Alternative Insufflation Gases For Laparoscopic Surgery
Funder
National Health and Medical Research Council
Funding Amount
$227,036.00
Summary
It is now recognised that laparoscopic (keyhole) surgery for cancer can be associated with the spread of tumour to surgical wounds, i.e. port sites. However, whether this is more likely following laparoscopy than conventional open surgery is controversial. Isolated case reports and the recent results of experimental studies suggest that the problem is important. Previous studies suggest that carbon dioxide gas used to inflate the abdomen during laparoscopy may be the specific cause of this probl ....It is now recognised that laparoscopic (keyhole) surgery for cancer can be associated with the spread of tumour to surgical wounds, i.e. port sites. However, whether this is more likely following laparoscopy than conventional open surgery is controversial. Isolated case reports and the recent results of experimental studies suggest that the problem is important. Previous studies suggest that carbon dioxide gas used to inflate the abdomen during laparoscopy may be the specific cause of this problem. A four to fivefold increase in the rate of cancer spread has been shown in previous experiments, and this can be reduced by using an inert gas such as helium. We propose to further investigate this issue using a combination of small and large animal models, and will also commence clinical trials of helium during clinical surgery. These studies aim will determine the gas of choice during laparoscopic surgery. They will also clarify advantages demonstrated for the use of helium in previous animal studies, and better investigate the safety of helium use. If our preliminary findings are supported by these studies, helium (or other inert gases) should be considered for routine use during clinical laparoscopy.Read moreRead less
Reevaluation Of The Anatomy Of The Human Lymphatic Vessel Network
Funder
National Health and Medical Research Council
Funding Amount
$539,750.00
Summary
The mode of spread of cancer cells from a primary tumour to other parts of the body is still not completely understood, although the lymphatic system is known to be important in this process. Lymph vessels are tiny transparent channels that form a network over the entire body. They transport tissue fluid to regional lymph glands in the neck, armpits, groin, chest and abdomen where the immune response maybe initiated to combat foreign agents such as bacteria and cancer cells. Current knowledge of ....The mode of spread of cancer cells from a primary tumour to other parts of the body is still not completely understood, although the lymphatic system is known to be important in this process. Lymph vessels are tiny transparent channels that form a network over the entire body. They transport tissue fluid to regional lymph glands in the neck, armpits, groin, chest and abdomen where the immune response maybe initiated to combat foreign agents such as bacteria and cancer cells. Current knowledge of the anatomy of these tiny vessels is based on work done by Sappey more than a century ago. There is an urgent need to update this work as many of his conclusions have been found to be inaccurate. We will use our pioneering methods of microsurgical tissue transfer- now being used worldwide - and our extensive experience in delineating fine channels, to address some of the basic questions about the anatomical pathways of spread of cancer. We hope to discover for example: why cancer on one side of the back can spread to glands in the opposite groin or armpit, thought by Sappey to be impossible; why cancer on one side of the tongue can spread to lymph glands on the opposite side of the neck; and why there is sometimes swelling of the limbs following lymph gland ablation by surgery or radiotherapy of glands in the groin or armpit. Currently it is thought that the only major connections with the venous system are at the base of the neck. Our initial work has shown unexpected connections with blood vessels in the periphery and unreported lymphatic vessel pathways between the skin and deep tissues. The results of this research will give information that will aid in localizing and treating the spread of malignancies and will underlie future treatment of obstructed lymph vessels that are the cause of painful, disabling swelling (lymphoedema) of the limbs.Read moreRead less
The Implementation Of MinimAlly INvasivE Hysterectomy (IMAGINE) Trial
Funder
National Health and Medical Research Council
Funding Amount
$656,854.00
Summary
Hysterectomy is the most common surgical [procedure among Australian women. Too many women still receive an open abdominal surgery, because too few Australian obstetricians and gynaecologists practice laparoscopic hysterectomy. This partnership will develop a model to systematically train practicing surgeons in advanced laparoscopic techniques. If successful, the model can be rolled out state and nationwide and also adapted for teaching future innovations in surgery.
Australasian Randomised Clinical Trial Comparing Laparoscopic And Open Surgical Treatment Of Colon Cancer: Follow-up.
Funder
National Health and Medical Research Council
Funding Amount
$233,000.00
Summary
Colon cancer is one of the most common solid tumours in western society. The usual initial treatment is excision of the cancer by an operation done through a cut down the midline of the abdominal wall. Over the past 15 years, minimally invasive technology has changed the approach to many surgical operations. A good example of this is an operation to remove the gall bladder. This is now routinely done using a laparoscope (telescope) which is introduced at the umbilicus. An image on a video screen ....Colon cancer is one of the most common solid tumours in western society. The usual initial treatment is excision of the cancer by an operation done through a cut down the midline of the abdominal wall. Over the past 15 years, minimally invasive technology has changed the approach to many surgical operations. A good example of this is an operation to remove the gall bladder. This is now routinely done using a laparoscope (telescope) which is introduced at the umbilicus. An image on a video screen of the gall bladder is then used to guide instruments to remove the gall bladder without making a large incision in the abdominal wall. This is called a laparoscopic cholecystectomy. The safety of a laparoscopic assisted approach in the removal of colon cancer is yet to be determined. This study will compare the long term and short term outcomes of people who have colon cancers removed whether by laparotomy ( a cut in the midline of the abdominal wall) or by a laparoscopic assisted approach (telescope).Read moreRead less
Regulation Of Adult Colonic Crypt Homeostasis And Activation Of Colon Cancer Metastasis Genes By C-Myb
Funder
National Health and Medical Research Council
Funding Amount
$666,116.00
Summary
Regulation of normal colon biology and activation of genes involved colon cancer The c-myb gene is essential for the normal biology of the blood system and the colon. This gene is involved in regulating the balance between the production of new cells and their timely removal once they have completed their assigned tasks. There is a large body of evidence that supports the role of c-myb in the regulation of the blood system. We believe that the rules that govern the production of the huge number ....Regulation of normal colon biology and activation of genes involved colon cancer The c-myb gene is essential for the normal biology of the blood system and the colon. This gene is involved in regulating the balance between the production of new cells and their timely removal once they have completed their assigned tasks. There is a large body of evidence that supports the role of c-myb in the regulation of the blood system. We believe that the rules that govern the production of the huge number of cells needed to have a healthy blood system are similar if not identical to the rules used by the colon. This is because the colon also produces a massive number of cells each with special tasks and a defined life span of a few days. It is this rapid expansion of cell numbers and the programmed short life span of cells that necessitates multiple controls and very tight regulation. Furthermore if this process is hijacked by genetic changes that undermine these controls then there are numerous opportunities to initiate and potentiate malignant change or cancer. This project examines the role of the same genes in two contexts. Firstly when the genes are expressed at normal, highly regulated levels associated with the normal biology of the colon. The second context is when these genes are permitted to be over-expressed and thus drive processes for longer or in inappropriate situations leading to malignant growth.Read moreRead less
AUSTRALASIAN MULTICENTRED PROSPECTIVE RANDOMISED STUDY OF LAPAROSCOPIC VS CONVENTIONAL SURGICAL TREATMENT OF COLON CA
Funder
National Health and Medical Research Council
Funding Amount
$495,000.00
Summary
Colon cancer is one of the most common solid tumours in western society. The usual initial treatment is excision of the cancer by an operation done through a cut down the midline of the abdominal wall. Over the past 10 years, minimally invasive technology has changed the approach to many surgical operations. A good example of this is an operation to remove the gall bladder. This is now routinely done using a laparoscope (telescope) which is introduced at the umbilicus. An image on a video screen ....Colon cancer is one of the most common solid tumours in western society. The usual initial treatment is excision of the cancer by an operation done through a cut down the midline of the abdominal wall. Over the past 10 years, minimally invasive technology has changed the approach to many surgical operations. A good example of this is an operation to remove the gall bladder. This is now routinely done using a laparoscope (telescope) which is introduced at the umbilicus. An image on a video screen of the gall bladder is then used to guide instruments to remove the gall bladder without making a large incision in the abdominal wall. This is called a laparoscopic cholecystectomy. The safety of a laparoscopic assisted approach in the removal of colon cancer is yet to be determined. This study will compare the long term and short term outcomes of people who have colon cancers removed either by a laparotomy (a cut in the midline of the abdominal wall) or by a laparoscopic assisted approach (telescope).Read moreRead less
Role Of The Inositol Polyphosphate 4-phosphatase Type 2 In Human Breast Cancer
Funder
National Health and Medical Research Council
Funding Amount
$611,032.00
Summary
Breast cancer is the most invasive cancer in females, affecting 1 in 9 women before the age of 85. Normally cells only divide when they receive a stimulus from a hormone or growth factor. The PI3K pathway responds to these stimuli and has been implicated in cancer when cells divide uncontrollably and invade surrounding tissue. We have identified a potential cancer suppressing gene, 4-ptase-2 that turns off the PI3K growth signals. We aim to characterize the role of 4-ptase-2 in breast cancer.
Functional Analysis Of The Roles Of The Serine Protease Kallikrein 7 And Its Variant Isoform In Serous Ovarian Cancer.
Funder
National Health and Medical Research Council
Funding Amount
$509,017.00
Summary
Ovarian cancer is the leading cause of death from gynaecological cancers with 1,200 women in Australia diagnosed with the disease in 2004, and 852 patients dying of ovarian cancer. The mortality rate has improved little over the last two decades with one of the major reasons being that ovarian cancer is often diagnosed at a late stage when cancer cells have spread into the abdomen or metastasised to other sites. The kallikrein family of serine proteases or enzymes is emerging as very useful diag ....Ovarian cancer is the leading cause of death from gynaecological cancers with 1,200 women in Australia diagnosed with the disease in 2004, and 852 patients dying of ovarian cancer. The mortality rate has improved little over the last two decades with one of the major reasons being that ovarian cancer is often diagnosed at a late stage when cancer cells have spread into the abdomen or metastasised to other sites. The kallikrein family of serine proteases or enzymes is emerging as very useful diagnostic or prognostic biomarkers for ovarian cancer as they often have higher levels in ovarian cancer tissue compared to the normal ovary. One of these enzymes is kallikrein 7, which is also involved in shedding of skin cells. Because of its involvement in skin, we hypothesise it may be playing a similar role in ovarian cancer and helping the cancer cells to detach from the ovary so they are free to move around the body to other sites. There are two different forms of kallikrein 7, a long form and a shorter form which is lacking a part that is crucial to enzymatic activity. While low levels of the short form have been found in normal ovary, very high levels of both forms were seen in ovarian cancer, especially the serous subtype which is the most common and most aggressive form of ovarian cancer. The aim of this project is to determine the function(s) of both forms of kallikrein 7 in ovarian cancer and to identify other molecules-proteins they are involved with. These findings will tell us if kallikrein 7 is involved in the spreading of ovarian cancer cells or metastasis and will lead to a better understanding of the development and progression of ovarian cancer. The finding from this study may also lead to better therapeutic approaches (ie blocking the action of Kallikrein 7), and-or markers to monitor ovarian cancer progression.Read moreRead less