‘‘Twas the Night before Christmas….”

‘Twas the night before Christmas, and in the big house,
Not a creature was stiring, not even a mouse,
The surgical team, and anaesthetist too,
Sat quiet in the mess, with the theatre crew. Foundation Trainees , all snug in their beds,
Core trainees playing pool, yellow V Reds,
Registrar reading, F.R.C.S text,
Consultant at home, can you guess what comes next?

The Appendix:

It’s existence was discovered in 1506,
Given the name, the caecal appendix,
Vermix by others, or vermiform process,
Latin for ‘worm like’, but we’re starting to digress; It measures on average, 9 centimetres,
Widest at tip, towards it’s neck down it peters;
Mesentery contains appendicular vessel,
Clip, tie or fry it, at appendix base level;

EPONYMS:

Morrison’s pouch, sphincter of Odi,
Langer’s lines, cover the body,
Virchow’s triad, virchow’s node,
Scarpa’s fascia, should it be sewed?

1/7 #SurgEd Angle of Louis, McBurney’s point,
Foramen of Winslow, Charcot’s joint,
Auerbach's plexus, keeps the gut well,
The long thoracic nerve of Bell,

2/7

The Inferior mesenteric, artery’s course,
Starts at the aorta, the original source,
Originates at, the level of L3,
At the inferior edge, of the 3rd part of Dueee…; Supplies splenic flexure, to upper rectum,
Of the three splanchnic vessels, this is the small one,
Keeps hind-gut alive, the proctologist’s chum,
Friend of that strange bunch, who work on the bum;

The makings of a surgeon…
Prize if you can name all four. 👍

What makes a surgeon, as good as they can be,
Technical prowess and dexterity?
A sympathetic smile, and good bedside manner?
Mechanical mind? Being good with a spanner?

1/4 An eagle’s eye, at least at the start,
The hand’s of a lady, a lion’s heart?
Decision making, thoughtful with care,
Acceptance of failure, hopefully rare,

2/4

Superior Mesenteric Artery:

The SMA is the next of the splanchnic vessels,
Leaves aorta at L1, to it’s right SMV nestles,
Drops anteroinferiorly behind the neck of the pancreas,
Occlusion up here makes the whole small bowel gangrenous; It’s branches are many, we’ll start from the top,
Pancreas gets a branch, acts as coeliac trunk prop,
Inferior pancreatico duodenal artery,
Adds to the pancreas and duodenal symphony;

Recall of gut anatomy wanes and waxes,
So let’s quickly recap the coeliac axis,
The first of three vessels to supply the intestine,
The content of these vessels normally fluid and sanguine;

#SurgEd @roux_group #SoMe4Surgery @ASiTofficial Arising from the aorta, at the level of T12,
From beneath the arcuate, into the abdomen it does delve,
Enters lesser sac, then divides into three,
At the upper border of ‘The Queen’, like an inverted tree;

My take on teamwork in healthcare…for what it’s worth. 😄#SurgEd

Ada from Lincoln, 4 score years and seven,
Had lived a good life, she was destined for heaven,
Developed a pain, down in her left groin,
Decided to fight, that it wasn’t her time; Called up her practice to book an appointment,
They listened intently, suggested some ointment,
Explained ‘if things get worse, call 999’,
They couldn’t see her, just didn’t have time;