A national research centre for bowel disease is to be set up in London to bring the Cinderella area of medicine to the forefront of surgical innovation.
Building of the -3 million centre of excellence has just begun at Queen Mary, University of London. It will be up and running in early 2012.
The aim is to fast-track new operations for bowel disease patients and revolutionise the way new surgical breakthroughs are rolled out to hospitals all over the UK.
The NCBRSI (National Centre for Bowel Research and Surgical Innovation) will bring together under one roof scientists, clinicians and clinical trial specialists to create a national resource.
Their role will be to develop groundbreaking surgical ideas, carry out clinical trials, then disseminate their knowledge and techniques to the operating theatres of hospitals all over the UK.
The centre is expected to deliver a number of 'firsts' and will become a Gold Standard for research into bowel disorders including cancer, colitis, faecal incontinence and constipation which affect millions of people in the UK.
The project is supported by the charity Bowel & Cancer Research which has raised -2.4 million to get the centre off the ground.
Director of the centre is Professor Norman Williams, who became President of the Royal College of Surgeons in July 2011. Until then he was Director of the Centre for Academic Surgery at Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, and a surgeon at the Royal London Hospital in Whitechapel.
Co-directors of the NCBRSI are Charles Knowles, Professor of Surgical Science in the Academic Surgical Unit at Barts and the London School of Medicine and Dentistry, Queen Mary, University of London; and Andy Silver, Professor of Cancer Genetics at the Centre for Academic Surgery, Institute of Cell and Molecular Science, Barts and The London School of Medicine and Dentistry, Queen Mary, University of London.
Professor Williams and his team believe the centre will revolutionise the way surgical advances for bowel disorders developed in hospitals all over the UK are rolled out. They say it could provide a framework for other areas of surgery to follow.
At the moment, says Williams, there is no recognised mechanism for developing an idea about innovative treatments for bowel disease, taking it through to clinical trial, and into routine clinical practice.
At the same time, collaboration between research scientists and surgeons is such that new techniques to help patients come about by luck more than strategy.
"Surgeons can trial a new technique in their own hospital but too often it goes no further. The infrastructure to roll out the accumulated knowledge about innovative procedures isn't there. There are loose liaisons, but no official method. We almost rely on hearsay. It's incredibly slow and very frustrating," said Professor Williams.
He added that the existing research networks which enable clinical trials to take place within the NHS are geared mainly to test new drugs and non-invasive therapy. He stressed that it's impossible to test surgical techniques in the same way.
"There is little room for a placebo in surgery. You can't tell someone when they go in for a bowel operation that they may, or may not, end up with a colostomy bag for life," he said.
"The centre of excellence will be able to pilot a new bowel surgery technique, then roll it out across the country. We want to develop new techniques which improve quality of life, test them, and teach them to others in a measured way. Let's spread the knowledge more efficiently and speedily.
"We can make great strides if we can pool expertise from different sectors of the medical chain, but we need an organisation and a structure with which to do that."
The centre's backers say bowel disease is a neglected area of medicine which doesn't get the research funding it deserves considering its prevalence. "Further, surgery in general is neglected, receiving less than 2 per cent of research council funding despite one in every three NHS hospital admissions requiring a surgical intervention," said Charles Knowles.
Diseases of the gastro-intestinal tract, or gut, account for one-in-six hospital admissions in the UK and are the third most common cause of death. Each year 38,000 people are diagnosed with bowel cancer in the UK and 17,000 die from it. It is the UK's second biggest cancer killer after lung cancer.
Surgery remains the only cure for bowel cancer and, if caught in time, can result in a 90 per cent survival rate.
There are 150,000 people in the UK living with a colostomy bag. And 240,000 people suffer from inflammatory bowel diseases such as colitis and Crohn's Disease.
"Despite the huge number of bowel disease sufferers, scientific research into bowel disorders has one of the poorest ratios of investment when compared with the burden of disease. Technical surgical trials are few and far between," said Professor Williams.
The research scientists involved in bowel and gut disorders look with envy at the funds directed at breast cancer and transplant surgery.
The centre of excellence will be based in the Abernethy building within the Blizard Institute which forms part of Queen Mary, University of London at Whitechapel.
It will be funded by grants and private donations.
A state-of-the-art laboratory will be dedicated to the study of human tissue from surgical patients, the first if its kind in the world. There will also be a video link from the operating theatre to a training room so that surgeons can watch new procedures being carried out.
The revenue costs for the first 10 years are estimated to be -26 million. Running costs will be met from existing funding streams and fundraising. The aim is to achieve break-even position in three years by funding the running costs with income from research activities.
"We can't leave this to the NHS, particularly in this harsh economic climate - it's charities that provide the funds for this type of project," said Professor Williams.
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