Mehrdad Nikfarjam | Doctor

Mehrdad Nikfarjam

Phone: +61 3 9108 7272

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25.01.2022 Short snippet of an operation. No cancer to deal with on this day for once. Great team #warringalprivate #givinghope

23.01.2022 Completed a right hepatectomy today on a patient with hepatoma. . Hepatoma, also known as hepatocellular carcinoma (HCC), is the most common primary malignant tumor of the liver. It occurs most often in people with underlying chronic liver disease, most commonly cirrhosis related to hepatitis B and C. . #hepatoma #liverresection #liversurgery #hbpsurgeon #surgery #hope #livercancer #treatment #theatre ... . Liver image adopted from mayo clinic. https://newsnetwork.mayoclinic.org//living-with-cancer-un/ See more

22.01.2022 Operating with the great HPB surgeon Mr Starkey on a complex major vein resection. #hpbsurgery #whipplesurgery #whipples #reconstruction #surgery #pancare #majorvein #hope

21.01.2022 Total pancreatectomy A few days ago we completed a #whipplesurgery with total pancreatectomy and vein resection/reconstruction. A total pancreatectomy removes the whole pancreas, the duodenum, the gall bladder, part of the bile duct and sometimes part of the stomach and the spleen. This surgery might be an option if the cancer has spread throughout the pancreas but can still be removed. However, as the whole pancreas is removed, you will need to take enzyme supplements to he...lp you to digest food. You will also develop diabetes and you will need to take insulin to manage this. Sometimes pancreatic cancer grows into or around the major veins next to the pancreas the superior mesenteric and portal vein. To remove the cancer completely, part of the vein may need to be removed. The vein is then joined back together. This is called vein resection and reconstruction. #totalpancreatectomy #veins #pancreascancer #diabetes #creon #bileduct #surgery

20.01.2022 It was a pleasure delivering a talk on the management of pancreas, liver and gallbladder disorders to general practitioners @estellenorthcote last night. Special thanks to all that were involved to make this event possible. #education #pancreaticcancer #pancreas #generalpractitioner #researchnurse #warringalprivatehospital #austinhealth #pancreaticfamilialscreening #hepatopancreatobiliary @estellenorthcote @ramsayhealth @pancarefoundation

20.01.2022 Meet one of the best anaesthetists in the world, A/Prof Laurence Weinberg. He is my teammate in research projects and in surgery. I am grateful for his professionalism and friendship. @laurence__weinberg #teammates #surgery #anaesthetist #pancreaticsurgeon #liversurgeon #friendship

18.01.2022 #pancreaticcancer surgery #whipples #warringalprivatehospital Honour having one of my mentors and Great Upper GI surgeon Mr Tom Sweeney helping. Giving individuals the #hope of life without pancreatic cancer. @pancarefoundation

18.01.2022 Endoscopic Retrograde Cholangiopancreatography (#ercp ) is a procedure that combines the use of a flexible, lighted scope (#endoscope) with X-ray pictures to examine the tubes that drain the liver, gallbladder, and pancreas. Stones can form in the gallbladder, if the stones travel into the #commonbileduct, the tube connecting the liver to the intestine, they can become stuck and block the flow of bile. This is called #choledocholithiasis. ERCP procedure allows the identification of blockage or presence of stone. If stone is present, balloons or baskets can be used to remove the stone from the duct, thereby avoiding open surgery. More information is available on https://www.ipbsurgery.com/ercp.html

17.01.2022 We want to talk about #hilarcholangiocarcinoma Hilar (HC). As we have recently operated on a patient with this condition. HC is a type of #bileductcancer that occurs in the bile ducts that lead out of the liver (#hepaticducts) and join with the gallbladder. It is a complex and aggressive disease. HC begins in an area called the hilum, where the right and left major bile ducts join and leave the liver. It is the most common form of the disease, accounting for more than half o...f all cases. A variety of risk factors have been associated with this disease. These Include #primarysclerosingcholangitis, biliary stone disease and #parasiticliver disease. Patients may present with symptoms such as abdominal pain, pruritis, weight loss, and jaundice. Diagnosis of the condition can involve computed topography (CT), magnetic resonance imaging (MRI), and ultrasound (US). These are used to characterize biliary lesions. Your doctors may recommend endoscopic retrograde cholangiopancreatography (#ercp) and percutaneous transhepatic cholangiography (#ptc). These procedures can be used to assess local ductal extent of the tumor and your surgeon can facilitate therapeutic biliary drainage during these procedures. Surgical treatment options would involve removing the cancer surrounding the bile ducts, the affected liver and nearby lymph nodes. Your surgeon would also need to do a #bileduct reconstruction which involves connecting the remaining bile ducts to the small intestine so that bile can still reach your digestive tract and help digest food. See your doctors for advise and treatment. Image adopted from https://ghr.nlm.nih.gov/condition/cholangiocarcinoma #surgery #hpbsurgeon #hope #cancertreatments #liver

15.01.2022 We operated on a patient with #metastaticbreastcancer - #livermetastasis yesterday and thought it would be a good topic to discuss. Secondary #breastcancer in the liver happens when breast cancer cells spread to the liver. It is also known as liver metastases. Liver metastasis may not be associated with obvious symptoms, some patients may not have symptoms at all. It is likely that the condition is picked up by #liverfunctiontests where abnormal levels can indicate liver di...sease or damage. If liver metastasis causes symptoms, they can include: * pain or discomfort in the abdomen * fatigue and weakness * weight loss/poor appetite * fever * bloating * swelling in the legs * #jaundice In addition to liver function tests, Other imaging tests may be used to screen/ diagnose for liver metastasis, these may include #mri #ctscan , #ultrasound and/or #petscan . Liver metastasis can be treated, #treatments are often aimed to control and slow down the spread of the cancer and relieve symptoms. The most common treatments for metastatic breast cancer in any location (bone, brain, lung, or liver) are #systemicmedications ,which treat cancer throughout the entire body. Systemic medications include #chemotherapy , #hormonaltherapy and #targetedtherapies Surgical treatments such as #liverresectionsurgery may be performed for specific patient group under certain circumstances. These considerations can include #tumoursize , #node negativity grading of breast cancer and looking at patient’s responses to #perioperative treatments and more. Your #specialist doctor will be able to evaluate your situation and provide the best treatment options for you. #hpbsurgeon #surgery #hope #cancertreatment #breastcancermetastases #breastcancertreatment #livermetsfrombreastcancer #livermets

15.01.2022 Completed the first whipples for the year 2020 on a patient with Ampullary tumour. Surgery is completed successfully, thanks to a great theatre team. . #ampullarycancer forms in an area of your digestive system called the ampulla of Vater. The ampulla of Vater is located where your bile duct and pancreatic duct join and empty into your small intestine. As it grows, it may affect the surrounding organs, and hence the treatment option often involves surgery- #whippleprocedure ... Image adopted from Mayo clinic. #2020 #pancreaticcancer #pancarefoundation #surgery #whipplesurgery #hope

14.01.2022 My 5 minute break in between #surgical procedures- hanging out with Teddy Boyd at #warringalprivatehospital. Keeping up with strict #socialdistancing rules.

13.01.2022 I am a consultant General Surgeon and member of the Hepato Pancreaticobiliary Association Australia and New Zealand specialising in high volume advanced liver, pancreas and biliary surgeries. I am also trained in advanced ERCP, laparoscopic gallbladder surgery and laparoscopic inguinal and incisional hernia repair. I completed my medical training in Australia in 1997 and received board certification in surgery in Australia (F.R.A.C.S) in 2007. After which i continued with fur...ther training in the USA for 2 years in Liver, Pancreas and Foregut Surgery and Minimally Invasive Laparoscopic and Endoscopic surgery before returning to practice in Melbourne. Current appointments are consultant pancreatic, liver and biliary surgeon and Associate Professor within the Department of Surgery at Austin Health. My private operating is performed at Warringal Private Hospital in Heidelberg. I strive to deliver world class surgery you can depend on that is tailored to the specific needs of the individual. Compassion, care support and dependability are my core values and those of my practice.

13.01.2022 We operated yesterday for a patient suffering from choledochal cysts. Choledochal cysts are also known as bile duct cysts. These are congenital dilatation of the bile ducts. They may occur as a single cyst or in multiples within the biliary tree. Choledochal cysts are inflammatory in nature. If untreated, this frequently lead to recurrent cholangitis (inflammation and infection in the bile ducts) or pancreatitis (inflammation of the pancreas). ... Bile duct surgery with total cyst removal is the definitive treatment for choledochal cysts. The surgical treatment of choledochal cyst is completed by excision, followed by reconstruction of the biliary tree with hepaticojejunostomy in a Roux-en-Y fashion. Image adopted from S. R. Banerjee Jesudason, Mark Ranjan Jesudason, Rajiv PaulMukha, Frederick L.Vyas, Sanjay Govil John C.Muthusami, Management of adult choledochal cysts a 15-year experience HPB Volune 8 issue 4, August 2006, Pages 299-305 #choledochalcyst #hepatojejunoatomy#bileduct #surgery #surgicalknowledge #operation #rouxeny #hpbsurgeon

12.01.2022 Pringle manoeuvre One common surgical technique I often use in a liver surgery is #pringlemanoeuvre . #surgeons must be able to isolate and control these sources of blood flow to control bleeding not only in traumatic injuries to the liver but also in elective #hepatic resections. Pringle maneuver is named after J. Hogarth Pringle, whom in 1908, first described the technique to minimize #bloodloss during a #liversurgery .... The Pringle maneuver temporarily clamps off blood flowing into the liver. A clamp is applied over the #hepatic vascular pedicle, the channel that contains the #hepaticduct, #hepaticartery and the #portalvein Pringle maneuver may be applied intermittently in 10- to 20-minute cycles, allowing five minutes of blood flow (reperfusion) in between. Pringle maneuver can reduce the risks involved with liver surgeries due to excessive bleeding. Image adopted from https://en.m.wikipedia.org/wiki/Pringle_manoeuvre #notchips #pringles #surgery #liver #cancersurvivor #loveforsurgery #hope #lookingforsurgeon #hpbsurgery

10.01.2022 Despite these challenging times we are facing due to the COVID-19 pandemic, some patients are also suffering from various health conditions with some requiring urgent surgeries. In today’s education series we are focusing on duodenal cancer. Small intestine cancer often starts in the duodenum (duodenal cancer), though rare, can affect digestive process.... Duodenal cancer can be divided into 5 major types: adenocarcinoma, sarcoma, carcinoid tumors, gastrointestinal stromal tumor, and lymphoma. The most common type of small intestine cancer is duodenal adenocarcinoma. It is a rare but aggressive malignancy. Surgical options: Pancreaticoduodenectomy (Whipple procedure) This extensive operation can be used to treat cancers of the duodenum, although it is more often used to treat pancreatic cancer. It removes the duodenum, part of the pancreas, part of the stomach, and nearby lymph nodes. Segmental resection: This operation resects the segment of intestine that has the tumor, as well as some of the normal tissue on either side of the tumour. Palliative surgery Bypass surgery: Another option might be for the surgeon to leave the tumor in place and to reroute normal parts of the small intestine around the tumor to prevent or relieve a blockage. Stent or tube placement: If major surgery isn’t a good option, sometimes an endoscope can be used to pass a stent down the digestive tract and into the blocked part of the intestine. The stent is left in place to help keep the intestine open and allow digested food to pass. Different factors can affect prognosis and treatment options. See your GP for advise and seek professional help. Image adopted from https://www.mayoclinic.org//s/symptoms-causes/syc-20352497

07.01.2022 Completed a #freysprocedure yesterday for the treatment of chronic pancreatitis where the diseased portion of the #pancreas head are cored out. This is followed by a pancreaticojejunostomy in which a loop of the jejunum is mobilised and attached over the exposed pancreatic duct to allow better drainage of the pancreas, including its head. #pancreaticcancer #pancreastreatment #pancreastreatmentspecialist #pancreaticcancer #pancreaticsurgeon #hbpsurgeon #surgerylife #education

06.01.2022 In the sky heading to Singapore to learn a new surgical and chemotherapy technique (PIPAC). Hoping to give my cancer patients more #hope Stay tuned for more updates. #singapore #qantasairways #pancreaticcancer #colorectalcancer #livercancer #biliarycancer

05.01.2022 An intraductal papillary mucinous neoplasm (IPMN) is a growth in the main pancreatic duct or one of its side branches. IPMN may be precancerous or cancerous. Depending on its location and other factors, IPMN may require surgical removal. Surgery usually consists of partial pancreatic resection, which leaves behind a pancreatic remnant at risk for recurrent disease and progression to cancer. As an alternative, total pancreatectomy (TP) provides the most complete oncologic rese...ction, but postoperative morbidity and quality of life issues have generally limited its use to only the highest risk patients. Discuss with your surgeon for an individualised treatment option/ plan. Image adopted from https://www.mayoclinic.org//diagnosis-treatme/drc-20375997 #education #ipmn #intraductalpapillarymucinousneoplasms #pancreaticcancer #totalpancreatectomy #hpbsurgeon #surgery #surgeonslife

04.01.2022 Tonight at ABC 730!

01.01.2022 Focal Nodular Hyperplasia FNH We operated on a patient today for FNH of liver. Focal nodular hyperplasia (FNH) is a benign tumor of the liver. FNH does not turn into liver cancer, in most people it does not produce any symptoms. If the tumor grows and becomes large it can cause some symptoms.... FNH most commonly occurs in young adult women, between 20 and 30 years of age. Infrequently, men are also known to develop this condition. FNH of the Liver is believed to be caused by congenital abnormalities in the liver blood vessels. Individuals, with such anomalies, have abnormal liver blood vessels from birth. In a majority of cases condition is found accidentally when undertaking an imaging test for evaluation of another disease. A diagnosis of FNH of the Liver may involve: physical exam, imaging studies such as CT scan or MRI of the abdomen or abdominal ultrasounds. Proposed treatment may be surgical removal of the tumour. See your GP for advice. #liversurgery #focalnodularhyperplasia #friday #education #pancare #hope #tumour #liversurgeon #hpbsurgeon #hpbsurgery

01.01.2022 No operations today, but staying up late to catch up on research. Working on several grants and papers. Surgery helps the individuals, but research helps entire populations. #research #nhmrc #discovery @unimelb #pancreaticcancer