Sarah Krishnanandan

Operative Surgery Vivas for the MRCS: Amputation (below knee)

What are the indications for limb amputation? Which is the commonest in the UK? Lower limb ischaemia secondary to atherosclerosis and/or diabetes is by far the commonest indication for amputation in the UK Trauma which is the commonest indication in the Third World Infection Malignancy Congenital deformity What types of lower limb amputation do you know? Hip disarticulation or hindquarter amputation Transfemoral or above knee amputation (AKA) Through knee amputation Transtibial or below knee amputation (BKA) Through ankle or Symes amputation Partial foot amputations What pre-operative measures should be taken? This is an entirely multidisciplinary process. All the members of the team (physiotherapy, occupational therapy (OT), rehabilitation specialist, prosthetic specialist, nursing staff, psychologists as well as the surgeon) must be involved and if possible meet the patient prior to surgery. The level of amputation must be decided upon. This depends on the patients “rehabilitation potential”, degree of tissue compromise, and severity and pattern of the vascular disease. Finally a careful anaesthetic assessment is made, bearing in mind that these patients may have atherosclerosis affecting their renal, coronary and cerebral vasculture as well as other co-morbid factors such as hypertension and diabetes. They may even be heavy smokers with associated pulmonary compromise. Name two common techniques used for a BKA Long posterior flap (the Burgess and Romano technique) Skew flap How do you perform a BKA? Position This is supine with the affected leg in a knee-flexed position.

Operative Surgery Vivas for the MRCS: Frontmatter

This is a comprehensive study manual for the operative surgery section of the MRCS examination. This unique text is set to the level of a basic surgical examination and the material is discussed in easy to access, simple and informative manner. The A–Z format means topics appear at random, mirroring the nature of the examination. For each operative procedure the basic principles, applied anatomy, indications and complications are discussed alongside an overview of technique. Frequently asked examination questions and practical tips for giving the fullest answer for the most marks are also included. Care has been taken to ensure compatibility with all UK syllabuses, and inclusion of material required for equivalent examinations internationally. This manual is an excellent source of information for use during personal study and self-testing, and as a teaching aid.

Operative Surgery Vivas for the MRCS: Contents

This is a comprehensive study manual for the operative surgery section of the MRCS examination. This unique text is set to the level of a basic surgical examination and the material is discussed in easy to access, simple and informative manner. The A–Z format means topics appear at random, mirroring the nature of the examination. For each operative procedure the basic principles, applied anatomy, indications and complications are discussed alongside an overview of technique. Frequently asked examination questions and practical tips for giving the fullest answer for the most marks are also included. Care has been taken to ensure compatibility with all UK syllabuses, and inclusion of material required for equivalent examinations internationally. This manual is an excellent source of information for use during personal study and self-testing, and as a teaching aid.

Operative Surgery Vivas for the MRCS

This is a comprehensive study manual for the operative surgery section of the MRCS examination. This unique text is set to the level of a basic surgical examination and the material is discussed in easy to access, simple and informative manner. The A–Z format means topics appear at random, mirroring the nature of the examination. For each operative procedure the basic principles, applied anatomy, indications and complications are discussed alongside an overview of technique. Frequently asked examination questions and practical tips for giving the fullest answer for the most marks are also included. Care has been taken to ensure compatibility with all UK syllabuses, and inclusion of material required for equivalent examinations internationally. This manual is an excellent source of information for use during personal study and self-testing, and as a teaching aid.