroushhaghighi.com.au.

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