Professor Haray established a laparoscopic service, initially for cholecystectomy in 1997 and then for colorectal surgery in 1998. He obtained training by attending various workshops and seminars in Europe and the USA. Prior to his appointment as consultant, he was a visiting Fellow at the Cleveland Clinic in the USA.
Laparoscopic Colorectal Surgery – Personal Learning Curve:
He started off with diagnostic laparoscopy and progressed on to laparoscopic resection in very selected cases, mainly in patients with simple benign problems (such as isolated Crohn’s strictures, angiodysplasia or large pre-malignant polyps) and later to patients with advanced metastatic disease needing palliative resection for impending obstruction or persistent anaemia.
After gaining some experience, he participated in the UK wide CLASICC trial. Once the results confirmed the safety of the laparoscopic approach in curative resections, he broadened his case selection criteria and over the last few years, since the publication of NICE guidelines recommending the laparoscopic approach in all suitable cases, his practice has been to offer this in almost all cases (> 95%).
Case Load (Laparoscopic Colorectal Surgery):
Since 1998, there has been a cautious and steady increase in the numbers of laparoscopic colorectal cases that Prof Haray has carried out per year. In the last 12 months, this has now reached over 100 cases per year. Total number of laparoscopic colorectal cases >1000. Resections for Cancer >800.
Case mix (Laparoscopic Colorectal Surgery):
Prof Haray uses laparoscopic surgery as the default approach for all colorectal resections including:
Right & left hemicolectomy, Sigmoid colectomies, Anterior resection of the rectum, Abdomino-perineal resections of the rectum, Total colectomies.
Segmental colectomies for various indications including Crohn’s, radiation strictures, angiodysplasia etc. Total colectomies with ileorectal anastomosis for functional problems, multiple polyps etc.
Restorative procto-colectomies with ileal pouch anal anastomosis for ulcerative colitis (UC) and familial adenomatous polyposis (FAP). Pan-procto-colectomies for UC and FAP, Lynch syndrome etc.
Preceptorship Experience in Laparoscopic Colorectal Surgery:
Having obtained considerable experience in the performance of laparoscopic colorectal surgery, Prof Haray agreed to become a preceptor to train other consultant surgeons in the UK in May 2008. He conducts demonstration ‘Masterclasses’ to visiting consultant surgeons and their surgical teams at Prince Charles Hospital and then operates several cases with them at their base hospitals to provide on-site Preceptorship training. Though this can be challenging, he has found it very gratifying to be able to impart advanced surgical skills to senior colleagues.
- Registered Preceptor for Laparoscopic Colorectal Surgery, Association of Laparoscopic Surgery at the Royal College of Surgeons.
- On the faculty of the European Surgical Institute, Hamburg for Laparoscopic Colorectal Surgery courses and workshops.
- Masterclasses: Conducted several Masterclasses for visiting consultant surgeons wishing to learn Laparoscopic Colorectal Surgery as well as many Live video linked surgical demonstrations to audiences comprising Consultants, Surgical Registrars, Junior Doctors, Medical Students, Nurses etc.
- Registered Preceptor with Ethicon Endo-surgery® Ltd.
- Preceptorship provided to more than nineteen consultant surgeons from seven hospitals across Wales.