Dr. Muralidharan Parthasarathy

• Gastrointestinal surgery

Throughout my surgical training, I've had excellent exposure to both benign and malignant pathologies involving upper GI and colorectal specialties. My final 2 years of UK training was at the Norfolk and Norwich University teaching hospital and Broomfield hospital, both being regional referral centers for Upper GI cancers. Both were high volume centers dealing with oesophageal and gastric cancers as well as benign UGI pathologies. Both centers specialised in minimally invasive oesophagectomy which involved laparoscopic abdominal phase and thoracoscopic approach for oesophageal mobilisation and resection as well as laparoscopic gastrectomy including D2 lymphadenectomy. I have had excellent exposure to complex Upper GI cases including more than 100 major Upper GI resections and being a referral center has managed complex postoperative complications following UGI resections. I also have a vast experience in benign Upper GI cases including reflux disease and Achalasia and have performed more than 30 anti-reflux procedures and a few Heller's cardiomyotomies. During my colorectal training at various hospitals in the UK, I've performed more than 200 colectomies which included right hemicolectomy, segmental colectomy, and anterior resection, both by laparoscopic and open approach. I have performed more than 100 fistula-in-ano surgery, an equal number of haemorrhoidectomy and numerous rectal prolapse surgeries. I've regularly conducted out-patient clinics covering general, upper GI and colorectal patients. I regularly presented patients in the relevant cancer MDT (Multi-disciplinary team) meetings.

• Bariatric surgery

I underwent specialist training for a year in Luton and Dunstable hospital, UK, the regional specialist referral center for Bariatric surgery. This is a high volume center, performing more than 300 bariatric procedures per year. Here I performed more than 50 sleeve gastrectomies and 25 gastric by-pass procedures. Being a regional referral center, I have managed complex post-operative complications following bariatric procedures including sleeve leaks, gastric band complications, and internal hernia. I closely worked with dieticians, psychologists, diabetologists and nurse specialists as part of the bariatric MDT.

• Biliary surgery

I've performed more than 300 cholecystectomies, including more than 100 on-table cholangiograms and trained in performing laparoscopic common bile duct exploration in patients with CBD stones. I have excellent experience in performing 'hot' gallbladder surgery for acute cholecystitis.

• General and emergency surgery

I have had extensive general and emergency surgery training from my MS General Surgery post-graduation days. I have performed more than 500 emergency laparotomies, more than 300 appendicectomies, and around 500 hernia operations. I'm fully trained in laparoscopic DU perforation closure, laparoscopic appendicectomy, and laparoscopic hernia repair and have performed more than 50 Hartmann's procedures as an emergency. On average, I did a 1 in 10 on-call covering general and GI emergencies in all UK hospitals with some vascular and urology cover. I'm competent in scrotal explorations, SPC insertion, circumcision and reduction of para-phimosis as well as excision of lumps and abscess drainage. I'm also a competent trauma surgeon, having attended trauma calls as a senior surgeon for many years in the UK and have performed numerous trauma laparotomies.

• Endoscopy

I'm competent in performing diagnostic upper GI endoscopy (300+), flexible sigmoidoscopy (250+) and colonoscopy (300+). I've performed numerous endoscopic biopsies, polyp removals, and esophageal balloon dilatations. I've attended both colonoscopy and Upper GI endoscopy course and have been JAG certified (Joint Advisory Group on GI endoscopy, UK).

Alongside my clinical commitments, I worked as an Honorary Research registrar at Ipswich Hospital for 3 years under the expert guidance of Mr. Thomas Groot-Wassink. Here, I was involved in data mining American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database, a well-reputed and internationally recognised clinical database to help answer clinical questions.

We identified the various risk factors for anastomotic leak after colorectal resections after analysing more than 17,000 patients and published our study in the reputed Colorectal Disease journal. We also analysed the effect of pre-operative oral antibiotics on the rates of Clostridium difficile infection and published the results in the same journal. The impact and safety of preoperative oral antibiotics on various post-operative outcomes was extensively studied in more than 68,000 patients undergoing colectomy and our paper is under consideration for publication. Our study comparing the recording of post-operative complications by the American database (ACS NSQIP) and UK database (HES - Hospital Episode Statistics) was published in the reputed BMJ journal.

As part of my MS post-graduation, I performed a research study on "Chronic Pancreatitis and its management" in Thanjavur Medical College & Hospital, Thanjavur, India, June 2000 - Nov 2002 under the guidance of Prof. Devakumari and Prof.Thirunavukkarasu.

I was the proposer of the UK National audit study on acute pancreatitis. This was a nation-wide study to identify the remedial factors in the quality of care provided to patients treated for acute pancreatitis in the UK. I was a member of the National confidential enquiry into patient outcome and death (NCEPOD) study advisory group on acute pancreatitis. We analysed a large number of adult patients treated for acute pancreatitis in more than 200 hospitals across the UK and put forward various recommendations with the aim of improving practice outcomes for future patients at the national level. Our study report 'Treat the cause - A review of the quality of care provided to patients treated for acute pancreatitis' was published in 2016. Read more

The results were presented at the 48th Annual meeting of the European Pancreatic Club, Liverpool, UK, July 2016. View more

I thoroughly enjoy teaching and have always been involved in formal and informal teaching throughout my surgical career. I have obtained formal structured feedback on my teaching which rates me as outstanding. I've conducted hands-on training sessions in suturing, knot tying and other practical surgical techniques for medical students and junior surgical trainees. I've regularly conducted OSCE (Objective Structured Clinical Examination) stations for medical students and teaching sessions for MRCS candidates and provided formal feedback. I've mentored a senior nurse in training to become a colorectal nurse specialist with an interest in an enhanced recovery programme. I was a faculty member at the MRCS Part B preparatory course conducted by Kauvery Hospital, Chennai in Oct 2018.

• M Parthasarathy, D Bowers, T Groot-Wassink - Do preoperative oral antibiotics increase Clostridium difficile infection rates? An analysis of 13,959 colectomy patients. Colorectal Dis. 2017 Oct 16. DOI: 10.1111/codi.13926
• M Parthasarathy, M Greensmith, D Bowers, T Groot-Wassink - Risk factors for anastomotic leak after colorectal resection - A retrospective analysis of 17518 patients. Colorectal Dis. 2017 Mar;19(3):288-298.
• UK National Surgical Research Collaborative. A multicentre observational study of adherence to Sepsis Six guidelines in emergency general surgery. Br J Surg. 2017;104(2):e165.
• Parthasarathy M, Reid V, Pyne L, Groot-Wassink T - Are we recording postoperative complications correctly? Comparison of NHS Hospital Episode Statistics with the American College of Surgeons National Surgical Quality Improvement Program. BMJ Qual Saf 2015;24:594-602
• Muralidharan Parthasarathy, Julian Orrell, Caroline Mortimer, Liz Ball - Chemotherapy-resistant breast implant-associated anaplastic large cell lymphoma BMJ Case Rep. 2013; 2013, bcr-2013-201950
• V. Stohlner, N. A. Chatzizacharias, M. Parthasarathy, T. Groot-Wassink - Jejunojejunal Intussusception as the Initial Presentation of Non-Hodgkin's B-Cell Lymphoma in an Adult Patient: A Case Report and Review of the Literature. Case Rep Surg. 2013; 2013:619031
• Muralidharan Parthasarathy, Avi Basu, Abdel Rahman Omer Massive per rectal bleeding in a child due to cecal arteriovenous malformation treated successfully by embolisation. BMJ Case Reports 2013; DOI:10.1136/bcr-2013-010187
• Muralidharan Parthasarathy'Surgery in Hepatitis and HIV' -Module author for e-learning for healthcare (e-LfH), a Department of Health Programme in partnership with the NHS and Professional Bodies, 2012.
• Muralidharan Parthasarathy - 'Radiation use and risks' - Module author for e-learning for healthcare (e-LfH), a Department of Health Programme in partnership with the NHS and Professional Bodies, 2012.
• Parthasarathy M, Eves T, Kappadath S - 'Rare visceral artery aneurysm' Snapshots in Surgery, British Journal of Surgery 2009; 96: 159 - 165.
• Parthasarathy M - Change of attitude required to improve surgical care - Rapid response to "NHS pressures mean that marking sites before surgery is essential" BMJ 2006; 333: 1211
• Parthasarathy M - Dangerous decision - Rapid response to "Doctors criticise proposal for community practitioners in rural India" BMJ 2007; 334 (7583): 12

• M Parthasarathy, D Bowers, T Groot-Wassink - Do preoperative oral antibiotics increase Clostridium difficile infection rates? An analysis of 13,959 colectomy patients - ASGBI, Glasgow, UK, May 2017(poster presentation) - Citation: British Journal of Surgery 2017; 104 (S6):83-243
• M Parthasarathy, M Greensmith, D Bowers, T Groot-Wassink - Risk factors for anastomotic leak after colorectal resection - A retrospective analysis of 17518 patients.Oral presentation at the ACPGBI chapter meeting, Norwich, UK, April 2016 - Best trainee presentation award
• D Shrestha, M Parthasarathy, A Basu Colorectal stenting for malignant large bowel obstruction: correlation between length and location of obstruction with success and complication rate, Oral presentation at the ACPGBI chapter meeting, Norwich, UK, April 2016
• Parthasarathy M, Reid V, Pyne L, Groot-Wassink T - Are we recording postoperative complications correctly? Comparison of NHS Hospital Episode Statistics with the American College of Surgeons National Surgical Quality Improvement ProgramOral presentation - ASGBI, Manchester, UK, April 2015 Citation: British Journal of Surgery 2015; 102 (S7):9-87
• M Parthasarathy, D Shrestha, A Basu Outcomes of colonic stenting for colorectal cancer - West Suffolk hospital, UK, Feb 2015(poster presentation)
• M Parthasarathy, S Kappadath - "Angioseal - Safe enough?" Oral presentation at the Clinical Section, Royal Society of Medicine, London, UK, June 2008.

• Basic skills in Upper GI endoscopy, Norwich, UK - Dec 2017
• Train the Trainer course, London, UK - Jun 2017
• ASGBI, Glasgow, UK - May 2017
• Higher trainee surgical skills course - Transplant, Cambridge, UK - Mar 2017
• Higher Surgical Simulation Training Day - HPB, Cambridge, UK - Dec 2016
• Laparoscopic UGI and colorectal training course for specialist registrars, Norwich, UK - Nov 2016
• EAES Laparoscopic Upper GI surgery course, Ninewells Hospital, Dundee, UK - Sept 2016
• ATLS course, Norwich, UK - Jun 2016
• ACPGBI chapter meeting, NNUH, UK - April 2016
• Complex abdominal wall repair symposium, Cambridge, UK - Jan 2016
• Laparoscopic Hernia Masterclass - Cambridge, UK - Nov 2015
• Transanal haemorrhoidal de-arterialisation course, Essex, UK - Jul 2015
• The leadership training course, Cambridge, UK - Jun 2015
• Basic skills in colonoscopy course, Norwich, UK - May 2015
• Stapled anastomosis workshop, Peterborough, UK - May 2015
• ASGBI, Manchester, UK - April 2015
• Stapled anastomosis workshop, Peterborough, UK - May 2014
• Critical appraisal workshop, London, UK - Mar 2014
• Time management course, Ipswich, UK - Feb 2014
• Intensive course in Laparoscopic General Surgery, Strasbourg, France - Jul 2013
• The 3rd International Laparoscopic TME Symposium, Portsmouth, UK - May 2013
• East Anglian chapter meeting of ACPGBI, Cambridge, UK - Mar 2013
• Specialist trainee surgical skills simulation course, Cambridge, UK - Nov 2012
• Cambridge trauma symposium, Cambridge, UK - Nov 2012
• International surgeons forum: Challenging abdominal wall defects, Germany - Oct 2012
• Peripherique Laparoscopic Colorectal Surgery course, Elancourt, France - May 2012
• The 2nd International Laparoscopic TME Symposium, Portsmouth, UK - Mar 2012
• Laparoscopic colorectal masterclass, Manchester, UK - Feb 2012
• The 3rd southwest Laparoscopic masterclass, Plymouth, UK - Nov 2011
• Stapled haemorrhoidopexy (PPH) workshop, MATTU, Guildford, UK - Jul 2011
• Laparoscopic colorectal surgery education day, LAPCO, Portsmouth, UK - Jun 2011
• 7th Annual laparoscopic training day, Taunton & Somerset, UK - Jun 2011
• National hernia symposium, International Convention Centre, Birmingham, UK - Mar 2011
• Laparoscopic Incisional Hernia repair course, Newcastle, UK - Aug 2010
• Laparoscopic Inguinal Hernia Repair Course, Hexham, UK - May 2010
• CCrISP course, Northwick Park Hospital, Harrow, UK - Jan 2008
• Middle Management Course, Milton Keynes, UK - Jan 2008
• Presentation Skills Course, Milton Keynes, UK - Nov 2007
• ATLS course, Lister Hospital, Stevenage, UK - Jun 2007
• Whipps Cross MRCS course, London, UK - Sept 2005
• Communication Skills Course, Hertford County Hospital, UK - Jun 2005
• Basic Surgical Skills Course, Norwich, UK - Apr 2005
• Basic Life support course, Derby, UK - Jul 2004

• General & Emergency
• Appendicectomy - 300+
• Emergency laparotomy - 500+
• Hernia repair - 500+
• Hartmann's - 50+
• DU perforation closure - 100+
• Small bowel resection & anastomosis - 75+
• Upper GI & Biliary
• Gastrectomy and Oesophagectomy - 100+
• Anti-reflux procedure - 30+
• Giant para-oesophageal hernia - 10+
• Cholecystectomy - 300+
• On-table cholangiogram - 100+
• Laparoscopic CBD exploration - 20+
• Colorectal
• Colectomies (Right, segmental, anterior resection) - 200+
• Fistula-in-ano procedures - 100+
• Haemorrhoidectomy - 100+
• Prolapse surgery - 25+
• Bariatric
• Sleeve gastrectomy
• Gastric by-pass