Upper gastrointestinal unit profile for ANZGOSA/ Concord hospital/Sydney/New South Wales
upper gastrointestinal surgery unit at Concord Hospital is composed of six surgeon's both with HPB and OG practice focus. The unit covers at least one third of the hospital urgent admissions in surgery. There is a range of complex and urgent surgery above and beyond the elective upper gastrointestinal. There are two fellows within the unit and an advanced trainee and six all day elective operating lists. Fellows are encouraged to gain experience in the private hospital when time permits. The fellow is responsible each subsequent week for total organisation and on call for the unit and on call for appropriate general surgical emergency from home. Both fellow positions are fully funded and long standing. There is accreditation for ANZGOSA and OSSANZ with these positions. This unit is renowned for advanced laparoscopic surgical training. The hospital is a major tertiary referral in situation offering most services.
During the 12 months within the public hospital alone there would be 80 laparoscopic hiatus hernia operations, 20 gastric cancer, 15 oesophagectomy, 200 sleeve gastrectomy, 20 gastric bypass and general surgery comprising 200 cholecystectomy, bile duct exploration 20, and acute general surgery. Liver resection , pancreatectomy and bile duct carcinoma surgery is performed frequently. There is a strong focus on therapeutic endoscopy of the upper gastrointestinal tract. There is a Department of surgery oesophageal physiology laboratory associated with the unit.
There is a unit audit meeting each week and a unit x-ray meeting, an MDT where public and private unit patients are discussed, surgical grand rounds weekly, surgical outpatients for preoperative and post-operative evaluation weekly.
Numerous consultants in the unit publish frequently on bariatric and upper gastrointestinal surgery. It is expected that each fellow will do a clinical research project during the 12 months leading to presentation and publication internationally. There is a long-standing database of antireflux surgery and hiatal hernia surgery, oesophageal cancer, with ongoing ethical approval for maintenance of these database.
It is expected that the fellow will be the primary surgeon in the majority of complex cases and is required to assist the advanced trainee with case is suitable to the individuals level of experience and mindful of appropriate numbers being available for training. The senior consultants consider the service to be strongly focused on development of tertiary level surgical skills and clinical experience.