Endocrine Surgical Unit, Royal North Shore Hospital
The University of Sydney Endocrine Surgical Unit has been in existence for over 50 years. Initially started as the Unit of Clinical Investigation by Professor Frank Rundle in 1950, the unit was at the forefront of thyroid investigation and thyroid surgery having been responsible for the introduction of radioiodine for investigation and treatment of thyroid cancer.
When Professor Tom Reeve joined the unit in 1957, he commenced a database which now has documentation of every aspect of over 18,000 thyroid, parathyroid and adrenal procedures performed in the Unit. In the first year of data collection (1957), only 20 thyroid procedures performed by one surgeon in one hospital were entered, whereas in the most recent year (2006), 1092 major endocrine procedures (761 thyroid procedures, 298 parathyroidectomies, 33 abdominal endocrine procedures) performed by 3 surgeons in 10 separate hospitals required entry. As well as providing for surgical audit, the database has been integral to the writing of 130 published articles and articles on the topic of thyroid, parathyroid or adrenal surgery. Such publications have been integral to significant changes in endocrine surgical practice worldwide, such as the introduction of total thyroidectomy for multinodular goitre with one of the very first papers ever on the topic published by the Unit in 1987.
Audit based research, with accumulation of data based on surgical outcomes, remains the fundamental basis of sound surgical practice. The other hallmark of an academic surgical unit is being at the forefront of clinical practice and innovation. The operating room is the academic surgeon’s research laboratory, requiring a significant commitment to maintaining high levels of clinical activity in order to pursue meaningful clinical research studies.
The University of Sydney Endocrine Surgical Unit is the largest and most active centre for endocrine surgery in Australia. The nature of endocrine surgery has undergone major changes over the past decade. On one hand, the advent of minimally invasive techniques has seen increasing numbers of procedures performed undertaken using this approach including laparoscopic adrenalectomy, minimally invasive thyroid surgery (MITS) and minimally invasive parathyroidectomy (MIP). This has, for example, been associated with an exponential increase in the numbers of parathyroid cases undergoing surgery overall. On the other hand, a more complete surgical approach to the management of thyroid cancer has seen a similar exponential increase in the numbers of selective cervical lymph node dissections being performed, either prophylactically as part of the initial therapy, or as part of follow-up for ultrasound detected local recurrence. In all these areas , particularly the development of new minimally invasive procedures, the University of Sydney Endocrine Surgical Unit has been a leader at an international level.
Current academic staffing of the unit is:
- Leigh Delbridge BSc(Med) MD FRACS – Professor of Surgery and Head of Unit
- Stan Sidhu MBBS PhD FRACS – Clinical Associate Professor of Surgery
- Mark Sywak MBBS FRACS – Clinical Lecturer