Paediatric Surgery

About Paediatric Surgery Research

What is the role of Hedgehog (Hh), a group of genes involved in mammalian embryogenesis and cancers, in gut healing, tissue engineering and stem cell therapy? Developing genetic screening of patients with bladder exstrophy (a congenital disease whereby baby is born with its bladder exposed to the exterior) to improve our understanding of the disease, it may also usher in new therapy to the disease.

These are the kinds of research projects our team are working on to improve the outcomes of paediatric surgery.

Paediatric surgery projects

Proposed projects currently in the design and feasibility stages

  • Randomised controlled trial examining the incidence of intra-abdominal abscesses (IAA) following either laparoscopic or open appendicectomies.
    • Comparison of the modality of appendicectomy on the incidence of IAAs following either laparoscopic or open appendicectomy in children.
    • Concerns as Cochrane review have suggested an increase association in adult populations.
    • Study protocol written and power calculation performed. In the process of finalisation and also ethical approval.
    • 3 centers have signed up for the trial provisionally although launch of the trial will be delayed until completion of other appendicitis trials.
    • Researchers: Ram Nataraja and local representatives once centers are recruited.
  • Development of a simulation programme involving both the patient journey and consent process in Paediatric Surgery.
    • Project combined with Prof Nestel (Simulation Professor at Monash University) and also with Paediatric Surgeons at the Royal Children’s Hospital.
    • The initial project will center on the translation of a simulation programme in the consent process to improve patient and parental outcomes.
    • Recruitment of paediatric surgical junior staff from both sites into the trial.
    • Will aim to launch the trial over the next few months.
    • Researchers: Ram Nataraja, Warwick Teague and Prof Debra Nestel.
  • Clinical outcomes of congenital diaphragmatic hernia patients and patch predictive score.
    • Retrospective trial between Monash Children’s Hospital, The Royal Children’s Hospital and also Chelsea Children’s Hospital in London.
    • Primary outcomes include the clinical course, recurrence and also mortality for CDH in both minimally invasive and open surgical groups.
    • Secondary outcome includes the use of regression analysis to identify factors that can pre-operatively predict the need for a patch repair.
    • This would aid the selection of patients suitable for a thoracoscopic congenital diaphragmatic repair.
    • Trial in the stages of data collection and interim analysis.
    • Researchers: Ram Nataraja and Warwick Teague.
  • Validation trial of eoSim Laparoscopic Bench trainer in medical students.
    • Study looking at laparoscopic skill acquisition and also retention in medical students at Monash University with an interest in surgery. Both content and construct validity will be assessed.
    • Basic laparoscopic skills will be assessed and also impact of a targeted simulation programme on skill acquisition.
    • Trainer will also have VR-type metrics to examine the economy of movement and other parameters.
    • Laparoscopic expert skill scores will be obtained with task completion by expert laparoscopic surgeons completing the task.
    • Funds have been acquired for purchase of initial bench trainers to start a pilot study.
    • Researchers: Ram Nataraja

Ongoing projects

  • Does Peritoneal Lavage Influence the Rate of Complications in Paediatric Laparoscopic Appendicectomy? A Prospective Randomised Trial.
    • Research project comparing the use of a directed washout following laparoscopic appendicectomy in complicated appendicitis versus directed suction.
    • Complicated appendicitis is defined as the presence of free intra-abdominal pus at the time of surgical intervention.
    • Currently recruiting patients to adequately power the trial
    • Researchers: Peter Ferguson and Ram Nataraja.
  • Are post-operative antibiotics indicated in simple appendicitis? A Prospective Randomised Trial.
    • Research project comparing the use of a single dose of intravenous antibiotics versus a longer course following laparoscopic appendicectomy in simple appendicitis.
    • Simple appendicitis is defined as the presence of acute appendicitis without the presence of a perforation or intra-abdominal pus.
    • Researchers: Nicole Mennie, Peter Ferguson and Ram Nataraja.
  • Presence of viable Germ Cells in testicular remnants: Is Routine Excision Indicated? A Systematic Review
    • Systematic review protocol published by PROSPERO (CRD42013006034).
    • Review examining the evidence whether there is a clinical need for the excision of testicular remnants in testicular regression syndrome to prevent future potential malignancy risk.
    • Currently in the final stages of the review process.
    • Researchers: Ram Nataraja and Chris Kimber.