The novel use of wooden spoons for control of massive intra-abdominal hemorrhage.

Massive intra-abdominal hemorrhage represents a challenging operative emergency. Temporary control of the aorta and inferior vena cava (IVC) using intra-luminal balloon occlusion, preemptive trans-thoracic clamping or infra-diaphragmatic clamping has been achieved with variable success. We report the use of wooden spoons with convex arches cut from their bases as a cheap and effective alternative.

Optimum mesh and port sizes for laparoscopic incisional hernia repair.

Purpose: Since incisional hernia repair was introduced into laparoscopic surgical practice it has been recognized that larger meshes can be problematic to successfully insert through laparoscopic ports. This study aims to facilitate the choice of mesh and port by documenting the minimum port sizes realistically needed for insertion of different types and sizes of onlay mesh. It also aims to evaluate the optimal insertion techniques.

Perceptions of the application of fast-track surgical principles by general surgeons.

Introduction: Fast-track surgery is a novel approach which uses a multimodal package of changes to traditional surgical care to reduce the stress response evoked by surgery allowing for enhanced recovery times. The depth of understanding and application of fast-track principles to general surgical practice by consultant surgeons is unknown.

Materials And Methods: 'Core management features' central to published fast-track general surgical studies were identified following a comprehensive Medline literature search.