The Endometriosis Clinic
DIRECTOR
Mr Peter Barton-Smith MBBS MD MRCOG FRGS
“Never give up; often something can be done or there are unexplored avenues!”
Having previously been an Army Officer in The Brigade of Gurkhas, Peter came to medicine as a mature student. He completed Officer training at The Royal Military Academy Sandhurst and then commanded Gurkha infantry soldiers for five years in Hong Kong, Singapore, Malaysia, South Korea, Brunei, the Falkland Islands and the UK.
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After completing his Commission in the Army he went to Imperial College, London to study Medicine. He chose gynaecology as it was so varied with plenty of action on the labour ward to suit his background! He completed most of his training in London though he also spent a year at the Karolinska Hospital in Stockholm, Sweden, where he developed his initial interest in laparoscopic surgery.
On his return to UK from Sweden he began a four-year training and Doctorate research fellowship at the Minimal Access Therapy Training Unit in Guildford, UK. His research was on the surgical treatment of endometriosis which demonstrated that excision is the preferred technique. Clinically he trained in surgery for complex benign conditions including the excision of severe endometriosis. Professor Jeremy Wright, who trained with David Redwine, and was the first gynaecologist to bring excision surgery for complex endometriosis to the UK, was one of his mentors.
He was co-opted onto the Board of the British Society of Gynaecological Endoscopy in 2006 to co-organise the National Theory Course in Laparoscopic Surgery for UK gynaecologists. During this time, He was also a faculty member for Ethicon Endo-Surgery teaching laparoscopic surgery both in the UK and at the European Surgical Institute in Hamburg, Germany.
In 2008, He went to train in robotic surgery with endometriosis expert Dr John Dulemba in Dallas, Texas. He then returned to Guildford in 2009 just as they received delivery of their first robot. He then began the first robotic gynaecological surgery programme in the UK along with two gynaecological cancer surgeons, Simon Butler-Manuel and Anil Tailor, and began offering robotic surgery for complex endometriosis in 2010. The Programme became one of five recognised robotic training Epicentres in Europe for gynaecological surgery and the only one in the UK. During this time he started the British & Irish Association of Robotic Gynaecological Surgeons with Professors Shepherd and Wright,
In 2013 he went to Singapore to establish a robotic surgery and complex endometriosis surgery programme at Singapore General Hospital for Singapore Health. He had the highest case volume for robotic surgery in gynaecology in South East Asia. He served on several Singaporean Ministry of Health expert panels and Chaired the Hospital Robotic Surgery Committee. He was a founding member of the Asian Society of Gynaecological Robotic Surgery in 2015. He was President of the British & Irish Association of Robotic Gynaecological Surgeons from 2015-2017. He was Vice President of the Society of European Robotic Gynaecological Surgery from 2013-2015. He is currently on the Faculty of Intuitive Surgical at Descartes University in Paris and ORSI Academy in Belgium teaching Advanced Courses in Complex Benign Gynaecological Surgery as well as being on the Royal College of Surgeons of England Expert Advisory Committee in Robotics and NHS National Digital Expert Working Group for Gynaecological Surgery.
He returned to the UK in 2016 and began The Endometriosis Clinic which is based at The Princess Grace Hospital in London where he currently practises when he is not away teaching and lecturing around the globe.
He has presented and proctored in many countries on endometriosis and robotic surgery, and has one of the largest robotic case series worldwide for the excision of complex disease.
He is a passionate believer in excision of endometriosis as giving the most long lasting and positive benefit for women with this debilitating disease.
He firmly believes that robotic surgery has enhanced the ability to do this by improved view, dexterity and ergonomics and that this has led to a significant reduction in the major complication rates that can occur in complex surgery.
For several years now with robotics we have been able to more easily offer a nerve sparing approach to complex cases to help reduce the often unmentioned autonomic urinary, bowel and sexual complications that can occur if pelvic autonomic nerves are damaged during excision.
As the Clinic's experience grows he finds endometriosis a constantly bewildering disease with ever more surprising presentations that has led to looking at patients who may have endometriosis in much more detail, especially with regard to unusual areas including the diaphragm, chest and deep pelvic nerves like the pudendal and sciatic.
He finds that many patients have been cast off by general gynaecologists or even specialist endometriosis centres, and we seek to find strategies to look more closely at what has been missed by working in a multidisciplinary environment.
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