The second episode of the BBC's Great Ormond Street documentary focused on the work of the surgical team at the hospital.
In this exclusive interview surgeons Ed Kiely and Joe Curry share their thoughts on surgery, decision-making and research to their work at Great Ormond Street Hospital.
General Surgery
How long have you worked in paediatric surgery?
Edward Kiely: I have been in Paediatric Surgery since 1975; initially as a trainee but as a consultant from 1983. I have been at Great Ormond Street Hospital (GOSH) as a Senior Registrar in 1980 and a Consultant from 1983.
Joe Curry: I came to GOSH as a trainee in 2001 and started working as a locum consultant in 2002, before being fully appointed in February 2003.
What specific contribution does general surgery have to the wider work of GOSH?
EK: Apart from dealing with general surgical referrals, we deal with all the other departments of the hospital as general surgical problems may arise in any child.
JC: General surgery has involvement with virtually every single one of the other specialties in the hospital, just by virtue of the fact those children treated by other specialties will have, or develop, problems requiring a general surgery operation.
How do the procedures featured in the programme differ from your day-to-day work?
EK: The procedures featured in the programme are what I do on a day-to-day basis. This is what we do all the time.
Most of the operations we do are not of such severity and do not carry such risk. However, most weeks there is something of this calibre.
JC: Sometimes at GOSH we do operations that are highly complex and, as such, carry an associated risk, but we also do operations that are, in some respects, more routine. However, these are commonly performed in children who have a background of being particularly unwell and more at high risk.
In the documentary, Sebastian’s is an example of an operation performed regularly – not the most regular operation by any means, but an operation that we would do probably eight to ten times a year – but his background represented specifically high-risk care.
There is a startling moment in the documentary where Dr Peppy Brock shows disbelief at a surgery Ed performed, can you explain the thought process you have when faced with such complex surgery and how you prepare?
EK: Peppy was very kind with her compliments. The operation looked intimidating from the imaging and was not as difficult as had been envisaged.
When faced with a difficult and dangerous operation, I go over the phases of the procedure again and again. In addition, I try to imagine what might go wrong at each stage and what I would do to deal with each difficulty. With tumours, this means going over the imaging repeatedly until I am happy that I have prepared as well as possible.
JC: For any child we care for it would begin with understanding the problem, through a series of investigations and tests. Once the problem is identified, we would, particularly if it is a complex case, discuss it in many of the forums we have within the Trust where we meet with either my consultant colleagues or other specialists to decide - what we think is the best way forward for treatment.
When this has been decided it is then implementing that treatment, both in terms of planning the surgery, planning for anaesthetic and preparing for their care afterwards, whether that’s on the ward or the intensive care unit.
Read part two
Read the second part of our interview with Ed Kiely and Joe Curry as they discuss decision-making in surgery.
