Description

All surgeons are convinced that they provide the best possible care to their patients and fortunately most patients are happy with their surgeons. Where safety and quality were once considered to be self-evident, these issues need to be made more explicit in modern surgery. Doctors and the general public alike are nowadays more aware of the variations in quality that exist among surgeons and institutions and of the unwarranted harmful effects surgery can have. Super- or sub-specialization seems one way to improve both its quality and safety. Surgical Gastroenterology or Gastrointestinal Surgery is one of these new superspecialties. The path towards this specialization is not easy and turf battles between General Surgery and Surgical Gastroenterology are still being fought. Professor Kaushik recounts the history and development of this superspecialty in India. He recounts that although the history of Surgical Gastroenterology in this country is short, its future is bright but, as has happened in other countries, its further division into organ-based superspecialties can be expected. ‘Practice makes one perfect’ is the motto that is probably true for the high-risk surgery which is still being performed in small institutions or by surgeons with only little expertise. The inverse correlation between volume and outcome expressed as mortality and morbidity has been shown all over the world. Wouters et al systematically analyze the literature covering this topic. They also show that concentration and regionalization do not automatically lead to an improved quality of surgery, since other issues for quality assurance are of equal importance, such as adherence to evidence-based guidelines, feedback, and monitoring. Despite all the inputs in training and instruction by experts, a uniformly high quality of surgery is hard to achieve in day-to-day gastrointestinal surgery. Sudhir Joseph and his colleagues show that a dedicated checklist can save lives and reduce postoperativ

Table of Contents

Surgical Gastroenterology in India

Procedural Volume and Quality Assurance in Surgery for Gastrointestinal Cancers

Checklists in Surgery

Enhancing Recovery after Gastrointestinal Surgery

Prophylactic Drainage in Gastrointestinal Surgery

Gastrointestinal Laparoscopic Surgery

Surgical Approaches to Peritonitis

Details

Language:
English
Copyright:
© 2011
Published:
Imprint:
Elsevier India
eBook ISBN:
9788131232453