I have just read an interesting article in relation to surgeon volume and outcomes in benign hysterectomy. The data, however, can be extrapolated to other areas of surgery. The thinking behind the concept is not new and was famously discussed in Malcolm Gladwell’s popular book, “Outliers”. He argued that 10,000 hours of deliberate practice is…
The Promotion of Robotic Gynecologic Surgery by Hospitals: Are Our Patients Being Misled?. Medscape. Oct 12, 2012. Hello. I’m Andrew Kaunitz, Professor and Associate Chair of the Department of Obstetrics and Gynecology at the University of Florida College of Medicine in Jacksonville, Florida. Today I’d like to discuss the promotion of robotic gynecologic surgery by…
Over recent months I have seen an unusual number of patients with endometriosis in various scar sites. The most common situation follows the performance of a caesarian section with a deposit of endometriosis within the operative field. More rarely and usually without prior surgery (including laparoscopy) the umbilicus can be affected. Interestingly I have not…
Clinical indicators to end June 2013. During this period I had major shoulder surgery and did not operate for almost 3 months. As a consequence the numbers are less than normal. There was one patient who was transfused unexpectedly. She had very substantial endometriosis and required a significant section of bowel to be removed and…
The answer seems simple. The bowel surgeon should be involved early in the process. I agree. The bowel surgeon should ideally have the seen the patient in a pre-operative consultation to discuss the planned procedure, results and potential complications. The intra-operative timing is the critical thing. If the gynaecologist has minimal surgical skills then invariably…
I have recently been asked this (or a very similar) question at a number of meetings. I have given this issue considerable thought over the years. The most common response I receive from both trainee surgeons and colleagues is that yes the surgeon should call for assistance in the event that there is unplanned damage…