Quick Search / Select a Section

Cancer Surgery

Surgery is an important part of treatment for many cancers and also plays a key role in diagnosis. In cancers that have not metastasised, surgery offers the greatest chance of a cure. Advances in surgical techniques have allowed surgeons to operate successfully on increasing numbers of patients, effectively removing the tumour while sparing as much normal tissue and function as possible.

The Regional Hepatopancreaticobiliary (HPB) Unit

The Regional Hepatopancreaticobiliary (HPB) Unit provides highly specialist expertise in the management of malignant liver disease, pancreatic cancer and complex benign conditions as well as a service for more “routine” HPB conditions such as gallstones.

Research efforts focus on improving treatment of cancers of the liver and pancreas and making the experience of major surgery better for patients.

Our published survival results after liver resection for colorectal cancer secondaries are amongst the best in the world, with 3 year overall survival of 61% and 5 year overall survival of 50%, compared with the published literature (range of 5 year survival 30-41%). http://www.ncbi.nlm.nih.gov/pubmed/18328668

We have recently published the results of a randomised controlled trial implementing Enhanced Recovery after Surgery techniques after major liver surgery, showing that patients stayed in hospital an average of 4 days, compared with 7 days in the control group. http://www.ncbi.nlm.nih.gov/pubmed/23696477

We also recruit patients into national trials treating colorectal, pancreatic, biliary tract and other cancers. In a recent audit publications, the Royal Surrey recruited more patients for these important trials than any other medium-size district general hospital in the UK.

For a list of recent publications:
http://www.ncbi.nlm.nih.gov/pubmed/?term=guildford+liver+resection

Find out more at:

http://www.royalsurrey.nhs.uk/service-list/general-surgery/the-regional-hepatopancreaticobiliary-hpb-unit/

Gynaecological Oncology Clinical and Translational Research (GOCTR) Group

The Gynaecological Oncology Clinical and Translational Research Group offers state of the art surgery to women diagnosed with gynaecological malignancies. The team is committed to pioneering research, both clinical and translational in the field of gynaecological oncology that will improve the management and survival of women diagnosed with a gynaecological cancer.

Over 17,000 women in the United Kingdom were diagnosed with a gynaecological malignancy in 2011. Our division is part of the St Luke’s Cancer Alliance, formerly the Surrey West Sussex and Hampshire Cancer Network. It was established to utilise the skills and knowledge of specialists in a multi-disciplinary setting to determine the most effective and complete treatment for all gynaecological cancers. The surgeons offer treatments with cutting edge technology such as the Da Vinci robot and other surgical devices to improve surgical outcomes and indeed have the biggest experience within the UK.

We are dedicated to developing novel surgical and molecular techniques that will identify new procedures and ideas in treating and managing women with gynaecological cancers. We have performed the largest number of robotic surgical cases in the United Kingdom, in women with cervical, endometrial and ovarian cancers. Surgery is tailored to the patient and is personalised including the option of fertility sparing surgery in young women using the Da Vinci Robot.

The team are actively involved in clinical and translational research including national and international collaborations. Work on surgical techniques, novel biomarkers and predictive modelling is on-going. Being at the forefront of clinical research, the team is one of the biggest recruiters to various international and UK surgical trials such as CHORUS, ICON 8 and DESKTOP III to name a few.

The team consist of three surgical oncologists, Mr Simon Butler Manuel, Mr Anil Tailor and Miss Patricia Ellis. Working alongside them is a Clinical Research Fellow, Dr Kavitha Madhuri. Based at the Royal Surrey Hospital, women across the network from Ashford and St Peter’s, Frimley and East Surrey Hospitals are managed here.

We are currently working on several projects, some of which involves collaboration with other centres, both nationally and internationally:

Randomised Controlled Trials

1. A pilot randomised controlled trial to evaluate the utility and efficacy of Neutral Argon Plasma (Plasma Jet) as a new technology achieving complete cytoreduction of advanced epithelial ovarian carcinoma

2. A pilot randomised controlled trial to evaluate the utility and efficacy of Neutral Argon Plasma (Plasma Jet) in reducing groin lymphocyst formation following bilateral groin node dissection

3. DESKTOP III. A randomised controlled trial evaluating cytoreductive surgery in patients with platinum sensitive recurrent ovarian cancer

4. Randomised studies to assess the effect of Patent Blue V (PBV) dye guidance and quilting sutures in reducing the incidence of groin lymphocyst following lymphadenectomy for vulval cancer: multicentre randomised trials.

Observational Studies

1. GROningen INternational Study on Sentinel nodes in Vulvar cancer (GROINSS-V) II

2. A prospective study to evaluate the role of squamous cell carcinoma antigen (SCC-Ag) combined with PET/CT in the prevention of tri-modality treatment for early stage cervical cancer

3. Role of DW MRI in predicting disease volume in ovarian cancer

4. A pilot study to evaluate the efficacy of wound catheters (PAINfusor) in midline laparotomies for gynaecological malignancies

5. Hypodontia as a screening tool for Ovarian Cancer

6. Sensitivity of CT reporting in Ovarian Cancer

7. Enhanced Recovery in Gynaecological Oncology

Translational Research

1. Investigating cell signalling pathways in young women with endometrial cancer. This is a joint collaboration with the Division of Investigative Science, Imperial College London.

2. Identification of novel biomarkers for the management of gynaecological cancers

3. Predictive modelling using novel biomarkers to predict response to treatment and survival outcomes

4. The identification of new prognostic indicators and markers of disease process and drug resistance for the management of gynaecological cancers

Quality of Life Studies

1. Explore Patient reported Outcome measures following Da Vinci Robot assisted surgery

2. Evaluate Quality of Life questionnaires post debulking surgery for ovarian cancer

GRACE (Gynaecological Research and Clinical Excellence) is our local charity (registered no 110997). It was founded in July 2005. GRACE contributed towards the purchase of the Da Vinci robot and also funds training and research resulting in one MD thesis and one PhD with two more PhD students enrolled. Find our more at:

Grace Logo

http://www.grace-charity.org.uk

The Uro-oncology Research Group

The Uro-Oncology research group is led by Professor Stephen Langley with Dr Robert Laing and Professor Christopher Eden.

Their focus is in prostate cancer and has been wide ranging including:

  • Development of a new biopsy technique to diagnose prostate cancer, template biopsy.
  • Studies to minimise the metabolic effects side of hormone therapy using diet, exercise and metformin.
  • Development of a new generation of LDR prostate brachytherapy, 4D Brachytherapy, improving both the dosimetry and clinical outcomes of patients in a time efficient technique.
  • Evaluation of focal LDR brachytherapy in patients with unilateral prostate cancer.
  • Demonstration of the value on extended lymphadenectomy at the time of laparoscopic radical prostatectomy.
  • The investigation of radical prostatectomy for high risk prostate cancer.

The unit also participates in a number of national clinical trials such as STAMPEDE.

Previous Grants have been awarded from PPP Healthcare Research Trust and the Prostate Project.

There are currently 4 Clinical fellows working in the research group.

Web links to the group’s clinical work include:

www.prostatecancercentre.com
www.prostatebrachytherapycentre.com
www.4dbrachytherapy.com

Minimal Access Therapy Training Unit (MATTU)

The MATTU was founded in 1995 by Professor Michael Bailey at the Royal Surrey County Hospital at the start of the laparoscopic era. It was partly funded by a competitive grant from the Department of Health and the Wolfson foundation. It moved to the Post Graduate Medical School of Surrey University in 1996 but remains an integral part of the Hospital and is linked by fibre optic cable to the integrated operating theatres in the Royal Surrey and more recently in the Nuffield Hospital. The unit delivers a variety of post graduate training courses in a wide spectrum of specialities with a focus on minimally invasive surgery and also hosts research activities providing opportunities for surgical trainees to undertake MD and PhD theses at Surrey University.

Current research projects include:

  • Health Service Research (Ethicon Endosurgery Grant €20,000)
  • Enhanced Recovery Research (EAES Grant €50,000)
  • 3D Research
  • Laparoscopic Surgery Outcomes Research

National / International Trial participation

  • EnROL:
    A multicentre randomised trial of conventional versus laparoscopic surgery for colorectal cancer within an enhanced recovery programme (Recruitment complete)
  • RoLaRR:
    Robotic versus Laparoscopic Resection for Rectal cancer (Recruitment complete)
  • Ethicon Harmonic ACE 7 trial (Recruitment active)

Local RCT's

  • Randomised trial of analgesia in laparoscopic colorectal resection
  • Randomised trial of fluid replacement in laparoscopic colorectal surgery
  • Randomised trial of 2D versus 3D surgery in laparoscopic cholecystectomy
Find out more at:

www.mattu.org.uk/

Equipment & Resources

  • 3D laparoscopic imaging systems
  • Surgical training equipment
  • Laparoscopic

Publications & Presentations

Click here for publications and presentations