Clinical Studies

For the first 10 years of my consultant career I undertook both oesophago-gastric and pancreatic resections for malignancy. From 15 years ago, following local reorganisation, I have concentrated entirely on oesophago-gastric pathology. I perform laparoscopic surgery for benign disease with a particular emphasis on anti-reflux surgery, large intra-thoracic hernias and revisional procedures.

My clinical work is almost exclusively in the area of upper gastro-intestinal surgery, which these days, unfortunately, means very largely upper G-I cancer. As the MDT lead for upper GI Cancer for Swansea Bay University Health Board, I am involved managerially as well as clinically in trying to provide the best possible care to the patients in our area.

We have been pioneers in the introduction of endoscopic and laparoscopic ultrasound in the staging of upper G-I cancer, established an EUS service in the staging of oesophageal malignancy, second only to Bristol in the UK, and were the first unit in the UK to offer EUS guided FNA/core biopsy.  At present all major resectional upper G-I services are offered including oesophagectomy and radical gastrectomy as well minimally invasive services including keyhole anti-reflux surgery. I offer a full service for oesophagogastric cancer including stenting, laser treatment, ablation and endoscopic mucosal resection. I have introduced what could be described as different ways to insert oesophageal stents, in particular without using radiological control.