Search

Background: Published data in the last decade showed that a majority of adrenal operations are done by surgeons performing only one such case per year and based on the distribution of personal workloads 'high-volume' surgeons are defined as those doing 4 or more cases/year. Purpose: This paper summarises literature data identified by a working group established by the European Society of Endocrine Surgeons (ESES). The findings were discussed during ESES-2019 conference and members agreed on a consensus statement. Results: The annual of adrenal operations performed yearly in individual countries was reported to be 800/year in UK and over 1600/year in France. The learning curve of an individual surgeon undertaking laparoscopic, retroperitoneoscopic or robotic adrenalectomy is estimated to be 20–40 cases. Preoperative morbidity and length of stay are more favourable in high-volume centres. Conclusion: The main recommendations are that adrenal surgery should continue only in centres performing at least 6 cases per year, surgery for adrenocortical cancer should be restricted to centres performing at least 12 adrenal operations per year, and an integrated multidisciplinary team should be established in all such centres. Clinical information regarding adrenalectomies should be recorded prospectively and contribution to the established EUROCRINE and ENSAT databases is strongly encouraged. Surgeons wishing to develop expertise in this field should seek mentorship and further training from established adrenal surgeons. [ABSTRACT FROM AUTHOR]

Introduction: Health-care workers are subjected to various occupational hazards within the National Health Service (NHS). Surgeons are not excluded from this group due to the nature of work carried out on a daily basis. As a result, we set out to investigate the common work-related health issues a surgeon practising in the UK may encounter. Method: A literature search conducted on PubMed, EMBASE, MEDLINE® and Health Management Information Consortium (HMIC) revealed 66 literature papers between the years 1990 and 2013. Thirty-seven were excluded from our review process for various reasons. Results: Surgeons in the UK are likely to be susceptible to stress, sharp injuries, burnout and psychiatric morbidities, substance abuse and musculoskeletal pain. Noise-induced hearing loss has been reported amongst orthopaedic surgeons due to the use of electric and air-powered drills and saws. No reports of skin-related illness, respiratory illness, nosocomial infections or malignancies were found within the published UK literature of our targeted group although they have been noted in other specialties. Conclusion: These occupational hazards pose a huge risk to the NHS and the personal well-being of its surgeons. As such, the importance of early awareness and education alongside prompt intervention is duly emphasized. [ABSTRACT FROM AUTHOR]

Aim: This review aims to outline the delivery of liver transplant services in the UK. Background: Liver transplantation in the UK is based on seven designated transplant units serving a population of just over 60 million people. Nearly 900 liver transplants were done in 2013/2014. Process: Potential deceased donors are identified and referred to centrally employed specialist nurses for obtaining family consent and for donor characterisation. Organs are retrieved by a National Organ Retrieval Service, based on seven abdominal and six cardiothoracic retrieval teams providing a 24/7 service which has shown to be capable of retrieving organs from up to ten donors a day. Donated organs are allocated first nationally to those who qualify for super-urgent listing. The next priority is for splitting livers, and if there is no suitable recipient or the liver is not suitable for splitting, then livers are offered first to the local centre; each centre has a designated donor zone, adjusted annually to ensure equity between the number of patients listed and the number of donors. The allocation scheme is being reviewed, and national schemes based on need, utility and benefit are being assessed. Governance: Outcomes are monitored by National Health Service Blood and Transplant (NHSBT), and if there is a possibility of adverse deviation, then further inquiries are made. Outcomes, both from listing and from transplantation, are published by the centre on the NHSBT website (). NHSBT works closely with stakeholders primarily through the advisory groups with clinicians, patients, lay members and professional societies and aims to provide openness and transparency. Conclusions: The system for organ donation and delivery of liver transplant in the UK has developed and is now providing an effective and efficient service, but there remains room for improvement. [ABSTRACT FROM AUTHOR]