The impact of cholecystectomy on the symptom relief and quality of life of patients with gallbladder dysmotility.

Background: The aim of this study was to demonstrate the impact of laparoscopic cholecystectomy on the physical and mental health of patients with gallbladder dysmotility.

Methods: Retrospective data was collected from 314 patients who had undergone a hepatobiliary iminodiacetic acid (HIDA) scan between June 2012 and June 2022 in a District General Hospital in South East England. Sixty-three patients who were diagnosed with gallbladder dysmotility were then contacted and asked to participate in a telephone interview regarding their symptoms.

Right-sided diaphragmatic hernia causing gastric outlet obstruction 1 month after trauma.

Diaphragmatic hernias arising from trauma are rare, and scarcely present in a delayed manner. This case report highlights a case of delayed presentation of a right-sided post-traumatic hernia in a woman in her early 70s following a fall. The aim of this report is to shed light on the diagnostic peculiarities and management.

Surgical experience and identification of errors in laparoscopic cholecystectomy.

Background: Surgical errors are acts or omissions resulting in negative consequences and/or increased operating time. This study describes surgeon-reported errors in laparoscopic cholecystectomy.

Methods: Intraoperative videos were uploaded and annotated on Touch SurgeryTM Enterprise.

Accuracy of Self-Estimated BMI in the Context of Telephone Assessment Before Elective General Surgery.

Background This study aimed to determine if self-estimated body mass index (BMI) from telephone consultation was accurate and useful for surgical planning prior to elective general surgery. Methods A prospective cohort study was performed under a single surgeon at a district general hospital in the United Kingdom. Estimated BMI was collected from consecutive patients attending a pre-operative telephone consultation.

Patient satisfaction with general surgery telephone consultations during the COVID-19 pandemic: a single surgeon experience.

Background: COVID-19 pandemic accelerated the development and use of telemedicine in surgical practice. Here we set out to understand patient satisfaction with the use of telephone consultation in the general surgical clinic and preference over face-to-face consultation.

Methods: A prospective cohort study was carried out for consecutive patients seen in a general surgery telephone clinic by a single surgeon in a district general hospital in the UK from 1 September 2021 to 10 March 2022.

Outcomes on mesh fixation vs non-fixation in laparoscopic totally extra peritoneal inguinal hernia repair: a comparative study.

Objectives: Inguinal hernia repair is one of the most common general surgical procedure, and laparoscopic approach gained popularity over the open approach. This study aimed to compare the clinical effects of TEP inguinal hernioplasty with or without mesh fixation. The primary outcome was acute post-operative pain.

Dysphagia due to spontaneous hyperinflation of a swallowable intragastric balloon.

A 49-year-old woman presented as an acute admission with persistent vomiting and an inability to tolerate both solids and liquids. Five weeks prior to the admission she had an Elipse swallowable intragastric balloon placed into her stomach as an aid to weight loss. This type of balloon stays inflated inside the stomach for 16 weeks before disintegrating and passing through the gastrointestinal tract.

Evaluation of a Novel Laparoscopic Cholecystectomy Curriculum With the Use of Animal Models and Live Operating.

Background: Despite wide recognition of the benefits of simulation training, there is no established model for the teaching of laparoscopic cholecystectomy. The authors developed a replicable, intensive 2-day proficiency-based curriculum, to include simulation and live operating, designed to be practical to both attend and organize. The primary objective of this study was to evaluate this curriculum for improved procedural confidence, measured by participant self-evaluation.

Perceived barriers to medical leadership training and methods to mitigate them in the undergraduate medical curriculum: A mixed-methods study of final-year medical students at two medical schools.

Introduction: Effective leadership is vital for high-quality healthcare. Despite progress in leadership development for junior doctors, studies reflect perceptions that junior doctors feel underprepared for leadership. This study aims to understand medical students' perceptions about barriers to effective leadership training and how to mitigate these.

Unusual fistula demonstrating the need for an early cholecystectomy.

A 79-year-old man developed a spontaneous cholecystocutaneous fistula 12 months after an initial episode of acute cholecystitis. A laparoscopic cholecystectomy procedure was twice abandoned due to extensive adhesions and active disease, limiting safe dissection of Calot's triangle. Abdominal collections formed and a spontaneous cholecystocutaneous fistula developed.

Self-Assessment of Surgical Skills: A Systematic Review.

Objective: Self-assessment is fundamental in surgical training to enhance learning in the absence of trainer feedback. The primary objective of this review was to assess the factors that influence accuracy of self-assessment at technical skills across all surgical specialties. The secondary objective was to assess whether there are any innate factors or attributes to predict those that will carry out effective self-assessment.

Introducing a reserve waiting list initiative for elective general surgery at a District General Hospital.

Cancelled operations represent a significant burden on the National Health Service in terms of theatre efficiency, financial implications and lost training opportunities. Moreover, they carry considerable physical and psychological effects to patients and their relatives. Evidence has shown that up to 93% of cancelled operations are due to patient-related factors.

Validation of a virtual reality laparoscopic appendicectomy simulator: a novel process using cognitive task analysis.

Background: Virtual reality (VR) simulation is a vital component of surgical training with demonstrated improvements in surgical quality and clinical outcome.

Aims: To validate the LAP Mentor (Simbionix™) laparoscopic appendicectomy (LA) VR simulator with inclusion of a novel tool, Cognitive Task Analysis (CTA).

Methods: Thirty-two novices and nine experienced surgeons performed two simulated LAs.

Penetrating trauma causing cerebrospinal fluid leak without nerve root damage.

A 19-year-old man with a stab injury to the lower back presented with no focal neurology or haemodynamic instability. He complained of a headache that was improved by lying flat and underwent imaging to look for damage to local structures. He was found to have air in his intraspinal space.

Spontaneous ruptured iliac artery aneurysm causing acute secondary AV fistula.

A 73-year-old woman presented with a 6-hour history of sudden onset lower abdominal pain. Her comorbidities included chronic obstructive pulmonary disease and hypertension. She was under surveillance for a known thoracoabdominal aneurysm.

The role of single-shot metronidazole in the prevention of Clostridium difficile infection following ileostomy reversal surgery.

Purpose: Symptomatic infection with Clostridium difficile is strongly linked to antibiotic use and rates are higher for colorectal surgery. In February 2015, trust policy for antibiotic prophylaxis of ileostomy reversal surgery was changed from three doses of metronidazole plus cefuroxime to single-dose metronidazole, in a bid to reduce rates of Clostridium difficile infection.

Methods: A retrospective cohort study was conducted at a single, large hospital trust between February 2014 and February 2016, before and after change in antimicrobial policy.

Emergency laparotomy in octogenarians: A 5-year study of morbidity and mortality.

Aim: To determine the morbidity and mortality associated with emergency laparotomy for a clinically acute abdomen in patients aged ≥ 80 years.

Methods: In this retrospective audit, octogenarians undergoing emergency laparotomy between 1st January 2005 and 1(st) January 2010 were identified using the Galaxy Theatre System. Patients undergoing abdominal surgery through groin crease incisions or Lanz or Gridiron incisions were excluded.

Diaphragmatic hernia: an unusual presentation.

A 53-year-old lady presented to A&E with a 3-day history of severe epigastric pain and vomiting. This was preceded by a 3-month history of generalised abdominal discomfort, early satiety and increasing shortness of breath. A CT scan showed a left-sided posterior diaphragmatic defect.

Outcomes of elective laparoscopic colorectal operations in octogenarians at a district general hospital in South East England.

Aim: To assess the outcomes of laparoscopic colorectal cancer resection in the octogenarian population at our institution.

Methods: Retrospective analysis of registry data accumulated prospectively were used in conjunction with the data obtained from patient notes to identify outcome data for octogenarians who had undergone elective laparoscopic colorectal cancer resection.

Results: Laparoscopic colorectal cancer resections were performed in 68 octogenarians between 2003 and 2011 at our institution.