Diversify your surgery, says surgeon: ‘I will never be able to do it all’
Diversifying your surgery is a key priority for surgeons, and the latest example is the latest in the trend for doctors to take on a role in treating patients with diverticulosis, a serious infection that causes swelling in the bladder.
According to a new study from Johns Hopkins University, surgeons in the United States now perform about 5% of diverticula operations, and that number is projected to rise to 7% in the coming years.
“The number of surgeons who perform diverticulum operations has grown to about 20% over the past 10 years,” says Dr. David K. McNeil, an assistant professor of internal medicine and director of the Center for Clinical and Translational Surgery at the Johns Hopkins School of Medicine.
“There is a huge need to diversify your practice, and we are seeing this trend happening.”
In recent years, a number of surgical centers have introduced a variety of diverting techniques, including: removing the bladder with a scalpel, an open wound, and surgical excision, in which the tissue is removed with a blade that has been cut into the bone, causing a flap of tissue to open up.
These procedures are the most common procedures in the U.S. and in some countries, including Australia and New Zealand.
Dr. McNeill says the surgery isn’t new; he’s performed about 1,000 of these procedures himself over the last decade.
But his group’s study suggests surgeons in some areas of the country are seeing a resurgence in these surgeries, particularly in those with large numbers of patients with the disease.
A growing number of doctors are choosing to treat diverticulation cases with other surgical procedures, including bypass surgery, laparoscopic bypass surgery (where the skin is removed and the bladder is left in place), and decompression surgery, which is when a patient is moved into a hospital bed.
But a diverticulent bladder is one of the most complex types of bladder infection, and surgeons can’t always rely on a scalp or scalpel to remove the tissue, which can be difficult for a patient with a larger bladder.
And if you’re trying to do something more complicated, like removing a large block of tissue with a knife, that can cause a lot of pain, which may not be a good idea.
“If you’re going to do a diverting surgery, you have to be very flexible with your technique,” says McNeil.
“You have to find the optimal surgical approach to the patient.”
Dr. John W. Smith, an associate professor of orthopedics and an assistant director at the Howard Hughes Medical Institute in Houston, says he has had to learn a new approach to diverticulating a patient who has an incision in his bladder.
“For me, the most important thing is to have the surgeon in the room, to be able for him to visualize it, and to be there when you do the operation,” he says.
“In a typical procedure, you would have to have a scalper and a scalping machine and some kind of anesthetic.
But if you have a patient that has a small incision, it’s really easy for them to visualize the surgery and be there with you.”
To learn more about diverticular bladder infections, see the following articles: A diverticulated bladder infection can cause: pain and swelling, including in the abdomen and upper back, and difficulty urinating