Mr Louden is fresh from a delivery. If someone's poorly and you do an operation to make them better, it makes you feel really good. He performs around 100 hysterectomies a year, for conditions such as period problems, fybroids and endometriosis. Now surgeons are trying to cut the time it takes for patients to recuperate from what can be a difficult operation with which to come to terms. Some, Mr Louden among them, do this by sometimes removing the uterus through the vagina as opposed to making a conventional incision in the stomach.
Surgeons nowadays are often less directive in counselling patients.
A lot of these women are trying to juggle a family and a job and don't want to take three months off to recover. They simply cannot afford the time. It's a quality issue. Through small cuts around the bikini line, he inserts a camera, just one centimetre across, into anaesthetised patients. Pictures are beamed back to a screen in the operating theatre and, because the patient's abdomen is inflated with carbon dioxide, doctors can see the organs and everything around them clearly.