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Article ; Online: Heterotopic pancreatic tissue masquerading as a neuroendocrine tumour.

Koullouros, Michalis / Stanzah, Fellicia / Swalling, Adam / Kanhere, Harsh

2022 Volume 92, Issue 12, Page(s) 3353–3355

MeSH term(s)	Humans ; Neuroendocrine Tumors/diagnosis ; Neuroendocrine Tumors/surgery ; Neuroendocrine Tumors/pathology ; Pancreas/diagnostic imaging ; Pancreas/pathology ; Choristoma/diagnosis ; Choristoma/surgery ; Pancreatic Neoplasms/diagnosis ; Pancreatic Neoplasms/surgery ; Pancreatic Neoplasms/pathology
Language	English
Publishing date	2022-03-28
Publishing country	Australia
Document type	Case Reports
ZDB-ID	2050749-5
ISSN	1445-2197 ; 1445-1433 ; 0004-8682
ISSN (online)	1445-2197
ISSN	1445-1433 ; 0004-8682
DOI	10.1111/ans.17661
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Article: A case report of septic shock and splenic abscess formation secondary to gastric band erosion: A rare complication of laparoscopic adjustable gastric banding.

Lu, Victoria / Kanhere, Harsh

International journal of surgery case reports

2020 Volume 69, Page(s) 55–57

Abstract: Introduction: With the rising burden of obesity, bariatric surgery is becoming more common as a treatment option. Laparoscopic adjustable gastric banding (LAGB) is considered safe and effective and is a popular procedure in Australia. However there are ... ...

Abstract	Introduction: With the rising burden of obesity, bariatric surgery is becoming more common as a treatment option. Laparoscopic adjustable gastric banding (LAGB) is considered safe and effective and is a popular procedure in Australia. However there are recognised complications to be aware of such as band erosion which can lead to infection and abscess formation. Presentation of case: A 59-year-old caucasian female presented with fevers, rigors and feeling generally unwell. She was previously fit and well with her only past medical history being LAGB 14 years prior. Clinically the patient was in septic shock and required intensive care admission for inotropic support. On investigations the CRP was 227 and abdominal computed tomography (CT) revealed a splenic abscess. Follow up upper gastrointestinal endoscopy diagnosed an eroded gastric band in the stomach. The patient proceeded to laparoscopy, a gastrotomy was performed and the band was removed. The splenic abscess was concurrently drained and the patient treated with an extended course of intravenous and oral antibiotics. Discussion: Band erosion is a rare but serious complications of LAGB surgery along with band slippage, pouch dilatation and abscess formation. Patients are often asymptomatic making early diagnosis difficult. Upper gastrointestinal endoscopy is used to locate the band and recommended treatment is band removal via laparoscopy or laparotomy. Conclusion: Band erosion should be suspected in patients with a history of LAGB presenting with nonspecific symptoms such as abdominal pain or fevers. This case also highlights the importance of appropriate patient follow up post operatively and counselling of operative risks and long-term complications.
Language	English
Publishing date	2020-04-01
Publishing country	Netherlands
Document type	Case Reports
ISSN	2210-2612
ISSN	2210-2612
DOI	10.1016/j.ijscr.2020.03.015
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Article: Loin to groin pain -A case report of an intermittent obturator hernia mimicking ureteric colic.

Herath, Matheesha / Kanhere, Harsh

International journal of surgery case reports

2019 Volume 66, Page(s) 356–359

Abstract: Introduction: Obturator hernia is a rare condition and can cause significant diagnostic challenges due to a lack of reliable clinical examination signs. Presentations can have a variety of features and it is a diagnosis that needs to be considered - ... ...

Abstract	Introduction: Obturator hernia is a rare condition and can cause significant diagnostic challenges due to a lack of reliable clinical examination signs. Presentations can have a variety of features and it is a diagnosis that needs to be considered - especially in elderly multiparous women. Presentation of case: We present a 76-year-old female who has multiple presentations to the Emergency Department (ED) with transient episodes of severe loin to groin pain. Imaging Computer Tomography (CT) initially demonstrated a mild left hydronephrosis and she underwent an unremarkable ureteroscopy and stenting. Following stent removal she continued to have recurrent episodes of the pain. She presented to the ED with one such episode. A repeat CT scan was performed and this demonstrated an obturator hernia with partial small bowel obstruction. She underwent a laparoscopy by which time the hernia had reduced and her pain had settled. Laparoscopy revealed bilateral obturator herniae with the one on left larger than the right. Both were repaired laparoscopically and she made an uneventful recovery. Discussion: Obturator hernia is an uncommon condition and can have a varied presentation. Comprehensive review of literature demonstrates the difficulty in making accurate diagnosis. Open intervention was the initial gold standard of treatment but there is a growing body of evidence advocating for the use of laparoscopy in an emergency setting. Conclusion: Early diagnostic imaging with CT while a patient is symptomatic can aid in making an accurate diagnosis. Laparoscopic repair can be safely used with good outcome in the context of an incarcerated obturator hernia.
Language	English
Publishing date	2019-12-28
Publishing country	Netherlands
Document type	Case Reports
ISSN	2210-2612
ISSN	2210-2612
DOI	10.1016/j.ijscr.2019.12.025
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Article ; Online: Value of the surgical pancreatic duct anatomy and associated outcomes in pancreatic cancer.

Harris, Mark Conor / Atanasov, Georgi / Neo, Eu Nice / Goldfinch, Andrew / Ng, Andrew Jin-Hean / Tew, Khimseng / Kuan, Lilian / Trochsler, Markus / Kanhere, Harsh

ANZ journal of surgery

2024

Abstract: Introduction: Pancreatic cancer recurrence following surgery is a significant challenge, and personalized surgical care is crucial. Topographical variations in pancreatic duct anatomy are frequent but often underestimated. This study aimed to ... ...

Abstract	Introduction: Pancreatic cancer recurrence following surgery is a significant challenge, and personalized surgical care is crucial. Topographical variations in pancreatic duct anatomy are frequent but often underestimated. This study aimed to investigate the potential importance of these variations in outcomes and patient survival after Whipple's procedures. Methods: Data were collected from 105 patients with confirmed pancreatic head neoplasms who underwent surgery between 2008 and 2020. Radiological measurements of pancreatic duct location were performed, and statistical analysis was carried out using IBM SPSS. Results: Inferior pancreatic duct topography was associated with an increased rate of metastatic spread and tumour recurrence. Additionally, inferior duct topography was associated with reduced overall and recurrence-free survival. Posterior pancreatic duct topography was associated with decreased incidence of perineural sheet infiltration and improved overall survival. Discussion: These findings suggest that topographical diversity of pancreatic duct location can impact outcomes in Whipple's procedures. Intraoperative review of pancreatic duct location could help surgeons define areas of risk or safety and deliver a personalized surgical approach for patients with beneficial or deleterious anatomical profiles. This study provides valuable information to improve surgical management by identifying high-risk patients and delivering a personalized surgical approach with prognosis stratification.
Language	English
Publishing date	2024-03-01
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2050749-5
ISSN	1445-2197 ; 1445-1433 ; 0004-8682
ISSN (online)	1445-2197
ISSN	1445-1433 ; 0004-8682
DOI	10.1111/ans.18903
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Article ; Online: The 'Surgical Time': a myth or reality? Surgeons' prediction of operating time and its effect on theatre scheduling.

Goel, Raghav / Kanhere, Harsh / Trochsler, Markus

Australian health review : a publication of the Australian Hospital Association

2020 Volume 44, Issue 5, Page(s) 772–777

Abstract: Objective In Australia, 2.7 million surgical procedures were performed in the year 2016-17. This number is ever increasing and requires effective management of operating theatre (OT) time. Preoperative prediction of theatre time is one of the main ... ...

Abstract	Objective In Australia, 2.7 million surgical procedures were performed in the year 2016-17. This number is ever increasing and requires effective management of operating theatre (OT) time. Preoperative prediction of theatre time is one of the main constituents of OT scheduling, and anecdotal evidence suggests that surgeons grossly underestimate predicted surgical time. The aim of this study is to assess surgeons' accuracy at predicting OT times across different specialties and effective theatre scheduling. Methods A database was created with de-identified patient information from a 3-month period (late 2016). The collected data included variables such as the predicted time, actual surgery time, and type of procedure (i.e. Emergency or Elective). These data were used to make quantifiable comparisons. Results Data were categorised into a 'Theatre list' and 'Scopes list'. This was further compared as 'Actual-Predicted' time, which ranged from an average underestimation of each procedure by 19min (Ear Nose and Throat surgeons) to an average overprediction of 13.5min (Plastic Surgery). Urgency of procedures (i.e. Emergency and Elective procedures) did not influence prediction time for the 'Theatre list', but did so for the 'Scopes list' (P<0.001). Surgeons were poor at predicting OT times for complex operations and patients with high American Society of Anaesthesiologists grades. Overall, surgeons were fairly accurate with their OT prediction times across 1450 procedures, with an average underestimation of only 2.3 min. Conclusions In terms of global performance at The Queen Elizabeth Hospital institution, surgeons are fairly accurate at predicting OT times. Surgeons' estimates should be used in planning theatre lists to avoid unnecessary over or underutilisation of resources. What is known about the topic? It is known that variables such as theatre changeover times and anaesthesia time are some of the factors that delay the scheduled start time of an OT. Furthermore, operating time depends on the personnel within the operating rooms such as the nursing staff, anaesthesiologists, team setup and day of time. Studies outside of Australia have shown that prediction models for OT times using individual characteristics and the surgeon's estimate are effective. What does this paper add? This paper advocates for surgeons' predicted OT time to be included in the process of theatre scheduling, which currently does not take place. It also provides analysis of a wide range of surgical specialties and assesses each professions' ability to accurately predict the surgical time. This study encompasses a substantial number of procedures. Moreover, it compares endoscopic procedures separately to laparoscopic/open procedures. It contributes how different variables such as the urgency of procedure (Emergency/Elective), estimated length of procedure and patient comorbidities affect the prediction of OT time. What are the implications for practitioners? This will encourage hospital administrators to use surgeons' predicted OT time in calculations for scheduling theatre lists. This will facilitate more accurate predictions of OT time and ensure that theatre lists are not over or underutilised. Moreover, surgeons will be encouraged to make OT time predictions with serious consideration, after understanding its effect on theatre scheduling and associated costs. Hence, the aim is to try to make an estimation of OT time, which is closer to the actual time required.
MeSH term(s)	Anesthesiology ; Australia ; Humans ; Operating Rooms ; Operative Time ; Surgeons
Language	English
Publishing date	2020-09-29
Publishing country	Australia
Document type	Journal Article
ZDB-ID	639155-2
ISSN	1449-8944 ; 0159-5709 ; 0156-5788
ISSN (online)	1449-8944
ISSN	0159-5709 ; 0156-5788
DOI	10.1071/AH19222
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Article ; Online: How to do a thoracoscopic-assisted oesophagectomy with oesophagogastric anastomosis using a circular stapler.

Schofield, Adam / McQuillan, Patrick / Kanhere, Harsh / Prasad, Shalvin

ANZ journal of surgery

2021 Volume 91, Issue 7-8, Page(s) 1610–1612

Abstract: Thoracoscopic mobilization of the oesophagus during oesophagectomy has many advantages over the traditional open approach including less blood loss, reduced pulmonary complications and shorter hospital stay. Minimally invasive intrathoracic ... ...

Abstract	Thoracoscopic mobilization of the oesophagus during oesophagectomy has many advantages over the traditional open approach including less blood loss, reduced pulmonary complications and shorter hospital stay. Minimally invasive intrathoracic oesophagogastric anastomosis can be technically challenging, with several different techniques described in the literature. Here, we describe a nuanced technique to perform an intracorporeal anastomosis using a circular stapler.
MeSH term(s)	Anastomosis, Surgical ; Esophageal Neoplasms/surgery ; Esophagectomy ; Esophagus/surgery ; Humans ; Laparoscopy
Language	English
Publishing date	2021-07-26
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2050749-5
ISSN	1445-2197 ; 1445-1433 ; 0004-8682
ISSN (online)	1445-2197
ISSN	1445-1433 ; 0004-8682
DOI	10.1111/ans.16888
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Article ; Online: Quality of Life After Bariatric and Body Contouring Surgery in the Australian Public Health System.

Barbaro, Antonio / Kumar, Ajan / Asokan, Gayatri / Green, Luke / Ibrahim, Abdullah / Goel, Raghav / Harries, Richard / Kanhere, Harsh / Prowse, Phoebe / Trochsler, Markus

The Journal of surgical research

2023 Volume 285, Page(s) 76–84

Abstract: Introduction: The goals of bariatric surgery are weight loss, improved management of obesity-related diseases, and enhanced health-related quality of life (HRQoL). The aim of this study is to determine HRQoL among postoperative bariatric surgery ... ...

Abstract	Introduction: The goals of bariatric surgery are weight loss, improved management of obesity-related diseases, and enhanced health-related quality of life (HRQoL). The aim of this study is to determine HRQoL among postoperative bariatric surgery patients. The aim of this study was to evaluate the utility of bariatric surgery and the role of body contouring surgery (BCS) when considering quality of life in low-volume centres in the Australian public health system. Methods: This cohort study compared patients who underwent bariatric surgery between 2008 and 2018, to those awaiting surgery. An additional analysis was completed for patients who also underwent BCS. Patients completed the Short Form-36 quality of life (SF-36) survey. Linear regression was used to assess the differences in mean scores between cohorts for each of the SF-36 domains. Results: A total of 131 postoperative patients were identified, with a follow up rate of 68%. The mean follow up was 5.4 y. The mean scores for all domains of the SF-36 in the postoperative group were higher than the preoperative group (P ≤ 0.0001). A significant difference in scores persisted after controlling for patients' current BMI. When considering patients who underwent BCS (n = 24), there was a further global improvement in HRQoL in physical function (P = 0.0065), role limitation to physical health (P = 0.0026), pain (P = 0.0004), energy (P = 0.0023) and general health perceptions (P = 0.0023). Conclusions: Bariatric surgery followed by BCS may improve HRQoL for the patient when compared to bariatric surgery alone. We advocate for the use of bariatric surgery followed by BCS in low-volume centres in the Australian public health system.
MeSH term(s)	Humans ; Body Contouring ; Quality of Life ; Obesity, Morbid/surgery ; Cohort Studies ; Public Health ; Australia ; Bariatric Surgery
Language	English
Publishing date	2023-01-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2022.12.037
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Article ; Online: Survey and literature review on the importance of peritoneal cytology in staging and treatment of gastric cancer: always wash it before you treat it.

Harris, Mark C / Cockbain, Andrew J / McQuillan, Patrick W / Kanhere, Harsh A

ANZ journal of surgery

2021 Volume 91, Issue 1-2, Page(s) 13–18

MeSH term(s)	Gastrectomy ; Humans ; Neoplasm Staging ; Peritoneum/pathology ; Prognosis ; Stomach Neoplasms/pathology ; Stomach Neoplasms/surgery
Language	English
Publishing date	2021-03-06
Publishing country	Australia
Document type	Journal Article ; Review
ZDB-ID	2050749-5
ISSN	1445-2197 ; 1445-1433 ; 0004-8682
ISSN (online)	1445-2197
ISSN	1445-1433 ; 0004-8682
DOI	10.1111/ans.16295
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Article: Perforated Giant Meckel's Diverticulum Mimicking Colonic Ischemia.

Rana, Abdul Ahad / Trochsler, Markus / Kanhere, Harsh

Cureus

2018 Volume 10, Issue 12, Page(s) e3753

Abstract: Meckel's Diverticulum is one of the most common congenital anomalies of the gastrointestinal tract. However, its presentation as a complicated Giant Meckel's Diverticulum in an adult is rare. We present a case of a perforated Giant Meckel's mimicking ... ...

Abstract	Meckel's Diverticulum is one of the most common congenital anomalies of the gastrointestinal tract. However, its presentation as a complicated Giant Meckel's Diverticulum in an adult is rare. We present a case of a perforated Giant Meckel's mimicking ischemia of the right colon. This case report highlights the importance of having a high index of suspicion for this rare diagnosis.
Language	English
Publishing date	2018-12-19
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.3753
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Article ; Online: Can pressurised intraperitoneal aerosol chemotherapy with oxaliplatin (PIPAC-O+) be added to standard treatment for resectable high-risk gastric cancer patients? A study protocol

Reid Jessica L. / Kanhere Harsh A. / Hewett Peter J. / Price Timothy J. / Maddern Guy J. / Trochsler Markus I.

Pleura and Peritoneum, Vol 6, Iss 4, Pp 151-

2021 Volume 154

Abstract: Gastric cancer remains one of the most fatal cancers, despite an intensive treatment regime of chemotherapy–surgery–chemotherapy. Peritoneal metastatic disease is commonly diagnosed post treatment regime and once established, patients are likely to die ... ...

Abstract	Gastric cancer remains one of the most fatal cancers, despite an intensive treatment regime of chemotherapy–surgery–chemotherapy. Peritoneal metastatic disease is commonly diagnosed post treatment regime and once established, patients are likely to die in 3–9 months. Systemic chemotherapy does not increase survival for these patients due to the poor vascularisation of this area. We are proposing the addition of pressurised intraperitoneal aerosol chemotherapy (PIPAC) to the treatment regime for curative patients as a preventive measure to reduce the risk of peritoneal metastases occurring.
Keywords	gastric ; pipac ; proof of concept ; Medicine ; R ; Specialties of internal medicine ; RC581-951
Language	English
Publishing date	2021-09-01T00:00:00Z
Publisher	De Gruyter
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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