Post CCT Fellowship in Colorectal & General Surgery 2010-2011 Laparoscopic and open surgery

North Shore Hospital, Waitemata District Health Board, North Shore City,Auckland, New Zealand.

Waitemata District health board has a catchments’ area of over half a million people. The surgical Unit has eleven general surgeons. Five of them are colorectal surgeons with one colorectal fellow. The Hospital deals with up to 300 Colorectal cancers per year making it the busiest centre in the whole of 4 New Zealand. North Shore Hospital is a teaching centre and one of the main training hospitals in the general surgical rotation scheme. The Fellow post is equivalent to junior consultant Surgeon under senior supervision. I undertook full clinical responsibilities for the patients under my care and have admitting rights.

I had two elective operating lists a week with the supervising consultant surgeons. I had one upper GI and lower GI endoscopy session per week with training in endoscopic dilatation, stenting, and EMR. I covered Emergency and Acute Theatre as acting consultant once or twice a week dealing with various surgical emergencies (including laparoscopic cholecystectomy, appendicectomy, adhesionolysis and colorectal emergencies). I was on the consultant oncall roster with senior backup if needed (one in eleven).

I did 26 consultant oncall days. I took responsibility in teaching and training the SpRs in the acute and elective operating lists.

I worked with two consultant Laparoscopic colorectal surgeons, John Jarvis and Mike Hulme-Moir as a firm and we had on average 30 – 50 patients at a time. The average hospital acute surgical admissions are 20 patients a night. The firm takes tertiary referrals for recurrent and advanced pelvic malignancies, including those needing sacrectomy. The Post has become accredited by the Colorectal Surgical Society of New Zealand and Australia Fellowship Training Board for next term.

I gained excellent laparoscopic and open surgical training for both benign and neoplastic colorectal conditions.

There is very good exposure to pelvic floor, pouch surgery, and major/complex resections for advanced and recurrent cancers. The post also offers a wide variety of general surgical experience on elective and emergency basis. I am the main operator in all the cases with consultant supervision.

Laparoscopic colorectal resections 60

Open colorectal resections 72,TME 30

Sphincter repairs 4

Rectocoele repairs 3

Abdominal Anterior Rectopexy 5

Laparoscopic Pouch Surgery 5

Total operations 342

Colonoscopies 120