http://hdl.handle.net/11434/17 2026-07-05T15:27:34Z http://hdl.handle.net/11434/2341 Title: Improving outcomes in pancreatic cancer surgery: benchmarking existing data for pancreatic surgery outcomes, stakeholder-lead development of the Pancreatic Cancer Surgical Outcome (PaCaSO) registry, and exploration of pancreatic cancer resection rate in Victoria. Epworth Authors: Lockie, Elizabeth; Zalcberg, John Abstract: Surgery with chemotherapy offers the best chance of long-term survival in pancreatic cancer. This suite of studies centres around optimising surgery for pancreatic cancer and the development of a bi-national registry. 2025-08-01T00:00:00Z http://hdl.handle.net/11434/2291 Title: An intraoperative diagnosis of sclerosing encapsulating peritonitis: A case report. Epworth Authors: Sivakumar, J; Brown, G; Choi, J Abstract: Primary sclerosing encapsulating peritonitis (SEP) is an idiopathic and rare condition characterized by chronic peritoneal inflammation. We describe the case of an intraoperative diagnosis of SEP, presenting as a mimicker of small bowel obstruction. The patient was a 59-year-old male with suspected small bowel obstruction. On exploratory laparotomy, it was noted that there was thick fibrous tissue involving the visceral and parietal peritoneum enveloping grossly dilated loops of small bowel. This case reports on the histopathological features of peritoneal biopsies as well as radiological findings. There is no consensus regarding the standard management for idiopathic SEP. The present case demonstrates a significant improvement in the patient's condition with conservative management alone. A critical teaching point is that in the absence of an obvious cause, SEP is a rare but important differential diagnosis for surgeons to consider in the context of recurrent bowel obstruction. 2020-09-01T00:00:00Z http://hdl.handle.net/11434/2283 Title: Learning curve of laparoscopic inguinal hernia repair: Systematic review, meta-analysis, and meta-regression. Epworth Authors: Sivakumar, Jonathan; Hii, Michael; Cullinan, Mark; Choi, Julian; Steven, Mark; Crosthwaite, Gary Abstract: Background: Laparoscopic inguinal hernia repair has a long learning curve. It can be a technically challenging procedure and initially presents an unfamiliar view of inguinal anatomy. The aim of this review was to evaluate published literature relating to the learning curve of laparoscopic inguinal hernia repair and identify the number of cases required for proficiency. The secondary aim was to compare outcomes between surgeons before and after this learning curve threshold had been attained. Methods: A systematic literature search was conducted in databases of PubMed, Medline, Embase, Web of Science, and Cochrane Library, to identify studies that evaluated the learning curve of laparoscopic inguinal hernia repair. A meta-regression analysis was undertaken to identify the number of cases to achieve surgical proficiency, and a meta-analysis was performed to compare outcomes between cases that were undertaken during a surgeon's learning phase and experienced phase of the curve. Results: Twenty-two studies were included in this review, with 19 studies included in the meta-regression analysis, and 11 studies included in the meta-analysis. Mixed-effects Poisson regression demonstrated that there was a non-linear trend in the number of cases required to achieve surgical proficiency, with a 2.7% year-on-year decrease. The predicted number of cases to achieve surgical proficiency in 2020 was 32.5 (p < 0.01). The meta-analysis determined that surgeons in their learning phase may experience a higher rate of conversions to open (OR 4.43, 95% CI 1.65, 11.88), postoperative complications (OR 1.61, 95% CI 1.07, 2.42), and recurrences (OR 1.32, 95% CI 0.40, 4.30). Conclusion: Laparoscopic inguinal hernia repair has a well-defined learning curve. While learning surgeons demonstrated reasonable outcomes, supervision during this period may be appropriate given the increased risk of conversion to open surgery. These data may benefit learning surgeons in the skill development of minimally invasive inguinal hernia repairs. 2023-04-01T00:00:00Z http://hdl.handle.net/11434/2177 Title: Colo-rectal fistula: a rare complication of diverticular disease. Epworth Authors: Pham, Toan Abstract: Colo-rectal fistula secondary to complicated sigmoid diverticular disease is a rare but important complication that can present with symptoms mimicking invasive malignancy. We present the case of a 47-year-old male who was referred with a six-week history of lower abdominal discomfort radiating to the perianal region, tenesmus, urinary urgency, frequency and occasional frank rectal bleeding. 2023-03-01T00:00:00Z