Imran Raza

JSES IllustCon 111 📌Gauze-Made Plane Dissection 📝In laparoscopic sigmoid colectomy, a folded gauze is used to elevate the mesentery with a broad surface, allowing wide and safe exposure of Toldt’s fusion fascia and facilitating rapid dissection. 🖊Desmoplastic reaction classification #JSESイラストコンテスト　#JSES_illustration_contest

The intuition makes sense. Reduce tumor burden, let systemic therapy finish the job. But intuition has a poor track record in oncology. ORCHESTRA just published in JAMA. Phase 3 RCT, 382 patients, multiorgan mCRC. The bar for entry was high. You had to be able to take out more than 80% of disease burden across all sites before randomization. These are the best-case patients. Response or stable disease after 3-4 cycles of CAPOX or FOLFOX, then chemotherapy alone versus chemo plus debulking. Median OS: 27.5 months versus 30.0 months. HR 0.88, 95% CI 0.70-1.10. p = 0.26. PFS essentially identical, 10.4 versus 10.5 months. Serious adverse events significantly higher in the debulking arm, 53% versus 39%. That said, this isn’t the whole story. Symptomatic Krukenberg tumors, oligometastatic disease with curative intent, isolated liver-only disease. Those conversations should still be had. The cytoreductive surgery literature gave us hints this was coming, but the use cases that make biological sense still stand. What changes now? At minimum, “we can get more than 80% of it” is not a sufficient reason on its own. Except in NETs, NETs are weird. jamanetwork.com/journals/jama/… @gutonclab @oncoalert

Just stunning! I'll get my trainees to draw this next time instead of writing an op note

JSES IllustCon 107 📌See the Concept: Illustrated Laparoscopic Sigmoid Colectomy 📝This illustration shows our standard laparoscopic sigmoid colectomy. It marks incision and mobilization directions, outlines the operative flow, and helps surgeons, trainees, and nurses understand each step. 🖊Nakata #JSESイラストコンテスト　#JSES_illustration_contest

Soft tissue sarcomas: recent therapeutic advances, multidisciplinary management, and the centralization of care in high-volume centres to optimize outcomes. Excellent review!!

Identifying novel indicators of non-technical skills derived from operative video annotation ➡️doi.org/10.1093/bjs/zn… 🤖 Can surgical gestures reflect cognitive skills? This study tested whether video-derived gestures can indicate surgeons’ cognitive non-technical skills (NTS). 🎥 Methods: 40 laparoscopic appendicectomy videos analysed (10,385 events; 87,374 data points). Twelve experts rated decision-making and situation awareness using NOTSS. 📊 Results: Mean cognitive NOTSS 5.6/8, with strong correlation between domains (r = 0.8; P < 0.001). Video-derived metrics explained 39.6% of variance in expert ratings. 🚀 Take-home: Cognitive NTS may be inferred from surgical video alone, enabling scalable automated assessment tools. Work by Lachlan Dick, MBChB , Connor Boyle, MBChB , Victoria Ruth Tallentire, MD , Joe Norton, MBBS , Emma Howie, MBChB , Douglas S Smink, MD, MPH , Richard J E Skipworth, MD , Steven Yule, PhD on behalf of , the Surgical Video Grading and Assessment (SVGA) Group #SurgicalEducation #NOTSS #SurgicalAI #SurgicalTraining #SoMe4Surgery #MedTwitter #SurgEd #Surgery @RCPSGTrainees @aecirujanos @SEIQuirurgica @iss_sic #MedicalTechniques @BJSAcademy @young_bjs @BJSOpen @evanscolorectal @robhinchliffe1 @bplwijn @MalinASund @nfmkok @TejedorPat @paulo_sutt @PVaughanShaw @JJEarnshaw @juliomayol @ksoreide #colorectalsurgery #StepUp4CRC @FightCRC @ACPGBI #ERAS @dice_europe #Crohn #proctology @Dukes_Club @ACPGBI_EduTrain @AECP_FAECP @PelvExGroup @escp_tweets @YouESCP #TeachMeColoproctology #Some4COLoprocto

My new website is now live — a dedicated platform for patients seeking expert hernia and abdominal wall care in London. ebiedsurgery.uk

Expert-led free AWR cadaveric masterclass in St Thomas Hospital London in collaboration with medtronic on the 10th April Delighted to invite consultants and senior trainees with an interest in abdominal wall reconstruction to attend @BritishHernia @asgbi @eurohernias

JSES IllustCon 85 📌Ta/Tp PE : Anatomy Through the Perineal Lens 📝At our department, transanal and transperineal pelvic exenterations (Ta PE and Tp PE) are performed by two teams: abdominal and perineal. This illustration shows the right pelvic side from the perineal approach. 🖊Nonaka Yukiko #JSESイラストコンテスト　#JSES_illustration_contest

JSES IllustCon 81 📌D3 Lymphadenectomy with Left Colic Artery Preservation during Laparoscopic Low Anterior Resection 📝By arranging simplified sequential diagrams, I illustrated the key points of D3 lymphadenectomy with preservation left colic artery. 🖊Anonymous #JSESイラストコンテスト　#JSES_illustration_contest

Surgical repair of a ventricular septal defect (hole in the heart) in a child 🤯🙇🏻‍♂️

@IntuitiveSurg congratulations @NNUH @uniofeastanglia for acquiring two more systems and 4 in total for our multispecilty programme.

JSES IllustCon 76 📌Robotic Distal Pancreatectomy: A Visual Guide from Exposure Techniques to Postoperative Complication Prevention 📝This illustration was created with passion by a budding female gastrointestinal surgeon?also the creator of the popular LINE stickers “Shokakigekai-kun.” 🖊Kaoperin #JSESイラストコンテスト　#JSES_illustration_contest

At CMC Vellore, we had one of the most renowned immunology labs in the country.😇 Yet ANA blot was NOT available...🥲 Not because it couldn’t be done but because we were taught something more powerful:😎 “Clinical evaluation first. Order only what will change your decision.” At the time, it felt limiting. Today, I realize it was deliberate training.👩🏾‍🔬🕵🏽‍♀️ Because great clinicians are not made by unlimited panels … they are made by sharp history, careful examination, and thoughtful questions.👩🏾‍🔧 The lab is an extension of your brain. It should never become a substitute for it.👩🏾‍🔬 That philosophy from CMC shaped how I practice today. Bedside before bloodwork. Thinking before ticking boxes. #ClinicalMedicine #MedicalEducation #CMC Vellore #Rheumatology #MedTwitter

Retrospective cohort study of long-term results of LIFT for perianal fistula. Read more in this month's #DCRJournal: bit.ly/4juexS4

Perioperative management of people with diabetes undergoing surgery ➡️ doi.org/10.1093/bjs/zn… 🩺 Diabetes is present in ~7% of UK adults, but affects ~20% of hospital inpatients, and surgical patients with diabetes have higher complication rates, longer stays, and greater costs. 📉 A national NCEPOD review showed major gaps in care: poor preoperative assessment, missing HbA1c data, incomplete medication records, and no clear inpatient diabetes plan in >50% of cases. 🩸 Both hypoglycaemia and hyperglycaemia increase perioperative risk—severe hypoglycaemia raises mortality, while glucose >10 mmol/L is linked to infections and complications. ⚠️ Harm is often preventable and driven by medication errors, insulin infusion misuse, steroid-related hyperglycaemia, and poor communication across the surgical pathway. ✅ Improving outcomes requires perioperative diabetes leads, standardized pathways, better documentation, multidisciplinary care, and national accreditation, with the potential to improve safety and reduce NHS costs. Work by Ketan K Dhatariya #SoMe4Surgery #MedTwitter #SurgEd #Surgery @RCPSGTrainees @aecirujanos @SEIQuirurgica @iss_sic #MedicalTechniques @BJSAcademy @young_bjs @BJSOpen @evanscolorectal @robhinchliffe1 @bplwijn @MalinASund @nfmkok @TejedorPat @paulo_sutt @PVaughanShaw @JJEarnshaw @juliomayol @ksoreide #some4hpb #some4tpl @DPCG_official @pancreatitis_nl @PancreasClub #PancreasClub2023 #PancreaticCancer #Pancreatitis #HCC @PanCAN #PanCANawareness @EurPancClub @P_C_E_ @dice_europe #PancreaticCancer #cholangiocarcinoma #colorectalsurgery #StepUp4CRC @FightCRC @ACPGBI #ERAS @dice_europe #Crohn #proctology @Dukes_Club @ACPGBI_EduTrain @AECP_FAECP @PelvExGroup @escp_tweets @YouESCP #TeachMeColoproctology #Some4COLoprocto #some4UGI #uppergi #esophagealcancer #gastriccancer #reflux @ISDE_net @Augishealth @roux_group @T4UGIS @SARONG_Trial @YoungIFSO #bariatricsurgery

In a 2013 paper, authors at a South African trauma center noted that during the Boston Marathon bombings, the busiest trauma center in Boston only received about half the patients that the South African trauma center gets on 'a typical Saturday'.😬 Note the quotation marks...😳

@CanesDavid The ability to say things directly and with the fewest words is underrated. It shows that a person knows what information is essential. Excess words also hijack some of the cerebral bandwidth of the listener, which is bad for both the speaker and the listener.

JSES IllustCon 65 📌Knack of #223 Lymph Node Dissection 📝Right hemicolectomy is often performed by junior surgeons, but approaches to lymph node dissection vary by institution and surgeon. Here, we present the techniques for right hemicolectomy and lymph node dissection (#223) used in our department. 🖊Higuchi Yudai #JSESイラストコンテスト　#JSES_illustration_contest

Reinforced tension-line suture after laparotomy: long-term results of Rein4CeTo1 randomized clinical trial ➡️doi.org/10.1093/bjsope… The aim of this randomized clinical trial was to investigate whether a reinforced tension-line (RTL) suture reduces 3-year computed tomography-detected incisional hernia incidence. The RTL technique significantly reduced the incidence of incisional hernia compared with the standard facial closure technique in patients undergoing open colorectal cancer surgery. The incisional hernia incidence was 6 of 43 (14%) in the RTL and 21 of 58 (36%) in the standard facial closure group. 👏👏👏Charlotta L Wenzelberg , Peder Rogmark , Olle Ekberg , Ulf Petersson , Carl-Fredrik Rönnow #SoMe4Surgery #MedTwitter #SurgEd #Surgery @BJSAcademy @BJSurgery @eurohernias #hernia #hernia @herniaistanbul @BritishHernia @HerniaIndia @awrsurgeons