Episode 166: Management of small bowel obstruction

In part 1 @CleoKenington, ASGBI lead for Sustainability, told us about the huge problem healthcare has with greenhouse emissions and what to do about improving pathways to minimise healthcare impact, In this eposode Cleo tell us what each of us can do once the patient gets to theatre. Practical solutions for all surgeons to embrace. Be part of the solution!Useful links: Resources for how to offer lifestyle advice to prevent disease:http://makingeverycontactcount.co.uk/training/healthy-lifestyle-information/https://www.e-lfh.org.uk/programmes/making-every-contact-count/To promote Shared decision making and improved perioperative see Centre for Perioperative care:https://cpoc.org.uk/about-cpocLean Healthcare pathwayshttps://sustainablehealthcare.org.uk/what-we-do/green-surgery-challengeCompanies that produce reusable kit:Hybrid Laparoscopic Ports, scissors & Clip applicatorshttps://www.surginno.com/resposable-8-2/Reprocessed Harmonic scalpelshttps://www.vanguard-medical.com/harmonic-scalpel/The zero waste operating theatre:https://www.ecoquip.eu/procurement-projects/towards-zero-waste-operating-theatres.html

In the UK, the National Health Service accounts for 5.4% of the carbon emissions for the whole country! Surgery accounts for 5-10% of this total. The target is an 80% reduction in greenhouse emissions by 2028. Find out what's going on and what you and your unit can do to save slow global warming in this podcast by @CleoKenington, Emergency Surgeon and ASGBI lead for sustainability. This is everyone's problem - be part of the solution!Links to helpful sites below:Resources for how to offer lifestyle advice to prevent disease:http://makingeverycontactcount.co.uk/training/healthy-lifestyle-information/https://www.e-lfh.org.uk/programmes/making-every-contact-count/To promote Shared decision making and improved perioperative see Centre for Perioperative care:https://cpoc.org.uk/about-cpocLean Healthcare pathwayshttps://sustainablehealthcare.org.uk/what-we-do/green-surgery-challengeCompanies that produce reusable kit:Hybrid Laparoscopic Ports, scissors & Clip applicatorshttps://www.surginno.com/resposable-8-2/Reprocessed Harmonic scalpelshttps://www.vanguard-medical.com/harmonic-scalpel/The zero waste operating theatre:https://www.ecoquip.eu/procurement-projects/towards-zero-waste-operating-theatres.html

All you need to know about investigation and treatment of this common and serious condition. Indications for pneumatic or hydrostatic reduction, plus operative intervention and complications are all covered.There are fantastic, beautifully handwritten notes to accompany both podcasts that you can download here: https://drive.google.com/file/d/1BTNoeYe-csn0X2mTsb3rGJ38o5KKyQdy/view?usp=sharingShalinder Singh is a consultant in Paediatric Surgery in Nottingham, UK, and David Kiely is a trainee in Paediatric Surgery in the East Midlands of the UK

David Kiely asks Shalinder Singh about intussusception, a common and serious cause of abdominal pain in children aged 3 months to 3 years.This podcast covers all you need to know about the incidence, history and examination of intussusception. Part 2 covers investigation and treatment.Accompanying notes can be downloaded from here https://drive.google.com/file/d/1BTNoeYe-csn0X2mTsb3rGJ38o5KKyQdy/view?usp=sharing

You'll need to operate on about 1/3 patients with SBO. Matt Lee tells you what approach is best and when, and how to look after your patients after the operationMatt Lee is Clinical Lecturer in Surgery at the University of Sheffield and a recognised leader in the management of SBO

Who's going to settle with drip and suck and who isn't? Matt Lee tells you how to tell, who to operate on and when and not to forget that patients with small bowel obstruction need feeding!Further reading: https://bmjopen.bmj.com/content/9/7/e029235.abstract

Once you've diagnosed small bowel obstruction, Matt Lee tells us the best initial managementMatt Lee is Clinical Lecturer in Surgery at the University of Sheffield and a world expert in small bowel obstruction

Matt Lee talks about causes of small bowel obstruction, important points in the history and examination.Matt Lee (@wannabehawkeye) is a Clinical Lecturer in Surgery at the University of Sheffield

If the National Audit of Small Bowel Obstruction was a car, Matt Lee is the engine and most of the other moving parts. In this podcast Matt (@wannabehawkeye) talks about NASBO and its main findings and recommendations.Further reading here: https://academic.oup.com/bjsopen/article/3/3/354/6060819

All you need to know about the management of this complex abdominal wall defect of the newborn. Similar to but different from exomphalos (listen to our other episode on that condition).With David Kiely and Shalinder Singh