First Incision

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 discussion and hope you get something out of this episode that helps you as well!

This is the 'ABC Conversations' podcast episode we kept mentioning which interviews Ben Crowe, Ash Barty's performance coach. It's a great listen: https://www.abc.net.au/radio/programs/conversations/ash-barty-sports-mentor-ben-crowe/13418314

Dr Sarah Dalton works with Capstan Partners if you want to look into coaching for your exam: https://capstan.com.au/about-us/

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 include any recommendations or medical advice by the author or publisher or any other person. The listener should conduct and rely upon their own independent analysis of the information in this document.
The author provides no guarantees or assurances in relation to any connection between the content of this podcast and the general surgical fellowship exam.  No responsibility or liability is accepted by the author in relation to the performance of any person in the exam.  This podcast is not a substitute for candidates undertaking their own preparations for the exam.
To the maximum extent permitted by law, no responsibility or liability is accepted by the author or publisher or any other person as to the adequacy, accuracy, correctness, completeness or reasonableness of this information, including any statements or information provided by third parties and reproduced or referred to in this document. 
To the maximum extent permitted by law, no responsibility for any errors in or omissions from this document, whether arising out of negligence or otherwise, is accepted.
The information contained in this podcast has not been independently verified.

© Amanda Nikolic 2021

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
- Follow-up
- and Prognosis

Happy studying!

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 include any recommendations or medical advice by the author or publisher or any other person. The listener should conduct and rely upon their own independent analysis of the information in this document.
The author provides no guarantees or assurances in relation to any connection between the content of this podcast and the general surgical fellowship exam.  No responsibility or liability is accepted by the author in relation to the performance of any person in the exam.  This podcast is not a substitute for candidates undertaking their own preparations for the exam.
To the maximum extent permitted by law, no responsibility or liability is accepted by the author or publisher or any other person as to the adequacy, accuracy, correctness, completeness or reasonableness of this information, including any statements or information provided by third parties and reproduced or referred to in this document. 
To the maximum extent permitted by law, no responsibility for any errors in or omissions from this document, whether arising out of negligence or otherwise, is accepted.
The information contained in this podcast has not been independently verified.

© Amanda Nikolic 2021

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.

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 include any recommendations or medical advice by the author or publisher or any other person. The listener should conduct and rely upon their own independent analysis of the information in this document.
The author provides no guarantees or assurances in relation to any connection between the content of this podcast and the general surgical fellowship exam.  No responsibility or liability is accepted by the author in relation to the performance of any person in the exam.  This podcast is not a substitute for candidates undertaking their own preparations for the exam.
To the maximum extent permitted by law, no responsibility or liability is accepted by the author or publisher or any other person as to the adequacy, accuracy, correctness, completeness or reasonableness of this information, including any statements or information provided by third parties and reproduced or referred to in this document. 
To the maximum extent permitted by law, no responsibility for any errors in or omissions from this document, whether arising out of negligence or otherwise, is accepted.
The information contained in this podcast has not been independently verified.

© Amanda Nikolic 2021

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 cholangiopathy
- IgG4 related cholangiopathy
Congenital
- Biliary atresia
- Choledochal cysts

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 include any recommendations or medical advice by the author or publisher or any other person. The listener should conduct and rely upon their own independent analysis of the information in this document.
The author provides no guarantees or assurances in relation to any connection between the content of this podcast and the general surgical fellowship exam.  No responsibility or liability is accepted by the author in relation to the performance of any person in the exam.  This podcast is not a substitute for candidates undertaking their own preparations for the exam.
To the maximum extent permitted by law, no responsibility or liability is accepted by the author or publisher or any other person as to the adequacy, accuracy, correctness, completeness or reasonableness of this information, including any statements or information provided by third parties and reproduced or referred to in this document. 
To the maximum extent permitted by law, no responsibility for any errors in or omissions from this document, whether arising out of negligence or otherwise, is accepted.
The information contained in this podcast has not been independently verified.

© Amanda Nikolic 2021

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 Surgery Fellowship Exam.
This information is not to be considered to include any recommendations or medical advice by the author or publisher or any other person. The listener should conduct and rely upon their own independent analysis of the information in this document.
The author provides no guarantees or assurances in relation to any connection between the content of this podcast and the general surgical fellowship exam.  No responsibility or liability is accepted by the author in relation to the performance of any person in the exam.  This podcast is not a substitute for candidates undertaking their own preparations for the exam.
To the maximum extent permitted by law, no responsibility or liability is accepted by the author or publisher or any other person as to the adequacy, accuracy, correctness, completeness or reasonableness of this information, including any statements or information provided by third parties and reproduced or referred to in this document. 
To the maximum extent permitted by law, no responsibility for any errors in or omissions from this document, whether arising out of negligence or otherwise, is accepted.
The information contained in this podcast has not been independently verified.

© Amanda Nikolic 2021

This episode covers pancreatic cystic neoplasms including:

Neoplastic mucinous cystic lesions
- Intraductal papillary mucinous neoplasms (IPMNs)
- Mucinous cystic neoplasms (MCNs)

Neoplastic non-mucinous cystic lesions
- Serous cystic neoplasms / serous cystadenomas
- Solid pseudopapillary neoplasms

We cover their workup, radiological appearance, demographic information, FNA results, likely cytology and management of these lesions

We also briefly mention non-neoplastic cystic lesions including simple cysts and pseudocysts, as well as the potential that ductal adenocarcinomas and neuroendocrine tumours have to have cystic degeneration.

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 include any recommendations or medical advice by the author or publisher or any other person. The listener should conduct and rely upon their own independent analysis of the information in this document.
The author provides no guarantees or assurances in relation to any connection between the content of this podcast and the general surgical fellowship exam.  No responsibility or liability is accepted by the author in relation to the performance of any person in the exam.  This podcast is not a substitute for candidates undertaking their own preparations for the exam.
To the maximum extent permitted by law, no responsibility or liability is accepted by the author or publisher or any other person as to the adequacy, accuracy, correctness, completeness or reasonableness of this information, including any statements or information provided by third parties and reproduced or referred to in this document. 
To the maximum extent permitted by law, no responsibility for any errors in or omissions from this document, whether arising out of negligence or otherwise, is accepted.
The information contained in this podcast has not been independently verified.

© Amanda Nikolic 2021

This week's episode covers three gallbladder pathologies from the hepatobiliary module of the curriculum:
- gallbladder adenomyomatosis
- gallbladder polyps
and
- gallbladder cancer

This episode covers the histopathology, pathophysiology, imaging findings, and what to do when you suspect gallbladder cancer preoperatively, intraoperatively and post-operatively.

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 include any recommendations or medical advice by the author or publisher or any other person. The listener should conduct and rely upon their own independent analysis of the information in this document.
The author provides no guarantees or assurances in relation to any connection between the content of this podcast and the general surgical fellowship exam.  No responsibility or liability is accepted by the author in relation to the performance of any person in the exam.  This podcast is not a substitute for candidates undertaking their own preparations for the exam.
To the maximum extent permitted by law, no responsibility or liability is accepted by the author or publisher or any other person as to the adequacy, accuracy, correctness, completeness or reasonableness of this information, including any statements or information provided by third parties and reproduced or referred to in this document. 
To the maximum extent permitted by law, no responsibility for any errors in or omissions from this document, whether arising out of negligence or otherwise, is accepted.
The information contained in this podcast has not been independently verified.

© Amanda Nikolic 2021

Welcome to the first episode of our new season! Moving onto hepatobiliary and pancreatic topics.

This week we talk about liver, biliary and pancreatic anatomy, embryology and clinically important variations.

Enjoy!

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 include any recommendations or medical advice by the author or publisher or any other person. The listener should conduct and rely upon their own independent analysis of the information in this document.
The author provides no guarantees or assurances in relation to any connection between the content of this podcast and the general surgical fellowship exam.  No responsibility or liability is accepted by the author in relation to the performance of any person in the exam.  This podcast is not a substitute for candidates undertaking their own preparations for the exam.
To the maximum extent permitted by law, no responsibility or liability is accepted by the author or publisher or any other person as to the adequacy, accuracy, correctness, completeness or reasonableness of this information, including any statements or information provided by third parties and reproduced or referred to in this document. 
To the maximum extent permitted by law, no responsibility for any errors in or omissions from this document, whether arising out of negligence or otherwise, is accepted.
The information contained in this podcast has not been independently verified.

© Amanda Nikolic 2021

This episode covers everything COLITIS!
- infectious colitis - including a quick touch on common infectious causes and how to treat them
- pseudomembranous colitis and clostridium difficile infection
- diverticulitis in all it's glory - be prepared for some pathophysiology, classification systems (Hinchey I'm looking at you), and discussion about treatment
- and to round them off we take a look at ischaemic colitis!

If you want to learn more about ischaemic colitis - feel free to read this awesome review article (by yours truly): Ischaemic colitis: uncertainty in diagnosis, pathophysiology and management. https://onlinelibrary.wiley.com/doi/abs/10.1111/ans.14237

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 include any recommendations or medical advice by the author or publisher or any other person. The listener should conduct and rely upon their own independent analysis of the information in this document.
The author provides no guarantees or assurances in relation to any connection between the content of this podcast and the general surgical fellowship exam.  No responsibility or liability is accepted by the author in relation to the performance of any person in the exam.  This podcast is not a substitute for candidates undertaking their own preparations for the exam.
To the maximum extent permitted by law, no responsibility or liability is accepted by the author or publisher or any other person as to the adequacy, accuracy, correctness, completeness or reasonableness of this information, including any statements or information provided by third parties and reproduced or referred to in this document. 
To the maximum extent permitted by law, no responsibility for any errors in or omissions from this document, whether arising out of negligence or otherwise, is accepted.
The information contained in this podcast has not been independently verified.

© Amanda Nikolic 2021

This week's mismatched topics (brought to you by boredom and Melbourne's 4th COVID lockdown) are:
- Volvulus: including sigmoid and caecal volvulus. What are they, how do they present, and how do we treat them? AND
- Pilonidal disease: what is it, pathophysiology, how it can present, how it is managed, and some operative steps for a Karydakis / Modified Bascom operation.

Thanks for the suggestion of the website pilonidal.org! It's a great resource to send your patients to and has some great resources for surgeons as well. Can recommend checking it out.

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 include any recommendations or medical advice by the author or publisher or any other person. The listener should conduct and rely upon their own independent analysis of the information in this document.
The author provides no guarantees or assurances in relation to any connection between the content of this podcast and the general surgical fellowship exam.  No responsibility or liability is accepted by the author in relation to the performance of any person in the exam.  This podcast is not a substitute for candidates undertaking their own preparations for the exam.
To the maximum extent permitted by law, no responsibility or liability is accepted by the author or publisher or any other person as to the adequacy, accuracy, correctness, completeness or reasonableness of this information, including any statements or information provided by third parties and reproduced or referred to in this document. 
To the maximum extent permitted by law, no responsibility for any errors in or omissions from this document, whether arising out of negligence or otherwise, is accepted.
The information contained in this podcast has not been independently verified.

© Amanda Nikolic 2021