Complex Surgery & Second Opinions
Advanced Surgical Care for Complex Conditions
Much of my specialist practice focuses on the treatment of advanced, metastatic (Stage 4), or otherwise complex conditions affecting the liver, bile ducts, gallbladder, and pancreas.
A Collaborative, Multi-Specialist Approach
I have trained in several major UK centres and spent time in specialist units in the USA and Japan, learning advanced surgical techniques that are not widely available in most hospitals. I work closely with a highly skilled team of surgeons, oncologists, and radiologists, allowing us to offer innovative treatment options — often to patients who have been told elsewhere that their disease is inoperable.
I regularly operate jointly with experts in bowel and urological surgery, as well as colleagues in interventional radiology and oncology. This collaboration means we can:
- Combine treatments such as surgery, ablation, and embolisation for greater effectiveness
- Offer surgery to patients who might otherwise be considered unsuitable
- Tailor each plan to achieve the best possible outcome for every individual
Types of Complex Surgery Offered
1. Staged or Multi-Modality Liver Surgery
For some patients, liver tumours that appear inoperable by standard criteria may still be treated successfully using a staged or combined approach.
Options include:
- Staged liver resection – removing tumours in phases to allow the liver to regenerate between operations
- Parenchymal-sparing surgery – removing only the affected tissue while preserving as much healthy liver as possible
- Combined treatments – such as surgery with microwave ablation, where heat destroys smaller areas of tumour that cannot be removed safely
These strategies can make curative surgery possible for many patients who were initially told otherwise.
2. Multivisceral (Multi-Organ) Resections
Sometimes, cancers or recurrences involve several organs or major blood vessels and are deemed “inoperable” at first assessment. However, in experienced hands, many of these can be removed successfully with a multivisceral resection — where all affected organs and tissues are removed together as a single unit.
Typical structures that may be involved include the liver, bile duct, bowel, stomach, kidney, pancreas, or abdominal blood vessels.
I have extensive experience performing these operations and work closely with specialist colleagues to ensure patient safety and the best possible outcomes.
Patients who also have disease affecting the peritoneal lining of the abdomen may be jointly treated with the Basingstoke Peritoneal Malignancy Service, offering a coordinated and comprehensive surgical approach.
3. Deep Abdominal Lymph Node Surgery
Cancers can spread in one of three different ways – invading directly into adjacent organs, via the blood stream or through the lymphatic channels. Spread through the lymphatic channels can lead to deposits in deep abdominal lymph nodes — often near to or involving vital blood vessels.
In carefully selected patients, these lymph nodes can be removed safely, sometimes achieving long-term remission or cure. This is technically demanding surgery and should only be undertaken by surgeons experienced in liver and retroperitoneal anatomy. I spent time in Japan learning their approach to this procedure, where it is provided far more widely than in the UK.
4. Surgery for Complex Pancreatitis
Pancreatitis is inflammation of the pancreas, which in most cases resolves without surgery. However, some patients develop complications such as:
- Pancreatic cysts
- Dead (necrotic) tissue
- Infections
- Persistent pain or recurrent attacks
I offer a range of minimally invasive and open surgical treatments to manage these complications, drain infected areas, and reduce the risk of further episodes of pancreatitis.
Second Opinions
If you’ve been told that surgery isn’t possible, a second opinion can make a difference.
I frequently review patients who have been:
- Advised that surgery is not possible
- Offered only palliative or non-surgical treatment
- Seeking confirmation or alternative options after multidisciplinary review
A second opinion can help you understand all available options, including advanced or combined treatments that might not be routinely offered elsewhere.
