If you’d like to discuss any symptoms or concerns with Mr Bille, or you’d just like a second opinion, you can call, email or book an appointment here.
Mr Andrea Bille
Treatments
Mr Bille is skilled at performing a wide range of specialist treatments, including those listed here. If you don’t see the treatment you’re looking for, get in touch and we can help.
Multi-specialist surgery for extensive thymoma
Multi-specialist surgery for extensive thymoma is a way to make sure any adjacent great vessels and organs, such as your lungs, are safely resected as part of your treatment.
If you have an advanced stage thymoma, Mr Bille will take a multidisciplinary approach, which means he’ll work with a team of specialists. This can include two or more other surgeons who specialise in thoracic, cardiac or vascular surgery. It’s a collaborative approach that helps ensure your tumour is completely and safely removed, along with any structures it has invaded.
Mr Bille is extremely experienced in working within a specialist team to deliver radical surgical resections. He trained in Italy and in the USA, developing his technique to minimise the risk of complications and achieve complete resections.
The team will usually carry out your surgery using an open (trans-sternal) surgical approach, which allows for the all-in-one removal of your tumour along with any affected areas, fat, lymph nodes or sections of organ.
This is a serious operation, which has an increased risk of general post-operative complications, including blood loss and infections and a significant hospital stay. These risks also increase if you’re in poor overall health, if you’re a smoker or if you have a serious pre-existing condition such as:
- Myasthenia gravis (MG): If you have severe pre-existing MG or generalised MG with bulbar symptoms, you have a higher risk of going into a potentially post-operative myasthenic crisis (PMC). This can require an extensive stay in intensive care.
- Cardiopulmonary disease: If you have a severe pre-existing heart or lung condition, it increases your risk of complications such as pneumonia, atelectasis, respiratory insufficiency and cardiac issues.
Your recovery time will depend on the extent of your surgery and the organs that may have been impacted. You’ll usually need to stay in hospital for seven to ten days, or longer if any post-surgical complications arise.
You won’t be able to drive for at least six weeks, and it can take several weeks or months for you to make a full recovery and return to your everyday life. Mr Bille will be on hand to explain your recovery process and support you along the way.
Surgery for slipped rib syndrome (the Hansen technique)
This minimally invasive procedure aims to stop nerve irritation and pain. It uses a strong figure-of-eight orthopaedic suture to secure your slipping rib back into its usual place, using your own cartilage to fix the gap. The suture is passed through the rib above and through the slipped rib's cartilage. This holds both ribs together, stops the slipping rib from moving and helps reduce your pain.
This surgery can be performed in under an hour, and should offer you:
- A faster recovery: Patients often experience significant pain reduction within a few weeks to a month, and many report little to no pain after six months.
- Reduced need for medication: Studies suggest a significant decrease in the use of pain medication after this surgery.
This suture repair is a less invasive alternative to traditional rib removal surgery. It aims to restore your rib's natural function, meaning you’ll be in significantly less pain without losing a rib or sustaining any tissue damage.
Traditional surgery would remove your slipped rib, but the Hansen technique leaves it intact. This preserves the protective function of your lower ribs, which work to protect your liver and spleen and support your diaphragm for proper breathing.
However, there are potential risks of complications from the surgery, such as a pleural opening. The repaired rib may also slip again, especially if you have an underlying connective tissue or hypermobility disorder.
It’s common to experience a significant reduction in pain within a few weeks to a month, and many people have little to no pain after six months. However, too much activity too soon can make your rib slip again, so it’s important to take the time to fully heal and recover.
Mr Bille can recommend pain management medication to make sure you’re as comfortable as possible while you heal.
Mesothelioma surgery
Mesothelioma surgery is an operation to control the fluid in your lung (pleural effusion) or to remove cancerous tissue in selected cases. Unfortunately, there’s currently no cure for mesothelioma. However, we can perform this palliative surgery to help extend your lifespan or relieve your symptoms.
- Radical surgery is often only an option if you’re in the early stages of the disease and are otherwise in good health. In some cases, we may offer a pleurectomy decortication, which removes the diseased outer lining of your lung. This can help to remove as much of the tumour as possible, as part of a wider range of treatments.
- Palliative surgery usually involves a partial removal of the tissue to help manage distressing symptoms such as fluid build-up. This can help you be in a better condition to receive other medical treatments.
Mr Bille can give you the right advice to help you decide on treatment for your specific condition. He might also recommend procedures such as a pleurectomy and decortication for pleural mesothelioma or cytoreductive surgery for peritoneal mesothelioma.
All surgeries carry a risk of bleeding and infection. This major surgery also carries a significant risk of blood clots developing, which can lead to deep vein thrombosis (DVT) or a pulmonary embolism, which is a clot in your lungs.
Other significant risks include:
- Pneumonia, with the risk increasing if you’ve had extensive surgery
- Heart problems, including heart rhythm changes (such as atrial fibrillation) and, in some cases, heart attack
- Chest fluid build-up in your pleural cavity, requiring drainage
- Shortness of breath, which is sometimes long-term, due to the removal of lung tissue and other factors relating to the surgery
Your recovery time will depend on the extent of the surgery you’ve had, your age and your overall health. If you have a pleurectomy and all or part of your lung lining is removed, you’ll typically need to stay in hospital for one to two weeks. Full recovery can take from several weeks to a few months.
Mr Bille can advise you about your own condition and what you’ll need to do to make your recovery as effective as possible.
Video-Assisted Thoracoscopic Surgery (VATS)
Video-assisted thoracoscopic surgery, known as VATS, is a common minimally invasive surgical technique. It can be used to investigate and treat certain pleural conditions, including pneumothorax, empyema and recurrent pleural effusion.
Mr Bille uses a tiny camera called a thoracoscope to insert surgical tools into your chest through one or more small cuts in your chest wall. This camera shows the inside of your chest on a video monitor, which he uses to precisely guide him during your procedure.
Mr Bille often opts for a VATS approach to minimise the risk of complications and improve your recovery. However, if you’ve had chest surgery before, VATS may not be suitable for you.
Like all surgeries, this approach carries a risk of bleeding and infection, as well as these specific risks:
- Pneumonia
- Short-term or permanent nerve damage with neuropathic pain
- Damage to adjacent organs
Mr Bille can talk you through all the benefits and risks to help you make the best decision based on your medical history and condition.
You’ll probably only need to stay in the hospital for two or three days, although you should take it easy at home for the first two weeks. You may also have soreness, numbness or a tingling sensation around your incision sites. These symptoms can last for several weeks.
Full recovery time from VATS is around three to six weeks, which is shorter than with open surgery. The precise time depends on the procedure you’ve had and your overall health.
Rib fixation with titanium plates
If you have several broken ribs, Mr Bille may suggest stabilising them with a surgical procedure that fixes titanium plates across the fractures and secures them with screws. This can help to reduce your pain, improve your lung function and speed your healing.
These titanium plates are durable, flexible, and can be pre-contoured to match the specific shape of your damaged ribs. If they’re fitted to fully adult ribs, they may remain permanently in place.
All surgeries carry a risk of bleeding and infection. You may also develop complications related to your implant, including irritation around the secured ribs, a plate breaking or the rib failing to heal properly. As your ribs are constantly moving, this is a reasonably common challenge.
You’ll also be at risk from:
- Damage to other internal organs during surgery
- Pain, numbness or feelings of tightness around the plate
- Implant failure (rare)
You should be able to leave hospital after a couple of days, with the support of good pain management and physical therapy. However, it's crucial that you avoid strenuous activity such as heavy lifting for the first six weeks and allow your ribs to fully heal.
The severity of your injury and your general health will affect how fast you fully recover.
Coiling and resection of nodules
If you have small lung nodules, Mr Bille can carry out a single step or two-step procedure to coil or mark them and then resect them. This can drastically reduce the need for open surgery and minimise the amount of lung that needs to be removed, while maintaining excellent margins.
Mr Bille will place a coil next to the nodule using a robotic bronchoscopy (ION), with a CT scan to guide him. This coil will help him to pinpoint the nodule and remove it during the robotic surgery that follows.
There are risks associated with both the coil placement and the subsequent surgical resection. Mr Bille will talk you through every aspect of your procedure so you can make an informed decision about what’s best for you.
The localised risks of coil placement include:
- A collapsed lung: Where air builds up in the space between your lung and chest wall, sometimes requiring a chest tube (happens in less than 1% of cases)
- Bleeding in your lung: Which is often minor but can also be more severe
- Dislodging or migration of the coil: Making it harder to find during surgery. The position of the coil is always checked with a CT scan before your surgery
- An air embolism: A serious complication which occurs when air enters your bloodstream, although this is rare
The risks of a nodule resection with robotic surgery include:
- Irregular heartbeat (arrhythmia), a common complication following lung surgery
- Persistent air leaks from your lungs
- Pneumonia and other lung infections
- Wound infections
- Bleeding in your chest cavity
- Blood clots in your legs (deep vein thrombosis) or lungs (pulmonary embolism)
Your recovery time depends on which surgical method is used for your lung resection and can range from two weeks to a few months.