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The Surgeon – Going Beyond the Basics

“I passionately believe that the practice of surgical intervention is like the making of a fine wine – part science, and part art.”

Patrick Leadbeater D.V.M., M.R.C.V.S
 

 

Dr. Leadbeater in the surgery suiteLong before a wine goes in the bottle, a winemaker will spend a great deal of time assessing not only the chemistry of the grape juice, but also what it tastes like. Because of a deep understanding of the marriage of science, intuition and creativity, they are able to produce what many consider liquid art. The approach, by a true surgeon, to a surgical procedure, no matter how routine, begins with this same focus and planning.

As a veterinary surgeon I do not have the same luxury of time that the winemaker has, but I still go through a similar process. Years of experience permit me to start with science, and then balance it with intuition and creativity. Prior to making the first incision, I must think beyond the scope of the procedure, and say “what if”. Spending a few minutes to consider complications that could be encountered, gives me the opportunity to react to an unexpected situation. For instance the operating theatre is always fully equipped so that I’m prepared for any unexpected situation. The surgical team prepares not only the instruments needed for the procedure; but all other potentially needed items are available to handle any unexpected emergency. There are times we’ve had only moments to react to a situation, and were able to do so because of our level of planning and readiness. Unlike wine, in our world, a life is at stake, and there’s no excuse for poor preparation. 

Sutures – A simple thing?

Image of a good suture job

Part of my preparation is in the selection of the instrumentation and materials I use. You may be surprised to know that the choice of suture material and the needle type make a difference in how quickly and effectively your pet heals. Any surgery involves intricate repair of the tissues disrupted by the procedure. Sutures, or “stitches”, that are put in to make these repairs should be done in a manner that allows your pet to heal quickly, comfortably and with only minor scarring.

One should understand that suture materials vary considerably in cost. As with most things, more expensive generally means better performance. Less expensive sutures can reduce the cost outlay, but may be detrimental to the healing process.

Less expensive sutures may promote unwanted reactions at the surgical site.

  • They tend to have dull needles, which inevitably causes greater tissue insult rather than sharper ones.
  • Larger (thickness) of the suture material is generally less expensive than smaller (thinner) suture.

More expensive sutures rarely cause tissue reactions.

  • Using the smallest suture consistent with the procedure is always a goal.
  • Smaller, sharper needles minimize tissue trauma when operating on delicate organs or tissue, as well as closing the incision

In the mind of the surgeon, this choice should never be a consideration.

We know that the closeness and tightness of each of the sutures, makes a difference in your pet’s healing process. Sutures that are a little too tight impede micro-circulation to the area that needs it most – the healing interface. With skin repair, attention to detail greatly reduces the likelihood of a pet licking and biting at the suture line. If you can minimize this, you’ll achieve the result of rapid healing with almost no scarring. So you can see that the balance of compassion and process – art and science, are the key to minimizing a patient’s discomfort, as much as humanly possible.

When faced with the recommendation of surgery for your pet, you should meet the surgeon, ask questions, research the procedure, and understand the surgeon’s philosophy. Only then can you be comfortable with your decision.

 
 Kahala Pet Hospital has developed a statewide reputation for thorough and compassionate patient care, as well as an extremely high rating for surgical excellence. As a final note, many veterinarians have chosen Kahala Pet Hospital for surgical procedures on their own pets. I feel honored and humbled that my peers put that kind of trust in me.

 

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