Top honour for Limerick-based surgeon

A SURGEON at the University Hospital Limerick (UHL) has received a prestigious honour of delivering the 47th Millin Lecture on the future of training in surgery.

HSE Mid-West consultant colorectal surgeon, associated professor Christina Fleming (PhD FRCSI), delivered the lecture to a standing-room only audience at the Royal College of Surgeons Ireland.

Prof Fleming is an early adopter of surgical innovation, in particular robotic surgery, in which she first trained in at UHL.

In 2016, led by Professor Calvin Coffey, UHL became the first public hospital in Ireland to install the Da Vinci Xi surgical robot, which allows for remote-controlled keyhole abdominal surgeries.

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Almost a decade on, many hundreds of patients across multiple surgical specialties in the Mid-West have benefited from these surgeries, which are less invasive and significantly reduce the length of stay in hospital.

The Millin Lecture is one of the most prestigious accolades for surgeons in this country, and is the centre-piece of the annual RCSI Millin Meeting, which honours former two-term RCSI President Terence Millin, who pioneered prostate cancer surgery and trained surgeons worldwide to perform it.

The Millin Lecture is awarded to candidates from across all surgical specialties, nominated by Fellows and selected by a panel of RCSI Council Members. 

Prof Fleming’s work as a consultant colorectal surgeon at UHL is complemented and informed by prolific research on colorectal cancer, robotic surgery and surgical training.

She has an academic portfolio that has earned numerous national and international prizes, bursaries and research grants and regularly contributes to webinars, podcasts and a vast array of education and training events relating to robotic surgery and surgical innovation.

Titled Future-Proofing Surgical Training – A Template for new Technologies, Prof Fleming’s 2024 Millin Lecture used her own clinical experience and research to demonstrate how we need to think outside the box when training future surgeons with continuous advances in new surgical technologies, using current robotic surgery training as a template.

"Advances in surgical technologies, including robotics, augmented reality and artificial intelligence (AI), can improve how we perform surgery and therefore improve patient outcomes and how our system works overall," she said.

"Patient safety is at all times the main priority when new technologies are introduced in the operating room and prioritising patient safety is rooted in training and education of surgeons and surgical teams."

"As a surgical trainer, I am particularly interested in developing sustainable training models that are adaptable for new and upcoming technology. Robotic surgery has been the biggest surgical technology advancement in my career to date and its use in practice has facilitated considerable opportunity to blueprint and standardise training methods in other future technologies.

"This has the benefits of ensuring patients can reap the benefits of new technology in a safe, structured and timely manner as these technologies continue to become available."

Prof Deborah McNamara, President, RCSI, commended Prof Fleming for a fantastic talk "laying out an ambitious vision for the future of surgical training and practice".

Prof Fleming returned to Limerick in 2022 following completion of a European Society of Coloproctology (ESCP) Fellowship in robotic colorectal surgery and advanced pelvic cancer at the University of Bordeaux, France.

During this time, she was a founding member of the EUREKA group, a European multicentre group comprehensively researching all elements of robotic rectal cancer surgery practice and outcomes and to support completion of this advanced training, she was competitively awarded an RCSI PROGRESS Fellowship.

Prof Fleming continues to work with colleagues locally, nationally and internationally to advance training structures, curriculum development and best practice guidelines for surgical innovation and robotic surgery. 

In her role as general surgery and colorectal lead on the National Robotic Surgery Leads Group, she recently co-authored Ireland's first National framework for safe and effective robotic surgery practice in Ireland with surgical and academic colleagues in RCSI. 

Along with adopting robotic surgery to an increasing profile of surgical operations she performs, Prof Fleming is currently performing research relevant to this area in postgraduate curriculum design and competency-based assessment in national surgical training programmes and validating and investigating training effectiveness of high fidelity simulation models in collaboration with the International Medical Robotics Academy.