The James IV Association of Surgeons was founded in 1957 by three distinguished surgeons: William Hinton (United States), Ian Aird (England) and John Bruce (Scotland). The aim of the association is to foster exchange of knowledge among surgeons in the English-speaking world. This has been accomplished by annually selecting surgeons who have each spent a month to six weeks traveling and exchanging surgical knowledge.
My trip in 1981 started in London at the Royal Postgraduate Medical School in Hammersmith. I watched Mr Spencer perform a proximal gastric vagotomy (PGV) using the intraoperative Grassi test. The demonstration of converting an area of low mucosal pH to a higher pH by the sectioning of a high posterior vagal branch was impressive.
At Hammersmith, they have mirrors on the operating lights, allowing visualization of the operative field by the junior houseman holding the retractor.
Professor Blumgart's liver unit had three patients awaiting operation