Special Session 6 - Striving for Clinical Excellence in HKUMed

Every year, the Hospital Authority performs more than 4,000 surgeries for hip and knee replacements. Although most of these procedures are successful, a small percentage of patients may experience early implant failure due to issues like loosening and dislocation. These problems are often caused by malalignment or technical errors. 


 


In 2019, the University of Hong Kong took the lead in introducing robotic joint replacement surgery to the Asia Pacific region. Professor Henry Fu played a key role in developing this innovative surgical technique, having received training in robotic surgery overseas and setting up the robotic surgery service at Queen Mary Hospital. He has also trained local and international surgeons in this field. Robotic joint replacement surgery uses CT scans to plan the operation and relies on haptic guidance for precise bone removal and prosthesis implantation. This reduces the risk of surgical errors. Prof. Fu and his team have achieved excellent radiological and clinical outcomes using this novel robotic system, especially for patients with severe deformities. 


 


In recent years, robotic joint replacement surgery has become increasingly popular. Several public and private hospitals have invested in orthopedic robotic systems, and many surgeons are showing a keen interest in this technology. This new surgical technique offers hope to patients with severe hip and knee deformities, allowing them to walk again and enjoy a better quality of life. 

The field of breast surgery has undergone significant transformation over recent decades. Historically, breast surgery was predominantly aggressive, with modified radical mastectomies being the standard. However, advancements in understanding breast cancer's biology have led to earlier detection and less extensive surgeries. 


Currently, breast conservation therapy, characterized by lumpectomies coupled with radiotherapy, offers equivalent survival rates to mastectomy. Oncoplastic surgery, incorporating various reconstructive techniques, further increases the possibility of breast conservation while limiting deformity. Partial breast reconstruction with locoregional flaps allows more patients to benefit from breast conservation. In patients who inevitably require a mastectomy, skin-sparing, and nipple-sparing options are safe in selective conditions, and immediate reconstruction further improves cosmetic outcomes.


In axillary management, sentinel lymph node biopsy has replaced routine axillary lymph node dissection. The Z0011 study further decreases the number of patients requiring axillary dissection. With significant advances and tight collaboration with oncologists and radiologists, targeted axillary dissection (TAD) is a feasible and safe alternative in locally advanced patients with good clinical response after receiving neoadjuvant therapy before their surgery, minimizing surgical extent while ensuring thorough cancer management.


In benign cases, alternative treatments to surgical excision, such as High-Intensity Focused Ultrasound (HIFU) and vacuum-assisted breast biopsy (VABB), offer scarless solutions to our patients.


Collaborations with the university have also led to the adoption of advanced techniques. Through clinical trials and overseas training exposure, innovative treatments like cryotherapy for early breast cancers, immediate lipo-filling for breast conservations, and robotic surgery for mastectomies. These methods not only effectively manage the disease but also significantly enhance patients' quality of life.


In conclusion, the evolution towards less aggressive management for breast diseases reflects a balance between oncological safety and aesthetic outcomes, profoundly impacting patient care in both the short term and long term, physically and mentally.

The University of Hong Kong Shenzhen Hospital (HKUSZH) is a public hospital that is operated by HKU and plays a crucial role in medical reform efforts. The hospital comprises six Areas of Excellence, one of which is the Division of Cardiology, which has been led by the applicant since its opening. The division oversees clinical operations across all areas, including the ambulatory center, out-patient department, in-patient care, cardiac catheterization laboratory, and cardiac rehabilitation center. As a tertiary center for diagnostics and therapy in SZ, the Cardiology Division aims to become a highly influential cardiac center in the region.
Thanks to the tremendous work and dedication of staff working in a brand-new hospital, the Cardiology Division has become one of the top and most visited public cardiology services in Shenzhen. With over 20 doctors and 70 nurses operating a 70-bed general cardiology ward, 8 CCU beds, and a 24/7 primary percutaneous coronary interventional service, the division has reformed cardiology practice in Mainland China. In 2021, the division provided over 60,000 out-patient visits, approximately 30,000 ambulatory cardiac investigations, and about 3,000 in-hospital admissions. 
Over the last 10 years, the Division has delivered high-quality, ethical, and evidence-based care while developing several key clinical services and reforming medical practice in the Mainland health system. As a result of these achievements, the hospital, faculty, and University were proud recipients of the distinguished Key Development Specialty Award by the Shenzhen Municipal Health Commission in 2020. The award provides funding of 700,000 RMB/year for 5 consecutive years and is only given to one Cardiology division in Shenzhen. 
The applicant has also established and led the first Precision Cardiovascular Imaging Centre in Guangdong province, which aims to provide a world-class clinical diagnostic service as well as a hub for research and training. Because of the significant contribution made by the applicant to clinical excellency and service development, he was named 廣東省傑出青年醫學人 - Elite Young Medical Leaders of the Guangdong Province, China in 2018. 
Overall, the Division of Cardiology at HKUSZH has made significant strides in delivering high-quality care, developing clinical services, and reforming medical practice in Mainland China. These achievements have been recognized by various awards and accolades, and the Division continues to strive towards becoming a highly influential cardiac center in the region.