The future of vascular surgery: An Australasian perspective

Abstract

This article briefly outlines the current status of vascular surgery in Australia and New Zealand, reports on the future practice and research challenges as perceived by vascular surgeons in our two countries, and finally, explores how the current vascular surgical research efforts in Australasia map to those challenges.

Vascular Surgery in Australia and New Zealand (Australasia)

“…1 In the modern times, the detailed history and initiation of vascular surgery and timeline has been well documented in articles by John Gurry and Philip J. Walker, including many contributions to the advances in endovascular interventions for aneurysms. 2,3 In brief, interest in vascular surgical procedures started in the 1950s by either general surgeons or cardiothoracic surgeons in both countries. Some surgeons travelled and gained international fellowships in North America and the UK, which allowed them to dedicate their practice solely to vascular surgery at that time.…”

Rural general surgeon confidence with managing vascular emergencies: A national survey

“…Vascular surgery rotations are no longer mandated for general surgery trainees. Concurrently, rapid advances in endovascular surgery has resulted in increasing centralisation of vascular services to large metropolitan centres where there is greater provision of subspeciality surgeons and specialised equipment 7 . However, given Australia's immense landmass and widely distributed population, there is a strong reliance on rural general surgeons to provide acute assessment and stabilisation of emergent vascular patients whilst awaiting urgent transfer 6,8 .…”

“…Concurrently, rapid advances in endovascular surgery has resulted in increasing centralisation of vascular services to large metropolitan centres where there is greater provision of subspeciality surgeons and specialised equipment. 7 However, given Australia's immense landmass and widely distributed population, there is a strong reliance on rural general surgeons to provide acute assessment and stabilisation of emergent vascular patients whilst awaiting urgent transfer. 6,8 Therefore, it is important to consider how we can ensure general surgeons are confident with managing vascular emergencies, in the environment in which they work.…”

Can you please come to theatre now? – A retrospective review of emergent intra‐operative vascular assistance in a tertiary centre

“…In 2021, there were 241 surgeons as members of the ANZ Society of Vascular Surgery (including 26 in New Zealand), with the majority practicing in metropolitan and tertiary hospitals 5 . This raises concern for a potential Australasian vascular surgeon staffing crisis ‐ in the context of a growing burden of vascular disease from both an aging population as well as an increasing prevalence of obesity, diabetes mellitus and renal failure 6 . Incongruence between a small vascular workforce and growing demand for services is also being seen in the United States and United Kingdom 7,8 .…”

“…5 This raises concern for a potential Australasian vascular surgeon staffing crisis -in the context of a growing burden of vascular disease from both an aging population as well as an increasing prevalence of obesity, diabetes mellitus and renal failure. 6 Incongruence between a small vascular workforce and growing demand for services is also being seen in the United States and United Kingdom. 7,8 It is therefore important to accurately define the burden of elective and acute work received through formal and informal referral pathways to allow professional bodies and institutions to make provisions for providing a sustainable vascular service.…”