Damien Mosquera

Damien Mosquera was a valued member of the VSNZ. He originally wrote most of the patient information material posted on this website along with significant contribution to the vascular service here and UK.

Damien Mosquera BSc MB ChB FRCS FRACS MD

Clinical

Extensive clinical and operative experience in all areas of vascular surgery. This includes the management of varicose veins, chronic venous disease and leg ulceration in addition to the treatment of all major arterial problems except those involving the heart.  Vascular surgery encompasses the management of aortic aneurysms (swollen arteries) and aortic occlusive disease (blocked arteries), carotid artery disease and the prevention of strokes, and peripheral vascular disease in which hardening of the arteries to the legs causes pain on exercise.  As about 30% of patients with vascular disease also have diabetes, managing patients with the vascular complications of diabetes is an important aspect of vascular surgery.  This can particularly include the management of patients with peripheral vascular disease and diabetic foot ulcers.

The management of arterial problems in particular involves a close relationship with radiologists.  With radiological colleagues I have many years experience in the radiological treatment of vascular disease including the use of angioplasty, stenting and thrombolysis.

Involved in the treatment of patients with renal failure for many years.  These patients require haemodialysis, and vascular access surgery for these patients is a crucial part of their treatment.  I am experienced in primary, secondary and complex vascular access procedures and also in the use of implantable access ports.

General surgical practice requires skills in evaluation and treatment of a wide range of surgical conditions including hernias, skin cancers, breast disease, gallstones, intestinal disease including cancer and general abdominal problems.  A significant proportion of general surgical work includes emergency surgical management of acute abdominal pain, trauma, infections and bleeding.

Audit

There is an extensive, active and on-going audit programme which takes place at Base Hospital and has included audits of colorectal surgery, cholecystectomy, appendicectomy, surgery in patients over the age of 80 years, skin graft audit, pancreatitis,  sentinel node biopsy in breast cancer, paediatric surgery in the provinces and trauma management. Other topics have included upper gastro-intestinal bleeding, intestinal obstruction, ERCP, anastomoses, vascular and DVT prophylaxis.  Many of these audits have led to presentations at national meetings and publications in surgical journals. Contributor to RACS breast audit and Australasian Vascular Audit.

Contributor to the ANZSVS Australasian Vascular Audit (AVA) and Australasian Breast Audit. Surgical performance assessment using risk prediction modelling. A presentation on this work was given in Melbourne at the Annual Australasian Vascular Society meeting in 2007 and was published in the ANZJ Surgery.

Research

MD by thesis examining the role of lining artificial grafts with human endothelial cells.

Teaching

Throughout my career I have been involved in teaching. At Taranaki Base Hospital we have junior and senior surgical trainees, trainee interns (senior medical students) and elective medical students.

Selected Publications

Welsh F, Mosquera D. Has laparoscopic placement improved long term outcome of peritoneal dialysis access catheter insertion in Taranaki? Peritoneal Dialysis International, September 2012; 32: S111(abstract).
Sandiford P, Mosquera D, Bramley D. Ethnic inequalities in incidence, survival and mortality from abdominal aortic aneurysm in New Zealand. J Epidemiol Commun Health 2012; 10.1136/jech-2011-200754.
Sandiford P, Mosquera D, Bramley D. The trend in incidence, mortality and burden of disease from abdominal aortic aneurysm in New Zealand. Brit J Surg 2011; 98: 645-651.
Van Rij S, Fancourt M, Mosquera D. Vascular workload in a provincial New Zealand Hospital. NZMJ 2011; 124: 18-28.
Henderson N, Fancourt M, Kyle SM, Gilkison W, Mosquera D. Skin grafts: a rural general surgical experience.  ANZJ Surg 2009; 79(5) :362-66.
Gollop SJ, Mosquera D, Fancourt M, Gilkison W, Kyle SM. Why women in Taranaki choose mastectomy over breast conservation. ANZJ Surg 2009; 79: 604-609.
Davenport E, Fancourt M, Kyle SM, Gilkison W, Mosquera D. Sentinel lymph node biopsy in Taranaki: a prospective audit in a provinicial NZ hospital. NZ Med J 2009; 122: 45-56.
Peng S, Fancourt M, Kyle SM, Gilkison W, Mosquera D. Paediatric surgery performed by general surgeons: a provinicial New Zealand experience. ANZJ Surg 2008; 78: 662-664.
Nichols K, Prytherch D, Fancourt M, Kyle SM, Gilkison W, Mosquera D. Risk adjusted general surgical audit in octogenarians. ANZJ Surg 2008; 78: 990-994.
Mosquera D, Chiang N Gibberd R. V-POSSUM risk adjusted evaluation of surgical performance. ANZJ Surg 2008; 78: 535-539. Gollop S, Fancourt M, Gilkison W, Kyle S, Mosquera D. A prospective audit of colorectal resections in a peripheral public hospital. ANZJ Surg 2006; 76: 817-820.
Sykes TCF, Morris A, Mosquera D. Vitamins C and E attenuate homocysteine and adenosine induced apoptosis by inhibiting hydrogen peroxide generation. Brit J Surg (abst) 2003; 90: 628-629.
Sykes TCF, Morris A, Mosquera D. Nitric oxide mediates the attenuation of homocysteine-adenosine-induced apoptosis by vitamin B12 supplementation. Brit J Surg (abst) 2002; 89: 657.
Burt CG, Little JA, Mosquera DA. The effect of age on radiocephalic fistula patency. J Vasc Access 2001; 2: 60-63.
Sykes TCF, Bradbury AW, Mosquera DA. Apoptosis and vascular disease. Eur J Vasc & Endovasc Surg 2001; 2001; 22(5): 98-106.
Burns P, Mosquera DA, Bradbury A. Thrombophilia and peripheral arterial disease. Eur J Vasc & Endovasc Surg 2001; 22(2): 98-106.
Sykes TCF, Molostov G, Morris A, Mosquera D. Homocysteine induced apoptosis in human vascular endothelium is inhibited by vitamin B6, B12, and folate. Brit J Surg 2001(abst); 88(Suppl 1): 4.
Sykes TCF, Molostov G, Morris A, Mosquera D. Homocysteine induces apoptosis in human vascular endothelium. Brit J Surg 2001 (abst); 88: 748-749.
Sykes T, Fegan C, Mosquera D. Thrombophilia, polymorphisms and vascular disease. J Molecul Pathol 2000; 53: 300-306.
Caldwell S, Burns P, Haggart P, Bradbury A, Mosquera D. Association between hyperhomocysteinaemia and abdominal aortic aneurysm. Brit J Surg 2001 (abst); 88: 609
Caldwell S, Martin G, Reid S, Fegan C, Mosquera D. Prothrombotic abnormalities in patients undergoing infrainguinal angioplasty. Brit J Surg 1999 (abst); 86 Suppl 1: 25-26.
Subramanian S, Mosquera D. Duplex ultrasonography versus angiography in the assessment of internal carotid artery disease. Brit J Surg 1998 (abst); 85: 1561.
Caldwell S, McCarthy M, Martin S, Hilton A, Bartlett W, Jones A, Mosquera D. Hyperhomocysteinaemia, peripheral vascular disease and neointimal hyperplasia in elderly patients. Brit J Surg 1998 (abst); 85: 709.
Mosquera DA, Manns R, Duffield R. Phlebography in the management of recurrent varicose veins. Phlebology 1995; 10: 19-22.
Mosquera D, Quayle J. Bascom’s operation for pilonidal sinus. J Roy Coll Phys 1995; 88: 45P-46P.
Mosquera D, Goldman M. Autopsy and audit in general surgery. Surgery 1995;13:7.
Mosquera DA, Goldman M. Surgical audit without autopsy: tales of the unexpected. Ann Roy Coll Surg Eng 1993; 75: 115-117.
Mosquera DA, Gibson SP, Goldman M. Vascular access surgery: a two year study and comparison with the Permcath. Nephrol Dialysis Transpl 1992; 7: 1111-1115.
Mosquera DA, Garner C, Paterson I, Goldman MD. The mechanism of neutrophil adhesion to reperfused endothelium. Brit J Surg 1992 (abst); 79: 443.
Gibson SP, Mosquera DA, O’Donnell MJ, Odurny A. Streptokinase in the treatment of innominate vein thrombosis in association with a haemodialysis catheter. Preservation of a precious arterio-venous fistula. Nephrol Dialysis Transpl 1991; 6: 206-208.
Gibson SP, Mosquera DA. Five years experience with the Quinton Permcath for vascular access. Nephrol Dialysis Transpl 1991; 6: 269-274.
Mosquera D, Goldman M. Endothelial Cell Seeding. Brit J Surg 1991; 78: 656-660.
Mosquera DA, Goldman M. An unusual variant of the Hypothenar Hammer Syndrome. Brit J Indust Med 1988; 45: 568-569.
Mosquera DA, Walker SJ, McFarland JB. Stomal Sclerotherapy. J Roy Coll Surg Ed 1988; 33: 337.

Selected Presentations

Liddle S, Fancourt M, Farrant G,Haddawi F, Kyle SM, Gilkison WTC, Mosquera D. Computed tomography and acute surgery at Taranaki Base Hospital. Nelson NZAGS March 2012.
Welsh F, Mosquera D.Has laparoscopic placement improved long term outcome of peritoneal dialysis access catheter insertion in Taranaki?ISPD 2012 conference Kuala Lumpur, September 2012.
Davenport E, Fancourt M, Farrant G, Kyle SM, Gilkison WTC, Mosquera D. Surgical success: a view from the other side of the fence. Prize presentation NZAGS, New Plymouth, March 2011.
Aschenberger S, Fancourt M, Gilkison W, Kyle S, Mosquera D. Etiology, management and outcome of acute intestinal obstruction in a provincial New Zealand hospital. NZAGS Tauranga, March 2010.
Liddle S, Mosquera D. The Taranaki leg ulcer clinic. Vascular Society NZ, New Plymouth 2010.
Van Rij S, Mosquera D. Vascular workload in a provinicial New Zealand hospital. Vascular Society NZ, New Plymouth 2010.
Van Rij S, Mosquera D. Risk adjusted vascular surgical audit – making it simpler. Vascular Society NZ, New Plymouth 2010.
Wright D, Fancourt M, Gilkison WG, El-Haddawi F, Kyle S, Mosquera D.  Simple interventions improve adherence to thromboprophylaxis guidelines, Australasian College of Phlebology, Auckland Feb 2010.
Nichols K, Prytherch D, Fancourt M, Kyle SM, Gilkison W, Mosquera D. Risk adjusted general surgical audit in octogenarians. RACS Conjoint Annual Scientific Congress, Hong Kong, May 2008.
Chiang N, Fancourt M, Kyle SM, Gilkison W, Mosquera D. Management of acute pancreatitis: perspective from a district hospital. NZ Annual General Surgeons Meeting, Bay of Islands, April 2008.
Davenport E, Fancourt M, Kyle SM, Gilkison W, Mosquera D. Sentinel lymph node biopsy in Taranaki: a prospective audit in a provinicial NZ hospital. NZ Annual General Surgeons Meeting, Bay of Islands, April 2008.
Foliaki A, Fancourt M, Kyle SM, Gilkison W, Mosquera D. Trauma, a provincial hospital experience. NZ Annual General Surgeons Meeting, Bay of Islands, April 2008.
Chiang N Gibberd R, Mosquera D. V-POSSUM risk adjusted evaluation of surgical performance. ANZSVS annual vascular meeting, Melbourne, 2007.
Gollop SJ, Mosquera D, Fancourt M, Gilkison W, Kyle SM. Why women in Taranaki choose mastectomy over breast conservation. Gyrus-ACMI Surgico prize winning paper, RACS Annual meeting, Christchurch 2007.
Henderson N, Fancourt M, Kyle SM, Gilkison W, Mosquera D. Skin grafts: a rural general surgical experience.  Awarded best free paper. NZ Association of General Surgons, Napier 2007.
Peng S, Fancourt M, Kyle SM, Gilkison W, Mosquera D. Paediatric surgery performed by general surgeons: a provinicial New Zealand experience. NZ Association of General Surgons, Napier 2007.
R. Tapper, D. Mosquera, W. Gilkison, S. Kyle, M. Fancourt. A Prospective Audit of Appendicectomies in a Rural Hospital and its Effect on Practice. Royal Australasian College of Surgeons NZ Annual Scientific Meeting, Hamilton, 2005.
Gollop S, Kyle S, Gilkison W, Fancourt M, Mosquera D. Delayed presentation of colorectal cancer in a district general hospital – a prospective audit. Royal Australasian College of Surgeons NZ Annual Scientific Meeting, Auckland, 2004.
Mosquera DA. All POSSUMs are equal? NZ Society Vascular Surgery Annual meeting, Dunedin, Feb 2004.
Sykes TCF, Morris A, Mosquera DA. Vitamins C and E attenuate homocysteine and adenosine induced apoptosis by inhibiting hydrogen peroxide generation. Society of Academic and Research Surgery, Leeds 2003.
Rehman A, Bradbury A, Mosquera D. Are amputees occupying too many acute surgical beds for too long?. Midland Vascular Surgical Society, Nottingham, March 2002.
Sykes TCF, Morris A, Mosquera D. Nitric oxide mediates the attenuation of homocysteine-adenosine-induced apoptosis by vitamin B12 supplementation. Society of Academic and Research Surgery Jan 2002 London.
Sykes TCF, Molostov G, Morris A, Mosquera D. Attenuation of homocysteine-adenosine-induced apoptosis by vitamin B12 supplementation. Midland Vascular Surgical Society, Nottingham, 2001.
Burt CG, Little JA, Mosquera DA. The effect of age on radiocephalic fistula patency. 2nd meeting of the International Vascular Access Society, London, 2001.
Williams DJ, Eardley K, Gannon MXG, Bradbury A, Mosquera DA. Workload implications of a renal access service. Midland Vascular Surgical Society, Nottingham, 2001.
Caldwell S, Burns P, Haggart P, Bradbury A, Mosquera D. Is there an association between hyperhomocysteinaemia and abdominal aortic aneurysms? Vascular Surgical Society of GB & I, Annual meeting, London, 2000.
Sykes TCF, Molostov G, Morris A, Mosquera D. Homocysteine induces apoptosis in human vascular endothelium. Surgical Research Society, Cork 2000.
Salaman R, Goldman M, Mosquera D, Henderson J, Gannon MX. Results of aortic endovascular stenting. West Midlands Surgical Society, Burton, 1999.
Subramanian S, Mosquera D. Duplex ultrasonography versus angiography in the assessment of internal carotid artery disease. Surgical Research Society, Dublin 1998.
Caldwell S, Martin G, Reid S, Fegan C, Mosquera D. Prothrombotic abnormalities in patients undergoing infrainguinal angioplasty. Midlands Vascular Surgical Society, Derby, 1999.
Mosquera DA, Quayle JB Early experience with Bascom’s technique for pilonidal sinus. Coloproctology Section, Royal Society of Medicine, London, 1993.
Mosquera DA, Manns R, Duffield RG. Phlebography in the management of recurrent varicose veins. Royal Society of Medicine, Venous Forum, London, December 1993.
Mosquera DA, Garner C, Paterson I, Shearman C, Goldman MD. The mechanism of neutrophil adhesion to reperfused endothelium. 17th European Conference on Microcirculation, London, July 1992.

Posters

Jenkins B, Fancourt M, Farrant G,Haddawi F, Kyle SM, Gilkison WTC, Mosquera D. General surgical outpatient clinic satisfaction questionnaire. Nelson NZAGS March 2012.
Abbott S, Fancourt M, Farrant G,Haddawi F, Kyle SM, Gilkison WTC, Mosquera D. Successful introduction of laparoscopic colorectal surgery ina provincial New Zealand hospital. Nelson NZAGS March 2012.
Butt A, Mosquera D, Fancourt M, Farrant G, Kyle SM, Gilkison WTC, Alwan M. Interhospital acute transfers of general surgical patients from Hawera public  hospital to Taranaki Base Hospital. NZAGS annual meeting, New Plymouth, March 2011.
Abbott S, Fancourt M, Farrant G, Kyle SM, Gilkison WTC, Mosquera D. Successful introduction of laparoscopic colorectal surgery in a peripheral New Zealand hospital. NZAGS annual meeting, New Plymouth, March 2011.
R. Ranjan, W. Gilkison, S. Kyle, M. Fancourt, G. Farrant, D. Mosquera. Anastomotic complications: still with us in the 21st century. NZAGS annual meeting, New Plymouth, March 2011.
Sarvepalli R, Fancourt M, Gilkison W, El-Haddawi F, Kyle S, Mosquera D. Colonoscopy audit at a provincial New Zealand Hospital. A prospective analysis. NZAGS Poster Tauranga, March 2010.
Johns E, Fancourt M, Gilkison W, El-Haddawi F, Kyle S, Mosquera D. Upper GI bleeding in a peripheral hospital. NZAGS Poster Tauranga, March 201.0
Chiang N, Gibberd R, Mosquera DA.  V-POSSUM risk adjusted evaluation of surgical performance.  Prize winning Poster, NZ Annual General Surgeons Meeting, Bay of Islands, April 2008
Nicholls K, Fancourt M, Gilkison W, Kyle S, Mosquera D. Prospective octogenarian surgical audit: predicting post-operative and non-operative mortality using minimum clinical data set.  RACS Annual meeting Christchurch, 2007.
Peng S, Fancourt M, Gilkison W, Kyle S, Mosquera D.  Paediatric surgery performed  by general surgeons: a provincial New Zealand experience. .  RACS Annual meeting Christchurch, 2007.

Invited Lectures

D Mosquera. Amputation audit. Birmingham Vascular and Endovascular Masterclass. January 2002.
D Mosquera. Thrombophilia. Mercian Vascular Group. Forest of Arden, Birmingham, May 2001.
D Mosquera. Vascular perspective on the management of the diabetic foot. Challenges to chronic wound management, Birmingham, September 2000.
D Mosquera. The prevalence and significance of thrombophilia in vascular patients. Edinburgh Vascular and Endovascular Masterclass, January 2000.
S Caldwell, D Mosquera. Homocysteine, the clinicians perspective. Kilmer McCully Homocysteine seminars September 1999.

Courses and Symposia attended

Melanoma Summit, Wellington, April 2013
Vascular Society NZ Hamilton, 2013
Vascular 2012, ANZSVS Annual meetingMelbourne 2012
13th European Congress of Trauma and Emergency Surgery. Basel, Switzerland, May 2012.
Vascular Society New Zealand, Nelson, NZ, Feb 2012.
ANZSVS Annual mtg, Brisbane, Nov 2011.
SET selection interviewer training workshop, New Plymouth, March 2011.
NZAGS Annual meeting, New Plymouth March 2011.
Vascular Society of New Zealand, New Plymouth 2010 (Local convenor)
Australasian College of Phlebology, 13th Annual Scientific Meeting, Auckland Feb 2010
Vascular 2009, Sydney, Oct 2009.
Laparoscopic General Surgery Intensive Course, Asia Ircad Taiwan, Oct 2009.
VSNZ meeting Tauranga, 2009.
Australasian College of Phlebology, Gold Coast, September 2008.
Vascular Society of New Zealand AGM, Queenstown, February 2008.
Otago Vascular Diagnostics, Venous disease & management, Queenstown, February 2008.
25th Annual UCLA Symposium: A comprehensive review and update of what’s new in vascular and endovascular surgery.
Beverley Hills, September 2007.
Australasian College of Phlebology, September 2006, Queenstown.
NZ Society of Vascular Surgery February 2006 Wellington.
Second National Conference on Diseases of the Breast, November 2005, Auckland.
Australian and New Zealand Society for Vascular Surgery Meeting, September 2005, Sydney.
Definitive surgical trauma care course (DSTC), August 2005, Auckland.
NZ Association of General Surgeons Annual Meeting, Gisborne, 2005.
Northern Vascular Group Meeting, Ultrasound guided foam sclerotherapy and endovenous laser treatment of varicose veins. Auckland, November 2004.
Royal Australasian College of Surgeons NZ Scientific Meeting, Auckland 2004.
NZ Royal Australasian College of Surgeons Scientific Meeting, Melbourne 2004.
NZ Society Vascular Surgery, Dunedin, Feb 2004.
Vascular 2003, Melbourne, Oct 2003.
Vascular 2002, Brisbane, 2002.
Thoracic outlet syndrome, Royal Society of Medicine, London, 2001.
Lymphoedema conference, Leicester, 2001.
Vascular Surgical Society of GB and Ireland, London, 2000.
Microvascular Surgery Course, London, November 2000.
Surgical Research Society, Cork, 2000.
Vascular surgery masterclass, Edinburgh, 13/14 January 2000.
Vascular access surgery, Frankfurt, 20/21 October 1999.
Aortic endovascular stent course, Nottingham, 23/24 September 1999.
Surgical audit, Royal College of Surgeons, London, 5th May 1999.
Vascular surgical course, Santa Monica, USA, October 1996.
Fundamentals of Laparoscopic Surgery, Dundee, 1993.
Advanced Trauma and Life Support, Stoke, 1993.
Sclerotherapy workshop. Prof G Fegan, Telford, April 1993.

Society Membership and Committees

Head of Department of Surgery, Taranaki Base Hospital.
Taranaki rep, NZ Higher Surgical training committee
Royal Australasian College of Surgeons
Royal College of Surgeons of England
New Zealand Medical Council
Vocational scopes
Vascular Surgery -is the diagnosis and treatment (operative and non operative, including endoluminal techniques and interventional procedures) of patients with disorders of: blood vessels (arteries and veins outside the heart and brain) and the lymphatic system. It also includes the management of trauma and surgical access to the vascular system.
General Surgery -is a broadly based specialty which includes the diagnosis and treatment (operative and non operative) of patients with disorders of: colon and rectum, upper gastro-intestinal organs, breasts, endocrine organs, skin and subcutaneous structures, blood vessels including varicose veins and the head and neck region. It also includes the early and ongoing management of trauma.

Education

BSc Hons (2.1) Medical Cell Biology & Biochemistry, Liverpool (1980).
MB ChB Liverpool (1983).   
FRCS London (1988).
MD Birmingham (1993) by thesis.
FRACS (2004)
Certificate of Completion of Specialist Training (CCST) London (1995).
The Effective Manager – Open University Business School (1989)

Employment Summary

Cons Gen & Vascular Surgeon, Taranaki Base Hospital, New Plymouth, New Zealand (2002-present).

Cons Gen & Vascular Surgeon, Birmingham Heartlands & Solihull NHS Trust
& Hon Clinical Senior Lecturer, Univ of Birmingham (1995-2002)

Senior Surgical Registrar, Walsgrave Hospital, Coventry (1994-5)
Specialist Surgical Registrar, Birmingham Heartlands Hospital (1993-4)
Specialist Surgical Registrar, Princess Royal Hospital, Telford (1992-3)
Specialist Surgical Registrar, Sandwell DGH, Birmingham (1992)
Hon. Research Fellow in Vasc Surgery, East B’ham Hospital, Univ. of Birmingham (1989-92).
Paediatric surgical registrar, Alder Hey Hosp., Liverpool (1989).
Surgical registrar, Clatterbridge Hospital, Wirral (1988-9).
Surgical registrar, Royal Liverpool Hospital (1987-8).
Senior surgical house officer, East Birmingham Hospital (1986-7).
Senior house officer in Accident & Emergency/ITU, Hope Hospital, Manchester (1985-6).
Lecturer in Anatomy,  University of Manchester (1984-85)
House Officer, Whiston hospital, Liverpool (1983-84).