Education and Training Webinar: EAGLE safe-anastomosis study

New webinar will look at the results from the recently completed EAGLE study

When is it?: Monday the 5th of June 2023 – 11:00 & 18:00 (GMT) – A 1hr webinar repeated twice during the day.

Who should attend?: Surgeons, surgical researchers, surgical nurses, scrub techs, ODPs and allied healthcare professionals

Hosted by: NIHR Global Health Research Unit        Hashtag:  #eagle2023

Anastomotic leak is a severe, potentially life-threatening complication following right colectomy. Internationally, anastomotic leak occurs after 8% of right colectomies. Prospective cohort data demonstrate that patient selection, intraoperative factors, and technical variation are risk factors for anastomotic leak. EAGLE was an international quality improvement programme to share best practice and harmonise procedures for surgeons and the theatre teams so that they might perform the best possible anastomosis for each particular patient. The study was carried out by 350+ hospitals across more than 60 countries.

This online webinar chaired by Prof. Dion Morton will provide all those working in surgical practice and research with an overview of the ground breaking global study EAGLE which is due to be published soon.

The main session will include three key presentations on (1) background and impact of anastomotic leak, (2) the design of the EAGLE study and (3) the headline results of the EAGLE study.

The format of the event includes a panel presentation of global experts discussing how the research was conducted, what the results showed, and the potential impact on surgical practice. There will be breakout sessions looking specifically at 2 key perspectives on the research (1) research methodology and results and (2) process evaluation. The webinar will conclude with a round table discussion of global experts discussing how these results can be implemented across the globe.

Register now to attend this ground breaking event

Register for the 11:00AM (UK BST) session using this form.

Or the 6:00PM (UK BST) session using this form.

You can also view Professor Dion Morton deliver a short promotional overview of the upcoming webinar by clicking here.

For instructions on how to use the Zoom meeting portal, desktop/ PC users click here for more information and iPhone/ Android users click here for further info.

NIHR Global Health Research Unit on Global Surgery (GSU) Attends 76th World Health Assembly in Geneva

Attendance at The Global Surgery Foundation (GSF) event enabled the GSU to identify pathways for Unit research to impact on global health policy

The event that took place in Geneva, Switzerland on the 23rd May was attended by GSU colleagues from the University of Birmingham who were able to join peers within the arena of surgical care at the GSF side event. The side event at the GSF 76th World Health Assembly looked at 'Strengthening Health Systems through upscaling Surgical Care' with participation from a multitude of countries including Croatia, Ecuador, Japan, Malaysia, Sierra Leone and Sweden.

The event provided colleagues from the GSU the opportunity to gain valuable insight into the current landscape of implementing surgical care systems on a global scale whilst also enabling the team to discuss pathways for the Unit to have completed research impact on international healthcare policy. The event hosted by The GSF, along with several co-sponsoring member states, also looked at the role of sustainable financing which is currently seen as a key topic within the delivery of surgical care, particularly in low- and middle-income countries.

You can find out more on how the NIHR GSU is improving global surgical outcomes through collaborative research by clicking here.

Paper Highlights Link between Investing in Safe Surgery and Reduced Burden on Healthcare Infrastructure in LMICs

A paper from the KIWI study demonstrates how investing in health technologies may help reduce the costs associated with Surgical Site Infections (SSIs) for both the patient and low-resource health systems

The Key resource use In Wound Infection (KIWI) study was carried out to estimate the cost burden associated with SSI. The specific objectives of KIWI were to:

  1. Measure the additional within-hospital resource use for patients with SSI compared to patients without SSI
  2. Identify and measure the resource use for patients who have SSI detected after hospital discharge
  3. Explore the relative cost burden for patients with contaminated-dirty operations compared to patients with clean-contaminated surgeries
  4. Explore the healthcare needs and resource use of patients with an unresolved SSI at 30 days and beyond

A total of 335 patients were included in the global study with data collected on postoperative resource use and costs from consecutive patients undergoing abdominal surgery with an incision >5cm (including caesarean section) that were recruited to the FALCON trial between April and October 2020. A mix of both prospective and retrospective data was used which recorded SSI occurrence in 7% of clean-contaminated cases and 27% of contaminated-dirty cases.

Using data from inpatients in India, Mexico, Ghana and Nigeria, researchers were able to conclude that SSI was associated with an increase in postoperative healthcare costs by 75.3% (€412) after clean-contaminated surgery and 66.6% (€331) after contaminated-dirty surgery. The overall mean additional post-operative costs with SSI were higher in clean-contaminated cases compared with contaminated-dirty cases. This led researchers to conclude that investment in health technologies to reduce SSI may mitigate the financial burden to patients and low-resource health systems.

The findings have been published in Journal of Hospital Infection which you can access by clicking here.

You can read the full UoB press release by clicking here.

You can also access additional information on the projects involved by clicking here for KIWI and here for FALCON.

Benin Hub Data Provides Valuable Evidence for Detection of Surgical Site Infections

TALON data enables student from the Faculty of Health Sciences of Cotonou to establish link between detection in Surgical Site Infections (SSIs) and telephone calls made to patients

The link was made in the student's doctoral thesis that looked at the diagnosis of infections of the operating site in abdominal surgery in 3 hospital centres in Benin. Thesis results showed that out of 103 patients surveyed from the 3 hospital sites, just under 8% had an SSI diagnosis made via telephone consultation. This compared to just under 9% receiving a diagnosis from a face-to-face examination.

This is the first time in which the Benin Hub have provided data to enable a student from a partner organisation to conduct their research. The team are hoping that they'll be able to assist more students with data generated through GSU based work and also stated how this relationship demonstrates the impact the hub is having on local healthcare and research based infrastructure.

You can view more on the Benin Hub team by clicking here.

You can also find out more on the TALON Study by clicking here.


GECKO International Study Formally Launches

Global Evaluation of Cholecystectomy (GECKO) will look to define the global variation in compliance to pre-, intra-, and post-operative audit standards

Cholecystectomy is amongst the most common surgical operations performed worldwide yet there is still insufficient evidence around the variations of safe provision of laparoscopic surgery for gallbladder disease internationally, including low- and middle-income countries.

In addition to the primary aim of the study, GECKO will also look at the following:

  1. To determine the quality of safe provision of cholecystectomy, including the rates of: (i)
    achieving a critical view of safety; (ii) intraoperative imaging use (e.g., cholangiogram); and (iii) initiating of different bailout procedures (e.g., subtotal cholecystectomy) when safe
    cholecystectomy is compromised.
  2. To assess adverse events following cholecystectomy (e.g., bile duct injury) and their
  3. To analyse rates and outcomes of unsuspected gallbladder cancer.
  4. To evaluate the global variation in the availability of cholecystectomy services and training
    amongst included hospitals.
  5. To assess sustainable practices in laparoscopic cholecystectomy globally.

The study will span over 8 separate 2 week data collection periods starting 31st July, ending on the 19th November 2023.

You can view the study summary video by clicking here.

You can also view further information on the study by clicking here.


Project of the Month Overview: HIPPO Study

Our new monthly 'project of the month' supplement looks at the recently launched HIPPO study

The HIPPO study is the short name for Hernias, Pathway and Planetary Outcomes for Inguinal Hernia Surgery. This is a global, prospective cohort study that includes all consecutive patients undergoing an inguinal hernia repair. Any hospital from any country was eligible to take part.

This study has three main aims:

  • To evaluate the waiting times to inguinal hernia repair.
  • To characterise technique, training, and operating surgeon variation.
  • To explore the uptake of environment sustainable practices in operating theatres.

The study started on 30th January we are reaching the last period of data collection, which starts on 24th April and will end in 21st May 2023.

Until now we count with more 6,500 patients, from 350 centres from 65 countries, making this the largest cohort study with inguinal hernia patients.

One of the key aims of the study will be the dissemination of relevant information to policy makers and governments on a global scale as well as inform future research.

You can view the HIPPO page for more information by clicking here.

Next European Society of Coloproctology Global Webinar this Monday 24th April

The next ESCP webinar will look at fecal incontinence on a global scale

Fecal Incontinence (FI) is a prevalent and debilitating condition that affects millions of people worldwide. Despite the significant impact of FI, its management has been challenging, and there is a lack of standardized guidelines and protocols for its diagnosis and treatment. This is particularly true for low- and mid- income countries, where FI is often underdiagnosed and undertreated due to limited resources and access to care.

Key highlights from the webinar:

· Leading researchers and speakers on FI

· Updated Consensus guidelines on management of FI

· Current evidence and future directions

· Opportunity for worldwide collaboration

Where: Online event with registration currently open

When: Monday 24th April @ 11AM UK BST/ 12PM CET/ 6PM Beijing & Hong Kong

You can find out more and register for the event by clicking here.

Professors Dion Morton and Dhruva Ghosh attend launch of FOxTROT 2 trial in India

New international trial to run across GSU India network

During his recent visit to India, NIHR Global Health Research Unit on Global Surgery Co-Director Professor Dion Morton was able to Join India Lead, Professor Dhruva Ghosh at G B Pant Hospital in Delhi for the launch of the FOxTROT 2 international trial.

FOxTROT 2 will be conducted across 12 hospitals in India that include sites within the NIHR Global Health Research Unit on Global Surgery network. The trial will look into the use of a short course of pre-operative chemotherapy for patients due to undergo surgery for colon cancer, with the aim being to significantly decrease the likelihood of the cancer returning.

Whilst in India, Professor Morton was able to meet with the Indian Health Ministry regarding a new healthcare partnership that will look to deliver improved healthcare for children across the Punjab region with congenital defects.

You can read more on FOxTROT 2 by reading the official University of Birmingham press release here.

You can also see Professor Morton speak during his time in India in a short video on our Twitter channel.




GSU Study on Impact of Malnutrition on Early Outcomes of Surgery Discussed in Podcast

Professor Pamela Jeyaraj and Mr Stephen Knight discussed recent study on Lancet Global Health podcast, hosted by Nina Putnis

During the recent on-line webisode both Stephen and Pamela were able to talk about the link between malnutrition and outcomes after surgery for bowel cancer, involving over 5700 patients from 381 hospitals across 75 countries.

During the programme both Pamela and Stephen were able to explain how the study will help surgical care professionals determine what treatments and interventions could be provided for patients undergoing surgery for cancer in LMICs.

You can access the webinar, published on the 17th February here.

You can view the recently published article in The Lancet Global Health here.



CHEETAH Trial Discussed During OrthoEvidence Podcast

The latest discussion on CHEETAH comes from India Hub Lead - Dhruva Ghosh during recent podcast on OrthoEvidence

Professor Dhruva Ghosh spoke with Editor-in-Chief of OrthoEvidence, Mo Bhandari in relation to the recently completed CHEETAH trial that recruited over 13000 patients from 81 hospitals, across 7 countries.

During the discussion, Professor Dhruva Ghosh discussed the rationale behind the international trial including why the NIHR Global Health Research Unit on Global Surgery decided on utilising a cluster-randomised trial format for the trial design. During the on-line discussion, Professor Ghosh was also able to discuss the implication of the ground-breaking trial results and how they will translate affect surgical policy on a global scale, particularly in LMICs.

The podcast can be accessed via the OrthoEvidence wesbite.

You can also find out further information on the CHEETAH trial by clicking here.