By Jane Elliott Health reporter, BBC News

Nikki was expecting open surgery

When head teacher Nikki Stevens needed to have a large tumour removed from her liver, she resigned herself to a long absence from school.

She was facing major open surgery and was anticipating at least 10 weeks away from school.

Doctors had told Nikki, 44, from Essex, she would need at least a week on the high dependency ward.

Her tumour was estimated to be the size of a melon.

But on the morning of her surgery, her consultant at Barts and The London NHS Trust, Satya Bhattacharya, told her he was going to try to take the tumour out by laparoscopic or keyhole surgery - something not usually done.

Pioneering surgery

The trust carries out only five to 10 such operations a year as it is still a new procedure and needs to be carried out by a surgeon skilled in both keyhole and liver surgery.

I got away quite lightly. I recovered very quickly and feel fine now Nikki Stevens

"They prepared me for quite major surgery which would involve spending up to two weeks in the hospital - and that was if everything went to plan," said Nikki.

"But on the morning of the operation one of Mr Bhattacharya's team said that he would hope to be able to do it by keyhole surgery.

"Until then I had been prepared for a full abdominal opening."

Scans had shown that Nikki, who had suffered from abdominal pain since her teens, had a number of tumours growing inside her liver.

They were thought to be benign, but Nikki needed a biopsy to check.

Quicker recovery

The surgeons also decided that the largest, a haemangioma - a tangle of abnormal vessels - had to be removed because it had grown to about six inches and was at risk of rupturing.

"I decided right away to have surgery," said Nikki.

"There is a long history of cancer on both sides of my family and I definitely wanted the tumour out - even if it wasn't malignant."

When she came round in the recovery room, the anaesthetist confirmed that she had undergone keyhole surgery.

We try to offer surgery that is minimally invasive where possible Consultant Satya Bhattacharya

"That was fantastic," she said.

"I obviously had a number of smaller incisions, but I had not had to have the enormous abdominal opening that I had expected, with the risk of infection. Therefore my recovery was much safer and swifter.

"I was just on the ordinary ward rather than high dependency and I was there for just a week and home after that, which I found absolutely amazing."

In the end Nikki needed only seven weeks off work.

"In effect I was only away half a term, which is a lot less than the original prognosis.

"So I got away quite lightly. I recovered very quickly and feel fine now."

Liver regrown

Nikki said her liver has now regrown and Mr Bhattacharya is happy the three remaining tumours are not cancerous - although she still needs to get them regularly checked.

"The bad news is though that it hasn't sorted out my problem. I have had another two episodes of pain and they are now looking at food intolerance. I think I could be intolerant of onions."

Mr Bhattacharya stressed that although laparoscopy had worked for Nikki, it was not suitable for everyone.

"Previously, liver surgery always involved a big open incision," he said.

"Now we try to offer surgery that is minimally invasive where possible - involving three or four tiny holes.

"This type of keyhole liver surgery is fairly new and we are one of the few centres in the country leading on this.