School Of Surgery

Recorded at the International Conference of Anal Fistula Treatment in Rome 2018, Techniques in Coloproctology interview Phil Tozer, a consultant at the world famous St Mark's Hospital, UK about current treatments for anal fistula. Phil takes us through why not to place a seton in the acute setting, the 5 factors preventing healing of fistulas, and the pros and cons of the whole range of fistula treatment including plugs, fibrin glue, permacol, LIFT, the place of sphincter repair, restoring the contour of the anus, VAAFT (including "palliative VAAFT and delta VAAFT"), FiLAC and finally the promise of stem cells in fistula. Essential listening for anyone who treats anal fistula.

The management of early rectal cancer is becoming increasingly complex.Find out all you need to know about diagnosis, staging, treatment, follow up and prognosis in this podcast.Steve Schlichtemeier is the colorectal robotic surgical fellow at the Royal Derby Hospital, UK and Bill Speake is a consultant colorectal surgeon and recent past ECAG lead for the East Midlands of the UK

In the second podcast on radiotherapy, Sindu Vivekanandan explains to Keaton Jones what is meant by the terms adjuvant and neoadjuvant, what the 3 main ways of delivering radiotherapy are, in which tumour radiotherapy is effective and in which it isn't, and the limiting factors and side effects associated with radiotherapy.Essential listening for anyone who's patients receive radiotherapy as part of their treatment.Keaton Jones is an academic surgeon at the University of Oxford, UK and Sindu Vivekanandan is a consultant oncologist.

Keaton Jones asks Sindu Vivekanandan what is radiotherapy, how it works and why we use it. Dose and fractionation are explained along with the '4Rs' of radiobiology: repair, reassortment, repopulation and reoxygenation. Toxicity is discussed as well as methods for increasing the effect of treatment on target tissues.Essential listening for surgeons and anyone who's patients receives radiotherapy as part of their treatment.Keaton Jones is an academic surgeon at the University of Oxford, UK and Sindu Vivekanandan is a consultant oncologist.

Rick Nelson knows more about anal fissure than almost anyone in the world and has recently published a comprehensive meta-analysis of the evidence supporting treatment for anal fissure in the leading journal, Techniques in Coloproctology.There are some surprises that will challenge what you think you know about efficacy of topical treatments, anal stretch, and the much lower than previously thought incidence of impairment of continence after sphincterotomy.Invaluable listening for updating knowledge or revising for an exam.You can read the full paper at http://bit.ly/2yeyCEZ A systematic review and meta-analysis of the treatment of anal fissure. Techniques in ColoproctologyAugust 2017, Volume 21, Issue 8, pp 605–625

How to recognise and immediately manage complications of sleeve gastrectomy and gastric bypass are discussed in the second part of this podcast. Understand why bariatric patients clinical examination might be unreliable, why vomiting or jaundice are danger symptoms which may need emergency intervention, why NSAIDs and smoking are very dangerous in bypass patients and many more things you're going to find very useful when on call or in an exam!Mapped to the 2016 General Surgery syllabus.Cat Boereboom is a trainee in surgery in the East Midlands, UK and Sherif Awad is a consultant in bariatric surgery at the East Midlands Bariatric Institute, based at the Royal Derby Hospital, UK

You're not a bariatric surgeon, but you need to know how the immediate management of complications of bariatric surgery because they might well come in to your hospital, even if its not a bariatric surgical centre.In the first of 2 podcasts, Cat Boereboom talks to Sherif Awad about recognition of complications of gastric band and what to do when you see them. You'll also be able to recognise when a band is in the right place and when it has slipped, what a Huber needle is and what to do with it and what to do if you don't have one, port infection and lots more.Part 2 covers sleeve gastrectomy and gastric bypass.Mapped to the General Surgery 2016 syllabus.Cat Boereboom is a trainee in the East Midlands, UK and Sherif Awad is a consultant bariatric surgeon at the East Midlands Bariatric Institute based at the Royal Derby Hospital, UK

For decades the only real option for perforated diverticular disease was a Hartmann's procedure, but there has been a lot of interest in the less invasive and stoma saving laparoscopic lavage and drainage procedure as an alternative. But is it effective? Jon Lund talks to David Humes about the background and the evidence for and against peritoneal lavage as a treatment for this common colorectal emergency. David Humes is Associate Professor of Surgery at the University of Nottingham, UK and an NIHR Postdoctoral Fellow. Get the meta-analysis referred to in the podcast here (http://bit.ly/2peBO1J)

A host of practical tips on difficult urethral catheter insertion, changing a suprapubic catheter, managing a 3-way catheter, what to do when you're called about testicular pain, paraphimosis or a nephrostomy.When you have listened to this podcast by Philly Horner and Suzie Hall you will be much more confident about how to manage these common problems yourself and be able to do it safely, knowing when you should ask for help. Essential listening for all foundation doctors, interns, and medical students, whatever your speciality

Dr Ruediger Prosst, Director of The Proctological Institute in Stuttgart, Germany, tells Jon Lund about his experience in treating the often challenging problem of high and complex anal fistula using a novel, sphincter sparing clipping device. This podcast links to Tech Coloproctol (2016) 20: 753. doi:10.1007/s10151-016-1537-0

All you need to know about the classification, presentation, diagnosis, investigation and treatment of causes of haematuria: Philly Horner talks to Simon Williams, Consultant Urological Surgeon

"Doctor, Mrs Smith's calcium is 2.9, what do you want me to do?"Cat Boereboom talks to Roger Stanworth about all aspects of the presentation, diagnosis and treatment of both high and low calcium. Once you've listened to this podcast you will know how to manage any calcium disorder. Mapped to the General Surgery 2016 curriculum, this podcast is also very useful listening to those taking MRCS or FRCS, as well as medical school finals.Cat Boereboom is a trainee in General Surgery, and Roger Stanworth is Clinical Lead for Diabetes and Endocrinology at the Royal Derby Hospital, UK

Philly Horner talks to Gill Tierney about the presentation, diagnosis and treatment of small bowel obstruction, a very common condition presenting as an emergency. This podcast contains all you need to know if you're a medical student, foundation doctor (intern), or early years trainee in surgery.Sorry about the sound in places, this was recorded on location without our usual high quality mic. Best on headphones.

A is the first letter of ABC and is the first thing to get right when managing a trauma patient. It can be very challenging and time is pressured. In this advanced level podcast for anaesthetists and surgeons involved in trauma management, Andrew Deytrikh talks to Craig Morris about how to manage the airway in critically ill and unstable patients, those with unstable cervical spines, patients with severe facial injury, burns and other injuries with airway implications. What to do when standard measures fail is also discussed, including the when, who and how of surgical airway formation.Listen now, so that you know what to do when you're in this situation.

Functional Constipation is a really challenging condition to treat in gastroenterology and surgery. In this podcast Jon Lund asks Robin Spiller about the condition, the underlying physiology, how to differentiate from IBS constipation and the range of treatments for FC. This podcast will tell you all you need to know and more.Robin Spiller is Professor of Gastroenterology at the University of Nottingham, UK, former editor of GUT, author of the Rome III criteria and world leading expert in this field

Its never too early to think about getting yourself ready for successful application to core surgical training, be you medical student or foundation doctor.In this podcast Ricky Ellis and Susan Hall explain the process and give their tips for success.Good luck!

It is not uncommon to be called to see a patient who has experienced a sudden change in their mental state. The patient is often suffering from one of the forms of delirium, and puts them at increased risk of complication, injury and death.In this podcast Ricky Ellis and Christine Taylor discuss what delirium is, why it is important, how to recognise it, who is at risk, how we can prevent it and how we can treat it

Assessing the capacity of patients is an essential skill for all doctors, not least surgeons, as it is intimately related to taking consent and treating any patient correctly.In one of the most important podcasts from the School of Surgery, Ricky Ellis and Christine Taylor discuss capacity, the Mental Capacity Act, how to assess and enhance capacity and how to care for patients without capacity. The 5 key principles of the Mental Capacity Act are clearly explained as is how to act in the best interest of patients without capacity - for example, the unconscious patient who requires life threatening surgery, with a best interests checklist to help you do thing correctly. How to deal with Advanced Directives or advanced decisions to refuse treatment is clearly explained here too.Its a long podcast but not knowing about issues related to capacity can lead to charges of assault being brought or omission of care leading to charges of negligence. This may be one of the most important 20 minutes you can spend, whethe

Every surgeon needs to obtain informed consent before proceeding with any procedure. Ricky Ellis talks to Daniel Couch about consent, how best to take it and the framework around consent. Essential listening for any medical student and surgeon in training.Ricky Ellis and Daniel Couch are both training in Surgery in the East Midlands of the UK at the Royal Derby Hospital

In the third and final episode of this series, Phil Herrod talks to Mark Sibbering about how to treat breast cancer with surgical and hormonal, chemo and radiotherapies, discussing the indications for each.