The philosophy of surgery – VET Festival 2017

Laurent Findji - The VET Festival - Surgical Philosophy

Something that I personally am passionate about is doing the best surgery possible, I honestly respect that there is an enormous learning curve in front of me. This learning curve is about the experience that allows me to understand why and how things are done.

However that does not mean that I should not be trying to be better, and one of the best ways to do this is by learning from others. I’ve recently read the biographies of Dr William Halsted and also Dr Harvey Cushion two of the pioneers of modern surgery who have outlined many of their thoughts on things.

This morning my first lecture was by Laurent Findji who was talking about the philosophy and practice of soft tissue surgery and how this can help you become a better surgeon. This afternoon Laurent is also talking about complications in surgery which I will also be attending however I wanted to make sure I blogged up this first with a clear mind.

So I am going start at the end with a quote…

Good surgeons know how to operate, better surgeons know when to operate, and the best surgeons know when not to operate

Going from this it is something that cannot be taught, and all vets will start at the basic of following recipes to learn how to do stuff. From this an understanding of why should develop and then with this why it enables you as a surgeon to be able to apply the principles without a recipe.

The secret is to choose your patients and your surgeries, there is no point operating on the skin when bone needs to be removed for example. And if you are operating and failing you need to know why as failure is not good for you or your team.

One of the most interesting thoughts from this lecture was about instruments. I’ve seen many instruments being used in the wrong way often, and even going as far as to say that sometimes even for non-surgical uses. Laurent highlighted the following points when it came to intruments:

Safety – if your forceps have been used unscrew a cap, or for holding a needle, can you really trust them? If you then use them to occlude an artery in liver surgery will they hold? Or will you have a blood filled abdomen?

Fluency – sometimes people are fast surgeons, and even worse they are fast without rushing. This is because they understand their instruments, how they are used, and what they are going to do. They will take their instrument into hand and use it.

Economics – are cheap instruments really worth it? Do they give you the performance you need? Do they feel good? Sometimes you really can tell whether an instrument or not with just whether it locks properly or slips.

The top tip from Laurent’s lecture is that you should film yourself operating, then watch this and look at your technique. How much time do you spend thinking? How much time do you spend doing? What can you do better?

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