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- •Acknowledgements
- •Foreword
- •Contents
- •Preface
- •Recognition of the Sick Patient
- •Shock and Organ Perfusion
- •Outcomes of Resuscitation
- •Investigations
- •Fluid and Electrolyte Replacement
- •Haematological Therapy
- •Coagulopathy
- •Antibiotics
- •Emergency Laparoscopic Surgery
- •Approach to Traumatic Abdominal Pain
- •Ancillary Investigations in the ED
- •Indications for Referral
- •References
- •Risk Factors for Surgery
- •Postoperative Care
- •Intensive Care/High Dependency
- •Sepsis Syndromes
- •Acute respiratory distress syndrome(ARDS)
- •Blood transfusion and blood component therapy
- •Postoperative Oliguria
- •Renal Replacement Therapy (RRT)
- •Abdominal compartment syndrome (ACS)
- •Nutrition
- •Pros and cons of TPN
- •Introduction
- •Initial Management
- •Rockall score
- •Glasgow–Blatchford score
- •Medical Therapy
- •Endoscopic Therapy
- •Timing of endoscopy
- •Epinephrine injection
- •Thermal therapy
- •Argon plasma coagulation
- •Endoscopic clipping
- •Failure of endoscopic therapy
- •References
- •Introduction
- •Management of Variceal Bleeding
- •Medical Management and Resuscitation
- •Endoscopic Management
- •Variceal band ligation
- •Cyanoacrylate glue
- •Endoscopic sclerotherapy
- •Subsequent endoscopy
- •Portosystemic shunts: TIPS and surgery
- •References
- •Introduction
- •Management Options
- •Catheter Angiography
- •CT Angiography
- •Embolic Agents
- •Complications of Angiography
- •Indirect Bleeding
- •References
- •I. Indications
- •II. Preoperative Preparation
- •B. Over-Sewing a Bleeding Ulcer
- •Pyloroplasty/gastroenterostomy
- •Truncal vagotomy
- •Ensure safe duodenal stump closure
- •Dealing with problems related to the posterior duodenal ulcer penetratinginto the pancreas
- •Mobilisation of distal stomach
- •Billroth II gastroenteral anastomosis
- •Surgical Techniques for BleedingGastric Ulcer
- •F. Local Excision of Gastric Ulcer
- •Key Points in Billroth I Gastrectomyfor Bleeding Gastric Ulcer
- •Incisional wound closure
- •Postoperative care
- •References
- •Indications
- •Preoperative Preparation
- •Operative Treatment
- •A. Benign Duodenal Ulcer Perforation
- •B. Benign Gastric Ulcer Perforations
- •References
- •2. Preoperative Preparation
- •3. Surgery
- •Open Appendectomy
- •Introduction
- •General Complications
- •Thromboembolism
- •Atelectasis
- •Nausea and Vomiting
- •Wound Complications
- •Acute Abdominal Complications
- •1. Bleeding
- •2. Leaks
- •Treatment options for GJ leak
- •Managing sleeve leak
- •3. Stenosis and Stricture
- •4. Gastric Band Slippage and IntestinalObstruction
- •5. Other Complications
- •Gastric banding
- •Gastric bypass
- •Nutritional problems
- •1. Indications
- •Operative Strategy of Acute Appendicitis
- •Laparoscopic Appendectomy
- •4. Postoperative care
- •Special Situations
- •Introduction
- •Management of Acute Sigmoid Colonic Diverticulitis
- •A. Preoperative Management
- •B. Indications for Surgery
- •C. Options of Surgical Procedure
- •Two-stage approach
- •Single-stage approach
- •Role of laparoscopic surgery in acute perforative sigmoid colonic diverticulitis
- •E. Position of Patient for Surgery
- •Intra-Operative Surgical Techniques
- •A. Incision and Laparotomy
- •Tips and tricks to help locate the ‘difficult’ left ureter
- •Common sites of left ureteric injury during anterior resection
- •D. Splenic Flexure Take Down
- •Tips and tricks to tackle difficultsplenic flexure
- •E. Vascular Control
- •Ligation of the inferior mesenteric artery (IMA)
- •How to identify the IMA?
- •On-table colonic lavage
- •When is it not safe to anastomose?
- •J. Completion of Surgery
- •K. Postoperation Care
- •References
- •Introduction
- •I. Preoperative Management
- •II. Management Options
- •III. Endoscopic Colonic Stenting
- •Indications
- •IV. Defunctioning Stoma
- •Indications
- •Postoperative Considerations
- •References
- •Definition
- •Risk Factors for DifficultLaparoscopic Cholecystectomyin Acute Cholecystitis
- •Preoperative preparation
- •Surgical Treatment
- •Laparoscopic approach
- •References
- •Pre- ERCP Preparation
- •ERCP for Choledocholithiasis
- •ERCP in Bile Duct Injuries
- •Difficult Biliary Cannulation
- •Post- ERCP Care
- •References
- •A) Acute Cholangitis
- •C) Bile Duct Injuries During Surgery
- •D) Pancreatic Trauma
- •E) ERCP Perforation
- •I. Introduction
- •IV. Postoperative Management
- •Special situations
- •Final Note
- •Introduction
- •Disadvantages of Radiological Drainage
- •Radiological Evaluation of the Abscess
- •1) Diagnosis of Abscess
- •2) Identify a Potential Cause for an Abscess
- •3) Determine Drainability of an Abscess
- •4) Identifying the Complications from an Abscess
- •5) Aid Drainage Planning
- •Role of RadiologicalIntervention
- •Contraindications
- •Technique
- •Imaging Guidance
- •Insertion of the Drain
- •Drainage Catheter
- •Site Specific Comments on Radiological Drainage of Intra-Abdominal Abscess
- •Liver Abscess
- •Subphrenic and Lesser Sac Abscess
- •Percutaneous Cholecystostomy
- •Pancreatic Collection/Abscess
- •Pelvic Abscess
- •Enteric Abscess
- •Others
- •Conclusion
- •References
- •I. Ectopic Pregnancy
- •Operative procedures
- •II. Ruptured Tubo-Ovarian Abscess
- •Preoperative
- •Operative procedures
- •Postoperative
- •III. Haemorrhage or LeakingOvarian Cyst and Adnexal Torsion
- •A. Adnexal torsion
- •Preoperative — Benign Ovarian Cyst
- •Laparoscopic intervention
- •2. Laparoscopic ovarian oophorectomy
- •3. Open Cystectomy
- •Introduction
- •Repair of Bladder Injuries
- •Boari Flap
- •Other Manoeuvres
- •Post-Operative Care
- •Conclusion
- •II. Perioperative Care
- •IV. Mycotic Aneurysms
- •VI. Post-Surgery Follow-up
- •I. Introduction and Indications
- •II. Preoperative Management
- •III. OT Preparation
- •IV. Operative Procedure
- •Damage Control Mode
- •Splenic Injuries
- •Bowel Injuries
- •Kidney Injuries
- •Pancreatic Injuries
- •Liver Injuries
- •VI. Postoperative Care
- •V. Wound Closure
- •Introduction
- •Preoperative Planning
- •Choice of Surgical Technique
- •Operative Procedure
- •1. Component Separation Technique
- •3. Bilateral Skin Flap Advancement
- •5. Use of Alloplastic Materials
- •Postoperative Management
- •References
- •Laparotomy
- •Laparoscopy
- •Interventional Radiology
- •Air Enema
- •Neonatal Intestinal Obstruction
- •Duodenal Atresia
- •Duodenoduodenostomy
- •Malrotation with Volvulus
- •Intestinal Atresia
- •Hirschsprung’s Disease (HD)
- •Anorectal Malformations
- •Inguinal Hernia in Children
- •References
- •Introduction
- •Benefits of Laparoscopy in Emergency
- •Indications of Emergency Laparoscopy
- •Instrumentation
- •Instruments for Removal of Specimen
- •Instruments for Port Closure
- •Patient Position and O.T. Setup
- •Suggested Reading
- •Index
- •Uploaded by [StormRG]
- •Contents

•
•
Feelings of pity toward the abusers, believing they are actually
victims themselves. Because of this, victims may go on a crusade
or mission to ‘save’ [protect] their abuser [see the venom
unleashed on those challenging the official ‘Covid’ narrative].
Unwillingness to learn to detach from their perpetrators and heal.
In essence, victims may tend to be less loyal to themselves than to
their abuser [ definitely see ‘Covid’].
Ponder on those traits and compare them with the behaviour of
great swathes of the global population who have defended
governments and authorities which have spent every minute
destroying their lives and livelihoods and those of their children and
grandchildren since early 2020 with fascistic lockdowns, house arrest
and employment deletion to ‘protect’ them from a ‘deadly virus’ that
their abusers’ perceptually created to bring about this very outcome.
We are looking at mass Stockholm syndrome. All those that agree to
concede their freedom will believe those perceptions are originating
in their own independent ‘mind’ when in fact by conceding their
reality to Stockholm syndrome they have by definition conceded any
independence of mind. Listen to the ‘opinions’ of the acquiescing
masses in this ‘Covid’ era and what gushes forth is the repetition of
the official version of everything delivered unprocessed, unfiltered
and unquestioned. The whole programming dynamic works this
way. I must be free because I’m told that I am and so I think that I
am.
You can see what I mean with the chapter theme of ‘I’m thinking –
Oh, but are you?’ The great majority are not thinking, let alone for
themselves. They are repeating what authority has told them to
believe which allows them to be controlled. Weaving through this
mentality is the fear that the ‘conspiracy theorists’ are right and this
again explains the oen hysterical abuse that ensues when you dare
to contest the official narrative of anything. Denial is the mechanism
of hiding from yourself what you don’t want to be true. Telling
people what they want to hear is easy, but it’s an infinitely greater
challenge to tell them what they would rather not be happening.

One is akin to pushing against an open door while the other is met
with vehement resistance no maer what the scale of evidence. I
don’t want it to be true so I’ll convince myself that it’s not. Examples
are everywhere from the denial that a partner is cheating despite all
the signs to the reflex-action rejection of any idea that world events
in which country aer country act in exactly the same way are
centrally coordinated. To accept the laer is to accept that a force of
unspeakable evil is working to destroy your life and the lives of your
children with nothing too horrific to achieve that end. Who the heck
wants that to be true? But if we don’t face reality the end is duly
achieved and the consequences are far worse and ongoing than
breaking through the walls of denial today with the courage to make
a stand against tyranny.
Connect the dots – but how?
A crucial aspect of perceptual programming is to portray a world in
which everything is random and almost nothing is connected to
anything else. Randomness cannot be coordinated by its very nature
and once you perceive events as random the idea they could be
connected is waved away as the rantings of the tinfoil-hat brigade.
You can’t plan and coordinate random you idiot! No, you can’t, but
you can hide the coldly-calculated and long-planned behind the
illusion of randomness. A foundation manifestation of the Renegade
Mind is to scan reality for paerns that connect the apparently
random and turn pixels and dots into pictures. This is the way I
work and have done so for more than 30 years. You look for
similarities in people, modus operandi and desired outcomes and
slowly, then ever quicker, the picture forms. For instance: There
would seem to be no connection between the ‘Covid pandemic’ hoax
and the human-caused global-warming hoax and yet they are masks
(appropriately) on the same face seeking the same outcome. Those
pushing the global warming myth through the Club of Rome and
other Cult agencies are driving the lies about ‘Covid’ – Bill Gates is
an obvious one, but they are endless. Why would the same people be
involved in both when they are clearly not connected? Oh, but they

are. Common themes with personnel are matched by common goals.
The ‘solutions’ to both ‘problems’ are centralisation of global power
to impose the will of the few on the many to ‘save’ humanity from
‘Covid’ and save the planet from an ‘existential threat’ (we need
‘zero Covid’ and ‘zero carbon emissions’). These, in turn, connect
with the ‘dot’ of globalisation which was coined to describe the
centralisation of global power in every area of life through incessant
political and corporate expansion, trading blocks and superstates
like the European Union. If you are the few and you want to control
the many you have to centralise power and decision-making. The
more you centralise power the more power the few at the centre will
have over the many; and the more that power is centralised the more
power those at the centre have to centralise even quicker. The
momentum of centralisation gets faster and faster which is exactly
the process we have witnessed. In this way the hoaxed ‘pandemic’
and the fakery of human-caused global warming serve the interests
of globalisation and the seizure of global power in the hands of the
Cult inner-circle which is behind ‘Covid’, ‘climate change’ and
globalisation. At this point random ‘dots’ become a clear and
obvious picture or paern.
Klaus Schwab, the classic Bond villain who founded the Cult’s
Gates-funded World Economic Forum, published a book in 2020, The
Great Reset, in which he used the ‘problem’ of ‘Covid’ to justify a
total transformation of human society to ‘save’ humanity from
‘climate change’. Schwab said: ‘The pandemic represents a rare but
narrow window of opportunity to reflect, reimagine, and reset our
world.’ What he didn’t mention is that the Cult he serves is behind
both hoaxes as I show in my book The Answer. He and the Cult don’t
have to reimagine the world. They know precisely what they want
and that’s why they destroyed human society with ‘Covid’ to ‘build
back beer’ in their grand design. Their job is not to imagine, but to
get humanity to imagine and agree with their plans while believing
it’s all random. It must be pure coincidence that ‘The Great Reset’
has long been the Cult’s code name for the global imposition of
fascism and replaced previous code-names of the ‘New World

Order’ used by Cult frontmen like Father George Bush and the ‘New
Order of the Ages’ which emerged from Freemasonry and much
older secret societies. New Order of the Ages appears on the reverse
of the Great Seal of the United States as ‘Novus ordo seclorum’
underneath the Cult symbol used since way back of the pyramid and
all seeing-eye (Fig 3). The pyramid is the hierarchy of human control
headed by the illuminated eye that symbolises the force behind the
Cult which I will expose in later chapters. The term ‘Annuit Coeptis’
translates as ‘He favours our undertaking’. We are told the ‘He’ is
the Christian god, but ‘He’ is not as I will be explaining.
Figure 3: The all-seeing eye of the Cult ‘god’ on the Freemason-designed Great Seal of the
United States and also on the dollar bill.
Having you on
Two major Cult techniques of perceptual manipulation that relate to
all this are what I have called since the 1990s Problem-ReactionSolution (PRS) and the Totalitarian Tiptoe (TT). They can be
uncovered by the inquiring mind with a simple question: Who
benefits? The answer usually identifies the perpetrators of a given
action or happening through the concept of ‘he who most benefits
from a crime is the one most likely to have commied it’. The Latin
‘Cue bono?’ – Who benefits? – is widely aributed to the Roman
orator and statesman Marcus Tullius Cicero. No wonder it goes back
so far when the concept has been relevant to human behaviour since

history was recorded. Problem-Reaction-Solution is the technique
used to manipulate us every day by covertly creating a problem (or
the illusion of one) and offering the solution to the problem (or the
illusion of one). In the first phase you create the problem and blame
someone or something else for why it has happened. This may relate
to a financial collapse, terrorist aack, war, global warming or
pandemic, anything in fact that will allow you to impose the
‘solution’ to change society in the way you desire at that time. The
‘problem’ doesn’t have to be real. PRS is manipulation of perception
and all you need is the population to believe the problem is real.
Human-caused global warming and the ‘Covid pandemic’ only have
to be perceived to be real for the population to accept the ‘solutions’ of
authority. I refer to this technique as NO-Problem-Reaction-Solution.
Billions did not meekly accept house arrest from early 2020 because
there was a real deadly ‘Covid pandemic’ but because they
perceived – believed – that to be the case. The antidote to ProblemReaction-Solution is to ask who benefits from the proposed solution.
Invariably it will be anyone who wants to justify more control
through deletion of freedom and centralisation of power and
decision-making.
The two world wars were Problem-Reaction-Solutions that
transformed and realigned global society. Both were manipulated
into being by the Cult as I have detailed in books since the mid1990s. They dramatically centralised global power, especially World
War Two, which led to the United Nations and other global bodies
thanks to the overt and covert manipulations of the Rockefeller
family and other Cult bloodlines like the Rothschilds. The UN is a
stalking horse for full-blown world government that I will come to
shortly. The land on which the UN building stands in New York was
donated by the Rockefellers and the same Cult family was behind
Big Pharma scalpel and drug ‘medicine’ and the creation of the
World Health Organization as part of the UN. They have been
stalwarts of the eugenics movement and funded Hitler’s race-purity
expert’ Ernst Rudin. The human-caused global warming hoax has
been orchestrated by the Club of Rome through the UN which is

manufacturing both the ‘problem’ through its Intergovernmental
Panel on Climate Change and imposing the ‘solution’ through its
Agenda 21 and Agenda 2030 which demand the total centralisation
of global power to ‘save the world’ from a climate hoax the United
Nations is itself perpetrating. What a small world the Cult can be
seen to be particularly among the inner circles. The bedfellow of
Problem-Reaction-Solution is the Totalitarian Tiptoe which became
the Totalitarian Sprint in 2020. The technique is fashioned to hide the
carefully-coordinated behind the cover of apparently random events.
You start the sequence at ‘A’ and you know you are heading for ‘Z’.
You don’t want people to know that and each step on the journey is
presented as a random happening while all the steps strung together
lead in the same direction. The speed may have quickened
dramatically in recent times, but you can still see the incremental
approach of the Tiptoe in the case of ‘Covid’ as each new imposition
takes us deeper into fascism. Tell people they have to do this or that
to get back to ‘normal’, then this and this and this. With each new
demand adding to the ones that went before the population’s
freedom is deleted until it disappears. The spider wraps its web
around the flies more comprehensively with each new diktat. I’ll
highlight this in more detail when I get to the ‘Covid’ hoax and how
it has been pulled off. Another prime example of the Totalitarian
Tiptoe is how the Cult-created European Union went from a ‘freetrade zone’ to a centralised bureaucratic dictatorship through the
Tiptoe of incremental centralisation of power until nations became
mere administrative units for Cult-owned dark suits in Brussels.
The antidote to ignorance is knowledge which the Cult seeks
vehemently to deny us, but despite the systematic censorship to that
end the Renegade Mind can overcome this by vociferously seeking
out the facts no maer the impediments put in the way. There is also
a method of thinking and perceiving – knowing – that doesn’t even
need names, dates, place-type facts to identify the paerns that
reveal the story. I’ll get to that in the final chapter. All you need to
know about the manipulation of human society and to what end is
still out there – at the time of writing – in the form of books, videos

and websites for those that really want to breach the walls of
programmed perception. To access this knowledge requires the
abandonment of the mainstream media as a source of information in
the awareness that this is owned and controlled by the Cult and
therefore promotes mass perceptions that suit the Cult. Mainstream
media lies all day, every day. That is its function and very reason for
being. Where it does tell the truth, here and there, is only because the
truth and the Cult agenda very occasionally coincide. If you look for
fact and insight to the BBC, CNN and virtually all the rest of them
you are asking to be conned and perceptually programmed.
Know the outcome and you’ll see the journey
Events seem random when you have no idea where the world is
being taken. Once you do the random becomes the carefully
planned. Know the outcome and you’ll see the journey is a phrase I
have been using for a long time to give context to daily happenings
that appear unconnected. Does a problem, or illusion of a problem,
trigger a proposed ‘solution’ that further drives society in the
direction of the outcome? Invariably the answer will be yes and the
random – abracadabra – becomes the clearly coordinated. So what is
this outcome that unlocks the door to a massively expanded
understanding of daily events? I will summarise its major aspects –
the fine detail is in my other books – and those new to this
information will see that the world they thought they were living in
is a very different place. The foundation of the Cult agenda is the
incessant centralisation of power and all such centralisation is
ultimately in pursuit of Cult control on a global level. I have
described for a long time the planned world structure of top-down
dictatorship as the Hunger Games Society. The term obviously
comes from the movie series which portrayed a world in which a
few living in military-protected hi-tech luxury were the overlords of
a population condemned to abject poverty in isolated ‘sectors’ that
were not allowed to interact. ‘Covid’ lockdowns and travel bans
anyone? The ‘Hunger Games’ pyramid of structural control has the
inner circle of the Cult at the top with prey much the entire

population at the boom under their control through dependency
for survival on the Cult. The whole structure is planned to be
protected and enforced by a military-police state (Fig 4).
Here you have the reason for the global lockdowns of the fake
pandemic to coldly destroy independent incomes and livelihoods
and make everyone dependent on the ‘state’ (the Cult that controls
the ‘states’). I have warned in my books for many years about the
plan to introduce a ‘guaranteed income’ – a barely survivable
piance – designed to impose dependency when employment was
destroyed by AI technology and now even more comprehensively at
great speed by the ‘Covid’ scam. Once the pandemic was played and
lockdown consequences began to delete independent income the
authorities began to talk right on cue about the need for a
guaranteed income and a ‘Great Reset’. Guaranteed income will be
presented as benevolent governments seeking to help a desperate
people – desperate as a direct result of actions of the same
governments. The truth is that such payments are a trap. You will
only get them if you do exactly what the authorities demand
including mass vaccination (genetic manipulation). We have seen
this theme already in Australia where those dependent on
government benefits have them reduced if parents don’t agree to
have their children vaccinated according to an insane healthdestroying government-dictated schedule. Calculated economic
collapse applies to governments as well as people. The Cult wants
rid of countries through the creation of a world state with countries
broken up into regions ruled by a world government and super
states like the European Union. Countries must be bankrupted, too,
to this end and it’s being achieved by the trillions in ‘rescue
packages’ and furlough payments, trillions in lost taxation, and
money-no-object spending on ‘Covid’ including constant allmedium advertising (programming) which has made the media
dependent on government for much of its income. The day of
reckoning is coming – as planned – for government spending and
given that it has been made possible by printing money and not by
production/taxation there is inflation on the way that has the

potential to wipe out monetary value. In that case there will be no
need for the Cult to steal your money. It just won’t be worth
anything (see the German Weimar Republic before the Nazis took
over). Many have been okay with lockdowns while geing a
percentage of their income from so-called furlough payments
without having to work. Those payments are dependent, however,
on people having at least a theoretical job with a business considered
non-essential and ordered to close. As these business go under
because they are closed by lockdown aer lockdown the furlough
stops and it will for everyone eventually. Then what? The ‘then
what?’ is precisely the idea.
Figure 4: The Hunger Games Society structure I have long warned was planned and now the
‘Covid’ hoax has made it possible. This is the real reason for lockdowns.
Hired hands
Between the Hunger Games Cult elite and the dependent population
is planned to be a vicious military-police state (a fusion of the two
into one force). This has been in the making for a long time with
police looking ever more like the military and carrying weapons to
match. The pandemic scam has seen this process accelerate so fast as

lockdown house arrest is brutally enforced by carefully recruited
fascist minds and gormless system-servers. The police and military
are planned to merge into a centrally-directed world army in a
global structure headed by a world government which wouldn’t be
elected even by the election fixes now in place. The world army is
not planned even to be human and instead wars would be fought,
primarily against the population, using robot technology controlled
by artificial intelligence. I have been warning about this for decades
and now militaries around the world are being transformed by this
very AI technology. The global regime that I describe is a particular
form of fascism known as a technocracy in which decisions are not
made by clueless and co-opted politicians but by unelected
technocrats – scientists, engineers, technologists and bureaucrats.
Cult-owned-and-controlled Silicon Valley giants are examples of
technocracy and they already have far more power to direct world
events than governments. They are with their censorship selecting
governments. I know that some are calling the ‘Great Reset’ a
Marxist communist takeover, but fascism and Marxism are different
labels for the same tyranny. Tell those who lived in fascist Germany
and Stalinist Russia that there was a difference in the way their
freedom was deleted and their lives controlled. I could call it a fascist
technocracy or a Marxist technocracy and they would be equally
accurate. The Hunger Games society with its world government
structure would oversee a world army, world central bank and single
world cashless currency imposing its will on a microchipped
population (Fig 5). Scan its different elements and see how the
illusory pandemic is forcing society in this very direction at great
speed. Leaders of 23 countries and the World Health Organization
(WHO) backed the idea in March, 2021, of a global treaty for
‘international cooperation’ in ‘health emergencies’ and nations
should ‘come together as a global community for peaceful
cooperation that extends beyond this crisis’. Cut the Orwellian
bullshit and this means another step towards global government.
The plan includes a cashless digital money system that I first warned
about in 1993. Right at the start of ‘Covid’ the deeply corrupt Tedros
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