Department of Surgery, CUHK

The Division of Hepato-biliary and Pancreatic Surgery is active in basic science and clinical research in hepatocellular carcinoma and pancreatic cancers. With a reputation for minimally invasive surgery, the Division was one of the first in the region to have a programme of laparoscopic and the robotic liver resections. In collaboration with other disciplines, we are also active in research on transarterial chemo-embolisation, microwave and radiofrequency treatment.

In pancreatic surgery, the Division is involved in several multicentre international studies on the role of pre-operative drainage in patients undergoing pancreatico-duodenectomy surgery, the use of fully-covered metallic stents in patients with benign bile duct strictures, and endoscopic ultrasound guided tissue acquisition in pancreatic tumours, among others.

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The Upper Gastro-intestinal and Metabolic Surgical Division is world renowned for its clinical research in interventional endoscopy and treatment of gastroesophageal malignancy and peptic ulcer diseases. In the past two decades, we have extended our service and research to bariatric/metabolic surgery, minimally invasive endocrine surgery, perioperative nutrition and the Early Recovery Program (ERAS) after gastric surgery. In bariatric surgery, we are interested in the specific aspects of diabetic control among Hong Kong Chinese people, endoscopic gastroplasty, and a study of the genetic profiles of obese patients and their correlation to post-obesity surgery outcomes. Other research interests included per oral endoscopic myotomy in the treatment of patients with achalasia, anti-reflux endoscopic mucosectomy, and the development and clinical application of endoscopic robots.

Our research also focuses on innovative endoscopic ultrasound guided interventional procedures, such as choledocho-duodenostomy and choledocysto-duodenostomy with various indications. In our clinical service, we offer robotic oesophago-gastrectomy and thyroid surgery. Our collaboration with interventional radiology was the first to compare percutaneous radiofrequency ablative treatment on benign adrenal tumours with laparoscopic adrenalectomy.

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Minimally invasive surgery has always been the main clinical and research focus of the Division. Over the years, we have published several landmark randomised controlled trials comparing laparoscopic and open surgery in patients with colorectal cancers. Supported by research grants, our current clincal trials aim to further improve outcomes of laparoscopic colorectal surgery. These include the application of a fast-track programme, colo-geriatric care, and electro-acupuncture.

Our Division offers the most advanced techniques, including robotic surgery, trans-anal surgery, and endo-luminal resection in treating colorectal neoplasms. In 2018, we completed the world's first clinical trial of robotic colorectal surgery using the da Vinci SP (Single Port) Surgical System.

Functional colorectal disease is another research focus of our Division, for which we are currently evaluating two innovative diagnostic systems - the EndoFLIP and Fecobionics. Moreover, we are investigating the use of transcutaneous electric nerve stimulation on acu-points (Acu-TENS) in patients with defaecatory disorders.

In collaboration with the Institute of Digestive Disease, we are conducting clinical research related to population-based colorectal cancer screening, as well as translational research in diagnostic and prognostic biomarker discovery for colorectal cancer. Other basic research interests of the Division include immunotherapy for colorectal cancer and adipose-derived mesenchymal stem cell therapy for anastomotic healing.

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The Academic Neurosurgical Unit was established in the early 1980s, providing care for patients with neurosurgical diseases in New Territories East, which has a catchment population of 1.5 million. We take great pride in having established clinical and experimental research in traumatic brain and spinal cord injuries, brain tumours, spontaneous subarachnoid and intracerebral haemorrhages, surgical treatment of Parkinson's disease and movement disorders, and epilepsy. Our research is supported by the University Grants Committee, Health and Medical Research Fund, Innovation and Technology Fund, and National Science Foundation of China, as well as generous donations from our patrons and the community. In 2011 and 2015, we received national prizes for improved management of severe head injuries and acute stroke respectively.

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At the Chinese University of Hong Kong, our team aspire to be a Centre of Excellence in Urology. Supported by research grants, we strive to conduct and execute high-quality research work with an aim to make practice changing moves from a global perspective. More than 60 research projects have been funded with a total grant money of more than HKD 80 million. We are the sole urology centre in Hong Kong accredited in National Medical Products Administration (previously known as the China Food and Drug Administration). At our centre, we are leading Phase 2 to Phase 4 clinical trials, publishing extensively in high-impact journals on all aspects of urology, especially on optimizing the performance of extracorporeal shockwave lithotripsy for urolithiasis and uro-oncology.

We have pioneered numerous urological procedures in Hong Kong, such as MRI/ultrasound fusion prostate biopsy, focal therapy for prostate cancer, single-port robotic radical prostatectomy, transurethral en bloc of bladder tumour, robotic cystectomy with intracorporeal urinary diversion, and robotic zero-ischemic partial nephrectomy. Our urology centre has been commissioned by the Hong Kong S.A.R. Government to evaluate patients with voiding dysfunction from ketamine uropathy. We have enjoyed close collaborations with other departments, university institutions and industrial partners.

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The Division has published research on minimally invasive thoracic surgery, aortic surgery, coronary bypass conduits and mitral valve repair.

As the long-term success of coronary artery bypass surgery is still limited by saphenous vein graft occlusion, we have conducted experimental research on the prevention of vein graft failure, using external support together with pharmaceutical and gene therapy.

Mitral valve repair is the gold standard in therapy for patients with degenerative mitral regurgitation. With the cardiology team at the Faculty of Medicine, we have used echocardiography to determine best ring selection as well as long-term outcomes.

We are also early adopters of new technologies in aortic surgery (frozen elephant trunk, false lumen occlude devices). Working with our colleagues in cardiology and radiology, we research novel techniques to determine outcomes after stenting (intra procedure pressure monitoring, transoesophageal echocardiography, computerised flow dynamics). Additionally, we are leading an echo screening project to detect aortic aneurysms. The Division has global reputation for data collection and is leading an international multicentre database project as well as hosting an Asian Aortic Database.

We reported the world's first combined hybrid operating room dynaCT guided single port video-assisted thoracoscopic surgery (VATS) lobectomy and are conducting ongoing prospective studies to compare conventional VATS and single port VATS. Also in progress are projects to develop surgical instruments and cameras in collaboration with the Department of Biomedical Engineering.

Our Division works with the Surgical Research Laboratory, with projects underway in the underlying cellular mechanism and signalling pathways of lung cancer. International multicentre studies are also investigating the role of hybrid operating room electromagnetic navigation bronchoscopy guided catheter ablation or direct-drug therapy in lung cancer.

Working with colleagues in anaesthesia, the Division is involved in research related to outcomes in patients following cardiac surgery, including post-operative delirium, fast tracking of patients, the generation of risk scores, and adoption of automated ventilation.

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