The risks associated with surgery (i.e., the likelihood that the surgery will cause serious problems or death) depend on the type of surgery and the characteristics of the person.
The types of surgery with the highest risks include: heart or lung surgery; liver surgery; and long-term or high-risk extensive abdominal bleeding;
prostate removal; serious surgical procedures on bones and joints (e.g., hip replacement). Generally, the worse a person’s general health, the higher the risks associated with surgery.
The risk is often increased in older people. However, it has been found that the risks are not so much related to age as to general health. Chronic disorders that increase the surgical risk, as well as other treatable disorders, including dehydration, infections and fluid and electrolyte imbalances, especially heart failure and angina pectoris, should be taken under the strictest possible control with treatment before surgery.
The opinion of another specialist
The decision about the need for a surgical intervention is not always obvious. In some situations, non-surgical treatments may be considered or one of several possible surgical procedures may be chosen. Therefore, a person may seek an opinion from other specialists (obtaining the opinion of another specialist). Some health insurance plans require another specialist’s opinion to be obtained before performing a planned surgical intervention. However, experts’ opinions about which doctor to seek such a conclusion may differ. Some experts advise that you should seek the opinion of another specialist from a doctor who is not a surgeon, in order to rule out the preference for a non-surgical method of treatment due to the specialist’s specialization. Others, in contrast, recommend seeking the opinion of another surgeon because they believe they know much more about the pros and cons of surgery than a non-surgical doctor. Some experts highlight the need to seek the opinion of another specialist from a doctor who will not be involved in the surgery to avoid conflicts of interest.
Surgical operations through a “keyhole”
Technical progress has made it possible to perform surgical operations that, unlike traditional surgical procedures, require fewer incisions and less damage to the tissue. To perform these operations, surgeons use tiny lights, video cameras and surgical instruments through incisions the size of a keyhole. Surgeons can then perform the necessary procedures by observing the images that are transmitted to video monitors and allowing them to follow the movements of the surgical instruments. For robotic surgery, cameras provide a three-dimensional image, and surgeons control the surgical instruments via a computer.
Surgical operations with minimal access can be named differently depending on whether they are laparoscopic (abdominal), arthroscopic (joint) or thoracoscopic (chest).
Since minimal access surgery damages tissue less than traditional surgery, it has several advantages, including the following:
- Reduction of time spent in hospital (in most cases);
- Reduced pain after surgery (in many cases);
- Opportunity for patients to return to work earlier;
- Smaller scars.
However, the complexity of performing minimum access surgery is often underestimated both by the person to be operated on and (in some cases) by the surgeons. Surgeons use video monitors, so they only see a two-dimensional image of the area where the surgery is performed. In addition, during such operations, surgical instruments with long arms located outside the human body are used, with the help of which surgeons perform all necessary actions, so working with these instruments may seem less familiar to them than with traditional ones. These reasons are associated with the potential disadvantages of minimum access surgery:
- Minimal access surgery often lasts longer than traditional surgery;
- Even more importantly, these operations are complex procedures, and errors may occur more frequently than with traditional methods.