Austin Health’s Dr Marcos Perini and GV Health’s Dr Georgi Atanasov are the surgeons who performed the first liver surgery at GV Health in September last year.
Photo by
Bree Harding
In a promising first for Goulburn Valley patients, liver surgery has been successfully performed at GV Health.
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The five-hour resection surgery, which involved the removal of two of the eight sections of the patient’s liver, took place in September last year.
The surgeons who performed the procedure, GV Health’s Georgi Atanasov and Austin Health’s Marcos Perini, said the surgery had been in the pipeline for many months prior.
The patient, a Shepparton man in his 60s who was suffering from a metastatic colorectal cancer and a lesion in his liver, had surgery months earlier to remove cancer from his bowel, where it had originated.
“We had to clear him up of cancer completely, so we had to operate on the liver,” Dr Atanasov said.
“I remember when I saw him (the patient) first, he told me, ‘I really don’t want to go to Melbourne; if we can, we should do it here.’
“He made us consider more and more doing it here than anywhere else.”
The specialised procedure required a dedicated, specialised team and new equipment.
To facilitate the surgery, GV Health purchased new equipment, which will remain at the hospital permanently for future operations.
“Luckily we have Georgi here in Shepparton, who is a specialised training surgeon working here,” Dr Perini said.
“And luckily we have Frans Pretorius, the director of surgery here. We met with Frans and then we had a meeting with the CEO from the hospital (Matt Sharp), who gave us his support.
“We had to do a preoperative workup and a huddle with an anaesthetic team, nurse team. We have to set up all the appliances ... there was someone coming from Melbourne with a specific machine in which we cut the liver, so the hospital acquired that machine in order for us to have the operation.”
Before Dr Atanasov moved to Shepparton for his job at GV Health, he and Dr Perini collaborated at Austin Health.
“We worked together for a year, which is quite a significant amount of time because we spent many hours in theatre together doing a lot of dedicated work, which also included liver transplant and also liver transplant in kids, paediatric patients,” Dr Atanasov said.
“But mainly it was work focused on grown-up patients with liver or pancreas malignancies or pathologies that required an operation.”
Some of the theatre team involved in the first liver surgery at GV Health.
A celebratory cake marked the momentous occasion for the team that performed the first liver surgery at GV Health.
The theatre team included the two leading surgeons Dr Atanasov and Dr Perini, a junior surgeon in training, doctors, nurses, an anaesthetic team and equipment technicians.
“I have to praise the technicians, they are very important because they know how to operate the machines,” Dr Atanasov said.
“If something needs to be improved or the machine stops working, it can happen, the technician is the one who sorts this out ... so we can’t work without technicians ... the equipment we need for liver operation is very dedicated and very specific.”
The representative who delivered the new equipment was also present.
“The water jet is a machine that we use to cut the liver without damaging the vessels,” Dr Perini said.
“The rep brought the machine and came to show the tanks and how the machine works.”
The surgeons also lauded their theatre team, describing members of it as “fantastic” and “amazing”, and crediting them with contributing to a “smooth operation”.
“Although it’s a big operation, things can go south because the liver is a very well vascularised organ, it can bleed a lot,” Dr Perini said.
“Patients can need blood transfusions and can stay for weeks in ICU.
“We didn’t have any complications.”
The patient was discharged seven days after surgery, which is the earliest window possible after his specific procedure.
“I’ve been seeing him in clinic after that and he’s recovering quite well,” Dr Atanasov said.
Sadly, the surgeons said the number of patients presenting with colorectal cancer was increasing.
Factors such as consumption of more processed food and alcohol, lack of vegetables in diets and genetic predisposition are what they believe is contributing to the problem.
“They are becoming younger,” Dr Perini said.
“There are definitely enough patients to be offered this type of treatment here in Shepparton.”
Dr Atanasov said other local patients would also benefit from being able to have pancreas and bile duct operations at GV Health.
“Unfortunately, before we started doing this, we just observed that all these patients had to be referred to different hospitals, some in Melbourne, some are very far away, in different states,” he said.
The surgeons regularly discuss treatments for their Goulburn Valley patients and manage them together, along with a GV Health oncologist.
“I’m pretty convinced it’s just a matter time that we will have another case that we’ll have to operate here,” Dr Atanasov said.
Dr Perini said the local team was an asset to the region.
“I would like to say that GV Health is lucky to have Georgi and Frans,” he said.
“I think they have been a very good combination for GV Health and that will reflect on the population.”
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