Hand surgery

The hand surgery service provided by QVH is recognised, both regionally and nationally, for its excellent high quality service covering a range of elective conditions as well as trauma.

It includes consultants with specific interests in congenital hand anomalies; rheumatoid and osteoarthritis; wrist surgery for arthritis and instability; compression neuropathies; and post-trauma reconstruction.

It accounts for approximately one quarter of all elective plastic surgical operations at QVH. It also comprises approximately 80% of the trauma workload at the hospital.

We offer, where appropriate, non-operative and minimally invasive treatment alternatives such as wrist arthroscopy, needle aponeurotomy (fasciotomy) and endoscopic carpal tunnel release.

We are continuously available to manage soft tissue and bony trauma and to provide advice on other urgent problems including tendon ruptures, infections, extravasation injuries and pain syndromes.

Patient information video

Axillary nerve block for hand/arm surgery

Page last update: 29 December 2023

Mr Asit Khandwala

Specialist interests: All aspects of plastic surgery especially hand surgery

Mr Asit Khandwala started in Plastic Surgery in 1989. He has trained both in the UK and India. He trained in Plastic Surgery at the St James University Hospital in Leeds, Charing Cross, Chelsea and Westminster, St Andrew’s Centre for Plastic Surgery in Chelmsford and Queen Mary’s, Roehamptom. He also trained at the Stoke Mandeville Hospital. He completed his specialist training and was appointed a Consultant at the Queen Victoria Hospital in 2004. Mr Khandwala is a fully accredited specialist in Plastic Surgery and a full member of the BAPRAS (British Association of Plastic Reconstructive and Aesthetic Surgery), BAAPS (British Association of Aesthetic Plastic Surgeons) and also a full member of the British Society for Surgery of the Hand (BSSH). Mr Khandwala is also involved with research, audit and education of medical students.

He runs general plastic surgery, skin cancer, breast surgery and hand surgery clinics at Queen Victoria Hospital. He has a special interest in Hand Surgery, especially rheumatoid hands and nerve reconstruction.

Mr Rikki Sunil Mistry

Specialist interests: Hand surgery; upper limb trauma reconstruction; international medicine; general plastic surgery; surgical innovation; and implant technology

Mr Rikki Sunil Mistry graduated in 2004 from the University of Dundee Medical School, where he was awarded the prestigious American Graduates Prize. He went on to obtain an intercalated degree in orthopaedic technology before beginning his surgical training at St Thomas Hospital; Stoke Mandeville Hospital; The Royal Free Hospital; Chelsea and Westminster Hospital; St George’s Hospital; as well as at Queen Victoria Hospital.

Mr Mistry’s passion for the field has been recognised through several awards from prestigious institutions including Oxford University, The Royal Society of Medicine and The Royal College of Surgeons. In addition, he holds the Cobbett Prize for Hand Surgery and has sat as a member of the Educational Committee for the British Society for Hand Surgery.

In 2020, Mr Mistry was awarded the fellowship in plastic surgery, FRCS (Plast). He subsequently embarked upon his hand fellowship at St Thomas Hospital in London and was appointed as a consultant plastic surgeon at the Queen Victoria Hospital in 2021.

Mr Mistry runs a weekly hand and general plastics clinic at QVH as well as one in Medway Hospital. He has a specialist interest in degenerative and progressive conditions such as Dupytrens contracture, osteoarthritis as well as nerve disorders. He is the clinical lead for trauma at Queen Victoria Hospital and conducts weekly trauma operating sessions, using innovative techniques to restore form and function for patients.

In his spare time, Mr Mistry enjoys cycling, travel and spending time with his three children.

Qualifications: MBChB BMSc FRCS (Plast). Mr Mistry is on the GMC Specialist Register for Plastic Surgery.

Page last updated: 4 December 2023

Mr Robert Pearl

Mr Robert Pearl is a consultant plastic surgeon with a specialist interest in hand surgery. He studied medicine at Southampton University and underwent basic surgical training at St Mary’s Hospital, London. He trained in plastic surgery at Mount Vernon Hospital, Northwood, where he completed his Medical Doctorate on treatment of melanoma, before completing the Pan Thames training scheme. This included plastic surgical training at The Royal Free Hospital, London; Queen Victoria Hospital, East Grinstead and St Thomas’ Hospital, London.

He attained the Royal College of Surgeons Fellowship for Plastic Surgery in 2012 for which he was awarded the McGregor Gold Medal.

Mr Pearl’s subspeciality training in hand surgery included fellowships at Great Ormond Street Hospital, the Windsor Hand Clinic and Queen Victoria Hospital, culminating in award of the BSSH Hand Diploma. He is a member of the British Society for Surgery of the Hand, and also holds the European Hand Diploma.

Mr Mark Pickford

Specialist interest: Hand surgery

Mr Mark Pickford is a Consultant Plastic and Hand Surgeon, subspecialising in the treatment of children with developmental differences. He trained in Plastic Surgery in the UK, and then completed a one-year Hand Surgery fellowship with Harold Kleinert’s group in Louisville, Kentucky (1996-1997).

Mr Pickford runs two hand surgery clinics a week at QVH, one for children, and one for adults. He also runs plastic surgery outpatient services at the Conquest Hospital, once a week on Tuesdays, where skin cancers are the commonest problems being managed.

Besides Children’s hand surgery he also treats Dupuytren’s disease, and a broad spectrum of other common degenerative hand conditions.

Mr Pickford’s interests include hand trauma, surgery for congenital hand differences, management of Dupuytren’s disease including all surgical options and Xiapex/collagenase injection treatment. His work routinely encompasses management of inflammatory arthritic conditions such as rheumatoid arthritis and also degenerative arthritis (osteoarthritis) which manifest themselves in the hand. He has an interest in wrist pathology including degenerative conditions and instabilities resulting from injury, and routinely performs arthroscopy examinations and treatments. His work routinely involves the management of nerve compression syndromes in the upper limb.

Mr Pickford’s work for general plastic surgery covers a broad scope ranging from skin cancer management to breast reconstruction using all available techniques (tissue expansion, Latissimus flaps and DIEP flaps).

Mr T C Teo

Specialist interests: Hand surgery; upper and lower limb reconstruction following trauma or disease.

Mr Teo graduated from Aberdeen University in 1982. In 1987 he was awarded a Harvard University Research Fellowship and spent a year in Boston, USA, studying the role of lipid in nutritional support of major burns and sepsis. His MD thesis, based on this work, was awarded with honours together with the Cash Medal in 1991. His plastic surgery experience included oversea fellowships in Taiwan and Australia.

TC is world famous for his pioneering work in the fields of propeller flaps, perforator flaps including the SCIP and post-auricular free flap, and supermicrosurgery. He is one of the first Plastic Surgeons to embrace the supermicrosurgery concept and was a pioneer in this field, together with contempories such as Koshima. He has been invited worldwide to teach and perform “live surgery” on many microsurgery, perforator and instructional courses, and is one of the founding faculty of the International Masters in Microsurgery course.

Recently, as Visiting Professor to the Canniesburn Flap and Perforator Course 2019 he gave special lectures on “Supermicrosurgery” and also on “Propeller and Perforator Flaps”.

He also likes teaching and doing voluntary work in developing countries and has been to operate in Ghana, Malawi, Kenya, Nepal, Bangladesh, India, Brazil and Siberia. He believes that engaging with young surgeons and teaching them techniques which they can then use to treat their own communities has a greater long-term benefit.

Mr Tomas Tickunas

Areas of expertise: adult and paediatric hand surgery (elective and trauma), general plastic surgery (including the correction of deformities, removal of lesions including skin cancer), paediatric plastic surgery and complex microvascular reconstruction (lower limb, major trauma, hand, and chest reconstruction).

Mr Tomas Tickunas is a Consultant Plastic, Orthoplastic and Hand Surgeon practicing at Queen Victoria Hospital in East Grinstead and Honorary Consultant Plastic Surgeon at Royal Sussex County Hospital in Brighton.

Mr Tickunas operates his NHS clinics at Queen Victoria Hospital and Royal Alexandra Children’s Hospital in Brighton. He completed the Pan Thames Plastic Surgery Training Rotation in London, supplemented by additional training in Wales and Yorkshire.

Holding a European Diploma of Hand Surgery, Mr Tickunas completed TIG Advanced Training Post Fellowship in Hand Surgery, under the supervision of the current President of British Society of Surgery of the Hand Mr Dean Boyce and the previous President Mr David Newington. He has also completed aesthetic surgery training in Swansea and London.

Driven by his passion for training the next generation of plastic surgeons, Mr Tickunas has assumed the role of KSS Training Programme Director for Plastic Surgery (Kent, Surrey and Sussex).

Page last updated: 8 December 2023