Introduction

Introduction



Robert D. Smink, Jr., MD, Douglas S. Smink, MD, MPH


This section on the conduct of specific operations is designed with the third-year medical student in mind. Not an atlas of technique or a “cookbook,” it is rather a guide to help students prepare for participation in the various procedures and orient themselves to perioperative care by anticipating potential complications.


This Operations section utilizes the six competencies as defined by the ACGME as its organizing principle. Each operative procedure is explained in terms of “Indications” (Medical Knowledge and Patient Care), “Major Steps” (Patient Care), “Complications” (Practice-Based Learning and Improvement), “You Need to Know” (Medical Knowledge), “Issues for Discussion” (Communication and Professionalism), and “CPT Codes and Reimbursement” (Systems-Based Practice). Struggling with the confines of space, we chose for inclusion the common operations that medical students are likely to encounter during surgical clerkship. As a result, operations that were common decades ago but are uncommonly performed today, such as vagotomy and antrectomy, were not included. The inclusion of a large number of minimally invasive procedures reflects both the training of the younger editor as well as the evolution of the art of surgery to a less invasive approach. We hope that as you spend time on your surgery rotations, you will find that, despite evolution in the surgical craft, one theme in surgery remains unchanged: the surgeon’s dedication to patient care.



GENERAL COMPLICATIONS TO BE CONSIDERED IN ALL POSTOPERATIVE PATIENTS


Regardless of the operation or the skill of the surgeon, all surgical procedures have potential complications. Some are specific to individual procedures and will be discussed in the context of the specific operations. The complications in Table 1, however, can occur with any procedure. For the sake of standardization, we have listed these general complications in a table format similar to the format used for the specific operations that follow. The inference to be drawn is that these complications should be anticipated and that by following the recommendations made, you will be doing your best to avoid them.


Table 1 Anticipating Potential Complications






• Infection

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Mar 20, 2017 | Posted by in GENERAL SURGERY | Comments Off on Introduction

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