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