Who does the surgery?

[windsurfer]

In planning for surgery we all take time selecting the right hospital and surgeon. But does the surgeon we pick really do the surgery or is it also done by others learning how? Is it better to avoid the big name surgeons and go to smaller hospitals where they do less teaching if you want the benefits of expertise?

Bobco

 

[ALCapshaw2]

I went to a major Teaching Hospital and this question to my surgeon. He informed me that HE would do all of the major work. It was not clear if his resident would participate in minor aspects such as closing.

Another Surgeon who oversees the second year residents has them open and close but he comes in and performs the actual HEART surgery himself.

Bottom Line: ASK the surgeon who does what and express any concerns you have about 'students' working on you. If you don't want any residents working on you, you may want to ask for a referal to another surgeon who does ALL of his own work.

'AL Capshaw'

 

[Ross]

I've seen both happen. If it's a teaching facility, it may or may not be the surgeon himself. Best thing to do is to outright ask him if he is going to be the one performing the procedure. In most cases, the answer is yes. Ask anyhow for your own piece of mind.

 

[perrybucsdad]

I do believe you can request that the Doc do the surgery and not the resident. I'll double check with the surgeon that my wofe works for.

 

[gijanet]

Make sure you ask that question............

Make sure you ask that question............

We, too, use a major teaching facility. We ask our surgeon every single time whether he is going to perform the operation. Even though he always replies yes, we write in on the consent form that we are consenting to Dr. Bove's performing all key portions of the operation. As complex as our daughter's anatomy is, I won't allow her to be used as a guinea pig. I know students have to learn, but not on my daughter.................

It is fairly common practice, though, for students to open and close the chest. I have to confess that I might not even consent to that this time............sigh!

Good luck. Hugs. Janet

 

[Gail in Ca]

I chose Stanford Hospital and after meeting with my surgeon, I also met the chief surgical resident who would be assisting my surgeon. I asked him who would stitch in the valve and he said my surgeon would and he would assist.
I really don't know who did most of my surgery. I assume my surgeon did most of it. But, as chief resident, my surgeon's assistant was totally capable and actually was released into the real world of being on his own as a cardiac surgeon just days after he helped on my surgery. I do think it is important to have the chief resident only assisting the surgeons, not just a regular resident, who did remove my chest tubes, and THAT was not a good experience.
Gail

 

[Mb]

I've never seen this topic discussed before, so I find it interesting others have the samefeelings my husband had.

The day before the surgery, as we went through the pre surgery tests, shavings, etc., my husband said in the afternoon that he wanted to see the surgeon again beforehand. And, that if he could not see him, then just cancel the surgery. Of course heads turned at that, as he was SO sick by this time. The surgeon was a true gentleman. Came down in his scrubs as soon as he finished a surgery. I'll admit he was annoyed at first. But, my husband said to him "I want to know if you or someone on your staff is going to do my surgery." The Dr. kind of grinned, and said that he was going to do the surgery, and that frankly there weren't a lot of Dr.'s hanging around Mass General that could actually do the surgery that needed to be done, so don't worry about it, he would be the one doing it all. (My husband had dual valves inserted, and they thought they might have to put in a dacron repair to his aorta.) - Not only did he do the surgery, but he was in the CICU many hours later, checking up on him, still in his scrubs.

 

[Mary]

When I signed my consent form, there were two doctors listed--my surgeon and someone else.

I didn't think too much of it. I assumed that there would be two individuals working on me, and in the event of a lawsuit, they both wanted their butts covered.

During my subsequent stay, I learned through daily visits from both, that the second individual was an Italian surgeon who was doing some type of internship with Dr. Kouchoukos.

 

[901]

I've never seen this topic discussed before, so I find it interesting others have the samefeelings my husband had.

The day before the surgery, as we went through the pre surgery tests, shavings, etc., my husband said in the afternoon that he wanted to see the surgeon again beforehand. And, that if he could not see him, then just cancel the surgery. Of course heads turned at that, as he was SO sick by this time. The surgeon was a true gentleman. Came down in his scrubs as soon as he finished a surgery. I'll admit he was annoyed at first. But, my husband said to him "I want to know if you or someone on your staff is going to do my surgery." The Dr. kind of grinned, and said that he was going to do the surgery, and that frankly there weren't a lot of Dr.'s hanging around Mass General that could actually do the surgery that needed to be done, so don't worry about it, he would be the one doing it all. (My husband had dual valves inserted, and they thought they might have to put in a dacron repair to his aorta.) - Not only did he do the surgery, but he was in the CICU many hours later, checking up on him, still in his scrubs.

I repeatedly asked the surgeon beforehand if he would be the only one doing the work or if they would have a "tag team" in the OR to do all the work He told every time that "He" would be doing the work unless he ran into something unexpected. As far as I know, the only unexpected thing that happened was getting me buttoned up. So, I'll have to assume, he did all the work (in surgery for 12 hours).

 

[perkicar]

I asked Dr Lytle the same thing when I met with him the week before my surgery. I work in a teaching hospital and told him that I know the reality of having residents and fellows assisting. He told me he would be doing the initial opening and exposure, and the valve replacement itself. In my case he enlarged my aortic root so I'm glad he was the one there doing the work!!! He did tell me he wouldn't do the actual closing--but having watched OHS as a nursing student, I don't think I ever saw the main surgeon close. At Jewish the physician assistant did the closing. Dr Lytle told me his fellow would do the closing for me. And in the written materials they give you before surgery, it's implied that someone other than the surgeon is doing the closing, since they talk about the surgeon talking to you while they are finishing the surgery, and that it's going to be 2 hours before your family can see you.
My brother and SIL went to talk to him in his office and I think I was still on the table while they finished up. My poor SIL got scared because they called them to his office to see him--but she said his first words to them was that I was fine!! He must have seen the stress on her face.
Janet, I'm with you on Katie's surgery--I'm sure lots will want to watch because of her anatomy, but I would only want the "pro" in there working.

 

[Joel]

Surgeon

Surgeon

I don't know how these things work, but I was told my surgery may last 6 hours. (Maybe more if the Aortic Arch needs to be touched.) I would hope that one person wouldn't be standing over me the entire 6 hours. I couldn't do something that demanding for 6 hours straight. I would hope that the main surgeon would take care of the critical parts of the procedure and competent assistants take care of the less critical parts. I would feel safer with that, rather than forcing a single person to spend that much time concentrating on a procedure.

During my wife's C-Section, after the baby was delivered, the ob sat by my wife's head and talked to her (He was her OB throughout the pregnancy.) While someone else closed her up, he reassured her that everything went well and she was being taken care of. It just seemed like the normal procedure.

Joel

 

[windsurfer]

Also, there is the issue of time on the H/L machine - the more teaching, or the less experience, the more time the operation may take. Most articles about beating heart surgery suggest that that the H/L machine is not the best thing for the body so I suspect minimizing time on it is a good thing.
Bobco

 

[bvdr]

My surgeon told me that he, himself would be doing the surgery. I know there were other doctors in with him though.

I believe my chest tubes were removed by an intern. There was someone there telling him "when you take chest tubes out....". I picked up on the subtle clue.

 

[perkicar]

My surgeon told me that he, himself would be doing the surgery. I know there were other doctors in with him though.

I believe my chest tubes were removed by an intern. There was someone there telling him "when you take chest tubes out....". I picked up on the subtle clue.

I think the nurse practicioner took mine out--but I don't really remember. I just remember the one hurt when they took it out!

 

[Phyllis]

Dick's hospital report said that Dr. Cohn verifies that he was there for the key portions of the operation, including cannulation, avr replacement, decannulation and was available until the patient left the room. I assume "being there" means he performed the avr replacement, but now I wonder? He was the one who called me in the waiting room when all was over and he was being sewn up.

 

[Big-Chuck]

surgery

surgery

well my wife informed me that it was 2 hrs from the time my surgeon came out and told my wife about my surgery and that everything went well and the time I appeared in ICU. So I assume that was when they were closing me up. My surgeon came to see me several times over the next couple of days but his assistant told me that the surgeon was off doing more surgeries and he would be the one coming to see me everyday. He was a very nice person.