The feasibility of disposable video-bronchoscopes, Ambu aScope3, for exploration of the common bile duct and extraction of stones.

Introduction: The aim of this study was to assess and evaluate the feasibility of using the Ambu aScope3 (aScope) for common bile duct (CBD) explorations, stone detection and extraction, as well as to assess feasibility of its use through the laparoscopic ports in a low-volume centre.

Methods: This is a dual centre prospective study, conducted between February 2015 and August 2019, of patients undergoing laparoscopic cholecystectomy and common bile duct exploration. Ethical approval was obtained from the North West - Greater Manchester South Research Ethics Committee.

The introduction of an emergency safety protocol coupled with simulation training in robotic surgery, has enabled a more cohesive and efficient response to emergencies.

With the increasing popularity of robotic surgery, arise a unique set of challenges. In-order to minimise the risk and optimise patient safety, teams need to anticipate these, plan and train to improve familiarity with the nuances of robotic surgery. Human factors and simulation training (ST) are now an integral part of surgery and we have extended these principles to our robotic practice.

Is there a standardised consent process within the surgical specialties?

Introduction: The consent process is central to surgical practice. Subsequent to landmark cases such as Montgomery and Thefaut there is increasing consensus that consent should be a staged process. The aim of our survey was to identify if there was any homogeneity in the practice of surgeons with regards to the consent process in comparison to national guidelines.

Upper gastrointestinal bleeding: gallstone-induced auto-sphincterotomy.

A 67-year-old gentleman with no significant medical history of note presented with sudden onset of epigastric pain, coffee ground vomiting and passing black tarry stool. A series of investigations including blood tests, ultrasound scan, CT abdomen and pelvis with contrast and endoscopy failed to reveal any site of active bleeding. The mystery remained and the patient continued to have upper gastrointestinal bleeding.