A British surgeon has admitted marking two patients' livers with his initials while carrying out transplant operations in Birmingham.

Simon Bramhall pleaded guilty to two counts of assault at Birmingham Crown Court in a case the prosecution said was "without legal precedent in criminal law".

The patients - one of whom cannot be named for legal reasons and the other being unknown - were under anaesthetic while the operations were carried out at Birmingham's Queen Elizabeth Hospital in February and August 2013.

Prosecutors said Bramhall used a medical instrument called an argon beam coagulator - which seals bleeding blood vessels by directing a beam of electricity on to the area - to "burn" his initials on to their livers.

Tony Badenoch QC, prosecuting, described the case as "highly unusual and complex", adding that Bramhall's guilty pleas "represent an acceptance that that which he did was not just ethically wrong but criminally wrong".

He said: "They reflect the fact that Dr Bramhall's initialling on a patient's liver was not an isolated incident but rather a repeated act on two occasions, requiring some skill and concentration.

"It was done in the presence of colleagues. It was an intentional application of unlawful force to a patient whilst anaesthetised.

"His acts in marking the livers of those patients were deliberate and conscious acts."

Bramhall - who now works at another UK hospital - will be sentenced at the same court on 12 January and faces a maximum penalty of six months in prison and/or a fine.

He has already received a formal warning from the UK's General Medical Council.