BSc (Hons) MBBS FRCS (Ed) FRCS (Eng) Master of Surgery (Univ. of London)
Lower GI surgery
Alteration in bowel habit
Anal Fissure management (including non-surgical)
Inguinal hernia (including recurrent)
All areas of colorectal and anal surgery; I accept Bowel Cancer Direct Access patients who are concerned about their symptoms based on NICE guidelines such as anorectal bleeding, a persistent altered bowel habit and unexplained weight loss.
Abdominal wall hernias; including inguinal hernia and other groin hernias. I specialise in repairs carried out under local anaesthesia for the less fit patient.
I have substantial experience in all aspects of elective and emergency surgery having trained in London, Leeds, and South Wales.
I see private patients only at St Joseph's Hospital. I have a busy NHS practice and run the Trusts Hernia pathway to streamline and improve patient care. I spent some time as a missionary surgeon in South Africa in my early career. I am fortunate to be able to continue operating in many foreign countries on a charitable and humanitarian basis, primarily on groin hernia patients. Discover more about my charitable work.
Whilst I am a trained general and colorectal surgeon my main sub-specialist interest is in groin hernia surgery and, on request, I wrote an authoritative review on open hernia repairs in 2003.
I reviewed the ‘Clinical and cost-effectiveness of laparoscopic inguinal hernia repair’ on behalf of the National Institute of Clinical Excellence (NICE) in 2004 and co-authored the UK Groin Hernia guidelines as an 'Issue in Professional Practice' on behalf of the Association of Surgeons of Great Britain & Ireland (ASGBI) in 2013 and the British Hernia Society (BHS) consensus statement on the management of groin pain in athletes (2014).
I have given Plenary lectures for the Association of Surgeons of Great Britain & Ireland and the British and European Hernia Societies.
As a general surgeon, I am proud that my audited recurrence rate for primary groin hernia repair in over 3000 cases is less than 1% (the UK average is 5-10% for reoccurrence of hernia).
I have taught my techniques to many colleagues in the UK and abroad including on humanitarian missions. In 2003 I co-founded the British Hernia Society BHS (www.britishherniasociety.org). I have set up a groin hernia database to assess care pathways and have introduced a one-stop hernia service in my NHS practice.
My personal day case rate is over 90% (national rate ~ 60%) and 96% of patients surveyed rating the service as excellent (published 2010).
Day case groin hernia repair rates in Wales have lagged behind the rest of the UK. Since 2003 I have improved my NHS Trust’s considerably by increasing the number of repairs under local anaesthesia with recommendations published in 2008 with the updated methodology described in 2020.
Through the BHS, I helped set measurable quality standards (infection and length of stay) for hernia repair across the NHS. A national registry is planned. I was appointed UK Chair to the National Institute Health Research (NIHR) "CIPHER" study to determine the risk factors for developing parastomal herniation.
I was elected to the Court of Examiners at the Royal College of Surgeons of England in 2004 and appointed to the Intercollegiate Speciality Board in General Surgery in 2009 to maintain the quality of UK consultant surgeons. I am one of only two surgeons recruited by the Association of Coloproctology of Great Britain & Ireland to its Welsh Disciplinary Panel.
I am committed to clinical research and have given over 200 presentations at regional, national, and international meetings and have over 160 publications in peer-reviewed journals with over 2900 citations (inc 48 'high-index) (please see www.pubmed.gov). In November 2020 I organised the BHS’s first virtual conference entitled “Improving our patients’ outcomes after hernia surgery”. This attracted over 600 delegates from all over the world to listen to the many well-known International speakers we involved. Most recently (September 2021), as part of the RCSEd Surgical Speciality Board Hernia Masterclass Webinar Series, I lectured on the management of difficult groin cases to many UK and International colleagues.
I review for a number of Journals including Annals of the Royal College of Surgeons, British Medical Journal, Colorectal Disease, Hernia, and The Lancet
I am committed to the charity; Hernia International www.herniainternational.org.uk that addresses the global problem of hernia by delivering modern techniques of hernia surgery in low-income /resource settings.
I personally investigated the safety and cost-effectiveness of sterilised mosquito net mesh in groin hernia repair, recently visiting: Tanzania (2014), Trinidad (2015), Sri Lanka (2016) and rural India in 2019.