Lung nodule assessment and early lung cancer surgery are the primary focus of the private practice — and the areas in which the pathway is most tightly developed. But thoracic surgery is a broad specialty, and Dr Okiror’s practice at Guy’s and St Thomas’ and London Bridge Hospital covers its full range.
Emphysema and advanced COPD represent a nationally commissioned subspecialty. Dr Okiror is the sole operator for both endobronchial valve therapy (Zephyr valves, Pulmonx) and lung volume reduction surgery (LVRS) at GSTT and London Bridge Hospital — procedures not widely available elsewhere in the UK. He leads the monthly emphysema MDT at GSTT, which uniquely includes the Harefield lung transplant team. Over 100 combined EBV and LVRS procedures have been performed since 2019. Bullectomy for giant bullous lung disease, including vanishing lung syndrome, is offered as a related private service. Emphysema treatment → · Bullectomy & giant bulla →
Pleural disease — including pleural effusion, empyema, mesothelioma, and complicated pneumothorax — forms a substantial part of both NHS and private practice. Dr Okiror is Lead Surgeon at GSTT for the NIHR-funded MIST-4 trial (ISRCTN16328099), comparing early VATS surgery against enzyme therapy for pleural infection across 25 UK sites, and Lead Surgeon at GSTT for PRO-SEAL (ISRCTN15099654), evaluating three approaches to persistent air leak in secondary pneumothorax. Pleural disease → · Empyema & pleural infection →
Thoracic outlet syndrome, hyperhidrosis, slipped rib syndrome, central airways disease, and diaphragm conditions are all treated regularly in the private clinic. Robotic keyhole first rib resection for thoracic outlet syndrome and ETS for hyperhidrosis both benefit from the same minimally invasive surgical platform that underpins the lung cancer programme. All conditions →
The breadth of the practice matters not just for completeness, but because many patients arrive with a diagnosis that has been made in one specialty when the cause lies in another. A patient labelled with atypical asthma who has tracheal stenosis. A patient with years of chest pain dismissed as musculoskeletal who has slipped rib syndrome. A patient whose breathlessness has been attributed to anxiety who has diaphragmatic paralysis. These are conditions that require a thoracic surgeon who recognises them — and a clinical environment with the infrastructure to investigate and treat them properly.
Active research — NIHR-registered trials
MIST-4 (ISRCTN16328099) — Phase III NIHR RCT comparing VATS surgery versus enzyme therapy for pleural infection. 604 patients, 25 UK sites. Dr Okiror: Lead Surgeon, GSTT.
PRO-SEAL (ISRCTN15099654) — NIHR randomised feasibility trial evaluating three interventions for persistent air leak in secondary spontaneous pneumothorax. Dr Okiror: Lead Surgeon and designated endobronchial valve operator, GSTT.
RoboReady / Proximie — GSTT Thoracics uses Proximie to record operative cases for surgical education. Dr Okiror’s robotic cases are part of this national programme for training the next generation of robotic thoracic surgeons.
