The Low Anterior Resection Syndrome (LARS) session

Chair: Donna Heggie

Donna Heggie RN, STN, Grad Cert Clinical Teaching, Continence Management Certificate.  Centre Manager, Continence Foundation of Australia in NSW Inc.

Donna has a long nursing career specialising in Stomal Therapy and Continence/ Colorectal Nursing at Royal Prince Alfred Hospital, Sydney.  Currently she manages the CFA in NSW Inc. Office in Newington. A position held since February 2015.  Donna is also a member of the CFA National Bladder Bowel Collaborative Steering Committee.


Six 15 minutes presentations followed by discussion and question time.

Anatomy and physiology of the surgery and why is it done

Professor Chris Byrne

A/Prof Chris Byrne is a colorectal surgeon at Royal Prince Alfred Hospital, Lifehouse and the Mater Hospitals. He has clinical practice and researched in advanced pelvic cancers, minimally invasive and robotic colorectal surgery as well as pelvic floor pathology.


Statistics and research findings on LARS

Dr Danette Wright

Danette is a colorectal surgeon currently completing a further fellowship in Intestinal Failure and Inflammatory Bowel Disease at Salford Royal Foundation Trust, Manchester, United Kingdom. Danette completed her general surgical training at the Royal Prince Alfred Hospital and Concord Hospital and colorectal fellowship at Westmead Hospital and The Austin Hospital in Melbourne. Throughout her training Danette has had a keen interest in understanding the pathophysiology of pelvic floor disorders and is the penultimate year of her PhD in anterior resection syndrome.


Diagnosis and anorectal physiology studies

Dr Caroline Wright 

Clin A/Prof Caroline Wright is a Colorectal Surgeon at the Royal Prince Alfred Hospital, Sydney. She completed her medical training at St Mary’s Hospital London and, after moving to Australia in 1988, did her general surgical training in Brisbane. Following 2 years of research and clinical work attached to the Royal Brisbane Hospital, she completed her post-Fellowship training at RPAH. Her clinical interests include pelvic floor disorders and the genetics of colorectal cancer. She was instrumental in establishing the multidisciplinary OASIS Clinic at RPAH, and is keen to increase the clinical awareness of, and facilitate a more collaborative approach to, the management of complex functional defaecatory disorders.




Conservative management of LARS

Janet Candido 

I work in the NSW Biofeedback and Continence Centre, also known as the Anorectal Diagnostic Facility. I work at RPAH as a CNC in disorders of defecation. RPAH is a large teaching hospital with a big colorectal department. I work with 9 colorectal surgeons with a variety of sub specialties and interests and one other CNS. I see patients with constipation, diarrhoea, incontinence, obstructive defecation, haemorrhoids fissures pruritus’ ani. Any patients that are struggling with bowel function post operatively. I have a keen interest in Lars syndrome as its quite difficult to deal with. We see between 1300-1500 patients a year for biofeedback and follow up consults either face to face or via the telephone to both metropolitan and rural patients. We perform approx. 430-450 Anal physiology  studies per year with some of the colorectal surgeons. We are also running an advanced GI program over three years in conjunction with all the other colorectal G/I discipline’s.

I think I am one of the luckiest people around as I have enormous job satisfaction. I may not be able to cure but I can certainly improve peoples quality of life.



Transanal irrigation treatment of LARS and surgery for a second stoma

Colleen Mendes, Stomal Therapy CNC, Royal Prince Alfred Hospital, NSW

Colleen Mendes is a Clinical Nurse Consultant in Stomal therapy at Royal Prince Alfred Hospital, Sydney, She has a 25 year nursing career, with 10 years specialising in this field. Colleen has extensive experience in stoma, wound, continence, antigrade colonic irrigation, sacral nerve neuromodulation programming and anorectal physiology.


Colorectal Cancer Support Group formation and outcomes

Ian Whiteley, Nurse Practitioner, Stomal Therapy and Wound Care, Concord Repatriation General Hospital, Sydney

Ian Whiteley is the Nurse Practitioner in Stomal Therapy and Wound Care at Concord Repatriation General Hospital in Sydney, a position he has held since 2005. The Stomal Therapy Department coordinates the care of both in-patients and out-patients with abdominal stomas. The service includes a nurse-led out-patient clinic.

Ian has academic affiliation as a Clinical Senior Lecturer with the University of Sydney Nursing School & Concord Clinical Medical School, Discipline of Surgery. He is a member of the Australian Association of Stomal Therapy Nurses and is a preceptor for nurses undertaking the Graduate Certificate in Stomal Therapy Nursing. He has published in national and international journals on a variety of topics.