challenges and opportunities in surgery research 9 february 2012 professor jane blazeby
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Challenges and Opportunities in Surgery Research
9 February 2012
Professor Jane Blazeby
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A good surgeon needs,
“The eye of an eagle, heart of a lion and hand of a lady”
15th Century English Proverb
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Spend of the MRC/NIHR on non-surgical & surgical research in 2008/9
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A paucity of surgical RCTs
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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
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BAND
BYpass
BAND
BYpass
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Difficult to select outcomes
• Technical outcomes
• Measuring ‘recovery’
• Complications poorly defined
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Operator expertise & culture
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Research infrastructure, CTUs & Hubs
ConDuCT
Edinburgh
Midlands
Cambridge
London
Oxford
All-Ireland
Northwest
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The lady you saw in clinic Monday wants to be randomized! !
It’s the way I talk to them young Jedi.
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Trainee-led Surgical Research Collaboratives
- Lessons learnt from the ROSSINI trial
• Mr Thomas Pinkney
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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
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Other research collaboratives• London – LSRG
• South West – SPARCS
• Mersey – MERGS
• Yorkshire
• Kent/Maidstone
• Trent
• Cardiothoracic collaborative
• Yorkshire orthopaedic group
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Opportunities
• Feasibility work/studies (RfPB, HTA)
• Program research, RCTs (NIHR & HTA)
• Clinical academic pathways, NIHR PhDs.
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Where there’s a will there’s a way
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Thank you
9 February 2012