Clinical Experience
During the years 1987 to 1996 I trained and worked in the South African medical system. The initial years were spent learning surgery in large tertiary referral centres in Natal, (Edendale and King Edward VII Hospitals) and in two years of National Service. I developed considerable experience in laparotomy for complex trauma as well as thoracotomy for chest trauma.
I performed a wide range of reconstructive surgeries typically required in Tuberculosis, Schistosomiasis and congenital abnormalities.
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During National Service, 6 months were spent in action in the war in Angola under the auspices of the Chief of Staff Intelligence Corps. This involved remote postings and operating in bush camps where I performed over 400 surgeries for injuries sustained in battle. The conditions were extremely challenging with surgery conducted in a rudimentary thatch operating theatre with limited facilities. After leaving the operational area I was posted to Mission Hospitals in remote areas in Natal, in which I worked alone clinically as well as managerially.
During my residency training at Groote Schuur Hospital and Red Cross Children’s Hospital in Cape Town, I dealt with considerable renal pathology, which formed the basis of my subsequent interest in renal surgery. The case mix was varied including extensive blunt and penetrating (sharp and gun shot) trauma, cancer, and congenital abnormalities. Due to a combination of trauma and a high incidence of sexually transmitted disease, there were considerable numbers of urethral strictures requiring urethroplasty.Our department pioneered the use of buccal mucosa in these repairs and I gained experience in performing this surgery and presented the data at international conferences.
After qualifying in 1996 in South Africa as an Urologist I went to the United Kingdom where I trained for a year as a Registrar at St. George’s Hospital, Charing Cross Hospital and the Institute of Urology. I spent a subsequent six months as a Locum Consultant at Whipps Cross and also at Addenbrookes Hospital, Cambridge.
I commenced my full time Consultant post at St George’s Hospital in July 1999. I soon began developing a tertiary referral practise for Renal and Prostate cancer.
In 2000 I commenced training in laparoscopy (keyhole surgery) for renal and prostate cancer. This took me on fellowships to Cleveland clinic, Ohio; and Jackson Memorial Hospital, Miami.
In 2003 I trained in laparoscopy for prostate cancer in a fellowship under the auspices of Prof Stolzenburg in Leipzig who is a world expert in the field. I therefore was one of the early adopters of laparoscopic approach to radical prostatectomy in the UK.
In 2004, I introduced Laparoscopic renal cryotherapy to the UK and have a large cohort of patients with long term follow up. This innovation was pioneering in the UK and encouraged other hospitals to follow suit over the next few years.
In 2005 I applied my laparoscopic skills to the field of Robotic surgery. I had done a fellowship a few years earlier at the Robotic centre at the Henry Ford Hospital, Detroit. This acted as a platform to be mentored under their auspices and, together with other colleagues, we started the robotic prostectomy programme in London . Thereafter , in 2008, I introduced the Robotic Surgery service to St George’s and in doing so have made our service competitive and nationally recognized. I pioneered the extraperitoneal approach to robotic prostatectomy in the UK as well as established myself as one of the early surgeons to develop robotic partial nephrectomy.
As an innovator, I have always readily been keen to develop new techniques. I performed clampless laparoscopic Partial Nephrectomies using a radiofrequency ablation technique and broadened the scope of robotic surgeries in our unit by performing adhesiolysis for retroperitoneal fibrosis, augmentation cystoplasty, bladder diverticulectomy.and pelvic lymphadenectomy penile cancer . I was the first surgeon in the UK to perform selective clamping assisted by immunofluorescence under the mentorship of Professor Alex Mottrie , a world renowned surgeon in this field.
I have developed a reputation in Renal Surgery and am considered an opinion leader in this field. I have established and fully comprehensive Renal Unit at St Georges which offers all treatment options including laparoscopic and robotic nephrectomy, partial nephrectomy, ablative therapy (percutaneous and laparoscopic cryotherapy) and receive many National tertiary referrals outside the local region.
I have established strong links with genetics dept and together perform comprehensive genetic clinics particularly for Von Hippel Lindau Disease and Tuberous Sclerosis sufferers and have published in these areas.
Under my auspices , in October 2018 and January 2019 the Urology Robotic service at St Georges Hospital was granted recognized status as an European Robotic Urology Society Fellowship for training and also a Royal College of Surgeons Senior Robotic fellowship for training, respectively.
I am a volunteer worker for the Swinfen Charitable Trust, which involves advising Doctors in 3rd World countries via Telemedicine link.
Professional Appointments
| 1999 | Appointed Consultant Urologist St Georges Hospital |
| 1998 | Locum Consultant Urologist Whipps Cross Hospital (6 months) |
| 1998 | Locum Consultant Urologist Addenbrooke’s Hospital, Cambridge (6 months) |
| 1997 | Higher Surgical Trainee (Urology) Charing Cross Hospital (3 months) |
| 1997 | Higher Surgical Trainee (Urology) Institute of Urology (3 months) |
| 1997 | Higher Surgical Trainee (Urology) St George’s Hospital London (6 months) |
| 1993 – 1996 | Registrar of Urology Training Programme (4 Years) Department of Urology, Groote Schuur Hospital, Cape Town |
| 1992 | Registrar in General Surgery: (1 Year) Department of Surgery, Groote Schuur Hospital, Cape Town (6/12 trauma surgery; 3/12 transplant surgery; 3/12 intensive care) |
| 1990 and 1991 | Senior House Officer in Anaesthetics: (18 months) Locum Registrar, general Surgery St Albans Hospital, Herts, United Kingdom |
| 1989 and 1990 | Registrar in Urology: (18 months) King Edward VIII Hospital, Natal University, South Africa |
| 1987 and 1988 | Medical Officer in General Surgery: (2 Years) South African Defence Force |
| 1986 | Intern: (1 Year) Edendale Hospital, Pietermaritzburg, South Africa |
Management History
- Clinical Lead to Urology Dept, St Georges Hospital, January 2000 – December 2004.
- Clinical Governance Lead, July 2000 – December 2004.
- Steering Committee member for Action on Urology St Georges and Queen Mary’s Hospital
- Steering committee for redesign of New Build of Queen Mary’s Hospital
- Lead Cancer Clinician Urology. St George’s Hospital .2005 -2016
- Director of Cancer Services, St George’s Hospital 2012- 2016
- Leadership Masterclass : Medicademy programme may 2013.
- Clinical Lead in Multidiscplinary Robotic development at St Georges. 2016- present
Cancer Directorship
From Sept 2012 to July 2016 I was Director of Cancer Services at St Georges. I dedicated considerable enthusiasm and leadership to motivating the cancer divisions to develop a culture of engagement as well as that of robust prospective data collection. I emphasised the benefit of using IT systems to enhance data submission and collectively this resulted in considerable improvements in St George’s cancer target performance. This was borne out by the fact that St Georges was the highest performer for Cancer Staging data submission in the London Cancer Alliance in 2013 and 2014.
I actively lead the directorate in ensuring robust response to the National Cancer Patient Survey. This involved arranging and placing management teams and nurses on educational courses and Sage and Thyme Communications courses; introducing a telephone Cancer Helpline as well leading in raising the profile of a high level of customer service. I was influential in supporting St George’s successful bid to be a pilot in using the electronic Holistic Needs Assessment Toolkit. During this time I was instrumental in establishing a joint McMillan / St Georges Cancer project involving financial and infrastructural investment in improving cancer care over a period of 3 years in the first instance.
Under my leadership I developed an all-encompassing renal cancer service thereby enhancing St George’s reputation. This has enhanced local centralization and increased referrals nationally. This growing service gave me experience in working with networks with the result that I influenced the development of a centralised and teleconferenced, weekly Renal Cancer Multi Disciplinary team meeting between Imperial, Royal Marsden and St George’s. This preceded any nationally mandated requirement for this level of centralisation and created a high quality and peer-reviewed service for all new diagnoses of renal cancer in these areas.
Education
| Schooling: | 1966 – 1978 Diocesan College (Bishops) ,Rondebosch, Cape Town, South Africa |
| University: | 1979 – 1985 University of Stellenbosch, South Africa Graduation MBChB. |
| Intership: | 1985 – 1986 Edendale Hospital, Pietermaritzburg, Natal, South Africa |
National Service
| Rank: | First Lieutenant |
| Unit: | SA Medical Services: July 1987-July 1989 |
| Position: | Medical Officer |
| Postings: | Home Unit Naval Base, Salisbury Island, Durban, South Africa Active Service 6 months active duty during Angolan War serving in Chief of Staff Intelligence: remote postings with Special Forces. Service Medal for Commendation of services rendered on active duty. |
Qualifications
| June 2016 | Honorary Professor of Urology University of Cape Town |
| June 1996 | Registration as Urological Specialist in UK General Medical Council |
| Nov 1998 | Intercollegiate Board in Urology FRCS (Urol) Glasgow, United Kingdom |
| June 1996 | Accreditation/Registration as Urological Specialist in SA South African College of Medicine |
| April 1996 | FCS(UROL)SA Urology Cape Town, South Africa |
| Dec 1985 | MBChB University of Stellenbosch |
| Nov 1995 | Microsurgery Department of Surgery University of Cape Town |
| March 1988 | Underwater Medicine Diploma South African Navy |
Personal Details
| DATE/PLACE OF BIRTH: | 1960, South Africa |
| NATIONALITY: | British and South African |
| PROFESSIONAL MEMBERSHIPS | General Medical Council, United Kingdom. (Membership # 3378841) British Association Urological Specialists: Section : Oncology Royal College of Physicians and Surgeons of Glasgow South African Medical and Dental Council (Membership # MP0291927) British Medical Association (Membership# 7100308) College of Medicine of South Africa European Association of Urology |