Operative Dictations in General and Vascular Surgery

A Special Word to Surgical Residents and Fellows The operative dictation, or “op note” as it is commonly called, is one of the most important pieces of the medical record that a surgeon creates. In an era when we increasingly rely upon electronic “templates” and check lists, it is especially important to accurately record what actually happened in the oper- ating room. This includes the indications, the findings, the steps in the proce- dure, who participated, and the sutures and devices that were used. This accurate yet efficient recording is a crucial skill that all surgeons must learn. It is, however, rarely taught. This book will help you with every phase of every dictation. This is a book we wished we had when we were residents. It is a book we want our residents to have and to use. Read it before going into the OR to do a case. For each operation, we list the indications and the essential technical steps, as well as common variations and complications. Make it your practice to scan through this material before you scrub. This will serve as a quick reminder and an excellent preparation for the case at hand. Then, in the operating room, concentrate on the details of the particular case – the findings and any particular variation in technique. Adapt the stan- dardized operative dictation note to your needs and promptly document what occurred. Consolidate what you learn by taking notes. Learn the technical variations favored by individual attending surgeons with whom you scrub. Note their preferences in suture materials, patient positioning, and other small details. Surgery is made up of thousands of small details. Sooner than you might believe, you will be facing your board exams and then the even greater chal- lenge of working independently. When you do, this book will prove to be a valuable resource. It will help you recall what you have learned and deter- mine your own technical preferences. The 3rd edition of this book, once again, seeks to put a world of technical information in your pocket, or OR locker. New operations have been added, so that the book continues to contain the majority of procedures commonly performed by general and vascular surgeons. All chapters have been compre- hensively revised to incorporate new variations in technique and indications.