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INTERNATIONAL POSTGRADUATE SURGICAL EDUCATION AND TRAINING
Erudition and Postgraduate Surgical Education
Delivered by Experts (EPSEDE)
Lecture Series 2021-2022

COVID-19 has engendered a signiﬁcant disruption globally to the education and training needs of surgeons-in-training. This is likely to continue into the foreseeable future. To address this issue, the EPSEDE lecture series has been developed which will provide free education and training in a structured manner. It is envisaged that this will enable surgical trainees to recuperate the knowledge and skills that they have lost during the pandemic. All the videos and educational resources are freely available for relevant healthcare professionals anywhere in the world.

The videos and educational contents are available to view only for healthcare professionals. To view the lectures, please Login or Register. The contents are free to access.

A Focused Case-Based Discussion Series on Common Orthopaedic Conditions and Emergencies: Trauma Basics

About
The second talk in the Focused Case-Based Discussion Series on Common Orthopaedic Conditions and Emergencies focused on the basics of fracture healing, common fractures and dislocations, closed reduction techniques, principles of casting, and casting techniques. It intended to provide Foundation Year Doctors and Core Surgical Trainees with a comprehensive overview of these aspects.
Speaker
Mr Vishesh Khanna, MBBS, MCh, MRCS, DNB Ortho, MNAMS, Dip SICOT
Registrar in Orthopaedic Surgery
The Grange University Hospital, Cwmbran

A Focused Case-Based Discussion Series on Common Orthopaedic Conditions and Emergencies: Orthopaedic Emergencies

About
The first talk in the Focused Case-Based Discussion Series on Common Orthopaedic Conditions and Emergencies focused on cauda equina syndrome, conus medullaris syndrome, compartment syndrome, necrotising fasciitis, gas gangrene, and septic arthritis. It intended to provide Foundation Year Doctors and Core Surgical Trainees with a comprehensive overview of these orthopaedic emergencies.

Viva Practice for Colorectal Trainees Sitting the FRCS Exit Exam

About
This half-day course is intended for trainees with a declared subspecialty interest in colorectal surgery who are preparing for the FRCS (Gen Surg) Exit Exam. The session will comprise of active case discussions and viva practice for a small number of delegates. The highlight of the course is the one-to-one vivas and focused, individual, structured feedback. The course is primarily intended for those who are preparing to appear for the exam within the next 6 to 8 weeks.

Essential Principles of Lasers in the Management of Common Cutaneous and Subcutaneous Conditions

About
Lasers are increasingly used in the treatment of a variety of conditions, as interest in less invasive treatment modalities have gained much interest and popularity in the last couple of decades. Lasers, such as pulsed dye, NdYAG and Erbium YAG Lasers, are used in many surgical disciplines, as well as to treat dermatological conditions. This interactive session aims to introduce the attendee to the basic physics of lasers, laser-tissue interactions, the effects of lasers on tissues, the manipulation of laser parameters for effective treatment, the concepts of selective photothermolysis and thermal relaxation time, the absorption spectrum of tissues, commonly used lasers in clinical practice, and the side effects of laser treatment. The session will provide a comprehensive overview of laser treatment with a focus on exam preparation, built on a sound understanding of the principles that underpin the clinical use of lasers to manage common cutaneous and subcutaneous conditions.

Speaker
Mr Ramesh Vidyadharan, MBBS, MS, MCh, FRCS
Department of Plastic and Reconstructive Surgery
University Hospital of Birmingham and Birmingham Children's Hospital NHS Trust

Upper Limb Topics for Plastic, Orthopaedic and Hand Surgeons: Preparation for the FRCS Exit Exam (Section I)

About
Upper limb conditions are extensively tested in the FRCS exam. These can include simple hand conditions, such as a ganglion or trigger finger, to moderately complex conditions, such as the management of a rheumatoid hand or Dupuytren’s disease. More complex management, such as that for brachial plexus injuries, nerve paralysis requiring tendon or free muscle transfers, hand fractures, conditions affecting the carpal bones, congenital hand conditions, and bone tumours, are also tested in sufficient depth in the exam. This talk by Mr Sam George, Consultant Plastic, Reconstructive and Hand Surgeon at the Queen Elizabeth Hospital, Birmingham and the Royal Orthopaedic Hospital, Birmingham, will cover the salient aspects of the above topics. It will discuss the main principles behind formulating a management plan for these conditions, as tested in the FRCS exam (Section I).

Speaker
Mr Samuel George, MB ChB, MSc, FRCS(Plast.), Dip Hand Surg(Br.), MFSTEd
Consultant (Locum) in Plastic, Reconstructive and Hand Surgeon
The Queen Elizabeth Hospital, Birmingham and the Royal Orthopaedic Hospital, Birmingham

A Focused Overview of Craniofacial Surgery: Preparation for the FRCS Exit Exam

About
Many craniofacial abnormalities (CFA) result from abnormal development of the 1^st and 2^nd visceral arches, which form the facial bones and ears during the second month of gestation. The aetiological factors include a number of genetic syndromes, as well as prenatal environmental factors. CFAs can impact swallowing, breathing, hearing, vision and speech; in some neonates, they can result in life-threatening airway compromise. The assessment and management of CFAs is tested in the FRCS Exit Exam. This talk by Mr Jagajeevan Jagadeesan, who is an experienced Consultant Plastic and Craniofacial Surgeon at the University Hospitals of Birmingham, will cover the classification of craniofacial anomalies, craniosynotosis, common craniofacial syndromes, the management, and surgical techniques for correction. It will provide a structured algorithm to prepare for the FRCS Exit Exam.

Speaker
Mr Jagajeevan Jagadeesan, MBBS, MRCS, MSc, M.Adv. Surg (Craniofacial), FRCS (Plast)
Consultant Plastic and Craniofacial Surgeon
University Hospitals of Birmingham and Birmingham Women's and Children's NHS Foundation Trust

Managing Facial Palsy: A Structured Overview of Principles for the FRCS Exit Exam

About
The facial nerve is important for both communication and expression, and impairment of its function can severely affect a patient’s quality of life. Since the facial nerve supplies all muscles of facial expression (except LPS), injury to it results in facial droop, as well as dry eye, reduced corneal reflex, drooling, hyperacusis, altered taste, otalgia, and speech articulation problems. The signs, symptoms and laterality will depend on if it is an upper or lower motor neurone type of facial palsy. The management is influenced by the aetiology and type of lesion, relevant patient factors, and the severity of symptoms.

Speaker
Mr Ramesh Vidyadharan, MBBS, MS, MCh, FRCS
Department of Plastic and Reconstructive Surgery
Birmingham Children’s Hospital

A Focused Overview of Common Congenital Hand Conditions: Preparation for the FRCS(Plast)

About
Hand deformities, present in about 1 in 200 births, can be particularly disabling as a child learns to interact with the environment through the use of his or her hands. The degree of deformity varies from a minor deformity, such as a simple syndactyly or a clinodactyly, to a major deformity, such as an aplastic thumb or a radial clubhand. A single gene mutation is present in most cases, but a teratogenic or a vascular disruption is also implicated. The presence of congenital hand deformities has a significant psychological impact on both the parents and the child and, in severe cases, can significantly affect limb function.

Speaker
Mr Wee Lam MB ChB, M Phil, FRCS (Plast), Dip Hand Surg (UK), Dip Hand Surg (FESSH)
Consultant Plastic and Hand Surgeon,
Royal Hospital for Sick Children, Edinburgh and St. John's Hospital, Livingston; Honorary Clinical Senior Lecturer, University of Edinburgh

Management of Rectal Cancers and Transanal Total Mesorectal Excision (TaTME): An Overview for FRCS (Gen Surg)

About
Despite significant scientific developments and technological advances, the treatment of rectal cancers continues to remain a significant challenge for clinicians and surgeons. Depending on the grade and stage, rectal cancers can lead to a considerabledegree of morbidity and mortality. A sound understanding of the pathologies and principles is required when managing complex rectal cancers. Transanal Total Mesorectal Excision (TaTME), the new minimally invasive robotic alternative to conventional surgery for patients with lower rectal cancers, allows a shorter recovery time, minimal scarring, and reduced pain. This talk, by Mr Howard Joy, Consultant General and Colorectal Surgeon in West Midlands with a special interest in locally advanced rectal cancers and pelvic malignancies, will provide an overview of this topic and address the current advances and updates in its management.

Speaker
Mr Howard Joy, MBBS, BSc, FRCS (Gen Surg)
Consultant General and Colorectal Surgeon in West Midlands, with a special interest in locally advanced pelvic malignancies.

A Focused Overview of Successfully Managing >40% TBSA Burns: An Overview for FRCS (Plast) Exam

About
Despite major advances in the last few decades in the therapeutic strategies (such as improved resuscitation, enhanced wound coverage, infection control, pharmacotherapeutics, and management of inhalation injuries) for the management of patients with large area burns, the consequences of a large area burn are severe and profound. Such a burn results in complex metabolic changes that can adversely affect every organ system. The management of a patient with a severe burn requires a multipronged, focused and structured approach which addresses the local burn wound, as well as the systemic, psychologic and social consequences of the injury. This talk, by Miss Elizabeth Chipp, Consultant Consultant Burns and Plastic Surgeon University Hospital Birmingham and Birmingham Children’s Hospital, will provide an overview of this topic and address the current advances and updates in its management, including emergency burn care, attenuating hypermetabolism and burn wound management.

Speaker
Miss Elizabeth Chipp, MBChB (Hons), FRCS (Plast)
Consultant Burns and Plastic Surgeon, University Hospital Birmingham and Consultant Burns Surgeon, Birmingham Children’s Hospital
Training Programme Director and Chair, Plastic Surgery Training Committee, Health Education England West Midlands

Current Updates and Advances in the Diagnosis and Surgical Management of Oesophageal Cancers: An Overview for FRCS (Gen Surg)

About
The incidence of oesophageal cancers, affecting half a million people annually worldwide, is rising rapidly. It is the sixth leading cause of cancer-related mortality. Although the overall five-year survival has increased from 4% in the 1970s to about 15 to 20% currently, oesophageal cancer remains a great challenge to treat as the clinical presentation is often late and diagnosis is made at advanced stages. The two key histological types -adenocarcinoma and squamous cell carcinoma - differ significantly in their fundamental patterns of incidence and aetiological factors. The management requires an MDT approach, an assessment of the patient's fitness (for surgery or chemotherapy), and surgery, chemotherapy or radiotherapy, a combination of the three or palliation in cases of metastasis, disseminated disease or recurrence. Locally advanced disease without signs of distant metastases is treated with an intention to cure. This talk, by Mr Christopher Peters, Consultant UGI Surgeon with specialist interest in oesophageal and gastric surgery at the Imperial College NHS Trust, will provide an overview of this topic and address the current advances and updates in the management of oesophageal cancers.

Speaker
Mr Christopher Peters, BSc, MBChB, FRCS (General Surgery), PhD
Consultant in Upper Gastrointestinal and General Surgery
Imperial College Healthcare NHS Trust (St Mary's and the Hammersmith Hospitals), London and The Harley Street Clinic
Honorary Clinical Senior Lecturer, Imperial College London

Update on Current and Novel Oral Anti-Coagulants and Anti-Platelets in Dental Extractions: Precautions, Management and Practical Tips

About
Post-extraction bleeding can lead to significant haemodynamic compromise and morbidity. The complications, occasionally, may even be life-threatening. A variety of anti-coagulants and anti-platelets are currently used in medicine to treat conditions such as atrial fibrillation, cardiac failure, ischaemic stroke, deep venous thrombosis, pulmonary embolism, and peripheral arterial disease. They are also indicated in patients with mechanical heart valves, cancer or gross obesity undergoing surgery. This talk, delivered by both an experienced dental surgeon and a physician, provides an overview of the anti-coagulants (e.g., warfarin, heparin, enoxaparin, dabigatran and rivaroxaban) and anti-platelets (e.g., aspirin and clopidogrel) that are currently used, the types and causes of post-extraction bleeding, haemostatic agents that are currently available, and the recommended guidelines for the management of patients who take these drugs and are undergoing dental extractions.

Speaker
Dr V. Murugaraj, BDS, MFDS RCS (Eng), FFD RCSI (Ire) Oral Surgery with Oral Medicine
Specialty Doctor in Oral and Maxillofacial Surgery
Royal Berkshire Hospital, Reading

Evidence-Based Management of Early Stage and Metastatic Colorectal Cancers: For FRCS (General Surgery) Exam

About
Colorectal cancer is one of the world's deadliest cancers, with almost a million deaths annually. Advances in the pathophysiological and molecular understanding have increased the range of treatment options available, including endoscopic and surgical excisions, downstaging preoperative radiotherapy and systemic therapy, local ablative therapies for metastases, palliative chemotherapy, targeted therapy, and immunotherapy. Although these novel treatment options have doubled the overall survival for advanced disease, survival is still best for those with non-metastatic disease. This talk, by Dr Kai-Keen Shiu, will discuss the rationale behind and the advances in the peri-operative treatment of colonic and rectal cancers, the rationale behind and the advances in the management of operable metastatic disease, and the management of the molecular subgroups. The talk is aimed at surgical trainees at a registrar level and, specifically, those preparing for the FRCS (General Surgery) Exit Exam.

Speaker
Mr Kai-Keen Shiu, MBBS, FRCP, PhD
Consultant Medical Oncologist, University College London Hospitals
Honorary Associate Professor, UCL Cancer Institute

Understanding Tumour Biology to Treat GI Cancers: An Overview for FRCS (General Surgery)

About
GI cancers are common and, depending on the grade and stage, lead to considerable degree of morbidity and mortality. In addition to surgery, chemotherapy, immunotherapy and radiotherapy play vital roles in the treatment of certain advanced cancers. A sound understanding of the cancer/tumour biology is essential in understanding how the cancer behaves at a molecular level and how chemotherapeutic drugs and radiation therapy disrupt the aggressive progression of cancers. Likewise, a clear understanding of the regulatory mechanisms of the immune system will help in ascertaining the role of immunotherapy in selected patients. This talk by Dr Kai-Keen Shiu, a Consultant Medical Oncologist for the Gastrointestinal Oncology Services at the University College London Hospitals, will discuss the epidemiology, staging and tumour biology of GI cancers, as well as the mechanism of action of systemic therapy and radiotherapy. The talk is aimed at surgical trainees at a registrar level and,specifically, those preparing for the FRCS Exit Exam.

Speaker
Mr Kai-Keen Shiu, MBBS, FRCP, PhD
Consultant Medical Oncologist, University College London Hospitals
Honorary Associate Professor, UCL Cancer Institute

Evidence Based Current Management of Salivary Gland Tumours

About
Salivary gland tumours make up about 6% of head and neck tumours. They have a wide range of presentations, with about 80% being benign and the rest being malignant (typically in patients >60 years of age). The diagnosis and treatment of salivary gland tumours remain complex and present a challenging problem for the head and neck surgeon. Surgery is the primary treatment for malignant tumours. This is often combined with postoperative radiotherapy, depending on the specific tumour characteristics and stage. Salivary gland tumours respond poorly to chemotherapy. This talk by Mr J Bernstein, Consultant in Otolaryngology - Head and Neck Surgery at the Imperial College Healthcare NHS Trust, London, will discuss the clinical presentation, surgical anatomy, pathology and the management options of these tumours. Operative ‘tips and pearls’ will also be provided.

Speaker
Mr Jonathan Bernstein, MBChB, MD, FRCS
Consultant in Otolaryngology, Head and Neck Surgery
Imperial College Healthcare NHS Trust, London

Borderline Resectable Pancreatic Adenocarcinomas

About
Pancreatic ductal adenocarcinoma is one of the most lethal cancers worldwide, characterized by poor prognosis and a rising incidence. It is highly destructive due to its particularly aggressive biology, late detection, local and distant spread, and the management challenges it pose. Consequently, it is the fourth most frequent cause of cancer-related deaths worldwide with a 5-year overall survival of <8%. Surgical resection is curative although only about 10-20% of cancers are resectable at diagnosis. Another 20% of patients present with Borderline Resectable Pancreatic Cancer or Adenocarcinomas (BRPC). In this cohort of patients diagnosed with pancreatic carcinomas, it is important to identify patients with BRPC from unresectable disease and recognize the role of oncological treatment modalities to increase the resectability rate and improve the long-term survival.

Speaker
Mr Ricky Bhogal, PhD, FRCS (Gen Surg)
Consultant HPB Surgeon
The Royal Marsden Hospital, London

Brachial Plexus Injury and Management

About
Brachial plexus injuries can have a devastating impact on the affected individual. In adults, brachial plexus injuries can be caused by trauma, stretching or diseases involving the lateral cervical region of the neck, cervical spine or the axilla. The signs and symptoms can range from complete paralysis to varying degrees of motor and sensory loss in the upper limb. It is important for plastic surgeons, orthopaedic surgeons and hand surgeons to understand the essential concepts of brachial plexus injuries and be well-versed with the principles of management of such injuries. The principles covered and the techniques discussed in this talk will be relevant for specialist trainees in plastic surgery, orthopaedic surgery and hand surgery.

Speaker
Mr Samuel George, MBChB, MRCS, MSc, FRCS(Plast.), Dip Hand Surg(Br.)
Consultant (Locum) in Plastic, Reconstructive and Hand Surgery
Queen Elizabeth Hospital, Birmingham and Royal Orthopaedic Hospital, Birmingham

Current Updates in Colorectal Surgery

About
Despite significant scientific developments and technological advances, treatment of colorectal cancers continues to remain a challenge for clinicians. A sound understanding of the pathologies and principles is required when managing complex colorectal conditions. This lecture, delivered by Consultant Laparoscopic, Colorectal and Robotic Surgeon Mr C Selvasekar from the globally acclaimed and reputed Christie Hospital in Manchester, is intended to address the current developments and novel advances in this field. The Christie is the only centre in the UK offering laparoscopic cytoreductive surgery and heated intraperitoneal chemotherapy for suitable patients. The talk will also address the common and important colorectal conditions, their incidence, aetiological factors and the principles of management. Relevant evidence will be highlighted.

Speaker
Mr Chelliah R Selvasekar, MD, FRCS (Ed), FRCS (Glas), FRCSEd (Gen Surg), MBA
Consultant Laparoscopic, Colorectal and Robotic Surgeon
Christie NHS Foundation Trust, Manchester

Tendon Transfers in Upper Limb Reconstruction

About
Tendon transfers are used when there is an unrecovered or irreparable nerve injury or where there is loss of a musculotendinous unit. It is important for Plastic surgeons and Orthopaedic surgeons to understand the principles of tendon transfers and be well-versed with the common tendon transfers used in peripheral nerve injuries of the upper limb. This specialised talk by an UK expert discusses the general principles of tendon transfers in the upper limb followed by the transfers for median, ulnar and radial nerve injuries. The principles covered and the techniques discussed will be relevant for specialist trainees in plastic surgery, orthopaedic surgery and hand surgery. The surgical nuances in the management of pertinent conditions of the hand will also be discussed.

Speaker
Mr Rajive M Jose, MS, MCh, FRCSEd, FRCS(Plast), DiplHandSurg
Consultant in Hand Surgery
Queen Elizabeth Hospital, Birmingham and Royal Orthopaedic Hospital, Birmingham

INTERNATIONAL POSTGRADUATE SURGICAL EDUCATION AND TRAINING Erudition and Postgraduate Surgical Education Delivered by Experts (EPSEDE) Lecture Series 2021-2022