Thank you @Ket_Tweetal an excellent point. Are there any suggestions for how training would be incorporated for non-general surgical trainees David Naumann ? #ASGBIEastMidsJC

@Ket_Tweetal ASGBIEastMidsJC East Midlands MTC @neilsurgeon Christopher Lamb Alex Navarro Adam Brooks @traumakhan @DissanaikeMD A dedicated trauma fellowship might help…? Or some post/peri-CCT training?

David Naumann ASGBIEastMidsJC East Midlands MTC @neilsurgeon Christopher Lamb Alex Navarro Adam Brooks @traumakhan @DissanaikeMD Sounds like a plan. I was wondering about laying foundations down earlier in career as well? Wonder if it's possible to do extra general surgery to build those skills within a vascular pathway 🤔 will have to do some digging

Tanvir Hossain ASGBIEastMidsJC @neilsurgeon susan moug Liz Vaughan Jaz Seehra Christopher Lamb Alex Navarro Adam Brooks Mansoor Khan Ewen A Griffiths Good question and each unit should think about this carefully and consensus guidance would be the best way forward. If it’s penetrating with breech and there’s any uncertainty then you’re most likely going to need a laparotomy.

ASGBIEastMidsJC David Naumann East Midlands MTC I think laparoscopy and to some degree thoracoscopy should be within the armamentarium of a trauma surgeon. It's an excellent way of visualising and repairing the diaphragm for those junctional injuries, and for managing retained haemothoarces 1/

ASGBIEastMidsJC David Naumann East Midlands MTC and in assessing those with diagnostic uncertainty following imaging, where the alternative is serial abdominal examinations. I imagine it could also affect LoS in these patients. 2/2

Thank you David Naumann for an excellent thought provoking presentation & to all who watched and participated. June's presentation will be Tues 28 June 7pm. See you there !

ASGBIEastMidsJC David Naumann Tanvir Hossain @neilsurgeon susan moug Liz Vaughan Jaz Seehra Christopher Lamb Alex Navarro Adam Brooks Mansoor Khan @CleoKenington I remember some cases where laparoscopy was used and seemed fine but missed small injuries ( duodenal leaks) presented later. Need to be really careful who is selected for laparoscopy. In LUQ stabbing - laparoscopy has a clear role to assess the diaphragm.

ASGBIEastMidsJC David Naumann Tanvir Hossain @neilsurgeon susan moug Liz Vaughan Jaz Seehra Christopher Lamb Alex Navarro Adam Brooks Mansoor Khan @CleoKenington Some patients might be better with active cat like observation rather than a poor and misleading ‘negative’ laparoscopy.

ASGBIEastMidsJC David Naumann East Midlands MTC @neilsurgeon Alex Navarro Adam Brooks @traumakhan @DissanaikeMD I did a lot of laparoscopy in training (GS on call) and now do none (vascular elective practice), so this is an issue for me. Is it necessary for OOH trauma management? No. Is it desirable for more “elective” trauma cases (eg diaphragm injury exclusion)? Yes. /1

ASGBIEastMidsJC David Naumann East Midlands MTC @neilsurgeon Alex Navarro Adam Brooks @traumakhan @DissanaikeMD Having done 0 lap cases in the last 7 or 8 years, there will certainly be another consultant surgeon on call who is therefore more appropriate to do that case. If I did it myself and had a significant complication, the obvious question is “why didn’t you phone a friend?”

ASGBIEastMidsJC David Naumann East Midlands MTC @neilsurgeon Alex Navarro Adam Brooks @traumakhan @DissanaikeMD So could I do it? Yes. I’ve done >300 laparoscopies in training and I think I could muddle through. *Should* I do it, when there are 2 or 3 better qualified consultants, on call in the same hospital? No. It’s a team sport. You don’t have to do everything yourself

Involved in surgical emergencies? Want to get it right? Make the ASGBI EGS Symposium on 28th September your target!! Registration opening soon for in person attendance in Nottingham and online!

The theme of our 2022 Hybrid EGS Symposium is Getting it right in Emergency General Surgery. Interested in finding out more? See the full programme here: asgbi.org.uk/emergency-gene… #ASGBIEGS

A third of our in person places are now occupied. If you want to attend our Nottingham EGS day in person here’s the link: asgbi.org.uk/emergency-gene…. We’d love to see you on the day! #asgbi #everyonematters #nowmorethanever

Session 2 at the EGS Symposium, 28th September, focuses on managing complications. Hear from Ravinder Vohra on the Perforated Duodenal Ulcer, Jim Tiernan on Salvaging the Leak and Sharad Karandikar on Necrotizing Soft Tissue Infections. See programme: asgbi.org.uk/event/asgbi-ev…

EGS Symposium Session 4 - Medicolegal issues when it doesn't go right in Emergency General Surgery. Looking forward to hearing from Parv Sains, Pete Sagar and charles maxwell-armstrong. We'll also have a lively case discussion to end the day. Register: asgbi.org.uk/event/asgbi-ev…

RCS England Training the Trainers course available Chesterfield Royal Hospital NHS FT Chesterfield Royal Hospital 18-19 Feb 2023 #SurgEd #MedEd Interested Email: [email protected] James Tomlinson Simon Fleming 🛠 Ronnie Davies ACPGBI-Education&Training @ACPGBI Becky Aspinall DME ASGBIEastMidsJC