Mr. Peter D. Nottle

M.B.,B.S., (MONASH 1970)
F.R.A.C.S. (1978)
Diploma Laparoscopic Surgery
University Strasbourg (1998)

Qualifications

Current Appointments:

Past Appointments:

Post Graduate Appointments

Professional Body Membership

Papers Published

Papers awaiting review for publication

Career Summary

Surgical Career

Following completion of my surgical training at Alfred Hospital in 1977, I continued my training at The Essex County Hospital and St. Marks Hospital, concentrating on Gastrointestinal surgery and Endoscopy. Early in my career I recognised the importance of surgeons performing Gastrointestinal endoscopy and gave a lecture at the Young Surgeons Forum R.A.C.S on “The Surgeon Endoscopist”. I have always been a strong advocate for the inclusion of endoscopy training in the Surgical training programme and I was appointed as a Surgeon to Alfred Hospital in 1979 and the emphasis in my practice was Upper GI and HPB surgery.

My main achievement in surgery has been the pioneering of Laparoscopic Surgery. In June 1990 I was the first surgeon to perform a laparoscopic cholecystectomy at Alfred Hospital using the French technique, skills for which were developed whilst studying under Professor Francois Dubois in Paris at L’Hospital International de l’Universite de Paris. Following that, I performed a number of live demonstration laparoscopic cholecystectomies during teaching courses at Alfred Hospital for other surgeons. I have also visited several other centres in Victoria and Tasmania and more recently Thailand performing demonstration laparoscopic operations.

I have continued to provide leadership in the development of laparoscopic techniques, updating my knowledge and skills by regular presentations at scientific meetings and several visits to the University of Strasbourg laparoscopic teaching unit where I obtained a Diploma in Laparoscopic Surgery in 1997.

In July 2000, I was honoured to be invited as the Foundation Visitor in Laparoscopic and General Surgery to the Royal College of Surgeons of Thailand Annual Scientific Meeting and gave lectures on :

1. The management of bile leaks following laparoscopic cholecystectomy.
2. The prevention of bile duct injuries during laparoscopic cholecystectomy.
3. Laparoscopic surgery of the oesophago-gastric junction.
4. Clinical assessment of the new technology.

During that visit to Thailand, I also performed demonstration operations (laparoscopic cholecystectomy and laparoscopic hernia repair) at the Lerdsin Hospital in Bangkok.

My current skills in laparosocpic surgery extend to :

1. Laparoscopic-hepato-bilary surgery (cholecystectomy, exploration of CBD, cholecyst-jejunostomy) and hepatic cyst marsupialisation.
2. Lapararoscopic oesophago-gastric surgery, fundoplication for G.O.R.D., cardiomyotomy for achalasia, repair of rolling hiatus hernia, gastro-enterostomy, pyloroplasty, total gastric mobilisation (for oesophageal replacement), laparoscopic gastrectomy.
3. Laparoscopic gastric banding and laparoscopic sleeve gastrectomy for morbid obesity.
4. Laparoscopic splenectomy.
5. Laparoscopic bowel surgery – right hemicolectomy, sigmoid colectomy, anterior resection, reversal of Hartmann’s procedure, colostomy, repair rectal prolapse and small bowel resection.
6. Laparoscopic appendicectomy.
7. Laparoscopic hernia repair – inguinal hernia, femoral hernia and incisional hernia.
8. Diagnostic laparoscopy with biopsy procedures ± lymph node excision.

My principal goals in this field are to ensure that laparoscopic surgery is performed safely and that laparoscopic procedures become the preferred technique for most abdominal operations.

R.A.C.S. Activities

Elected member of the R.A.C.S. State Committee for 1994-1998 being Honorary Treasurer in 1998. During that time I was Co-Ordinator for the second part course (at that time organised by the State Committee) and a member of the Standards Subcommittee and Victorian Council Casemix Committee.

Member of the Upper GI Committee of the R.A.C.S. in 1993 and was Chairman of that group in 1998 and 1999 and was the clinical Co-Ordinator for the Upper GI Training Program. As a member of that committee, guidelines were developed for several laparoscopic procedures.

Hospital Committee Roles

Williamstown

Appointed to the Board of Williamstown Hospital in 1989 and continued in that role until individual hospital boards were replaced by network boards in 1994. I was Chairman of the Board from 1992-1994 inclusive. During that time the Board oversaw the successful introduction of Casemix funding the Williamstown Hospital. The Board also developed the plans for the recent reconstruction of the wards, operating theatre and rehabilitation unit, all of which were completed in the past 3 years. I spent 3 years on the executive of the Williamstown Hospital Staff Group as Chairman of that group in 1987 and 1988 and again from 1998-2007. I remain the Chairman of that group.

Alfred

Five years have been spent on the executive of the Division of Surgery from 1994 and I was Chairman in 1998.

Werribee

Appointed as director of Surgical Services, the Werribee Mercy Hospital in 1998 and remain in that position.

Other Hospitals

Director of both Western Private Hospital and Hobsons Bay Endoscopy.

At Western Private Hospital I am also Chairman of the Medical Advisory Board which oversees credentialing of medical practitioners. Monthly Board meetings require deliberation on all matters (including budgeting) related to the running of the hospital.

Teaching

Undergraduate

Since 1978, as a member of the Alfred Hospital Surgical Staff, was an Honorary Lecturer in the Department of Surgery, Monash University. This involved active participation in the student teaching programme for 5th and 6th years and has included the formal lecture programme, regular tutorials and teaching in outpatients and the operating theatre.

In 2002, I obtained final year Melbourne University medical student attachment to the General Surgical Unit at The Williamstown Hospital. They participate in all unit activities and have a formal tutorial program.

Postgraduate

Registrar Level

Actively participate in the Registrar Surgical training programme with regular tutorials and operating theatre demonstrations and assistance. Whilst a member of the Victorian State Committee, I was also responsible for the organisation of the Second part course which is now run by the Board of General Surgery. I was also, as curriculum co-ordinator for the Upper GI section committee of the R.A.C.S., responsible for the development of the curriculum for advanced training in Upper GI Surgery. I have established, and have had accredited by the College in the past 5 years, four general surgical registrar positions, two at Williamstown Hospital, one at the Werribee Mercy Hospital and one at Western Private Hospital.

Surgical Colleagues

As a pioneer in laparoscopic surgery, I have taught many of my colleagues laparoscopic surgical procedures. This has been at a formal level during courses run at the Department of Surgery, Monash University, Alfred Hospital where demonstration operations were performed along with a formal lecture programme. It has also been at an informal level with visits by colleagues to operating sessions.

I have also produced several video tapes at the Monash Teaching Services Unit which are used for teaching purposes. (Also at undergraduate and registrar levels.)

As head of the General Surgical Unit at the Williamstown Hospital and Director of Surgical Services at the Werribee Mercy Hospital, I have introduced regular Death and Complication meetings and a Surgical Audit programme in both institutions.

Research Activities

I have published 27 scientific articles in various journals, most resulting from clinical research activities (see list).

Summary

• A leader in the field of laparoscopic surgery pioneering the introduction of laparoscopic cholecystectomy and other laparoscopic techniques.
• Extensive clinical surgical experience at a senior level with knowledge and experience in laparoscopic surgical procedures, particularly upper GI procedures, second to none.
• A knowledge of hospital management and systems including :
  • Budget management
  • Human resources
  • Quality Improvement
• Long experience with surgical teaching at undergraduate and postgraduate level.
• Significant experience with clinical research projects.