TREATMENTS
At the heart of all the treatments offered is a patient-centred approach. Ensuring you are fully informed of all options and have a detailed understanding of the treatment offered is of utmost importance. Prof Chand believes in a collaborative approach with his patients whereby all decisions are made together.
All procedures are carried out using the latest modern equipment in line with national guidance. Prof Chand is appropriately accredited for all treatments offered. Some of Prof Chands publications on laparoscopic and robotic surgery can be seen here.
COLORECTAL CANCER
COLONOSCOPY AND FLEXIBLE SIGMOIDOSCOPY
A colonoscopy or flexible sigmoidoscopy involves passing a narrow calibre camera into the bowel under sedation. The camera is inserted into the bottom and a high definition picture is brought up showing the inside of the bowel. This is a very accurate test to detect abnormalities in the colon including benign growths (polyps), inflammation and tumours. Biopsies may be taken at the time of the procedure.
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The endoscopy suite at The London Clinic has a state-of-the-art facilities and is ideally suited for these procedures ensuring a caring and comforting surrounding.
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MINIMALLY-INVASIVE SURGERY
If you are undergoing major abdominal or pelvic surgery, Mr Chand offers a number of minimally-invasive alternative options suited to your needs. Unfortunately, many surgeons still offer 'open surgery' and this has now been shown to be a sub-optimal approach with greater complications both short and longer term. If you have been offered traditional 'open surgery', it is always worth seeking a second opinion to understand your options as this type of surgery is rarely recommended in modern practise.
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Modern approaches may involve a laparoscopic or robotic approach. This means that instead of one large incision which can cause increased post-operative pain and potentially other complications, smaller incisions of a 1cm or less are used to pass fine instruments into the abdominal cavity. The surgery is then performed using state-of-the-art cameras displayed on a high-definition monitor. The surgeon’s hands do not enter the abdominal cavity. This precise approach to surgery is known to lead to faster recovery, shorter hospital stay and fewer complications without compromising the surgery itself.
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A laparoscopic approach may be suggested whereby tiny incisions (less than 1cm) are made to introduce instruments from outside the body. The surgeon controls those instruments directly with their hands. The surgery is conducted using the latest high definition monitors which allows for far more precision than traditional open surgery. There is now clear evidence that laparoscopy is superior to open surgery in terms of patient outcomes and, in most cases, laparoscopy should be offered to patients over open surgery unless there is a clear reason not to do so. Often this is dictated by the skillset of the operating surgeon, but can be down to the underlying disease.
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Another option is robotic surgery. Mr Chand uses the latest Da Vinci operating robot – Xi. In some cases, there may be an advantage to using the Da Vinci Xi over laparoscopy for surgery which involves technical difficulty. The robotic platform allows the surgeon to use advanced instruments which act like the surgeon’s wrists, and these are superior to laparoscopic instruments. To ensure the highest levels of safety and excellence, he undertakes these procedures with his colleague, Mr Jim Khan, who is also recognised as a global opinion leader in the field of MIS and robotics, specifically. Mr Chand would be happy to discuss your requirements and provide you with a detailed treatment plan.
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Mr Chand is recognised as a global expert in laparoscopic and minimally-invasive surgery. He is actively involved in the training of surgeons across Europe, India, Middle East and North Africa. He is widely published in minimally-invasive surgery and offers this approach to the majority of his patients undergoing major surgery. As a recognised expert in performing minimally invasive surgery and is happy to discuss the appropriateness of laparoscopy or robotic surgery with you. An example of this surgery can be found here
FLUORESCENCE GUIDED SURGERY
New research has shown that special dyes can be used during surgery to highlight important structures and pathology. By injecting a safe dye during the procedure, we are able to see additional information relating to the surgery eg the bloodflow to important organs as well as glands which may be diseased. In colorectal surgery, research has shown that use of such dyes may lead to fewer complications.
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The London Clinic has a state-of-the-art machine which allows surgeons to use a special dye in colorectal surgery. Mr Chand is one of the most experienced surgeons in the world using such dyes both in clinical practise and research. Mr Chand is also currently lead investigator on a number of trials to investigate how to better identify anatomy and pathology using fluorescent dyes. These are registered with REC. An example of this surgery can be found here
IMAGING
Many colorectal conditions are best investigated using cross-sectional imaging techniques such as CT or MRI. These highly accurate and detailed images are able to show the internal anatomy with such clarity that they provide your surgeon with invaluable information to help diagnose your condition. Mr Chand is one of the few surgeons in the world who has a detailed knowledge of imaging in colorectal disease as he completed a PhD in the imaging of the GI tract.
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The facilities of The London Clinic are world class and it houses the latest CT scanning machines and 3T MRI scanner. The scans are reported by world leading radiologists. Mr Chand would discuss with you the rationale behind suggesting the different types of scans during your appointment.
MULTIDISCIPLINARY TEAM
Complex conditions are best managed by a multidisciplinary team whereby experts form different fields are able to input into the best treatment strategy. Mr Chand is a firm believer in such an approach to offer his patients optimal care and consideration. His practise often involves input from other affiliated specialities. A combined approach to healthcare has been consistently shown to improve patient satisfaction and outcomes. All patients with complex disease are discussed within a multidisciplinary forum. This will give you reassurance the your case is discussed with leading experts in the field to give you the optimal treatment plan
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The London Clinic undertakes regular MDTs for colorectal cancer which are in line with NICE guidelines. Mr Chand is also part of a BSGE accredited multidisciplinary endometriosis unit.
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Professor Chand is currently part of a collaborative effort to update national guidelines in light of the COVID-19 pandemic.
