Surgery

Devoy T, Smith N, Effect of sugammadex on the serum plasma levels of circulating oestrogens and progesterones in healthy females who take hormone contraception in the perioperative setting.
Locations: Wollongong Hospital.

Lab studies suggest that sugammadex can reduce plasma oestrogen and progesterone concentrations to the equivalent effect of 1 missed dose of the pill. However, there has been no investigations of this in real life patients.

Hegedus J, Gemmell-Smith M, Perioperative oral Paracetamol Administration and intraoperative IV paracetamol administration; potential cost and plastic waste benefits.
Locations: Wollongong Hospital.
External Partners: The University of Wollongong.

The peri-operative administration of paracetamol is associated with improved pain outcomes in surgical patients, however the IV administration of paracetamol intraoperatively is thought to be associated with increased plastic waste and is more costly than the alternative (oral paracetamol). Paracetamol can be administered as an oral premedication in surgical patients, with comparable outcomes and an excellent safety profile. It is the purpose of this project to collect data regarding the use of IV and oral paracetamol in elective surgical patients in the perioperative period at TWH to contribute to a collaborative audit. It is hypothesised that the pre-operative administration of oral paracetamol will be associated with decreased plastic waste and financial cost compared with IV paracetamol.

Myles P, Peyton P, Henderson G, Marriott A, Ward T, Bulach R, Tan N, Phillips B, Leslie K, Phan T, Bramley D, Bullingham A, Bennett M, Dieleman S, Corocoran T, Hillyard S, Herdy C, Miller A, Bartlett D, Gurunathan U, Pilling E, Campher M, Lee J, Correa P, Rouhani F, Paton J, Tranexamic acid to Reduce Infection after Gastrointestinal Surgery: the TRIGS Trial.
Locations: Wollongong Hospital.
External Partners: The Alfred Hospital, Austin Hospital, Ballarat Hospital, Geelong Hospital, Box Hill Hospital, Dandenong Hospital, Epworth Healthcare Richmond, Monash Medical Centre, Royal Melbourne Hospital, St Vincent's Hospital Melbourne, Western Hospital, Blacktown Hospital, Prince of Wales Hospital, Westmead Hospital, St John of God Hospital Subiaco, Rockingham General Hospital, Royal Perth Hospital, Caboolture Hospital, Gold Coast University Hospital, Mackay Base Hospital, Prince Charles Hospital, Princess Alexandra Hospital, Redcliffe Hospital, Royal Brisbane and Women's Hospital, Tweed Hospital.

Tranexamic acid is a lysine analogue that acts by blocking the lysine-dependent production of plasmin and resultant fibrinolysis. Plasmin has direct effects on immune function and inflammation, and we have compelling laboratory and clinical evidence demonstrating tranexamic acid may reduce infection risk in surgery. This multicentre, pragmatic, double-blind, randomised clinical trial will compare the incidence of surgical site infection and red cell transfusion requirements after IV tranexamic acid and placebo in patients undergoing gastrointestinal surgery.

Peyton P, Smith N, Kini R, Reduction of chronic post-surgical pain with ketamine - ROCKet Trial.
Locations: Wollongong Hospital.
External Partners: The University of Melbourne.

This trial examines the effect of perioperative intravenous ketamine on the incidence and severity of chronic post-surgical pain.

Smith N, McNamara P, Climbing a flight of stairs: Patient self-report compared to objective measurements.
Locations: Wollongong Hospital.

This project aims to identify whether patient self reported ability to climb a flight of stairs (FOS) correlates with objective measures, and whether self-reported or objective measures correlate with NIRS measures of leg muscle oxygen saturation. Patients from an anaesthetic pre-admission clinic will be asked to self report their ability to climb a FOS before having a NIRS device (non invasive way to measure muscle oxygen saturation) attached to their leg, and then climbing a flight of stairs. Additional parameters will be measured including Borg scale, heart rate and duration of exercise.

Smith N, Bonin C, Investigating postoperative renal function in a cohort of patients with severe obesity undergoing non-bariatric surgery.
Locations: Wollongong Hospital.

Obesity is known to be a risk factor for chronic kidney disease. The perioperative period is also a time of danger for people with impaired renal function. We have already recruited a group of patients with severe obesity for a study investigating the use of the six minute walk test (6MWT) as a method of preoperative assessment to predict postoperative functional outcomes. Preoperative renal function was collected as part of this study. We also collected information on the level of disability in patients, which has also not been previously investigated as a predictive tool for postoperative renal function. We found a high number of patients with previously undiagnosed impaired renal function. This has led us to investigate more details about renal function in this patient group.  We now propose to look at their postoperative renal function and relate this to their preoperative renal function.

Waldman B, Smith N, Lawson T, STOP: Smoking and quitting Throughout the peri-Operative Period.
Locations: Wollongong Hospital.

The proposed study will be the first to evaluate perioperative smoking and cessation trends since the release of the ANZCA and RACS position statements on perioperative smoking. It will also be the first to record both pre-operative and post-operative prescription of smoking cessation therapy for a cohort of patients.

Still A, Selak T, Putnis S, Brinton J, Australia and New Zealand Emergency Laparotomy Audit Quality Improvement.
Locations: Wollongong Hospital.

Approximately 15,000 patients need emergency laparotomies in Australia each year. International studies show that the standard of care provided varies significantly from hospital to hospital, as does the patient outcome. This project is an initiative to provide real-time data on the management of emergency laparotomies in Australia and New Zealand, to empower clinicians and hospitals to improve the quality of care provided to the vulnerable and sizeable cohort of patients who undergo this procedures.

Ashford B, Hewitt L, Impressions of a career in surgery. Reflections from retired surgeons. An observational study.
Locations: Illawarra Shoalhaven Local Health District.

Retired surgeons who are Australian or New Zealand will be asked to participate in an anonymous survey. The aim of this study is to categorise and describe the impressions/reflections from retired surgeons regarding their career in surgery. The results of this study will provide valuable insights into the training and education of junior surgeons.

Ashford B, Clark J, Wykes J, Yabe T, Hewitt L, Periosteum and PEEK. The potential viability of its use in head and neck surgery.
Locations: Illawarra Shoalhaven Local Health District.
External Partners: University of Wollongong, University of Sydney, Chris O'Brien Lifehouse.

The use of a periosteal flap with Polyetheretherketone (PEEK) in the setting of maxillofacial reconstruction is expected to reduce donor site morbidity significantly compared to the traditional vascularised bone graft such as fibula and scapula flap. However, this is currently untested. Our study aims to assess the viability to use the periosteum from the scalp, scapula, humerus, femur, sternum, tibia, and pelvis to wrap a PEEK prosthesis. We will assess a minimally morbid surgical approach to obtain suitable pedicled periosteal flaps on cadaveric specimens. This study will then enable a recommendation regarding further investigation into the use of PEEK covered periosteum as a customized bone fragment for use in Head and Neck Surgery.

Ashford B, Clark J, Wykes J, Yabe T, Seth I, Hewitt L, Vastus lateralis free flap for head and neck reconstructive surgery. An assessment of post-surgical donor site morbidity. Retrospective and concurrent study.
Locations: Wollongong Hospital.
External Partners: Chris O'Brien Lifehouse.

Studies have found that a section of vastus lateralis myofascial free flap (VLMFF) can be removed and is feasible to treat various disorders of the head and neck. No studies have demonstrated the prevalence of patients receiving VLMFF surgery and lower limb morbidity in receiving from this type of surgery. Identifying potential complications may assist in the prevention of various conditions e.g. patellofemoral pain syndrome, obesity, assisting in future early prevention and intervention. Identifying the number and types of patients receiving this surgery may assist in quantifying the impact of VLMFF use and patient health outcomes. Our aim is to determine the prevalence of patients receiving a VLMFF to reconstruct the head and neck in the Illawarra Shoalhaven Local Health District and to determine the association between patients who have had surgery and donor site morbidity (knee pain, decreased overall function and decreased lower limb strength/length/sensation).

Ashford B, Mourad A, Yabe TE, Wykes J, Pearson S, Utility of fine needle aspiration cytology as a diagnostic aid for parotid tumours.
Locations: Wollongong Hospital.

Parotid tumours are rare disease entities comprising less than 5% of all head and neck cancers. The pre-operative workup includes a thorough physical examination alongside directed imaging to better characterise the lesion and assess for any distant disease. While initially contentious, pre-operative Fine Needle Aspiration and Cytology (FNAC) has become a valuable ancillary that is advocated by several guidelines globally. The sensitivity and specificity of FNAC in predicting the final histopathology of parotid tumours has garnered much interest in recent years . There is however limited data on its utility in a contemporary Australian setting. In this study, we look to retrospectively evaluate parotidectomies performed across the ISLHD over the last 10 years. Using the eMR and MOSAIQ clinical systems, data on the FNAC and final histopathology for these patients will be extracted and the concordance between the two will be assessed.

Ashford B, Yu P, Spillance J, Selak T, Deng C, Hewitt L, Qian S, Song T, Mitchell J, An operating Theatrics: A Day in the Life of an Operating Theatre.
Locations: Wollongong Hospital.
External Partners: University of Wollongong, Illawarra Health and Medical Research Institute.

As the “financial hub” of any hospital, operating theatres (OT) are resource-intense, consuming about 40% of hospital running cost for the generation of up to 60% of the total gross revenue. Therefore, maximising OT efficiency is essential to maintaining an economically viable hospital. At Wollongong Hospital (TWH), an OT costs $7,000 in one hour. With 15 OTs running daily for 10 hours, from 8 am to 6 pm, the daily cost of OTs at TWH amounts to $1.05 million.   It is obvious that with the same level of quality of care, improving cost effectiveness of OTs is a universal objective for hospital management. This project is aimed at understanding the surgical patient journey through ethnographic field investigation. As there is a lack of baseline data about the activities a patient experience in journey through an OT in Australian hospitals, this proposed research is significant in contributing the essential baseline data. This data can be used to identify current problems in OT management, thus will has a significant impact on hospital administrators, providers, staff and patients. 

Ashford B, Hewitt L, Mitchell J, Yabe E, Factors associated with morbidity post reconstructive free flap surgery of the head and neck. An observational study.
Locations: Illawarra Shoalhaven Local Health District.

The aim of this study is to identify potential factors associated with morbidity post-reconstructive free flap surgery of the head and neck. It will be achieved via the medical record review of patients who underwent free flap reconstruction in ISLHD. 

Ashford B, Hewitt L, Mitchell J, Yabe E, Tkac S, Tan B, Donor-site morbidity following radial free flap reconstruction for head and neck surgical patients. An observational study.
Locations: Illawarra Shoalhaven Local Health District.

This study aims to investigate into post-operative donor site morbidity following radial free flap reconstruction for head and neck surgical patients. Modern advances in head and neck reconstructive surgery has expanded the horizons in terms of safe and effective treatment options surgeons can offer their patients, but with novelty comes a limited data on long-term safety. Our evaluation of donor site morbidity will aid in both clinician and patient’s decision-making process, and contribute to the body of research in this ever-expanding field of head and neck surgery. 

Beck M, Ashford B, Napaki SM, Appendicitis in the COVID-19 Pandemic.
Locations: Wollongong Hospital.

During the COVID-19 pandemic we noticed a reduction in the number of patients presenting to Wollongong Hospital for the assessment of suspected appendicitis. Recent research seems to confirm a drop in the number of cases of appendicitis during the pandemic, but the reasons for this change and the health outcomes of these patients remain unclear. To our knowledge, no previous Australian study has been carried out to examine the association between COVID-19 and appendicitis. If we know why the number of cases of appendicitis have changed, and the characteristics of these cases, we can better prepare for treating our patients during the pandemic.

Clark J, Charters E, Dunn M, Cheng K, Ashford B, Boehm J, Efficacy of Hospital-Based Manufactured Medical Device Restorabite for treatment of Trismus.
Locations: Wollongong Hospital.
External Partners: Chris O'Brien Lifehouse, Royal Prince Alfred Hospital.

Trismus is a restriction in jaw opening often experienced by people treated for head and neck cancer. Once onset begins, an intensive intervention program involving passive and active range and strengthening of jaw motion is required. The impact of trismus is long term dental problems arising from insufficient oral care, malnutrition due to swallowing problems and loss of income due to increased frequency of medical appointments and hospital admissions. Despite the serious consequences of long-term effects of trismus, research into an interventional passive and active stretching exercise is currently inadequate. There is currently an unmet need to develop a passive and active jaw stretching device that is biomechanically validated, safe, easy to use, and affordable for trismus patients. This project aims to evaluate efficacy of Hospital-Based Manufactured Medical Device Restorabite for treatment of Trismus.

Craig S, Yabe TE, Ashford B, Davis KJ, Stretch C, Bathe O, Validation of a novel prognostic gene assay for papillary thyroid cancer to improve appropriateness of care.
Locations: Wollongong Hospital, Shoalhaven District Memorial Hospital.
External Partners: University of Calgary.

Thyroid cancer is the 8th most common cancer by prevalence, and the incidence has been increasing by more than 6% per year since 1992. In 2021, there is projected to be over 1,600 new cases in New South Wales. Papillary thyroid cancer (PTC) is the most common thyroid cancer. PTC usually has a favorable prognosis with high cure rates. However, approximately 10-15% of PTC’s display a more aggressive behavior and are often resistant to conventional adjuvant therapies such as radioactive iodine. Although the current clinical systems have been validated in clinical studies, the proportion of variance explained is sub-optimal and accounts for only a small proportion of the uncertainty in PTC prognosis.   We have developed a novel algorithm that has identified 44 genes that most highly impact PTC prognosis. From these results, we have designed a practical clinical assay to help guide treatment decisions.

Hewitt L, Ashford B, Wykes J, Yabe T, Clark J, Steele L, Challita M, Dunn M, Donor site functional implications post head and neck surgery. An assessment of the use of the fibula free flap to reconstruct the head and neck. 
Locations: Illawarra Shoalhaven Local Health District.
External Partners: Chris O'Brien Lifehouse.

Head and neck patients are a complex cohort, many with multiple co-morbidities and health related issues. Functional deficits in the lower limb from the use of the fibula free flap may lead to a further deterioration of health due to the impacts of reduced exercise tolerance, reduced mobility, and increased carer or health service burden due to the possible increase in activity of daily living support requirements and functional decline. To provide an evidence for an alternative method, such as the use of PEEK as a customised bone, further investigation into the donor-site morbidity is required. The aim of this study is to investigate the functional impact on the donor-site morbidity after the use of the fibula free flap to reconstruct the head and neck. 

Hewitt L, Ashford B, Yabe TE, Mitchell J, Douglas C, Quality of Life impacts following head and neck surgery for advanced stage skin cancer.
Locations: Illawarra Shoalhaven Local Health District.

A recent scoping review of the literature concerning patients with head and neck cancer identified that prospective observational studies to evaluate clinically-relevant limitations were required. The current clinical practice guidelines for head and neck cancer include information regarding incidence, diagnosis, staging and risk assessment, treatment, evaluation and follow-up. Specific strategies to assess and manage quality of life outcomes are lacking. A robust evidence base needs to be established before rehabilitation practice guidelines can be developed to inform strategies regarding quality of life in head and neck cancer survivors. Further understanding the impact of this surgery on restrictions caused for these patients will enable clinicians to provide holistic follow-up and care options. This is an observational study which aims to investigate the Quality of Life impacts following head and neck surgery for advanced stage skin cancer.

Joseph K, Seth I, Lower K, Outmezguine J, Derflingher LP, Ashford B, Curtis K, Antibiotic vs. Surgical Management of Uncomplicated Acute Appendicitis in the Illawarra Shoalhaven Health District: a 20-year retrospective analysis comparing proportions and trends in management, 28-day readmissions, and length of stay.
Locations: Illawarra Shoalhaven Local Health District.
External Partners: Center for Health Research Illawarra Shoalhaven Population (CHRISP).

The aim of this study is to estimate the proportion of acute uncomplicated appendicitis cases that are treated with antibiotics only in the Illawarra Shoalhaven Health District, as well as compare the overall patient lengths of stay and 28-day readmission rates between those who undergo antibiotic and surgical management. Results will contribute to existing literature and help inform the optimal management of future acute appendicitis cases. 

Lee J, Boyer M, Ashford B, Wykes J, A Phase 0 Master Protocol Using the CIVO® Platform to Evaluate Intratumoural Microdoses of Anti-Cancer Therapies in Patients with Solid Tumours.
Locations: Wollongong Hospital.
External Partners: Chris O'Brien Lifehouse.

The research project is testing  potential new treatments for solid tumours by assessing local responses certain anti-cancer drug(s) have after very small amounts (microdoses) of these drugs are injected directly into tumours for which there is a scheduled surgical intervention.  The microdose injections are performed using the CIVO (Comparative In Vivo Oncology) device platform. The master study will consist of multiple substudies that will include specified investigational agents and combinations to be evaluated. This substudy is assessing a potential study treatment for head and neck cancer of an experimental drug called MVC-101. The tumour injection may include MVC-101, cMVC-101 (modified MVC-101), or nivolumab by themselves and as drug combinations (MVC-101 + nivolumab, cMVC-101 + nivolumab).  

Mordaunt D, Craig SJ, Davis KJ, Yu P, Thilakarathne N, Song T, Ashford B, Health pathway discovery, conformance and enhancement: appendicitis as an archetype.
Locations: Illawarra Shoalhaven Local Health District.
External Partners: University of Wollongong

This study will apply process mining (which uses machine learning) to clinical data from appendicectomies performed between 01 July 2010 and 30 June 2020 for patients presenting to ISLHD hospitals. This will produce appendectomy pathway models that represent an unbiased view of patient movements through the diagnostic and treatment process. Analysis of the discovered pathways will enable identification of the major areas of clinical variability, such as reasons for longer than usual treatment times to be explored, as well as reasons for deviations from standard treatment pathways, and will assist with identifying sources of unwarranted clinical variability. Results obtained will be able to be translated into a basis for data-driven, consensus-based clinical pathways thereby reducing unwarranted clinical variability and improving health outcomes for these patients.

Richardson A, Putnis S, Watson E, Ramsay A, Patel B, Jones M, Sutherland A, American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP).
Locations: Wollongong Hospital, Shoalhaven District Memorial Hospital.
External Partners: Coffs Harbour Health Campus, Queensland Children's Hospital, Coffs Harbour Hospital.

ACS NSQIP is a hospital based surgical quality improvement program that allows facilities to collect data on a variety of variables on all patients undergoing major procedures that meet program criteria. Data is collected in the pre-operative, intra-operative and post-operative phase up to 30 days post surgery and entered into the NSQIP database. Monitoring of surgical outcomes will highlight areas for improvement and change in service provision.

Wykes J, Clark J, Subramanian N, Charters E, Leung L, Tongue Reconstruction with Innervated Vastus Lateralis and Antero-Lateral Thigh Free Flap.
Locations: Wollongong Hospital.
External Partners: Chris O'Brien Lifehouse.

This is a study to determine tongue function (speech and swallowing) after removal for cancer and reconstruction using thigh muscle and reestablishing its nerve supply.

Yabe T, Ashford B, Wykes J, Balu S, Mitchell J, Hewitt L, Impact of geriatric services on head and neck surgery patients.
Locations: Illawarra Shoalhaven Local Health District.

This study aims to assess the effect of perioperative geriatric input on  elderly head and neck patients (75 years of age and above), and to make recommendations regarding the increased oncogeriatric service provision to head and neck surgical patients

Jaeger M, Ecroyd H, Identifying biomarkers of idiopathic normal pressure hydrocephalus in cerebrospinal fluid and brain tissue.
Locations: Wollongong Hospital.
External Partners: University of Wollongong, Illawarra Health and Medical Research Institute.

Idiopathic normal pressure hydrocephalus (iNPH) is part of the large group of neurodegenerative diseases affecting mainly the elderly population. Treatment of iNPH is surgical (insertion of a CSF Shunt). In clinical routine the correct diagnosis of iNPH and differentiation from other diseases, such as Alzheimer's dementia, is the key challenge and patients might undergo unnecessary operations or being unjustly withheld from effective treatment. The goal of this study is to investigate and search for biomarkers from cerebrospinal fluid and brain tissue of patients undergoing CSF Shunt insertion that might help to correctly diagnose iNPH, better understand disease mechanisms and help differentiate form other neurodegenerative disorders.

McLoughlin J, Hewitt L, Cherukuri R, Attewell L, Complications post elective neurosurgery. A local health district analysis.
Locations: Wollongong Hospital.

Outcomes from this study could potentially identify which patient type/surgery type is more at risk of getting a certain complication. This would mean that appropriately placed screening tools can be put into current practice in an attempt to either prevent the complication from occurring or put in place a strategy designed to mitigate the risk. 

Murambi R, Jaeger M, Chour H, Glenn D, The association of radiological features of idiopathic normal pressure hydrocephalous with intracranial pressure monitoring.
Locations: Wollongong Hospital.

This project aims to study the relationship between radiological features on MRI/CT imaging and physiological intracranial pressure monitoring parameters in patients with suspected idiopathic normal pressure hydrocephalus. 

Farey J, Harris I, Bhimani A, DISTINCT: Dual Mobility Versus Standard Total Hip Arthroplasty In Femoral Neck Fractures, A Registry-Nested, Cluster-randomised Trial.
Locations: Wollongong Hospital.
External Partners: The University of Sydney, Liverpool Hospital, the University of New South Wales, Nepean Hospital, Royal Prince Alfred Hospital.

Fractured neck of femur (FNF) is a common problem, affecting 25,000 Australians per annum. Total hip replacement (THR), which involves replacing the ball and socket of the hip joint, is the current standard of care for fractured neck of femur in community-dwelling patients with minimal co-morbidities.  However, despite superior pain and functional scores compared to the alternative treatment, partial hip replacement (hemiarthroplasty), THR exposes patients to an increased risk of prosthesis dislocation.  Prosthesis dislocation involves separation of the prosthetic head and acetabular cup, and may require a patient to undergo revision THR, a procedure associated with increased costs and morbidity. Dual mobility cups (DMC) are an alternative THR design in common use in Australia, and are hypothesised to reduce the risk of dislocation. This trial will compare the outcomes of standard THR versus DMCs in the FNF population.

Lower K, Moules S, Joseph K, Outmezguine J, Carillo-Hayley J, Anjum S, Curtis K, Retrospective analysis of patient and health services outcomes associated with use of intramedullary nail compared with sliding hip screw for the treatment of trochanteric hip fractures in a New South Wales Regional Local Health District.
Locations: Illawarra Shoalhaven Local Health District.
External Partners: Center for Health Research Illawarra Shoalhaven Population (CHRISP).

This study aims to evaluate patient and health services outcomes (30-day, 90-day and 12-month) associated with the use of intramedullary nail versus sliding hip screw for the treatment of trochanteric hip fractures. 

McNamara W, Dares M, The Orthopaedic Response to COVID-19: The Australian Experience.
Locations: Wollongong Hospital.

This observational descriptive study is designed to determine the key changes made in day to day functioning of orthopaedic departments in Australia that have been implemented in response to COVID-19. Currently, there is no guidelines for orthopaedic trauma services. It is expected that this study will identify key strategies used to promote social distancing, reduce hospital flow and ensure quality trauma services are continued. These findings would be used as a benchmark for international orthopaedic institutions and for similar situations in the future.

McNamara W, Dares M, The effect of COVID-19 on orthopaedic trauma in a tertiary institution.
Locations: Wollongong Hospital.

Since March 2020 our orthopaedic department has anecdotally noticed an increase in trauma volume and a change in trauma patterns. The study is a retrospective analysis designed to very if this anecdotal evidence is true. Outcomes of this study are important because they firstly identify high risk behaviours that can be broadcast to the community to avoid or prevent, it may direct governmental regulation formation to help prevent unnecessary traumas and it would demonstrate the essential role of orthopaedic trauma management in the setting of a pandemic that would attract funding and justify regular trauma lists.

Every J, Sideris A, Sarkis L, Lam M, MacKay S, Pearson S, Parathyroid gland autotransplantation as a strategy for preventing hypocalcaemia following pharyngolaryngectomy.
Locations: Wollongong Hospital.

This study aims to describe transient and permanent hypocalcaemia rates in patients undergoing total or partial pharyngolaryngectomy with preservation or autotransplantation of the parathyroid gland.

Every J, Sideris A, Miljkovic D, Do T, Jones A, MacKay S, Evaluating surgical and non-surgical mean disease alleviation scores in Obstructive Sleep Apnoea.
Locations: Wollongong Hospital.

This is the first project to utilise a score that incorporates both efficacy and compliance in surgical and non-surgical treatments of Obstructive Sleep Apnoea

Lindsay B, Sideris A, Sarkis L, Lam M, Mackay S, Modified Uvulopalatopharyngoplasty and radiofrequency-in-saline tongue channeling in the management of primary snoring.
Locations: Wollongong Hospital.

This study aims to determine the effect of modified uvulopalatopharyngoplasty and radiofrequency-in-saline tongue channeling upon simple snoring.

Jha P, O'Donnell J, McGlade D, Rodgers H, Villalba L, Leighton C, Robinson S, Sutton L, Nguyen T, VenaSeal Spectrum.
Locations: Wollongong Hospital.
External Partners: Sunshine Coast University Hospital.

This study is to evaluate adult patient's experience and clinical improvement after treatment with the VenaSeal system compared to standard surgical stripping of varicose veins. It will measure the patient's clinical improvement, ability to return to work, vein closure, patient experience and healthcare utilisation.