Ms Michelle Choynowski, currently a final year medical student at NUI Galway, has garnered national attention for being the youngest William O’Keeffe lecturer at the XXVIth Waterford Surgical October Meeting earlier this month – an honour typically given to surgical registrars and those undertaking postgraduate training in surgery. Her lecture, titled ‘Re-excision in breast-conserving surgery – a surmountable challenge?’ gave recommendations to reduce re-excision rates and was presented to surgeons travelling from within Ireland, the UK and the USA, including the Gordon Watson lecturer, Dr James O’Connor, who is the Chief of Thoracic and Vascular Surgery & Intensive Care at the second ranked trauma centre in the USA.

Ms Choynowski was invited to give the William O’Keeffe lecture after winning the William O’Keeffe award for best original research at last year’s conference. The prize-winning oral presentation, titled ‘Variability following positive margin breast-conserving surgery: a meta-analysis’, was performed under the supervision of Mr Michael Sugrue, Consultant general and breast surgeon at the Letterkenny University Hospital. Her research, funded by community donations from the North West, confirms the variability in re-excision rates worldwide and the need for international consensus guidelines to better manage patients undergoing breast-conserving surgery and prevent additional operations causing emotional distress, poorer oncological outcomes and further economic implications.

Ms Stephanie Vincent also presented her original research, carried out at Breast Centre North West-Letterkenny University Hospital in conjunction with the Donegal Clinical Research Academy, at this prestigious national meeting. Her study on ‘The Keys to Optimising Breast Wounds: A Meta-analysis’ aims to develop an evidence-based wound care bundle following meta-analysis identifying key risk factors and interventions for breast surgical site occurrences. Adopting a breast wound care bundle may streamline care and help reduce potential complications and cost.

Photo from left to right (Dr Gordon Watson, Ms Michelle Choynowski, Ms Stephanie Vincent and Mr Michael Sugrue) at the XXVIth Waterford Surgical October Meeting.

Mr Michael Sugrue, Nobel Laureate Professor William Campbell and Mr Zsolt Bodnar (new Consultant Surgeon) discussing Donegal Clinical Research Academy and on-going research at the Letterkenny University Hospital.
Professor Campbell is very supportive of developing research opportunities at the Hospital.

Research work carried out at Breast Centre North West by Ms Alison Leong (Research Medical Student) was a Highly Commended Entrant in The Undergraduate Awards of 2016. Her paper, entitled "Variations in Abnormal Nipple Discharge Management in Women- a Systematic Review and Meta-analysis" performed in the top 10% of all submissions in the Medical Sciences category 2016 programme; this identifies her as an outstanding academic at the international level. This year the Awards received 5,514 submissions from students in 243 universities across 40 countries. Alison will now attend the Undergraduate Awards Global Summit, a unique invitation-only event that will gather all the international Highly Commended Entrants and Winners together in Dublin, Ireland for a 3 day event.

Critical Surgical Abdomen Conference July 22-26th 2016

(Note: Click images for full brochures)

World leaders in Emergency Surgery will meet in Dublin and Donegal on July 22nd to July 26th to describe new advances in the management of Emergency Surgery in patients with critical abdominal infections. 

A conference to be held over 2 days in Dublin at the Royal College of Surgeons in Ireland has a faculty of 40 World Leaders. The World Society of Emergency Surgery, in conjunction with the World Society of the Abdominal Compartment Syndrome, have put together an exciting consensus meeting.
Followed by this 2 day Dublin meeting for the first time in the World consensus regarding resources for the management of Emergency Surgery patients will be outlined. The Donegal Emergency Surgery Summit has published a comprehensive discussion document outlining suggested requirements for resources ensuring to help in improving outcomes.
The conference co-convenor, Mr Michael Sugrue- Surgeon, said he was delighted to be able to host this meeting in Ireland reflecting on our long respected surgical history and our significant workload in Emergency Surgery. He was grateful for support from Letterkenny University Hospital and Donegal Clinical Research Academy for facilitating the summit with delegates from over 40 countries coming to Ireland and also Donegal.
Professor Luca Ansaloni from Bergamo, Italy, current President of the World Society in Emergency Surgery believes that the guidelines produced in Dublin and Donegal will help Clinicians who treat Emergency patients.
Professor Ron Maier, President Elect of the American College of Surgeons who co-edits Resources for Optimal care in Emergency Surgery said this was an important step forward and while not prescriptive acts as a discussion document to advance surgical care. This Summit, organised by Donegal Clinical Research Academy and supported by the Royal College of Surgeons of Ireland, the World Society of Emergency Surgery, HSE, and many International affiliated societies, will stress the importance of early management of the Emergency Surgery patient.

To finish the 4 days the World Leading Emergency Surgery training course will be held in Donegal with an International Faculty of 25 Surgeons. This is an exciting opportunity for those wishing to up skill in the key aspects of Emergency Surgery Care. This course, designed in Donegal in 2012, has now gone global; the course is run in Europe, South America, Asia and next year North America. Mr Michael Sugrue was proud that this Irish Course is now regarded as the World leading Emergency Abdominal Surgery Course. He feels it reflects well on the level of care provided in Ireland and the ability to collaborate with International Colleagues with co-edit resources for critical Emergency Surgery from around the globe.
Professor Catena from Italy is delighted that the World Society of Emergency Surgery are coming to Ireland and feels that guidelines from this conference will save many lives. Professor Ernest Moore on the organising committee will receive an honorary Fellowship of the Royal College of Surgeons in Ireland. Professor Moore stated that to develop indicators in Emergency Surgery is pivotal to monitoring outcomes and he has been involved in this in Trauma Surgery for over 2 decades.

Media Contact
Michael Sugrue Co Convenor Meeting Consultant Surgeon +353 87 7614906

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Saolta Newletter Issue #26

Research from the Breast Centre North West-Letterkenny University Hospital in conjunction with the Donegal Clinical Research Academy was recently presented at the 24th Sylvester O’Halloran Scientific Symposium. Mary Gallagher, a 4th year medical student, identified significant variation worldwide in the completeness of breast cancer excision at the first index operation the patient undergoes. On average one fifth of ladies having breast cancer surgery around the world have to return for re-excision. Breast Centre North West and Letterkenny University Hospital have achieved consistent results of less than 10% of patients having to undergo second and further surgery. This reduced re-excision rate is a result of teamwork within the Unit, combining a number of novel techniques developed at the Hospital and in conjunction with Radiology and Pathology. It benefits the patients and reduces resource requirements. 

Mr Kin Ng, Senior Registrar at LUH, identified novel techniques to assist in reducing the amount of breast tissue excised. Mr Michael Sugrue, Consultant Breast and General Surgeon, said that this is very exciting and will allow us to determine patients’ views of outcomes.
Two other 4th year medical students, Alison Leong and Adrinda Affendi, also presented their work at the meeting. Alison’s poster presentation was a meta-analysis of nipple discharge probabilities and diagnostic accuracy of investigations. The variability of breast implant loss from implant-based reconstruction surgery was the topic presented in Adrinda’s poster. All of the 4th year medical students were summer research fellows at the Unit and their posts were funded through local contributions from people in the North West.

Click here to download a flyer for the 10th Emergency Abdominal Surgery which is due to take place on April 1st, 2016.

Nobel prize winner supports DCRA

Ramelton, County Donegal, is a beautiful heritage village located just 12km from Letterkenny University Hospital/Donegal Clinical Research Academy. It is the birth place of William C Campbell who was jointly awarded the 2015 Nobel Prize in Physiology and Medicine for discoveries concerning a novel therapy against infections caused by roundworm parasites. Professor Campbell is a supporter of the on-going development of Donegal Clinical Research Academy.

Photo: Courtesy www.independent.ie

The 10th Emergency Abdominal Surgery Course run by Donegal Clinical Research Academy was held in Royal College of Surgeons of Ireland in Dublin on April 1st 2016. The 100 doctors who attended were treated to 9 international world leaders in Emergency Surgery from 3 continents. These included Professors Marja Boermeester-Amsterdam Holland, Rangjith Ellawala-Colombo Sri Lanka, Paula Ferrada-Richmond USA, Tina Gaader-Oslo Norway, Yoram Klein-Tel Aviv Israel, Hayato Kurihara-Milan Italy,Carlos Mesquita-Coimbra Portugal, Selman Uranus-Gratz Austria and Pantelis Vassiliu-Athens Greece.

The international key note speakers were complemented by 8 Irish Surgeons, Radiologists and Gastroenterologists including Professor Calvin Coffey-University Hospital Limerick, Professor Simon Cross-Waterford University Hospital, Professor Ronan O’Connell-St Vincent’s University Hospital, Dr Barry Kelleher-Gastroenterologist-Mater Dublin, Dr Leo Lawler-Radiologist-Mater Dublin, Mr Ken Mealy-Surgeon Co-Lead Acute Hospital Program, Dr Siobhan McGrane- Radiologist Limerick, Dr Chris Steele-Gastroenterologist Letterkenny University Hospital.

The participants, mostly from Ireland but some from Italy, raved about the course and the manner in which it was delivered. As one surgical trainee stated “Never been at such an excellent meeting, perfect organisation! Thank you”. The course was attended by a small number of nurses which Mr Sugrue feels is so important in selecting the team approach to care.

Mr Michael Sugrue from Letterkenny University Hospital, who developed and chaired the course, was proud that such an initiative (now in its 4th year) was leading emergency surgery care training around the world. The course was first run in Letterkenny in 2012; it will run this year in Asia, South America and next year in North America. Mr Sugrue said he would love to be able to run the course in the Donegal Clinical Research Academy’s newly designed auditorium, which has planning permission but needs further capital funding before it can proceed.
The Chair of Donegal Clinical Research Academy Trust Henry McGarvey said it will improve outcomes for those attending with acute abdominal conditions, such as appendicitis, gall bladder disease and bowel cancer.
The next course will be held in Donegal on July 25th where remarkably 40 of the world leaders in surgery will come to the North West.

Almost there, A beacon of light!

NUI Galway Medical Academy at Letterkenny, December 2015. This modern campus is getting excitedly close to completion. Our medical students, who are such integral and participatory components of life in Letterkenny University Hospital, will soon have a ‘state of the art’ building within which they will have great facilities to help consolidate their learning.

Letterkenny University Hospital’s 4th Annual Multidisciplinary Research Symposium was held on Friday 27^th November 2015. It was a hugely successful event showcasing the extensive range and quality of multidisciplinary clinical research being undertaken at the hospital. The judging panel had a tough job adjudicating as the calibre of research presented on the day was of an extremely high quality.

Two invited guest speakers delivered stimulating lectures on their specialist areas.  Dr Sam Huddart, Consultant Anaesthetist NHS Foundation Trust, Redditch UK, gave a stimulating talk on ‘Quality improvement and emergency laparotomy. Dr Petrousjka van den Tol, a Consultant Breast Surgeon from the University Hospital of Amsterdam Holland, shared her work on ‘New developments in Dutch Breast Cancer Surgery’. All the prizewinners (pictured below) were presented with their medals by Dr Sam Huddart and Dr Petrousjka van den Tol. 

Pictured: Mary Byrne, NUIG,
receiving her 1^st place medal for best medical students’ oral presentation. Mary’s research, centred on the bacterium-Yersinia entercolitica, was entitled ‘Is Yersinia entercolitica as a cause of community-acquired diarrhoea in the west of Ireland underdetected? A comparison of selective culture and molecular detection.

Pictured: Dr Sinead O’Gorman, Consultant in Emergency Department, accepting the 1^st place medal for best medical students’ poster presentation on behalf of Eoin Farrell. Eoin’s poster related to the ‘Development of a model to predict bed requirements for patients requiring admission from the Emergency Department’.

Pictured: Dr Ashfaque Memon - Reg with Dr Miranda receiving his 1^st place medal for best NCHD oral presentation. Dr Memon’s research was on ‘Thromboprophylaxis in patients with atrial fibrillation admitted by the medical team’. Best poster in the NCHD category went to Dr Michael Casey- SHO with Dr Keatings- who carried out an audit on emergency oxygen administration in Letterkenny University Hospital.

Pictured: Alison Johnston, Research Nurse at Breast Centre North West, accepting the 1^st place medals for best Allied health professionals’ oral and poster presentations. Alison presented the results of a research project carried out at Breast Centre North West, this study looked specifically at evaluating the current assessment and screening of primary relatives of breast cancer patients.

Letterkenny University Hospital’s re-excision rate in conservative breast cancer is one third the national average. A low re-excision rate must be a balance between oncological, functional and cosmetic outcomes. Better Outcomes for Breasts (BOBs Project) is a new exciting, objective patient-outcomes monitoring tool developed at the Breast Unit. The breast nurse specialist Geraldine MacGregor and Alison Johnston, research nurse, were delighted that their poster describing the development of this new outcomes tool in women undergoing breast conserving surgery  was 1^st place winner in the Allied health professionals category.