Surgery at The Royal Melbourne Hospital

About Us

The Department of Surgery at the Royal Melbourne Hospital, The University of Melbourne, has broad and diverse areas of interest in basic science, clinical research and education. The clinical research involves cardiovascular, anaesthesia, clinical ultrasound, prostate, general surgery and neurosurgery. The Royal Melbourne Hospital is one of the two trauma centres in the state of Victoria. The key focus of basic science laboratories relates to cancer and genetic research. The Department has an extensive online learning platform, and the Ultrasound Education Group (UEG) is one of the largest providers of clinical ultrasound training in the world. It is also a pioneer in simulator-based training which also includes the use of robots for surgery. The education platform is also the basis for the Mobile Learning Unit (MLU), which delivers continuing professional development training on behalf of the Melbourne Medical School and the Faculty of Medicine, Dentistry and Health Sciences (MDHS).

We are located within the educational and research hub known as the “Parkville Precinct”, allowing for strong linkages to other research institutions and internationally renowned groups.

Academic Lead

The Academic Precinct Lead (Acting) at the Royal Melbourne Hospital, Department of Surgery is Professor Alistair Royse.

AR Protrait

Professor Alistair Royse is a cardiothoracic surgeon and the acting head of the Royal Melbourne Hospital precinct. 

He completed his general surgical training in 1992 and his cardiothoracic training in 1994.  His MD thesis by research was in the field of complex total arterial coronary revascularisation. These strategies tried to achieve avoidance of any saphenous vein graft in coronary surgery and required numerous operative innovations and new techniques as well as the routine use of the radial artery from the forearm. Since 1997, the local coronary surgery practice is to avoid vein graft in approximately 85% of patients. From 1996, these techniques and strategies have led to very large-scale change which has persisted. Internationally, and elsewhere in Australia, the practice remains traditional, with 95% of patients who undergo coronary artery bypass surgery, receiving at least one saphenous vein graft. Large scale research by the group identifies a significant survival advantage for those who do not receive any saphenous vein graft.

He was also instrumental in the introduction of intraoperative echocardiography and epivascular ultrasound. He later was the foundational co-director of the Ultrasound Education Group (UEG) at the University of Melbourne. The first Diploma in clinical ultrasound was released in 2003, and the number of course participants, as well as the technologies used for the delivery platform, have increased exponentially. This has allowed tremendous scalability of education and is placing the University at the forefront of online learning capability. In response to the COVID-19 pandemic, eight courses were developed between late March 2020 and early May 2020, and more than 10,000 enrolments were received in this time.

Alistair was promoted to Professor by academic merit in 2012 and has been the Deputy Head of the Department of Surgery since 2013, and the acting head since 2019. He is also the co-director of the Ultrasound Education Group, the Melbourne Learning Unit, the Cardiovascular Research Group and a member of the Melbourne Medical School Executive Committee.

Key Research Areas

A diverse and wide-ranging interest in research reflects the large size and diverse nature of the members of this precinct:

  • Arterial coronary bypass surgery (total arterial revascularisation)
  • Radial artery as a conduit in coronary bypass surgery
  • Tracking the progression and performing a definitive analysis of metastatic subclones of prostate cancer
  • Improving glioblastoma diagnosis and treatment through identification and validation of serum biomarkers and understanding pro-tumorigenic properties.
  • Phase 0 or “window of opportunity” clinical trials in glioma
  • Brain oxygen neuromonitoring in severe head injury
  • Standardising practice and access in neuroimaging to improve patient outcomes
  • Molecular mechanisms of cerebral vasospasm after subarachnoid haemorrhage
  • Identifying novel therapeutics for combating cancer cell invasion by targeting invadopodia
  • Study of human pluripotent stem cells for modelling neurodegenerative diseases.
  • Identifying the change in diagnosis and management of patients with point of care clinical ultrasound to assist examination and guide procedures.
  • Measuring the educational benefit of using simulators and self-directed learning techniques for teaching skill-based workshops
  • Investigating the use of focused cardiac and lung ultrasound and DVT scan in general medical patients with a cardiorespiratory diagnosis
  • Dynamic TGF-β signalling regulation of tumour cell dissemination and tumour derived exosomes
  • Treatment for Fuchs’ Endothelial Dystrophy (FED) without the need for traditional corneal transplantation.
  • Safety and efficacy of multiple doses of IONIS-FB-LRX in patients with Geographic Atrophy secondary to Age-Related Macular Degeneration (AMD).
  • Management and treatment of Phaeochromocytoma, Hyperparathyroidism, thyroid cancer and Graves Disease.

Research Groups

  • Ultrasound Education Group
  • Cardiothoracic Surgery
  • Neurosurgery
  • Stem Cell Disease Modelling
  • Glioblastoma Survival Signaling Lab
  • Prostate Cancer
  • Cancer Signalling
  • Brain Cancer Microenvironment and Biology Laboratory
  • Breast Cancer
  • Endocrine Surgery
  • Head and Neck Tumour Stream Research Group
  • Ophthalmology

Ultrasound Education Group

Head of Research Group

Research Overview
The Ultrasound Education Group comprises of academics, including Prof Alistair Royse (Cardiothoracic surgeon, Deputy Director of Surgery), Prof Colin Royse (Anaesthetist), Dr David Canty (Anaesthetist, Senior Lecturer) and Dr Lindsay Bridgford (Emergency Physician, Academic), who supervise higher research degree students, undergraduate medical students performing research projects, and post-graduate clinicians pursuing active research and education projects.

Research themes include a wide range of ultrasound, including transoesophageal echocardiography for cardiac surgery, clinical point of care diagnostic ultrasound of heart, lungs, abdomen, vascular, invasive procedures, and new techniques. Other active areas of research include cardiac surgery, cardiothoracic anaesthesia, postoperative quality of recovery in all types of surgery, and medical education.

Ultrasound Education Group Courses

UEG develop and administer graduate courses in clinical ultrasound at a certificate, diploma or master’s level, which is well subscribed both within Australia and Internationally. The courses have been very successful amongst medical specialists, trainees and residents and are likely to change the way that practical ultrasound skills are learned.

Details of the courses and workshops can be found at Ultrasound Education Group Courses

Cardiothoracic Surgery

Head of Research Group


Research Overview
The cardiothoracic surgery unit performs all types of cardiac surgery and thoracic surgery. Operations at The Royal Melbourne Hospital as well as Melbourne Private Hospital. The multidisciplinary team includes surgeons, anaesthetists, perfusionists, intensive care and other associated specialties within the Royal Melbourne Hospital including cardiology oncology, radiation therapy and many more.

Across the two campuses, approximately 1100 cardiac surgery cases and approximately 400 thoracic surgery cases are performed.

Particular areas of interest:

  • Total arterial coronary artery bypass surgery
  • Radial artery use as a coronary bypass conduit
  • Sutureless aortic valve replacement
  • Aortic aneurysm reconstruction
  • The PEARS operation for aortic aneurysm
  • Minimally invasive valve surgery
  • Minimally invasive thoracic surgery

Neurosurgery

Head of Research Group


Research Overview
The Department of Neurosurgery at the Royal Melbourne Hospital is the busiest neurosurgical unit in Australia, sitting in the heart of the Parkville Biomedical precinct, and provides a comprehensive service for patients with neurosurgical diseases. The Department is one of the few genuinely academic Neurosurgery Departments in Australasia, with active clinical and laboratory research programs that augment each of the clinical specialised programs undertaken by the Department alone and in conjunction with the Departments of Neurology, Radiology and Oncology. Data and tissue collection, and clinical trials, are central to the work of the Department. Enquiries for fellowships in Neuro-Oncology and Spinal Surgery are welcomed, as are enquiries for PhD supervision.

The particular areas of research include:

  • Brain Tumours
  • Cerebrovascular Diseases
  • Neurotrauma
  • Neuroimaging
  • Functional Neurosurgery

Stem Cell Disease Modelling

Head of Research Group


Research Overview
Our laboratory focuses on the study of human pluripotent stem cells for modelling neurodegenerative diseases.

The difficulty in obtaining brain or ocular tissue from living people is a major barrier to developing new treatments for neurodegenerative disease. We can now generate stem cells from adult tissue, and these “induced pluripotent stem cells” (iPSCs) represent a powerful disease modelling tool. Generating iPSCs directly from patients allows cells to be differentiated into specific cells of interest for disease modelling, drug screening, and understanding of fundamental pathogenic mechanisms.

We differentiate iPSCs into various cell types of the nervous system, as monolayers or as organoids. Using these cells, we model age-related macular degeneration, glaucoma, inherited retinal dystrophies and optic neuropathies, in order to establish the molecular events leading to disease progression and aspects of neurodegeneration. We also use gene editing technology for the correction of monogenic diseases of the retina and the optic nerve.

Brain Tumours and Epilepsy

Head of Research Group

Research Overview
Our lab focuses on brain tumours and epilepsy. We aim to understand the neurobiology of brain tumours, particularly glioma, the most common cancer of the brain. Our current major project is discovering new blood-based biomarkers for glioma diagnosis and monitoring using microRNA and DNA. We also focus on understanding the role of glioma stem cells and their underlying genotypes in progression of glioma and using stem cell organoid cultures as a basis for discovering new molecular-targeted treatments for glioma. We also work on the neuroscience behind how brain tumours cause epileptic seizures and have published on the role that the glutamate neurotransmitters play.

Glioblastoma Survival Signaling Lab

Head of Research Group


Research Overview
Our lab aims to understand how cancer signaling molecules and pathways regulate the pro-tumorigenic characteristics of glioblastoma, the most aggressive and lethal brain tumour in adults.

Prostate Cancer

Head of Research Group

Research Overview
The Prostate research group is focused on :

  • Deciphering the genomic drivers of metastatic potential in prostate cancer
  • Tracking the dissemination of cancer cells from the primary organ to distant sites
  • To further the clinical translation of a small molecule that targets the Tau protein in the brain to treat neurodegenerative diseases.
  • Developing tissue and blood tests that will predict future risk of progression in men at the time of diagnosis
  • Developing new ‘curative’ treatments in patients with high risk disease
  • Developing new tests that will predict how patients will respond to treatment

Cancer Signalling

Head of Research Group


Research Overview
Cancer Signalling Research Laboratory focuses on how molecular signalling pathway, particularly TGF-b signalling regulates each different stages of cancer development from initiation and growth to dissemination by invasion, circulation and metastatic seeding. More importantly, we translate out fundamental novel findings into therapeutic opportunities.

Brain Cancer Microenvironment and Biology Laboratory

Head of Research Group


Research Overview
Our research goal is to understand the molecular and cellular biology of brain cancer.

One of our key research areas is to investigate the brain tumour microenvironment.

Breast Cancer

Head of Research Group

Research Overview
Our team's main research interests are clinical trials into tailored treatments in early breast cancer, prevention and screening of patients at high risk of developing breast and endocrine malignancies and outcomes in emergency general surgery.

Key research areas:

  • Value-based outcomes research in surgery
  • Patient reported outcomes after breast cancer surgery and risk-reducing surgery
  • De-escalation of therapies after cancer diagnosis

Brain Cancer Invasion Group

Head of Research Group

Research Overview
The Brain Cancer Invasion Group is focussed on:

  • Understanding how invadopodia contribute to brain cancer invasion
  • Investigating the role of exosomes in brain cancer invasion
  • Repurposing drugs to target invadopodia and brain cancer invasion
  • Investigating the impact of current therapies on invadopodia, exosomes and brain cancer invasion

Endocrine Surgery

Head of Research Group

Research Overview
Endocrine Surgery involves clinical management of patients suffering from tumours of the endocrine system, including:

  • Benign and malignant tumours of the thyroid gland.
  • Primary hyperparathyroidism
  • Adrenal tumours, including phaeochromyctoma
  • Familial endocrine tumour syndromes such as Multiple Endocrine Neoplasia
  • Familial cancer and secondary endocrine malignancies
  • De-escalation of treatments of thyroid nodules and thyroid cancers

Head and Neck Tumour Stream Research Group

Head of Research Group

Research Overview  
Our main area of research has been in the management of mucosal head and neck cancers, with an interest in cutaneous head and neck cancer and sarcoma. There is a successful collaboration with WEHI in conducting a PhD program in oral cancer genomics and in establishing an oral cancer organoid culture.

Ophthalmology

Head of Research Group

Research Overview
Descemetorhexis Without Endothelial Keratoplasty (DWEK)

This study evaluates the possibility of removing a section of Descemet’s membrane along with its diseased endothelial cells, without corneal transplantation, and simply leaving the cornea to heal on its own, as a new treatment for Fuchs’ Endothelial Dystrophy (FED). This procedure is known as ‘Descemetorhexis Without Endothelial Keratoplasty (DWEK)’ or ‘Descemet’s stripping only (DSO)’.  DWEK/DSO may improve vision in persons with FED without the need for traditional corneal transplantation.

Keratoconus International Consortium (KIC)

International collaborative study to evaluate Keratoconus.

RMH Ophthalmology Clinical Trials

IONIS: A Phase 2, randomised, placebo-controlled, double-masked study to assess safety and efficacy of multiple doses of IONIS-FB-LRX, an antisense inhibitor of Complement Factor B, in patients with Geographic Atrophy secondary to Age-Related Macular Degeneration (AMD).

Facilities

Laboratory Facilities at Department of Surgery, Victorian Comprehensive Cancer Centre (VCCC)

VCCC Lab

VCCC2-Lab

RMH-VCCC

Contact Us

Executive Assistant to Professor Alistair Royse

Michelle Chu
Ph:  +61 3 8344 2033 / +61 3 8344 5492
Email:   michu@unimelb.edu.au

Research Co-ordinator

Dr Hong-Jian Zhu
Ph:  +61 3  8344 3025
Email:   hongjian@unimelb.edu.au

Graduate Research Programs Coordinator

Kim Ng
Ph:  +61 3  8344 3296
Email:  kmng@unimelb.edu.au

Location:

Royal Melbourne Hospital,
Centre for Medical Research building
Level 6 / 300 Grattan St, Parkville