Upper GI surgery

Academic department of abdominal wall (Northern services) and upper GI surgery (Northern services)

The North Devon Comprehensive Hernia Centre is a specialist referral service for all aspects of hernia and abdominal wall surgery. We receive and welcome referrals from across the South West of England and elsewhere in the UK.

We provide a complete multidisciplinary service personalised to our patients’ circumstances and treatment goals.  We run dedicated Specialist Hernia and Chronic Postoperative Inguinal Pain (CPIP) clinics, and a weekly Abdominal Wall Multidisciplinary Team Meeting.

We offer a full range of operations for hernias, including open and robotic surgery (Da Vinci Xi), mesh removal and neurectomy (nerve division), as well as denervation injuries and diastasis recti.

We are an internationally-recognised centre of excellence for complex incisional hernias, and offer specialist services including pre-operative Botox, peritoneal flap hernioplasty and component separation.

We are a nationally-recognised centre of excellence for chronic post-operative inguinal pain (CPIP).

Location

The North Devon Comprehensive Hernia Centre is part of the Academic Department of Abdominal Wall and Upper GI Surgery, at North Devon District Hospital, Barnstaple, and is one of the flagship services of the Royal Devon University Healthcare NHS Foundation Trust.

The team

We are a multidisciplinary team of three Consultant Surgeons (all of whom have been awarded Fellowship of the European Board of Surgery in Abdominal Wall Surgery), supported by a full complement of middle grade and junior doctors, and two Advanced Clinical Practitioners with subspecialty expertise in Abdominal Wall surgery. We work closely with Colorectal, Orthopaedic and Plastic Surgeons, radiologists, dietitians and physiotherapists.

Pre-optimisation

We create a bespoke pre-optimisation programme for all our patients, to achieve the best results from surgery for our patients. This involves targeted weight loss and exercise, stopping smoking, and improving conditions such as diabetes.

Research, education and fellowships

As an Academic Department, we aim to offer all our patients the opportunity to take part in clinical research. We teach medical professionals at all stages of training, from medical students at the University of Exeter, to junior and senior post-CCT surgical fellowships.

For information about our fellowship programme please contact us at rduh.ugisecretaries@nhs.net or rduh.hernia@nhs.net

Chronic Postoperative Inguinal Pain (CPIP)

We are a nationally-recognised centre of excellence, offering one-stop multidisciplinary service for patients with chronic pain after hernia surgery. Patients are assessed by a Consultant Surgeon (John Findlay), Consultant Pain Specialist Anaesthetist (Dr Lucy Miller and Dr Alan Bennett), Pain-specialist Physiotherapist (Matthew Lund and David Sanders) and specialist Advanced Clinical Practitioner (Alice Birch and Federica Cocciolo), and are discussed at our Chronic Pain Multidisciplinary Team meeting.

We offer ultrasound-guided nerve blocks and ablation, mesh explantation and neurectomy, and psychological and physiotherapy support.

For referrals, advice and support please contact  rduh.ugisecretaries@nhs.net, rduh.surgicalacps@nhs.net or rduh.hernia@nhs.net

Contact us

We welcome referrals for advice and management from across the UK.

For clinical advice and referrals please email rduh.hernia@nhs.net

For referrals and secretarial information please email rduh.ugisecretaries@nhs.net

For support from our Advanced Clinical Practitioners please email rduh.surgicalacps@nhs.net

Our Consultant Surgeons

Mr David Bunting BSc MBBS MSc FRCS FEBS-AWS MD

  • Consultant Upper GI and Abdominal Wall Surgeon
  • Clinical lead for Upper GI Surgery
  • President of the British Association of Day Surgery
  • Honorary Senior Lecturer, University of Exeter Medical School

Secretary: Angela McEnaney 01271 322749

David is a Consultant in Upper Gastrointestinal and Abdominal Wall Surgery working in the at the North Devon Comprehensive Hernia Centre. His undergraduate training was at Guy’s and St. Thomas’s Hospitals Medical School, London. In addition to higher specialist training in the UK, he spent time training in Australia, undertook a Trauma Fellowship in Cape Town, South Africa and completed a Fellowship in Upper GI Surgery in Derriford Hospital, Plymouth.

His clinical interests are in robotic surgery, day-case surgery, abdominal wall reconstruction and hernia repair, endoscopic retrograde cholangiopancreatography (ERCP), anti-reflux surgery and bile duct exploration. He has been invited to present nationally on the role of robotics and emerging technology in ambulatory surgical care, abdominal wall closure techniques and in developing ambulatory surgical care pathways.

David became a British Association of Day Surgery (BADS) Council member in 2018 and was Editor of the Journal of One Day Surgery until December 2021. He took on the position of BADS President in June 2023. As part of this role, he works closely with several national organisations including NHS England through the Getting it Right First Time (GiRFT) programme to promote excellence and maximise delivery of UK day surgery.

Prof John Findlay BMedSci (hons) BMBS (hons) FRCS FEBS-AWS PhD

  • Consultant Upper GI and Abdominal Wall Surgeon
  • Co-lead Academic Department of Abdominal Wall and Upper GI Surgery
  • Clinical Lead for Upper GI Cancer
  • Honorary Associate Professor and Senior Clinical Tutor, University of Exeter
  • NIHR Exeter BRC Senior Investigator Fellow
  • Director of Science, British Hernia Society

Secretary: Sonia Woodage 01271 322424

John FindlayJohn is a Consultant Upper Gastrointestinal and Abdominal Wall surgeon at the North Devon Comprehensive Hernia Centre, Academic Department of Upper GI and Abdominal Wall Surgery at North Devon District Hospital, an Honorary Associate Professor and Senior Clinical Tutor at the University of Exeter Medical School, Senior Investigator Fellow at the NIHR Exeter Biomedical Research Centre, Director of Science for the British Hernia Society, and Chief Investigator of the British Hernia Society Registry.

John went to University in Nottingham, trained in Surgery in Oxford and was appointed as a Consultant in North Devon in 2019. He was an Honorary Clinical Lecturer at the University of Oxford, Senior Clinical Research Fellow in informatics at the Oxford NIHR Biomedical Research Centre and Cancer Research UK Oxford Centre, and Lecturer in Clinical Medicine at Corpus Christi College, Oxford.

His clinical interests are based around complex and minimally invasive hernia surgery, and he was awarded Fellowship of the European Board of Surgery in Abdominal Wall Surgery in 2021. He has a PhD in Genomic and Clinical Informatics, and his research interests are based around measuring and improving outcomes and decision-making for patients with hernias through clinical studies and data science.

Prof David Sanders MBChB BSc (hons) FRCS MD PG Dip Med Ed Hon FEBS-AWS

  • Consultant Upper GI, Paediatric and Abdominal Wall Surgeon
  • Clinical Lead for General Surgery
  • President of the British Hernia Society
  • Honorary Associate Professor, University of Exeter
  • Co-lead Academic Department of Abdominal Wall and Upper GI Surgery

Secretary: Angela McEnaney 01271 322749

Professor David Sanders is a consultant Abdominal Wall and upper GI surgeon, clinical lead and joint academic lead for the academic department of Abdominal Wall and Upper GI Surgery at North Devon Hospital in Barnstaple and chair of clinical strategy for the Royal Devon University Hospital Trust. He is an honorary Associate Professor of Surgery at the University of Exeter. He completed specialty laparoscopic upper GI training in the South West of England and a trauma fellowship in South Africa. His doctorate thesis was on the influence of mesh and fixation techniques on infection in abdominal wall hernia repair and he has over 70 publications in the field of hernia surgery and has written  several book chapters. He has given numerous invited lectures on the topic both nationally and internationally a has held a number of senior leadership positions and advisory roles in healthcare. These include President of the British Hernia Society, Co-Chairing the National Institute for Clinical Excellence approved commissioning guidance for groin hernia, developing the RightCare patient decision aid for inguinal hernias and was on the European working group that developed the Abdominal Wall Closure Guidelines and the International Hernia Guidelines. He was the co-chair of the European Hernia Society Incisional Hernia Guidelines Group and was previously editor of the Bulletin of the Royal College of Surgeons of England.

Our Advanced Clinical Practitioners

Alice Birch RN BSc MSc

Alice BirchAlice is an Advanced Clinical Practitioner specialising in Abdominal Wall and Upper GI surgery. Alice went to university in Plymouth, and worked as a Staff Nurse at Southmead Hospital in Bristol after graduating. Alice then returned to North Devon and worked as a Deputy Sister on a surgical ward whilst undertaking her MSc in Advanced Clinical Practice with Plymouth University.

Alice currently works as part of the North Devon Comprehensive Hernia team alongside her ACP colleague Federica. They help provide a service to patients from across the UK who are living with complex abdominal hernias. This includes a pre-optimisation service for patients needing hernia surgery, which involves supporting patients with smoking cessation, diabetic control and weight loss prior to surgery. Alice also helps manage the weekly multi-disciplinary team meeting as well as being involved in and publishing research.

Federica Cocciolo RN BSc MSc

Federica CoccioloFederica is an Advanced Clinical Practitioner, who specialises in Abdominal Wall and Upper GI surgery. She also collaborates with Plymouth University, supervising student nurses and postgraduate students. Her nursing career began in Italy, where she worked as a Community nurse and GP nurse practitioner for 3 years after graduating as a Nurse. Seven years ago, she moved to England, working as a Deputy Sister on KGV ward while pursuing her MSc Apprenticeship, which she completed in 2022 with Plymouth University.

Currently, Federica works with her colleague Alice in the North Devon Comprehensive Hernia team, offering services to local and tertiary patients with complex abdominal hernias from across the UK. They conduct weekly MDT meetings and manage a pre-optimization program for patients needing preparation for hernia surgery, addressing factors like smoking, diabetes, and high BMI. Federica has also authored several papers on the work conducted at the North Devon Comprehensive Hernia Centre.

Our Specialist Physiotherapists

Matthew Lund MCSP BSc MSc

Is a physiotherapist and the non-medical lead for the pain team in North Devon.  He is a non-medical prescriber and also lectures at the university of Plymouth.  He has contributed to the national guidelines on the management of pain in the frail elderly and has led research on living well with pain. 

Last updated: June 03, 2024.