Department of Colorectal Surgery, Park Road, Auckland, New Zealand

Auckland City Hospital (ACH) is a tertiary referral teaching hospital in central Auckland. It is situated close to the Auckland City CBD, and is immediately across the road from the University of Auckland School of Medicine. Five of the seven Colorectal Consultants are CSSANZ members, and supervise one fellow (either ANZTBCRS or International), a SET trainee and a junior surgical trainee, 3 nurse specialists, and 2 Interns. The Fellow participates in general surgical on call (1 in 6) and also receives colorectal acutes daily. The position is fully funded from the hospital. Strengths of ACH are an emphasis on minimally invasive techniques, including taTME, TAMIS, and advanced laparoscopy; multidisciplinary meetings in cancer, IBD, and Pelvic floor; surgical nutrition and intestinal failure with resulting experience in enterocutaneous fistulas and short gut; pelvic floor clinics; peritoneal malignancy and involvement with the NZ Familial GI Cancer Service. The unit has a strong research emphasis.

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members):

Operative exposure per year:

Diagnostic exposure:

Research:

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

Department of Colorectal Surgery, Christchurch, South Island, New Zealand

Christchurch Hospital provides services to over 90,000 inpatients each year. Approximately 80% of these patients are admitted acutely. A further 30,000 people are day patients.

Christchurch Hospital operates 980 beds. There are over 400,000 outpatient attendances at the hospital, excluding those for radiology and laboratory services. In addition, Christchurch Hospital has the busiest Emergency Department in Australasia treating more than 120,000 patients a year.

Many of the doctors and specialists working in the hospital are involved in leading international research. Often, they are engaged in joint projects with medical research scientists at the Christchurch School of Medicine, part of the University of Otago. The School is integrated into the hospital campus. Christchurch Hospital is the major tertiary teaching hospital in the Te Waipounamu/South Island where medical students and junior doctors receive clinical training, and it is one of the four main teaching hospitals in New Zealand.

There are 10 colorectal surgeons within the department, two of whom job share clinical duties to equate to 9 full-time colorectal surgeons. All bar two of these surgeons are involved in the acute general surgery roster.

Each surgeon has minimum 1 all day operating list each fortnight and 1 acute on call each fortnight which alternates as SMO1 (0800-0800 and running primary acute theatre) and SMO 2 (0800-1700 on call and running second acute theatre). Most surgeons have an additional 1-2 elective operating lists over a 4-week period. There are two dedicated exenteration lists that take place on a Friday twice a month where plastics/orthopaedics/urology etc are available to assist as required.

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members):

GENERAL SURGERY CLINICAL DIRECTOR: Mr Richard Tapper
ANZTBCRS Program director: Dr Rebecca Shine 
ANZTBCRS Research supervisor: Prof Tim Eglinton 

Unit Surgeons: 

Operative exposure per year:

Diagnostic exposure:

Research:

The unit has a broad clinical and translational research base with multiple local, national and international collaborations. Presently there are greater than 50 active projects, a sample of which are provided below:

Colorectal Cancer

• Biomarkers for response to neoadjuvant therapy for rectal cancer
• Influence of the microbiome in CRC
• Early onset colorectal cancer
• Neoplastic CR polyp prevalence and distribution
• Quality of Life in CRC
• Nutrition in CRC
• Canine CRC diagnosis
• RACER study: Recurrence After Conventional Excision of the Right colon
• Organ preservation in rectal cancer
• TaTME clincal and functional outcomes
• PELVEX studies

Inflammatory Bowel Disease

• Preoperative EEN in Crohn’s disease
• Molecular markers of dysplasia and IBD related CRC
• Outcomes of colectomy for IBD

Artificial Intelligence and Surgical Data Science

• SynOPsys CRC: synoptic operation note development
• Computer Vision Supported Automated Recognition and Reporting of Operative Events in     Laparoscopic Surgery
• AI enhanced digital pathology interpretation

Method of funding:

Expected "on call" roster commitments:

The Fellows cover the registrar position 1:4 Saturdays and they provide cover for vacancies during the week to assist with leave for SMO call as an SMO. They should not be on call more than once a week covering SMO call and they do not cover weekend vacancies. We try to minimize the impact to elective commitments when they are covering call. There is no specific call back rate but after hours work for the fellows is kept to a minimum.

Other strengths of unit:

Auckland, New Zealand

North Shore Hospital is a metropolitan Auckland hospital providing tertiary colorectal services for a population of over 570,000 people. In addition we provide a pelvic exenteration service for much of the North Island of New Zealand. One of our surgeons has an interest in reconstruction of the perineum after exenteration and APR with extensive experience in VRAM and IGAM flap construction. We currently have five fulltime colorectal surgeons, one part-time colorectal surgeons one fellow, three advanced trainees, three basic trainees and six interns. The Fellow works at a junior consultant level with all of the other consultants and has admitting rights. Fellows cover general acute call at consultant level with senior consultant backup. Funding is via a grant and public funding. We promote laparoscopic surgery and have regular cancer and IBD multidisciplinary meetings. There is a dedicated TPN team, access to pelvic floor manometry (off site) and endoanal uss list run by the fellow. Endoscopic training is excellent, with acute colonic stenting and advanced polypectomy provided by the surgeons. We are the site for the NZ colorectal cancer screening pilot. We have a strong background in colorectal research and have participated in ALCAZ and ALaCaRT and a currently initiating ADIPOSE.

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members):

Operative exposure per year:

Diagnostic exposure:

Research:

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

Waikato Hospital, Hamilton, NZ

Waikato Hospital is a tertiary referral centre located in central Hamilton, New Zealand (1.5 hours south of Auckland). Although Hamilton is a relatively small city (population 165,400), the 759 bed hospital serves a large geographical area and provides specialised and emergency healthcare for the Te Manawa Taki/ Midlands and Waikato region.  

Waikato Hospital is an accredited level 1 trauma centre. It is one of the busiest trauma centres in New Zealand, with a dedicated trauma team to manage complex patients with multi-system injuries. There is a large general surgical department comprised of 18 consultant surgeons and multiple sub-specialty teams including oesophago-gastric/bariatric, hepatopancreatobiliary, oncoplastic breast, endocrine and colorectal/peritoneal malignancy.

There are two colorectal teams (each with 3 consultants, 1 general surgical trainee and 1 junior registrar). The colorectal fellow works with the all the consultants and provides support to both colorectal teams but is not responsible for running the wards. This allows them to focus on elective commitments during working hours. The fellow acts as a direct line of contact for IBD referrals.

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members):

Operative exposure per year:

Diagnostic exposure:

Research:

Method of funding:

Expected "on call" roster commitments:

The colorectal fellow participates in the senior registrar call roster:

• Longday weekdays (onsite) 7.30am until 10.30pm (approx 1 in 8)
• Weekends on call (onsite) 8am-10.30pm (approx 1 in 8)

These after-hours shifts are supported by 2x junior registrars and interns. 

No overnight on call.

Other strengths of unit:

Sydney, New South Wales

Bankstown-Lidcombe hospital is a Tertiary teaching hospital in South West Sydney. It services a primary referral population of approximately 200,000 (the Sydney West Area Health Service serves a population of approximately 900,000). The area is one of the most culturally diverse in Australia. The colorectal unit is comprised of 5 surgeons, an ANZTBCRS accredited fellow, an accredited registrar and a JMO. The unit provides a high number of colorectal cancer and benign cases with a special interest in minimally invasive surgery, pelvic floor disorders, IBD and fistula surgery. The Colorectal unit treats the highest number of colon and rectal cancer patients in the Southwest Area Health Service and is one of the busiest cancer public hospitals in the state. The year includes excellent exposure to laparoscopic surgery, with TEMS /TAMIS and robotic surgery (in the private). There is also a weekly MDT and a monthly IBD MDT. There is an on-site anorectal physiology lab including 3D-ultrasound, with significant exposure for training. Extra clinics can be run by fellows once they are trained. Outpatient clinics are run on a fortnightly basis to allow follow up of patients who have been operated on by the fellow. The unit is also interested in colorectal endometriosis. There is opportunity to be involved in complex cases in both public and private.

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members):

Operative exposure per year:

Diagnostic exposure:

Research:

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

Sydney, New South Wales

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members):

Operative exposure per year:

Diagnostic exposure:

Research:

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

Newcastle, New South Wales

The John Hunter Hospital is a tertiary referral university hospital, located centrally in Newcastle, with one private hospital co-located on campus (Newcastle Private), and two affiliated public hospitals located within the area (Belmont and the Calvary Mater). There are six colorectal surgeons supervising an ANZTBCRS fellow, one SET registrar, one unaccredited registrar/SRMO, and one intern. The fellow takes in-hours colorectal referrals and participates in alternate (1 in 2) weekend on-call/ward round. The fellowship’s strengths include a full range of elective and emergency colorectal work, available and approachable consultant level supervision, and high operative numbers, with ad hoc access to the Da Vinci Xi at Newcastle Private as an assistant. There is a fortnightly cancer MDT and monthly IBD MDT, as well as general surgery and colorectal journal club, and supervised outpatient clinics. There is a strong culture of clinical research. There is a monthly endoscopy list (or more if required) as well as colonic stenting, TEMS/TAMIS, and anorectal US available. Living in Newcastle offers a family-friendly and affordable lifestyle, adjacent to pristine coastline, national parks and the Hunter Valley region.

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members):

Operative exposure per year:

Diagnostic exposure:

Research:

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

Sydney, New South Wales

The Liverpool Hospital is the principal Tertiary / Quaternary Hospital of the South Western Sydney Local Health District (SWSLHD) which serves a population of just over one million. Liverpool is now one of the two largest hospitals in NSW with a capacity of 877 beds, 23 operating theatres and 3 endoscopy rooms; further hospital expansion is ongoing. The Department of Colon and Rectal Surgery  is become a leading surgical player; two consultants have been the Head of Department of General Surgery within the hospital and the Gastrointestinal Stream Director for the Local Health District. The Liverpool Department of Colon and Rectal Surgery provides excellent educative exposure for its trainees via three regular MDTs (Colorectal Cancer, Inflammatory Bowel Disease and Complex Pelvic Surgery). There is extensive exposure to complex pelvic surgery (benign and malignant) via collaboration with urology and gynaecology (oncology and endometriosis) along with advanced open and laparoscopic colorectal surgery. In addition, there is a very significant proportion of emergency and semi urgent acute surgery so training in emergency colorectal surgery. Exposure to operative management of advanced pathology is excellent. The hospital has a DaVinci robot and the Colorectal unit has been given permission to start cases in 2025.The unit actively participates in medical student teaching and is closely affiliated to the program of Western Sydney University and the University of New South Wales.

Hospitals involved in programme:

(there may be opportunity to assist at South West Sydney Private Hospital, Strathfield Private Hospital and Macquarie University Hospital)

University affiliation:

Colorectal surgeons (*CSSANZ Members):

Operative exposure per year:

Diagnostic exposure:

Research:

The Innovation, Surgical Teaching and Research (iSTAR) unit leads Surgical research at Liverpool Hospital

• Circulating Tumour Cells in Cancer Management
• Natural Orifice Specimen Extraction Database
• Intra-corporeal Intestinal Anastomosis Database
• Complex Pelvic Surgery Database
• Laparoscopic reversal Hartmann Database

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

Sydney, New South Wales

Nepean Hospital is the tertiary referral centre in Western Sydney (Nepean Blue Mountains Area Health Service). The unit comprises of 5 colorectal surgeons, an ANZTBCRS accredited fellow, a SET trainee and a JMO. This has been a well-established unit for over 20 years. The unit provides a variety of colorectal experience including a high number of cancer and benign cases, including IBD work, endometriosis surgery, pelvic floor disorders including incontinence work with SNS, TEMS, TAMIS and Robotic surgery. It does provide a high level of minimally invasive surgery. The unit has an anophysiology unit on site which the fellow attends. The fellow has the opportunity to run their own endoscopy list once a week, as well as the ability to attend endoscopy lists with consultants. Outpatients clinic is also on site for postoperative patients. There are fortnightly multidisciplinary meetings for colorectal cancer and monthly for endometriosis surgery, and weekly general surgical meetings which cover morbidity and mortality, research meetings and protocol meetings. There are also fortnightly unit meetings for either teaching or unit rounds.

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members):

Operative exposure per year:

Diagnostic exposure:

Research:

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

Sydney, New South Wales

Prince of Wales Hospital is a tertiary referral teaching hospital in the beachside Eastern Suburbs of Sydney. It is affiliated with the University of NSW which is located in close proximity. There are three Colorectal surgeons supervising one JMO and one SET surgical trainee. The Fellow provides 2nd on call cover about every 3rd weekend for acute general surgery. Funding is from the public hospital and assisting in the private hospital. Strengths of POWH are affiliation with the campus hospitals, Sydney Children’s Hospital and Royal Hospital for Women. This provides experience in pelvic malignancy, endometriosis, complex pelvic floor disorders, 3rd and 4th degree obstetric tears and obstetric fistulas. High volume colonoscopies and routine laparoscopic and robotic colorectal resections are performed by the unit. Experience in anal manometry and endoanal ultrasound is available. A weekly oncology multidisciplinary meeting, weekly colorectal clinic and monthly colorectal meeting (in addition to the CSSANZ meeting) are available to the Fellow.

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members):

Operative exposure per year:

Diagnostic exposure:

Research:

Both clinical and laboratory research are available including collaborative programs within affiliated campus hospitals, St George Hospital, and UNSW. Recent research projects included learning curve in robotic colorectal surgery, bowel function after endometriosis and rectal surgery, ergonomics of robotic colorectal surgery, stage II colon cancer and chemotherapy, stoma formation in spinal patients, and acute care surgery.

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

Northern Sydney, New South Wales

Royal North Shore Hospital is a principal tertiary referral hospital for Northern Sydney Local Health District providing a comprehensive range of complex services to patients from across NSW. It has a strong and proud history in education, research and provision of high quality clinical care. Royal North Shore Hospital provides specialty services including major trauma, severe burns, spinal cord injuries, neonatal intensive care, bone marrow transplantation, neurosurgery and interventional neuroradiology alongside acute medical, surgical, mental health, paediatric, cancer and maternity services. The campus is also home to The Kolling – a medical research institute jointly governed with the University of Sydney.

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members):

5 CSSANZ qualified surgeons, including:

Operative exposure per year:

Diagnostic exposure:

Research:

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

Sydney, New South Wales

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members):

Operative exposure per year:

Diagnostic exposure:

Research:

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

Sydney, New South Wales

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members):

Operative exposure per year:

Diagnostic exposure:

Research:

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

Westmead, New South Wales:

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members):

Operative exposure per year:

Diagnostic exposure:

Research:

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

Parklands Drive, Southport, Queensland

The Gold Coast University Hospital (GCUH) opened in late September 2013. It is a 750 bed public hospital and is the major tertiary referral centre for colorectal disease for the south coast of Queensland . It services a population of around 600,000.

The Colorectal Unit (CU) manages a large volume of major colorectal cases for cancer and inflammatory bowel disease. We run a weekly cancer multidisciplinary (MDT) and are supported by a dedicated colorectal clinical nurse co-ordinator. A fortnightly inflammatory bowel disease MDT is run in conjunction with our Gastroenterology department. There is a weekly endoscopy list and proctology list. There is an on-site radiology, oncology and stoma therapy service. The Colorectal clinics operate at GCUH and Robina Hospital. The unit currently has five colorectal surgeons, an ANZTBCRS fellow, a non-ANZTBCRS fellow, a RACS SET trainee, Principle House Officer and two interns. The unit participates in the Bi-National Colorectal Cancer Audit of the CSSANZ. Research opportunities exist within the unit’s clinical work or at the co-located Griffith University. There is the opportunity to participate in private assisting.

The GCUH CU is a cohesive, welcoming unit. The job is busy but well supported, ideal for 2nd year fellows seeking graduated operative independence and a high volume of cases. A beach-side locale with great weather and abundant leisure activities means fellows and their families will enjoy their time on the Gold Coast.

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members):

Operative exposure per year:

Diagnostic exposure:

Research:

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

Ipswich Road, Buranda, Brisbane

The Princess Alexandra Hospital is one of three tertiary level facilities in Queensland providing care in all major adult specialities with the exception of obstetrics and gynaecology and is one of Australia’s leading academic and research health centres. Princess Alexandra Hospital's Colorectal Unit provides a comprehensive colorectal surgery service to South East Queensland. This Colorectal Unit has a strong emphasis on teaching and is one of the leading Colorectal teaching facilities in Queensland. It is also the quaternary referral centre for peritoneal malignancy in Queensland.

The Princess Alexandra Hospital is also a major centre dealing in complex inflammatory bowel disease. Joint Surgical/Gastroenterology IBD clinics are run, and trainees are involved in these clinics as well as the subsequent surgery which may result from these consultations.

The Princess Alexandra Hospital Colorectal Unit has a strong interest in ensuring that all levels of Health Care Professionals working within it have strong and ongoing exposure to education and education forums to maintain current and best practice under the areas of care in the area in which we operate.

Hospitals involved in programme:

Fellows are predominantly based at the PA Hospital, but also gain experience from time spent at Mater Private, Greenslopes Private and the QE2 Hospital.

University affiliation:

The Princess Alexandra Hospital is affiliated with The University of Queensland.

Colorectal surgeons (*CSSANZ Members):

The Princess Alexandra Hospital Colorectal Unit is supervised by Dr Nicholas Lutton* (Chairman of Colorectal Unit), Dr Peter Gourlas*, Dr Brian Meade*, Dr Timothy Slack*, Dr Christopher Gillespie*, Dr Joy Chakraborty*, Dr Alex Croese* and Dr Richard Gartrell*. It provides comprehensive training experience to all levels of resident medical officers such as Interns, Principal House Officers, Registrars and Fellow. The Unit has two dedicated specialist nurse co-ordinators attached to the unit. The Colorectal Unit has 2 fellows, an ANZTBCRS fellow and a second fellow which can be local or international. Both fellows are exposed to all aspects of Colorectal Surgery, including laparoscopic, open and robotic surgery, as well as endoscopy and anorectal physiology.

Operative exposure per year:

Diagnostic exposure:

Research:

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

Bowen Bridge Road, Herston, Queensland

The Royal Brisbane & Women’s Hospital (RBWH) is a major tertiary referral centre for colorectal disease. The Colorectal Unit has a special interest in the application and development of minimally invasive techniques for colorectal disorders.

The RBWH is the major centre for complex inflammatory bowel disease cases and there is thus considerable exposure to laparoscopic total colectomies for acute severe colitis and the subsequent restorative ileal pouch procedures. The unit has a strong philosophy of combined Gastro/surgical consultation. Early surgery in ileal Crohn’s disease is an area of interest and thus there is considerable exposure to laparoscopic surgery for Crohn’s disease. There is also considerable experience in the treatment of functional disorders including sacral nerve stimulation and laparoscopic and robotic surgery for prolapse. An exenteration unit is now well established with around 25 exenterations annually, and a number of lateral node dissections performed robotically. A dual console Da Vinci Xi Robot is available at the RBWH and is ideal for training. Further exposure to the robotic platform occurs in the private sector. Colorectal cancer is well represented and the trans-anal approach to rectal diseases is currently under evaluation. Brisbane is a major teaching centre for the binational workshops in TaTME.
The Colorectal Unit also has a second training Fellow from overseas who has similar operative experience and logbook numbers as the ANZTBCRS Fellow. Both Fellows are intimately involved in the 3 day workshop in laparoscopic colorectal surgery which is held every 8 weeks. The workshop has been a regular fixture since 2001. The Fellow is supported by 2 advanced training registrars, a principle house officer and 3 interns. There is a dedicated unit nurse co-ordinator.

Data has been prospectively collected on laparoscopic surgery since 1991 and over 4,500 patients are now on the database. A further comprehensive database is separately maintained for inflammatory bowel disease. The Brisbane Colorectal Research Unit supervises and co-ordinates numerous research projects and clinical trials. There are a number of ongoing prospective research studies to participate in. It is supported by a dedicated research co-ordinator and forthcoming clinical trials co-ordinator in 2022.

The RBWH ANZTBCRS training unit is based in the South-east QLD city of Brisbane, the capital of Queensland and enjoys nearly perfect weather almost every day.

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members):

Operative exposure per year:

Diagnostic exposure:

Research:

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

The Tweed Colorectal Group – NSW/QLD

The Tweed Valley Hospital opened in May 2024.  Located 15km south of the Gold Coast International Airport on the Cudgen Plateau this 430 bed facility is brand new, state of the art development.  It is the major referral and teaching hospital for the Tweed-Byron District within the Northern NSW LHD.

Improved facilities include increased operating theatres, outpatient clinics, expanded emergency and urgent care, expanded radiology services & improved access to integrated cancer care services.  The Learning, Development and Research Centre is a co-located research and education facility with modern library facilities and is home to the Northern NSW Academic Health Alliance.  

John Flynn Private Hospital is a 345 bed acute care hospital located at Tugun, on the southern end of the Gold Coast, within 5 minutes from the Gold Coast Airport. The hospital provides services to the population of the Gold Coast and the Tweed Coast extending into the NSW Northern Rivers area.

John Flynn provides a wide range of health care services with a 24 hour emergency department, comprehensive cardiac services, general and orthopaedic surgery, cancer services, medical, maternity and paediatrics, renal dialysis, day surgery and rehabilitation services. John Flynn has a Tier One Contract with the Department of Veteran Affairs and also provide services to the Gold Coast and Tweed Veteran community.

The John Flynn Hospital Colorectal Unit, equipped with two robots, has over a decade of experience in robotic colorectal surgery. With 3 busy colorectal surgeons performing robotic surgery there is a large exposure for fellows to this including colorectal resection procedures, complex pelvic floor disorders and ventral/parastomal hernia repairs. In development, at present, is a robotic training pathway to allow fellows to be involved and gain proficiency with robotic surgery.

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members):

Operative exposure per year:

Diagnostic exposure:

Research:

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

Adelaide, South Australia

Flinders Medical Centre is a teaching hospital associated with and adjacent to the Flinders University, 10km south of the CBD of Adelaide. The Colorectal Unit comprises 8 Colorectal surgeons, a full time (ANZTBCRS) Fellow as well as a part time / research fellow, and junior staff including a SET Registrar, a service Registrar, 2 RMOs and 3 interns, as well as several specialist nurses.

The unit manages over 500 elective and 1100 emergency inpatients annually, as well as 1200 endoscopic procedures. Over 175 new cancers are managed annually, and a high volume of inflammatory bowel disease patients. The full range of colorectal conditions are managed, and the unit runs an anorectal physiology service including clinics and diagnostics, participates in multidisciplinary meetings, and collaborates with the Department of Gastroenterology in the management of IBD patients and in the provision of endoscopic services. It is active in the development, implementation, and audit of treatment protocols for common elective and acute colorectal conditions.

The Unit’s workload and outcomes are presented and audited by an external auditor on a yearly basis.

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members, #CSSANZ Provisional Member)):

Operative exposure per year:

Diagnostic exposure:

Research:

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

Continuing Education:

Adelaide, South Australia

The Lyell McEwin Hospital is a 280 bed tertiary referral hospital situated at Elizabeth Vale in the northern suburbs of Adelaide. The LMH colorectal unit provides a tertiary level colorectal service to the North and North-Eastern regions of metropolitan Adelaide. The unit also manages patients from rural centers throughout South Australia as well as the Northern Territory. The Colorectal unit consists of seven consultant surgeons, one colorectal fellow, two advanced SET trainees (SET 3/4 and a SET2), two resident medical officers, two interns and a colorectal nurse specialist.

The Unit provides specialist colorectal surgical services and participates in the general surgery on call roster on a 1 in 3 rotation. Colorectal emergencies including obstetric injuries are handled 24/7 by the unit.

The Colorectal Unit manages a broad range of colorectal diseases including colorectal and anal cancer, benign colorectal diseases, inflammatory bowel disease, pelvic floor disorders and perianal disease. The Colorectal Fellow is exposed to a high volume of advanced laparoscopic and open surgery for colorectal cancer including transanal total mesorectal excision. There is a weekly multidisciplinary pelvic floor clinic which provides exposure to pelvic floor disorders and the use of 3D anorectal USS. There is also the possibility of exposure to robotic colorectal surgery.

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members):

Operative exposure per year:

Diagnostic exposure:

MDT / other exposure:

Research:

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

Adelaide, South Australia

The Royal Adelaide Hospital (RAH) is South Australia's flagship hospital, providing a comprehensive range of the most complex clinical care to an estimated 85,000 inpatients and 400,000 outpatients each year. Located in the CBD, the RAH spans the equivalent of three city blocks and is one of Australia’s most technologically advanced healthcare facilities, integrating the latest innovations across health, education and research to deliver quaternary level care.

The RAH Colorectal Unit comprises six consultant surgeons, 1 ANZTBCRS fellow, a senior SET trainee, an RMO, 3 interns and 3 research fellows. A full-time colorectal cancer care coordinator dedicated colorectal ward and theatre charge nurses, a comprehensive stoma and wound care service, and a full-time research officer are also an integral part of the unit.

The unit provides specialist colorectal surgical services, and the consultants participate in a dedicated colorectal on call roster (1 in 6) with fellow participation during working hours. The unit also contributes to emergency general surgical cover supported by a dedicated separate Acute Surgical Unit and Trauma service.

The RAH CSSANZ fellow position consistently offers high volume primary operating exposure to major open and laparoscopic colorectal cancer surgery, complex pelvic malignancy and inflammatory bowel disease cases, interventional colonoscopy and trans-anal endoscopic microsurgery. Pelvic floor and continence surgery are supported by an anorectal physiology facility and a continence clinic. Robotic surgery is offered in highly selected cases, with a dedicated dual console Xi robot on site. Involvement in weekly multidisciplinary colorectal oncology and IBD meetings is strongly promoted within the unit.

At the end of their year the fellow can expect to gain confidence in managing high volume elective and complex acute colorectal cases, and to develop well rounded evidence-based decision-making skills, with a shared decision-making approach to complex colorectal conditions.

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members ^#CSSANZ Provisional Member):

Operative exposure per year:

Diagnostic exposure:

Research:

The RAH is co-located with University of Adelaide and SAHMRI in the new Adelaide Biomedical Precinct, creating a vibrant atmosphere for academic activity. The RAH Colorectal Research Group is embedded within the RAH colorectal unit. Our singular focus is patient centred outcomes research in colorectal surgery, with three main stems: colorectal surgical oncology, post-operative recovery, and artificial intelligence research. Up to date details on the current research activity of the unit, including international collaborations, can be found here: www.colorectalresearch.org

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

Adelaide, South Australia

The Queen Elizabeth Hospital Department of Colorectal Surgery is a Major Tertiary Emergency and Elective Colorectal Centre which services central and western Adelaide. It is a tertiary referral centre for major rural areas of South Australia, and the Northern Territory. There is a strong association with the University of Adelaide Department of Surgery with a culture of research teaching and service commitment.

The unit offers a unique experience in broad range of colorectal disciplines. In addition to a solid workload of open and laparoscopic surgery for colorectal cancer, inflammatory bowel disease and benign colorectal conditions, the QEH provides experience and training in a number of important areas. Specifically, Peritonectomy and HIPEC for peritoneal malignancy, Robotic Colorectal Surgery, Pelvic Floor Diagnostics, Advanced laparoscopic colorectal procedures, Sacral Nerve Modulation, and advanced open and minimally invasive abdominal wall reconstruction. Colonoscopy is an important part of the unit activities.

The unit is staffed by six surgeons, supervising one ANZTBCRS trainee, two SET trainees, one RMO and 3 interns. There are fortnightly multidisciplinary meetings for both colorectal malignancy and IBD cases. Clinical activities include significant access to colonoscopy lists and fortnightly anorectal diagnostic clinics (US, manometry, PNTML). The fellow is rostered 2nd on call for general surgery emergency cover, one in 4, and the unit covers colorectal specific emergencies at consultant level.

Exposure to robotic surgery and training is via a monthly public list (daVinci Xi) where the Fellow is encouraged to be actively involved. After completion of initial online & simulator training, the Fellow will progress through patient side assisting and console surgery, utilizing the dual console system. In addition to public access, there is significant opportunity for further experience to be obtained in the private system, with approx. 70 to 100 cases being performed per annum. It is envisaged that, at completion of the year, the Fellow would be in a position to attend final wet lab training and progress to proctored solo cases on return to their home institution.

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members):

Operative exposure per year:

Diagnostic exposure:

Other Duties:

Research:

Randomised trial involving adjuvant chemotherapy in the post radiotherapy period in rectal cancer (WAIT)

Numerous trials on learning minimally invasive surgery and non technical skills in the operating theatre.

Projects involving simulation of surgical activities are ongoing.  Some of these projects are conducted within the structure of the Adelaide Northern Colorectal Unit which involves the Colorectal Surgical Departments of The Queen Elizabeth Hospital, Royal Adelaide Hospital and Lyell McEwin Hospital. Joint meetings between these departments are held every 3 months.

The unit also hosts the Adelaide University Masters of Minimally Invasive Surgery Course, a unique advanced course with opportunity for the ANZTBCRS fellows to gain a higher degree during their year. The course involves an extensive theoretical grounding in laparoscopic and robotic surgery. There are also a significant research and clinical components built into the degree. This is an online course and participants can be in any state in Australia. (https://www.adelaide.edu.au/degree-finder/mmis_mmininvsur.html)

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

Continuing Education:

Melbourne, Victoria

The Alfred Hospital is a tertiary referral teaching hospital adjacent to parklands just south of Melbourne’s CBD. There are eight Colorectal surgeons in the Department supervising an ANZTBCRS training fellow, one registrar, one HMO 3 and two interns. Strengths of the Alfred Hospital unit are a wide range of advanced laparoscopic surgery, and a strong exposure to pelvic surgery for malignant disease, IBD and other benign conditions. There is excellent exposure to endoscopy and pelvic floor labs; along with TEMS/TAMIS surgery and colorectal specific trauma. The Fellow receives specialist colorectal referrals, and has general surgical on call commitment as a consultant, with supervision. Funding is from the Public hospital commitments, and may be supplemented by Private assisting. There are multidisciplinary meetings in cancer and IBD. There is a close working relationship with the gastroenterology unit for IBD management, with resulting experience in enterocutaneous fistulas and short gut. The fellow attends the pelvic floor investigation unit at Alfred Hospital, and has good exposure to functional and pelvic floor surgery. There is a large volume of Transanal Endoscopic MicroSurgery. There are regular research meetings to support the fellow progress and publish significant research.

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members):

Operative exposure per year:

Diagnostic exposure:

Research:

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

Studley Road, Heidelberg, Victoria

Austin Health is a tertiary referral teaching hospital located in Heidelberg, a north-eastern suburb of Melbourne. Austin Health comprises the Austin Hospital, Heidelberg Repatriation Hospital and the Royal Talbot Rehabilitation Centre.

Austin Health operates 671 beds across acute, sub-acute and mental health with an annual operating budget of more than $700 million.

Austin Health is an internationally recognised leader in clinical teaching and training, affiliated with eight universities. In addition, it is the largest Victorian provider of training for specialist physicians and surgeons.

During 2013-14, Austin Health completed 95,142 inpatient admissions,177,027 outpatient attendances and 75,366 emergency attendances.

The Colorectal Unit is one of five general surgical units and provides dedicated colorectal services in the Hospital. There are eight surgeons in the Unit supervising one ANZTBCRS Fellow, one Research Fellow, two advanced General Surgery Trainees and three interns.

The ANZTBCRS Fellow shares the on call with the Research Fellow on an alternating 1 in 2 weekend basis, as the second on call person. Overall, the Unit participates in the on call roster for Colorectal and General Surgery one day a week and one weekend in six weeks.

The ANZTBCRS Fellow receives full funding from the hospital with additional income from private assisting.

Strengths of the Unit are the high volume of colorectal cancer cases of primary and recurrent state, significant IBD workload, busy colonoscopy lists, surgery for spinal patients within the Victorian Spinal Unit, combined pelvic surgery for gynaecological malignancy and endosurgery for endometriosis in collaboration with gynaecologists from the Mercy Hospital. A pelvic floor lab and surgery for Faecal Incontinence including Sacro neuromodulation.

The Unit provides training in laparoscopic surgery, TAMIS, TaTME , anorectal surgery, advanced colonoscopy and colonic stenting, endo-anorectal ultrasound and anorectal manometry. A recent addition is the training opportunity in assisting in Robotic colorectal surgery at the Private Hospital. There is also exposure to teaching in MRI through the colorectal cancer MDT meetings and research through the University of Melbourne Department of Surgery.

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members):

Operative exposure per year:

*These figures do not include private assisting, which is readily available on an ad hoc basis at Warringal Private Hospital.

Diagnostic exposure:

Research:

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

Box Hill, Victoria

Box Hill Hospital is a large teaching hospital located 15 kms from Melbourne’s CBD, in the eastern suburbs. It is part of Eastern Health, and the main site of colorectal surgery within Eastern Health. There are ten colorectal surgeons in the unit, a non accredited fellow, an advanced surgical trainee and one intern. The Fellow is first on call for the Colorectal Unit but does not take general surgical calls. There is co-location with Epworth Eastern Private Hospital. Funding is through the public hospital and is supplemented by private assisting. The strengths of the unit are a large surgical work load, particularly in colorectal cancer both open and laparoscopic. There is a strong association with medical and radiation oncology, radiology and anatomical pathology with regular multi disciplinary cancer meetings. There is also a strong association with the Gastroenterology Unit and a large referral practice in inflammatory bowel disease. In addition, there is exposure to regular colonoscopy lists and anorectal manometry.

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members):

Operative exposure per year:

Diagnostic exposure:

Research:

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

Monash Health Surgery – Dandenong, Victoria.

Monash Health is the largest Health Service in Victoria serving over 1 million people in the south east of Melbourne across 5 campuses providing surgical services at Clayton, Dandenong, Casey – Berwick, Moorabbin and Cranbourne Integrated Care Centre. Tertiary services are provided at Clayton and Dandenong, both with busy ED and ICU facilities. All campuses are affiliated teaching hospitals with Monash University.

The Colorectal Surgery Unit is based at the Dandenong campus and the unit’s structure consists of: nine colorectal surgeons, a CSSANZ ANZTBCRS fellow, a colorectal research fellow, two SET trainees in General Surgery, one non-accredited registrar, two HMO and five interns, a ward dedicated to colorectal surgery, colorectal cancer care nurse, data manager, secretary and an expert stomal therapy and wound management nursing team.

The Unit has daily operating lists, colonoscopy lists every Thursday and alternative Fridays, a weekly Outpatient Clinic at Dandenong and access to Anorectal manometry and Endorectal Ultrasound at South East Colorectal adjacent to the hospital.

The consultants also have access to operating lists at Clayton, Moorabbin, Casey and Cranbourne. The Fellow participates in all aspects of the Unit activities on all campuses, is on call exclusively for colorectal referrals and is funded totally by Monash Health, but may obtain extra income from assisting in private at either Mulgrave Private, St John of God (Berwick), Waverley Private, Peninsula Private or Knox Private hospitals.

Strengths of the Monash Health Colorectal Surgery Unit are: the sheer volume of major and range of minor ano‐rectal cases; advanced laparoscopic surgery particularly for rectal cancer, integrated IBD and pelvic floor services with the gastro‐enterologists and uro‐gynecologists respectively, multidisciplinary meetings in cancer aligned with SMICS and a strong commitment to Education, Training and Research through the MASTER program.

Sub‐specialty interests of the consultants include: Transanal endoscopic Microsurgery, TAMIS, TaTME, robotic surgery (in private hospital), sacral nerve modulation, endometriosis and IBD. There are regular research meetings to support the fellow’s research project and publications.

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members):

Operative exposure per year:

Diagnostic exposure:

Research:

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

Epping, Victoria

Northern Hospital is a tertiary hospital in Epping in outer metropolitan Melbourne.
It is the principal hospital in the Northern Health hospital network. Collaborating hospitals in the Northern Health network are:

• The Northern Hospital, Epping: All major units and surgical specialties except neurosurgery and cardiac surgery. It has a busy Endoscopy unit, Gastroenterology IBD service and Obstetrics and Gynaecology with whom we collaborate. There is also a very busy emergency department and an Acute General Surgery Unit which regularly refers to Colorectal surgery. We have collaborations with hepatobiliary pancreatic surgery and thoracic surgery through our Colorectal Cancer MDM.
  Outsourced Radiology has been brought in house to Northern Health in 2023 and Anatomical Pathology has been brought in house in February 2024.
  Northern Health Oncology services are spread across The Northern Hospital, Epping and Craigieburn.
  Radiation Oncology is through a shared care public private partnership, Genesis Care, which has its service in Epping close to the Northern Hospital.
• Broadmeadows Hospital: Surgicentre, Endoscopy & Surgical Rehabilitation
• Craigieburn Hospital: Consulting clinics & Allied Health, Day Oncology
• Kilmore Hospital: Surgery, Obstetrics & Gynaecology, Endoscopy
• Bundoora Hospital: Aged Care services
  
  

Hospitals involved in programme:

• The Northern Hospital - Epping

University affiliation:

Colorectal surgeons (*CSSANZ Members):

• Dr Neil Strugnell*
• Dr Basil D'Souza*
• Dr Andrew Bui*
• Dr Eric Daniel*
• Dr Ankur Sidhu*
• Dr Sarit Badiani 
• Dr Atan Das
  *denotes CSSANZ Member

Operative exposure per year:

• 175 majors per year

Diagnostic exposure:

• Fortnightly cancer MDM
• Fortnightly IBD MDM
• Anorectal lab 2-3 patients per month
• Colonoscopies anticipate 100 per year

Research:

• Assessment approaches for sacral nerve stimulation literature review
• Presented talk on High Resolution Anoscopy
• Participating in Emergency laparotomy trial Prevena vs Honeycomb dressings as recruiter and assessor.
• RCT collaborative research trial design under consideration: Elective colorectal surgery wound management strategies and SSI outcomes

Method of funding:

• ANZTBCRS clinical fellow is paid at full time senior registrar rates.

Expected "on call" roster commitments:

• 9 weekdays /weeknights out of 10
• 2 weekend days / nights out of 4
• Acute General Surgery 1/5 nights, 1/5 weekends. Weekend off (every second) from Colorectal is also always off for General Surgery also.

Other strengths of unit:

• Overall operative exposure very good.
• Mentorship at Northern Health very good.
• Overall operative exposure to IBD resections: eg: colectomies for ASUC, primary and re resections for Crohn’s diseases very good

Melbourne, Victoria

The Royal Melbourne Hospital (RMH) is one of Melbourne’s major teaching hospitals and a level 1 trauma centre. It is situated in the inner suburb of Parkville in a major medical and research precinct including The University of Melbourne, The Walter and Eliza Hall institute, The Victorian Comprehensive Cancer Centre (VCCC), Peter MacCallum Cancer Centre and The Royal Women’s Hospital. 

The Colorectal Surgery Unit comprises 8 surgeons, all of whom are members of CSSANZ. We have an ANZTBCRS clinical fellow, a research fellow, 2 registrars and 2 interns. While our unit is focused on tertiary referral elective work, we are also heavily involved with the complex emergency cases that are generated by a major general hospital with a large emergency and trauma workload. All this produces a busy and rewarding training environment for our ANZTBCRS fellow.

The position also includes regular clinic and operating sessions at the Royal Women's Hospital for the fellow to gain experience in the laparoscopic management of complex endometriosis involving the rectum.

The unit has regular DaVinci Xi (dual console) operating lists with the opportunity for the fellow to gain experience in robotic surgery. Further exposure to the robotic platform occurs in the private sector. 

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members):

Operative exposure per year:

Diagnostic exposure:

Research:

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

The RMH Colorectal unit is a consultant led service with an emphasis on high quality clinical outcomes. Most of our major elective work is colorectal cancer and inflammatory bowel disease, and the majority of major cases are laparoscopic or robotic. 

Strengths of the unit is the exposure to complex colorectal trauma, complex young patients with IBD (that transition to our unit from RCH), exposure to ileal pouch surgery, as well as dedicated RWH sessions to manage rectal endometriosis. There are regular dual console DaVinci Xi operating lists to gain robotic experience.

Our fellow is heavily involved in running the unit but we hold the philosophy that the follow position is for high level supervised training rather than just service provision. Overall this is a busy clinical job with good exposure to a wide range of complex cases and it provides the ANZTBCRS clinical fellow with very solid training.

Melbourne, Victoria

St Vincent’s is a tertiary public healthcare service. We provide a range of services, including acute medical and surgical services, emergency and critical care, aged care, diagnostics, rehabilitation, allied health, mental health, palliative care and residential care. We work with a vast network of collaborative partners to deliver high quality treatment, teaching, education and research. We have more than 5,000 staff and 880 beds in daily use across our services.

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members):

Operative exposure per year:

Diagnostic exposure:

Research:

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

Melbourne, Victoria

Western Health is a tertiary referral teaching hospital network with its principal campus in Footscray, located 8 km to the west of the centre of Melbourne. Western Health has a large, growing catchment area, comprising a diverse population. In addition to the main campus in Footscray, there are hospitals at Sunshine, Williamstown and Sunbury. A new Footscray Hospital is under construction and a new hospital at Melton is planned.

There are six surgeons, supervising a senior SET registrar, a pre-SET registrar and three interns. The Fellow has supervised on-call responsibilities on an average 1/5 roster. The hospital network funds the position; payment is for hours worked at a rate commensurate with experience. Western Health provides other benefits: https://www.westernhealth.org.au/Careers/Pages/Our-Benefits.aspx

In 2020, a new position has been created – a combined research / clinical fellow (non-ANZTBCRS position). This is a 2-year appointment leading to a Master of Surgery with the University of Melbourne. There is a clinical component with access to some operating and endoscopy lists, and some on-call opportunities. The research fellow will share on-call commitments with the ANZTBCRS fellow.

The Fellow position offers excellent operative experience (primarily laparoscopic and hybrid cases), a weekly colorectal MDT, a weekly outpatient clinic, a monthly combined IBD clinic, colonoscopy (including advanced techniques), pelvic floor assessment and management, and collaboration with the gastroenterology unit, obstetric and gynaecology service and radiology (MRI and interventional services). Exposure to endoluminal colorectal stenting is available. Clinical research projects are encouraged and supported by a dedicated supervisor of research

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members):

Operative exposure per year:

Diagnostic exposure:

Research:

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

Fremantle Hospital Group, Murdoch, Western Australia

Fiona Stanley Hospital is a tertiary referral teaching hospital in Perth, opened in 2015. There are 5 colorectal surgeons on the Unit.

Fiona Stanley Hospital's strengths include being the major colorectal cancer centre for the South Metropolitan Area of Perth, with a very busy cancer workload, including large numbers of rectal cancers. It is the main laparoscopic colorectal unit in Perth, with almost all elective cases being performed this way. Fiona Stanley has both the Centre for Inflammatory Bowel Diseases and the Intestinal Failure Unit of Perth and is the only public hospital performing TEMS. Weekly colonoscopy lists are available including colonic stenting. There are multidisciplinary meetings in colorectal cancer, IBD and GI Radiology.

0.8 FTE Fellow salary is funded by Fiona Stanley Hospital. Assisting 2 of the surgeons at the co-located private St John of God Hospital provides additional experience and income. The Fellow is supported by a first year, non CSSANZ fellow, an advanced surgical trainee and 3-4 Interns. There is a full-time colorectal nurse specialist, and 3 stomal therapists who form part of the unit.

The Fellow is required to provide a 1 in 8, 2nd on call cover from home to the advanced trainee covering general surgical and colorectal emergency cases.

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members ^# CSSANZ Provisional Member):

Operative exposure per year:

Diagnostic exposure:

Research:

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit:

Perth, Western Australia

Sir Charles Gairdner Hospital is the major teaching hospital for the North Metropolitan Health Service Board situated centrally in Perth in the suburb of Nedlands.

Strengths of the unit include:

The unit has a high volume of laparoscopic cancer and IBD work as well as pelvic floor surgery. There is a high volume of emergency colorectal surgery with the majority performed by the colorectal unit. Weekly proctology lists are available at Osborne Park Hospital. Private assisting is available (not compulsory) for interesting cases at Hollywood Private Hospital.

There are on average 8 elective operating sessions and 1 colonoscopy list per week. There is 1 outpatient clinic per week. Oncology MDT meetings are conducted weekly with fortnightly IBD meetings.

The fellow participates in a 1 in 4 fellow on call from home as the first point of call for the training or service registrar. Weekend ward rounds are shared between training registrar and fellow. The colorectal unit includes 1 fellow, 1 SET registrar, 2 service registrars, 2 RMOs and 4 interns. There are 2 colorectal / sarcoma cancer nurses and dedicated stoma nurses.

Hospitals involved in programme:

University affiliation:

Colorectal surgeons (*CSSANZ Members):

Operative exposure per year:

Diagnostic exposure:

Research:

Method of funding:

Expected "on call" roster commitments:

Other strengths of unit: