Your initial appointment
Dr. Pram Sirimanna sees both public and private patients in his consulting rooms in Burwood (Digestive Pelvic Floor Centre) and Norwest/Rouse Hill (Complete Health Australia), as well as through the public clinic at Concord Repatriation General Hospital.
Bookings can be made via telephone and urgent referrals will be seen within a week.
A referral from your GP or specialist is required to access a Medicare rebate for your consultation.
Initial consultations typically last around 30 minutes. You are welcome to bring a family member or support person to your appointment.
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To ensure your consultation is as efficient and informative as possible, please bring:
Referral letter from your GP or specialist
Medicare card
Private health insurance details (if applicable)
An up-to-date list of medications and allergies
Relevant medical history or summary (if available)
Recent imaging (CT, MRI, ultrasound) and reports
Blood test results
If your scans were performed at an external radiology provider, please inform reception when booking so they can be reviewed prior to your consultation.
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During your consultation, Dr Pram will:
Take a detailed history of your symptoms and medical background
Review your imaging, blood tests and previous investigations
Explain your diagnosis in clear, understandable terms
Discuss all appropriate management options, including non-operative and surgical treatments
Provide a personalised treatment plan tailored to your individual circumstances
If surgery is required, the procedure, risks, benefits and recovery will be explained in detail, and you will have the opportunity to ask any questions.
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Following your appointment:
A detailed summary will be sent to your referring doctor
Further investigations may be arranged if needed
Surgery or treatment can be scheduled where appropriate (a second appointment may be arranged for you to take the time to consider the options)
Ongoing care will be coordinated with your GP and other specialists as required
Assessment and Planning
In many cases, further assessment is required to ensure the most appropriate and safest treatment plan.
This may include:
Additional imaging (Ultrasound, CT, MRI, PET scans)
Endoscopy or specialist procedures
Blood tests and functional assessments
Multidisciplinary team (MDT) discussion with other surgical, oncology, radiology and gastroenterology colleagues
For complex liver, pancreatic and biliary conditions, treatment decisions are often made in collaboration with a specialist multidisciplinary team to ensure the best possible outcomes.
Not all patients require surgery. Dr. Pram will discuss all appropriate options, which may include:
Observation or surveillance
Medical or endoscopic treatment
Interventional radiology procedures
Surgery
Treatment Options
Where surgery is recommended, the approach will be carefully tailored to your condition, overall health and personal preferences. The options include:
Open surgery
Laparoscopic surgery
Robotic surgery
Surgery
If surgery is required, Dr. Pram will guide you through every step of the process.
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You will receive clear instructions regarding what you need to do to prepare, what medications need to be stopped and what you need to bring
Pre-operative assessment and anaesthetic review will be arranged
Risks, benefits and expected recovery will be discussed in detail
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Depending on your condition, surgery may include:
Liver resection
Pancreatic surgery (including Whipple procedure and distal pancreatectomy)
Biliary surgery
Upper gastrointestinal surgery
General surgical procedures (such as gallbladder or hernia surgery)
Where appropriate, minimally invasive techniques (laparoscopic or robotic surgery) are used to support recovery.
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Patients treated in the public system under Medicare generally incur no out-of-pocket costs for their hospital care.
For patients undergoing surgery in the private system, fees will vary depending on the procedure and your level of health insurance. In addition to the surgical fee, there may be separate charges from the anaesthetist, surgical assistant and hospital, which are billed independently.
A detailed estimate of all known costs will be provided prior to surgery, and our team will take the time to explain these clearly so you can make informed decisions with confidence.
If you have any questions about fees at any stage, we encourage you to discuss these with us — transparency and clarity are an important part of your care.
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Care is provided in a specialist surgical environment
Pain is carefully managed
Early mobilisation and recovery protocols are used where appropriate
Your progress is closely monitored by Dr. Pram and the multidisciplinary team
Learn about liver and pancreas surgery with Dr. Pram
Dr. Pram has developed comprehensive patient information booklets covering key procedures including pancreatic (Whipple’s procedure and distal pancreatectomy), liver surgery and laparoscopic cholecystectomy (gallbladder surgery). These resources are designed to provide clear, practical information about your diagnosis, the operation, recovery, and what to expect at each stage of your journey.
They are intended to support discussions during your consultation and help you and your family feel informed and confident in decision-making. Click on the link on the right to download the relevant patient information booklet.
Recovery and Follow-up
Recovery varies depending on the procedure and your individual circumstances. After discharge, you will receive clear guidance on wound care, activity and diet, and will be reviewed by Dr. Pram in rooms. Your results will be explained in detail, with any further treatment coordinated as required. Ongoing follow-up is tailored to your needs, with clear communication maintained with your GP and care team.
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I understand that being referred for surgery can be an uncertain and often overwhelming time. My role is to guide you through this process with clarity, honesty and care.
You can expect me to take the time to ensure you fully understand your diagnosis, the available treatment options, and what each step of your journey involves. Every decision is made with careful consideration of your individual circumstances, values and goals.
I am committed to providing safe, high-quality surgical care, using modern techniques and evidence-based practice, while always prioritising what is right for you.
Equally important is how you are supported throughout your care. You and your family will be kept informed, your questions will be answered, and your concerns will be taken seriously at every stage.
Above all, my aim is simple — to treat every patient with the same honesty, respect and compassion that I would want for my own family.