Opportunity in Wales

Mr Ashraf Rasheed, the AUGIS regional representative in Wales reports that the Welsh AUGIS chapter will be held in association with WAGE (Welsh Association of Gastroenterology and Endoscopy) on Friday March 1, 2013. The day is intended to be educational and interactive covering topics of practical value. It will be declared as a surgical and gastroenterology training day in Wales and we hope that the meeting will attract attendees from outside Wales also. To obtain a provisional programme for this event, please email Nichola Coates at nichola@augis.org


Bile Duct Injury Symposium

The Bile Duct Injury Symposium  – Are Cholecystectomy Related Bile Duct Injuries Avoidable? will be taking place on Friday, 14 December at the Royal College of Surgeons. The Symposium will highlight the continuing problem posed by iatrogenic bile duct injuries occurring during the performance of cholecystectomy in the UK, identify the reasons why, the steps to avoid it, what to do when it is suspected, the medico-legal implications for patients, doctors and hospitals and, finally, define who should be undertaking this procedure.



The 2013 Price Thomas Travelling Fellowships

The Travelling Surgical Society of Great Britain and Ireland is pleased to invite applications for the 2013 Price Thomas Travelling Fellowships

The Travelling Surgical Society of Great Britain and Ireland is a group of surgeon which travels to various hospitals and surgical departments around the world and in the UK. These are academic and clinical meetings and the purpose is to encourage educational and surgical exchanges. The Society was founded in 1924 with Lord Moynihan as its first president. The current membership consists of about 50 surgeons of whom 30 are in active practice. It is distinguished by numerous titles, honours, and Presidencies of learned organisations, including Royal Colleges.

Sir Clement Price Thomas was the third President of the Travelling Surgical Club (as it was then known) from 1952 to 1972. His other Presidencies including that of the BMA and the Royal Society of Medicine: he also became a Council Member and Vice President of the Royal College of Surgeons of England.

His son Martyn was consultant general surgeon to the Royal Gwent Hospital in Newport from  1975 to 1990, developing an interest in urology and breast cancer. He served as surgical tutor to the Royal College of Surgeons and was a popular examiner in Wales and the University of Cambridge. Having retired early in 1990 from his post in Newport, he continued in clinical practice as Consultant Surgeon to Addenbrooke’s Hospital in Cambridge. Martyn’s natural teaching ability inspired him to volunteer as a demonstrator in the Department of Anatomy.

These awards were established in their memory. There will be two bursaries. The holders of the 2013 awards will travel to Charlottesville, Virginia, USA, with the Travelling Surgical Society in May 2013. During this time they will deliver at least two papers each at scientific meetings at local hospitals. The bursaries will cover registration fees, travelling expenses, hotel costs and all organised meals.

Who may apply?


Stomach and Oesophageal cancer audit reveals increased survival rates

A greater proportion of patients who have curative treatment for oesophageal or stomach cancer are living longer after diagnosis, according to new findings released today by the National Oesophago-Gastric Cancer Audit.

The Audit – commissioned by the Healthcare Quality Improvement Partnership and carried out by a partnership between AUGIS, the British Society of Gastroenterology, the Royal College of Radiologists, the Health and Social Care Information Centre and the Royal College of Surgeons of England – found that nearly 50% of patients with stomach tumours and around 45% of patients with an oesophageal tumour were still alive three years after diagnosis. Ten years ago, only about one third of patients survived longer than three years.

The audit is the largest of its kind in the world and collected data on more than 17,000 patients in England and Wales diagnosed between October 2007 and June 2009. It is the first time that national data on three year survival rates for this patient group has been published.

It shows that if patients are diagnosed early enough and have curative treatment, their chances of long-term survival are stronger.

The 2012 Annual Report of the National Oesophago-Gastric Cancer Audit – http://www.ic.nhs.uk/services/national-clinical-audit-support-programme-ncasp/audit-reports/oesophago-gastric-cancer – also highlights that the pattern of referral from general practice to hospital varies significantly by region in England and Wales. The proportion of patients who were diagnosed after an urgent GP referral ranged from 88 per cent to 38 per cent among the regional cancer networks.

In addition, 16 per cent of patients were diagnosed with cancer after an emergency hospital admission. These patients are less likely to benefit from treatment than patients diagnosed after a GP referral as the disease has advanced considerably.

Together, oesophageal and stomach cancers are the fourth most common cause of cancer death in the United Kingdom, affecting around 13,500 people each year.

The improved results outlined in the audit reflect better organisation of NHS cancer services in England and Wales. The centralisation of cancer services has allowed patients to have better access to the best available treatment. More than two-thirds (71%) of local hospitals have now combined multi-disciplinary team meetings with specialised hospitals, compared to one third (34%) five years ago. This has transformed patient care and surgery is now safer than it was 10 years ago.

Richard Hardwick, consultant surgeon and AUGIS member, said: “Survival of patients undergoing curative surgery for oesophageal or stomach cancerhas improved significantly. Our next challenge is to reduce the rates of complications following these major operations so that our patients recover more quickly from their surgery.”


 


AUGIS member gives Hunterian oration

AUGIS member Professor Alan Osborne, who works in Bristol gave a very well-received Royal College of Surgeons Hunterian Oration at the DDF in Liverpool, speaking on ‘Gut Hormones in Bariatric Surgery.’

Professor Osboure described a study to find out what happens to gut hormones after laparscopic RYGB which measured gut hormone changes post-operatively and changes to appetite and satiety. The results showed a significant decrease in hunger. He also looked at insulin resistance, diabetes adding and quality of life studies. He said: “Bypass surgery provides a fascinating model for the study of metabolic surgery but we need to look beyond weight loss and study diabetic outcomes.”

Prof Osborne also said that looking at the economic impact of surgery showed how bariatric operations saved millions of pounds. He referred to a study of 78 people which showed that before operations they had collectively worked 1,023 hours per week whilst after operations this figure rose to 1,611 hours, a 57% increase. Before bariatric surgery, the patients were claiming 32 different benefits but after surgery this dropped to eight. There was a 75% reduction in disability benefit claims.

Prof Osborne moved on to talk about the incidence of obesity in society compared with the number of bariatric trainee positions around the country He estimated that 50 new consultant posts would results in a £75 million economic saving.

In conclusion, he said: “Bariaric surgery is metabolic surgery. It is cost-effective – patients return to a normal quality of life – and it saves lives.”



AUGIS adds its voice to NHS ‘access to treatment’ debate

AUGIS President Bill Allum was a signatory to a letter which appeared in the Daily Telegraph on June 21 calling for all patients to be treated according to their need and not compromised by financial pressure (http://www.telegraph.co.uk/comment/letters/9345146/The-need-to-broaden-access-to-surgery.html). The letter followed reports that operations were being rationed by the NHS due to financial pressures.

As well as Mr Allum, the letter was signed by Professor John MacFie, President, Association of Surgeons of Great Britain and Ireland, Professor Norman Williams,
President, The Royal College of Surgeons of England, Alberic Fiennes, President, British Obesity and Metabolic Surgery Society and Professor Joe Dias President, British Orthopaedic Association.

The full text of the letter read as follows:

SIR – Restricted access to surgery is of great concern to surgeons who believe that patients’ treatment should be driven by need based on clinical assessment, and must not be compromised by financial pressure. Most methods to restrict access to surgery use unproven and arbitrary thresholds, which unfairly deny patients some of the most successful operations that improve quality of life.

Delaying patient access to hip and knee replacements and other orthopaedic operations can affect the outcomes of surgery, with evidence that patients are less mobile and suffer more pain if their operation is delayed or denied. Also, any hernia left untreated puts the patient at serious risk should the hernia strangulate, meaning that they would require emergency surgery to address the potentially life-threatening problem.

The compelling evidence that weight-loss surgery (bariatric surgery) is one of the most cost-effective treatments in acute health care cannot be ignored. Severe obesity is a new disease of epidemic proportions and bariatric surgery improves lives and reduces overall health care costs. Restricting access to surgery by raising the threshold on Body Mass Index above the recommendations of National Institute for Health and Clinical Excellence is not in patients’ best interests.

While we recognise resource constraints faced by NHS commissioners, we must not cut front-line services. Decisions about whether to put patients forward for surgery are best left to patients with direct support from their surgeon.


Calling all Trainees!

AUGIS Trainee members are invited to the 2012 AUGIS Training Day, taking place on Sunday, 17 June, at the Arena & Convention Centre, Liverpool, prior to the Digestive Diseases Federation – www.ddf2012.org.uk
This year’s training day will build on the success of previous years and for the first time sees us join forces with British Society of Gastroenterology trainees to offer a fantastic educational programme and a unique opportunity to network with other trainees and leaders in the field of GI disease.

The morning will involve a combined multidisciplinary session for surgeons and medics to discuss some challenging and provocative cases.  In the afternoon we will break out for the AUGISt surgical forum with wet labs, a mock multi-disciplinary conference and the traditional “Meet the Professors” viva session.

The evening will see the annual AUGISt dinner in Gusto, Albert Dock, with a drinks reception on their waterfront terrace.

Places are limited and available on a first-come-first-served basis. There is a £25 registration fee for the training day and £10 cover charge for the trainee dinner.  In past years the training day and annual dinner have been over-subscribed  so Trainees are encouraged to reserve a place now to avoid disappointment.  To register, please click here: AUGIS Registration



Register now for the DDF

The Early Bird Registration Deadline for DDF is on March 22; to register you will need your AUGIS registration number which is 208974.

It is vitally important you register as an AUGIS member, as a proportion of the profit from the conference is directly dependant on the number of AUGIS registrations.

Please ensure you tick the AUGIS box when completing the online registration form.

http://www.ddf2012.org.uk/default.aspx?PageID=RegistrationAccommodation

 


AUGIS appointments

We are pleased to announce that following a vote by Council the new AUGIS President-elect is Mr Ian Beckingham and the new AUGIS Chair of Education, Training and Research is Mr Giles Toogood. We are grateful to all who stood for these positions as it reflects the strength of the AUGIS membership.