School of Surgery

Sliding or rolling? That is the question! Or at least one of the questions you will need to know the answer to when you encounter a hiatus hernia.
Whatever branch of medicine or surgery you go into you will need to know about this increasingly common condition. Eleanor Rudge discusses anatomy, types of hernia, physiology, presentation, investigation and treatment of hiatal hernia with Eric Sheu.
Eleanor Rudge is a research fellow in surgery at Brigham and Women's Hospital and University of Harvard and Eric Sheu MD, PhD is a Bariatric Surgeon at Brigham and Women's Hospital, Boston, USA

Nissen's fundoplication is probably the most common procedure used to treat gastro-oesophageal reflux disease (GORD or GERD, depending where you live and how you feel about a dipthong). In this video Keaton Jones explains the indications, anatomy, technique and complications of this operation and you can watch the operation being performed by Mr Shaun Appleton, Consultant Upper GI Surgeon at Buckinghamshire Healthcare, UK. Watch this with our other podcast, All you need to know about antireflux surgery (https://www.youtube.com/watch?v=OWCEMXLfF1M). Keaton Jones is an academic trainee in surgery at the University of Oxford, UK

If you want to know what bone is: watch this!
An essential guide to bone, its formation, remodelling and maintenance is given by Susan Anderson in this microscopic tour of the substance that holds us up and will be here long after the rest of us is gone.
Underlying mechanisms are discussed as is the pathogenesis at a cellular level of osteoporosis, Paget's Disease and osteogenesis imperfecta.
Susan Anderson is Associate Professor of Pathology at the University of Nottingham.

Download this for Susan Anderson to show you hyaline cartilage, and you can also find out why 18th century sailors had wobbly teeth and wounds which didn't heal well...

Susan Anderson (Associate Professor of Pathology, University of Nottingham) takes you on a microscopic tour of the structure of bone with some of the most beautiful histological images in the series yet. See the structure of bone, haversian canals, osteons, lamellae and learn how osteocytes communicate information about stresses in the bone and how to grow and maintain bone.
Also, if you're stuck for naming your baby, you can decide whether Clopton is a nice name for a boy!

"Doctor!" the nurse shouts, "the patient admitted earlier with abdominal pain has a blood sugar of 36! He doesn't look very well! What shall I do?!"
Fortunately, you had listened to this podcast by Naomi Laskar and Roger Stanworth about recognising and dealing with diabetic emergencies on the surgical ward, and you knew exactly what was going on and what to do!
This podcast covers diabetic ketoacidosis (not infrequently presenting to surgery as abdominal pain as the main symptom), the superbly named HONC (now more boringly called HHS), other causes of ketosis and what kind of fluids to give diabetic patients.
Essential listening for all medical students and trainee doctors, you can save a life in the middle of the night.
Naomi Laskar is a doctor at Royal Derby Hospital, UK, and Roger Stanworth is a Consultant Diabetologist, also at RDH.

Many patients who we operate on have diabetes as well. Complications are more common in patients with diabetes and we need to know how to look after their blood sugar, where to put them on the operating list, how to deal with the nil by mouth periods, how to prescribe insulin and when and special precautions which we need to take when arranging imaging for these patients.
Naomi Laskar talks to Roger Stanworth about how to look after a patient with diabetes on a surgical ward. Essential listening for any medical student or surgical trainee.
Next time - how to recognise and deal with diabetic emergencies presenting on a surgical ward

Diabetes is a common and growing co-morbidity in whatever branch of medicine you go in to. In this audio podcast, Roger Stanworth talks to Naomi Laskar about this condition. Types of diabetes and their aetiology and presentation are covered as well as HbA1c, WHO recommendations, different management plans for each type of diabetes, drugs and their contraindications are also covered.
Roger Stanworth is a consultant diabetologist and Naomi Laskar is a foundation doctor, both at the Royal Derby Hospital, UK

"Doctor - what do you want to do with the patient with abdominal trauma now? Laparotomy? CT??" you are asked by the Emergency Room staff. You strike a wise pose, remember that you have listened to Andrew Deytrikh talk to Adam Brooks about abdominal trauma in this podcast, and say "Physiology drives decision making in major trauma" and then do the right thing for the patient.
This podcast discusses all aspects of blunt and penetrating abdominal trauma beyond immediate ATLS. Patterns of injury, injuries across boundary areas (diaphragm, groin), straight to theatre vs CT, stabbing vs gunshot vs blunt trauma are all discussed. If you're not working in a Major Trauma Centre this podcast discusses which patients with trauma to transfer and when, should they have a CT before transfer?
How to manage a gunshot wound to the abdomen and how to manage bowel eviceratation are also discussed.
Use this podcast with the Chest Trauma podcast to build up an essential body of knowledge for the correct management of these emergencies.
Andrew Deytrikh is a core trainee in surgery at Royal Derby Hospital, UK and Adam Brooks OBE is a consultant and lead for Trauma at the East Midlands Major Trauma Centre, Nottingham, UK

Can you tell the difference between a monocyte and a basophil? Would you know what an eosinophil looked like if it came up to you and introduced itself? Where do platelets come from? If I have worms, what cells are responsible for killing them?
All this and much more answered as Susan Anderson takes you on a tour of blood on a microscopic scale, teaching you how to identify red cells, granulocytes, lymphocytes, platelets, monocytes, basophils, eosinophils and neutrophil polymorphs and going through what each cell type is for.
Don't miss this if you are a medical student or doctor taking early postgrad exams.
Susan Anderson is Associate Professor of Surgery at the University of Nottingham, UK