November Annual Academic Surgery Conference Program 2023

November Annual Academic Surgery Conference 16 - 17 November 2023

We are proud to announce our 2023 Conference Sponsors Baxter Healthcare Kooyong / Avant Wilhelm Integrated Solutions Proteomics International Lexington Medical Inc Becton Dickinson Pty Ltd Bongiorno Group Elsevier

Section of Academic Surgery 24 King William Street Kent Town SA 5067 Contact Details: Section of Academic Surgery T +61 8 219 0901 academic.surgery@surgeons.org

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TABLE OF CONTENTS Page 3

Page No. 2023 Conference Sponsors

2

Program

4-9

Welcome by Chair of Academic Surgery Committee

Professor Jonathan Karpelowsky

11

Welcome by November Annual Academic Surgery Conference Organising Committee

A/Professor Payal Mukherjee

12

Invited Speakers - Association for Academic Surgery

Professor Kasper Wang Dr Timothy Frankel

14

Jepson Lecturer

Professor Wendy Brown

Invited Speakers for Section of Academic Surgery

16 - 21

Scientific Moderators

24 - 27

Quick Shot Oral Presentations

30 - 37

Oral Presentations

38 - 49

Award Information

50

Section of Academic Surgery Information

51

November Annual Academic Surgery Conference Program Thursday 16 November 2023 Morning Sessions

Program

Section of Academic Surgery

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8:15am

Registration Desk Opens

8:45am

SESSION 1: ACKNOWLEDGEMENT OF COUNTRY Professor Owen Ung

8:47am

Welcome by Chair of Academic Surgery Committee Professor Jonathan Karpelowsky

8:49am

Welcome by Organising Committee Associate Professor Payal Mukherjee

8:53am

Introduction of Invited Speaker Dr Siobhan McKay

8:59am

How to effectively promote your research / Maximising the impact of your research Associate Professor Sheraz Markar, Oxford University

9:18am

SESSION 2: HOW TO ENSURE DIVERSITY AND EQUITY IN RESEARCH Moderator: Dr Matthew Read

9:24am

Introduction of Invited Speakers

9:27am

Collaborating with Lived Experience experts: Why and How? Melissa Le Mesurier

9:42am

Patient perspective on research and clinical trials Trevor Seaman

9:57am

Panel Discussion - Q & A

10:12am

MORNING TEA

10:32am

SESSION 3: ESSENTIAL SKILLS FOR ACADEMIC SURGEONS Moderator: Dr Siobhan McKay

10:35am

Introduction of Invited Speakers

10:37am

Fundamentals of qualitative research Associate Professor Clare O’Callaghan

10:52am

How clinicians can provide feedback for research students Professor Elizabeth Molloy

11:07am

To Be Confirmed

11:22am

Panel Discussion - Q & A

11:37am

LUNCH BREAK

November Annual Academic Surgery Conference Program Thursday 16 November 2023 Afternoon Sessions

12:32pm SESSION 4: RESEARCH INFRASTRUCTURE AND PRIORITIES / SUPPORTING THE ECOSYSTEM Moderator: Professor Henry Woo 12:32pm Introduction of Invited Speakers 12:39pm NHMRC / MRFF –Priority of diversity Associate Professor Ruth Griffiths, Director, Patients & Infrastructure Aust Dept of Health 12:54pm Clinician Researcher Advocacy Professor Julian Smith, Monash University

Program

Section of Academic Surgery

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1:09pm

Aligning Research with Government priorities Professor Ben Thomson, Victorian Chief Surgical Adviser

1:24pm

Global health and importance of equitable access to surgical education and research Professor Cathy Vaughan, University of Melbourne

1:39pm

Data Security Allen Didovich, Netlinkz

1:54pm

Setting yourself up for a successful grant Professor Christobel Saunders, James Stewart Chair of Surgery, University of Melbourne

2:09pm Panel Discussion - Q & A 2:19pm

BREAK

2:24pm SESSION 5: 101 OF MODERN RESEARCH: ADAPTING TO CHANGE Moderator: Professor Jonathan Karpelowsky 2:27pm Introduction of Invited Speakers 2:29pm RACS and the University. Should RACS and the Universities be more closely aligned? How can RACS and the universities best work together?

Professor Mike McGuckin, Dean of Research, University of Melbourne 2:44pm KEYNOTE SPEAKER: PROFESSOR KASPER WANG, SOCIETY OF UNIVERSITY SURGEONS, USA Team Science: building strategic collaborations 3:04pm Research opportunities for novel research and collaboration Chad Wilhelm, Wilhelm Integrated Solutions 3:19pm

Panel Discussion – Q & A

3:29pm AFTERNOON TEA

November Annual Academic Surgery Conference Program

3:49pm

SESSION 6 Moderator: Professor Owen Ung

Thursday 16 November 2023

3:54pm

Introduction of Invited Speaker

3:55pm

Developing leadership in Surgical Innovation Professor Peter Choong, University of Melbourne

Afternoon Sessions

4:10pm

QUICK SHOT ORAL PRESENTATIONS Scientific Moderators: Professor Peter Choong and Professor Owen Ung

4:10pm

Screening for colorectal cancer in Australia: the stage shift and decreased incidence caused by colonoscopy and polypectomy rate Dr Amir Ashrafizadeh presenting on behalf of Dr Mina Sarofim

4:15pm

The loss of psoas muscle during neoadjuvant treatment for rectal cancer is associated with poor oncological and surgical outcomes.

Dr Shahed Yassaie

4:20pm

Improving junior doctors out-of-hours surgical handovers Dr Mirana Leung-Tack

4:25pm

Modifiability of Surgical Timing in Postinjury Multiple Organ Failure Patients Mr Ryan Ting

4:30pm

Proposed clinical operative synoptic report for ileocolic resection for Crohn’s disease Dr Zi Qin Ng

4:35pm

A comparison of the accuracy and feasibility of a mobile application versus handheld 3D scanner for digital auricular prosthetic production Dr Rhea Darbari Kaul

4:40pm

Ergonomics of 3D Exoscope versus the Operating Microscope in Major Otological Surgery Dr Ankit Ajmera

4:45pm

Neoadjuvant chemotherapy in cytoreductive surgery and HIPEC for colorectal cancer with peritoneal metastases: efficacy depends on extent of metastasis Dr Leonora Long

4:50pm

Closing Remarks

5:00pm

END OF PROGRAM

Program

Section of Academic Surgery

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November Surgical Research Society of Australasia Conference Program

Friday 17 November 2023

08:30am Registration Desk Opens 09:00am SESSION 1 WELCOME Professor Jonathan Karpelowsky 09:02am Introduction of Association for Academic Surgery Speaker Professor Jonathan Karpelowsky

Morning Sessions

09:04am ASSOCIATION FOR ACADEMIC SURGERY PRESENTATION Young Patients with Metastatic Colorectal Cancer Demonstrate Increased Cytotoxic T Cell Engagement Dr Timothy Frankel, AAS Overall Best Abstract by an AAS Member Award Recipient 2023

Surgical Research Society of Australasia

09:24am Questions and Discussion 09:34am QUICK SHOT ORAL PRESENTATIONS Scientific Moderators: Dr Siobhan McKay, Professor Kasper Wang 09:35am Body surface gastric mapping for the non-invasive assessment of gastric function post-fundoplication Dr William Xu

Program

09:40am Microcomputerised Tomography of Biological Scaffolds for Cardiac Surgery: Development of a Novel Imaging Methodology Dr Steve Waqanivavalagi

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09:45am Clinical integration of trans-sacral magnetic stimulation evoked sphincter potentials and high-density electromyography in pelvic floor assessment Dr Chris Varghese 09:50am Enhancing Effectiveness: A Mixed Methods Comparative Evaluation of Online and In-Person Laparoscopic Training Dr Jessica Ng 10:05am

Upper Chest Chemotherapy Ports in Breast Reconstruction Patients Dr Nirmal Dayaratna

10:10am

Low Grade Dysplasia in Barrett's Oesophagus: Wait or Ablate?

A cost-effectiveness analysis Dr Ravi Vissapragada

10:15am

Patients’ preferences for centralisation of surgical services for oesophageal cancer: a discrete choice experiment Dr Josipa Petric

10:20am

Risk of atrial fibrillation with Del Nido cardioplegia in isolated coronary bypass surgery Dr Kaushik Thungathurthi

10:25am

MORNING TEA

10:45am

SESSION 2: SOCIETY OF UNIVERSITY SURGEONS GUEST Scientific Moderators: Professor Marc Gladman

10:45am

Introduction of Society of University Surgeons Speaker Professor Marc Gladman

10:47am

SOCIETY OF UNIVERSITY SURGEONS PRESENTATION Professor Kasper Wang, SUS President 2022-2025

11:07am

Questions and Discussion

November Surgical Research Society of Australasia Conference Program

11:17am

ORAL PRESENTATIONS Scientific Moderators: Professor Marc Gladman, Professor Wendy Brown

Friday 17 November 2023

11:20am

Predicting the need for opioids at discharge after surgery: development and validation of machine learning algorithm in an international cohort Dr Chris Varghese

11:31am

Bariatric surgery impacts maternal, fetal and infant outcomes: a population-based, matched cohort study Dr Olivia Lovrics

11:42am

International management and outcomes of acutely presenting colorectal cancer: preliminary results from the APOLLO prospective snapshot study Dr William Xu

11:53pm

The use of a novel convoluted neural network for the diagnosis of malignant thyroid nodules Dr Karishma Jassal

12:04pm

Inequality in Hospital Use is experienced by Culturally and Linguistically Diverse Patients with Peripheral Artery Disease Dr Sophie James

12:15pm

Patient’s preferences for surgical management of oesophageal cancer: a discrete choice experiment Dr Josipa Petric

12:26pm

The role of opioid prescriptions on discharge from surgery on patient-reported outcomes: international results from the OPERAS prospective study Dr William Xu

12:40pm

LUNCH BREAK

1:30pm

SESSION 3 JEPSON LECTURE Scientific Moderators: Professor Chris Pyke

1:30pm

Introduction of Jepson Lecturer

1:35pm

Jepson Lecture: Surgical Research – still a comic opera?

Professor Wendy Brown

1:50pm

Introduction of Scientific Moderators

2:00pm

ORAL PRESENTATIONS Scientific Moderators: Professor Christobel Saunders, Dr Matt Read

2:01pm

Circulating Tumour Cells in Osteosarcoma Dr Bapesh Bollu

2:12pm

Delivery of regulatory T-cell therapy via ex-situ machine perfusion of the liver Dr Angus Hann

2:23pm

A Randomised Controlled Trial of Topical Analgesia PostHemorrhoidectomy (TAPH Trial) Dr James Jin

2:34pm

Achieving Equity: Patient Demographics and Outcomes after Surgical and Non-Surgical Procedures in South Australia, 2022 Dr Joshua Kovoor

Morning / Afternoon Sessions

Program

Surgical Research Society of Australasia

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November Surgical Research Society of Australasia Conference Program

2:45pm

Friday 17 November 2023

The influence of pre and post operative stoma on long-term quality of life following pelvic exenteration Dr Tess Porges

2:56pm

Inhibition of P21-activate kinase 1 and 4 synergistically suppress pancreatic cancer growth Dr Yi Ma

3:07pm

Quality of life after hemi and total thyroidectomy: an observational study Mx Natasha Newman

3:20pm

AFTERNOON TEA

3:40pm

SESSION 4: QUICK SHOT ORAL PRESENTATIONS Scientific Moderator: Associate Professor Sheraz Markar

3:41pm

Empowering antimicrobial stewardship in diabetic foot osteomyelitis with proximal bone microbiology Dr LongHai Jin

3:46pm

Endothelial glycocalyx shedding during shock and resuscitation is independent of tissue injury in a porcine shock model Mr Raushan Lala

3:51pm

Genomic Profiling and Biomarker Discovery for Predicting Early Intrahepatic Recurrence Following Resection of Colorectal Liver Metastases Dr Geoffrey Yuet Mun Wong

3:56pm

Ethnic disparities in computerised tomographic aortography use for diagnosing acute aortic syndrome Dr Sameer Bhat

4:01pm

Optimal resection margin width for colorectal liver metastasis Dr Kaushik Thungathurthi

4:06pm

Unlocking the educational potential of ward rounds: perspectives from medical trainees and educators Dr Jessica Au

4:11pm

Acute mesenteric ischaemia is associated with elevated lactate and pyruvate levels in the peritoneal fluid: a prospective observational pilot study Dr LongHai Jin

4:16pm

Cardiopulmonary Resuscitation Strategies - Systematic Review and Meta-Analysis, and the Role of Surgeons Dr Steve Waqanivavalagi

4:21pm

SHORT BREAK

4:40pm

SESSION 5: AWARDS AND PRIZES PRESENTATION

4:55pm

Closing Remarks Professor Jonathan Karpelowsky Professor Marc Gladman

5:00pm

END OF PROGRAM

Afternoon Sessions

Program

Surgical Research Society of Australasia

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Baxter Healthcare Pty Ltd

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For more than 85-years, we have been at the critical intersection of saving and sustaining lives. And now, we are determined and uniquely positioned to realise our greatest opportunity to transform global healthcare for years to come.

Baxter has invested heavily in the Australia and New Zealand (ANZ) region for over 50 years with Australian operations commencing in 1963.

Baxter comprises a manufacturing plant in Western Sydney; distribution and warehousing depots in NSW, QLD, VIC, SA, WA and TAS; and aseptic compounding facilities in NSW, QLD, VIC, WA and SA.

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Welcome to the November Annual Academic Conference 2023!

We are excited to hold this event in the newly renovated offices of the Royal Australasian College of Surgeons in Melbourne. Our organising committee has put together an exceptional program, featuring a panel of top-notch speakers who will discuss highly relevant topics related to academic surgery. We are confident that their presentations will inspire, engage, and ignite your interest in this field.

Welcome from Chair of Academic Surgery

We extend a warm welcome to our colleagues from the United States, Professor Kasper Wang from the Society of University Surgeons and Dr Timothy Frankel from the University of Michigan, who will be joining us in person.

This year, we are honoured to have Professor Wendy Brown, Head of Monash University Department of Surgery, Director, Centre for Obesity Research and Education and Clinical Lead, Bariatric Surgery Register, deliver the prestigious Jepson Lecture. Professor Brown will share her views on “Surgical Research – still a comic opera?”.

PROFESSOR JONATHAN KARPELOWSKY

We would like to express our gratitude to Conference and Events Management (RACS) for their close collaboration in organising this successful conference. We also want to acknowledge the incredible colleagues who have participated in and assisted with this important annual event of the Section of Academic Surgery.

Our program has been carefully crafted to be highly relevant to all attendees, regardless of their career stage.

We hope you enjoy the day and find the conference informative and inspiring.

Professor Jonathan Karpelowsky Chair, Academic Surgery Committee Chair, Surgical Research Society of Australasia

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November Annual Academic Conference Organising Committee

Welcome to the November Annual Academic Surgery Conference from the Organizing Committee!

We are excited to present a carefully crafted program that explores the significant topics of Leadership and Engagement, Creating Impact through Research, and the Impact of Big Data on Surgery.

Our lineup includes a well-balanced mix of presentations that aim to engage attendees at all stages of their careers.

A/PROFESSOR PAYAL MUKHERJEE

PROFESSOR JONATHAN KARPELOWSKY

We are honored to have Professor Kasper Wang as our speaker from the United States. Professor Wang is the Robert M. Filler Chair of Paediatric Surgery, Head of General and Thoracic Surgery at The Hospital for Sick Children, and Professor of Surgery at the University of Toronto Temerty Faculty of Medicine.

We are eagerly anticipating Professor Wang's presentation on "Team Science: building strategic collaborations."

Associate Professor Payal Mukherjee On behalf of the November Annual Academic Surgery Conference Organising Committee

DR MATTHEW READ

DR SIOBHAN MCKAY

A/PROFESSOR CHERRY KOH

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Kooyong Group / Avant Financial Services

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Invited Speakers Professor Kasper Wang

Society of University Surgeons, USA Dr. Kasper Wang is the Robert M. Filler Chair of Paediatric Surgery, Head of General and Thoracic Surgery at The Hospital for Sick Children (SickKids), and Professor of Surgery at the University of Toronto Temerty Faculty of Medicine. He received his education at Johns Hopkins University and Johns Hopkins University School of Medicine.

Dr. Wang received his general surgery training at Stanford University and his paediatric surgery training at Children’s Hospital Los Angeles.

He subsequently stayed on as faculty at CHLA and the Keck School of Medicine of the University of Southern California, where he practiced the full breadth of paediatric general, neonatal, thoracic, and oncologic surgery. Wang is well published in high impact journals such as JAMA, Nature Communications, Cell, Gastroenterology, Hepatology, Surgery, Annals of Surgery, Journal of Hepatology, and Paediatrics. Dr. Wang is the Past President of the Society of University Surgeons and past Chair of the Western Paediatric Surgery Research Consortium. He is the current Chair of the Paediatric Surgery Board of the American Board of Surgery.

Dr Timothy Frankel

University of Michigan, USA Association for Academic Surgery (AAS) Overall Best Abstract by an AAS Member Awardee Dr. Timothy L. Frankel is a faculty member within the Section of General Surgery at the University of Michigan. He graduated Magna Cum Laude from Connecticut College in 2000 with a B.A. in Physics and was elected into Phi Beta Kappa. He earned his medical degree from George Washington University in 2004 and was inducted into the Alpha Omega Alpha Honor Medical Society. He completed a residency in General Surgery at the University of Michigan in 2011 during which time he spent two years at the National Cancer Institute studying tumor immunology and genetic engineering.

He developed techniques to genetically modify peripheral blood lymphocytes allowing them to more effectively target tumors for destruction. His work resulted in multiple publications and awards including the James Crudup Surgical Research Award. After completion of residency, he completed a two-year surgical oncology fellowship at Memorial Sloan-Kettering Cancer Center in New York.

His clinical interests are in the treatment of gastrointestinal malignancies including cancers of the liver, pancreas and stomach.

He has published multiple clinical papers on techniques in liver resection for colorectal metastases.

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Invited Speakers

Jepson Lecturer

Professor Wendy Brown Chair Monash University Department of Surgery

Professor Wendy Brown is an Upper GI and Bariatric Surgeon.

She is the Programme Director for Surgical Services and Chair of the Monash University Department of Surgery at Alfred Health, the Director of the Oesophago-Gastric and Bariatric Unit Alfred Hospital as well as Clinical Director of the ANZ Bariatric Surgery Registry and Clinical Lead of the Victorian State Upper GI Cancer Registry.

Jepson Lecturer

Her sub-specialist interests are Oesophago-gastric Cancer, Gastro-oesophageal Reflux Disease (GORD) and Bariatric Surgery. Her research interests focus on the health benefits from weight loss, physiology of upper GI procedures, optimal service delivery models for bariatric surgery and registry science.

She collaborates with basic researchers exploring mechanisms of satiety, NASH and oesophageal cancer.

She is Chair of the International Federation for Surgery for Obesity and Metabolic Disorders (IFSO) Global Registry, Chair of the Victorian Perioperative Consultative Council Surgical Sub-Committee, Past President of OSSANZ and ANZGOSA, Past Senior Examiner in General Surgery for the RACS, Past- Chair of the Scientific Committee of IFSO.

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Invited Speakers PROFESSOR PETER CHOONG Professor Peter Choong's career has been defined by his significant contributions to surgical leadership, medical education, and innovative research. With a trajectory spanning decades, Professor Choong's expertise and leadership are evident in his roles as the Sir Hugh Devine Professor of Surgery at St. Vincent's Hospital Melbourne, the Head of the University of Melbourne Department of Surgery and Associate Dean of Innovation and Enterprise in the Faculty of Medicine Dentistry and Health Sciences.

Leading the Bone and Soft Tissue Tumour Service at the Peter MacCallum Cancer Centre and the Department of Orthopaedics at St. Vincent's Hospital Melbourne for almost a quarter of a century underscored his unwavering commitment to patient care and clinical excellence.

Educated at the University of Melbourne, Professor Choong's academic journey encompasses institutions in Australia, Sweden (Lund University), and the United States (Mayo Clinic), lending him a diverse perspective that enriches his contributions to the field. His ambitious musculoskeletal research program spans fundamental science, bioengineering, and clinical epidemiology.

He is the Lead Investigator for the NHMRC Centre for Research Excellence in Total Joint Surgery and the MRFF Stem Cell Mission Programme Grant on Cartilage repair and regeneration with over 500 publications and an H Index of 90. He is a Fellow of the Royal Australasian College of Surgeons, Australian Orthopaedic Association, and Australian Academy of Health and Medical Science.

His leadership roles include Chief Medical Officer at St. Vincent's Hospital (2005-8), Board Chair in Orthopaedic Surgery at the Royal Australasian College of Surgeons (2008-11) and President of the Australian Orthopaedic Association (2013-14). In the he was appointed an Officer in the Order of Australia in the 2022 Queen's Birthday honours.

ASSOCIATE PROFESSOR RUTH GRIFFITHS A/Professor Ruth Griffiths is the Director of Patients and Infrastructure in the Health and Medical Research Office at the Department of Health and Aged Care.

She manages a range of MRFF funding including the Clinical Trials Activity Initiative. Ruth’s background is in medical research with a focus on improving management of cardiovascular risk in primary care.

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Invited Speakers MELISSA LE MESURIER Melissa is the Director of Advocacy and Engagement with Consumers Health Forum of Australia (CHF), the national peak body for health consumers, responsible for media, government, communications and consumer engagement.

After initially training as a journalist, Melissa moved into corporate communications and was a senior corporate affairs executive for over 25 years with blue-chip organisations such as Medibank, Kraft/Cadbury and Foster’s Group. Melissa transferred her skills into consumer leadership after recovering from bladder cancer and major bowel surgery in 2018.

She is a Graduate of AICD’s Company Directors Course, a director of Lung Foundation Australia, Chair of the VCCC Alliance’s Cancer Consumer Advisory Committee and a member of ANZUP’s Consumer Advisory Panel.

Both professionally and personally, Melisa is passionate about medical research, health literacy and encouraging health professionals and patients to work together to improve the health system. She is also writing a book called Patient Power.

PROFESSOR SHERAZ MARKAR Professor Sheraz Markar qualified from Cambridge University in 2007, and currently Associate Professor & Academic Director Surgical Interventional Trials Unit, Nuffield Department of Surgery, University of Oxford.

He has undertaken two PhDs concerning the diagnosis and management of oesophageal and gastric cancer, with over 290 peer-reviewed publications.

His primary research interests are concerning survivorship and surveillance following oesophageal and gastric cancer treatment, and standardisation of surgical quality assessment in upper gastrointestinal surgery.

PROFESSOR MIKE MCGUCKIN Professor Mike McGuckin is the Deputy Dean in the Faculty of Medicine, Dentistry and Health Sciences at the University of Melbourne.

Mike is the author of over 170 scientific publications with his research currently focused on mucosal infection, chronic inflammation and cancer in the gastrointestinal tract, and diabetes, and has held 4 patents.

He is heavily involved in national and international peer review and has served on multiple committees and boards for scientific societies, collaborative research centres and charities.

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Invited Speakers PROFESSOR ELIZABETH MOLLOY Liz Molloy is Associate Dean, Learning and Teaching, in the Faculty of Medicine, Dentistry and Health Sciences.

She is also Professor of Work Integrated Learning in the Department of Medical Education, Melbourne Medical School, at the University of Melbourne. Liz is responsible for learning and teaching strategy and implementation in the Faculty.

Her research focuses on workplace learning, feedback and assessment, interprofessional education, and teacher professional development. Prior to her current role, Liz worked as Academic Director of Interprofessional Education and Practice in the Faculty of Medicine, Dentistry and Health Sciences.

In 2015, Liz received an inaugural Fellowship of the Australian and New Zealand Association for Health Professions Education and in 2019 received a Karolinksa Fellowship Prize for Excellence in Research in Medical Education.

ASSOCIATE PROFESSOR CLARE O’CALLAGHAN Clare O’Callaghan AM BSW BMus MMus PhD RMT RGIMT is a music therapist at Caritas Christi (palliative care unit), a researcher with the Psychosocial Cancer Care team at St Vincent’s Hospital Melbourne, and an Honorary Associate Professor with the Department of Medicine, St Vincent’s Hospital, The University of Melbourne, Australia.

Throughout an extensive practitioner-researcher career, Clare developed expertise in qualitative and mixed methods research and has collaborated on many studies focussed on improving support and outcomes for people affected by lifethreatening conditions. She is a current co-investigator examining psilocybinassisted psychotherapy for the treatment of depression and anxiety associated with life-threatening illness and is focussed on music’s role in this study.

Clare also works as a qualitative and mixed methods research consultant, recently working with the Victorian Mesothelioma Registry and the Asylum Seekers Resource Centre. Clare’s academic contributions encompass over 110 refereed journal articles and book chapters and, in 2019, Clare became a Member of the Order of Australia for significant service to community health.

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Invited Speakers

PROFESSOR CHRISTOBEL SAUNDERS Professor Christobel Saunders AO, MB BS, FRCS, FRACS, FAAHMS is the James Stewart Chair of Surgery, the Head of the Department of Surgery at the University of Melbourne (Royal Melbourne Hospital precinct), Director of Medical Research at Melbourne Medical School, and consultant surgeon in the Department of General Surgery at Royal Melbourne Hospital and the Peter MacCallum Cancer Institute. Christobel is internationally recognised as one of Australia’s most prominent research-orientated cancer surgeons. She has substantially contributed to breast cancer research, including clinical trials of new treatments, and psychosocial, translational and health services research.

In recognition of her sustained career excellence and innovation, Christobel has been publicly acknowledged through numerous awards and honours including the Order of Australia 2018, the Uccio Querci della Rovere Award (2018), WA Women’s Hall of Fame Inductee (2018), WA Scientist of the Year (2017), Cancer Council WA Career Achievement Award (2021) and was elected to the Australian Academy of Health and Medical Science in 2016.

She has performed research for >30 years evaluating the efficacy and utility of therapy for early breast cancer. In the past five years, Christobel has published over 200 peer-reviewed journal articles. She sits on the boards of several health and research organisations including as Vice-President for All.Can International and on the boards of All.Can Australia, Breast Cancer Trials, the Australian Centre for Value-Based Health Care and PathWest. Christobel is closely involved in strategic planning and management of health and cancer services in Australia including being a member of the Medicare Review Advisory Committee, panel member of the Medical Services Advisory Committee, past President of the Breast Surgical Society of ANZ, and past Advisory Council member of Cancer Australia. She was the Inaugural Chair of the state Health Service Provider, PathWest Laboratory Medicine.

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Invited Speakers TREVOR SEAMAN

Trevor Seaman will provide a first hand account of a patients perspective on research and clinical trials.

PROFESSOR JULIAN SMITH

MBBS, MS, MSURG ED, FRACS, FACS, MAMSE, FFSTRCSED, FCSANZ, FAICD Professor Julian Smith is Professor and Head of the Department of Surgery (School of Clinical Sciences at Monash Health) at Monash University and Senior Cardiothoracic Surgeon in the Department of Cardiothoracic Surgery at Monash Health (Monash Medical Centre).

His recent roles include being a Councillor of the Royal Australasian College of Surgeons, the immediate past-President and Governor of the Australian and New Zealand Chapter of the American College of Surgeons and a past-President of the Australian and New Zealand Society of Cardiac and Thoracic Surgeons.

He is currently Editor-in-Chief of the ANZ Journal of Surgery. His main clinical and research interests are in less invasive cardiac surgery, robotically assisted surgery, mechanical support of the circulation, cardiothoracic surgery clinical trials/audits/registries, the use of evidence-based medicine by surgeons and surgical education from which over 450 publications have arisen.

PROFESSOR BEN THOMSON Ben is the Chief Surgical Advisor to the Victorian Department of Health within the Planned Surgery Recovery & Reform branch. He is an HPB, general & trauma surgeon and the Director of Surgery and Head of the Department of General Surgical Specialties at The Royal Melbourne Hospital. He is an Honorary Clinical Professor at The University of Melbourne and currently a board member of the Australian Aotearoa New Zealand HepatoPancreaticoBiliary Association (AANZHPBA) and Asia-Pacific HPBA (AP-HPBA). He is a past chair of the Conjoint Committee for Recognition of Training in Gastro-Intestinal Endoscopy (CCRTGE) and an examiner to the General Surgical Court of the Royal Australasian College of Surgeons. He was deployed in 2009 following the Samoan Tsunami as part of the Australian Medical Assistance Team (AusMAT) response.

Originally a medical graduate of Melbourne University, Ben trained at The Royal Melbourne Hospital and was awarded his fellowship of the Royal Australasian College of Surgeons in 2001. He then completed further specialist training in Hepatopancreaticobiliary surgery at St Vincent’s Hospital Melbourne and The Royal Infirmary of Edinburgh. He was a consultant HPB and transplant surgeon in Edinburgh in 2003 before returning to Melbourne in 2004. He completed a Doctor of Medical Science at The University of Melbourne in 2013.

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Invited Speakers ALLEN DIDOVICH Allen Didovich - Chief Network Officer, Netlinkz Allen is a very experienced IT&T professional who, for the last 25+ years, has been involved in major telecommunications and critical infrastructure programs in Australia and abroad. Most recently, before joining Netlinkz to head the development and rollout of the global Neuro Smartcloud network, Allen has been with Vodafone Australia for last 13 years, being the head of 5G rollout in Australia.

Before this he rolled out the 4G network, the Vodafone NBN fixed network and was heavily involved in the AU$1 billion 3G network overhaul that Vodafone completed in 2013. He has a background in engineering and project management and has worked for other companies such as Hutchinson Telecommunications, Orange, Ericsson and Nokia Siemens all in very senior delivery and infrastructure roles.

PROFESSOR CATHY VAUGHAN Professor Cathy Vaughan is Director of the Nossal Institute for Global Health and Chair of Global Health at the Melbourne School of Population and Global Health, The University of Melbourne. Cathy has worked as a researcher and practitioner in diverse settings in Asia, the Pacific, and with populations experiencing health inequalities in Australia, for over 25 years.

Her current research focuses on the impact of intersecting inequalities on health, and in particular on the ways intersecting inequalities shape experiences of gender-based violence and the effectiveness of violence prevention and response initiatives. This includes a particular focus on technology-facilitated gender-based violence in Asia and the Pacific.

Cathy has extensive experience using qualitative and participatory research methods to work with groups including migrant and refugee women, women with disability, faith communities and young people to generate evidence about the social and structural underpinnings of health. She uses her expertise in co-design approaches to work with community groups, NGOs and government departments to strengthen the use of research in the development, implementation and evaluation of health programs in settings across Asia and the Pacific.

Cathy has taught into the Master of Public Health program at The University of Melbourne since 2011, coordinating subjects on participatory research methodologies and community engagement, and on women's health. She also currently co-leads the kNOwVAWdata course to strengthen capacity to conduct safe, ethical and rigorous research on violence against women in low and middle income countries; is a Director of the WHO Collaborating Centre for Women’s Health; and leads the Co-Design and Implementation Effectiveness node of the Methods and Implementation Support for Clinical and Health research hub (MISCH) at the university.

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Invited Speakers CHAD WILHELM

Chad Wilhelm – Managing Director at Wilhelm Integrated Solutions Since starting operations in 2016 and with 20 years industry experience, Chad has built Wilhelm Integrated Solutions into a leading Australian owned healthcare technology company. Known for its outstanding reputation for innovation and service delivery, Wilhelm leads the way in modular design and construction, infection control, radiation safety and digital health, through locally engineered solutions, harnessing the latest in innovation here and from trusted brands overseas.

With a particular focus on clinician and patient safety, reducing manual handling injuries, radiation protection and infection prevention and control, Chad is committed to sourcing, developing and delivering solutions that reduce costs, drive efficiency improvements and sustainability gains across their operations, as Wilhelm delivers on its mission to improve health in Australia and New Zealand.

We’re an Australian owned healthcare technology company on a mission to improve health in Australia and New Zealand.

We exist to raise the bar on health standards in a world needing and expecting greater protection, where this has become more challenging than ever before. Technology enables us to lead the way in modular design and construction, infection control, safety and digital health, through locally engineered solutions, harnessing the latest in innovation here and from trusted brands overseas.

Wilhelm takes care of everything, from end-to-end design, engineering, project management, installation, training and ongoing support. Whilst our reputation for superior project delivery has been achieved within the hospital and healthcare sector, there is a clear opportunity for other markets to benefit from some of our solutions.

Our team has some of the most experienced and connected experts, dedicated to demonstrating that there are significant opportunities to deliver better health solutions in more cost-effective ways. We show people that safer environments can be achieved with advanced technology.

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Scientific Moderators Professor Wendy Brown is an Upper GI and Bariatric Surgeon. She is the Programme Director for Surgical Services and Chair of the Monash University Department of Surgery at Alfred Health, the Director of the Oesophago-Gastric and Bariatric Unit Alfred Hospital as well as Clinical Director of the ANZ Bariatric Surgery Registry and Clinical Lead of the Victorian State Upper GI Cancer Registry.

Her sub-specialist interests are Oesophago-gastric Cancer, Gastro-oesophageal Reflux Disease (GORD) and Bariatric Surgery. Her research interests focus on the health benefits from weight loss, physiology of upper GI procedures, optimal service delivery models for bariatric surgery and registry science. She collaborates with basic researchers exploring mechanisms of satiety, NASH and oesophageal cancer.

She is Chair of the International Federation for Surgery for Obesity and Metabolic Disorders (IFSO) Global Registry, Chair of the Victorian Perioperative Consultative Council Surgical Sub-Committee, Past President of OSSANZ and ANZGOSA, Past Senior Examiner in General Surgery for the RACS, Past- Chair of the Scientific Committee of IFSO.

Professor Marc Gladman is a is surgeon scientist specialising in the care of patients with functional lower gastrointestinal and pelvic floor disorders. He received his degree in Medicine from King’s College in the UK and was awarded a PhD by the University of London prior to completing a NIHR lectureship in the UK. He is a highly accomplished researcher and medical educator with research interests focusing on the understanding of bowel structure and function in health and disease and the application of such knowledge to improve patient care and teaching interests focusing on technology- enhanced learning and personalised education.

Professor Gladman is immediate-past Chair of the Academic Surgery Committee and Section of Academic Surgery of the Royal Australasian College of Surgeons and the past Chair of the Surgical Research Society of Australasia.

Professor Sheraz Markar qualified from Cambridge University in 2007, and currently Associate Professor & Academic Director Surgical Interventional Trials Unit, Nuffield Department of Surgery, University of Oxford.

He has undertaken two PhDs concerning the diagnosis and management of oesophageal and gastric cancer, with over 290 peer-reviewed publications.

His primary research interests are concerning survivorship and surveillance following oesophageal and gastric cancer treatment, and standardisation of surgical quality assessment in upper gastrointestinal surgery.

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Scientific Moderators Dr Siobhan McKay

Professor Chris Pyke

Dr Matthew Read is a general and upper gastrointestinal surgeon. After completing his general surgical fellowship in 2016, Matthew was accepted by the Australian and New Zealand Gastro Oesophageal Surgery Association for subspecialty training in the field of upper gastrointestinal surgery.

Following this, Matthew completed a combined clinical and research fellowship in surgical oncology at the University Medical Centre in Utrecht, the Netherlands. Upon returning to Australia, Matthew has taken up a combined clinical and academic position through both the University of Melbourne and St Vincent’s Hospital. He is the current supervisor of two PhD students.

Dr Read also has a background in basic and translational research, having completed a PhD through the University of Melbourne and the Peter MacCallum Cancer Centre, which was focused on the development of preclinical models to better understand oesophageal cancer and its precursor, Barrett’s oesophagus.

This work has led to numerous publications, awards and international collaborations. Dr Read was a recent current recipient of the senior lecturer fellowship from the Royal Australasian College of Surgeons and serves as the younger fellow representative on the Academic Surgery Committee.

Dr Read also has positions in both OESO and ISDE, two key international oesophageal societies. In these roles he serves on both scientific and education committees.

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Scientific Moderators Professor Christobel Saunders AO, MB BS, FRCS, FRACS, FAAHMS is the James Stewart Chair of Surgery, the Head of the Department of Surgery at the University of Melbourne (Royal Melbourne Hospital precinct), Director of Medical Research at Melbourne Medical School, and consultant surgeon in the Department of General Surgery at Royal Melbourne Hospital and the Peter MacCallum Cancer Institute. Christobel is internationally recognised as one of Australia’s most prominent research-orientated cancer surgeons. She has substantially contributed to breast cancer research, including clinical trials of new treatments, and psychosocial, translational and health services research.

In recognition of her sustained career excellence and innovation, Christobel has been publicly acknowledged through numerous awards and honours including the Order of Australia 2018, the Uccio Querci della Rovere Award (2018), WA Women’s Hall of Fame Inductee (2018), WA Scientist of the Year (2017), Cancer Council WA Career Achievement Award (2021) and was elected to the Australian Academy of Health and Medical Science in 2016.

She has performed research for >30 years evaluating the efficacy and utility of therapy for early breast cancer. In the past five years, Christobel has published over 200 peerreviewed journal articles. She sits on the boards of several health and research organisations including as Vice-President for All.Can International and on the boards of All.Can Australia, Breast Cancer Trials, the Australian Centre for Value-Based Health Care and PathWest. Christobel is closely involved in strategic planning and management of health and cancer services in Australia including being a member of the Medicare Review Advisory Committee, panel member of the Medical Services Advisory Committee, past President of the Breast Surgical Society of ANZ, and past Advisory Council member of Cancer Australia. She was the Inaugural Chair of the state Health Service Provider, PathWest Laboratory Medicine.

Professor Julian Smith is Professor and Head of the Department of Surgery (School of Clinical Sciences at Monash Health) at Monash University and Senior Cardiothoracic Surgeon in the Department of Cardiothoracic Surgery at Monash Health (Monash Medical Centre).

His recent roles include being a Councillor of the Royal Australasian College of Surgeons, the immediate past-President and Governor of the Australian and New Zealand Chapter of the American College of Surgeons and a past-President of the Australian and New Zealand Society of Cardiac and Thoracic Surgeons. He is currently Editor-in-Chief of the ANZ Journal of Surgery. His main clinical and research interests are in less invasive cardiac surgery, robotically assisted surgery, mechanical support of the circulation, cardiothoracic surgery clinical trials/audits/registries, the use of evidence-based medicine by surgeons and surgical education from which over 450 publications have arisen.

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Scientific Moderators

Professor Jonathan Karpelowsky is a paediatric surgeon at the University of Sydney and Children’s Hospital Westmead, Sydney Australia. He initially undertook his training in Cape Town. He remained on as a senior specialist at the Red Cross Children’s hospital during which time he completed his PhD. In 2010 he migrated to Australia. Prof Karpelowsky has over 75 publications in peer reviewed journals and major paediatric surgical text books .He is active in clinical and basic science research in the areas of paediatric oncology, thoracic conditions of childhood and clinical trials in paediatric surgery.

He leads a basic science research group looking at liquid biopsies in paediatric cancer.

His laboratory - The Advanced Molecular diagnostics group, looks to utilise liquid biopsies to provide adaptive and diagnostic risk stratification for paediatric solid tumours. Prof Karpelowsky has been awarded over 4 million dollars in competitive grant funding for his work in this area.

In he was awarded the John Mitchell Crouch Fellowship RACS’s most prestigious scholarship. The fellowship recognises the efforts in making an outstanding contribution to the advancement of surgery or to fundamental scientific research in the field in which they are actively working.

He is the chairperson of the Surgical Research Society and deputy chairperson of the Royal Australasian College of Surgeons (RACS) Section of Academic Surgery. He is a past head of training for RACS paediatric surgery in Australia and New Zealand, and a current member of the RACS Court of Examiners.

He is a full professor at the University of Sydney and is one of the Research and Education Academic Directors at Sydney medical School.

Clinically his work focuses on paediatric solid tumours and complex thoracic conditions .

He often travels to other Australian children’s’ hospitals to perform cases as well as receiving referrals from throughout Australia and New Zealand .

Associate Professor Payal Mukherjee is an Adult and Paediatric ENT Surgeon subspecialising in hearing and balance disorders.

She is an Executive Committee member of RACS NSW State committee, the Innovation Lead of the RPA Institute of Academic Surgery, an executive member of the Section of Academic Surgery and a committee member for RandE ASERNIPS. She is a translational researcher with a passion for surgical innovation with her PhD on the translation of personalised medicine and 3D technologies in Otology.

She also has a great interest in advocating for surgical research, building respect in surgery and gender equity in surgery and academia.

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Scientific Moderators

Elsevier is a global information analytics business that helps institutions and professionals advance healthcare, open science and improve performance for the benefit of humanity.

Through the RACS Library, you have access to Clinicalkey www.clinicalkey.com.au ClinicalKey provides clinicians and researchers with access to the eBooks, Journals, Clinical Overviews, AMH Drug Monographs, Images which can be extracted to PowerPoint presentations, videos and more including guidelines and the latest research including Clinical Trials. Users can also track time-based CME/CPD when reviewing eBooks, Journals and Clinical Overviews.

If you would like more information please reach out to the RACS library or contact customerengagement@elsevier.com Page 28

QUICK SHOT ORAL PRESENTATIONS

SCREENING FOR COLORECTAL CANCER IN AUSTRALIA: THE STAGE SHIFT AND DECREASED INCIDENCE CAUSED BY COLONOSCOPY AND POLYPECTOMY RATE Mina Sarofim (1), Dr Amir Ashrafizadeh (presenter, 1), Anthony Gill (2), Keshani De Silva (2), Justin Evans (1), Stephen Clarke (3), Nick Pavlakis (3), Ian Norton (4), Alexander Engel (1).

1. Royal North Shore Hospital, Dept of Colorectal Surgery, Sydney, Australia.

2. Royal North Shore Hospital, Dept of Anatomical Pathology, Sydney, Australia.

3. Royal North Shore Hospital, Dept of Medical Oncology, Sydney, Australia.

4. Royal North Shore Hospital, Dept of Gastroenterology, Sydney, Australia.

Quick Shot Oral Presentations

INTRODUCTION: Existing literature supports the principle of early detection of colorectal cancer (CRC) via screening but has not definitively demonstrated an association between colonoscopy or polypectomy rates and CRC stage over time.

METHODS: A longitudinal study was performed using the Australian national health database to obtain colonoscopy and polypectomy rates between 1998-2017. A second prospective database of CRC resection specimens was analysed for this period. The cohort was divided into three based on time intervals related to the national bowel cancer screening program: pre-commencement 19982006 (Period A), immediately post-commencement 2007-2011 (Period B), and subsequent years 2012-2017 (Period C).

RESULTS: Annual colonoscopy rates doubled, and polypectomy rates tripled during the study (p<0.001). There was a total of 4506 patients who underwent colon cancer resections. Annual colonoscopy rate correlated to a lower T-stage (p=0.038) and lower N-stage (p=0.026) leading to a 7% absolute (13.4% relative) increase in early CRC (stage I-II) in Period C (p<0.001). Across the study there was also a significant increase in right-sided tumours, and concurrent MMR deficiency and BRAF mutation.

CONCLUSION: Polypectomy and colonoscopy rates increased after the introduction of a national screening program which correlated to a clinically relevant shift to earlier CRC stages and a reduction in CRC incidence which manifested five years after implementation.

THE LOSS OF PSOAS MUSCLE DURING NEOADJUVANT TREATMENT FOR RECTAL CANCER IS ASSOCIATED WITH POOR ONCOLOGICAL AND SURGICAL OUTCOMES Dr Shahed Yassaie (presenter, 1), Renqiao Lan (1), Rupert Hodder (1) 1. Sir Charles Gairdner Hospital, Perth.

Background: Sarcopenia has been associated with poor outcomes in rectal cancer patients. This study aims to assess the degree of muscle loss during neoadjuvant therapy in patients with rectal cancer, and its relationship with tumour response, post-operative complications and long-term disease recurrence.

Methods: The change in the psoas muscle area was determined by measuring the psoas muscle area at L4 on initial staging PET CT scans and comparing this with the restaging scan 8-10 weeks after radiation treatment had been completed. The average change in the psoas muscle area was compared between patients who had residual disease vs. complete clinical/pathological response, anastomotic leak vs. no leak, and distant recurrence vs. no recurrence on follow-up imaging.

Results: 92 patients were included in the study. The mean loss of psoas muscle area was 5%.

Patients who had a complete response to chemoradiotherapy showed a statistically significant difference in muscle mass loss (2.8%) compared to those with residual tumour present after therapy (6.2%), p=0.02 on multivariable analysis. There was a statistically significant greater loss of muscle in patients who had an anastomotic leak vs those that did not (10.2% vs 4.1%) and in those who developed metastatic disease vs. those that did not (10.7% vs 4.1 %) (p <0.05).

Conclusion: Our study adds to the growing body of evidence that sarcopenia is a predictor of poor surgical and oncological outcomes in rectal cancer patients. We postulate that the loss of muscle is an indication of disease burden and worse tumour biology.

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IMPROVING JUNIOR DOCTORS OUT-OF-HOURS SURGICAL HANDOVERS Dr Mirana Ines Leung-Tack (1), Tadashi Matsumoto (2)

Quick Shot Oral Presentations

1. University Hospitals Birmingham, United Kingdom 2. University of Warwick, United Kingdom

FY1 junior doctors often handle out-of-hours handovers without formal instruction. This study assesses the impact of a surgical handover proforma at University Hospitals Birmingham, aligning with RCSEng guidelines. This QIP conducted three cycles from April to August 2023, surveying newly appointed surgical FY1 doctors on handovers. A surgical proforma was introduced through various methods: printed proforma in doctors' rooms, electronic distribution via work email, and distribution via WhatsApp. Each cycle lasted about a month, participation was voluntary and anonymous. Over four months, 147 FY1 doctors at University Hospitals Birmingham (UHB) were surveyed. Of these, 65% were in their inaugural surgical rotation, with only 8% having formal surgical handover education.

Initially, the average handover score stood at 33%. Interestingly, introducing a physical proforma in doctors' rooms didn't significantly alter this score. Adopting a digital proforma led to a 27% average handover score increase, which was supported by a statistical significance (p = 0.05) compared to the first cycle (p = 0.84) and second cycle (p = 0.51). Particularly noteworthy was a substantial 56% increase in handover scores between the second and third cycles. This resulted from distributing the digital proforma via the FY1 doctor WhatsApp group, most notably improving the communications of 'Resuscitation plan', 'Consultant surgeons' contact details, and 'Operational issue' communication. Implementing the proforma via WhatsApp was most effective, aligning with young doctors' smartphone use. This innovation facilitates seamless integration of administrative tasks into personal workflows. To broaden impact, integrating similar digital solutions into established healthcare communication systems warrants exploration.

MODIFIABILITY OF SURGICAL TIMING IN POSTINJURY MULTIPLE ORGAN FAILURE PATIENTS Mr Ryan S. Ting (presenter, 1), Kate L. King (2, 3), Daniel P. Lewis (2, 3), Natasha A. Weaver (3), Zsolt J. Balogh (2, 3)

1. The Sutherland Hospital Clinical Teaching Unit, University of New South Wales, Sydney, New South Wales 2. Department of Traumatology, Division of Surgery, John Hunter Hospital, Newcastle, New South Wales 3. School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales Introduction: Postinjury multiple organ failure (MOF) is the leading cause of late trauma deaths, with primarily non-modifiable risk factors. Timing of surgery as a potentially modifiable risk factor is frequently proposed, but has not been quantified. We aimed to compare mortality, hospital length of stay (LOS), and ICU LOS between MOF patients who had surgery that preceded MOF with modifiable timings versus those with non-modifiable timings.

Method: Retrospective analysis of an ongoing 17-year prospective cohort study of ICU polytrauma patients at-risk of MOF. Among MOF patients (Denver score>3), we identified patients who had surgery that preceded MOF, determined whether the timing of these operation(s) were modifiable(M) or nonmodifiable(non-M), and evaluated the change in physiological parameters as a result of surgery.

Results: Of 716 polytrauma patients at-risk of MOF, 205/716(29%) developed MOF, and 161/205(79%) of had surgery during their ICU admission. Of the surgical MOF patients, 147/161(91%) had one or more operation(s) that preceded MOF, and 65/161(40%) of them had operation(s) with modifiable timings. There were no differences in age (mean(SD) 52(19)vs53(21)years), injury severity score (median(IQR) 34(26-41)vs34(25-44)), admission physiological and resuscitation parameters, between M and non-Mpatients. M patients had longer ICU LOS (median(IQR) 18(12-28)vs 11(816)days,p<0.0001) than non-Mpatients, without difference in mortality (14%vs16%,p=0.7347), or hospital LOS (median(IQR) 32(1852)vs27(17-47)days,p=0.3418). M-patients had less fluids and transfusions intraoperatively. Surgery did not compromise patient physiology.

Conclusions: Operations preceding MOF are common in polytrauma and seem to be safe in maintaining physiology. The margin for improvement from optimising surgical timing is modest, contrary to historical assumptions.

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PROPOSED CLINICAL OPERATIVE SYNOPTIC REPORT FOR ILEOCOLIC RESECTION FOR CROHN’S DISEASE Dr Zi Qin Ng FRACS(1,2), Scott Mackenzie FRACS (1,3), Andrew Gilmore FRACS (1,3,4), Jason Diab MS (1,2), Katherine Gibson FRACS (1) 1. Department of Colon and Rectal Surgery, Liverpool Hospital, Liverpool, New South Wales 2. School of Medicine, University of New South Wales, New South Wales 3. Western Sydney University, New South Wales 4. Macquarie University Hospital, New South Wales Introduction: Crohn’s disease patients usually require multiple surgeries during their lifetime.

Unfortunately, the documentation in operative reports is often deficient in certain data. The synoptic report used in other fields like histopathology has proven to be effective and allows similar understanding of the results. The aim of this study was to retrospectively review the completeness of the operative reports for ileocolic Crohn’s resections and to propose a synoptic report.

Quick Shot Oral Presentations

Methods: A draft synoptic operative report for ileocolic resection for Crohn’s disease was performed and discussed in the IBD meeting to obtain consensus from the panel. With that, a retrospective analysis of consecutive ileocolic resections from Jan 2010 to April 2023 was assessed for the presence of the operative details and its completeness.

Results: A total of 66 ileocolic resections were performed in 63 patients during the study period. No operation reports were excluded. The examination of bowel for macroscopic disease was partially documented in majority of cases (88%). The extent of mesenteric resection and any difficulty encountered during dissection were poorly documented. The remaining length of small and large intestines was not documented in most of operative reports. The clinical sections that were compulsory entrance in the electronic operative report achieved 100% compliance.

Conclusion: This study has demonstrated that key information was often deficient in the operative report. This has a significant impact on the future management of Crohn’s patients and affects the interpretation of research outcomes. A proposed clinical synoptic operative report is easy to use and ensures compliance.

A COMPARISON OF THE ACCURACY AND FEASIBILITY OF A MOBILE APPLICATION VERSUS HANDHELD 3D SCANNER FOR DIGITAL AURICULAR PROSTHETIC PRODUCTION Dr Rhea Darbari Kaul (presenter, 1), Cindy Duong (1, 2), Jolande Ma (1), Sepidar Sayyar (3,4), Gordon Wallace (3), Masako Dunn (5), Kai Cheng (1, 5), Sophie Fleming (1,5), Sarah Whereat (1,6), Jonathan Clark (1,5,6), Payal Mukherjee (1,5,6) 1. Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, 145 Missenden Road, Camperdown, NSW 2050, Australia 2. School of Biomedical Engineering, Faculty of Engineering, The University of Sydney, Camperdown, NSW 2006, Australia 3. ARC Centre of Excellence for Electromaterials Science (ACES), Intelligent Polymer Research Institute (IPRI), AII Facility, University of Wollongong, Wollongong, NSW 2522, Australia 4. Australian National Fabrication Facility – Materials Node, Innovation Campus, University of Wollongong, Wollongong, NSW 2500, Australia 5. Department of Head and Neck Surgery, Chris O’Brien Lifehouse, 119-143 Missenden Road, Camperdown, NSW 2050, Australia 6. Sydney Medical School, Susan Wakil Building, Faculty of Medicine and Health, The University of Sydney, Anderson Stuart Building, Camperdown, NSW 2006, Australia Introduction: Facial prosthetics are an important means to rehabilitate patients with congenital or iatrogenic facial defects. However, with a purely manual workflow and workforce shortage, access to facial prosthetics is limited in Australia, especially for rural and remote patients. 3D scanning has become increasingly integrated in digitising data acquisition. With the development of TrueDepth camera technology on mobile phones, there is an increasing availability of mobile applications which can generate 3D images to enable access and reduce cost. This study compares the accuracy of mobile phone applications to high resolution 3D scanners for auricular data acquisition.

Methods: We conducted a case-control study comparing the EM3D application with the EinScan Pro 2x Plus Shining 3D handheld scanner in 22 healthy participants equating to 44 ears, using CloudCompare software analysis.

Results: On average, the mobile EM3D application acquired images 2.5 minutes quicker than the EinScan 3D handheld scanner. The mean absolute directional distance difference was 1.10mm, (95% CI ± 0.15mm, p<0.05), within the accepted deviation range of 2mm. Out of the 44 ears, only 1 ear (2.27%) did not meet the accepted value of accuracy within 2mm. The average comparative quantitative completeness was 85% and the overall qualitative completeness obtained from the EinScan scanner and EM3D application were 53.5% and 57.7% respectively.

Conclusion: Mobile iPhone applications such EM3D are a viable alternative to 3D handheld scanners such as Shining EinScan Pro 2X Plus. This study demonstrates reliable results in accuracy, and improved results in time, cost, completeness and operational feasibility.

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ERGONOMICS OF 3D EXOSCOPE VERSUS THE OPERATING MICROSCOPE IN MAJOR OTOLOGICAL SURGERY Dr Ankit Ajmera (presenter, 1), A/Prof Payal Mukherjee (1), Prof Raewyn Campbell (1) 1. Sydney Adventist Hospital, Sydney, NSW

Microscopes are frequently used for otological procedures, however, its repetitive fine motor movements and prolonged static, ergonomically unfavourable postures have led to an increase in work related musculoskeletal injuries, with up to 97% of ENT surgeons reporting musculoskeletal pain. The 3D Exoscope is thought to help mitigate this risk, allowing for a more ergonomically favourable posture thus reducing static time. There is currently only limited comparative reviews assessing the ergonomics between the 3D-Exoscope and an operating microscope.

Quick Shot Oral Presentations

A prospective study was conducted, analysing the ergonomic posture of ENT Surgeons while performing major otological cases. Cases were either performed with a Roboticscope 3D-Exoscope (BHS Technologies) or an operating microscope (Ziess). A comparative analysis between both systems was conducted by using a Rapid Upper Limb Assessment (RULA) and a questionnaire based on the NASA Load Index.

Surgeons had a more ergonomically favourable posture when using a 3D-Exoscope with a reduced RULA score, however, there was no significant difference between both devices on the subjective questionnaire comparing mental and physical fatigue. Furthermore, the image quality and ease of use of the Roboticscope was satisfactory. Improved theatre set up, having an adjustable theatre bed, chair with arm support and articulated microscope eye pieces were all areas that could improve ergonomic positioning.

3D-Exoscopes appears to be a suitable device for the use of otologic surgery while also providing an ergonomically favourable advantage. Further data collection is planned to assess the utility of the exoscope in improving ergonomics in otological surgery on a larger scale.

NEOADJUVANT CHEMOTHERAPY IN CYTOREDUCTIVE SURGERY AND HIPEC FOR COLORECTAL CANCER WITH PERITONEAL METASTASES: EFFICACY DEPENDS ON EXTENT OF METASTASIS Mina Sarofim (1, 2, 3), Dr Leonora E Long (presenter, 1, 2), Ruwanthi Wijayawardana (1, 2), Nima Ahmadi (1, 2), Shoma Barat (1, 2), David L Morris (1, 2) 1. Peritonectomy Unit, St George Hospital, Sydney, NSW 2. School of Medicine, University of New South Wales, Sydney, NSW 3. School of Medicine, The University of Sydney, NSW INTRODUCTION: Transcoelomic spread of colorectal cancer (CRC) represents peritoneal metastasis, which is present in up to 15% of patients at initial diagnosis, and up to 50% in those who develop recurrence. Evidence for neoadjuvant chemotherapy (administered prior to cytoreductive surgery/HIPEC) is unclear with conflicting data regarding efficacy.

OBJECTIVES: Our aim was to determine the survival outcomes of neoadjuvant chemotherapy in patients undergoing cytoreductive surgery (CRS) and HIPEC for CRC with peritoneal metastases.

METHODS: All patients who underwent CRS with HIPEC for PM from CRC at our institution were analysed over a 15-year period from 2004-2019. Survival (from time of diagnosis) was calculated.

RESULTS: A total of 337 patients underwent CRS with HIPEC with a mean age of 55 years. There were 116 patients who received neoadjuvant chemotherapy, and 221 patients who were chemotherapy naïve. There was no significant difference in baseline characteristics, mean PCI score, or completeness-ofcytoreduction (CC) score between the groups. HIPEC used was oxaliplatin (46%) or mitomycin C (39%), again similar between groups. 87% of patients had PCI score < 17, and median survival between the neoadjuvant and chemotherapy naïve groups was 59 months versus 77 months respectively (p = 0.1). In those with PCI score 17, median survival was 40 months versus 38 months respectively (p = 0.15) CONCLUSION: Neoadjuvant chemotherapy for CRC with peritoneal metastases did not significantly improve median survival, especially those with PCI score less than 17. Its use may benefit patients with PCI score greater than or equal to 17.

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BODY SURFACE GASTRIC MAPPING FOR THE NON-INVASIVE ASSESSMENT OF GASTRIC FUNCTION POST-FUNDOPLICATION Dr William Xu (presenter, 1)

Background: Adverse gastric symptoms persist in up to 20% of fundoplication surgeries completed for gastroesophageal reflux disease, causing significant morbidity, and driving the need for revisional procedures. Non-invasive techniques to assess the gastric physiology underlying persistent postoperative symptoms such as bloating, pain, and reflux are lacking. We aimed to investigate gastric myoelectrical abnormalities in patients after fundoplication using a novel non-invasive body surface gastric mapping (BSGM) device.

Quick Shot Oral Presentations

Methods: Patients with previous fundoplication surgery and ongoing significant gastroduodenal symptoms, and matched controls were included. BSGM using Gastric Alimetry (Alimetry, New Zealand) was employed, comprising of a high resolution 64-channel array, validated symptomlogging App, and wearable reader.

Results: 16 patients with significant ongoing symptoms after fundoplication were recruited, with 16 controls. Overall, 5/16 (31.3%) of patients showed significant spectral abnormalities defined by unstable gastric myoelectrical activity (n = 2), abnormally high gastric frequencies (n = 2) or high gastric amplitudes (n = 1). Those with spectral abnormalities had higher Gastroparesis Cardinal Symptom Index scores (3.2 IQR:2.3 to 3.2 vs 4.0 IQR:3.8 to 4.2, p =0.039). There was no difference in the prevalence of delayed gastric emptying (50% spectral abnormalities vs 66.7%, p =0.999). Decreasing gastric myoelectrical activity stability (measured by BSGM) was associated with an increasing symptom severity (R=-0.42, p = 0.033).

Conclusion: A significant number of patients with persistent post-fundoplication symptoms display disrupted gastric myoelectrical activity on BSGM. BSGM evaluation furthers our pathophysiological understanding in this cohort, presenting possible targets for diagnosis and patient selection for revisional surgery.

MICROCOMPUTERISED TOMOGRAPHY OF BIOLOGICAL SCAFFOLDS FOR CARDIAC SURGERY: DEVELOPMENT OF A NOVEL IMAGING METHODOLOGY Dr Steve Waqanivavalagi (presenter, 1, 2), Dane Gerneke (3), Marcus Ground (4), Jillian Cornish (1), Paget Milsom (5) 1 Department of Medicine, University of Auckland, New Zealand 2 Cardiothoracic Surgical Unit, Te Whatu Ora Waikato, Waikato Hospital, New Zealand 3 Auckland Bioengineering Institute, University of Auckland, New Zealand 4 Department of Surgery, University of Otago, New Zealand 5 Green Lane Cardiothoracic Surgical Unit, Te Whatu Ora Te Toka Tumai, Auckland City Hospital, New Zealand Background: Glutaraldehyde-treated collagen matrices are used in the development of bioprosthetic valves but are associated with a chronic inflammatory response and calcification, which limits their long-term use. Tissue-engineering technology has been explored as a means of developing innovative scaffolds that avoid the deleterious immunogenic and calcific outcomes of standard matrices. We sought to develop a microcomputerised tomography (microCT) imaging methodology for the high-resolution, volumetric assessment of collagen scaffolds prior to clinical assessment.

Methods: Bovine pericardia were glutaraldehyde fixed or decellularised and then subcutaneously implanted in rats for four weeks. Samples were excised en bloc and then treated with one of four staining regimens prior to microCT imaging. Histological analyses were performed to verify the microCT findings. DNA was extracted from native and decellularised tissue and then quantified.

Results: Cell nuclei were absent following decellularisation. There was a significant reduction in the DNA concentration when compared with native tissue (7.2±0.3 vs 498.2±76.3 ng/mg dry extracellular matrix; p<0.0001). A phosphotungstic acid-based staining regimen produced higher contrast microCT images of bovine pericardia than osmium tetroxide, iodine, or control stains. Following subcutaneous implantation in rats, decellularised pericardia maintained the highly organised, ribbon-like morphology of native pericardia. However, glutaraldehyde-treated pericardia became calcified (volumetric calcification fraction 21.2% vs 0.1%).

Conclusion: A novel microCT imaging methodology has been produced comprising staining with 0.3% phosphotungstic acid in 70% ethanol for 24 hours. MicroCT is a non-destructive method for producing high-resolution, volumetric images of bovine pericardia that show potential in comparing the three-dimensional effects of novel tissue-engineering protocols.

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CLINICAL INTEGRATION OF TRANS-SACRAL MAGNETIC STIMULATION EVOKED SPHINCTER POTENTIALS AND HIGH-DENSITY ELECTROMYOGRAPHY IN PELVIC FLOOR ASSESSMENT Dr Chris Varghese (Presenter, 1), Xavier Harvey (2), Armen Gharibans (1, 4), Peng Du (4), Rowan Collinson (2), Ian P Bissett (1, 2), Cathy Stinear (3), Greg O’Grady (1, 4), Niranchan Paskaranandivadivel (4) 1. Department of Surgery, University of Auckland, New Zealand 2. Department of Surgery, Auckland City Hospital 3. Department of Medicine, University of Auckland, New Zealand 4. Auckland Bioengineering Institute, University of Auckland, New Zealand Background: Faecal incontinence is common and of multifactorial aetiologies, yet current diagnostic tools are unable to objectively assess nerve and sphincter function. We developed and evaluated anorectal highdensity electromyography (HD-EMG) of motor-evoked potentials via trans-sacral magnetic stimulation (TSMS).

Quick Shot Oral Presentations

Methods: Anorectal probes with an 8x8 array of 1 cm spaced electrodes were developed for recording HD-EMG of the external anal sphincter. HD-EMG probes were used to map motor-evoked potential (MEP) amplitudes and latencies evoked via TSMS delivered through the Magstim Rapid² (MagStim Company, Dyfed, UK). Patients undergoing pelvic floor investigations were recruited for this IDEAL Stage 2a pilot study.

Results: Eight participants (5 female, median age 49) were recruited. Methodological viability, safety, and diagnostic workflow were established. The test was well tolerated with median discomfort scores ≤2.5/10, median pain scores ≤1/10 and no adverse events. Higher faecal incontinence severity index scores correlated with longer MEP latencies (r = 0.58, p <0.001) and lower amplitudes (r = -0.32, p=0.046), as did St Mark’s incontinence scores with both MEP latencies (r = 0.49, p = 0.001) and MEP amplitudes (r = -0.47, p = 0.002).

Conclusion: This high-density EMG probe in conjunction with trans-sacral magnetic stimulation presents a novel diagnostic tool for anorectal function assessment. Spatiotemporal assessment of magnetically stimulated MEPs correlated well with symptoms and offer a feasible, safe, and patient tolerable method of evaluating pudendal nerve and external anal sphincter function. Further clinical development and evaluation of these techniques is justified.

ENHANCING EFFECTIVENESS: A MIXED METHODS COMPARATIVE EVALUATION OF ONLINE AND IN-PERSON LAPAROSCOPIC TRAINING Dr Jessica Ng (presenter, 1), Justin Ng (1), Belinda Lowe (1), Jack Matulich (1), Victoria Brazil (1) 1. Gold Coast University Hospital, Queensland, Australia Background: The landscape of surgical education has undergone substantial changes in response to the challenges posed by the COVID-19 pandemic and remote learning. The need to ensure the continuity and effectiveness of surgical training has prompted a re-evaluation of traditional educational approaches. This study seeks to assess whether online laparoscopic training can maintain the same level of effectiveness as conventional in-person training methods. This investigation is particularly relevant as the medical field adapts to new modes of knowledge dissemination while examining methods for implementation of laparoscopic simulation skills training.

Methodology: A prospective randomized control trial was conducted at Gold Coast University Hospital, involving 23 Surgery and Ob¬stetrics/Gynaecology residents and registrars. Participants were randomly assigned to two groups: online (Group A) and in-person (Group B) laparoscopic training. A validated curriculum was delivered over a five-week period; both groups received comprehensive preparatory materials, including theoretical modules and pre-recorded exercise demonstrations. Participants in both groups were given the opportunity for personalized feedback. The primary outcome measure was the mastery of laparoscopic skills, evaluated using predefined time benchmarks. Secondary measures included engagement, trainee confidence and satisfaction and kinematic metrics of left and right hands (distance travelled, time out of view).

Results: Descriptive statistics were performed to summarize the improvement times achieved by the participants across the five exercises. Welch's t-tests showed no statistically significant difference in the mean improvement times in all exercises between Group A and Group B. Log-rank test did not show a statistically significant difference in engagement between the two groups (p=0.949). Survival analysis of both groups showed complete engagement within the first week, however participant attrition occurred throughout the curriculum with participants in Group A staying engaged for a longer period. Additionally, a qualitative analysis was conducted using Braun and Clarke's thematic analysis framework to provide an insight into participants’ attitudes and experiences.

Conclusion: In this prospective randomized control trial, online and in-person laparoscopic training methods showed no significant difference in skill mastery or engagement levels. These findings suggest that online training is a viable alternative for surgical education, offering flexibility without compromising quality, especially relevant in the context of the COVID-19 pandemic and remote learning.

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UPPER CHEST CHEMOTHERAPY PORTS IN BREAST RECONSTRUCTION PATIENTS Dr Nirmal Dayaratna (Presenter, 1, 2, 3), Dr. Chu Luan Nguyen (1,2), Mr Stanley Grech, (1) Dr Frederick Clarke (1), A/Prof Cindy Mak (1,2), A/Prof Sanjay Warrier (1,2), Dr. Joseph R Dusseldorp (1,2) 1. Faculty of Medicine, Sydney University, Sydney, New South Wales 2. Chris O’Brien Lifehouse, Camperdown, Sydney, New South Wales 3. Concord Repatriation General Hospital, Concord, Sydney, New South Wales

Quick Shot Oral Presentations

Background: As breast and plastic surgeons put significant effort into achieving optimal aesthetic outcomes and improving a patient’s quality of life (QoL) in post-mastectomy, we hypothesise that the visible port-scar following chemotherapy treatment has a significant psychosocial impact on this cohort of patients. We underwent a two-part study, assessing and evaluating the psychosocial impact and scar quality of visible upper chest port scars compared to scarring following breast cancer surgery and public perceptions of port placement.

Methods: In Part 1, female breast cancer patients who underwent either post-mastectomy breast reconstruction (implant-based or autologous) or mastectomy-only at our institution were invited to complete a Short Form 12 (SF-12), BREAST-Q and SCAR-Q questionnaire for breast, abdominal and port scars. Univariate and multivariate analyses of questionnaire scores and clinical characteristics were performed. In Part 2, we conducted a public survey to investigate perceptions of upper chest chemotherapy port placement.

Results: 165 respondents (55% response rate) completed the initial questionnaire. Patients with port scars reported statistically lower SCAR-Q outcomes for their port scars compared to scarring from breast surgery. While patients reported similar breast surgery satisfaction results in both chemotherapy port and no-chemotherapy port groups, patients with chemotherapy ports had lower psychosocial well-being scores. In the public survey, we identified that if individuals had a choice, they would prefer to have a chemotherapy port not placed in the upper chest compared to other port locations*.

Conclusions: Placement of upper chest chemotherapy ports leaving a visible scar significantly impacts patient well-being and QoL. Discussions surrounding discrete placement should be considered in breast cancer care due to the visible scarring following removal, improve the patient’s QoL and support reconstructive efforts by breast and plastic surgeons. * The final findings will be available to be presented at NAASC 23

LOW GRADE DYSPLASIA IN BARRETT'S OESOPHAGUS: WAIT OR ABLATE? A COST-EFFECTIVENESS ANALYSIS Dr Ravi Vissapragada MBBCh PhD (presenter, 1, 2), Chih-Han Kung MD, PhD (3, 4), Norma Bulamu BPharm, MPH, PhD (1), Tim Bright MS FRACS (3), David I Watson (1, 3) MD, PhD, FRACS 1. Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, Australia 2 Department of General Surgery, Monash Health, Melbourne, Australia 3 Department of Surgery, Flinders Medical Centre, Room 3D211, Bedford Park, Adelaide, SA, 5042, Australia.

4 Department of Surgical and Perioperative Sciences, Surgery, Umeå University, 90187 Umeå, Sweden

Background: Barrett’s oesophagus (BE) is a precursor to oesophageal adenocarcinoma (OAC), but the risk of progression in its non-dysplastic variant is very low. Dysplastic BE is divided into high-grade (HGD) and low-grade (LGD). While endoscopic treatment (EET) is unanimously recommended for HGD, such treatment is controversial in LGD because of the variability of histopathological diagnosis, which is difficult even for expert gastrointestinal pathologists. The aim of this study was to 1) identify the risk of progression of LGD to OAC in patients referred to Flinders Medical Centre (Adelaide, SA) and 2) determine the cost-effectiveness of EET. Methods: Markov-cohort model for progression of NDBE to OAC, previously presented was modified to include both groups. Data from the Barrett’s oesophagus surveillance study (BOSS) from 2002-2023 was used to populate the cohort model. Two groups were identified a) Progression to LGD from BOSS; 2) Referred to BOSS with LGD and assigned either surveillance or endoscopic ablation with radiofrequency ablation (RFA). End outcome was incremental cost-effectiveness ratio with a willingness-to-pay threshold of AU$50,000/QALY. Results: Surveillance of LGD was the base-strategy, which cost AU$46,884 and produced 24.048 QALYs over 35 years. Only 1/3 tested strategies was cost-effective compared to the base strategy, namely RFA of LGD progressors from BOSS with endoscopic surveillance of referred LGD with an ICER of AU$26,763/QALY. Conclusions: Risk of progression from LGD is likely related to strength of histopathologic diagnosis and presence of persistent dysplastic features on repeat endoscopy. RFA for LGD is cost-effective when double-reviewed by expert pathologists and confirmed on second endoscopy, at least 3 months apart.

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PATIENTS’ PREFERENCES FOR CENTRALISATION OF SURGICAL SERVICES FOR OESOPHAGEAL CANCER: A DISCRETE CHOICE EXPERIMENT Dr Josipa Petric (presenter, 1, 2), Norma Bulamu (1), Gang Chen (3), Tim Bright (2), David I Watson (1,2) 1. Flinders University, Adelaide, South Australia 2. Flinders Medical Centre, Adelaide, South Australia 3. Monash University, Melbourne, Victoria

Quick Shot Oral Presentations

Purpose: Oesophageal cancer surgery in a centralised high-volume centre has significant benefits to outcomes for patients. However, rural and remote patients may value and perceive these benefits differently and may be willing to make trade-offs for local specialist care with a familiar and trusted physician. This may be due to a lack of a support network, the need to travel, or costs associated with travel. The aim of this study was to understand whether these factors are important to patients, and if they influence decisions for care.

Methodology: A discrete choice experiment was carried out using four characteristics or attributes selected in consultation with experienced upper gastrointestinal surgeons and patients. The attributes included were: (1) travel distance to hospital, (2) risk of in-hospital mortality, (3) length of hospital stay and (4) cost. Two groups of respondents were recruited: patients with Barrett’s Oesophagus, and doctors. The framework of random utility theory was used to analyse the data collected.

Results: 60 doctors and 63 patients responded to the survey. The preference for centralised services over localised services for both patients and doctors was influenced by travel distance (r=-0.861 if traveling for 400km compared to under 10km), death rate (r=0.528 if 1% and -0.731 if 8%), hospital stay, out-of-pocket cost and finally 5-year survival (r=-0.655 if survival was 40% and r=0.307 at 50% chance of survival). Preferences for doctors in rural and remote areas were influenced by lower death rate, shorter hospital stay and lower patient costs. Patient preferences were influenced by travel distance, death rate and cost.

Conclusion: Centralised oesophageal cancer surgical services seem to be preferred over local services by both doctors and patients if they are delivered at lower cost, with a lower risk of hospital death, less time in hospital and higher long-term survival outcomes.

RISK OF ATRIAL FIBRILLATION WITH DEL NIDO CARDIOPLEGIA IN ISOLATED CORONARY BYPASS SURGERY Dr Kaushik Thungathurthi (presenter,1), Ms Rosemary Belbin (1), Ms Sarah Varghese (1), Dr Glenn Mckay (1), Dr Peter Bissaker (1) 1. The Canberra Hospital, ACT Health, Australia

Introduction: Atrial fibrillation (AF) following cardiac surgery can adversely affect length of stay, morbidity and hospitalisation costs. The utility of Del Nido cardioplegia in adult cardiac surgery has been demonstrated and with its increasing use in coronary artery bypass graft surgery (CABG) the risk complications such as AF are not well known. We aimed to assess the risk of AF with Del Nido versus other cardioplegia solutions in patients undergoing isolated CABG. Methods: A retrospective study was conducted using a prospectively maintained National Cardiac Surgery Database (ANZCTS) between 2016 and 2021. All patients who underwent isolated CABG were included. Patients with concomitant valvular surgery was excluded. Cardioplegia solutions used included hyperkalemic, Bretschneider HTK (custodial) and Del Nido.

Results: A total of 36,052 patients underwent isolated CABG, 23,409 (64.9%) patients were given hyperkalemic cardioplegia solution (A), 504 (1.4%) had Bretschneider (B) and 747 (3.2%) had Del Nido cardioplegia (C). The median age was [A: 74 years, B: 60 years, C: 67 years], median BMI [A: 30, B: 28, C: 23.3] and pre-operative ejection fraction [A: 48%, B: 47%, C: 37.5%]. Median cross clamp and bypass times were [A: 71mins, B: 57mins, C: 50mins] and [A: 100mins, B: 106mins, C: 80mins] respectively. On multivariate regression analysis, the odds ratio for AF was [A: OR 1.2, 95%CI: 0.83, 1.72, p=0.325], [B: OR 1.554, 95%CI: 0.96, 2.51, p=0.07] and [C: OR 0.93, 95%CI: 0.56, 1.56, p=0.78].

Conclusion: The use of Del Nido cardioplegia in isolated CABG was associated with a lower incidence of postoperative AF in our cohort.

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ORAL PRESENTATIONS

PREDICTING THE NEED FOR OPIOIDS AT DISCHARGE AFTER SURGERY: DEVELOPMENT AND VALIDATION OF MACHINE LEARNING ALGORITHM IN AN INTERNATIONAL COHORT Dr Chris Varghese (presenter, 1) on behalf of the TASMAN Collaborative 1. University of Auckland, Auckland, New Zealand Introduction: The ‘Opioid PrEscRiptions and usage After Surgery’ study found opioids are significantly overprescribed after surgery. Inappropriate prescribing contributes to opioid-related harm including excess circulation of unused opioids within our communities. This study aims to use novel methods to predict if patients require opioids after surgery.

Methods: An international, multi-centre, prospective cohort study of general surgical, urological, gynaecological, and orthopaedic surgery was performed by the Trials and Audits in Surgery by Medical Students in Australia and New Zealand (TASMAN) collaborative. Random forest machine learning algorithms were used to predict the need for opioid at discharge, and a 80:20 training/testing split was used for validation.

Oral Presentations

Results: Of 4268 patients recruited across 24 countries (mean age 50; 51.9% female), 1308 (30.6%) were prescribed opioids, but only 1014 (23.8%) consumed them. Our model ranked the total amount of opioids consumed in the day prior to discharge, alcohol consumption, surgery-type, smoking status, and age as the most important factors. Area under the curve for the random forest model was 0.84 (95% CI 0.83-0.84; compared to 0.76 (95% 0.76 - 0.77) in a logistic regression model).

Model sensitivity was 92%, specificity 49%, and overall accuracy was 82% (95% CI 79 - 84%).

Conclusions: The need for an opioid prescription could be accurately predicted using 11 routinely available preoperative variables (age, gender, alcohol intake, smoking status, BMI, surgery-type, ASA score, indication for surgery, urgency, total amount of opioids consumed the day before discharge, and preadmission opioid use). Future work could enable clinical translation of this decision support aid to rationalise opioid overprescribing after surgery.

BARIATRIC SURGERY IMPACTS MATERNAL, FETAL AND INFANT OUTCOMES: A POPULATION-BASED, MATCHED COHORT STUDY Aristithes G. Doumouras MD MPH (1,2), Giulia M. Muraca PhD MPH (3,4), Elizabeth K. Darling PhD RM (3,5), Emma K. O'Callaghan PhD (2), Francis Nguyen MPH (2), Dr Olivia Lovrics (presenter, 1), Vanessa Boudreau MD(1,3), Mehran Anvari MD PhD (1,2) 1. Department of General Surgery, McMaster University, Hamilton, Canada 2. ICES, Toronto, Canada 3. Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada 4. Health Research Methodology, McMaster University, Hamilton, Canada 5. Midwifery, McMaster University, Hamilton, Canada Background: Obesity during pregnancy is associated with adverse outcomes. Bariatric surgery is the most effective weight-loss treatment, reducing many obesity-related comorbidities, however, it’s impact on pregnancy is poorly understood.

Objectives: Examine maternal, fetal and infant outcomes post-bariatric surgery.

Methods: This was a retrospective, population-based, matched cohort study in Ontario, Canada using data from multicentre linked databases from July 2011 to September 2017. Individuals with obesity who had bariatric surgery before pregnancy were matched to individuals eligible for, but who did not undergo, bariatric surgery before pregnancy. Primary outcomes included incidence of gestational diabetes, preeclampsia/HELLP, hemorrhage, severe perineal laceration, cesarean delivery, stillbirth/neonatal death, preterm birth, small-for-gestational-age (SGA), large-forgestational-age (LGA), severe birth trauma, Apgar score at 5-minutes<7, congenital malformation, and a composite of severe fetal/infant morbidity/mortality. Multivariable logistic regression assessed outcomes.

Results: The analysis included 680 post-surgical patients who later became pregnant and 2002 non-surgical pregnant individuals with obesity. Both gestational diabetes (8.7% surgical vs. 18.8% non-surgical; OR 0.29, 95%CI 0.21-0.40, p<0.001) and preeclampsia/HELLP rates (4.0% surgical vs.

12.5% non-surgical; OR 0.20, 95%CI 0.13-0.31, p<0.001) were lower post-surgery. Cesarean delivery rate was different between groups (35.9% surgical vs. 44.7% non-surgical; OR 0.50, 95%CI 0.40– 0.63, p<0.001). Bariatric surgery impacted rates of SGA and LGA. Severe adverse fetal/infant outcome rates were similar between groups. A composite of severe fetal/infant morbidity/mortality was decreased in the surgical (10.7%) vs. non-surgical group (13.6%; OR 0.73, 95%CI 0.54-0.97, p<0.05).

Conclusion: Bariatric surgery decreased many obesity-related adverse pregnancy risks and was not associated with severe adverse fetal/infant outcomes.

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INTERNATIONAL MANAGEMENT AND OUTCOMES OF ACUTELY PRESENTING COLORECTAL CANCER: PRELIMINARY RESULTS FROM THE APOLLO PROSPECTIVE SNAPSHOT STUDY Dr William Xu (presenter, 1) 1. University of Auckland, Auckland, New Zealand

Introduction: The APOLLO study aimed to describe the characteristics and management of emergency colon and rectal cancer presentations in an international cohort. Secondary aims were to define 30- and 90- day mortality.

Oral Presentations

Method: This prospective, international, cohort study enrolled consecutive adult patients presenting acutely with colorectal cancer in 6-week periods from January to June 2023. Local teams prospectively reviewed theatre, ward, emergency department, and referral lists.

Results: 1414 patients from 216 centres in 39 countries have completed 90-day follow-up to date (median age 70 years; 645 female [45.6%]; ASA Grade I-II: 689 [48.7%]). Most patients presented with large bowel obstruction (n=774, 54.7%), gastrointestinal haemorrhage (n=297, 21.0%) or bowel perforation (n=161, 11.4%). Overall, 56.9% of patients presented with a new diagnosis of cancer (n=804), 13.9% presented while awaiting elective surgery (n=196), and 9.3% presented while undergoing neoadjuvant therapy (n=132). Most cases were managed with curative intent (n=805, 56.9%). Of the 1022 patients undergoing surgery, 813 underwent surgical resection (79.5%), 582 underwent stoma formation (56.9%), and 498 (48.7%) underwent primary anastomosis. Only 57 patients underwent colonic metallic stenting (4.0%). Overall, 90-day mortality was 19.4%; 90-day surgical mortality was 13.9% and 90-day non-operative mortality was 33.7%. There was significant variation in overall mortality, but not surgical mortality, between countries after case-mix adjustment on funnel plot analysis.

Conclusion: Acute colorectal cancer presentations carry significant mortality both with and without surgery internationally. Many acute presentations are in patients with known colorectal cancer awaiting treatment. Further work predicting mortality risk at an individual level is needed.

THE USE OF A NOVEL CONVOLUTED NEURAL NETWORK FOR THE DIAGNOSIS OF MALIGNANT THYROID NODULES. Dr Karishma Jassal (presenter), Afsaneh Koohestani, Bruno DiMuzzio, Jonathan Serpell, James C Lee 1. Monash University Endocrine Surgery Unit, Alfred Hospital, Melbourne, Victoria, Australia.

2. Department of Surgery, Central Clinical School, Monash University, Melbourne, Victoria, Australia.

Purpose: Preoperative identification of malignant thyroid nodules remains challenging. Risk stratification models like TIRADS have introduced a standardised lexicon to assist treatment strategies however ultrasound (USG) is operator dependent and subject to radiologist inter-reader variability. The aim of this study was to determine the diagnostic performance of an USG image recognition artificial intelligence (AI) model in classifying nodules as benign or malignant.

Method: Patients were recruited from our prospectively maintained Endocrine Surgery Unit (2015 2021) and assigned into training or testing groups. USG image review and nodule annotation of malignant nodules was performed by a radiologist and benign nodules by a surgeon. Final surgical histology was noted as a target for the model. The AI model created involved image segmentation and attention (the process of localising the target nodule from the entire USG screenshot) and application of a Convoluted Neural Network. Internal validation testing was performed.

Results: A total of 414 images were collected from 105 patients for training and internal validation.

Of these, 36 had malignant histology and 69 benign. 331 images were assigned to the training group, 83 images were for used for testing and internal validation. Accuracy, sensitivity and specificity for the training group was 94%, 92% and 91% respectively and for the internal validation group; 90%, 90% and 85% respectively.

Conclusion: This is one of the first studies using a hybrid AI method for thyroid cancer detection.

Our results suggest that AI can differentiate benign from malignant nodules using USG images alone. Further work is underway combining a multifaceted approach to thyroid nodule diagnostics.

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INEQUALITY IN HOSPITAL USE IS EXPERIENCED BY CULTURALLY AND LINGUISTICALLY DIVERSE PATIENTS WITH PERIPHERAL ARTERY DISEASE Dr Sophie James (presenter, 1, 2, 3), Sarah Aitken (1, 2, 3) 1. Concord Repatriation General Hospital, Sydney, NSW 2. Concord Institute of Academic Surgery, Concord Repatriation General Hospital, Sydney, New South Wales 3. The University of Sydney, Sydney, New South Wales Introduction: More than 50% of Australian residents are culturally and linguistically diverse (CALD), with over 20% speaking a language other than English (LOTE) at home. Health inequalities exist for CALD populations with vascular diseases; however, the extent is not well characterised. Barriers accessing hospital services are a major driver to observed inequalities. We aim to explore differences in measures of hospital use between CALD and non-CALD patients with peripheral artery disease (PAD).

Oral Presentations

Methods: Routinely-collected health data from the Admitted Patient Data Collection and Scheduling data were linked for all patients having PAD surgery during 1 July, 2022 - 30 June, 2023 at a tertiary referral hospital in inner-city Sydney. CALD patients were identified by country of birth (outside Australia and the UK), LOTE, or interpreter use. Logistic regression identified differences in hospital service access between patient groups.

Results: During the study, 279 patients underwent 397 PAD operations. CALD patients comprised 54.9% of patients (n=152), were older (P<.001) and more multimorbid (61.5%, P=.024) compared to non-CALD. CALD patients were more likely to attend public outpatient clinics than private rooms (62.8%), however interpreters were infrequently utilised (9%, P<.300). Compared to English speakers, non-English speaking patients attended clinics less frequently (OR 1.91, 95% CI 1.08-3.39).

Emergency/Elective surgery rates did not differ according to CALD status.

Conclusions: CALD patients access health services less than non-CALD, despite similar prevalence of PAD. Further research exploring the impact of CALD on health outcomes is required to align health services with the whole community’s needs.

PATIENTS’ PREFERENCES FOR CENTRALISATION OF SURGICAL SERVICES FOR OESOPHAGEAL CANCER: A DISCRETE CHOICE EXPERIMENT Dr Josipa Petric (presenter, 1, 2), Norma Bulamu (1), Gang Chen (3), Tim Bright (2), David I Watson (1,2) 1. Flinders University, Adelaide, South Australia 2. Flinders Medical Centre, Adelaide, South Australia 3. Monash University, Melbourne, Victoria

Purpose: Oesophageal cancer surgery in a centralised high-volume centre has significant benefits to outcomes for patients. However, rural and remote patients may value and perceive these benefits differently and may be willing to make trade-offs for local specialist care with a familiar and trusted physician. This may be due to a lack of a support network, the need to travel, or costs associated with travel. The aim of this study was to understand whether these factors are important to patients, and if they influence decisions for care.

Methodology: A discrete choice experiment was carried out using four characteristics or attributes selected in consultation with experienced upper gastrointestinal surgeons and patients. The attributes included were: (1) travel distance to hospital, (2) risk of in-hospital mortality, (3) length of hospital stay and (4) cost. Two groups of respondents were recruited: patients with Barrett’s Oesophagus, and doctors. The framework of random utility theory was used to analyse the data collected.

Results: 60 doctors and 63 patients responded to the survey. The preference for centralised services over localised services for both patients and doctors was influenced by travel distance (r=-0.861 if traveling for 400km compared to under 10km), death rate (r=0.528 if 1% and -0.731 if 8%), hospital stay, out-of-pocket cost and finally 5-year survival (r=-0.655 if survival was 40% and r=0.307 at 50% chance of survival). Preferences for doctors in rural and remote areas were influenced by lower death rate, shorter hospital stay and lower patient costs. Patient preferences were influenced by travel distance, death rate and cost.

Conclusion: Centralised oesophageal cancer surgical services seem to be preferred over local services by both doctors and patients if they are delivered at lower cost, with a lower risk of hospital death, less time in hospital and higher long-term survival outcomes.

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THE ROLE OF OPIOID PRESCRIPTIONS ON DISCHARGE FROM SURGERY ON PATIENT-REPORTED OUTCOMES: INTERNATIONAL RESULTS FROM THE OPERAS PROSPECTIVE STUDY Dr William Xu (presenter, 1) on behalf of the TASMAN Collaborative

Introduction: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is a challenging worldwide problem. The OPERAS study aimed to comprehensively assess the prescribing practices and effects of opioid analgesia on patientreported outcomes after common surgical procedures internationally.

Oral Presentations

Methods: This multicentre, prospective cohort study included patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. Primary outcomes were patient-reported time in severe pain post-discharge, and patient-reported satisfaction with analgesia reported at 7 days post-discharge.

Results: Out of 4,273 patients from 144 centres in 25 countries, 1311 patients (30.7%) were prescribed opioids on discharge. For those prescribed opioids, a median of 100 oral morphine equivalents (OMEs) were prescribed but only a median of 40 OMEs were consumed at 7-day follow-up (p<0.001). On negative binomial regression, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio=1.52, p<0.001) but not with patient satisfaction (β-coefficient=0.92, p=0.468) when compared to opioid-free analgesia. While 54.5% of 1923 patients from high-income countries (HIC) were prescribed an opioid compared to 12.5% of 2350 patients from low- and middle-income countries (LMIC), there was no clinically significant difference in time spent in severe pain post-discharge between country groups (10% HIC vs 10% LMIC, p<0.001).

Conclusions: Opioids on discharge after surgery are overprescribed and are not associated with decreased pain severity or patient satisfaction after surgery. Significant global variations in prescribing practices may reflect ingrained cultural practices. For many operations, opioid-free analgesia at surgical discharge should be routinely adopted.

CIRCULATING TUMOUR CELLS IN OSTEOSARCOMA Dr Bapesh K Bollu (presenter) 1,2,3, Smadar Kahana-Edwin(1,3), Suat Dervish (4), Jonathan Karpelowsky (1,2,3) 1. Children’s Cancer Research Unit, Kid Research Institute, The Children’s Hospital at Westmead, Sydney, New South Wales 2. Department of Paediatric Surgery, Children’s Hospital at Westmead, Sydney, New South Wales 3. Westmead Clinical School, University of Sydney, New South Wales 4. Westmead Cytometry, Westmead Institute for Medical Research, Sydney, New South Wales Background: Circulating tumour cells (CTCs) are part of the growing field of liquid biopsy research.

Metastatic osteosarcoma, a common bony malignancy is Paedaitrics, has a poor prognosis. The aim of this project is to develop a technique to identify osteosarcoma CTCs. Methods: Osteosarcoma cell lines where assessed for potential surface markers using flow cytometry. Cell lines used include 143B, HOS and MG63. Following this normal control blood samples where spiked with osteosarcoma cells. Cell recovery was tested using different preanalytical techniques and processing time points. Techniques compared include red blood cell (RBC) lysis and Ficoll density gradient processing. Timepoints included fresh processing, after 24hours and frozen samples. Finally patient blood samples that were collected at different timepoints of the clinical course. All samples were processed using RBC lysis and stained with dioganglioside (GD2), Ephrin type-a receptor 2 (EphA2) and CD45. All samples were run through BD FACS Symphony and data was analysed using FlowJo software.

Results: The use of GD2, EphA2 as positive markers and CD45 as a negative marker was effective in identifying osteosarcoma CTCs. The use of RBC lysis processing with fresh sample processing yielded the best cell recovery rate. Within our patient samples we noted that presence of CTCs in 16/18 samples which were collected from seven patients. There was no correlation between the timepoint of collection and the number of CTCs identified in relation to comparing risk of recurrence and active disease and samples taken when in remission.

Conclusion: A reproducible technique to identify osteosarcoma CTC was developed. This was seen with both spiked normal control samples and patient samples.

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DELIVERY OF REGULATORY T-CELL THERAPY VIA EX-SITU MACHINE PERFUSION OF THE LIVER Dr Angus Hann (presenter 1,2) Scott P. Davies (1), Remi Fiancette (1), Naomi Richardson (1), Grace Wootton (1), George Clarke (1,2), Jingwen Mao (1), Vince Ronca (1), Kayani Kayani (1), Amber Bozward (1), M Thamara PR Perera (1,2), Ye H. Oo (1, 2) 1. Centre for Liver Research and NIHR Birmingham BRC, Institute of Immunology and Immunotherapy, University of Birmingham, United Kingdom 2. Liver Unit, Queen Elizabeth Hospital, Birmingham, United Kingdom 3. Austin-Northern general surgery training hub, Victoria Australia Introduction: Regulatory T-cells (Tregs) have shown promising results for induction of operational tolerance following liver transplantation. The delivery of Tregs directly to the donor liver via ex-situ machine perfusion (MP) obviates the need for signaling and migration. Our aim was to determine if Tregs administered to the liver using an MP model are retained in the hepatic parenchyma and maintain a suppressive phenotype.

Oral Presentations

Methods: Human Tregs were isolated via fluorescence-activated cell sorting and expanded. A custombuilt normothermic (37 C) wedge perfusion model, that had an experimental and control lobe, was utilized for the Treg infusion experiments. Prior to infusion, cells were labelled with cell tracker red (CMTPX). Cell localization was determined with confocal microscopy. After the perfusion period, mechanical dissociation of the liver was performed, and lymphocytes within the liver tissue and perfusate isolated. Phenotyping of these cells was performed with flow cytometry, including functional markers (CTLA4, CD39, TIGIT).

Results: Five experiments were performed using wedges of liver between 30 and 45 grams. Between 3-8 x106 labelled Tregs were infused into the experimental lobe and the perfusion continued for 12-14 hours. Microscopy identified the CMTPX+ Tregs within hepatic sinusoids and parenchyma. CMTPX+ Tregs were successfully identified from liver infiltrating lymphocytes and perfusate using flow cytometry. The CMTPX+ perfused Tregs maintained CTLA4 and TIGIT expression however CD39 expression was downregulated.

Discussion: Tregs administered via this ex-situ MP model have migrated from the vascular compartment to engraft into hepatic parenchyma and maintain suppressive function via coinhibitory CTLA-4 and TIGIT pathways.

A RANDOMISED CONTROLLED TRIAL OF TOPICAL ANALGESIA POSTHEMORRHOIDECTOMY (TAPH TRIAL) Dr James Jin, MBChB (presenter 1,) Weisi Xia, MBChB, PhD (1), Runzhe Gao, BSc, MSc (2), Alain C. Vandal, PhD (2), Maree Weston, MBChB, FRACS (3), Lincoln Israel, MBChB, FRACS (3), Andrew Connolly, MBChB, FRACS (3), Primal (Parry) Singh, MBChB, PhD, FRACS (1,3), Darren Svirskis, BHB, BPharm, PhD (4), Andrew Hill, MD, FRACS, FACS, FRCSEd (Hon), FRSNZ (1,3) 1. South Auckland Clinical Campus, The University of Auckland, Auckland, New Zealand 2. Department of Statistics, The University of Auckland, Auckland, New Zeaand 3. Te Whatu Ora Health New Zealand, Counties Manukau Region, New Zealand 4. Department of Pharmacy, The University of Auckland, Auckland, New Zealand Background: Hemorrhoidectomy is often associated with postoperative pain. We developed a combination topical cream targeting three hypothesized pain mechanisms, and performed an RCT to test these agents after hemorrhoidectomy.

Methods: The TAPH trial was a multicenter, double-blind trial conducted on adult participants undergoing excisional hemorrhoidectomy. Participants were randomly assigned (1:1:1:1) to one of four parallel arms of combination topical creams containing 10% metronidazole (M), 10% metronidazole + 2% diltiazem (MD), 10% metronidazole + 4% lidocaine (ML), or 10% metronidazole + 2% diltiazem + 4% lidocaine (MDL). The patients were instructed to apply topical treatments three times daily for seven days. The primary outcome was pain on the visual analog scale on day 4.

Results: Between Sep 2020 and Jan 2022, 192 patients were randomized (48 per group) and analyzed. There was no significant difference in the pain and recovery scores when diltiazem or lidocaine was added to metronidazole ( MD vs. M: -3.69, -13.3, and 5.94, p= 0.46). ML vs M: -5.67, 95%CI -15.5 to 3.80, p=0.24). The combination of MDL did not further reduce pain. The interaction model showed a significant difference between the best (ML) and worst group (MDL) in both pain and functional recovery scores. There were no significant differences in analgesia usage, complications, or return to work between the groups. No significant adverse events were noted.

Findings: Metronidazole combined with lidocaine appears to be an efficacious topical treatment and could be considered part of a multimodal approach to enhance recovery following excisional hemorrhoidectomy.

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ACHIEVING EQUITY: PATIENT DEMOGRAPHICS AND OUTCOMES AFTER SURGICAL AND NON-SURGICAL PROCEDURES IN SOUTH AUSTRALIA, 2022 Dr Joshua Kovoor (presenter, 1,2), Aashray Gupta (3,4), Stephen Bacchi (3,5), Brandon Stretton (1,5), Gerry O’Callaghan (3,5), Elizabeth Murphy (6), Thomas Hugh (7), Robert Padbury (8), Markus Trochsler (1), Guy Maddern (1,2) 1. University of Adelaide, Queen Elizabeth Hospital, Adelaide, South Australia, Australia 2. Royal Australasian College of Surgeons, Adelaide, South Australia, Australia 3. University of Adelaide, Adelaide, South Australia, Australia 4. Gold Coast University Hospital, Gold Coast, Queensland, Australia 5. Royal Adelaide Hospital, Adelaide, South Australia, Australia 6. Lyell McEwin Hospital, Adelaide, South Australia, Australia 7. University of Sydney, Royal North Shore Hospital, Sydney, New South Wales, Australia 8. Flinders University, Flinders Medical Centre, Adelaide, South Australia, Australia Background: Although modern Australian healthcare systems provide patient-centred care, the ability to predict and prevent suboptimal post-procedural outcomes based on patient demographics at admission may improve health equity. This study aimed to identify patient demographic characteristics that might predict disparities in mortality, readmission, and discharge outcomes after either an operative or nonoperative procedural hospital admission.

Oral Presentations

Methods: This retrospective cohort study included all surgical and non-surgical procedural admissions at three of the four major metropolitan public hospitals in South Australia in 2022.

Multivariable logistic regression, with backwards selection, evaluated association between patient demographic characteristics and outcomes up to 90 days post-procedurally.

Results: 40,882 admissions were included. Increased likelihood of all-cause, post-procedure mortality inhospital, at 30 days, and 90 days, were significantly associated with increased age (p<0.001), increased comorbidity burden (p<0.001), an emergency admission (p<0.001), and male sex (p=0.046, p=0.03, p<0.001, respectively). Identification as ATSI (p<0.001) and being born in Australia (p=0.03, p=0.001, respectively) were associated with an increased likelihood of 30-day hospital readmission and decreased likelihood of discharge directly home, as was increased comorbidity burden (p<0.001) and emergency admission (p<0.001). Being married (p<0.001) and male sex (p=0.003) were predictive of an increased likelihood of discharging directly home; in contrast to increased age (p<0.001) which was predictive of decreased likelihood of this occurring.

Conclusions: This study characterised several associations between patient demographic factors present on admission and outcomes after surgical and non-surgical procedures, that can be integrated within patient flow pathways through the Australian healthcare system to improve healthcare equity.

THE INFLUENCE OF PRE AND POST OPERATIVE STOMA ON LONG-TERM QUALITY OF LIFE FOLLOWING PELVIC EXENTERATION Dr Tess Porges (presenter, 1, 2), Cherry Koh (1, 2, 4), Michael Solomon (1, 2, 4), Colleen Mendes (1, 2) Kiera Taylor (2), Daniel Steffens (1, 2, 4), Sascha Karunaratne (2, 3) 1 Department of Colorectal Surgery, Royal Prince Alfred Hospital, Camperdown New South Wales, Australia 2 Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown New South Wales, Australia 3 Faculty of Medicine and Health, School of Public Health, The University of Sydney, Camperdown New South Wales, Australia 4 Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Camperdown New South Wales, Australia Background: Pelvic exenteration (PE) is often the only curative treatment for patients with advanced primary or recurrent cancers within the pelvis, with the formation of at least one stoma postoperatively commonly inevitable. Many individuals have stomas pre-operatively, however, there has been no long-term evaluation regarding how number of stomas affects patient quality of life.

Objectives: To investigate the influence of stoma on quality of life (QoL) outcomes following PE. Methods: A prospective cohort study of consecutive patients undergoing PE at a single institution for advanced primary or recurrent cancers of the pelvis between January 2011 and June 2022 were recruited. The primary outcome was QoL assessed with SF-36 (Mental Component-MCS and Physical Component-PCS scores) and FACT-C total score at baseline, 6, 12, 18 and 24 months.

Higher scores indicate better QoL. Patients were divided into groups based on having or not having a stoma preoperatively and post-operatively. Between and within group differences in QoL scores were analysed using nonparametric statistics.

Results: A total of 550 patients were included. Most patients were male (55%) and underwent PE due recurrent rectal cancer (36%), presenting a mean age of 59 years. Preoperatively, PCS was worse in patients with stoma from baseline to 12 months, thereafter, no differences in PCS was observed. No difference in MCS and FACT-C was observed. Postoperatively, patients with stoma (one or two) presented worst QOL trajectories.

Conclusions: The results of this study demonstrate that the presence of stoma pre- and postoperatively negatively influence QoL trajectories following PE surgery.

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INHIBITION OF P21-ACTIVATE KINASE 1 AND 4 SYNERGISTICALLY SUPPRESS PANCREATIC CANCER GROWTH Dr Yi Ma (presenter 1), Chelsea Dumesny (1), Li Dong (1), Ching-Seng Ang (2), Khashayar Asadi (3), Mehrdad Nikfarjam (1), Hong He (1) 1. Department of Surgery, University of Melbourne, Austin Precinct, Studley Road, Heidelberg, Victoria, Australia 2. Bio21 institute, University of Melbourne, Flemington Road, Parkville, Victoria, Australia 3. Department of Anatomical Pathology, Austin Health, Studley Road, Heidelberg, Victoria, Australia Introduction: Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal types of cancer, and KRAS oncogene accounts for over 90% of cases. P21-activated kinases (PAK) function downstream of KRAS and include six members (PAK1 to 6). Studies have pointed to an important role of PAK1 and PAK4 in carcinogenesis, but their combination effect remains unknown. In this study, we have assessed the effect of dual PAK1 and PAK4 inhibition in PDAC development.

Oral Presentations

Method: Wild-type (WT) and PAK1 gene knock out (KO) cell lines were generated by outgrowth technique from pancreatic cancer of KPC pak1-/- mice. PAK4 KO and PAK1 and 4 KO cell lines were then created by CRISPR-CAS. In vitro growth of cancer cells was studied by MTT assay. Cell cycle and apoptosis were determined by FACS. In vivo tumour growth was assessed by syngeneic mice model. Proteomic studies as well as FACS for lymphocyte infiltration were conducted.

Results: PAK1 and PAK4 KO inhibited PDAC tumour growth synergistically in mouse model. This is mediated through increased intra-tumoral infiltration of CD8+ T cells. However, PAK4 KO failed to inhibit cancer cell growth in vitro. This effect was reversed by addition of PAK1 KO. PAK1 KO increased cancer cell susceptibility to apoptosis and reversed the cytoprotective effect of PAK4 KO. It also induced cell cycle arrest in cancer cells.

Conclusion: PAK1 and PAK4 KO have synergistic inhibitory effect on PDAC development through immune modulation, as well as effect on cancer cell death and cell cycle.

QUALITY OF LIFE AFTER HEMI AND TOTAL THYROIDECTOMY: AN OBSERVATIONAL STUDY Mx Natasha Newman (presenter, 1), Professor Jeremy Millar (1, 2, 4), Associate Professor James Lee (1, 2, 3, 4) 1. Central Clinical School, Monash University, Melbourne, Victoria 2. The Alfred Hospital, Melbourne, Victoria 3. Monash University Endocrine Surgical Unit, Melbourne, Victoria 4. Australian and New Zealand Thyroid Cancer Registry, Melbourne, Victoria Introduction: Despite a rapid increase in incidence, thyroid cancer is associated with low mortality and excellent prognosis overall. Recent literature has debated the role of less extensive hemithyroidectomy as definitive treatment for patients with low-risk thyroid malignancy. We sought to compare Quality of life (QOL) after different extents of thyroidectomy in this relatively young surgical cohort.

Methodology: A prospective observational study was conducted to investigate the differences in QOL between hemithyroidectomy and total thyroidectomy patients. Responses to the European Organisation for Research and Treatment of Cancer (EORTC) Thyroid Cancer QOL Module were collected at 3, 6 and 12 months postoperatively. Analysis was conducted using the Wilcoxon Rank Sum Test and multiple linear regression modelling.

Results: Of 291 total thyroidectomy and 246 hemithyroidectomy patients included, the proportion of malignant cases was 95.3%. Hemithyroidectomy patients reported significantly better scores in 4 of 32 QOL domains at 3 months, with higher scores for role function and less issues with pain, swallowing and shoulder function. By 6 months postoperatively these differences were replaced by an improved social support score for total thyroidectomy patients. A slightly superior swallowing score for hemithyroidectomy was the only significant result at 12 months.

Conclusion: The extent of thyroidectomy performed is a significant predictor of QOL within the first postoperative year, after which it becomes negligible. These results can help guide the extent of surgery performed for suspicious lesions, and they allow surgeons to reassure patients that resulting QOL differences are likely to be temporary.

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EMPOWERING ANTIMICROBIAL STEWARDSHIP IN DIABETIC FOOT OSTEOMYELITIS WITH PROXIMAL BONE MICROBIOLOGY Dr Longhai Jin (presenter, 1), Kathryn Daveson (2), Gert Frahm-Jensen (1,3), Alister Jones (1,3) 1. Department of Vascular Surgery, The Canberra Hospital, Yamba Drive, Garran, ACT 2605, Australia 2. Department of Infectious Diseases, The Canberra Hospital, Yamba Drive, Garran, ACT 2605, Australia 3. Australian National University, Canberra, ACT 2600, Australia Purpose: Diabetic foot osteomyelitis (DFO) has complex pathophysiology and microbiology.

Treatment failure can lead to sepsis and loss of limb; however, unnecessary antibiotics has many disadvantages including adverse reactions and prolonged hospitalisations. Antimicrobial stewardship is crucial for optimising DFO treatment. Recent guidelines regard proximal bone sampling as conditional. This study aimed to assess the patterns of microbiology and antibiotic use to determine the value of routine proximal bone sampling in DFO.

Oral Presentations

Methods: A prospective single-centre study was conducted involving adult patients with diabetes mellitus having minor amputations for DFO. Data was collected for comorbidities; site of DFO; level of amputation; proximal bone microbiology; antibiotic choice and duration; and outcome at 6 months.

Results: 77 patients had minor amputations for DFO; 33 (43%) of whom had significant positive microbiology, 18 (23%) had non-significant coagulase-negative Staphylococcus, 26 (34%) had negative microbiology. 31% had Gram-positive organisms; 17% had Gram-negative organisms. 13% had multi-drug resistance organisms. From analysing the antibiotic use patterns, routine proximal bone microbiology would save 2571 potential days of antibiotics per 100 patients with further 1232 potential days of broad-spectrum antibiotics and 214 days of piperacillin-tazobactam saved per 100 patients. 171 days of extra Grampositive coverage and 375 days of broader Gram-negative antibiotics per 100 patients were identified. The overall impact was a reduction of 4037 days of therapy of piperacillin-tazobactam per 100 patients than currently administered.

Conclusion: Analysis of proximal bone microbiology has significant implications for antimicrobial stewardship in DFO. Routine sampling should be incorporated into the treatment algorithm for DFO.

ENDOTHELIAL GLYCOCALYX SHEDDING DURING SHOCK AND RESUSCITATION IS INDEPENDENT OF TISSUE INJURY IN A PORCINE SHOCK MODEL Mr Raushan Lala (presenter, 1, 3, 4), Wendy Goodwin (2, 3), Shaun Pratt (2, 3), Professor Mark Midwinter (1, 3, 4) 1. School of Biomedical Sciences, The University of Queensland, St Lucia, Queensland 2. School of Veterinary Sciences, The University of Queensland, Gatton, Queensland 3. Traumatic Injury Sciences Group, The University of Queensland, St Lucia, Queensland 4. Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Herston, Queensland

Introduction: Elevations in markers of endothelial injury following trauma have been reported in several cohort studies. The independent roles of tissue injury and hypotension in elevations of such markers is unclear. We present data demonstrating that shedding of the endothelial glycocalyx during shock occurs independently of tissue injury in a porcine trauma model.

Methods: This study was undertaken in a porcine model of haemorrhagic shock with variable tissue injury developed by our group. 18 anaesthetised pigs were allocated to control, isolated haemorrhagic shock, or combined musculoskeletal injury and haemorrhagic shock groups. Plasma samples were collected during shock and after saline resuscitation. Samples at equivalent time points were also collected from anaesthetised control pigs. Plasma hyaluronan concentration was quantified by enzyme linked immunosorbent assay (ELISA) at each timepoint and compared between groups.

Results: Increased plasma hyaluronan was observed after 30 and 60 minutes of shock in both the haemorrhagic group and traumatic haemorrhage group compared to anaesthetised control animals. Plasma hyaluronan then decreased after saline resuscitation (likely dilutional). No difference was observed in the temporal profile of plasma hyaluronan in groups undergoing isolated haemorrhagic or traumatic haemorrhagic shock.

Conclusion: Elevated markers of glycocalyx shedding are evident during haemorrhagic shock independent of the presence of musculoskeletal injury. This may suggest that release of these markers is more likely related to hypotension rather than mechanical tissue injury.

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GENOMIC PROFILING AND BIOMARKER DISCOVERY FOR PREDICTING EARLY INTRAHEPATIC RECURRENCE FOLLOWING RESECTION OF COLORECTAL LIVER METASTASES Dr Geoffrey Yuet Mun Wong (presenter 1, 2), Jun Li (2), Nazim Bhimani (1), Connie Diakos (3), Mark P Molloy (2), Thomas J Hugh (1) 1. Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, St Leonards, New South Wales, Australia 2. Bowel Cancer and Biomarker Research Laboratory, Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, St Leonards, NSW, 2065 3. Department of Medical Oncology, Royal North Shore Hospital, St Leonards, New South Wales, Australia Introduction: The role of genomics in driving tumour biology and its influence on early recurrence in patients with colorectal liver metastases (CRLM) is inadequately understood. This study aims to profile and discover genomic biomarkers for early intrahepatic recurrence following curativeintent resection of CRLM.

Oral Presentations

Methods: Comprehensive genomic profiling of 24 fresh frozen CRLM samples from patients with early intrahepatic recurrence after resection of CRLM was performed using the TruSight Oncology 500 assay (Illumina, San Diego, CA). Functional annotation of somatic variants and filtering was performed using open-source genomic databases (ExAc, gnomAD) and software packages (ANNOVAR). Aggregated mutation information was summarised, analysed and visualised using the maftools package (version 2.16.0). Function and interaction networks of genetic alterations were explored using GeneMANIA. Estimation of the selective advantage conferred by somatic mutations was performed using cancereffectsizeR (version 2.7.0).

Results: 117 of 523 profiled genes were altered in samples from patients with early recurrence. TP53 (88%), APC (71%), KRAS (38%), SMAD4 (21%) and PIK3CA (17%) were the top 5 frequent cancer drivers.

The identified gene alterations are implicated in diverse biological processes and complex molecular interactions, including cell population proliferation, signalling response to external stimulus, DNA repair, DNA methylation, RNA binding, cell adhesion, cell cycle control, chromatin remodelling and lineage-specific transcription factors. BRAF mutation had the highest relative importance in early intrahepatic recurrence.

Conclusion: Comprehensive genomic profiling of CRLM in this cohort has identified biological characteristics associated with early recurrence and BRAF mutation as a strong prognostic biomarker relative to other cancer-related genes.

ETHNIC DISPARITIES IN COMPUTERISED TOMOGRAPHIC AORTOGRAPHY USE FOR DIAGNOSING ACUTE AORTIC SYNDROME Dr Sameer Bhat (presenter, 1, 2), Shreya Bhat (2), Franco Schreve (3), Colleen J. Bergin (4), Peter G. Jones (1, 3), Steve W.F.R Waqanivavalagi (5) 1. Department of Surgery, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, Aotearoa New Zealand 2. Department of Surgery, Te Whatu Ora MidCentral, Palmerston North, Aotearoa New Zealand 3. Adult Emergency Department, Auckland City Hospital, Te Whatu Ora, Auckland, Aotearoa New Zealand 4. Department of Radiology, Auckland City Hospital, Te Whatu Ora, Auckland, Aotearoa New Zealand 5. Cardiothoracic Surgical Unit, Waikato Hospital, Te Whatu Ora, Hamilton, Aotearoa New Zealand Introduction: Acute aortic syndrome (AAS) forms a group of life-threatening vascular emergencies with high rates of misdiagnosis. However, under- and over-investigation of patients using computerised tomographic (CT) aortography carries significant risk. The aim of this study was to determine whether CT aortography scans were performed in proportion to patient risk for acute aortic syndrome (AAS), and the incidence of AAS, for different ethnic groups.

Methods: All atraumatic thoracic aorta CT aortographic examinations performed in adults (age > 15 years) suspected of having AAS between January 2009 and December 2019 at Auckland City Hospital (New Zealand (NZ)) were included. Patients were risk stratified using the aortic dissection detection risk score (ADD-RS). Ethnicity were self-identified by patients according to NZ Ministry of Health protocols.

The primary outcome was the ratio of CT aortography scans to the rates of positive CT aortographic examinations. The secondary outcome was the incidence of AAS. Population census data were used to determine age-standardised incidence of AAS in the emergency department (ED).

Results: In total, 1,646 CT aortographic examinations were performed in 1,543 patients (mean age, 62 years ± 16 [standard deviation]; 877 male patients). Māori (34% [68 of 203]) and Pacific Islanders (35% [80 of 229]) were more likely to be at high risk of AAS (ADD-RS > 1) compared with patients from other ethnic groups (25% [308 of 1,214]); in the ED catchment population, age-standardised AAS incidence was significantly higher in Māori (6.9 per 100 000 person-years [95% CI: 4.3 to 10.4]) and Pacific Islanders (5.3 [95% CI: 3.4 to 7.8]) than in other ethnic groups (2.3 [95% CI: 1.8 to 2.8]). Despite this higher incidence, disproportionately fewer CT aortographic examinations were requested in the ED for Māori (9.2 CT aortographic examinations per AAS diagnosis) and Pacific Islanders (9.2 CT aortographic examinations per AAS diagnosis) compared with other ethnic groups (13.8 CT aortographic examinations per AAS diagnosis).

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Conclusions: Māori and Pacific Islanders were at disproportionately higher risk of AAS but had fewer requested CT aortographic examinations compared with other ethnic groups. This increased risk of AAS in Pacific Islander and indigenous Māori patients should be considered by clinicians when investigating AAS.

OPTIMAL RESECTION MARGIN WIDTH FOR COLORECTAL LIVER METASTASIS Dr Kaushik Thungathurthi (presenter,1), Shalvin Jassal (1), Adrian Fox (1) 1. Eastern Health, Melbourne, VIC Purpose: Debate remains regarding the optimal resection margin distance and its impact on overall survival and recurrence. This study seeks to investigate the influence of RM width on overall survival, local recurrence rates and the factors impacting attainment of clear RMs (R0).

Method: This retrospective single-centre cohort study includes 90 consecutive patients undergoing resection from 2000-2021 in Eastern Health. Baseline characteristics including age, gender, BMI, preoperative CEA, operation type, tumour characteristics (size, number, RM width, LVI/PNI) and postoperative complications Clavien-Dindo scores (CDS) were assessed.

Oral Presentations

Results: Seventy patients had an R0 resection, and 20 patients with an R1+2 resection. The mean age of patients in <1mm (n=7), 1-10mm (n=53) and >10mm (n=30) resection margin cohorts were 58, 63 and 61 years respectively (p=0.49). Baseline characteristics did not differ between margin cohorts. Patients in the R0 cohort had a higher BMI compared to the R1+2 cohort (29.29 vs 25.13, respectively; p = 0.03). More patients in the R1+R2 group underwent a pringle manoeuvre (33.3%) compared to those in the R0 cohort (7.8%) which was significant (p=0.022). Overall disease-free interval for the cohorts was not significant, p=0.35. More patients in the R1+2 cohorts required readmission compared to the R0 cohort (25% vs 7.1%, respectively; p=0.03), although on logregression recurrence post-resection demonstrated no significant differences between R0 and R1+2 cohorts (p=0.44).

Conclusion: Our study demonstrated no significant differences in disease free and overall survival between RM widths. Future large-scale prospective studies are crucial to investigate the optimal RM width for CLM resections whilst limiting associated morbidity.

UNLOCKING THE EDUCATIONAL POTENTIAL OF WARD ROUNDS: PERSPECTIVES FROM MEDICAL TRAINEES AND EDUCATORS Dr Jessica Mi Yee Au (Presenter, 1), Ravi Vissapragada (2) 1. Alfred Health, Melbourne, Victoria 2. Monash Health, Melbourne, Victoria Introduction: Ward rounds are fundamental in surgical education, providing trainees with opportunities to apply theoretical knowledge with practical clinical experience. This review explores the qualitative aspects of ward rounds to identify the learning opportunities available, the challenges faced by both trainees and educators, and potential strategies to enhance their educational value.

Method: A systematic review of existing literature from 2003-2023 was conducted, identifying studies that investigated barriers to teaching and learning during ward rounds. OVID Medline and Embase were searched, with 323 articles identified. 59 duplicates were removed and 259 articles excluded based on abstract and full-length text. Five studies were added based on reference searching. The data from these studies were analysed thematically.

Results: A total of 11 articles were included. Key themes encompassed high clinical workload causing time constraints, lack of conducive learning environments, influence of educators, and the need for structured, learner-centred ward rounds. Trainees also highlighted the importance of enthusiastic educators to provide constructive feedback and engage in discussions. Challenges such as interruptions and high workload were consistently reported, emphasising the need for strategies to mitigate these obstacles.

Conclusion: The educational value of ward rounds in surgical training cannot be understated. We divided themes affecting learning during ward rounds into “alterable” and “unalterable” factors.

This is the key to performing higher quality, large participant studies such as stated preferences methods. This will uncover the overlap in factors between both educators and trainees to identify an ideal ward round structure that is educational whilst maintaining clinical efficiency.

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ACUTE MESENTERIC ISCHAEMIA IS ASSOCIATED WITH ELEVATED LACTATE AND PYRUVATE LEVELS IN THE PERITONEAL FLUID: A PROSPECTIVE OBSERVATIONAL PILOT STUDY Dr LongHai Jin (presenter, 1), Rong Xian Chia (1), Miho Mugino (1), Krishanth Naidu (1), Eleni Baird-Gunning (1), Alice Richardson (2,3), Soon-Ngee Lau (1), Sivakumar Gananadha (1,3) 1. Department of General Surgery, The Canberra Hospital, Yamba Drive, Garran ACT 2605, Australia 2. Statistical Support Network 3. Australian National University, Canberra, ACT Australia Purpose: Acute mesenteric ischaemia (AMI) has high morbidity and mortality. Reliable early diagnosis of AMI is challenging due to non-specific clinical, biochemical and radiological findings.

An ideal biomarker for diagnosing AMI is currently lacking. We hypothesised that biomarkers in peritoneal fluid could be present prior to notable changes in serum and could help with the early diagnosis of AMI.

Oral Presentations

Methods: A prospective single-centre observational pilot study was conducted with adult patients undergoing emergency laparotomy for suspected AMI. Preoperative blood test and intraoperative peritoneal fluid were analysed to identify biomarkers of AMI. Patients were excluded if there was perforation of the bowel.

Results: Sixty-nine patients identified during the study; 5 were excluded for perforation and 6 for incomplete data. Fifty-eight patients were included in the analysis, 24 were in the control group and 34 were in the ischaemia group. The ischaemia group had significantly higher means of preoperative serum white cell count (16.23 x109/L vs 9.77 x 109/L; p = 0.001), neutrophils (13.97 x 109/L vs 7.03 x 109/L; p < 0.001) and C-reactive protein (95.56 mg/L vs 53.42 mg/L; p = 0.039). Peritoneal fluid of the ischaemia group had higher median lactate (3.85 mmol/L vs 1.2 mmol/L; p = 0.002) and pyruvate levels (190.0 μmol/L vs 114.0 μmol/L; p = 0.003).

Conclusion: This pilot study showed that serum glucose, leukocytes and neutrophils, as well as peritoneal fluid lactate and pyruvate were significant diagnostic biomarkers for AMI. A combination of these factors allows for further improved accuracy of AMI diagnosis.

CARDIOPULMONARY RESUSCITATION STRATEGIES - SYSTEMATIC REVIEW AND META-ANALYSIS, AND THE ROLE OF SURGEONS Dr Steve Waqanivavalagi (presenter, 1, 2), Peter Jones (3,4), Michael Iwashita (4), Eunicia Tan (3,5), Tobias Merz (6) 1. Green Lane Cardiothoracic Surgical Unit, Te Whatu Ora Health New Zealand - Te Toka Tumai, Auckland City Hospital, New Zealand.

2. Department of Medicine, University of Auckland (Waipapa Taumata Rau), New Zealand.

3. Department of Surgery, University of Auckland (Waipapa Taumata Rau), New Zealand.

4. Adult Emergency Department, Te Whatu Ora Health New Zealand - Te Toka Tumai, Auckland City Hospital, New Zealand.

5. Emergency Department, Te Whatu Ora Health New Zealand - Counties Manukau, Middlemore Hospital, New Zealand.

6. Cardiothoracic and Vascular Intensive Care Unit, Te Whatu Ora Health New Zealand - Te Toka Tumai, Auckland City Hospital, New Zealand.

Introduction: Development of an ECMO-assisted CPR (ECPR) program requires consideration of the evidence for both in and out of hospital arrests (IHCA and OHCA), and for all potentially eligible participants. Prior systematic reviews of ECPR compared to Conventional CPR (CCPR) are at high risk of bias because they included studies with overlapping patient populations or were limited to certain subgroups of cardiac arrest patients. The aim was to determine neurologically intact survival (Cerebral Performance Category 1-2) up to one year, including comparative studies controlling for CPR duration prior to the intervention.

Methods: Structured searches were conducted in Embase, the Cochrane Library and Medline from inception to 1/08/23. RCTs and observational studies that controlled for CPR duration were included.

Two reviewers independently screened articles for inclusion, assessed risk of bias (ROB) using standard tools and extracted summary data from published and unpublished reports. Meta-analysis was conducted using RevMan5 and publication bias was assessed using Funnel plots. The certainty of evidence was assessed using the GRADE approach. The review was registered in PROSPERO CRD42022345115.

Results: We found 997 studies, with 52 full texts assessed for eligibility. Fourteen studies from Asia, Europe and the USA were included in meta-analyses. Neurologically intact survival was higher for ECPR: 12 studies, n=3268; 2654 male / 616 female, average age <60 years; AR 0.05, 95%CI (0.03, 0.07), p<0.001. I2=72%.

Conclusion: ECPR is likely associated with improved neurologically intact survival up to one year, although the effect size is lower than previously reported.

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Awards The Surgical Research Society of Australasia conference has multiple awards available to eligible presenters.

These are: Lexington Medical ANZ, Young Investigator Award: One AUD5,000 prize is awarded to a presenter 40 years or younger. The Young Investigator Award funds the attendance and presentation at the Academic Surgical Congress (ASC) in the USA in 2025.

Becton-Dickinson, DCAS Award: One AUD4,000 prize is awarded to a presenter who is a SET Trainee, Prevocational Doctor or Medical Student. The DCAS Award funds attendance at the Developing a Career and Skills in Academic Surgery Course at the Annual Scientific Congress in May 2024.

Travel Grants sponsored by Becton Dickinson and Bongiorno Group: Three prizes (AUD1,000 each) are awarded to presenters who must be a SET Trainee, Pre-vocational Doctor or Medical Student. Each Travel Grant funds expenses towards travel, accommodation and conference/course registration.

ANZ Chapter of the American College of Surgeons: One AUD2,000 prize is awarded to a presenter who has been a Fellow not more than 5 years. The ANZ Chapter of the American College of Surgeons Award requires the Awardee to present their research at the ANZ Chapter Surgical Forum at the RACS Annual Scientific Congress the following year.

Elsevier eBook Vouchers: Elsevier have generously donated two eBook vouchers valued at AUD150 each.

These prizes will be awarded to the best visual presentation in each category (oral and quick shot presentation). All presenters are eligible unless they have already received an award during the conference, or as otherwise communicated.

Responsibilities for Winners: All award and prize winners are to submit a 300 word report to the Academic Surgery Committee within 12 months detailing their learnings, and any resulting collaborations and/or publications/presentations.

Aboriginal and Torres Strait Islander motif

Aboriginal and Torres Strait Islander motif

The Māori motif indicates RACS’ commitment to address Māori health inequity to accept obligations inherent in te Tiriti o Waitangi.

The Aboriginal and Torres Strait Islander motif indicates RACS’ commitment to address Aboriginal and Torres Strait Islander health inequity.

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Section of Academic Surgery Do you have an interest in academic surgery?

Eligibility Membership of the Section of Academic Surgery is open to Fellows, Trainees and International Medical Graduates (SIMGs) on a pathway to Fellowship who have an interest in academic surgery. The Executive Committee of the Section can also offer membership to individuals who are external to the College on recommendation from the Chair. Non College members may have to pay a membership fee but will not have voting rights and are not eligible to hold governance positions.

Objectives of the Section To develop and monitor standards in academic surgical departments in Australia and Aotearoa New Zealand To enhance career pathways in academic surgery and to encourage younger surgeons to pursue opportunities in academic surgery To develop an Australasian curriculum for undergraduate surgery, to provide advice to Australian and Aotearoa New Zealand medical schools regarding appropriate surgical content, and which is appropriate for continuation to surgical education and training To advise RACS Council on professional and policy issues related to academic surgery, as well as issues of relevance to surgery in general To respond to requests from Council for consideration of relevant issues.

To establish and maintain a registry of academically active members in order to support the Section's activities and plan appropriate workforce issues.

Governance The Section of Academic Surgery is governed by the Academic Surgery Committee reporting to the Research & Academic Surgery Committee (RASC) and the Professional Standards and Fellowship Services (PSFS) Committee.

Submitting an application: Do you have an interest in academic surgery? To join the community of academic surgeons today for free, simply complete this application form. More information can be found here Page 51