Background: The aim was to compare short term outcomes between patients undergoing standard abdominoperineal resection (APR) with those that had an extralevator abdominoperineal excision (ELAPE).Methods: A retrospective study was done on 123 consecutive patients who underwent an abdominoperineal resection for low rectal cancer at the Townsville hospital between August 2003 and January 2015. Data was collected from medical records.  Short term oncological outcomes were compared between the APR and ELAPE group.Results: The circumferential resection margin (CRM) involvement rate was significantly lower in the ELAPE group 13.2% versus 19.3% in the APR group. The local recurrence rates in the two groups were not significantly different: 16.8% in the ELAPE versus 17.4% in the APR group. Intraoperative perforations were lower in the ELAPE group 15.3% versus 23.2 % in the APR group. The post-operative wound infection rate was however higher in the ELAPE group 20.3% versus 12.4 % in the APR group.Conclusions: ELAPE was shown to be superior in the CRM and intraoperative perforation rate but the local recurrence rates were similar. ELAPE had a higher wound complication rate than APR.

Background: For generations, surgical training has followed the example of an apprenticeship model. However, many doctors see this training as insufficient and potentially unsafe for the patient. Web-based simulation training for teaching laparoscopic surgery is not only becoming increasingly popular but is cheaper in comparison to the traditional apprenticeship method. Objective is to assess the educational value of web-based training videosMethods: Data was obtained through questionnaires sent to consultant surgeons and   surgical trainees at three sites in North Queensland. Study invited participants to complete a 24-item questionnaire on knowledge and attitudes. The questionnaires were distributed using online survey monkey software to send emails to the three Government Hospitals.Results: There was a response rate of 11.40%, Consultant surgeons (13/17; 72.20%) and surgical trainees (4/17; 22.20%).  Majority of participant`s sources of learning laparoscopic surgery was from supervisors in operating theatre (64.30%) and online Web-based training video (WBTV; 7.10%), although satisfaction with current web-based training video resources was found to vary widely for a variety of reasons. WBTV were used mainly when required for clinical rotation.Conclusions: There was a response rate of 11.40%, Consultant surgeons (13/17; 72.20%) and surgical trainees (4/17; 22.20%).  Majority of participant`s sources of learning laparoscopic surgery was from supervisors in operating theatre (64.30%) and online Web-based training video (WBTV; 7.10%), although satisfaction with current web-based training video resources was found to vary widely for a variety of reasons. WBTV were used mainly when required for clinical rotation.

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Background: Acute testicular pain is one of the commonest reasons of testicular exploration. Testicular appendage torsion is one of conditions presenting with testicular pain. If the diagnosis is certain this can be managed conservatively. Operative management is reserved for those patients in whom non-operative management fails. The objective of this study was to ascertain the success of conservative management.Methods: The medical records of thirty-four consecutive patients who were diagnosed with testicular appendage torsion, were managed non-operatively and satisfied the inclusion criteria were retrospectively analysed.  Results: The average age of patients was 16.3 years. 94% of the patients were successfully managed non-operatively. Pain not controlled by analgesia was the main reason for representing to the emergency department. All patients were discharged from any further follow up by day 9.Conclusions: Where the diagnosis of testicular appendage torsion is confidently made, non-operative management is a viable option. Larger studies are required to confirm these findings.