Qualità della chirurgia

Qualità della chirurgia

Qualità della chirurgia endometriosiisterectomia   Quality of surgery is variable In Belgium we are having a discussion on quality of surgery and cost for the patient. At the University hospital gasthuisberg, patients were informed that for private patiens the Professor would do the intervention himself; otherwise it would be done by a registrar in training. This has been widely considered unethical and socially unacceptable since equal quality for everybody is a dogma of Belgian medicine.  In a press release, the conclusion was that quality was the same for everybody since the registrars in training  were well supervised and since all gynecologist or surgeon are considered equal because of their diploma. Unfortunateoly this is  not true and the quality of diagnosis and of treatment can be very variable.  This is easy to illustrate for surgery and the examples given are restricted to comments made before during presentations or in publications. Quality is variable “We only recognize what we know ”. This is well known for the diagnosis of endometriosis. Even large and vaginally visible nodules are often missed during clinical exam. Even during surgery many severe deep endometriosis nodules of the sigmoid will be missed. ‘The best technique is the one the surgeon is familiar with  ”, is often heard at meetings . This is unacceptable.  If the superiority of a technique has been demonstrated, the surgeon should be obliged to use it.  The advantages of a laparoscopic treatment of an extra-uterine pregnancy in comparison with a laparotomy are well demonstrated. Yet so many women are still treated by laparotomy because the gynecologist on duty does not have the skills.“Do...

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