GlobalSurg recruitment starting soon

I’m excited to be involved in an enthusiastic young collaborative called GlobalSurg. Research in surgery has been a predominately first world affair and it...


54937 people died In Scotland in 2012. Here’s how. Click to enlarge.
Pablo Picasso - Death of Harlequin.

Life expectancy of acute hospital inpatients

I liked the study published this week by David Clark and Christopher Isles. On 31st March 2010 there were 10,743 inpatients in 25 Scottish...
Sample size for Ontario study.

Introduction of Surgical Safety Checklists in Ontario, Canada – don’t blame the study size

The recent publication of the Ontario experience in the introduction of Surgical Safety Checklists has caused a bit of a stooshie. Checklists have consistently...

Landmark Papers in General Surgery: Review

A longer version of my review in Surgeons’ News. When should a clinical study be considered a landmark? Must it have changed practice? Does...
HCV virus exploding (iStock)

Hepatitis C virus, tumour and liver transplantation

From my HPB highlights this month. Do patients with hepatocellular carcinoma (HCC) on a background of hepatitis C virus (HCV) have worse outcomes after...
Europe by tweets,  by Miguel Rios @miguelrios

A map of the world by tweets

With geo-tagging enabled, tweets include information on the location of the user when the tweet was sent. Miguel Rios (@miguelrios) has plotted locations of...
Staging laparoscopy. Begin with a full inspection of the peritoneal cavity lifting the left and right liver to view the underside (A) and paying particular attention to the peritoneum (B). Use laparoscopic ultrasound to orientate on the origin of the left and right portal vein branches and carefully visualise the parenchyma of the right lobe (C). Look on the left side of the falciform ligament and scan segments II and III. Place the probe on the hepatoduodenal ligament in the transverse plane to examine the portal pedicle (E). The probe can also be placed on the underside of any part of the liver and orientated anteriorly (F). Adhesions around the gallbladder can be seen as a result of recent acute cholecystitis.

Images in operative ultrasound

A selection of images to aid in the use of laparoscopic ultrasound. All images and captions remain under my copyright.
Portal pedicle on ultrasound. CHD, common hepatic duct; LHA, left hepatic artery; RHA, right hepatic artery; PV, portal vein; CBD, common bile duct; PHA, proper hepatic artery; aRHA, accessory right hepatic artery (if present); CHA, common hepatic artery; GDA, gastroduodenal artery; SMV/SV, superior mesenteric vein / splenic vein

Mickey Mouse and the tubes connecting the liver

In liver surgery, it’s often important to know the exact layout of the connections the liver has to the rest of the body. Here...

Publication of paediatric cardiac surgery results

The National Institute for Cardiovascular Outcomes Research (NICOR) has published the results of its investigation into mortality after paediatric heart surgery in England 2009-12....