About us
The Hunter Surgical Clinical Research Unit (the Unit) promotes excellence in clinical research in surgery by encouraging surgeons to build their research knowledge, understanding and practice.
In 2022, the Unit became a part of the Surgery and Perioperative Care Research Group at Hunter Medical Research Institute.
Our vision
Our vision is to enhance the health and wellbeing of patients and community in our District by:
- conducting health and medical research.
- translating the research evidence into high quality and effective health service delivery.
Our aims
Our aims are to:
- enhance the research capacity of surgeons and departments, specifically in clinical and laboratory research.
- support the research activities of medical officers and other professional groups, including nursing and allied health.
- include research practice in undergraduate and graduate surgical education and training across disciplines.
- develop and implement opportunities to improve research skills through professional development and education with partner organisations.
- promote PhD scholarships, fellowships, traineeships and research capability development opportunities.
- promote and support recruitment of PhD and research fellow candidates conducting relevant research in Hunter New England.
- build a supportive research environment in surgery, including professional groups.
How we can help
We can support research projects, which can include:
- protocol development
- research idea development and advice
- advice and assistance with research ethics and governance
- assistance with access to RedCap database for approved projects
- advice and assistance with preparing abstracts and manuscripts for presentations and publications.
Learn more about research ethics and governance in Hunter New England.
Email HNELHD-SurgeryResearch@health.nsw.gov.au for more information about our work.
Our team
Stephen Smith - Director
Conjoint Professor Stephen Smith is the Director of the HSCRU at John Hunter Hospital and Co-Director of the Surgical and Perioperative Care Research Program at Hunter Medical Research Institute.
Stephen is a colorectal surgeon and Director of Network Surgical Training in the Hunter New England Surgical Training Network.
Jon Gani - Research Mentor and Supervisor
Conjoint Professor Jon Gani recently retired from John Hunter Hospital as a Hepatobiliary and General Surgeon, and Medical Director of Surgical Services.
Jon remains an honorary medical officer in Hunter New England. He mentors and supervises junior researchers and surgical trainees.
Christine O'Neill - Research Mentor and Supervisor
Conjoint Associate Professor Christine O'Neill is a General Surgeon with specialisation in endocrine surgery.
She is the Head of Department for General Surgery at John Hunter Hospital and Co-deputy Director of the Surgical and Perioperative Care Research Program at Hunter Medical Research Institute.
Her research interests focus on quality-of-life outcomes in patients with thyroid cancer and disease.
Research coordinators
Our 4 research coordinators are registered nurses with extensive research experience in healthcare. They are:
- Rosemary Carroll
- Natalie Lott
- Sarah Dalton
- Michelle Chapman
Their research experience specialisations cover:
- critical care
- cardiovascular
- childhood cancer
- trauma and surgery
Their tertiary qualifications include:
- nursing
- clinical epidemiology
- clinical trials research
All team members are certified in Good Clinical Practice (GCP) for research (TransCelerate endorsed).
Our researchers
Our current and past Junior Clinical Research Fellows and Research Higher Degree students.
Current
Junior Clinical Research Fellows
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Research Higher Degree students
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Research Higher Degree graduates
- Dr Veral Vishnoi PhD 2023
- Dr Dilharen (Dhiva) Eliezer MPhil 2022
Past
Past Junior Clinical Research Fellows
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Affiliations
This list links to more information on surgical training and research.
- University of Newcastle
- University of New England
- General Surgeons Australia
- Hunter Medical Research Institute
- Royal Australasian College of Surgeons (RACS)
- RACS - The SET program
- Gastroenterological Society of Australia
- The Australasian Gastro-Intestinal Cancer Trials Group
- Colorectal Surgical Society of Australia and New Zealand
- Australia and New Zealand Hepatic, Pancreatic and Biliary Association
- Australian and New Zealand Gastric and Oesophageal Surgery Association
Our projects
The Unit and trainees manage projects in collaboration with the Hunter Medical Research Institute and the University of Newcastle.
The projects use several research designs and methodologies, including:
- basic science research
- surveys and questionnaires
- biobanking and biomarkers
- meta-analysis and systematic reviews
- investigator-initiated randomised trials
- co-operative study group randomised trials
- retrospective cohort, audit and chart review
- co-operative and sponsored trials, especially in cancer treatment.
- collaboration with clinical trial units in the Hunter New England Clinical Cancer Research Network.
Learn more about our current projects in this section. For more information, email HNELHD-SurgeryResearch@health.nsw.gov.au
Current projects
| Study name | Study design | Description |
|---|---|---|
| A Randomised Clinical Trial (RCT) to Assess the Use of Nasogastric Tubes (NGT) in Patients with Adhesive Small Bowel Obstruction for Prevention of Operative Intervention. | Investigator-initiated RCT | Nasogastric tubes (NGTs) have long been considered standard practice for the management of adhesional small bowel obstructions (ASBOs). However, in current literature, evidence to support the routine use of NGTs in ASBO is sparse. This RCT aims to compare outcomes associated with NGT or no NGT in patients presenting with ASBO. |
| Should Mixed Methods Study to analyse stakeholder feedback regarding accessibility, usability and content of a Prototype Decision Aid for patients with Low-Risk Thyroid Cancer | Mixed Methods | Low-risk thyroid cancer has historically been treated with surgical removal of the entire thyroid. Recent evidence has shown that active surveillance or lesser surgery with removal of half of the thyroid may be reasonable alternatives for many patients. The aim of this study is to use patient and clinician feedback to assess the acceptability of a prototype decision aid and guide further refinements. |
| Should Intermittent Pneumatic Compression Devices (ICPDs) be Standard Therapy for the Prevention of Venous Thrombosis for the Prevention of Venous Thrombo-embolic Events; A Randomised Clinical Trial in Patients Undergoing Surgery | Investigator-initiated RCT | Explores if the use of ICPDs offer any adjuvant benefit when the combination of graduation compression stockings (GCS) and chemical prophylaxis (LMWH) is used for venous thromboembolism prophylaxis in patients undergoing major surgery. |
| A Randomised Clinical Trial (RCT) to Assess the Effects of Enhanced Versus Standard Laparoscopic Cholecystectomy on Postoperative Spirometry | Investigator-initiated RCT | To assess if an enhanced suite of treatments can improve recovery after laparoscopic cholecystectomy, as assessed by spirometry and mobility. |
| Improving the sustainability of elective laparoscopic cholecystectomy | Cohort Study | To document the effectiveness of laparoscopic cholecystectomy using only essential equipment and avoiding opening and disposing of gear not actually used within both the public and private sectors locally. |
| John Hunter Hospital Cystectomy Registry and Assessment for Surgery | Observational study | This retrospective and prospective study aims to assess outcomes with pre-operative CPET (Cardiopulmonary Exercise Testing) assessment in radical cystectomy surgery for bladder cancer in the Australian context and clarify how practice and pre/peri-operative care may be optimised. |
| Patient Comprehension Study in Urology Patients | Investigator-initiated RCT | To assess and improve the knowledge and comprehension of surgical patients regarding their care in John Hunter Hospital's Urology department- including diagnosis, planned investigations, estimated discharge date and follow-up plan. |
| Use of MRI (Magnetic Resonance Imaging) in Patients with Bladder Lesions: A pilot study. | Pilot Study | This pilot study aims to evaluate the application of VI-RADS (Vesical Imaging-Reporting and Data System) in the staging of bladder lesions. |
| Purse string Ileostomy Closure with Negative Pressure Wound Therapy: A Prospective Cohort Study in Patients Undergoing Stoma Closure Compared to a Retrospective Cohort Study | Investigator-initiated prospective observational | To assess the time to healing of ileostomy purse string wounds when a negative pressure wound therapy is applied. Secondary outcomes include surgical complications, surgical site infection, and length of hospital stay and cost of wound care. |
| Braun Enteroenterostomy for Reconstruction after Pylorus-resecting Pancreaticoduodenectomy | Investigator-initiated RCT | A Braun Enteroenterostomy is an optional surgical technique which may reduce the risk of delayed gastric emptying (DGE) after such procedures. This study will examine whether the routine addition of this surgical technique will reduce rates of DGE after PD (Pancreaticoduodenectomy). |
| Masterplan | Co-operative Group RCT | A study testing the impact of adding high dose RT (radiotherapy) to standard chemotherapy for the treatment of pancreatic cancer. This study is being led by the Australasian Gastro-intestinal Trials Group and is coordinated by the NHMRC Clinical Trials Centre Sydney. JHH and Calvary Mater Newcastle are also involved. |
| Follow-up of Patients with Well-Differentiated Thyroid Cancer: A Survey of Clinician Preferences | Cross-sectional survey | Despite good survival rates, recurrence of thyroid cancer can occur many years and even decades after initial treatment. This has led to most thyroid cancer patients being followed up for many years (minimum of 5 years) and in some cases for life. |
| Evaluating Quality of Life Assessment Tools in Patients Undergoing Thyroid Surgery | Cross-sectional survey | Research into the quality of life of people undergoing thyroid surgery. This study is about better understanding patient’s experiences and the impact a diagnosis could have on daily life. |
| A Randomised, Blinded Clinical Trial (RCT) of Scalpel vs Electrocautery Skin Incisions in Participants undergoing Thyroid Surgery. | Investigator-initiated RCT | An RCT to compare cosmesis and wound healing |
| Mitochondrial Density and Function in Parathyroid Disease | Biomarker study | To describe the mitochondrial mass and activity found in parathyroid adenoma, hyperplasia and normal parathyroid tissue. |
| Closed vs Open Laparotomy for Severe Complicated intra-abdominal sepsis. COOL Study | International Cooperative Group RCT | A study comparing open (with negative pressure vacuum device) vs closed abdominal mortality. |
| Melatonin to improve sleep in patients undergoing major abdominal surgery | Investigator-initiated Phase III RCT | This project compares a sublingual dose of melatonin to placebo to investigate if it improves sleep whilst in hospital, based on a patient-reported outcome measure. |
| Quality of Life After Thyroid Disease | Cross-sectional survey | Assess the self-reported quality of life of thyroid cancer survivors compared to that of patients who have had thyroid surgery or radioiodine ablation for benign disease, and patients who have been investigated for a potential thyroid malignancy. |
| PIMCO Study | Investigator-initiated prospective observational | A comparison of perioperative inflammatory markers and their relationship to sepsis and surgical outcomes in colorectal cancer. |
| Microleaks | Investigator-initiated prospective observational | A study looking at identifying pathogens at the site of bowel anastomoses. |
| DOCTOR STUDY | Co-operative Group Phase II RCT | A trial of pre-operative cisplatin, 5 fluorouracil and docetaxel A ± (plus-minus symbol) radiotherapy based on poor early response to standard chemotherapy for resectable adenocarcinoma of the oesophagus and/or OG Junction. |
Closed to accrual
When a research study is "closed to accrual" it means that no additional subjects will be enrolled in the study.
| Study name | Study design | Description |
|---|---|---|
| PEGDP-01 | Investigator-initiated RCT/Co-operative group | A randomised controlled single blinded multicentre trial of polyethylene glycol sealant to the staple line vs staple line alone in distal pancreatectomy. |
| Bacillus Calmette-Guerin (BCG) + Mitomycin Trial | Co-operative Group RCT | Adding mitomycin to BCG as adjuvant intravesical therapy for high-risk, non–muscle-invasive bladder cancer: a randomised phase 3 trial. |
| LICPIC Study | Investigator-initiated Phase III RCT | Lignocaine in Laparoscopic Colorectal Surgery and effect on Natural Killer Cells. |
Closed
| Study name | Study design | Description |
|---|---|---|
| ERACS Study | Investigator-initiated RCT | RCT comparing post-operative pain and mobility in tack vs suture mesh fixation in laparoscopic ventral hernia repair. |
| CAPPS Study | Investigator-initiated Phase I study | A study to investigate the safety and tolerability of 2 medicinal cannabis agents in surgical patients. |
Completed and results published
| Study name | Study design | Description |
|---|---|---|
| Post-banding of Haemorrhoids Topical Analgesia | Investigator-initiated Phase III RCT | This project compares 3 topical ointments for post-procedure analgesia. |
| The Newcastle Skin Prep Study | Investigator-initiated Phase III RCT | This project is a large RCT comparing 3 standard skin disinfectants used for skin preparation in incisional surgery. Recruitment was completed late in 2018, and results are to be published shortly. |
| CRP Trajectory in Colorectal Resections | Investigator-initiated prospective observational | A multisite international study to validate the utility of CRP trajectory as a predictor of anastomotic leak in colorectal resections. |
| Wound Bacteriology | Investigator-initiated prospective observational | A study to identify and characterise pathogens in colorectal surgical incisions at time of operation. |
| A La CaRT | Co-operative Group Phase III RCT | Australian laparoscopic cancer of the rectum trial. A Phase 3 prospective Randomised Clinical Trial (RCT) comparing laparoscopic-assisted resection versus open resection for rectal cancer. |
| VIDIT Study | Investigator-initiated Phase III RCT | A double-blind, randomised, placebo-controlled trial to assess the efficacy of preoperative oral cholecalciferol versus placebo at preventing postoperative hypocalcaemia in patients undergoing total thyroidectomy. |
| LAPLAP Study | Investigator-initiated Phase III RCT | A double-blinded, randomized, placebo-controlled clinical trial assessing postoperative recovery using intraperitoneal local anaesthetic in laparoscopic colorectal surgery. |
| Procalcitonin Study | Investigator-initiated prospective observational | Procalcitonin as a Marker of Anastomotic Leak - An Observational Study. |
| CRP in Acute Appendicitis | Investigator-initiated prospective observational | A Prospective Observational Study of CRP Velocity in Suspected Acute Appendicitis. |
| Liver Biopsies | Investigator-initiated retro-prospective review | The futility of FNA (Fine-Needle Aspiration) and CNB (Core Needle Biopsy) in the management of patients with solid liver lesions. |
| Efficacy of Bolus Versus Infusion | Investigator-initiated Phase III RCT | Trial to assess the efficacy of Bolus Versus Infusion as a mode of delivery for local anaesthetic blocks following abdominal surgery. |
Publications
We have listed our published research here. For publications before 2022, please contact us.
2024
- The Microleaks study: 16S community profile and metagenomic shotgun sequencing signatures associated with anastomotic leak - Emily C. Hoedt, Georgia Carroll, Bree Stephensen et al. 07 March 2024, PREPRINT (Version 1) available at Research Square.
- Optimal antiseptic skin preparation agents for minimizing surgical site infection following surgery: cost and cost-effectiveness analysis - Simon Deeming, Xenia Dolja-Gore, Jon Gani, Rosemary Carroll, Natalie Lott, John Attia, Penny Reeves, Stephen R Smith; BJS Open, Volume 8, Issue 1, February 2024, zrad160.
- The Prognostic Utility of KRAS Mutations in Tissue and Circulating Tumour DNA in Colorectal Cancer Patients - Petit J, Carroll G, Zhao J, Pockney P, Scott RJ. Gastroenterology Insights. 2024; 15(1):107-121.
- Influence of the bile acid/microbiota axis in ileal surgery: a systematic review - Senanayake T, Makanyengo S, Hoedt EC, Goggins B, Smith SR, Keely S. Colorectal Dis. 2024; 00: 1–15.
2023
- Evaluation of a Multi-Gene Methylation Blood-Test for the Detection of Colorectal Cancer - Petit J, Carroll G, Williams H, Pockney P, Scott RJ. Medical Sciences. 2023; 11(3):60.
- The Importance of Evaluating the Lateral Neck in Patients with Papillary Thyroid Microcarcinomas - Christopher W. Rowe and Christine J. O'Neill. Clinical Thyroidology®.Oct 2023.429-431.
- A pilot study: intraoperative 16S rRNA sequencing versus culture in predicting colorectal incisional surgical site infection - Vishnoi V, Hoedt EC, Gould T, Carroll G, Carroll R, Lott N, Pockney P, Smith SR, Keely S. ANZ J Surg. 2023 Oct;93(10):2464-2472. Epub 2023 Apr 6. PMID: 37025037.
- Venous thromboembolic prophylaxis: current practice of surgeons in Australia and New Zealand for major abdominal surgery - Lott, N., Senanayake, T., Carroll, R. et al. BMC Surg 23, 265 (2023).
- Protocol paper for SMART OPS: Shared Decision-making Multidisciplinary Approach – A Randomised Controlled Trial in the Older Adult Population considering Surgery - Ajitsaria P, Lott N, Baker A, et al. BMJ Open 2023;13:e070159.
- Use of caller ID and text messaging from cell phones to increase response rates in patient surveys - Peters LE, Zhao J, Gelzinnis S, Smith SR, Martin J, Pockney P. Research Methods in Medicine & Health Sciences. 2023;0(0).
- Thyroid cancer patient reported outcome measures in clinical practice: analysing acceptability and optimizing recruitment - O'Neill, C.J., Morris-Baguley, H., Alam, A.S., Carlson, M.A., Blefari, N., Rowe, C.W., Fradgley, E.A. and Paul, C. ANZ Journal of Surgery (2023).
- Hearing the Voices of Australian Thyroid Cancer Survivors: Qualitative Thematic Analysis of Semi-structured Interviews Identifies Unmet Support Needs - Christine J. O'Neill, Melissa A. Carlson, Christopher W. Rowe, Elizabeth A. Fradgley, and Christine Paul. Thyroid® (ahead of print).
- Sigmoid volvulus in a 14-year-old male mimicking acute gastroenteritis - Tharindu Senanayake, Ellie C McEwen, Taryn Naidoo, Senan Al-Mahaidi, Saad Al-Mahaidi. Journal of Surgical Case Reports, Volume 2023, Issue 3, March 2023, rjad166.
- A Systematic Review and Meta-Analysis of Intra-Operative Surgical Site Sampling: Culture versus Culture-Independent Techniques in Predicting Downstream Surgical Site Infection - Veral Vishnoi, Tristan Morey, Emily C. Hoedt, Simon Keely, Peter Pockney, and Stephen R Smith. Surgical Infections (ahead of print).
- Vascular Invasion in Follicular Thyroid Cancer: How Much is Too Much? - Christopher W. Rowe, Shaun McGrath, and Christine J O'Neill. Clinical Thyroidology. Mar 2023.120-122.
- Topical Lidocaine or Lidocaine/Diltiazem Ointment Following Rubber Band Ligation of Haemorrhoids: A Prospective Three-Armed Randomized Controlled Trial - Kwok AMF, Smith SR, Zhao J, Carroll R, Leigh L, Draganic B. Dis Colon Rectum. 2023 Mar 17. Epub (ahead of print). PMID: 36940309.
- Effectiveness and cost-effectiveness of a digital health intervention to support patients with colorectal cancer to prepare for and recover from surgery: study protocol of the RecoverEsupport randomised controlled trial - Wyse R, Smith S, Zucca A, et al. BMJ Open 2023;13:e067150.
- Intermittent pneumatic compression devices: time to reassess the evidence - Lott, N., Smith, S., Gani, J. and Reeves, P. (2023). ANZ Journal of Surgery.
- Current patterns of care in low-risk thyroid cancer-A national cross-sectional survey of Australian thyroid clinicians - Widjaja W, Rowe CW, Oldmeadow C, Cope D, Fradgley EA, Paul C, O'Neill CJ. Endocrinol Diabetes Metab, e398 (2023) [C1].
- A systematic review of the colorectal microbiome in adult cystic fibrosis patients - Gilbert, B, Kaiko, G, Smith, S, Wark. Colorectal Dis. 2023; 00: 1– 10.
- The unrestricted global effort to complete the COOL trial - Kirkpatrick, A.W., Coccolini, F., Tolonen, M. et al. World J Emerg Surg 18, 33 (2023).
- Renal transplant anastomotic time–Every minute counts! - Nikhil Mahajan, Munish K. Heer and Paul R. Trevillian. Front. Med., 18 January 2023 Sec. Nephrology Volume 9 2022.
2022
- Parental decision regret among Australian parents after consenting to or refusing hypospadias repair for their son: Results of a survey with controls - Vavilov S, Roberts E, Smith GHH, Starkey M, Pockney P, Deshpande AV. J Pediatr Urol. 2022;18(4):482-8.
- Prospective multicentre randomised controlled trial of the effect of Braun Enteroenterostomy in the Reconstruction after Pancreaticoduodenectomy on delayed gastric emptying (DGE): protocol for the BERP study - Gupta S, Brown K, Lott N, et al. BMJ Open 2022;12:e068452.
- Evaluation of epigenetic methylation biomarkers for the detection of colorectal cancer using droplet digital PCR - Joel Petit, Georgia Carroll, Jie Zhao et al. 01 November 2022, PREPRINT (Version 1) available at Research Square.
- Efficacy of intermittent compression devices for thromboembolic prophylaxis in major abdominal surgery: a systematic review and meta-analysis - Lott N, Robb F, Nolan E, Attia J, Reeves P, Gani J, Smith S. ANZ J Surg. 2022 Oct 19. Epub (ahead of print). PMID: 36259216.
- Perceived Provision of Perioperative Information and Care by Patients Who Have Undergone Surgery for Colorectal Cancer: A Cross-Sectional Study - Zucca A, Mansfield E, Sanson-Fisher R, Wyse R, Johnston S-A, Fakes K, et al. Int J Environ Res Public Health, 19; 2022.
- Attitudes towards Enhanced Recovery after Surgery (ERAS) interventions in colorectal surgery: nationwide survey of Australia and New Zealand colorectal surgeons - Toh JWT, Collins GP, Pathma-Nathan N, El-Khoury T, Engel A, Smith S, et al. Langenbeck's Archives of Surgery, 407 1637-1646; 2022.
- Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study - Knight SR, Shaw CA, Pius R, Drake TM, Norman L, Ademuyiwa AO, et al. The Lancet Global Health, 10 e1003-e1011; 2022.
- Using the Patient Health Questionnaire to estimate prevalence and gender differences of somatic symptoms and psychological co-morbidity in a secondary inpatient population with abdominal pain - Stieler M, Pockney P, Campbell C, et al. Australian & New Zealand Journal of Psychiatry. 2022;56(8):994-1005.
- Somatic symptom severity association with healthcare utilization and costs in surgical inpatients with an episode of abdominal pain - Melissa Stieler, Peter Pockney, Cassidy Campbell, Vaisnavi Thirugnanasundralingam, Lachlan Gan, Matthew J Spittal, Gregory Carter. BJS Open, Volume 6, Issue 4, August 2022, zrac046.
- Long-Term Health-Related Quality of Life Outcomes Following Thyroid Surgery for Malignant or Benign Disease: Deficits Persist in Cancer Survivors Beyond Five Years - Blefari, Nicholas D. A. Rowe, Christopher W. Wiadji, Elvina Lambkin, David Carroll, Rosemary Fradgley, Elizabeth A. O’Neill, Christine J. World J Surg (2022).
- Sarcopenia 'made simple' and outcomes from emergency laparotomy - Ming YJ, Howley P, Holmes M, Gani J, Pockney P. ANZ J Surg. 2022 May 16. Epub (ahead of print) PMID: 35578776.
- The effect of preoperative skin preparation on clinical outcomes with incisional surgery: a network meta-analysis - Hampton J, Park SSW, Palazzi K, Oldmeadow C, Carroll R, Attia J, Smith SR. ANZ J Surg. 2022 Jun 14. Epub (ahead of print) PMID: 35698832.
- Sigmoid mesenteric cyst of urogenital origin: A rare cause of bilateral hydroureter - Kwok, A.M.F., Thomas, N.A. and Smith, S.R. (2022). ANZ Journal of Surgery, 92: 884-886.
- C1q and mobility score in predicting sarcopenia in an Australian cohort of cancer surgery patients - Senanayake, T., Loh, E.J., Carroll, R., Chan, V. and Smith, S.R. (2022). ANZ Journal of Surgery.
Upcoming conferences and meetings
Find out about upcoming medical conferences relevant to your interests.
Note: The link does not provide a complete list. Visit other organisations' websites listed in the affiliations section for more event and conference information.
Contact us
For assistance or more information call (02) 4923 6397 or email HNELHD-SurgeryResearch@health.nsw.gov.au