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Preventing recurrent Crohns Disease after surgery: the Kono-S anastomosis
These avatar-based videos have been created via AI to summarise the key content of the article, with the authors' permission. This is a trial, and we would appreciate your feedback on whether you find them a useful addition to the publication.
Please note that these videos are for informational purposes only and do not constitute medical advice. Viewers should consult their own doctors for any medical concerns.
Cast your vote: ‘A surgical problem I helped manage on a plane, boat or train’ essay competition
We invited medical students and trainees to share their most memorable experiences managing surgical problems while in transit — on planes, boats or trains. Now, it’s your turn to decide the winner.
Read the entries and cast your vote by clicking the thumbs-up icon next to your favourite:
A surgical challenge on the evacuation train
Georgios Karagiannidis MBBS, MRCS, AFHEA
I was on holiday in Greece when news broke that a wildfire had erupted northeast of Athens, rapidly approaching the small town of Varnavas. On the morning of 12 August 2024, the skies were already heavy with smoke, and the wind carried an ominous, ash-laden warmth. I had planned a brief train trip north to admire the countryside, but instead, I found myself in the midst of an emergency evacuation, with local authorities urging everyone to board trains heading away from the fire zone.
I was ushered onto a crowded carriage filled with anxious families, many clutching their belongings in small bags. The train began rolling slowly southward, but before long, the atmosphere grew tense and unsettling. Amid the chaos, a frail-looking older man, who had been coughing incessantly, suddenly collapsed in the aisle. I identified myself as a doctor (the only medical personnel on board) and rushed to his side.
When I knelt down, I noticed a small wound on his arm. He must have brushed against jagged metal or broken glass during the hurried boarding. He was also breathless, appearing to verge on shock. Quick assessment revealed that in addition to the laceration on his forearm, he might be suffering from inhalation of smoke or an exacerbation of a chronic lung condition.
Everyday emergencies: “It’s the journey that matters”
Ayesha Unadkat
We often hear "It’s the Journey That Matters," but this took on new meaning for me one evening on a train. I realised surgical problems begin long before the first incision—sometimes in the everyday moments, often unnoticed.
It had been a long day, my mind cluttered with unread emails as the train hummed on. Suddenly, a shopping bag slipped from an elderly woman’s hand, spilling groceries. She barely reacted, staring at her hand as her grandson scrambled to collect the items. “Nan, you dropped everything!” he laughed, but she didn’t respond. Her eyes met mine, blinking as if clearing a fog. Her voice, slow and slurred, murmured, “Sorry, I just feel a little off”. Something felt wrong. This wasn't mere clumsiness but a silent alarm bell, a surgical emergency unfolding amidst the mundane.
Introducing myself, I gently inquired about her symptoms. "Can you raise your arms?" I asked. Her left arm wavered; the right remained motionless. Her history, reluctantly revealed, included a recent ‘tumble’, a detail she'd dismissed as trivial. My mind raced—could this be a stroke? An intracranial haemorrhage? The "FAST" mnemonic, a staple of stroke diagnosis, flashed through my mind: Facial droop, Arm weakness, Speech difficulties, Time to call emergency services. Without scans or senior clinicians, what was once just a memory aid from a lecture now felt very real. If this was a neurosurgical emergency, ‘Time’ was critical.
High stakes on a plane
Oliver Kooseenlin
I was sleeping on a flight and I am woken by a flight attendant asking a man in the opposite row “are you sure you’re OK?”
He was hyperventilating and complaining of chest pain. When the flight attendants started to bring out medical equipment from a locker, a curiosity spark lit up. I never experienced a medical emergency on a flight since graduating. I assisted a passenger on a train before, but never in the air.
I introduced myself, informed them I was training to become a surgeon and tried to get a brief history. I had no idea where to start. I asked, with little confidence, if there was any emergency kit? The crew proceeded to show me vials of adrenaline, an airway kit, an oxygen cylinder and plasters. The patient had low sats, so I went through my A to E in my head – thinking of my recent CCrISP -, putting on oxygen as we moved onto C and D, asking the cabin crew to be my “scribe” for the findings. A whirl of surgical differentials started spinning in my head when examining the abdomen. Could this be a pneumothorax, would he need a chest drain? Is this a perforation needing urgent intervention. Is this an episode of pancreatitis triggered by one too many in the bar pre-flight?
Volatile versus intravenous anaesthesia for oesophagectomy: addressing confounding factors and temporal trends in clinical practice
Shuting Yin
Correspondence to: Shuting Yin (e-mail: yin13938214200@163.com)
Department of Education and Sports
Zhengdong New District
A view from the coffee room...How to retire gracefully: 10 commandments for surgeons
Dhananjaya Sharma, MBBS, MS, PhD, DSc, FRCS, FCLS (Hon), FRCST (Hon)
Retirement is a major transition for any professional, but for surgeons, it is particularly complex. The identity, purpose and intense commitment associated with surgical practice make stepping away from the operating room both a psychological and logistical challenge. To ensure a smooth transition, surgeons must plan their exit strategy. Here are 10 commandments for retiring gracefully from surgical practice:
The key to a seamless retirement is early and thoughtful planning. Ideally, this process should begin 5–10 years before retirement. This period allows time for assessment of financial security, professional succession planning, and gradual disengagement from clinical duties. Developing a timeline ensures that retirement is a proactive decision rather than a reactive necessity due to declining health or external pressures. Such planning is the key to a graceful landing in the post-retirement life.
Financial security is crucial to a stress-free retirement. Surgeons should work with financial planners to evaluate their savings, investments and retirement benefits. Diversifying income sources—such as pensions, savings, and passive investments—ensures stability.1It is also wise to consider medical insurance coverage post-retirement, and planning to safeguard wealth for future generations.
Comment on: Parathyroid vascular anatomy using intraoperative mapping angiography: the PARATLAS study
Rajni K Sah, Sabaretnam Mayilvaganan
Correspondence to: Sabaretnam Mayilvaganan (drretnam@gmail.com)
Additional Professor
Department of Endocrine Surgery
Inflammation in tissue regeneration and vascular disease
Listen into to Katherine Gallagher's lecture "Inflammation in tissue regeneration and vascular disease".
This lecture is presented as a part of our 2025 vascular series in conjunction with lectures recorded at the 2024 Vascular Society of Great Britain and Ireland Annual Scientific Meeting.
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BJS Academy is an online educational resource for current and future surgeons. It serves as the home for all things relating to the BJS Foundation as well as produces content, both original and in conversation with material published in the BJS Journals.
BJS Academy was founded as a part of the charitable activity of BJS Foundation, which owns and operates the following.
A celebration of excellence in surgical science, the BJS Award recognises a discovery, innovation or scientific study that has changed clinical practice. Awarded every two years, this international accolade gives an exceptional individual the recognition they richly deserve.
Academy content is comprised of five distinct sections: Continuing surgical education, Young BJS, Cutting edge, Scientific surgery and Surgical news.
BJS Institute provides formal certified online surgical courses to surgeons in training and established surgeons who wish to develop their skills in surgical writing and publishing.
Championing a Partners collaborative approach, the Foundation offers two levels of partnership, each with their own unique benefits.