Type of Surgery

Calculating the Risks and Benefits of Surgery

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Last updated: 04/29/2009

Calculating the Risks and Benefits of Surgery
Before every surgical procedure, surgeons will determine a risk/benefit ratio either informally or as part of a patient workup. If the ratio is too high, meaning that the risk greatly outweighs the benefit, the surgeon will not proceed with the surgery. This risk/benefit ratio is not always straightforward and some surgeons may opt to operate in the face of certain risks while others may not. Some surgeons may be more skilled at a particular procedure, and while quite risky, may be relatively safe in that surgeon’s hands.
Perhaps it is best to consider some examples. If a person has a brain tumor and the only way to remove it is with a complicated and potentially risky procedure, the doctor and patient may decide to take that risk because the benefit could be freedom from cancer. Therefore even though the risk is great, the benefit is greater. On the other hand, certain cosmetic procedures may not be judged to provide that much benefit and could be halted because of medical risk. For instance if a patient with uncontrolled diabetes who smokes and had a heart attack in the past six months calls on a plastic surgeon for a tummy tuck, the surgeon will likely say no. Even though tummy tuck procedures are relatively safe and routine, the coexisting medical conditions put this patient at very high risk for a complication from the procedure.
Fortunately, many of the medical conditions that make surgery risky can be modified in order to minimize risk. For instance, if we take that last hypothetical patient as an example, if the person was able to control their diabetes through medication and insulin, stop smoking and pass a stress test, the surgeon is much more likely to proceed with the tummy tuck operation.
The risk/benefit ratio is not only for surgeons to decide. The anesthesiologist can stop a surgery even if the surgeon has consented to perform it. Most complications from surgery arise from anesthesia so it is the anesthesiologist’s responsibility to screen patients for safety before administering anesthetic. Clearance from a primary care physician goes a long way towards helping anesthesiologists determine risk, but they have the right and the power to stop a surgery at any time if they feels that the risk to the patient is too great.
The other person that can help determine the risk/benefit ratio of a surgical procedure is you! By learning as much as you can about the possible complications of a given procedure, the rate at which they occur, and the permanence of them should they happen, you can make a decision as to whether the surgery is right for you. You are the one that will have to live with the complication if it does occur and you always have the right to refuse a surgery if you truly believe that the risks outweigh the benefits. In order to make this decision, however, you need to take it upon yourself to ask questions, do research, and talk to friends and family about the possibility of success but also how to deal with failure should it occur.

Last Updated: 04/29/2009

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