This episode explores pancreatic disease as one of surgery’s most demanding domains. Listeners are guided through acute and chronic pancreatitis, pancreatic cancer, and cystic lesions — conditions where timing, physiology, and complication risk intersect.

The discussion emphasises investigation, staging, and perioperative optimisation, alongside the realities of morbidity and mortality. Surgical intervention is framed as a carefully balanced decision rather than a reflex response.

This chapter teaches respect for pancreatic pathology — where restraint, planning, and multidisciplinary care are essential to survival.

This episode examines gallstone disease and biliary pathology, from biliary colic and cholecystitis to cholangitis and malignancy. Listeners are guided through anatomy, symptom patterns, and the interpretation of liver biochemistry and imaging.

The discussion highlights surgical timing, complications of delay, and the interface between endoscopy and surgery. Particular emphasis is placed on recognising red flags and preventing progression to sepsis.

This chapter reinforces biliary surgery as a discipline where prompt, decisive action prevents systemic collapse.

This episode explores splenic disease in trauma, haematological disorders, and hypersplenism. Listeners are guided through splenic anatomy, immunological function, and the clinical implications of splenic enlargement or rupture.

The discussion balances operative urgency with long-term risk, particularly the immunological consequences of splenectomy. Indications for surgery, non-operative management, and postoperative vaccination strategies are examined in detail.

This chapter teaches that splenic surgery is never isolated — it alters physiology and immunity long after the incision has healed.

This episode examines liver disease across inflammatory, obstructive, malignant, and cirrhotic spectrums. Listeners are guided through hepatic anatomy, function, and the clinical interpretation of liver dysfunction — from subtle biochemical change to end-stage failure.

The discussion integrates portal hypertension, ascites, variceal bleeding, and hepatocellular carcinoma with surgical principles and thresholds for intervention. Emphasis is placed on timing — recognising when surgery can restore function and when disease has progressed beyond reversibility.

This chapter reinforces the liver’s remarkable regenerative capacity, while emphasising the narrow margins within which surgeons must act.

This episode explores bariatric and metabolic surgery as a deliberate, evidence-based intervention for obesity and its systemic consequences. Rather than focusing solely on weight loss, the discussion reframes surgery as a metabolic reset — influencing diabetes, cardiovascular risk, and long-term survival.

Listeners are guided through patient selection, preoperative assessment, surgical options, and postoperative follow-up. The episode addresses ethical considerations, complications, and the necessity of multidisciplinary care, highlighting that success depends as much on long-term support as on the operation itself.

This chapter positions bariatric surgery not as a last resort, but as a strategic intervention for complex metabolic disease.

This episode examines surgical conditions of the stomach and duodenum, including peptic ulcer disease, gastric outlet obstruction, upper gastrointestinal bleeding, and malignancy.

Listeners are guided through risk factors, acute presentations, investigation pathways, and operative principles. The episode balances emergency scenarios with elective disease, emphasising decision-making under pressure and the importance of haemodynamic stability.

This chapter teaches clinicians to recognise when medical management has reached its limits — and when surgery becomes lifesaving rather than optional.

This episode explores oesophageal disease across benign and malignant spectra, from reflux and motility disorders to oesophageal cancer. Listeners are guided through anatomy, physiology, and symptom patterns including dysphagia, reflux, chest pain, and weight loss.

The discussion integrates investigation strategies — endoscopy, manometry, imaging — with surgical decision-making. Particular attention is given to recognising red flags and understanding when surgical intervention improves survival or quality of life.

This chapter reinforces the importance of early detection and multidisciplinary planning in a disease process where delay carries significant consequence.

This episode examines the often-overlooked anatomical spaces of the abdomen that dictate the spread of disease, infection, and malignancy. Listeners are guided through the structure and function of the peritoneum, mesentery, greater omentum, and retroperitoneum.

The discussion highlights conditions such as peritonitis, ascites, intra-abdominal sepsis, and retroperitoneal pathology, emphasising how fluid, gas, and disease track along anatomical planes. Imaging interpretation is framed around recognising patterns rather than isolated findings.

This chapter trains clinicians to think three-dimensionally — understanding why abdominal disease behaves the way it does, and why delay in intervention can be catastrophic.

This episode explores the anatomy and pathology of the abdominal wall, focusing on hernias and umbilical disorders. Listeners are guided through the classification of hernias, risk factors for development and recurrence, and the principles underlying surgical repair.

The discussion balances anatomy with real-world decision-making — when to observe, when to operate, and how patient factors such as obesity, comorbidity, and occupation influence management. Techniques ranging from open to minimally invasive repair are framed around tension, reinforcement, and long-term outcomes.

This chapter teaches that hernia surgery is not merely mechanical — it is strategic, preventative, and tailored to the individual.

This episode lays the foundation for all abdominal surgery by returning to first principles: listening, observing, and examining. Listeners are guided through structured abdominal history-taking, recognising patterns of pain, change in bowel habit, bleeding, weight loss, and systemic symptoms.

The examination is explored as an active diagnostic process — inspection, palpation, percussion, and auscultation — with emphasis on distinguishing peritonism, organomegaly, masses, and hernias. The episode highlights how a careful clinical assessment directs investigations, prioritises urgency, and prevents diagnostic drift.

This Chapter reminds clinicians that abdominal surgery begins not in theatre or imaging suites, but at the bedside — where the patient’s narrative sets the direction of care.