Mr Ashwini K Trehan MBBS, DRCOG, FRCOG, FRCS (Edin)
Consultant Minimal Access Gynaecologist
(Gynaecologist - specialising in keyhole hysterectomies and treatment of endometriosis)
Recognised "Endometriosis Centre"
for the management of advanced Endometriosis
by the BSGE (British Society of Gynaecological Endoscopy)
General
Information regarding Mr Trehan's practice
Mr Trehan is a (Keyhole) Laparoscopic Minimal Access Gynaecological Surgeon.
He is well known for his excision treatment of endometriosis and
overnight keyhole
hysterectomies.
Mr Trehan has shown a unique new direction to the future of major/complex
gynaecological surgery by proving that almost all non-cancerous
gynaecological surgery can be undertaken via keyhole means. He strongly
believes that there is very little need for the traditional and widely used
choice of open (laparotomy) benign gynaecological surgery where a large cut is
given to the patient’s stomach; and this is reflected in his practice.
Mr Trehan has pioneered, developed, introduced and is running effectively
the UK’s only one of its kind “Overnight hospital stay service
following major/complex benign gynaecological surgery". He also offers one
of the most advanced endometriosis surgical services in the country.
Mr Trehan’s expertise has also demonstrated that after major/complex gynaecological surgery almost all patients can return home after overnight hospital stay and return to daily activities within days. This contrasts to the usual duration of 5-7 days in the hospital post surgery and weeks of recovery.
Mr Trehan’s keyhole experience as a consultant spans over a period of 18
years and he has undertaken over 2500 major benign gynaecological procedures
using keyhole surgery. The majority of his operations involve complicated
procedures, many of which are referred to him by other consultants and from
other parts of the country (many of whom have had several previous
operations by others by the time to come to see Mr Trehan).
Patient safety is Mr Trehan’s prime consideration, which is substantiated by
miniscule complication rates of his surgery in spite of operating on
patients with complicated problems.
Women having their operation by him are confident that:
-
Their operation will be undertaken laparoscopically as Mr Trehan undertakes all operations for all Gynaecological benign conditions by keyhole means (exceptions: hysterectomy for uterus size more than 24 weeks of pregnancy and myomectomy for multiple large fibroids).
-
Their operation will be completed by laparoscope as his conversion rate (change over to open operation during keyhole) is under 0.3%.
-
It is unlikely that they will return back to theatre for postoperative complications.
-
Their overall risks of suffering a complication is miniscule, and is among one of the lowest reported in the literature.
-
That they will be fit to leave for home after overnight stay. Over 90% of Mr Trehan's patients do leave after an overnight stay (most of those staying back for more than one night did so for social reasons).
-
It is unlikely they will be readmitted due to complications, as there has been only two readmissions amongst over 1500 consecutive patients (the national readmission rate is 5-7%).
The success of his service can be demonstrated by the fact that they attract tertiary referrals & patients nationally. In addition, they have been covered widely by newspapers both national (1998, 1999, 2007, 2010) and locally on numerous occasions, as well as on Television (ITV 1999, BBC1 2003). Furthermore, his services have been complimented in the House of Lords (2004) by the Under Secretary of State, Lord Warner and have attracted the Modernisation Agency of the Department Of Health. Likewise, his service has received several awards (1998,2003, 2004, 2006,2007).
Click here to view the media coverage regarding Mr. Trehan's work.
Mr Trehan undertakes a wide range of benign intra abdominal gynaecological operations by keyhole means. The includes hysterectomies, myomectomies, ovarian cysts including those occurring in pregnancy (cysts of any size and type and also all cyst complications), tubal surgery, extensive adhesiolysis, excision procedures for endometriosis including rectovaginal advanced disease, tubo-ovarian abscess and masses, drilling the ovaries for polycystic disease, surgical treatment of ectopic pregnancy, Ventrosuspension (bringing the tilted womb forward ) and other benign gynaecological procedures for which patients traditionally required laparotomy (an open cut on the stomach), prolonged hospital stays and long recovery times.
Mr Trehan has innovated surgical techniques and services aimed at improving the quality of life for women. For instance, he has pioneered:
-
The UK's only one of its kind "Overnight Hospital Stay Service" following major/complex gynaecological surgery.
-
"Temporary Ovarian Suspension" for chronic pelvic pain and dyspareunia; now used around the globe (see below).
-
"Total Peritoneal Excision"; for the management of endometriosis (see below).
-
"Post-Hysterectomy Vaginal Vault Excision" for chronic pelvic pain and dyspareunia following hysterectomy (see below).
KEYHOLE PROCEDURES UNDERTAKEN BY MR. TREHAN
For more information on any of the procedures below, please use the navigation pane on the left.
Polycystic ovaries (ovarian drilling)
TEACHING & TRAINING
Mr Trehan is a Royal college - recognised principle for laparoscopic
training and is a preceptor for the University of Surrey MSc degree
in advanced gynaecological endoscopy.
DOCUMENTATION & PHOTOGRAPHS
Mr Trehan routinely takes photographs of the pathology (disease) at
the time of keyhole surgery to document the findings before, during
and after the operation. This helps patients understand their
condition better and is useful for future records if further
investigation / treatment is necessary and is also useful for
medicolegal purposes.
INTERNATIONAL PRESENTATIONS & PUBLICATIONS
Mr Trehan has written peer reviewed papers and presented abstracts
relating to his work all over the world and is propagating his view
points on a wider scale. To view the publications and a list of presentations which Mr Trehan has
presented, click
here.
Not only has Mr Trehan pioneered and run effectively a unique service, but based on his service he has also floated his vision to the to the department of health to establish “Multidisciplinary Overnight Hospital Stay Unit in every NHS hospital to overcome the bed crisis, save NHS resources and reduce hospital acquired infection. To view information on the unique service which he has implemented and his future vision for the NHS, click here.