Services Provided
Mr Worthington performs a number of procedures as a General Surgeon specialising in Hepatobiliary and Pancreatic surgery. A brief overview of procedures performed is set out below. If you would like to book an initial consultation to discuss your concerns, please contact the office. Please be aware that your private medical insurance may require you to be referred through your GP. Self-funding patients may self-refer or may prefer to see their GP for a referral to Mr Worthington. Insured patients should check the terms of their policy with their insurer before attending their appointment.
Hernia repair
The most common type of hernia is an inguinal hernia which, whilst more common in men, can also affect women. It can occur at any age and generally speaking, if a patient is fit, hernias are best treated by repair to avoid complications such as incarceration or strangulation.
In the vast majority of patients, inguinal hernia repair is carried out laparoscopically, which involves three tiny incisions in the abdomen. The hernia is reduced and the abdominal wall reinforced by using a prosthetic polypropylene mesh.
Laparoscopic hernia repair has the following benefits:-
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Less postoperative pain.
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A quicker return to work and exercise.
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Improved cosmesis.
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Reduced incidence of chronic groin and wound pain postoperatively.
Mr Worthington favours a technique called totally extraperitoneal hernia repair (TEP) which avoids entry into the abdominal cavity and the associated complications.
A less common type of hernia is a femoral hernia, but this too can be approached laparoscopically.
Patients can also develop hernias elsewhere within their abdomen and abdominal wall, and these are usually repaired using prosthetic mesh to reduce recurrent.
Laparoscopic cholecystectomy (gallbladder removal)
The procedure of gallbladder removal has been revolutionised by the advent of keyhole surgery. In the 1970s and 80s, patients routinely stayed in hospital for seven to ten days following cholecystectomy, but with laparoscopic surgery it is now often performed as a daycase. Mr Worthington is a course director and surgical tutor for laparoscopic cholecystectomy at the Minimum Access Therapy Training Unit at the University of Surrey. He is expert at the procedure of laparoscopic cholecystectomy and also offers the service of laparoscopic clearance of stones from the bile duct.
In Mr Worthington’s hands the risk of an open procedure is less than 1%, with a similar risk of bile leak postoperatively. A very rare significant complication of gallbladder surgery is bile duct injury, and Mr Worthington is part of the regional team that manages patients with complex biliary disease and often manages such cases from other centres.
The vast majority of patients go on to make a complete recovery from cholecystectomy and no change in their diet is required. Occasionally diarrhoea can occur following gallbladder removal, but this is usually self-limiting and can be treated with a variety of agents if it were to persist.
Upper gastrointestinal
Symptoms of indigestion, nausea and abdominal pain are often investigated by upper gastrointestinal endoscopy, which involves the placement of a flexible telescope into the oesophagus and stomach under sedation and local anaesthetic. This enables diagnosis of a variety of conditions and allows for biopsy and therapy. The procedure is well-tolerated and allows for a fast and efficient diagnosis.
Bowel
A variety of pathologies can present with an alteration in bowel habit, and certainly this needs to be taken seriously and investigated. Colonoscopy involves the placement of a flexible telescope into the bowel and allows for immediate diagnosis and biopsies if necessary. This procedure is carried out under sedation, and prior to it patients are required to take a strong laxative.
Hepatobiliary
Detection of colorectal liver metastasis.
The most common site for a metastatic (secondary) disease in colorectal cancer is the liver. Increasingly these patients can be offered radical surgery and chemotherapy, and with these techniques there has been a paradigm change in the outcome of patients with colorectal liver metastasis. Depending on the site, size and number of metastasis, a proportion of patients can undergo keyhole surgery, with more major operations being carried out with an open incision. Mr Worthington’s patients have access to the Royal Surrey County Hospital Intensive Care Unit and the multidisciplinary team that is vastly experienced at managing such patients, and the outcome of patients undergoing the resection of colorectal liver metastasis at the Royal Surrey is amongst the best in the world.
Pancreatic surgery
Mr Worthington offers all aspects of pancreatic surgery including laparoscopic and open pancreatic resection for both benign and malignant disease. He is a member of the tertiary referral unit at the Royal Surrey County Hospital which is a specialist centre for pancreatic disease. Outcomes following pancreatic resection at the Royal Surrey County Hospital have a comparison with the best centres in the world with an operative mortality within the region of 1% with excellent lengths of stay and low levels of morbidity.
Skin
All types of skin lesions and lumps and bumps are seen, diagnosed and removed if necessary.