How to Choose a Colorectal Surgeon in Sydney: A Gastroenterologist's Perspective
Updated: 2 days ago
Introduction: the right surgeon depends on the problem
Most patients do not need the most famous colorectal surgeon in Sydney. They need a surgeon with the right experience for their particular condition, working in a hospital that can provide the right support around the operation.
That distinction matters because colorectal surgery is not one job. A surgeon who spends most of the week removing rectal cancers has a different skill set from one who spends it repairing pelvic floors or managing Crohn's disease fistulas. All are fully qualified colorectal surgeons, but their day-to-day work has shaped them differently.
As a gastroenterologist, I refer patients to colorectal surgeons every week, and I see the difference a good match makes. This guide sets out six types of colorectal expertise, what to look for in each, and some Sydney surgeons and centres whose public profiles describe experience in that area.
Two things to keep in mind as you read. First, the names below illustrate publicly described areas of practice; they are not rankings, and many excellent surgeons are not listed. Second, most patients reach a colorectal surgeon through a referral, and that referral is often the most important decision in the whole process.
1. Colorectal cancer surgery
For bowel cancer, the surgeon's experience with cancer operations and the team around them matter more than any single piece of equipment.
What makes it different. Cancer surgery is judged on whether the tumour and its lymph nodes are removed completely, with the bowel reconnected safely. For rectal cancer in particular, the pelvis is a tight space, and the quality of the operation affects both cure and long-term bowel, bladder and sexual function.
What to look for
A surgeon whose practice is weighted toward cancer, not an occasional cancer case among many other operations.
Membership of a colorectal cancer multidisciplinary team (MDT), where surgeons, oncologists, radiologists and pathologists plan treatment together. Public MDT membership is listed on the Cancer Institute NSW's CanRefer directory.
Access to laparoscopic (keyhole) and, where appropriate, robotic techniques. Robotics is an additional capability that helps in some technically difficult pelvic operations; it is not a requirement for a good outcome, and an experienced laparoscopic rectal surgeon may do equally well. The question is whether the surgeon has the appropriate techniques available and knows when to use them.
For complex or low rectal cancer, a surgeon who can discuss organ-preserving options and refer onward if the case is beyond the scope of their unit.
Sydney examples to investigate
Prof Kim-Chi Phan-Thien (St George and Hurstville Private): colorectal cancer is central to her practice; one of Australia's most experienced robotic colorectal surgeons, with research collaborations in Lynch syndrome.
A/Prof Matthew Rickard (Concord and Macquarie University Hospital): head of colorectal surgery at Concord, a member of two colorectal cancer MDTs, with published work on how to choose among the many surgical options for rectal cancer.
Dr Penelope de Lacavalerie (Northern Beaches Hospital and Prince of Wales Private): completed a CSSANZ-accredited robotic colorectal fellowship and a PhD on rectal cancer response to chemoradiation; a Bowel Cancer Australia spokesperson.
2. Complex polyps and early cancers: when you may not need surgery at all
Some large or awkward bowel polyps, and some very early cancers, can be removed through the colonoscope rather than by cutting out a segment of bowel. Choosing the right surgeon here starts with asking whether surgery is needed in the first place.
What makes it different. Advanced endoscopic techniques such as endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) can remove lesions that a generation ago would have meant a bowel resection. They avoid an abdominal operation, a hospital stay and the risks that go with both. But they suit only certain lesions, and the decision depends on the polyp's size, position and appearance, and on what the pathology shows.
What to look for
Before agreeing to surgery for a "large polyp", ask whether an advanced therapeutic endoscopist has reviewed it. Many lesions referred for surgery can be managed endoscopically.
A colorectal surgeon who works alongside advanced endoscopists and is comfortable saying "this one does not need me". That relationship, in both directions, is what protects you from both over-treatment and under-treatment.
Clear pathology review when a polyp turns out to contain early cancer, so the decision to operate or to watch is made on the right evidence.
Sydney examples to investigate
A/Prof Shing Wai Wong (Prince of Wales Public and Private): head of the colorectal unit at Prince of Wales Hospital, with a stated interest in advanced colonoscopy including difficult polypectomy, stricture dilatation and colonic stenting, alongside colorectal cancer surgery. A surgeon who performs difficult polypectomy himself is well placed to judge when surgery is and is not needed.
Public advanced endoscopy units: several Sydney teaching hospitals run dedicated advanced therapeutic endoscopy services for large and complex lesions. If your surgeon is unsure whether a lesion can be removed endoscopically, ask for a referral to one of these units for an opinion before surgery is booked.
Where this sits in my own practice. As a gastroenterologist I perform colonoscopy and polyp removal, including larger lesions, and refer onward for surgery when the lesion is not suitable for endoscopic removal. If you have been told you need surgery for a polyp and want a second opinion on whether endoscopic removal is possible, that is a reasonable question to ask any gastroenterologist before you book an operation.
3. Inflammatory bowel disease (IBD) surgery
Surgery for Crohn's disease or ulcerative colitis is a partnership between the surgeon and the gastroenterologist, and the best outcomes come from surgeons who work in that partnership routinely.
What makes it different. IBD is a lifelong condition, so the surgeon is operating on a bowel that may need further surgery later. The goals are different from cancer surgery: preserve as much bowel as possible, time the operation around medications, and plan for the years ahead. Crohn's fistulas, strictures and perianal disease need a particular kind of judgement about when to operate and when to hold off.
What to look for
A surgeon who is part of a hospital IBD team and meets regularly with IBD gastroenterologists. Ask directly: "Do you work with an IBD multidisciplinary clinic?"
Experience with bowel-preserving techniques such as strictureplasty, and with staged operations in unwell patients.
For ulcerative colitis, experience with ileal pouch (J-pouch) surgery, which is technically demanding and done well only in units that do it regularly.
For Crohn's perianal disease, a combined medical and surgical approach, including seton placement and timing surgery with biologic therapy.
Sydney examples to investigate
A/Prof Matthew Rickard (Concord and Macquarie University Hospital): inflammatory bowel disease, anorectal physiology and anorectal ultrasound are listed among his areas of expertise, a combination that suits Crohn's perianal disease in particular.
Dr Gareth Owen (St Vincent's and The Mater): IBD surgery is a stated special interest, and he works with the St Vincent's IBD multidisciplinary team.
A/Prof Jonathan Hong (The Mater and St Vincent's): IBD is listed first among his subspecialty interests.
4. Pelvic floor and functional bowel disorders
Problems like obstructed defaecation, rectal prolapse and faecal incontinence are about how the pelvis works, not about removing something, and they need a surgeon who thinks that way.
What makes it different. Two patients with the same symptom can have completely different causes: a rectocele, an internal rectal prolapse (intussusception), a weak or injured sphincter, a muscle that will not relax, or a combination. The right treatment ranges from physiotherapy and biofeedback through to a range of operations, and the wrong operation for the wrong mechanism makes things worse. A surgeon whose practice is dominated by cancer resections may not be the best fit here.
What to look for
A surgeon who investigates before offering surgery: anorectal physiology testing, endoanal ultrasound and defaecating proctography or MRI, as appropriate.
Experience with the full range of options, including non-surgical ones, and willingness to involve a pelvic floor physiotherapist.
For women, a surgeon who works with gynaecologists and urogynaecologists, because bowel, bladder and gynaecological pelvic floor problems often coexist.
For sphincter injury after childbirth, specific experience with obstetric anal sphincter injury (OASI).
Sydney examples to investigate
Dr Penelope de Lacavalerie (Northern Beaches Hospital and Prince of Wales Private): founder of Sydney Obstetric Anal Sphincter Injuries (OASI) Specialists, with a stated interest in collaborating with gynaecologists on functional pelvic floor problems and bowel endometriosis.
A/Prof Cherry Koh (Royal Prince Alfred Hospital and Mater Hospital North Sydney): pelvic floor disorders are listed among her subspecialty interests, with a research background in anorectal physiology and biofeedback for faecal incontinence and evacuation disorders.
5. Highly specialised cancer surgery: when a referral centre is the right answer
A small group of cancers need operations so complex that they are done well only in dedicated units, and the right surgeon is whoever leads that unit, wherever it is.
What makes it different. Cancer that has recurred in the pelvis, cancer that has grown into neighbouring organs, and cancer that has spread across the lining of the abdomen (peritoneal disease) all require multi-organ operations lasting many hours, with intensive-care support and a team drawn from several surgical specialties. Outcomes in these operations are closely tied to the volume of cases the unit does.
What to look for
Honesty from your treating surgeon about whether your case is beyond their unit, and a prompt referral if it is. A good colorectal surgeon knows when to refer.
A unit with a published track record in the specific operation you need, whether that is pelvic exenteration or cytoreductive surgery with heated intraperitoneal chemotherapy (HIPEC).
A multidisciplinary assessment before any decision, because these operations are not right for everyone and the decision to proceed is as important as the operation itself.
Sydney examples to investigate
Prof Michael Solomon and the RPA pelvic exenteration unit: an internationally recognised centre for locally advanced and recurrent pelvic cancer, with one of the world's largest published experiences in these operations.
Prof David Morris and the St George Hospital peritonectomy unit: the NSW centre for cytoreductive surgery and HIPEC for peritoneal cancers including pseudomyxoma, appendix cancer, colorectal peritoneal disease and mesothelioma, established in the mid-1990s.
These are public hospital programs. If you are told you need this kind of surgery, ask your surgeon or gastroenterologist to refer you to the unit directly rather than searching for a private alternative.
6. Haemorrhoids, fissures, fistulas and other anal conditions
Haemorrhoids are common and most colorectal surgeons treat them well; what separates surgeons here is judgement about which treatment to use, not the newest equipment.
What makes it different. Anal conditions are small operations with a big effect on quality of life, and the wrong choice can mean recurrence, prolonged pain or, in the worst case, damage to the sphincter and continence. Simple haemorrhoids are a different problem from a recurrent fistula, a sphincter injury or Crohn's-related anal disease, and the second group deserves a different level of expertise.
What to look for
For haemorrhoids, a surgeon who offers the full range, from rubber-band ligation in the rooms to haemorrhoidal artery ligation (HAL-RAR), laser and excisional haemorrhoidectomy, and who explains why one suits you over another. Be cautious of a practice built around a single branded technology.
Honest discussion of recurrence rates and recovery time for each option; the least invasive option is not always the one with the best long-term result.
For fistulas, especially recurrent or complex ones, a surgeon with specific experience in sphincter-preserving techniques such as LIFT or advancement flaps, and in the staged approach that complex fistulas often need.
For anal pain or bleeding that has not been properly diagnosed, a surgeon who examines and investigates first; haemorrhoids are often blamed for bleeding that has another cause.
Sydney examples to investigate
Dr Darren Gold (Sydney Proctology, St Vincent's): a subspecialty interest in proctology, covering haemorrhoids, anal pain, fissure, fistula, pilonidal sinus and faecal incontinence.
Dr Francis Lam (Prince of Wales and Double Bay Day Hospital): proctology is listed alongside colorectal cancer among his areas of expertise, with endoscopy lists at a day hospital for office-based and minor procedures.
Questions worth asking before you book
Five questions will tell you most of what you need to know about whether a surgeon is the right fit for your condition.
How much of your practice is made up of my condition?
Which hospital would you operate at, and what support is there if something goes wrong?
Are you part of a multidisciplinary team for this condition, and will my case be discussed there?
What are the alternatives to the operation you are recommending, including non-surgical ones?
If my case turns out to be more complex than expected, who would you refer me to?
A surgeon who answers these openly, including the last one, is usually a surgeon you can trust.
Where a gastroenterologist fits in
Most patients see a gastroenterologist before they see a surgeon, and that visit is often where the matching happens.
A gastroenterologist makes the diagnosis, performs the colonoscopy, removes polyps that can be removed endoscopically, manages IBD medically, and investigates functional symptoms. By the time surgery is on the table, we usually know which kind of colorectal expertise is needed and which surgeons in Sydney have it. That knowledge is one of the most useful things a referral carries.
If you are in Sydney and unsure whether you need surgery, or which surgeon is right for your condition, a gastroenterology consultation is a sensible first step. The outcome is sometimes no surgery at all.
Frequently asked questions
Do I need a referral to see a colorectal surgeon in Sydney? Yes, for a Medicare rebate you need a current referral from a GP or another specialist. A GP referral lasts 12 months; a specialist-to-specialist referral lasts 3 months.
Is a robotic colorectal surgeon better than a laparoscopic one? Not necessarily. Robotic surgery is useful for some technically difficult pelvic operations, but an experienced laparoscopic surgeon can achieve equally good results for most conditions. What matters is that the surgeon has the appropriate techniques available and chooses the right one for your case.
Can a large bowel polyp be removed without surgery? Often, yes. Advanced endoscopic techniques (EMR and ESD) can remove many large or flat polyps through the colonoscope. If you have been told you need surgery for a polyp, it is reasonable to ask whether an advanced endoscopist has reviewed it first.
What is the difference between a general surgeon and a colorectal surgeon? A colorectal surgeon has completed general surgical training and then a further two or more years of accredited subspecialty training in bowel surgery through the Colorectal Surgical Society of Australia and New Zealand (CSSANZ). Many general surgeons also operate on the bowel, but colorectal surgeons concentrate on it.
How do I know if my cancer needs a specialised referral centre? Your surgeon or oncologist should tell you. Cancer that has come back in the pelvis, grown into other organs, or spread across the lining of the abdomen is usually managed at a dedicated unit such as RPA (pelvic exenteration) or St George Hospital (peritonectomy and HIPEC).
About this guide
This article is general information from a consultant gastroenterologist in Sydney and is not a substitute for individual medical advice. The surgeons and units named are examples drawn from their own publicly available profiles as at October 2026; they illustrate areas of practice and are not rankings, endorsements or a complete list. Practice details change, so please confirm current information directly with any surgeon before booking. No surgeon named here has paid for or reviewed this article.
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