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Mr Jonathan Koea - Hepatobiliary and General Surgeon

Private Service

Description

While I have trained in general surgery in New Zealand, I have undertaken further study specialising in cancer surgery and particularly cancers of the liver, gallbladder, bile ducts and other organs of the upper gastrointestinal tract (pancreas, stomach, intestine and spleen).
 
My specific area of clinical interest is in the investigation and management of tumours of the upper gastrointestinal tract. This includes surgical resection or ablation of tumours of the liver, gallbladder, stomach, pancreas and bowel. I also have a significant interest in the management of neuroendocrine and carcinoid tumours of the gastrointestinal tract.

In addition to the Mercy Specialist Centre, I also hold regular clinics at the following locations (see right of page for contact details):

  • Apollo Centre for Health & Wellness, Albany
  • Silverdale Medical, Silverdale
  • Kowhai Surgery, Warkworth

I also have regular operating lists at Mercy Hospital in Epsom, Southern Cross North Harbour in Glenfield and Rodney Surgical Centre in Warkworth.

 

 
What is General Surgery?
General surgeons developed from barber surgeons who were tradesmen practitioners skilled in the use of procedures to treat conditions of the head, chest, abdomen, limbs and skin. However as surgery developed it proved impossible for single practitioners to deal with all conditions affecting the body. General surgery now deals with a wide range of conditions within the abdomen, breast, neck, skin and, very often, the vascular (blood vessel) system.
Ironically, as knowledge of conditions affecting the areas normally managed by the general surgeon has expanded, many general surgeons have subspecialised in a particular aspect of surgery and developed specific expertise.

Consultants

Referral Expectations

Most patients are referred by their general practitioners or other specialists.

When you come to your appointment, I will ask questions about your illness and examine you to try to determine or confirm the diagnosis. This process may also require a number of tests (e.g. blood tests, x-rays, scans etc). Often you may have already had investigations such as CT scans and if you are able to bring these with you it will be of great help. In addition, copies of any medical records or test reports can also be of assistance. Sometimes this can all be done during one visit, but for some conditions this will take several follow-up appointments. Occasionally some tests are arranged even before your appointment to try to speed up the process.

Once a diagnosis has been made, I will discuss treatment with you. In some instances this will mean surgery, while other cases can be managed with medication or other non-surgical interventions. If surgery is advised, I will outline the risks, benefits and alternatives and go through the steps involved in the surgical process with you.

Common Conditions / Procedures / Treatments

  • Gallstones and Cancers of the Liver, Gallbladder and Bile Ducts

    Gallbladder

    The most common disorder of the gallbladder is pain caused by gallstones and their complications such as cholecystitis. Gallstones are formed if the gallbladder is not working properly and cause symptoms by preventing the gallbladder from functioning normally or by causing obstruction to the flow of bile. The standard… More

  • Cancers of the Stomach, Pancreas & Bowel (Adenocarcinoma, Neuroendocrine and Carcinoid Tumours)

    Other conditions of the gastrointestinal tract dealt with by general surgery include disorders of the oesophagus, stomach, small bowel, large bowel and anus.… More

  • Skin Cancers (Moles, Lumps and Tumours)

    Skin conditions dealt with by general surgery include lumps, tumours and other lesions of the skin and underlying tissues.… More

  • Hernias

    A hernia exists where part of the abdominal wall is weakened and the contents of the abdomen push through to the outside.… More

  • Laparoscopic Surgery

    Historically, surgery of the abdomen and gastrointestinal tract has been carried out through incisions in the abdominal wall.… More

Charges

Associate Professor Jonathan Koea is a Southern Cross Affiliated Provider for a range of services (detailed below). Please contact the practice for more information.

General surgery (Breast, gall bladder, hernia) services:

  • Laparoscopic cholecystectomy
  • Laparoscopic cholecystectomy with an intraoperative cholangiogram
  • Open or laparoscopic repair of inguinal hernia
  • Open or laparoscopic repair of umbilical hernia
  • Open repair of epigastric hernia
  • Open or laparoscopic repair of femoral hernia
  • Open repair of epigastric hernia
  • Open repair of incisional hernia
  • Laparoscopic repair of hiatus hernia
  • Laparoscopic Nissen fundoplication

Skin services:

  • Skin lesion removal under general anaesthesia, with another procedure

Varicose veins:

  • Varicose vein surgery

Refreshments

A cafeteria is available on the Mercy Hospital site immediately adjacent to the Cancer Centre and behind the Specialist Centre. The cafeteria has inside and outside seating and serves great coffee.

Travel Directions

The Mercy Specialist Centre can be accessed from the northern motorway by taking the Gillies Avenue exit, taking the first right turn into Gillies Avenue, first left into Seccombes Road, third left into Mountain Road and then entering Mercy Hospital Gate 3. A parking building is immediately adjacent to the entrance and the Mercy Specialist Centre is immediately behind the parking building. Please use Entrance C to the Specialist Centre. Parking is free.

The Apollo Health Centre can be accessed from either Rosedale Rd or Apollo Drive in Albany. Free parking is provided and take the lift to the Specialist Centre on the first floor.

Silverdale Medical can be accessed from the Hibiscus Coast Highway. Turn left into Millwater Parkway and first left into Central Blvd and then first left into Polarity Rise. Free parking is provided.

Kowhai Surgery is on the corner of Alnwick Street and Percy Street in Warkworth. Turn off State Highway 1 into Whitaker Rd and then into Alnwick Street. Free parking is provided.

Get directions

Parking

Parking is available at Mercy Hospital in the hospital grounds and in a two level car park building that can be accessed through Entrance 3 from Mountain Road.

Free parking is also available at Apollo Health Centre, Silverdale Medical and Kowhai Clinic.

Accommodation

Accommodation for patients and families can be arranged at a number of hotels close to Mercy Hospital.

Domain Lodge
Auckland Division of the Cancer Society
1 Boyle Cres
Grafton
Auckland, New Zealand
Phone: 64 9 308 0160
Fax: 64 9 308 0173
email:
 
Alpers Lodge
16 Alpers Avenue
Newmarket
Auckland, New Zealand
Phone: 64 9 523 3367 (freephone 0800 160 880)
Fax: 64 9 520 3809
email:

 

Boulevard Hotel
15 Alpers Ave
Newmarket
Auckland, New Zealand
Phone: 64 9 522 0160
Fax: 64 9 522 0975

Pharmacy

A pharmacy (phone 09 623 5703) is available on the Mercy Hospital site and can be accessed through the main entrance of the Mercy Hospital.

Pharmacies are also available on site at Apollo Health Centre and Silverdale Medical and adjacent to Kowhai Clinic.

Other

Selected Publications

National Guidelines

Thomson B; Samra J; Koea J; Padbury R; Crawford M. Guidelines for the diagnosis and management of gastropancreatic neuroendocrine tumours (GEP NETs). Surgery

http://wiki.cancer.org.au/australia/COSA:NETs_guidelines/Surgery

Standards of service provision for patients with hepatobiliary-pancreatic and upper gastrointestinal (HPB-Upper GI) cancer in New Zealand. Deputy Chair HPB section.

http://www.health.govt.nz/system/files/documents/pages/standards-of-service-provision-uppergastrointestinal-cancer-patients-dec13.doc&rct=j&frm=1&q=&esrc=s&sa=U&ei=2fd8VJ7ROuOhmQW3-YEY&ved=0CBoQFjAA&usg=AFQjCNHkOpgrh9nib9TRBvO5_SwD4Xd9Qw

Book Chapters

Rajkomar K; Koea JB. Intrahepatic cholangiocarcinoma. Surgery of the Liver, Biliary Tract and Pancreas. Jarnagin W (ed). 6th edition WB Saunders New York, 2016.

Martin R; Masters K; Maddern G; Coventry B; Koea JB.  Liver Surgery. Surgical Complications, Risks and Consequences. Blumgart LH; Friend P (eds). Springer Verlag, London, 2014, pp 283-300.

Koea JB. Central hepatectomy. Chapter 21 in Master Techniques in Hepatobiliary and Pancreatic Surgery. Lillemoe K, Jarnagin W (eds). Lippencott, Williams and Wilkins 2012. pp 269-286.

Koea JB. Intrahepatic cholangiocarcinoma. Surgery of the Liver, Biliary Tract and Pancreas. Jarnagin W (ed). 5th edition WB Saunders New York, 2011 pp 760-770.

Ronald M; Koea JB. Social policy and indigenous health: lessons from New Zealand. In Social Policy and Indigenous Health, Nova Publications, New York, 2011.

Aramoana J; Bassari R; Koea JB. Jaundice and pruritus: Pathophysiology and management. In Advances in Medicine and Biology. Berhardt L (ed). Volume 94, Nova Publications, New York, 2015. Pp 107-124.

 
Original Investigations

Wylie N; Hider P; Armstrong D; Rajkomar K; Srinivasa S; Rodgers M; Brown A; Koea JB. From scratch: Developing a hepatic resection service for metastatic colorectal cancer. ANZ J Surg 2016; epub: 1 DEC 2016 | DOI: 10.1111/ans.13848.

Bowman M; Koea JB. Hepatic hydatid disease in New Zealand: Is it still a problem? Annals of Clinical Cytology and Pathology 2016;2(1023):1-3.

Brown A; Wylie N; Rodgers M; Casement J; McIlree N; Gray L; Mulholland G; Volkova V; van der Watt E; Booth M; Koea JB. Development and initial outcomes of an upper gastrointestinal multi-disciplinary clinic. NZ Med J 2016;129(1437):1-7.

Rajkomar K; Bowman M; Rodgers M; Koea JB. The quadrate lobe: A reliable landmark for bile duct anatomy during laparoscopic cholecystectomy. ANZ J Surg 2016: Early view April 8, 2016, DOI:10.1111/ans.13509.

Koea JB; Batiller J; Aguirre N; Shen J; Kocharian R; Bochicchio G; Garden OJ. A multicenter, prospective, randomized, controlled trial comparing EvarrestTM fibrin sealant patch to standard of care in controlling bleeding following elective hepatectomy. HPB 2016;18:221-228. epub 01/2016; http://dx.doi.org/10.1016/j.hpb.2015.12.006.

Srinivasa S; Lee WG; Aldameh A; Koea JB. Spontaneous hepatic haemorrhage: A review of pathogenesis, aetiology and treatment. HPB 2015;17(10):872-880. epub 08/2015; DOI:10.1111/hpb.12474.

Hundal H; Koea JB. Alvarado Scoring in Primary Health Care: Managing Acute Surgical Workload at the Source. ANZ J Surg 2015;85(7):593.

Bassari R; Koea JB. Jaundice associated pruritus: A review of pathophysiology and treatment. World Journal of Gastroenterology 2015;21:1404-1413. DOI: http://dx.doi.org/10.3748/wjg.v21.i5.1404    

Srinivasa S; McEntee B; Koea JB. The role of PET scans in the management of cholangiocarcinoma and gallbladder cancer: A systematic review for Surgeons.International Journal of Diagnostic Imaging 2015;2:1-10. DOI: 10.5430/ijdi.v2n1p1

Koea JB. Henry Barrett: Pioneer paediatric surgeon. ANZ J Surg 2015;85:324-326. DOI: 10.1111/ans12926

Sarfati D; Gurney J; Stanley J; Koea J. A retrospective cohort study of patients with stomach and liver cancers: the impact of comorbidity and ethnicity on cancer care and outcomes. BMC Cancer.2014, 14:821 DOI: 10.1186/1471-2407-14-821URL: http://www.biomedcentral.com/1471-2407/14/821

Chong V; Zhou L; Hundal H; Koea JB. Acute Surgical Treatment of Cutaneous Abscesses: Cost Savings from Prioritization in Theatre. NZMJ 1 August 2014, Vol 127 No 1399; ISSN 1175 8716 URL: http://www.nzma.org.nz/journal/read-the-journal/all-issues/2010-2019/2014/vol-127-no-1399/6238

Koea JB; Yeong ML. Focal Nodular hyperplasia and hepatocellular carcinoma: Uncommon companions? Pathology 2014;46(4):348-350.

Signal V; Sarfati D; Cunningham R; Koea J; Gurney J;  Blakely T. Ethnic inequalities in the presentation and management of stomach cancer in New Zealand: a country with universal healthcare coverage. Gastric Cancer: Official Journal Of The International Gastric Cancer Association And The Japanese Gastric Cancer Association [Gastric Cancer], ISSN: 1436-3291, 2014 Aug 7; Publisher: Springer-Verlag Tokyo; PMID: 25098927

Sarfati D; Gurney J; Stanley J;  Salmond C; Crampton P;  Dennett L; Koea J;  Pearce N. Cancer-specific administrative data-based comorbidity indices provided valid alternative to Charlson and National Cancer Institute Statistics. J Clin Epidemiology 2014; 67:586-595.

Chamberlain J; Sarfati D; Cunningham R; Koea J; Gurney J;  Blakely T. Incidence and management of hepatocellular carcinoma among Maori and non-Maori New Zealanders. Australian and New Zealand Journal of Public Health 2013;37:520-526.

Oh JS; Koea JB. Radiation risks associated with serial imaging in colorectal cancer patients: Should we worry? World Journal of Gastroenterology 2013;19(47):1-10. 

Dew K; Stubbe M; Signal L; Stairmand J; Dennet L; Koea J; Simpson A; Sarfati D; Cunningham C; Batton L; Ellison-Loschman L; Barton J; Holdaway M. Cancer care decision-making in a multidisciplinary meeting: A qualitative observational study. Qualitative Health Research March 2015; Vol. 25, No. 3 http://qhr.sagepub.com/content/25/3?etoc

Gurney J; Sarfati D; Dennett E; Koea J.The completeness of cancer treatment data on the national health collections. The New Zealand Medical Journal [N Z Med J], ISSN: 1175-8716, 2013 Aug 30; Vol. 126 (1381), pp. 69-74; Publisher: New Zealand Medical Association; PMID: 24150267

Aramoana J; Koea JB. Developing an Indigenous surgical workforce. ANZ J Surg 2013; 83:912-917.

Koea JB; Srinivasa S; Hundal H. Provision of Acute General Surgery: A Systematic Review of Models of Care. Trauma and Acute Care Surgery 2014;76(1):219-225.

Sarfati D; Gurney J; Lim B; Bagheri N; Simpson A; Koea J; Dennett E. Identifying important co-morbidity among cancer populations using administrative data: prevalence and impact on survival. Asia-Pacific Journal Of Clinical Oncology [Asia Pac J Clin Oncol], ISSN: 1743-7563, 2013 Dec 19; Publisher: Blackwell Pub. Asia; PMID: 24354451.

Gurney J; Sarfati D; Stanley J; Simpson D; Lim B; Koea J. Unstaged cancer in a population-based registry: Prevalence, predictors and patient prognosis. Cancer Epidemiology 2013; 37:498-504.

Koea JB; Baldwin P; Shen J ; Patel B; Batiller J; Arnaud A; Hart J; Hammond J; Fischer C; Garden OJ. A randomized, controlled, superiority trial to evaluate the safety and haemostatic effectiveness of fibrin pad for severe soft tissue bleeding during abdominal, retroperitoneal, pelvic and thoracic (non-cardiac) surgery. World J Surg 2015; DOI 10.1007/s00268-015-3106-5. Erratum published 31 July 2015. DOI: 10.1007/s00268-015-3163-9.

Koea JB; Batiller J; Patel B; Shen J; Hammond J; Hart J; Fischer C; Garden OJ. A phase III randomised, controlled, superiority trial evaluating the fibrin pad versus standard of care in controlling parenchymal bleeding during elective hepatic surgery. HPB 2013;15(1):61-70.

Koea JB. Hepatic incidentaloma: The rule of tens. HPB 2013;15:379-373.

Koea J. “Goodwill Dr George Home: RACS Fellow 169. ANZJ Surg 2012;82:827-831.

Koea J. The first elective liver resection in New Zealand?. ANZJ Surg 2012;82:289-90.

Koea J. Laparoscopic treatment of hepatic hydatid disease. ANZJ Surg 2012;82:499-504.

Koea JB; Kua H. Pigmented hepatic adenoma: Rare but benign. ANZ J Surg 2012;82:86-87.

Koea JB; Beban GR. Indigenous child health in New Zealand: Some surgical issues. Journal of Paediatrics and Child Health 2010;46:466-470.

Mathur S; Plank L; McCall JL; Shapkov P; McIlroy K; Gillanders L; Merrie AE; Torrie JJ; Pugh F; Koea JB; Bissett IP; Parry BR. Randomized controlled trial of  preoperative oral carbohydrate treatment in major abdominal surgery. British Journal of Surgery 2010;97:485-494.

Koea JB; Young Y; Gunn K. Fast track liver resection: The effect of a comprehensive care package and analgesia with single dose intrathecal morphine with gabapentin or continuous epidural analgesia. HPB 2009, Article ID 271986. http://www.hindawi.com/journals/hpb/2009/271986.html  Accessed March 9 2010.

Creamer G; Dahl A; Perumal D; Tan G; Koea JB. Anatomy of the ward round: The time spent in different activities. ANZ J Surg 2010; 80: 930-32.

Koea JB. Indigenous health: A New Zealand perspective. Injury 2008; 39(Suppl 5):S11-S18.

Koea JB. Cystic Lesions of the Liver:  Six Years of Surgical Management in New Zealand. NZ Med J 2008; 121(1277). http://www.nzma.org.nz/journal/121-1277/3145/

Koea JB; Smith D. Solitary necrotic nodule revisited. ANZ J Surg 2008; 78:109-111.

Bartlett AS; McCall JL; Koea JB; Holden A; Yeong ML; Gurisinghe N; Gane E.Liver Resection for Hepatocellular Carcinoma in New Zealand. World J Surg 2007; 31:1775-81.

Leung U; Wong P; Roberts R; Koea J. Gallbladder polyps in sclerosing cholangitis: Does the 1 cm rule apply. ANZ J Surg 2007;77:355-57.

Jarnagin WR; Browne W; Klimstra DS; Ben-Porat L; Roggin K; Cymes K; Fong Y; DeMatteo RP; D’Angelica M; Koea J; Blumgart LH. Papillary phenotype confers improved survival after resection of hilar cholangiocarcinoma. Ann Surg 2005;241(5):703-14.

Hsee LC; McCall JL; Koea JB. Focal nodular hyperplasia: What are the indications for resection. HPB 2005;7:298-302.

Aldameh A; McCall JL; Koea JB. Is routine placement of surgical drains necessary after hepatectomy? Results from a single institution. J Gastrointestinal Surgery 2005;9:667-671.

Koea JB; Gane E; McCall JL. Laparoscopic hepatectomy for hepatocellular carcinoma: A Caution. ANZ J Surg 2005;75:86.

Koea JB. Getting started as a hepatobiliary surgeon: Lessons learned from the first 100 hepatectomies as a consultant. NZ Med J 2005;118:1210-1215.

Contact Details

  • Phone

    (09) 630 8216

  • Healthlink EDI

    akgastro

Corner Alnwick St and Percy St
Warkworth
Auckland 0910

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Street Address

Corner Alnwick St and Percy St
Warkworth
Auckland 0910

Postal Address

Mercy Specialist Centre
100 Mountain Road
Epsom
Auckland 1023

Mercy Specialist Centre, 100 Mountain Road, Epsom, Auckland

Central Auckland

  • Phone

    (09) 630 8216

  • Healthlink EDI

    akgastro

More details…

119 Apollo Drive, Rosedale, Auckland

North Auckland

  • Phone

    (09) 630 8216

  • Healthlink EDI

    akgastro

More details…

Silverdale Medical Centre, 7 Polarity Rise, Silverdale, Auckland

North Auckland

  • Phone

    (09) 630 8216

  • Healthlink EDI

    akgastro

More details…

This page was last updated at 9:49AM on February 28, 2020. This information is reviewed and edited by Mr Jonathan Koea - Hepatobiliary and General Surgeon.