Frequently Asked Questions

Mr Marco Scarci is a consultant thoracic surgeon at Imperial College NHS Healthcare Trust, where he has held his consultant post since 2011. He holds the qualifications MD(Hons) FRCS(Eng) FCCP FACS FEBTS and has a GMC registration number of 6159768. He specialises in minimally invasive VATS and robotic thoracic surgery and has performed over 5,000 minimally invasive procedures, with more than 170 peer-reviewed publications. He sees private patients at five London hospitals.

Mr Scarci holds private outpatient consultations at five locations: The London Clinic in Marylebone (Monday evenings 5:30–7:30pm), The Wellington Hospital in St John’s Wood (Monday mornings 11am–1pm), HCA Elstree in Borehamwood (Tuesday evenings 5:30–7:30pm), Imperial Private Healthcare at Hammersmith Hospital (Wednesday mornings 9–11am), and Bupa Cromwell Hospital in South Kensington (Thursday mornings 9:30am–12:30pm). Surgery is arranged at the most appropriate of his surgical hospitals.

Namita Patel, the assistant practice manager, coordinates all new patient bookings, insurance checks, pre-authorisation, and general enquiries. She can be reached by phone on 020 7459 4367, by email at [email protected], or via WhatsApp on +44 7300 789 130. She is available Monday–Friday 9am–6pm and responds to messages the same business day.

Yes, always. Mr Scarci sees you at consultation, performs your surgery personally, and conducts your post-operative review. There is no relay through different team members. This continuity — from consultation through surgery to recovery — is one of the most clinically important aspects of private care and something Mr Scarci is committed to unconditionally.

Both malignant and benign thoracic conditions. Cancer: lung cancer surgery (lobectomy, segmentectomy, wedge resection), second opinions on operability. Benign: pneumothorax, slipping rib syndrome, rib fracture fixation, diaphragmatic plication, thymoma, pleural effusion, empyema, pectus deformities, thoracic outlet syndrome, sternal fractures, and more. Sympathetic nerve surgery: ETS for hyperhidrosis and facial blushing.

Yes. Remote video consultations are available and widely used — by patients from outside London, across the UK, and internationally. Send your existing CT scans, imaging, and clinical letters to [email protected] in advance. Mr Scarci reviews them before the remote consultation, which covers diagnosis, all treatment options, and next steps — exactly as a face-to-face appointment would. Booking is through the same Carebit portal.

Yes. Family members, partners, or a trusted friend are welcome to attend consultations. Many patients find it helpful to have someone with them to ask questions and to help remember what was discussed afterwards. Let Namita know when booking if you will be bringing someone, particularly if interpretation might be needed.

No. You can book a private consultation with Mr Scarci without a GP referral. If you have a referral letter, bring it — but it is not required to attend. Some private health insurers require a GP referral for reimbursement purposes; in that case, your GP can issue one and this can run in parallel with your private booking rather than delaying it. Namita will advise you on this for your specific insurer.

Urgent cases — a suspicious scan result, rapidly progressing cancer, recurring pneumothorax, or any time-sensitive situation — are seen the same day or within hours of contacting the practice. Routine new patients are typically offered an appointment within 24–48 hours of first contact. Call 020 7459 4367 and describe the urgency of your situation.

Three ways: book online through the Carebit portal at mr-marco-scarci.carebit.co/patients/bookings/new (choose your preferred location and date), call 020 7459 4367 (Mon–Fri 9am–6pm), or send a WhatsApp message to +44 7300 789 130. All routes go through Namita, who confirms the appointment, checks your insurance, and sends you pre-appointment information.

For patients outside London or overseas, a remote video consultation is available as a full first appointment. A phone call alone is less useful because imaging review is central to what Mr Scarci does in a consultation. If you are unable to attend and have existing scans, email them to [email protected] and a video consultation can be arranged at a time that works for your schedule and time zone.

Yes. The five consultation locations are spread across London and Hertfordshire — choose the most convenient for you. All offer the same clinical standard. For patients driving, Bupa Cromwell and HCA Elstree have on-site parking. For tube users, The London Clinic (Regent’s Park), Wellington Hospital (St John’s Wood), and Bupa Cromwell (Gloucester Road) have the most convenient tube connections.

Most importantly: any existing imaging (CT scan on disc or digital link, PET, MRI). Also useful: biopsy or histology reports, letters from previous consultants, a list of current medications, your private health insurance membership number if applicable. Sending imaging by email to [email protected] before your appointment means Mr Scarci can review it in advance — making the consultation significantly more efficient.

Yes, strongly. What is considered “inoperable” varies significantly between centres based on available surgical technique, experience, and approach. Cases regarded as too complex at one centre can be entirely routine at a centre with a full uniportal VATS and robotic programme. Mr Scarci regularly reviews cases referred as inoperable and finds that a significant proportion are resectable when assessed properly. The only cost of a second opinion is a consultation fee and time. The cost of not seeking one may be much greater.

All three remove part of the lung. A lobectomy removes an entire lobe — the most common operation for lung cancer, typically appropriate for Stage I–II disease. A segmentectomy removes one or more anatomical segments — preserves more lung tissue than a lobectomy and is appropriate for smaller tumours or patients with reduced lung function. A wedge resection removes a small wedge-shaped section of lung — the most limited resection, appropriate for very small or peripheral tumours. The choice is determined by tumour size, location, and lung function and is discussed with you at consultation.

For VATS (keyhole) lobectomy, the typical hospital stay is 2–4 days. For open thoracotomy, 5–8 days. For a wedge resection via VATS, often 2–3 days. The main factor determining discharge is removal of the chest drain, which stays in until air leak stops and fluid output reduces. Most patients are mobile and walking within 24 hours of VATS surgery.

Mr Scarci calls you personally with your biopsy results within 24 hours of the laboratory report being available. You do not receive a letter, and you do not wait for a follow-up appointment to understand the findings. The call covers what the pathology shows, what it means for your treatment, and what the next steps are — including referral to medical oncology if adjuvant chemotherapy or immunotherapy is recommended.

Yes. Mixed NHS/private pathways are very common in thoracic oncology. Private surgery followed by NHS chemotherapy, radiotherapy, or immunotherapy is entirely possible. Mr Scarci provides a full surgical and pathology report to your NHS oncology team and coordinates the handover personally. Your NHS entitlement is completely unaffected by having surgery privately.

Adjuvant chemotherapy (given after surgery to reduce recurrence risk) typically begins 4–6 weeks after surgery, once wound healing is established and recovery is sufficient. Radiotherapy timelines depend on the specific indication and technique. These timelines are coordinated with your medical oncologist and are discussed as part of the post-operative planning after pathology results are available.

For most patients having a lobectomy or lesser resection with good pre-operative lung function, the long-term breathing impact is modest. The remaining lung tissue has significant capacity to adapt and compensate over the first 6–12 months. Patients who had good exercise tolerance before surgery typically return to similar activity levels. Those with pre-existing COPD or reduced lung function will notice more impact — pulmonary rehabilitation can help significantly and is routinely recommended.

After a first spontaneous pneumothorax, the recurrence rate is around 25–30%. After a second, it rises to 50–80%. Most guidelines recommend surgical treatment (VATS bullectomy and pleurodesis) after a second ipsilateral pneumothorax, or after a first if there are specific risk factors — bilateral disease, ongoing air leak, certain occupations (pilots, divers), or tension pneumothorax. A consultation will clarify which applies to your situation. Private care means surgery can be arranged quickly rather than waiting for a third episode.

Slipping rib syndrome is significantly underdiagnosed — it is frequently misattributed to costochondritis, musculoskeletal strain, or labelled as unexplained. The characteristic features are sharp or catching pain at the lower rib margin, often reproduced by specific movements, sometimes with a clicking sensation. The Hooking Maneuver is the diagnostic bedside test. If this fits your history, a consultation is strongly recommended. Costal cartilage resection offers excellent long-term relief.

Recurrent pleural effusion is best managed by pleurodesis — a procedure that obliterates the pleural space so fluid cannot re-accumulate. This can be done via VATS (thoracoscopic talc pleurodesis) or via chest drain (talc slurry). VATS pleurodesis also allows biopsy of the pleura at the same time. For patients unfit for surgery, an indwelling pleural catheter (IPC) allows the effusion to be drained at home repeatedly without repeat hospital admissions. The best approach depends on your diagnosis, fitness, and lung re-expansion — all assessed at consultation.

In the vast majority of cases, yes. Endoscopic thoracic sympathectomy (ETS) produces a permanent reduction in sweating for palmar (hand), axillary (armpit), and facial hyperhidrosis. The main side effect to be aware of is compensatory sweating — increased sweating in other areas (typically the trunk, thighs, or back) as the body compensates. The severity varies between patients. The procedure, results, and compensatory sweating risk are discussed in detail at consultation.

Not always. Most isolated, non-displaced sternal fractures heal conservatively with pain management and activity restriction over 6–12 weeks. Surgical fixation with titanium plates is considered for: significantly displaced fractures, fractures causing chest wall instability, non-healing fractures causing chronic pain at 3+ months, or fractures in patients who need to return to physically demanding activities. A consultation will clarify whether surgery is appropriate for your specific fracture.

VATS (video-assisted thoracoscopic surgery) uses 3–4 small incisions of 1–3 cm, a camera, and long specialised instruments — avoiding the 15–25 cm incision and rib-spreading of open thoracotomy. The result is significantly less post-operative pain, a shorter hospital stay (2–4 days vs 5–8 days), faster return to normal activity (4–6 weeks vs 8–12 weeks), and less scarring. For lung cancer, the oncological outcomes are equivalent to open surgery.

The vast majority of patients are. The main factors that might lead to open surgery instead are: a very large or centrally located tumour, extensive previous chest surgery causing dense adhesions, or certain complex vascular situations. These are assessed from your CT scan at consultation. If open surgery is needed, Mr Scarci explains why explicitly and ensures pain management is optimised. When keyhole surgery is appropriate, it will always be offered.

Standard VATS uses 3–4 small incisions. Uniportal VATS performs the entire operation through a single incision of 2–3 cm — everything (camera and all instruments) passes through one port. Mr Scarci has published original research on uniportal VATS technique and was one of the founders of the International VATS Symposium. When appropriate for a specific case, single-incision VATS offers the most minimal approach available.

Yes, for most lung operations. A chest drain is placed during surgery to drain air and fluid from around the lung as it re-expands. For VATS procedures it is typically a smaller, better-tolerated drain than those used after open surgery. It is removed when air leak has stopped and fluid output is low — usually day 2–3 after VATS lobectomy, often sooner for simpler procedures.

The consultation fee is approximately £350. This covers a full clinical assessment, review of all existing imaging, a written treatment plan, and direct follow-up access to Mr Scarci for questions arising from the consultation. If you have private health insurance, the consultation fee is typically covered by your policy (subject to your excess). Namita verifies this before your appointment.

All major UK private health insurers — Bupa, AXA Health, Aviva, Vitality, Cigna, WPA, Healix, Simplyhealth, The Exeter, and others. International health insurance (Bupa International, AXA Global, Allianz, Cigna International, April International) is also accepted. The practice team handles pre-authorisation and direct billing — you pay only your policy excess.

Approximately: VATS lobectomy £20,000–£32,000 all-in; VATS for pneumothorax £13,000–£20,000; pleurodesis £8,000–£14,000; rib fracture fixation £15,000–£26,000; pectus excavatum correction £20,000–£36,000. All figures are all-in estimates covering surgeon, anaesthesia, hospital stay, and post-operative review. A full written estimate is provided before any commitment.

Yes. 0% interest finance is available for eligible self-pay patients through Ideal4Finance — a regulated UK credit broker. Apply online in around 10 minutes once you have your written estimate from the practice. The loan covers the total surgical cost including surgeon, anaesthesia, and hospital. Monthly repayment terms from 6 to 24 months. Finance is subject to credit assessment and personal circumstances.

No. Your NHS entitlement is a permanent right unaffected by any private care you choose. You can have private surgery and continue NHS oncology, chemotherapy, or follow-up. You can have a private second opinion and then proceed on the NHS. The NHS RTT clock resets if you re-enter the NHS pathway after a private consultation, but your underlying entitlement never changes.

It depends on your insurer and policy type. Many corporate Bupa policies require a GP referral for reimbursement. AXA Health and Aviva often do not. Vitality varies by plan tier. Namita checks this specifically for your insurer before your consultation — if a GP referral is needed, your GP can issue one quickly and this can run in parallel with your private booking.

The written estimate provided by the practice covers surgeon fees, anaesthesia, hospital stay, theatre, and post-operative review as an all-in figure — there are no hidden costs within the planned episode of care. If an unexpected complication arises requiring additional care, this is handled transparently and discussed before any further costs are incurred. The initial consultation fee (approximately £350) is charged separately.

The key criterion is not a fixed time but whether you can perform an emergency stop safely without pain or hesitation. For most VATS procedures, this is achievable from week 4–6. You must also inform your car insurer of your surgery. Until you are confident of emergency braking without flinching, you should not drive regardless of elapsed time.

Desk or office work: typically 3–5 weeks after VATS surgery (6–8 weeks after open thoracotomy). Light manual work: 6–8 weeks (VATS). Physical or heavy manual work: 10–12 weeks (VATS), 14+ weeks (open). These are typical ranges; your specific return-to-work timeline is confirmed at your post-operative review based on your recovery progress, procedure type, and job demands.

Short-haul flying (Europe): generally from 6 weeks after uncomplicated VATS. Long-haul flights: typically from 8 weeks after VATS, 10 weeks after open surgery. Mr Scarci provides a fitness-to-fly letter for airlines and travel insurers if required. Always inform your travel insurer of recent surgery before booking.

Yes. Breathlessness on exertion immediately after surgery is expected and normal. It improves significantly over 4–8 weeks as the remaining lung tissue expands and adapts. Daily breathing exercises and gradually increasing walking are the most effective ways to accelerate this improvement. If breathlessness is worsening rather than improving, or is accompanied by chest pain, high heart rate, or fever, contact Mr Scarci’s team or attend A&E.

Contact Mr Scarci’s practice or go to A&E immediately if you experience: sudden worsening breathlessness, coughing up blood, fever above 38°C, increasing chest pain, a wound that becomes red, swollen, or discharging, a swollen and painful calf (possible DVT), or any symptom that feels genuinely alarming to you. Mr Scarci’s patients have direct access to the practice on 020 7459 4367 — when in doubt, call.

The NHS is excellent. The specific differences private care offers are: faster access (days vs weeks to months), the ability to choose your surgeon and see the same surgeon throughout, your existing imaging reviewed before your first appointment, surgery within days of a confirmed plan, biopsy results communicated personally within 24 hours, and a private single room during your hospital stay. For time-sensitive conditions — particularly lung cancer — the speed difference has clinical significance.

Yes. You can have private surgery and then return to NHS follow-up care at any point. Your NHS entitlement is unaffected. Note that if you have a private consultation and then choose to proceed on the NHS pathway, the RTT clock resets from when you re-enter the NHS system. This is worth factoring into your decision if your NHS wait has already started.

Mr Scarci holds an NHS consultant post at Imperial College NHS Healthcare Trust (Hammersmith Hospital). NHS patients at Imperial College are referred through standard NHS referral pathways from their GP or another NHS consultant. If you are seeking to be seen by Mr Scarci on the NHS, a referral to the thoracic surgery service at Imperial College is the route. For private care, no referral is needed and you can contact the practice directly.

Yes, and this is common. Many patients have surgery privately and continue NHS oncology, chemotherapy, or radiotherapy. Mr Scarci provides a full operative report, pathology report, and clinical summary to your NHS oncology team and coordinates the handover personally. If you are in an NHS MDT, the outcome of your private surgery can be fed back to that MDT to inform ongoing treatment planning.