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The annual Presidential Address of the Section of Surgery, of the Manchester Medical Society, was held on Tuesday 14th October 2003 at 8.00 pm in Chancellors Conference Centre, University of Manchester. Mr Nicholson, the outgoing President, introduced the incoming President, Mr M E Lambert, to the audience (Consultant Surgeon, Fylde & Wyre Hospitals NHS Trust) and wished him a successful year of office as he handed over the Presidential Medallion. Mr Lambert gave his presidential address entitled:- "The bigger the better" This was a tour de force of medical curiosities that included giant lipomas, extra ears, disappearing feet, foreign bodies small and large, massive bezoars, huge ovarian cysts and spleens, not to mention penile pathology in various forms. The lecture gave us an insight into Mark as someone who thoroughly enjoys his work sees and is a great observer of life. His archive of medical pictures is a reminder of how general General surgery used to be and the fact that many current trainees will sadly not experience the same variety of pathology in their careers. The traditional Presidential Dinner was held before the lecture in honour of Mr Lambert which took place in Chancellors Restaurant at 6.30 pm. A number of members and guests enjoyed a splendid meal and took the opportunity to mingle with old acquaintances and to make new ones.
The second meeting of the Section of Surgery of the Manchester Medical Society, took place on Tuesday 11th November 2003 at 8.00 pm at Chancellors Conference Centre, University of Manchester. Mr M E Lambert, President of the Section, was in the chair and introduced the speaker for the evening Mr B Hancock (Honorary Consultant Surgeon, South Manchester University Hospitals NHS Trust and Fistula Surgeon in Africa). Mr Hancock spoke on "Surgical repair of childbirth injuries in Africa". He began by showing a video that illustrated the techniques of repair of vesico-vaginal fistula and the difficulties that this problem gave to the women of Africa. The injuries are thought to be brought about by ischaemic pressure of the baby’s head impacting in a small pelvis against the vagina and bladder. This left these young women as outcasts in their society as they were continually leaking urine. Mr Hancock detailed several visits he had made to different parts of Africa over the past thirty years and illustrated different approaches to the treatment of this problem, in particular those brought about by the Hamlins in Addis Ababa and the Dutch surgeon, Kees Waaldijk, in Northern Nigeria. By observing and working with these surgeons he developed his own approach to this problem. Members of the Society were amazed by the very basic facilities that were available for carrying out quite complex surgery and impressed by the dedication of the people involved. For four years from 1999 in Uganda, Mr Hancock had made twenty two visits to carry out three hundred and forty one operations of which forty three were re-do procedures. His arrival at the hospital was notified on the local radio and a queue of women would be waiting. He illustrated the different varieties of vesico-vaginal fistula and the importance of preservation of the urethra in terms of the functional outcome. He gave details of his results with 84% of women being dry post-operatively. He finished by emphasising the opportunities for training of young surgeons in Africa and other third world countries and hope that this would be encouraged. A vote of thanks was given by Mr Lambert. An informal dinner was held prior to the meeting in honour of Mr Hancock, in Chancellors Restaurant, when he was joined by members and guests of the Section.
A meeting of the Section of Surgery of the Manchester Medical Society, took place on Tuesday 9th December 2003 at 6.30 pm at Chancellors Conference Centre, University of Manchester. The recipient of the 2001/2002 Kenneth Bloor Memorial Fund Travel Scholarship, Miss Shirley Fearn, gave us an enthralling insight into the developments within vascular surgery which she had experienced on her travels in Quebec, Perth and Sidney. She showed us examples of laparoscopic approaches to the aorta and of endovascular stenting and grafting in the carotid and other major vessels. This was clearly an exciting time to be involved in vascular surgery and members of the Section were delighted to see that the Kenneth Bloor Fund had been put to such good use. The President, Mr Lambert, then introduced five distinguished local surgeons who were to try and persuade us of the merit of their particular specialist field of surgery. The evening was aimed at trainees who had yet to make a choice but the audience was also invited to choose which speaker had been most persuasive. Mr Neil Hulton (Vascular Surgeon, Oldham NHS Trust) needed to say little to persuade us of the merits of 'vascular surgery' following Miss Fearn’s presentation. Nonetheless, he emphasised the fact that the surgery was not limited to one part of the body, that the immediate results were gratifying and that on call work was becoming easier with larger groups. Mr Jim Hill (Lower GI Surgeon, Central Manchester and Manchester Children’s University Hospitals NHS Trust), speaking for 'colorectal surgery', began with a tongue in cheek demolition of the other specialties. Breast surgery meant only being able to work on women. Upper GI surgery was associated with poor outcomes for cancer. General surgery was for dinosaurs. This left colorectal surgery where one could treat all age groups with a variety of different pathologies from genetic, functional and inflammatory to neoplastic. Undoubtedly this was a convincing argument. Mr Andy Baildam (Breast Surgeon, South Manchester University Hospitals NHS Trust) pointed to the reduction in mortality obtained for breast disease in this country by the changes that have been brought about only in the past twenty years. He felt there were an enormous number of challenges for surgeons in this field involving reconstruction, oncoplastic surgery and different forms of mastectomy. He illustrated this with a series of pictures. He showed that the training was good and that 'breast surgery' had moved on from where most of us remember it. Mr William Brough (Upper GI Surgeon, East Cheshire NHS Trust) gave an expected robust, not to say prejudiced, view of why 'laparoscopic surgery' would take over the worked. He described laparoscopic surgeons as the wolf in sheep’s clothing who were out to steal other people’s operations. He felt it had the great merit that this would avoid boredom particularly after the age of fifty. It gave the opportunity to do challenging surgery and break new frontiers. There were opportunities for plenty of research and international travel. He could not imagine why everybody was not doing it and felt that Manchester was sadly lagging behind. Mr Rob Watson (General Surgeon, Blackburn, Hyndburn, and Ribble Valley Health Care NHS Trust) appeared last but not least. He demystified titles of the other specialties for us. Vascular surgeons were really interventional radiologists. Breast surgeons were dermatologists. The upper GI surgeons and laparoscopists were in fact general surgeons with a tool and colorectal surgeons were not really sure what they were. He was sure that emergency surgery would be the saving of 'general surgeons' and that whereas anyone could train to be a specialist in a short time, to be a general surgeon would take longer and thus they would need to be paid more. He assured us that general surgeons would undoubtedly come back. His presentation was overwhelmingly thought to be the most convincing which earned him the right to buy a round of drinks for us all. The meeting was followed by a wine reception and then the annual dinner, which took place in Chancellors Restaurant. Members and guests joined the speakers and an excellent, sociable evening ensued.
The first meeting of the New Year for the Section of Surgery, of the Manchester Medical Society, was the Michael Boyd Memorial Lecture. It took place on Tuesday 13th January 2004 at 8.00 pm in Chancellors Conference Centre, University of Manchester. Mr S Watson (Consultant Plastic Surgeon, South Manchester University Hospitals NHS Trust) was introduced to the audience by the President and then gave the Michael Boyd Memorial Lecture entitled:- ‘Blood supply to skin: clinical
applications of He traced the history of flaps starting with the description in 1897 by Tanzini, Professor of Surgery at Naples, of the latissimus dorsi flap to cover a large defect resulting from mastectomy. Somehow this innovation appears to have been forgotten until the late 60s. Up to then, pedicle grafts remained the principle form of tissue transfer. He showed several examples of this staged procedure, which was fraught with problems and had uncertain results. In the late sixties the concept of the axial flap based on a source vessel and the development of microsurgical techniques widened the choice of tissue transfer. He then took us through fascinating examples of myocutaneous and faciocutaneous flaps. He related the painstaking work of Taylor who had mapped out the blood supply of the entire skin covering of the body, identifying 374 perforators each supplying what he calls an angiosomes. He finished by describing recent developments including distally based flaps and the ability to use veins for arterial inflow and arteries for venous outflow in tissue transfers. An informal dinner was held prior to the meeting in honour of Mr Watson, at Chancellors Restaurant, where he was joined by members and guests of the Section.
A meeting of the Section of Surgery of the Manchester Medical Society took place on Tuesday 10th February 2004 at 8.00 pm in Chancellors Conference Centre, University of Manchester. The President of the Section, Mr M E Lambert introduced the speaker for the evening, Mr I Robertson TD OBE QHP DL (Brigadier in the Territorial
Army & Consultant Gynaecologist, who gave a lecture entitled "Medical care for War". He started by describing the logistics of providing medical support for the Iraq war. 2800 medical personnel were mobilised at short notice to support 467000 British troops, with complete field hospitals being set up in a very short space of time. Medical care provided at the frontline was basic but became increasingly more sophisticated towards base. ATLS principles were practised and initial surgical management was in the form of damage control surgery. The aim of this was to staunch bleeding to enable the casualty to be transported to base where definitive surgery was carried out after a period of stabilisation. Facilities in field hospitals included CT scanning and intensive care. The elite fighting unit, the paras even travelled in their own plane quipped with an operating theatre and their own surgeons! Burns and limb trauma were the main injuries and there was a 60% survival from battlefield injuries. He illustrated his lecture with many examples of injuries that could not have been better managed in the NHS. Lessons learnt included the value of training together during quiet periods and availability of laboratory support. All in all, the whole exercise was a tribute to British troops and the medical support they were given, in many cases by personnel from the Territorial Army. A lively question and answer session followed and Mr Trevor Farrington gave a vote of thanks to Mr Robertson for his excellent lecture. Prior to the meeting, an informal dinner was held in honour of Mr Robertson at Chancellors Restaurant.
A meeting of the Section of Surgery of the Manchester Medical Society, took place on Tuesday 30th March 2004 at 8.00 pm in Chancellors Conference Centre, University of Manchester. Mr M E Lambert, President of the Section, chaired the meeting and introduced the speaker for the evening, Dr S P J Reid. Dr Reid has been in general practice in Lytham for 24 years following a variety of hospital jobs in his other aspects of interests in obstetrics and surgical positions. That evening he gave a lecture entitled :- "The anatomy of Doctor Tulp" The title refers to a painting of Rembrandt’s depicting Dr Tulp demonstrating by dissection anatomy to worthies of Amsterdam. Dr Reid had made a detailed study of the painting and in an erudite lecture, exposed various facets of this painting – what it told us about Rembrandt, Dr Tulp, some of the attendants and what exactly Dr Tulp was explaining about the flexors of the forearm. He also discussed how the emerging knowledge of anatomy lay uneasily side by side with religion. The audience was enthralled by Dr Reid’s mastery of the subject and the way in which he conveyed it in the lecture. There followed a lively discussion and Mr David Jones gave a vote of thanks. Prior to the meeting, members and guests of the Section attended an informal dinner held in honour of the speaker in Chancellors Restaurant. This offers not only a delicious choice of a three-course menu but also the opportunity to network and socialise with old friends and new.
The final meeting of the 2003/2004 session for the Section of Surgery, of the Manchester Medical Society, took place on Tuesday 27th April 2004 at 6.30 pm at Chancellors Conference Centre, University of Manchester. The President, Mr M E Lambert, was in the chair and introduced the enthusiastic trainees along with the titles of their presentations as follows:- A Halka Rowena Sheldon Sarah Duff Tass Malik Claire Nockolds For the third year running, the audience participated by evaluating the presentations and recording their opinions on a scorecard. The results would be tallied at the end of the meeting and compared with the adjudicating panel. All five presenters were thanked immensely by the President for presenting and sharing their knowledgeable studies. He also gave a special thank you to the audience for participating in the marking process and informed them that the winner would be announced during the meal to follow, which was being held in Chancellors Restaurant. Although all papers were of a very high standard and capable of winning the prize, the scores and debate were in favour of Rowena Sheldon, who was awarded the cheque of £250.
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MANCHESTER
MEDICAL SOCIETY
