In-service training

The unit is actively involved in both basic and specialty surgical training. Basic surgical trainees spend approximately 6 months of their training programme (M.S General Surgery) in Surgery – Unit II. During this period they will be exposed to all aspects of the specialty including diagnosis, investigation, multidisciplinary planning, post operative care, continuing outpatient management and surveillance. The trainee will be also be exposed to a variety of colorectal surgical operations as an assistant and trained to perform some of these operations.

The unit runs a 2 year Post-doctoral Fellowship, tailored to train surgeons in the specialty of colo-rectal surgery. The fellow will be trained in all aspects of the specialty including diagnosis, investigation, multidisciplinary planning, execution of various surgical procedures, post operative care and continuing outpatient management and surveillance. The fellow will be exposed to a variety of colorectal surgical operations including laparoscopic colon and rectal resections, trans-anal resection of low rectal lesions, sphincter preserving resections for low rectal cancer, anal sphincter reconstruction and restorative procto-colectomy with ileal pouch anal anastomosis. The fellowship also includes training to perform colonoscopy and anal manometry. Fellows will be required to maintain a log of all diagnostic procedures and surgical operations they are involved in.

Continuing Medical Education

The unit conducts a Continuing Medical Education (CME) programme once in two years.  Each of these has focussed on a particular aspect of colorectal disease and surgery. These are targeted at trained surgeons who wish to update themselves. Both national and international faculty participate in these programmes.

• 2004    Colorectal cancer
• 2006    Laparoscopic colorectal surgery
• 2008    Inflammatory bowel disease
• 2010    Disease of the pelvic floor
• 2012    Changing concepts in management of colorectal cancer
  
  

 The following faculty have participated in our CMEs over the years:

Audit

There is one half day session a week devoted to audit and academic activity. The faculty and trainees are actively involved in scientific research and encouraged to present the work done in the unit at conferences and publish in peer reviewed journals.  A system of documentation of all operations is in place along with internal and external audit of all adverse events and post operative complications and mortality.  The unit also maintains a database of all patients with colon and rectal cancer who have had their treatment at CMC, Vellore and audits treatment outcomes once a year.

Research

The unit is actively involved in research, both in the field of general surgery and colorectal surgery. Research activities include both clinical and basic molecular research.

The following are some of the research projects that the unit is involved with:

• Rectal Cancer in India: Outcomes based on protocol based management
• Role of bone marrow stem cells in perianal wound healing after radiation therapy – along with the department of Hematology
• Midline versus transverse incision for right, left hemicolectomy and segmental colectomy: A randomized control trial
• The role of drains in pelvic surgery – a randomized controlled trial
• Effect of Radiation therapy on anal sphincter function
• Occult obstetric anal sphincter injuries in primiparous women: Incidence and outcomes in Southern India - along with the department of Radiodiagnosis and Obstetrics and Gynecology
• Tuberculous fistula in ano : Current gold standard for diagnosis
• Effect of fistula surgery on the anal sphincter complex and continence – a prospective study
• Effect of preoperative carbohydrate loading in colorectal cancer – a randomized controlled trial
• Rod vs. no rod in loop colostomies :  A randomized controlled trial
• Use of topical GTN in trans anal stapled anastomosis : A randomized controlled trial
• Use of normal saline wound wash in colorectal surgery : A randomized controlled trial

PUBLICATIONS