A surgeon's framework for the unplanned intraoperative consultation.

Langenbecks Arch Surg

Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.

Published: January 2023

Purpose: Surgeons will likely be called to assist with or offer advice regarding an unanticipated intraoperative event or finding many times during their careers. Yet, there is no practical framework of how to respond to these consults nor is there any formal training in this area. The review of the limited literature and expert senior opinions can help explain the ethical components involved but does not address some of the practical aspects that the consulting surgeon may need to confront when responding to an unplanned intraoperative consultation.

Methods: We reviewed the existing surgical literature on intraoperative consultation across surgical disciplines and interpreted it in light of our own experiences and the advice of senior surgical colleagues.

Results: We present a framework for the minimum professional expectations of a surgeon responding to an intraoperative consultation.

Conclusion: In this manuscript, we present a selected review of the available literature on the topic, establish some of the guiding ethical principles, and offer an actionable and detailed framework that can support trainees and practicing surgeons dealing with these increasingly common and stressful unplanned circumstances.

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00423-022-02733-zDOI Listing

Publication Analysis

Top Keywords

unplanned intraoperative
8
intraoperative consultation
8
intraoperative
5
surgeon's framework
4
framework unplanned
4
consultation purpose
4
purpose surgeons
4
surgeons will
4
will called
4
called assist
4

Similar Publications

Background: Intraoperative hypotension is very common during surgery and is linked to major organ dysfunction and mortality. Current perioperative blood pressure management is largely based on universal blood pressure thresholds ranging from a mean arterial pressure of 60-70 mmHg. However, the effectiveness of this conventional management remains unproven in prospective randomized trials.

View Article and Find Full Text PDF

Background: Patients receiving intraoperative ventilation during general anesthesia often have low end-tidal CO (etCO). We examined the association of intraoperative etCO levels with the occurrence of postoperative pulmonary complications (PPCs) in a conveniently-sized international, prospective study named 'Local ASsessment of Ventilatory management during General Anesthesia for Surgery' (LAS VEGAS).

Methods: Patients at high risk of PPCs were categorized as 'low etCO' or 'normal to high etCO' patients, using a cut-off of 35 mmHg.

View Article and Find Full Text PDF

Impact of intraoperative adverse events in general and gastrointestinal surgery: A nationwide study.

Am J Surg

December 2024

Division of Trauma, Emergency Surgery & Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA. Electronic address:

Background: Intraoperative adverse events (iAEs) during general surgery can lead to significant morbidity and healthcare burden, yet their impact remains underexplored. We aimed to estimate the nationwide incidence of iAEs in general surgery and explore their associations with mortality, complications, length of stay, and costs.

Methods: We conducted a retrospective cohort study using the Nationwide Readmissions Database 2019 and included adult patients (aged 18 years and older) who underwent general surgical procedures.

View Article and Find Full Text PDF

Accidental tracheostomy decannulation: Risk factors and complications in pediatric patients using the NSQIP-P database.

Int J Pediatr Otorhinolaryngol

December 2024

Department of Pediatric Anesthesiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University Chicago, IL, USA. Electronic address:

Background: Accidental tracheostomy decannulation (ATD) is a life-threatening event in pediatric patients. The factors associated with ATD in children are largely unknown. Utilizing the National Surgical Quality Improvement Pediatric (NSQIP-P) dataset, we sought to identify the incidence of ATD and associated factors.

View Article and Find Full Text PDF

Protein as a preoperative predictor - Impact of hypoalbuminemia on 30-day outcomes of breast reduction surgery.

J Plast Reconstr Aesthet Surg

November 2024

Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA. Electronic address:

Article Synopsis
  • * An analysis of over 7,000 breast reduction cases revealed that patients with low albumin levels had significantly more comorbidities, a higher body mass index, and were more likely to be Black or African American.
  • * The study found that those with hypoalbuminemia experienced nearly double the rate of postoperative complications and readmissions compared to those with normal albumin levels, highlighting the importance of preoperative nutritional evaluations.
View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!