Andy Skovsen

@EzraTeitelbaum @mj_pucci @amber_shada @EricKnauerMD @DissanaikeMD @htjacks 1) Preparation is key 2) “Slow is fast”! Speed comes from precision, not the other way around! 3) Good surgeons know when to operate, better surgeons know how to operate, great surgeons know when not to operate.

This is Demis Hassabis. He’s Google's DeepMind CEO, who’s studied AI for 30+ years. In his new interview with 60 Minutes, he revealed mind-blowing facts about health & AI that 99% of people wouldn’t know. Here are my top 8 takeaways: 🧵 (No. 6 will shock you)

@TopKniFe_B “Breast, endocrine, general, and vascular surgeons were coded as non-GI specialists”… no wonder they found a difference in emergency laparotomies, but it speaks to the way emergency cases are managed very broadly in the UK? @wannabehawkeye thoughts?

What defines a gastro-intestinal specialist ? So many questions right now? Asking for a friend ?

@ross_prager Always made me wonder where the surgeons were, when “Surviving Sepsis” campaign(s) were rolling. Extremely sparse recommendations on the need for source control! #SoMe4Surgery #emergencysurgery #surgery #sepsis

(3/x) The importance of source control. By far, the most common cause of deterioration is a failure of source control. This looks different depending on the site, but here are a few: 1) Pneumonia --> parapneumonic effusion or empyema 2) Urosepsis --> septic stone or obstructive uropathy 3) Wound infection --> abscess 4) Skin Infection --> nec fasc / abscess 5) Intrabdominal Infection --> abscess 6) Bacteremia - endocarditis. Don't miss source control. This is the most common cause of failure to respond to appropriate antibiotic treatment.

(1/x) Here are the top things I think of when a patient with sepsis is worsening despite 'appropriate therapy'. (note: it rarely is that the bug developed resistance..) A 🧵 #medtwitter #foamed

@wannabehawkeye @asgbi @ACPGBI @escp_tweets @JakobBurcharth @EMERGECph BTW, @wannabehawkeye if you want to discuss pitfalls, don’t be a stranger!

@wannabehawkeye @asgbi @ACPGBI @escp_tweets Running an RCT in Denmark! Randomizing between early (day 2) and “late” (day 5) PN. #EATERS #EATERStrial #emergencysurgery @JakobBurcharth @EMERGECph

Great to talk about the TONIC #RCT at #ESCP24 in new trials session A #nutrition trial in the #emergencysurgery setting. Does early PN improve outcomes? Pilot in March 2025, then full trial. Please get in touch if interested. #some4surgery @asgbi @ACPGBI @escp_tweets

@rbarbosa91 @MigsRunner Used “a” fish in South Africa. It wasn’t single use, was thicker, shaped like a fish, worked great. Want to find that product again!

@MigsRunner Dare I bring your attention to how I acquired the fish? 😬😬😬 It…uh…expired. 🙄 I’m not sure exactly what part wears out but you get the point.

🧵regarding the 'Fish' -- officially known as the Glassman viscera retainer. The Fish is an occasionally used surgical tool that is used in abdominal operations during closure of the fascia to cover the bowel, protecting it from being accidentally stuck with the needle. (1/ )

@Neil_J_Smart @wannabehawkeye Gotcha! Then not really. Maybe we should make one!

@apskovsen @wannabehawkeye Apologies we didn't clarify before. Bjorck classification is for open abdomens. We are after one for closed abdomens.

Following conversations with @Neil_J_Smart Does anyone have a good and reproducible definition of 'hostile abdomen'? #SoMe4Surgery

Thanks to @BJSurgery for invitation to contribute to 'Acute threat to life' series with an overview of #sbo, written with @josiewalshaw1 (SBO-ACTION) & @HenryG_Smith (DASBO). Hopefully useful revision material for junior colleagues! #some4surgery doi.org/10.1093/bjs/zn…

@PipeCabreraV Most drains are NOT indicated - they need to know that and the selected few cases, where it is.

Surgical Drains: What the Resident Needs To Know 🪢⚡️!

@rbarbosa91 @EricKnauerMD @EzraTeitelbaum @DouglasAdlerMD @mj_pucci @MBosleyMD @cutitoutPODCAS1 @amber_shada @JRTriggs @AhsunR T-tubes are still being made and distributed (Europe).

@EricKnauerMD @EzraTeitelbaum @DouglasAdlerMD @mj_pucci @MBosleyMD @cutitoutPODCAS1 @amber_shada @JRTriggs @AhsunR *if T-tubes still exist Apparently not currently being made (?)

WWYD?? Patient presenting with abdominal pain, bilirubin 3, CT w gallstones and 12 mm CBD stone (arrow). History of open distal gastrectomy and Roux-en-Y reconstruction for ulcers. @DouglasAdlerMD @EricKnauerMD @mj_pucci @MBosleyMD @cutitoutPODCAS1 @amber_shada @JRTriggs @AhsunR

@EricKnauerMD @rbarbosa91 @VNikolian @CPark_MD @ericpaulimd @SAGES_Updates @RScott571 @TWorrest @mj_pucci … and a (WHO) surgical checklist pre-incision

@apskovsen @rbarbosa91 @VNikolian @CPark_MD @ericpaulimd @SAGES_Updates @RScott571 @TWorrest @mj_pucci That seems fine as long as everyone is on board with that system. NO upside down is ON

What is your hospital policy regarding surgical site marking. (Who does it, where is mark, what is mark, etc). Have a great weekend! @VNikolian @rbarbosa91 @CPark_MD @ericpaulimd @SAGES_Updates @RScott571 @TWorrest @mj_pucci

@EricKnauerMD @rbarbosa91 @VNikolian @CPark_MD @ericpaulimd @SAGES_Updates @RScott571 @TWorrest @mj_pucci No, just mark near surgical site with an X and initials.

@rbarbosa91 @VNikolian @CPark_MD @ericpaulimd @SAGES_Updates @RScott571 @TWorrest @mj_pucci Do you include a “yes” at the surgical site. How about a “no” at the contralateral non-operative site. Yes, you should not have to mark things such as an umbilical hernia, or chole.

@EricKnauerMD @rbarbosa91 @CPark_MD @VNikolian @FilipinoSurgeon @RScott571 @Mike_TruittMD @SAGES_Updates @MISIRG1 @Cirbosque @EdLinEmory @ericpaulimd Full feeding immediately postop. No drains. Lap repair can sometimes be discharged on day 2.

How long after repair of a small perforated peptic ulcer do you keep pt NPO? UGI before diet? @rbarbosa91 @CPark_MD @VNikolian @FilipinoSurgeon @RScott571 @Mike_TruittMD @SAGES_Updates @MISIRG1 @Cirbosque @EdLinEmory @ericpaulimd youtu.be/mYSiOKuFfWY?si…

@jakobmelgaard Jeg ser ikke lige behovet?

@apskovsen Og han er jo ganske cool, men Wozzy!!!

Vi skal huske at hylde vores helte! Og hvis Basel kan få en Roger Federer-sporvogn bare fordi han engang har vundet Australien Open, skal vi så ikke også have en Caroline Wozniacki-letbane? #Wozniackipåtoget

@ericpaulimd Thanks for providing a cheat sheet! I was worried about passing my next e-learning on hand washing! 😂😜

Everyone!! Everyone!!!! I passed the mandatory hand washing module my university requires!!! I only need 80% but I ACED it. All those years of hand washing have really paid off for me.

@rbarbosa91 @elliotthaut @estesonline Technical skills aren’t very easy to evaluate objectively. See this study for instance: jamanetwork.com/journals/jamao…

@elliotthaut @estesonline If you think about it, technical skills aren’t evaluated in applicants. Selection for residency is essentially almost entirely based on prior demonstration of non-technical skills as you’ve listed. The technical part comes later. 🤷‍♂️

What do non-technical skills in surgery mean to you? I need answers in next 24 hours for my talk at @estesonline conference. #ECTES2024 #ECTES24 #SurgTweeting #SoMe4Surgery

@AndreasLundh2 Jeg kunne ikke få filet mignon serveret da min hustru fødte. Mon @larsgaardhoj også mener, at der på sigt skal tages hensyn til det??

Still 10 days left to apply! Would you like to learn from stellar teams of @BJSurgery / @BjsOpen / @BJSAcademy? Is there something you would like to bring to the table of academic publishing? This is YOUR chance!