How to prevent and manage nightmare cases in urology
Preparation is key, but sometimes even the best planning will not result in prevention.
Urologists don’t often talk about surgical disasters, but surgical complications are an accepted part of practice. Part of that acceptance is discussing those complications and appropriate planning to minimize and manage them so that they do not get compounded.
“We all have to recognize that complications do occur,” said Sam S. Chang, MD, MBA, professor of urology and chief surgical officer at Vanderbilt Ingram Cancer Center, and chief of urologic oncology at Vanderbilt University Medical Center in Nashville, Tennessee. “With the honest information and experience learned from others, practicing urologists can work to avoid complications and mitigate the severity of those that happen because complications do occur despite our best efforts.”
From left: Sarah Psutka, MD, MSc; Ojas Shah, MD; and Chandru Sundaram, MD
Dr. Chang will moderate “When Disaster Strikes: Preventing and Managing Nightmare Cases in Urology,” 7:40-8:30 a.m. on Saturday, May 4, in the Stars at Night Ballroom. He will be joined by Chandru Sundaram, MD, professor of urology at Indiana University in Bloomington; Ojas Shah, MD, professor of urology at Columbia University College of Physicians and Surgeons, and director of endourology and stone disease at Columbia University Medical Center in New York; and Sarah Psutka, MD, MSc, associate professor and associate director of urologic oncology at the University of Washington Fred Hutchinson Cancer Center in Seattle.
From left: Khurshid Ghani, MBChB, MS, FRCS; David Ginsberg, MD; and Kathleen Kobashi, MD, FACS
“We are going to have an interaction among experts who may agree and who may disagree on what to do in these situations,” Dr. Chang said. “And then I get to ask the tough questions: What was your thought process and what were you thinking about before and during this complication? What were you worried about when you saw this complication developing? What other things did you consider? What might you have done differently to prevent it from happening in the first place? What would you change so it doesn’t happen in the future?”
There are specific approaches to surgical planning that can minimize some of these complications, Dr. Chang noted.
“There are also approaches that can help surgeons manage complications that occur despite all the appropriate preventative steps,” Dr. Chang said. “It is just as important to examine complications in detail to determine what might have prevented them from occurring and steps to take to avoid similar situations in the future.
“Bottom line: Our goal is to provide practical information to help urologists avoid these complications in the first place,” Dr. Chang said. “But if and when they occur, we all have to be prepared as best we can to manage them.”
