When surgery is required, it is important that patients understand what the procedure involves, the risk and the recovery process. Below is advice and information that I give to patients. It is also important that Surgeons know when to operate. I give reference to my studies and experience.
Surgical Risk Assessment
Each patient is assessed individually as to the risk of surgery compared to the benefits. Much work has been done to quantify the risk of surgery. Patients who have a higher risk of operative problems are offered a score which estimates how likely they are to come through an operation. They can then work with their physician to determine the course of their treatment.
The following paper is a paper I wrote giving an in-depth analysis of how and why surgeons measure risk.
My old colleagues have written a superb website which makes estimating surgical risk straightforward. This can be found at www.riskprediction.org.uk.
Whilst much work has been undertaken to quantify the surgical risk, it should be noted that every surgeon has different surgical results. My personal results from 200 consecutive abdominal operations (2003 to 2009) for elective colorectal cancer patients are a 30 day mortality rate of 0% with a re-operation rate of 0%.
In addition to the risk of surgery of safety following surgery that may be discussed depending on the surgery required. Please refer to my publications on Surgical Safety.
Sepsis And Surgery
Infection is the enemy of the surgeon and techniques in reducing the terrible effects of infection have been sought by generations of surgeons. Objects that healthcare workers touch may transmit infection, thus my idea about an infection resistant watch in 2007. Please click here for more information about the Antibacterial Watch that I developed. Other novel ideas have resulted in patents and publications that aim to improve the management of surgical infections.
The ideal surgeon is a physician who can operate. However, knowing when not to operate is a skill many never master, but is just as important. The lost art of taking a history from patients is necessary to avoid unnecessary morbidity.
I recommend two books (Symptoms and Signs of Surgical Disease by Norman Browse and Talking Sense by Richard Asher written in 1972) as “bibles” to those who wish to understand these skills better. I have written many papers concerned with surgical training and it is a great challendge to make future surgeons reach the standards of some current consultants. Please refer to my publications on Surgical Training.
For senior Surgical Registrars, I have made an (almost) foolproof guide to passing the final Part 3 (ICE) Surgical Exam. Please email me at the address given in the appointments section, and I will forward it to you.