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The bust of Lord Moynihan adorns the top of the staircase of the old Leeds Teaching Hospital on Great George Street in Leeds, Yorkshire, United Kingdom.

Although, Lord Moynihan is more famed for his phrase ‘heart of a lion and hands of a woman’, we believe his insight into the handling of tissues with purposeful, quiet and effective movements is more pertinent.  This refers to lightness of touch and the rhythm and flow of an operation. We have all witnessed expert surgeon at work; their action is deliberate and soft. There is no wasted movement. The time it takes an expert surgeon to put a needle through the tissue is much the same as for a trainee i.e. the ‘ SYSTOLE – action’ (although the trainee frequently lacks the understanding of the movement) but the time to take the next stitch is significantly deferent i.e. DIASTOLE – inaction (compounded by a lack of understanding of the geometry, posture and functional anatomy of the upper limb to effect the correct movement).  

BBASS explains basic surgical techniques and offers a framework for practice for the aspiring surgeon at any level.  The concept is drawn from the learning of Martial Arts. The power and speed of the techniques in Martial Arts can only be attained with the correct adherence and understanding of the basic movements.  Martial Art extols fundamental principles that apply to surgery.

– Mastery is not absolute
– It is not a ‘final destination’
– You are always refining your skills
– Correctness
– Patience
– Persistence
– Perseverance
– Effort over Skill
– Self-Control

These principles are further reinforced in a Samurai text – The Book of Five Rings by a warrior and philosopher of 1600’s

We believe these are the tenets are ideal for the mastery of surgery and note that in Japan the legacy of the Samurai does live on in the development of surgery and surgical dynasties