Mr Kelvin Ramsey publishes lymphoedema article in British Journal of Surgery

Lymphoedema specialist Mr Kelvin Ramsey and colleagues recently had an article published in the British Journal of Surgery.

Following treatment for breast cancer, damage caused by surgery or radiotherapy to the lymph nodes under the arm can result in a build-up of lymph fluid causing a swelling of the tissues known as lymphoedema. Treating breast cancer-related lymphoedema presents a significant cost to the healthcare system and the symptoms – swelling, discomfort, a sensation of tightness, dry skin and possible infection – all adversely affect the quality of life of patients.

Mr Ramsey and his colleagues conducted a feasibility study into the use of combined dynamic imaging and lymphaticovenous anastomosis surgery for the treatment of breast-cancer related lymphoedema.

Using near-infrared spectroscopy with indocyanine green lymphatic mapping to identify suitable lymphatic channels, patients were then treated with end-to-end anastomoses to subdermal venules. After surgery, compression garment therapy (CGT) was recommended. Excess volume reduction was assessed at regular intervals and an excess volume reduction of -33·2 per cent was recorded at 12 months.

The authors concluded that this combined approach could result in sustained volume reduction, but further work would be required to identify biomarkers that would allow practitioners to predict who would best respond to this treatment.

Chosen as the front cover article for this month’s journal, the editor tweeted his excitement at the study’s findings.

Advice on breast implant safety

On Monday, BBC Panorama’s programme focused on medical implants, after working with the International Consortium of Investigative Journalists and a large number of media organisations around the world including the British Medical Journal, who had highlighted what they feel to be regulatory deficiencies in bringing medical implants to the healthcare sector and their subsequent surveillance in patients.

In light of this programme, the British Association of Aesthetic Plastic Surgeons (BAAPS), of which I’m a member, has released a statement focusing on breast implant safety and giving advice to any previous or prospective patients: “As a result of the media attention regarding medical devices, many of our patients will be understandably concerned and we publish a statement by our partners, the International Collaboration of Breast Registry Activities (ICOBRA), to clarify some questions around the safety of breast implants.”

Please click here to read the full BAAPS statement on breast implant safety.

Groundbreaking surgery developments at the Royal Marsden

The Royal Marsden continues to lead the way in groundbreaking surgery internationally, as surgeons perform a UK-first in robotic surgery. Using pioneering da Vinci robotic technology, a patient underwent a robotic total pelvic exenteration to treat advanced rectal cancer. This procedure entails removing all the organs from the pelvic area and the traditional approach would have required a large incision being made from the chest down to the pubic bone.
With robotic technology, however, surgeons at the Royal Marsden were able to perform the procedure through a minimally invasive approach. Robotic surgery potentially has a number of benefits; less blood loss, less pain experienced, a quicker recovery and a much quicker return to home.

Mr Kelvin Ramsey published in the British Journal of Surgery

Breast cancer‐related lymphoedema (BCRL) presents a significant healthcare burden and adversely affects the quality of life of breast cancer survivors. Mr Kelvin Ramsey has just had his series of lymphaticovenous anastomosis surgery for breast cancer-related lymphedema published in the British Journal of Surgery.

This is the first UK series of this type of technique and is paving the way to a randomised controlled trial which will start in 2019.

Important information for patients considering breast implant surgery

Breast implant surgery is a very popular cosmetic surgery procedure and is typically very successful, with a high patient satisfaction rate. However, any surgical procedure carries a degree of risk and potential complications and it is essential that patients are fully aware of the implications of their decision to go ahead with surgery at that time.

Last month, a joint statement was released by the Association of Breast Surgeons (ABS), the British Association of Aesthetic Plastic Surgeons (BAAPS) and the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS), who have been working in close collaboration with the Medicines and Healthcare products Regulatory Agency (MHRA) to evaluate the risk factors associated with Breast Implant Associated – Anaplastic Large Cell Lymphoma (BIA-ALCL).

Click here to read the statement in full.

Mr Kelvin Ramsey always offers a comprehensive consultation where all aspects of the surgical procedure are discussed in depth to ensure that patients are fully informed. If you have further questions, then please call 020 3764 0399 to arrange a consultation.

Mr Kelvin Ramsey completes the Royal College of Surgeon’s Cosmetic Surgery Professional Behaviours Masterclass

In response to the 2013 review of the cosmetic surgery industry by Professor Sir Bruce Keogh KBE, the Royal College of Surgeons has developed a cosmetic surgery certification scheme aimed at improving patient safety in this sector.

The aim of this scheme is to recognise surgeons that have the necessary and relevant training, qualifications and experience to carry out these surgical procedures. Patients will then be able to search for certified surgeons on the Royal College of Surgeons website prior to booking a consultation.

Part of the certification process is attending a Professional Behaviours Masterclass at the Royal College of Surgeons which ensures that surgeons are conversant in the appropriate professional skills and patient interaction that is required. Mr Kelvin Ramsey recently completed this course which covered consultation techniques and the approach to post-operative care and how any complications should be dealt with.

 

New study questions use of neoadjuvant chemotherapy in breast cancer treatment

Published this month in the British Medical Journal was an interesting paper on the application of neoadjuvant chemotherapy in the treatment of breast cancer. This type of chemotherapy refers to medicines that are used prior to surgery to reduce the size of the tumour.

Lead author of the paper, Mr Jayant S Vaidya, professor of surgery and oncology and consultant breast cancer surgeon at University College London and the Royal Free Hospital, argued that in some cases we must reconsider current the use of neoadjuvant chemotherapy as there is evidence to suggest that there is a higher rate of local recurrence and no evidence of survival benefit.

Prince William joins the team at The Royal Marsden

Our president, HRH The Duke of Cambridge, recently visited us at The Royal Marsden to watch one of our surgical teams perform a robotic oesophagectomy using the Da Vinci robotic surgical system.

This pioneering surgery is only available at The Royal Marsden and allows our surgeons to substantially reduce operating times for our patients. This minimally invasive approach means visible scarring is reduced and patients are able to return home quickly after their operation.

William is following in the steps of Princess Diana who was previously patron of The Royal Marsden and visited us many times