Challenges and Opportunities in Surgery Research

9 February 2012

Professor Jane Blazeby

A good surgeon needs,

“The eye of an eagle, heart of a lion and hand of a lady”

15th Century English Proverb

Spend of the MRC/NIHR on non-surgical & surgical research in 2008/9

A paucity of surgical RCTs

Gastric Bypass

Gastric Band

Sleeve

Other

US Bariatric centres of excellent 2008/9

De Maria E. www.surgicalreview.org

Operations for morbid obesity

UK National Bariatric surgery registry

NBSR www.dendrite.org

BAND

BYpass

BAND

BYpass

Difficult to select outcomes

• Technical outcomes

• Measuring ‘recovery’

• Complications poorly defined

Operator expertise & culture

MRC Framework

Research infrastructure, CTUs & Hubs

ConDuCT

Edinburgh

Midlands

Cambridge

London

Oxford

All-Ireland

Northwest

The lady you saw in clinic Monday wants to be randomized! !

It’s the way I talk to them young Jedi.

Trainee-led Surgical Research Collaboratives

- Lessons learnt from the ROSSINI trial

• Mr Thomas Pinkney

ROSSINI Reduction Of Surgical Site Infection

using a Novel InterventionA randomised controlled trial of a wound-edge protection device to reduce surgical site infection

Inclusion: All patients undergoing laparotomyExclusion: Laparoscopic-assisted surgery

Blinded wound reviews Pre-discharge (5-7 days) & at 30-33 days

Funded by NIHR Research for Patient Benefit programme

Other research collaboratives• London – LSRG

• South West – SPARCS

• Mersey – MERGS

• Yorkshire

• Kent/Maidstone

• Trent

• Cardiothoracic collaborative

• Yorkshire orthopaedic group

Opportunities

• Feasibility work/studies (RfPB, HTA)

• Program research, RCTs (NIHR & HTA)

• Clinical academic pathways, NIHR PhDs.

Where there’s a will there’s a way

Thank you

9 February 2012