First Incision

This episode covers the topic of chest trauma, with the James Mckay, an incredible general surgeon, trauma surgeon, and dual trained intensive care physician. Topics covered include: - rib fractures - flail chest - blunt cardiac injury - chest drains - resuscitative thoracotomy And more! 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 r...

This guest episode with colorectal surgeon Chris Wakeman focuses on the common familial cancer syndromes. For each we go through diagnosis, genetics, surveillance, management, decision making and more. Topics include: - Familial Adenomatous Polyposis (FAP) - Lynch Syndrome - Serrated Polyposis Syndrome - Oligopolyposis Here are some resources Dr Wakeman suggested might be helpful when covering this topic: Lynch syndrome - InSiGHT (insight-group.org) Adenomatous polyposis syndromes - InS...

This episode is the first part of a series that has been produced in collaboration with the Australian and New Zealand Training Board in Colon and Rectal Surgery (ANZTBCRS). It has come out of work prepared for the Colorectal Fellow's Training Weekend held in Adelaide in August 2023. Henry Drysdale won the Phillip Douglas Prize for his presentation on malignant colorectal polyps and is our guest for this episode. We cover: - definition - endoscopic features correlated with malignant po...

For this guest episode we are joined by Dr Simon Richards, as colorectal surgeon from Christchurch New Zealand. This episode is a masterclass in Total Neoadjuvant Therapy (TNT) for Rectal Cancer. We cover: - the traditional paradigm of rectal cancer management and how it's progressed to where we are now - what is TNT - what is 'watch and wait' and 'organ preservation' - the main three trials you need to know! - some cases and why you might consider different approaches for different patients...

On this guest episode we are joined by Dr Carla Gillespie, an UGI, bariatric and general surgeon from Sydney to cover the topic of bariatric surgery. We cover: - pathophysiology - types of operations - considerations when deciding what operation - complications - immediate and late - how to remove a lap band - and some general exam and career advice! Disclaimer The information in this podcast is intended as a revision aid for the purposes of the General Surgery Fellowship Exam. This informa...

From the vault (courtesy of Tara who found it). This episode covers the topic of intestinal failure. It includes: - definition - classification - pathophysiology - prevention - the three phases - intestinal adaptation - management - complications (short and long term) 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...

In this week's 'Christmas Special' episode I am joined by Ashwini Pondicherry and Jamie Crichton to reflect on our first year of fellowship. We discuss some of the good things about this transition, but also some of the more difficult and formative aspects and how we negotiated them. The step from registrar to fellow/consultant is a HUGE one and we hope that by talking about some of these topics it will make it slightly easier for you. We also discuss the application processes for ANZHPBA, Br...

Our first episode back (in a while - sorry!) is an incredible guest episode that is worth the wait. We talk through a series of breast cancer cases with Ashwini Pondicherry, the current breast fellow at Christchurch hospital, to cover a wide range of topics in breast cancer. This includes some updates from the original breast cancer episodes (which were published over 2 years ago now). This episode not only covers content, but is presented in long viva style taking you through a number of ca...

This guest episode covers the essentials you need to know when talking about operative surgery in inflammatory bowel disease. We are joined by colorectal and general surgeon Mr Michael Johnston who has significant experience in looking after these patients. We talk about: - ileocolic resections - what to do with crohn's fistulas to the sigmoid - stricturoplasty techniques - how to handle the crohn's mesentery - what join to do and why - when to operate on acute colitis - how to do a subtotal ...

In this episode we go into some of the pathologies that can affect the salivary gland, as well as the different neck infections we need to know about. Topics covered include: Salivary Gland Pathology - Salivary gland calculi (sialolithiasis) - Infections / Inflammation including sialadenitis - Plunging ranulas Cervical Infections - Compartments of the neck - Different infections and neck abscesses As I mentioned in the first episode of this series I can highly recommend the Open Access Atl...

On this guest episode, we talk to Anthony Payne, a financial and tax consultant with DPM Financial about some of the financial changes we will face transitioning from being a registrar to fellowship and consultancy. Some of the topics we cover include: - Transitioning from employee to sole trader, and the implications on this for Tax, Super, Insurances and Leave. - What an ABN is and why you need it - GST as a sole trader and what you need to know - The typical financial set-ups ...

In this first episode from the Head and Neck module of our curriculum we touch on salivary gland pathology. Including: - Salivary gland anatomy - including the parotid and submandibular glands. As part of this we cover the important anatomical relations and the parasympathetic supply (highly examinable!) - Common tumours of the salivary glands and how to treat them - Some operative tips and how to describe how you would perform a superficial parotidectomy and submandibular gland extirpation -...

This week we are joined by the incredible urologist Dr Anita Clarke to talk about all things urology! We cover: - the benefits of multidisciplinary surgical approach - putting in a ureteric stent - the diagnosis and management of bladder cancer (for general surgeons) - management of intra-operative ureteric injuries - the difficult urinary catheter and inserting a suprapubic catheter As well as other life advice, insight into the life of a surgeon, and exam advice (from a previous chief exami...

Welcome to this guest episode with A/Prof Phil Carson. A/Prof Carson is a general surgeon from Darwin and the most recent ex-censor in chief of RACS. We are lucky enough to have him for this special episode to cover a range of topics filled with pearls and insights from his varied and interesting career. We cover: - some background into his life as a rural generalist in Darwin. - what to do to prepare for practice if you are considering a career as a rural general surgeon. - we gain some insi...

We are lucky enough this week to be joined by the incredible Kellee Slater - HPB and hernia surgeon from Queensland. In addition to being an incredible surgeon, researcher, published author and presenter, A/Prof Slater has been extremely generous and joined us to cover topics from the hepatobiliary and transplant modules. I hope you enjoy listening to this episode as much as I enjoyed recording it. Once again I'm overwhelmed by the time surgeons spend working with us to help us prepare for e...

I'm back! After a nice break holidaying around Italy I bring you an introduction to the transplant module! Hopefully this covers enough background to get started with the module including transplant immunobiology, immunosuppressive medications, criteria for organ donation and complications of immunosuppression. 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 ...

I know I promised you all a series on urology but I'm taking a break this week and releasing a bonus episode from the vault! This episode covers all the appendiceal pathologies from the 'emergency' module of the curriculum: - acute appendicitis - appendiceal tumours including adenocarcinoma, mucinous adenocarcinoma, mucinous neoplasms, goblet cell adenocarcinoma, and neuroendocrine tumours. - and we also touch on pseudomyxoma peritonei I hope you enjoy this episode! Disclaimer The in...

This episode continues our foray into the urology topics we need to know for our general surgical exams. We cover: - testicular tumours including the presentation, subtypes, workup, radical inguinal orchidectomy and management - Varicoceles - Hydroceles (including some operative points on Jaboulay and Lord's procedures) - and epididymal 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 n...

From the abdominal wall, retroperitoneum and urogenital module from the curriculum I bring you the first in a series of podcasts covering urology! We have to know quite a few urology topics for our exam, but where better to start than by covering anatomy and embryology. In this episode we cover the clinically relevant anatomy of: - the kidneys - ureter - bladder - testes - vas deferens - seminal vesicles And some embryology of the kidneys and testes. Disclaimer The information in this podc...

This episode is number 3 in our series of pathophysiology quiz episodes. We cover pathophysiology topics from the following modules: - sepsis and critical care - nutrition - skin and soft tissue - trauma - vascular, and - abdominal compartment syndrome 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...

This episode is number 2 in our series of pathophysiology quiz episodes. We cover pathophysiology topics from the following modules: - Upper GI - Breast - Colorectal - Emergency - Head and Neck 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 re...

After the success of our Genetic Syndrome's Quiz episode, we bring you the first in a series of Pathophysiology quiz episodes! This episode is in a question and answer format - where I ask a question and give you time to think of the answer before giving it to you. We cover a variety of pathophysiology questions from the endocrine, small bowel, bariatric and hepatobiliary modules from the general surgery curriculum. Disclaimer The information in this podcast is intended as a revision aid fo...

After a short hiatus First Incision is back! This episode goes through the definitions of all the conditions which may affect our critically ill surgical patients. It also goes through the pathophysiology of these conditions. We finish off by talking a little bit about some of the medications that may be used by the ICU for these critically ill patients. In my exam pathophysiology VIVA they asked me what the definition and diagnostic criteria for sepsis were so this is definitely examinable...

Hi everyone! We're trying something different this week with a new format for the podcast. This episode covers a range of genetic syndromes that we need to know for the exam. The format is a 'call and respond' or 'question-answer' type format where I ask a question and give you a chance to see if you know the answer before telling you myself! You might find this useful in the few months leading up to the exam to practice recalling answers, and to identify what you've forgotten and what has s...

Spoiler alert - We Passed! In this week's episode we reflect on the exam and the whole process of preparation for and actually sitting the exam. We are joined by Ben Finlay (circa the trauma podcasts) to share his experience as well! We discuss: - exam preparation - study group - tutorials and other resources - the written exam - the viva exam - practicalities from travelling for the exam and how we structured our leave, to timing for the written questions - the exam ceremony and lif...

This week's episode covers retroperitoneal sarcoma. Another difficult sarcoma topic most trainees wouldn't see during their training. This episode covers the presentation, subtypes, workup and management of these tumours. It also features a discussion with Dr Julie Howle, a medical oncologist from Westmead Hospital who has been so helpful discussing many difficult surgical oncology topics with us. I hope you enjoy this episode and learn as much as I did! Disclaimer The information in thi...

This week's episode covers everything we need to know about soft tissue sarcomas. There are so many sarcomas it can feel a bit overwhelming, so this episode breaks it down into what we need to know as general surgeons, and for the exam. It features some of my discussions on this topic with the incredible Dr Julie Howle - a surgical oncologist from Westmead Hospital in Sydney. In particular we cover: - soft tissue sarcoma subtypes, presentation, workup, and management - when to investi...

This week's episode finishes our series on limb anatomy! This is an area of anatomy which is not as frequently encountered by general surgeons so is a great topic to revise before the exam. These episodes covered the anatomy and also the clinically and surgically relevant anatomy for each area. 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 recommendation...

This week's episode continues our series on limb anatomy. This is an area of anatomy which is not as frequently encountered by general surgeons so is a great topic to revise before the exam. These episodes aim to cover the anatomy and also the clinically and surgically relevant anatomy for each area. Also happy birthday to me! :) 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 con...

This week's episode completes the upper limb component of our series on limb anatomy. Limb anatomy is not as frequently encountered by general surgeons so is a great topic to revise before the exam. These episodes aim to cover the anatomy and also the clinically and surgically relevant anatomy for each area. Good Luck to everyone sitting their clinical VIVA exams this week! Disclaimer The information in this podcast is intended as a revision aid for the purposes of the General Surgery...

This week's episode is the second in our series on limb anatomy. This week we cover the anatomy of the forearm and cubital fossa. This is an area of anatomy which is not as frequently encountered by general surgeons so is a great topic to revise before the exam. These episodes aim to cover the anatomy and also the clinically and surgically relevant anatomy for each area. Disclaimer The information in this podcast is intended as a revision aid for the purposes of the General Surgery Fellowshi...

This week's episode kicks off a series on limb anatomy. This is an area of anatomy which is not as frequently encountered by general surgeons so is a great topic to revise before the exam. These episodes aim to cover the anatomy and also the clinically and surgically relevant anatomy for each area. 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 recommenda...

This episode covers the topic of aneurysmal disease from the vascular module of the general surgical curriculum. We cover: - definition - classification - pathogenesis - risk factors - natural history focussing on abdominal aortic aneurysms - 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 include any recommendations or medical advice by the author or publ...

This episode covers what we need to know about the diabetic foot - a favourite topic for the general surgical exam. - background - pathophysiology - workup and important factors to consider - classification systems - management - some information about charcot neuroarthropathy 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 med...

This week's episode covers the topic of venous disease. This includes varicose veins and venous hypertension (chronic venous insufficiency). - the epidemiology - anatomy of lower limb veins - pathophysiology of chronic venous htn and the consequences of this disease (haemosiderin deposition, lipodermatosclerosis and venous eczema) - classification systems - risk factors - presentation - workup - management Disclaimer The information in this podcast is intended as a revision aid for the pur...

This episode covers everything we need to know about acute limb ischaemia. - definition - aetiology - risk factors - severity assessment - pathophysiology - presentation - workup - management Including how to perform embolectomy and fasciotomy 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 publishe...

This week's episode starts us off with the vascular module of the general surgical curriculum. We cover chronic limb ischaemia, also known as chronic arterial disease. - definition - presentation - pathophysiology - risk factors - the rutherford classification - workup - severity classifications - 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 i...

This week's episode covers the sweat-gland related pathologies covered in the skin and soft tissue module: Starting with anatomy of the sweat glands and the autonomic nervous system. Hyperhydrosis including - presentation - primary and secondary causes - management Hydraadenitis Suppurativa - presentation - pathophysiology - diagnosis - classification - management Disclaimer The information in this podcast is intended as a revision aid for the purposes of the General Surgery Fellowship Exam...

This week's episode covers everything you need to know about basal cell carcinoma including - presentation - risk factors - histological subtypes - poor prognostic factors - management including topical treatments, surgery, radiotherapy and targeted treatments 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 o...

This week's episode covers everything you need to know about cutaneous squamous cell carcinoma. - presentation - risk factors - premalignant lesions - histopathology - workup and when to stage - grading - TNM staging - poor prognostic markers - management including topical treatments, surgery, radiotherapy, systemic treatments and nodal treatment Disclaimer The information in this podcast is intended as a revision aid for the purposes of the General Surgery Fellowship Exam. This informatio...

This week's episode covers the topic of Merkel Cell Carcinoma - a favourite question in the exam. We have added the discussion we had with Dr Julie Howle onto the end of this episode. Dr Howle a surgical oncologist from Westmead Hospital who has an interest in these rare cancers. We cover: - background - risk factors - pathogenesis - presentation - diagnosis - staging - histopathology - and management Disclaimer The information in this podcast is intended as a revision aid for t...

This week's episode welcomes our guest Dr Julie Howle who is a surgical oncologist from Westmead Hospital in Sydney. We cover a wide range of topics related to management of melanoma including: - precursor lesions - whether ulceration relates to the clinical or histopathological diagnosis of ulceration - when to perform systemic staging for melanoma - management of in-transit and satellite lesions including whether you need do a sentinel lymph node biopsy if these are present - sentinel lymp...

This week's episode continues on from last week to discuss the management of Melanoma This episode covers: - wide local excision and the surgical margin - lymph node biopsy and when to perform it, as well as a summary of the MSLT 1 and MSLT2 trials - the role of lymphadenectomy - the role of radiotherapy in melanoma - systemic therapy including the targeted therapies (BRAF and MEK inhibitors), and immunotherapies (Anti-PD1, Anti-PD-L1, and CTLA-4) - when to give adjuvant treatment - managem...

This week's episode introduces us to the topic of melanoma We cover: - Risk factors - Precursor lesions - Histopathology and important histopathological features related to poor prognosis - Melanoma types and their appearance including superficial spreading, nodular, lentigo maligna melanoma, acral lentiginous, and desmoplastic - Workup including excisional biopsy and when to stage patients - Staging with AJCC 8th edition TNM staging classification - When to perform sentinel lymph node ...

This week's episode introduces us to the topic of 'skin'. I know it seems weird that I would do an episode just on this but bear with me! The topics covered include: - the function of the skin as an organ - histopathology of the layers of the skin - Fitzpatrick skin types - history and examination of a skin lesions - principles and pathophysiology of flaps and grafts - topical treatments for skins cancers Everything we need before taking a deep dive into skin cancers in the coming weeks! Dis...

This week's episode covers the useful topics of topical haemostatic agents and anticoagulants. We discuss principles of haemostasis, the coagulation cascade, how topical haemostatic agents work, the different classes and when to use them. We also cover anticoagulants, the different types, how they work, when to stop them before surgery and how to reverse them if you need to quickly! Great high yield topics for the exam. Disclaimer The information in this podcast is intended as a revision ...

This week's episode is co-hosted by Ben Finlay. We cover a wide range of topics including: Burns - initial resuscitation including the parkland formula - assessment of depth and extent of burns (rule of nines - burns management - frostbite Blast injuries - pathophysiology - management Extremity compartment syndrome and how to perform fasciotomy The blast injury talk Ben mentioned was from the recent GSA trainees day and is accessible for general surgical trainees through the GSA websi...

This week's trauma episode is presented with our guest host Ben Finlay. We cover hollow viscus injuries including: - gastric - duodenal - small bowel - colonic, and - rectal injuries We also cover pelvic trauma including: - pelvic fractures and the Young and Burgess classification - pelvic bleeding management including how to perform preperitoneal pelvic packing - bladder injuries, and - ureteric injuries including how to do a retrograde urethrogram Disclaimer The information in this pod...

This week's episode welcomes back Ben Finlay to help present abdominal trauma. We go through: - trauma laparotomy - liver trauma - splenic trauma - pancreatic trauma - renal trauma - and retroperitoneal haematomas and what to do with them! Special mentions include how to do right and left medial visceral rotations, and some operative decision making that will be super high yield for the exam. The ANZAST (Australian and New Zealand Association for the Surgery of Trauma) has some great recor...

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 'no-zone' approach - exposures of zone I, II and II injuries - repair of carotid and aerodigestive tract injuri...

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 is intended as a revision aid for the purposes of the General Surgery Fellowship Exam. This informa...

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 gallbladder including subtotal cholecyste...

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 metastases - Chemotherapy - Liver first? - Liver remnant and functional assessment - Criteria of when ...

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 aid for the purposes of the General Surgery Fellowship Exam. This information is not to be consi...

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, confirmatory and localisation tests for functional lesions - imaging characteristics of malignant versus benign l...

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 which ones are suitable for surveillance, surgery, management of unresectable or metastatic disease...

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 surgical management of hyperparathyroidism and hypercalcaemia - and management of postoperative...

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 information in this podcast is intended as a revision aid for the purposes of the General Surgery ...

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 - follicular - medullary - anaplastic - lymphoma And summaries the different types, what differentiates ...

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 eye disease, the toxic multinodular goitre, toxic adenoma/toxic solitary nodule, and amiodarone thyroiditis ...

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 purposes of the General Surgery Fellowship Exam. This information is not to be considered to include any recomm...

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 in this podcast is intended as a revision aid for the purposes of the General Surgery Fellowship Exam....

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 Fellowship Exam. This information is not to be considered to include any recommendations or medical ...

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 and open splenectomy - OPSI (overwhelming post-splenectomy infections) - splenic artery aneurysms...

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 include any recommendations or medical advice by the author or publisher or any other person. The listener sho...

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 of pancreatitis --- including acute management which addresses fluid resuscitation, nutrition, ERCP, as...

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 information is not to be considered to include any recommendations or medical advice by the author or ...

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 colorectal primary - other liver targeted treatments We talk about liver surgery including: - pr...

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 variations - ureteric catheter not flushing - the 'difficult' gallbladder' - the dreaded bile duct injur...

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 C...

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 inte...

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 ...

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 Disclaime...

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...

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 incl...

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. ...

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 liste...

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 a...

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 ...

Finishing off the perianal content for the colorectal module with perianal fistula and hemorrhoids. Everything you ever wanted to know about all the classification systems, treatment options, and some operative descriptions for these conditions. 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 publish...

This week's episode covers the topics of faecal incontinence and rectal prolapse. These conditions are commonly encountered in the general surgical clinic. We cover the pathophysiology, workup and treatments of these conditions. 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...

This episode covers anal cancer and perianal paget's disease. We cover the presentation, workup, aetiology, and treatment of these diseases. Special attention is given to the management of precursor lesions including anal intraepithelial neoplasia (now low and high grade squamous intra-epithelial lesions). Also a corrections corner about last week's episode! Disclaimer The information in this podcast is intended as a revision aid for the purposes of the General Surgery Fellowship Exam. Th...

This episode covers large bowel obstruction and pseudoobstruction. We go into the causes, presentation, workup, and management of both of these conditions, as well as some great perioperative pearls of wisdom. 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 shou...

This episode takes us away from IBD and into the realm of perianal pathology. Although not the prettiest side of general surgery, these topics are commonly encountered and definitely fair game for the exam! This episode covers: - Anal fissures - Perianal abscess, and - Pruritis ani We cover the presentation, workup, diagnosis and management of these conditions. We also cover the surgical steps of botox for fissures, lateral internal sphincterotomy, and incision and drainage of perianal absc...

This special addition to our IBD episodes covers three bonus topics: - Perianal Crohn's Disease - IBD and Pregnancy - Indeterminate Colitis 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 ...

In this episode we cover Crohn's Disease. - presentations: both gastrointestinal and extra-intestinal - differential diagnoses - workup and diagnosis - histopathological findings - macroscopic features - management - surgical tips and pearls - malignancy risk and surveillance 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 ...

We are diving back into the colorectal module from the curriculum this week to talk about Ulcerative Colitis. This episode goes into the presentation, endoscopy findings, histopathology, medical and surgical treatment options, and more! 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...

This week's special guest episode is with Dr Emily Olive - a successful 2020 fellowship exam candidate. Just in time for the first sitting of the exam this year, this episode has everything! - what to expect when actually sitting the exam. - great tips for each component of the exam from someone with recent insight into how it runs. - what is different about the COVID exam format. - great tips for those just starting to think about study: including how to keep y...

This episode has everything: - Carolyn Vasey (enough said - an incredible colorectal surgeon from Ballarat in Victoria) - Discussions about colorectal cancer surgery, what to do with the splenic flexure tumour, stomas, parastomal hernias, endoscopy and tattooing for rectal cancers, total neoadjuvant treatment, and watch and wait - Chats about surgery and parenthood, and male champions of change; and - Talk about research and manky belly buttons What more could you want!? Carolyn's e-mail is ...

This episode picks up where episode 4 ((introduction to colorectal cancer) left off - delving into the treatment of rectal cancer. This is a fun topic with lots of nuances and 'it depends' management decisions. We cover: - neoadjuvant treatment - adjuvant treatment - total neoadjuvant treatment - the 'watch and wait' approach - surgery for rectal cancer - surgery for obstructing rectal cancer and more. Disclaimer The information in this podcast is intended as a revision aid for the pur...

This episode continues from our last - 'introduction to colorectal cancer'. We are exploring the treatment of colon cancer, and specifically the differences in the management of: - resectable non-metastatic - resectable metastatic; and - non-resectable metastatic disease Some of the topics touched upon include chemotherapy, different types of resections, peri-operative management strategies, and palliative options. Disclaimer The information in this podcast is intended as a revision aid for...

This episode covers everything else you need to know about colorectal cancer (see last 2 episodes!) without talking about treatment options. This includes epidemiology, risk factors, presentation, investigation, diagnosis, staging and more! 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 ...

Be prepared for some knowledge in this episode exploring the different genetic syndromes associated with colorectal cancer. Great episode to cram before the exam! We will cover: Polyposis syndromes: - FAP (Familial Adenomatous Polyposis) - MAP (MUTYH-Associated Polyposis) - Peutz-Jegher's syndrome - Familial juvenile polyposis - Serrated polyposis - PTEN tumour syndromes Non-polyposis syndromes - HNPCC and Lynch Syndrome Disclaimer The information in this podcast is intended as a revisio...

Let's dip our toes into the topic of colorectal cancer by taking a look at different types of colorectal polyps. This includes neoplastic and non-neoplastic types, as well as what to do with malignant polyps (I'm looking at you Haggitt and Kikuchi classification). Next we take a dive into genetic pathways in colorectal cancer. This includes the CIN, serrated and MSI pathways. This episode gives us all the basics we need before heading into genetic syndromes in colorectal cancer next week. Di...

We are launching into the colorectal module from the curriculum this week - and starting off with some anatomy! There is a little bit of physiology and surgical anatomy thrown in there for good measure! Happy Studying :D 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 li...

This episode covers approaches to the workup and management of oesophageal perforation, plus everything you need to know about corrosive and caustic ingestions 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 anal...

Today's episode covers a few smaller topics in oesophageal surgery including: - oesophageal foreign bodies - oesophageal diverticulum - benign oesophageal tumours References/Resources: - World Journal of Gastroenterology, 2015, Benign esophageal lesions: endoscopic and pathologic features. Tsai et al. - Surgical clinics of North America Vol 95, issue 3. benign esophageal tumours. Ha eg al. 2015 Disclaimer The information in this podcast is intended as a revision aid for the purposes ...

Everything you need to know about peptic ulcer disease you will find right here in this episode. We cover how to manage uncomplicated presentations, what the go is with helicobacter pylori, and how to approach complications such as perforated ulcers and bleeding. 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 ...

In this episode, we will be covering the rest of gastric tumours. This includes: - Gastrointestinal Stroma Tumours (GIST) - Gastric Lymphoma - Gastric Neuroendocrine Tumours including Zollinger-Ellison Syndrome - and Gastric Polyps 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 pers...