First Incision

This episode explores blunt and penetrating neck trauma with special guest Ben Finlay. We discuss: Blunt cerebrovascular injury including: - the grading system - Denver screening criteria - diagnosis - management Penetraing neck trauma - zones of the neck - hard and soft signs of vascular and aerodigestive tract injuries - approaches to management including the 'zonal approach' and &apos...

This week's episode introduces us to some concepts in trauma with our new guest host Ben Finlay! We cover a wide range of topics including: - Primary and secondary survey - Trauma adjuncts - Fast exam - Pathophysiology of trauma and shock - Massive transfusion protocol - Principles of damage control surgery and resuscitation - Teg and ROTEM And more! Disclaimer The information in this podcast...

This week's guest episode features Dr Michael Crawford who is a hepatobiliary, hernia and liver transplant surgeon from Sydney. We cover a wide range of operative topics including: How to perform gastroenterostomy Difficult laparoscopic cholecystectomy -       Features preoperatively that make you suspicious it will be difficult -       Mirrizi syndrome -       Bail out options for difficult...

This week's guest episode is with Dr Laurence Webber, a hepatobiliary surgeon from Western Australia. We cover a wide range of topics including: Practicalities of post-fellowship exam life including: - Pathways in surgical training  - How to get a job after surgical training 00:00 - 00:25 mins Clinical topics including: Colorectal liver metastases: - What to do with disappearing liver metasta...

This episode has everything you need to know about genetic conditions that predispose to endocrine tumours. We cover: - Multiple endocrine noeplasia (MEN) type 1 - MEN types 2a and 2b - SDH syndromes - Von Hippel-Lindau Syndrome - Neurofibromatosis type I (and brief mention about type 2) - Hyperparathyroidism-jaw tumour syndrome Disclaimer The information in this podcast is intended as a revision...

This episode looks at the adrenal gland: - adrenal incidentalomas - the important questions to ask about adrenal lesions - is it cancer and is it functional? - workup of adrenal lesions - functional tests for corticosteroid hypersecretion (cushing's), catecholamine hypersecretion (pheochromocytoma), primary hyperaldosteronisms (Conn's syndrome) and sex hormone excess - screening, confirm...

This episode covers everything you need to know about pancreatic neuroendocrine tumours - what they are - classification into functional and non-functional - risk factors and associated genetic syndromes - the different types of functional tumours, how they present and their biochemical testing - how to image localise and stage these tumours - WHO grading and TNM staging - management including whi...

This episode covers a range of topics related to calcium: - pathophysiology of calcium homeostasis - causes of hypercalcaemia - workup of hypercalcaemia - presentation including symptoms and signs of hypercalcaemia - primary, secondary and tertiary hyperparathyroidism - diagnostic tests for diagnosis of primary hyperparathyroidism - imaging modalities to localise parathyroid adenomas - medical and...

This episode follows on from last week's episode on thyroid nodules and an introduction to thyroid cancer. We cover: - surgery for thyroid cancer - what to do with the lymph nodes - tumour markers (calcitonin, thyroglobulin and anti-Tg antibodies) - risk stratification - radioactive iodine - TSH suppression with thyroxine therapy - treatment of recurrent and palliative disease Disclaimer The...

This episode covers the presentation and workup of thyroid nodules. It includes a targeted history, examination, blood tests, and imaging modalities. We also discuss the TI-RADS reporting system for thyroid nodule ultrasound scanning, and the Bethesda classification of thyroid FNA cytology. The end of this episode introduces us to the different types of thyroid cancer including - papillary - folli...

This week's episode kicks off the endocrine content with the thyroid. In this episode we cover: - Physiology of thyroid hormone and iodine metabolism - Hyper and hypothyroidism - Interpreting thyroid function tests  - Thyroiditis, covering: hashimoto's subacute, reidel's, postpartum, radiation and amiodarone thyroiditis - Thyrotoxicosis, covering: grave’s disease including thyroid e...

Hi everyone! It's time to change tack and tackle the endocrine module from our curriculum. I have a feeling this will be a wild, feedback-cycle kind of ride, so let's ease ourselves into it with the anatomy and embryology of our favourite endocrine organs: the thyroid, parathyroids and adrenal glands. Disclaimer The information in this podcast is intended as a revision aid for the purpos...

This week's episode covers chronic liver failure: - the causes - pathophysiology of what actually happens when the liver fails - diagnosis of chronic liver disease and cirrhosis - portal hypertension diagnosis and management - grading classification systems (Child-Pugh-Turcott and MELD scoring) - the perioperative management of a patient with chronic liver disease Disclaimer The information i...

This week's episode covers liver infections, including pyogenic liver abscesses, hydatid cysts, amoebic abscesses and other rarer types of liver infections. We discuss the pathophysiology, lifecycle of the hydatid parasite, microbiology, diagnosis and treatment of these infections. Disclaimer The information in this podcast is intended as a revision aid for the purposes of the General Surgery...

This week's episode covers all surgical topics related to the spleen: - anatomy - embryology - pathophysiology and function - all the things that can go wrong with the spleen including infections, cysts, splenomegaly, neoplastic conditions (primary and secondary),  haematological disorders, congestive disorders, immunological disorders and trauma. - surgery for spleens including laparoscopic...

This week's episode covers chronic pancreatitis - what is it - risk factors - pathophysiology of it's aetiology and complications - how it presents - diagnosis - imaging findings - complications - and management Disclaimer The information in this podcast is intended as a revision aid for the purposes of the General Surgery Fellowship Exam. This information is not to be considered to incl...

This episode covers acute pancreatitis. - risk factors - aetiology - pathophysiology (a beloved question in the exam) - workup - severity classification (including the apache score, modified glasgow critiera, ranson's criteria, IAP/APA guidelines, and revised Atlanta classification) - radiological classification (revised Atlanta) and radiological severity classification systems - management o...

This episode covers pancreatic cancer. Topics discussed include: - risk factors - familial pancreatic cancer syndromes - pathophysiology - presentation - workup - staging - and treatment including chemotherapy, radiotherapy, surgery and palliative approaches Disclaimer The information in this podcast is intended as a revision aid for the purposes of the General Surgery Fellowship Exam. This inform...

This episode delves into liver metastases and liver surgery. We discuss both colorectal and non-colorectal liver metastases For colorectal liver metastases we cover: - epidemiology - how they are diagnosed and how to work them up - medical treatment including chemotherapy both neoadjuvantly and adjuvantly - the decision making on who to operate on, and the treatment sequence when considering the c...

This week's operative episode covers laparoscopic cholecystectomy, and some of the intraoperative pitfalls they might throw your way in the exam. Topics covered, how to avoid them, and how to deal with them if they happen include every way your day can go from bad to worse when doing a laparoscopic cholecystectomy: - bleeding (hepatic artery, portal vein, middle hepatic vein) - anatomical var...

We're taking a break this week from the HPB module to talk about the exam. Specifically how to manage your stress and maximise your performance in this awesome discussion with Dr Sarah Dalton. Dr Dalton is a performance coach and works with trainees on how to use the power of their mindset and thinking to overcome the issues we all face leading up to these sorts of exams. I really enjoyed our...

This episode covers hepatocellular carcinoma (HCC). Topics covered include: - Epidemiology - Risk factors - Presentation - Surveillance - Histopathology including of pre-neoplastic / precursor lesions such as microscopic dysplastic foci and macroscopic dysplastic nodules - Diagnosis and imaging (including LIRADS) - Staging (TNM and Barcelona Clinic Liver Cancer Staging System) - Treatment options...

Ever wanted to know how to differentiate all the different types of non-malignant liver lesions? Us too! Don't fret - this is the episode for you! It covers: - liver cysts - focal nodular hyperplasia - hepatocellular adenomas - haemangiomas And more! Learn what they are, how to diagnose them and differentiate them on imaging, and what to do with them on this episode of First Incision. Disclai...

This episode briefly covers the various causes of benign biliary strictures. This includes: Iatrogenic causes - Bile duct injuries at cholecystectomy - Trauma, post-liver transplant, and hepaticojejunostomy Gallstone related - Mirrizi syndrome Inflammatory causes - Primary Sclerosing Cholangitis - Parasitic infections including liver flukes, echinococcus and roundworm - HIV/AIDS-associated cholang...

This episode covers cholangiocarcinoma: - the different types (intrahepatic, hilar and distal bile duct) - classification systems (Bismuth, TNM) - risk factors - presentation - imaging / workup - features of operability - management: including, operative, medical, interventional and palliative Disclaimer The information in this podcast is intended as a revision aid for the purposes of the General...