The Pacific Islands Project (PIP), funded by AusAid and managed by the Royal Australasian College of Surgeons (RACS), has progressed through three phases from 1995 to 2010. During this time, it has sent over 520 teams to 11 Pacific Island Countries, providing over 60 000 consultations and some 16 000 procedures. In addition to this delivery of specialist medical and surgical services that were not previously available in-country, the project has contributed as a partner in capacity building with the Fiji School of Medicine and Ministries of Health of the individual nations. By 2011, Fiji School of Medicine, which began postgraduate specialist training in 1998, had awarded 51 doctors a diploma in surgery (1 year), 20 of whom had completed their Masters in Medicine (4 years). PIP was independently evaluated on completion of every phase, including the bridging Phase III (20062010). The project delivered on its design, to deliver services, and also helped build capacity. The relationship established with the RACS throughout the project allowed Pacific Island graduates to access the Rowan Nicks scholarship, and the majority of MMed graduates received International Travel Grants to attend the Annual Scientific Meeting. PIP has been a highly successful partnership in delivering and building specialist medical services. Although AusAid contributed some $20 million over 16 years, the value added from pro bono contributions by Specialist Teams, Specialty Coordinators and the Project Directors amounted to an equivalent amount. With the emergence of Pacific Island-trained specialists, PIP is ready to move into a new phase where the agendas are set, monitored and managed within the Pacific, and RACS fulfils the role of a service provider. A critical mass of Pacific Island surgeons has been trained, so that sub-specialization will be an option for the general surgeons of the larger island nations.

ANZ Journal of SurgeryVolume 73, Issue 4 p. 209-209 General Surgical Anatomy and Examination. Hamish Ewing MB BS, FRACS, Hamish Ewing MB BS, FRACS Associate Professor of Surgery,Northern Hospital,Epping, Victoria,AustraliaSearch for more papers by this author Hamish Ewing MB BS, FRACS, Hamish Ewing MB BS, FRACS Associate Professor of Surgery,Northern Hospital,Epping, Victoria,AustraliaSearch for more papers by this author First published: 15 April 2003 https://doi.org/10.1046/j.1445-1433.2003.02590.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume73, Issue4April 2003Pages 209-209 RelatedInformation

BACKGROUND:An ageing population will increase the need for resources to treat patients with a fractured neck of femur (DRG 210/211). Provision of these resources will be helped by a better understanding of current practices.METHODS:A prospective study of outcome at discharge for 100 consecutive patients with DRG 210/211 was conducted at five Victorian metropolitan teaching hospitals to assess length of stay and the reasons for any variations.RESULTS:The major influences on timing of discharge were: delayed availability of rehabilitation beds; the timing of referral and assessment by the Geriatric Assessment Team; delay in surgery more than 24 h after admission; and development of postoperative complications.CONCLUSION:The efficient management of patients with DRG 210/211 requires a strong protocol of treatment and referral strategies with adequate resources.

A survey of Victorian surgeons performing laparoscopic cholecystectomy was carried out. This report discusses the bile duct injuries identified in the survey. Twelve injuries were recorded, a rate of 0.2%. Three of the 12 required formal repair, the other 9 being treated by T-tube alone. Possible mechanisms of these injuries, the experience of the surgeon, the role of operative cholangiography and delays in recognition of the injury are discussed.

The management of 27 patients who presented with cholangiocarcinoma of the hepatic confluence over the past 20 years is reviewed, and the dramatic changes, both in accuracy of diagnosis and modes of treatment, are documented. All 27 presented with jaundice, three underwent laparotomy only, four had a T-tube inserted, one had a straight transhepatic tube inserted, seven U-tubes were placed and four patients underwent surgical resection. More recently, seven patients were drained percutaneously and a further patient was treated by an endoscopic stent. There were six postoperative deaths. Of the 24 who received active treatment, the mean survival was 8 months with a range of 0-40 months. The advantages and disadvantages of the various methods of diagnosis and treatment are discussed. The possible role of radiotherapy and chemotherapy are reviewed briefly.