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Utilisation of Thiel embalmed cadavers to influence surgical performance in negotiating the vascular anatomy of the right colon and its variants in the resection of bowel cancer

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  • Full or part time
    Prof T Wilkinson
    Mr Kenneth Campbell
  • Application Deadline
    No more applications being accepted
  • Competition Funded PhD Project (European/UK Students Only)
    Competition Funded PhD Project (European/UK Students Only)

Project Description

Bowel cancer is the 4th most common cancer in the UK and the 3rd in Scotland, with colorectal cancer accounting for 12% (41,804) of new cancer cases in the UK (Cancer Research UK, 2015). Despite improvements in chemotherapy and radiotherapy, surgery is the primary form of treatment, with early identification leading to far better outcomes. It has been demonstrated previously for rectal tumours that Total Mesorectal Excision, involving meticulous surgery with careful dissection of the lymph nodes accompanying supplying blood vessels and strict following of the embryological planes, led to greatly improved rates of cure. This approach is now embedded in clinical practice, transforming the outcome of rectal cancer.

There is a growing concern that the same level of attention has not been applied to cancers in the rest of the colon. Outcomes of right sided bowel cancer in particular have remained poor since the 1980s and are now worse than cancers of the rectum, with evidence of a shift in incidence both in location (to the right colon) and to a younger age group. Also, the accessibility of the right colon has led to a perception of right colon surgery as being less challenging and therefore safely left to less specialised surgeons. A more extensive surgical approach than current practice has been suggested, involving Complete Mesocolic Excision (CME) with Central Vascular Ligation (CVL). This technique, together with the much wider anatomical variation found in this part of the colon, demands a greater level of surgical complexity and good anatomical awareness; it therefore has potentially higher risks, especially with minimal access techniques.

There is emerging evidence that simply adopting this technique without a comprehensive reappraisal of the anatomy and gain of specific technical expertise will lead to increased rates of injury, especially to the vascular structures.

The overall aim of this project is to determine whether a simulated training environment using Thiel embalmed cadavers can be created which is sufficiently realistic to allow surgeons to prepare for and train to perform CME with CVL procedures for cancers of the right colon, including the use of minimal access (laparoscopic) surgery.

Objectives:
• to investigate the pattern and incidence of colon cancer in the Tayside population (epidemiological study).
• to investigate anatomical variation in vasculature of the right and left colon in the body donor population of Tayside (anatomical study)
• to develop and test the Thiel cadaveric model as a training tool for CME and CVL surgery using contrast injection and cross sectional imaging techniques to create arterial and venous reconstructions of the blood supply of the right colon prior to surgery (imaging and surgical stimulation study)

Candidates must be UK/EU students and MUST have an undergraduate and/or Master’s degree which includes experience of full body gross anatomical human dissection. Applicants who do not have such experience will not be considered for the scholarship.

An essential part of the remit of the Greenhouse Research Studentship Programme is that successful applicants are required to teach in the dissecting room throughout semesters 1 and 2 and to assist with other classes as and when required.

Funding Notes

The studentship will commence in January 2020. The 2019/2020 tax free stipend for the scholarship is £15,009 p/a.

Candidates are requested to:
(i) submit their full CV,
(ii) indicate which of the two projects they wish to apply for,
(iii) provide a one page A4 summary of their suggestions for developing their research project choice.

Applications should reach Dr. Craig McKenzie ([Email Address Removed]) by midnight, 13th October 2019. Please do not use the ‘Email Now’ function as your application may not reach the correct department by the deadline.

Shortlisted applicants will be called for interview in week commencing 4th November 2019.



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