Department of Surgery

Overview

The Department of Surgery is one of 13 Departments in the Faculty, and comprises 11 Divisions, including Cardiothoracic Surgery, Emergency Medicine, General Surgery, Global Surgery, Neurosurgery, Ophthalmology, Orthopaedic Surgery, Otolaryngology, Paediatric Surgery, Plastic & Reconstructive Surgery and Urology, each run by a Head of Division and overseen by the Head of Department. The various Divisions are spread across offices within the Faculty of Health Sciences campus and Red Cross War Memorial Children’s Hospital, but most can be found within the iconic Old Main Building of the GSH precinct. 

Members of the Department provide clinical care at GSH, RCWMCH and the various hospitals of the Metro West complex, extending to the Eden District. We offer the full spectrum of surgical specialties, with a growing number of subspecialties, and are committed to providing the best possible surgical care for patients from the Western Cape and elsewhere in the country.  

The Department prides itself on providing an outstanding, highly specialised clinical service and excellent teaching to under- and postgraduate students, with a strong emphasis on research. In addition to undergraduate teaching, the Department of Surgery provides surgical training for postgraduate students (South African and international registrars) as well as Senior Registrars undertaking sub-specialist training and also Research Fellows. There are over 200 registrars registered for a Masters in Medicine as well as numerous fellows undertaking subspeciality training in the Department. Teaching is in the form of formal tutorials, Morbidity and Mortality meetings, research meetings, clinical meetings, observation, ward rounds as well as supervised surgical procedures. Our graduates are among the most sought-after worldwide, many having taken up leadership positions in other centres around the country and internationally.  

This is a highly productive department for cutting-edge research with an excellent track record in terms of research output. Clinical research has always been one of the strengths of the Department of Surgery, and the last 100 years have seen major contributions to the science of surgery emanating from our hospitals. Each Division has a rich tradition of research and innovation, with some having their own dedicated research laboratories, and Global Surgery has grown as an area of shared interest linking Surgery, Anaesthetics, Obstetrics & Gynaecology and Public Health with a  rapidly expanding number of disciplines. 

Areas of Study

The Department of Surgery is committed to maintaining high standards of teaching. It has had five recipients of the prestigious University Distinguished Teacher Award: Professors Edward Immelman, Jake Krige, Anwar Mall, Robert Dunn and Pradeep Navsaria. 

Undergraduate studies

Each of the department's divisions is involved in the undergraduate teaching programme focused on 5th year and 6th year MBChB students who rotate through the divisions in 6 week blocks throughout the year. The department is actively involved in the new curriculum and is committed to the philosophy of problem-based learning and curriculum transformation. 

Postgraduate studies

Each division has its own MMed programme. Registrars write the College of Medicine examinations and a completed  dissertation is a requirement in order to obtain a Masters in Medicine in the respective surgical disciplines.  The success rates in the various College examinations are high. 

 

Research

The Department of Surgery is committed to surgical research. Each division boasts its own research programmes, mostly involving clinical research. However Cardiothoracic Surgery, Orthopaedic Surgery, Ophthalmology and General Surgery have active laboratory-based research programmes. 

The annual Department of Surgery Research Day has been renamed the Del Kahn Research Day since the retirement of the previous Head of Department, Professor Delawir Kahn and is usually held in November. This annual event focuses on research across the whole of the Department and is an opportunity for undergraduate, postgraduate and consultant staff to showcase research projects to the wider Department as well as the rest of the faculty. The highlight of the day is the invited speaker at the John Terblanche Lecture. 

 

Divisions

The department of Surgery prides itself on providing an outstanding clinical service, excellent teaching to both undergraduate and postgraduate students, and world-class research. It is made up of the following divisions: 

General Surgery

General Surgery is the largest Division in the Department of Surgery  and functions very much as a subspecialist service. It consists of six surgical firms (Hepatobiliary Surgery, Colorectal Surgery, Vascular Surgery, Surgical Oncology/Endocrine, Upper Gastrointestinal Surgery, and Acute Care Surgery), the Trauma Centre, the Transplant Unit, the Surgical and Surgical Gastroenterology.  

The Units/Firms in the Division provide a highly specialised clinical service and are responsible for providing an in-patient and out-patient surgical service, as well as an element of outreach, and functions relatively independently although there are common academic and morbidity and mortality meetings. 

The Division is responsible for teaching undergraduate medical students in the 5th and 6th years of the MBChB curriculum.  The teaching is in the form of formal in-person and online lectures and tutorials and with on-site bedside clinical teaching/training.  The Division also has a substantial postgraduate teaching and training commitment for registrars training in general surgery and for surgeons sub-specializing in various General Surgery subspecialties, such as surgical gastroenterology, vascular surgery, critical care and trauma.  The trainees write the examinations set by the College of Surgeons of South Africa and are also required to complete the MMed degree by way of a mini-dissertation after passing the FCS examination from the College. 

Surgical research is a high priority of the Division, and the Division has an exceptional record with regard to publications and presentations at national and international conferences.  The Division has a surgical research laboratory and access to small and large animal surgical facilities. 

Although the clinical service is largely based at Groote Schuur Hospital, the surgical services at the regional and district hospitals form an integral part of the Division.  These hospitals include the New Somerset Hospital, Victoria Hospital and Mitchell’s Plain Hospital, as well as Red Cross War Memorial Children’s Hospital. 

The Division is staffed by 19 full-time consultants, 9 junior consultants/senior registrars, and 49 registrars, which includes international (supernumerary) registrars.  There is also one surgical scientist post.

The division offers a full range of adult and paediatric cardiac and thoracic surgery services, catering to congenital heart disease, myocardial revascularization, cardiac valvular repair and replacement surgery, and thoracic aortic surgery. 

The UCT Division of Emergency Medicine was formed in 2001, at the same time as that of Stellenbosch University and historically the two Divisions have worked closely together. The speciality of Emergency Medicine became nationally recognised in 2003, with the College of Emergency Medicine (CEMSA) founded in 2004, and UCT  took the lead to become the first South African institution to offer a specialist exit degree in Emergency Medicine that same year. Today we offer several degree options, including doctoral degrees. We host the largest emergency medicine school in Africa and are responsible for a large proportion of all emergency medicine research produced on the continent.

The Division of Neurosurgery treats various diseases of the brain and spinal cord including traumatic brain injury, brain tumours, vascular diseases of the brain and various types of stroke, spinal disorders, congenital abnormalities, hydrocephalus, and functional disorders such as epilepsy. 

The Division is staffed by 6 full-time consultants, several sessional consultants, 10 registrars and 2 clinical fellows. The adult clinical service is based at Groote Schuur Hospital, while children under the age of 13 years receive care at the Red Cross War Memorial Children’s Hospital. 

The full complement of subspeciality services are provided for, which include: orbit/oculoplastics, anterior segment/cornea, uveitis, glaucoma, medical and surgical retina, neuro-ophthalmology, ocular oncology, paediatric ophthalmology and strabismus. 

Red Cross War Memorial Children’s Hospital (RCWMCH) provides care to the children of Cape Town and a large portion of the Western Cape Province and serves a national referral base. The Division of Paediatric Surgery is responsible for comprehensive elective and emergency surgical services to children under the age of thirteen years. Specialised services include neonatal surgery, trauma, burns, liver and renal transplantation, hepatobiliary surgery, upper gastroenterology surgery, colorectal surgery and oncology surgery, including thoracoscopic surgery, laparoscopic surgery, endoscopic and day case surgery. 

The Paediatric Surgical Division sees a wide array of surgical pathology, performing about 2500 general surgical operative cases a year as well as over 500 burn procedures. General surgical cases account for about 2000 hospital admissions and over 4000 out-patient cases a year with over 1000 admissions for burns. The trauma unit treats more than 8000 patients annually. 

The Division of Paediatric Surgery liaises with other surgical divisions within Surgery Department at RCWMCH to provide comprehensive and multidisciplinary care including neurosurgery, ophthalmology, plastic surgery, orthopaedics, otorhinolaryngology, cardiothoracic surgery and urology. 

We recruit and develop some of the top orthopedic trainees in South Africa and provide training in all facets of orthopedic trauma and elective surgery.  During their clinical rotations our students are exposed to orthopaedic trauma surgery, hand surgery, paediatric orthopaedic surgery, hip and acetabular surgery, sports orthopaedics, arthroplasty, shoulder and elbow surgery as well as spine surgery.  They are paired with one subspecialist consultant who supervises the acquisition of operative and clinical skills.  Daily tutorials and meetings for academic training are held as a group and on an individual basis. We offer subspecialist fellowship training in arthroplasty, spine surgery, paediatric Orthopaedic surgery, Orthopaedic tumour surgery, shoulder and elbow surgery, hand surgery, foot and ankle surgery, Orthopaedic trauma surgery, and knee surgery. For our medical students we have established a curriculum with bedside teaching, tutorials, shadowing, and orthopedic skills stations such as plaster technique and injection techniques.  This program has received strong support from our Health Professions Council and is lauded as an example of quality medical student teaching. We have also developed a consensus-based student-centered curriculum with an open online textbook.  

We have also established an UCT accredited Orthopaedic Research Unit with a MSc in musculoskeletal research with an output of 25 to 30 publications per year.  

The Division of Otorhinolaryngology provides a comprehensive ENT service to state patients and to private patients at the University of Cape Town Private Academic Hospital (UCTPAH). It has the following subspecialty expertise: head and neck; rhinology/anterior cranial base; otology/neurotology/cochlear implantation; paediatric otolaryngology; and complex airway surgery. It runs the only 1yr clinical fellowships in Africa in rhinology, paediatric otolaryngology, and otology, as well as a fellowship in head & neck surgery. 

The Division of Plastic, Reconstructive and Maxillo-facial Surgery combines an academic service with university teaching, clinical training and research at both Groote Schuur and Red Cross War Memorial Children’s hospitals. The Division is comprehensively involved in all areas of Plastic and Reconstructive Surgery including Cosmetic Surgery and Maxillofacial Trauma, the latter being a shared service with the Department of Maxillofacial Surgery, based at the University of the Western Cape. Orthoplastic surgery on spinal patients are dealt with at Eerste River Hospital via the Western Cape Rehabilitation Centre. Specialist tertiary services are provided to patients of the Western and Southern Cape but we have a wide referral base sometimes extending beyond the South African border. 

Teaching is provided at an undergraduate level to fifth year medical students and many elective students from both local and international universities, Professions Allied to Medicine (PAM), and to postgraduates in the form of specialist training – including supernumerary registrars from other African and developing nations. The Division enjoys a strong partnership with colleagues in private practice. These sessional surgeons provide valuable input to the Division both in teaching and in clinical service. 

The Division is actively involved in all aspects of Plastic and Reconstructive Surgery research, including paediatric Plastic Surgery. The Division has published many peer reviewed articles and enjoys teaching and research collaboration with the Universities of Amsterdam, Oslo, UCLA and Bristol, currently. 

 

In the Division of Urology, children & adults requiring medical and surgical care are seen and treated on an elective and emergency basis. Specialised units cater for urological malignancies, renal stones, kidney transplantation, female continence, trauma, paediatric and ambulatory day case cystoscopy. 

An active outpatient service and comprehensive urology community outreach programme are run. 

Staff are engaged in undergraduate and postgraduate teaching of local and international trainees 

Research and innovation is a key focus of the division