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The future of obesity treatment
The International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) has released a consensus position statement addressing the integration of obesity management medications (OMMs) with metabolic bariatric surgery (MBS)1.
Currently, obesity treatment encompasses four primary modalities: lifestyle modification, OMMs, endoscopic bariatric and metabolic therapies (EBMTs), and MBS. The recent introduction of newer-generation OMMs, such as semaglutide and tirzepatide, has sparked a surge in their use and increased awareness of obesity as a treatable chronic disease2,3. While these medications show significant promise, they also have limitations, including non-response rates, potential adverse events, and challenges with long-term adherence.
This position statement is particularly timely, as an increasing number of patients who have tried or discontinued OMMs are now seeking additional interventions to support their weight management or maintenance goals. Furthermore, since not all patients respond optimally to MBS, incorporating adjunctive therapies, such as adding OMMs after surgery, should enhance outcomes.
Widening participation in cardiothoracic healthcare: INSINC Insight
Kirstie Kirkley, Georgia R. Layton, Javeria Tariq, Heen Shamaz, Mostin Hu, Alana Atkinson, Deborah Harrington, Elizabeth Belcher, Jason Ali, Narain Moorjani, Farah Bhatti, Karen Booth
Equality, diversity and inclusion (EDI) within surgery is important.1 The recent Kennedy Review on Diversity and Inclusion, commissioned by the Royal College of Surgeons of England, made 16 recommendations to improve EDI in the surgical workforce.2 Cardiothoracic surgery in the UK lacks diversity, exemplified with only 13% of the consultant workforce being female, despite females accounting for 49% of UK doctors.3 One method of improving EDI in the specialty, is to focus on widening participation (WP) activities.
In the UK, WP activities and government policies aim to increase representation of lower socio-economic groups in higher education. Published schemes focus on peer-to-peer mentorship from medical to school students. The King’s College London scheme is a monthly seminar series offered to WP school students, publishing a 50% success rate of translation to successful application to medical school.4
Comment on: Risk factors and protective measures for desmoid tumours in familial adenomatous polyposis: retrospective cohort study
Davide Serrano, Lucio Bertario
Correspondence to: Dr. Davide Serrano (email: davide.serrano@ieo.it)
Division of Cancer Prevention and Genetics
European Insitute of Oncology
ACPGBI 2024 BJS Prize Session: The empty pelvis syndrome: a core dataset from the PelvEx Collaborative
We are proud to present the BJS Prize session from the Association of Coloproctology of Great Britain & Ireland's 2024 Annual Meeting, which was held 1 July to 3 July in Wales. The BJS prize winner was Charlie West for "The empty pelvis syndrome: a core dataset from the PelvEx Collaborative."
Oesophageal cancer awareness month 2025
Matthew Lee PhD FRCS
It is becoming increasingly common to dedicate days, or even months, to ‘health awareness’. These events should help people to learn about these conditions. From these, we can hope that people might learn about symptoms that help them get a diagnosis, or learn about new treatment options for their conditions. It also provides a focal point where we can come together as a community to recognise those impacted, and find ways to address these serious health conditions. It may even act as a clarion call, moving charities, governments, and individuals, to make efforts to fund and deliver research to further understand and improve outcomes for these conditions.
The BJS Academy, alongside BJS & BJS Open, feel it is an important part of our mission to contribute to these awareness months. So much research is published with enthusiasm, but then resides solely within the pages of a journal (or latterly, as a lonely PDF on a server). It is important to ensure that new information is shared with people who might find it useful. This is particularly important when it comes to conditions which currently have a poor prognosis, or may affect only a small number of people. With this in mind, our team will contribute to the online discussion for disease months by highlighting 2-3 papers from BJS and BJS Open, and sharing them across our social media channels. This will include a short summary and a link to the paper.
This move comes as part of our commitment to sharing key clinical research to support the knowledge of surgeons around the world, and to ensure our patients receive care informed by evidence of the highest possible standard.
How to avoid being sued
Jonothan J Earnshaw DM FRCS
This is part of a series on the medicolegal aspects of surgery, in collaboration with the Association of Surgeons of Great Britain and Ireland (ASGBI), which you can also find on www.bjsacademy.com. This article aims to discuss simple and straightforward ways to avoid you having to make any contact with your hospital legal department. My qualifications for giving this podcast include a 30 year career as a general and subsequently a vascular surgeon. In the last 15 years of my career I started writing expert reports from the perspective of a vascular surgeon on medicolegal cases, which I can tell you was an eye-opener. I have seen many patterns, some of which seem preventable. I hope to be able to communicate some of the things I've learned from the other side of the table.
View from the coffee room…LARPing ChatGPT
Virve Koljonen MD, PhD
LARP, live action role play, is immersive role-playing where participants physically and mentally/emotionally portray their characters, interact in real-world settings, and shape the story through improvisation. There are not many chances for surgeons to LARP during professional hours. Well, other than occasionally LARP internist, when someone asks about medicines.
Medical research and writing have changed after introduction to LLMs, large language models, such as ChatGPT (OpenAI, San Francisco, CA, USA) launched Nov 30, 2022. LLMs employ neural network and have been trained to understand and generate human language and produce human-like responses1.
2024 ACPGBI BJS Lecture: Happy workforce, better surgery
Tamzin Cuming presents her BJS Lecture "Happy workforce, better surgery" at the 2024 Annual Meeting of the Association of Coloproctology of Great Britain and Ireland.
Preventing recurrent Crohn’s Disease after surgery: the Kono-S anastomosis
Michele Cricrì, Antonio Miele, Francesca Paola Tropeano, Giovanni De Palma, Gaetano Luglio
In gastrointestinal surgery, anastomosis plays a crucial role in restoring bowel continuity after resection. However, postoperative complications such as anastomotic leaks, strictures, and disease recurrence, especially in conditions like Crohn’s disease, remain significant challenges. Crohn's disease presents a unique set of difficulties, as disease recurrence often occurs at the anastomotic site, underscoring the need for improvements in surgical techniques to mitigate this issue.1
The failure of biological therapies to control post-surgical recurrent Crohn’s disease has drawn attention to surgical technique as a potential key factor in improving long-term outcomes, particularly the configuration of the anastomosis itself. The Kono-S anastomosis, named after its creator Dr Toru Kono, was specifically developed to reduce recurrent Crohn’s disease and enhance the success of bowel resection.2
This article explores the development, technique, and clinical evidence for outcomes of the Kono-S anastomosis, and how it may shape the future management of Crohn’s disease.
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About
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.