Extinction of Non laparoscopic surgeons

Sat Mar 31 18:12:06 BST 2007

It is not my understanding that acute care surgery is attempting to fragment 
surgery.  I have been led to believe that it is exactly what you have cited 
to be the areas you were trained in during the 1980's.   I do not believe it 
should include neurosurgery and orthopedic surgery as has been advocated by 
Dr. Trunkey.  It should include the emergency and urgent surgical aspects of 
vascular surgery, pediatric surgery, thoracic surgery (except acute cardiac 
and vascular conditions requiring a pump) and abdominal surgery.   It should 
not become merely a surgical hospitalist who does 12 hour shifts.  It should 
not become merely a surgeon that inserts central lines and drains pus.

Mo

>From: Jeffrey Hammond <hammond at umdnj.edu>
>Reply-To: "Trauma &amp; Critical Care mailing list" 
><trauma-list at trauma.org>
>To: "'Trauma &amp; Critical Care mailing list'" <trauma-list at trauma.org>
>Subject: RE: Extinction of Non laparoscopic surgeons
>Date: Thu, 29 Mar 2007 13:23:26 -0500
>
>Really? That's not my understanding of "acute care surgery."  The acute 
>care
>surgeon (which is all I've ever known since graduating from Univ of Miami's
>program in 1980) would essentially become the surgical hospitalist as part
>of an "emergency surgical service" that does trauma, manages the ICU and
>covers emergency general surgery. I sincerely doubt that the current 
>concept
>would also lead to expertise in advanced laparoscopic surgery. Those that
>chose the laparoscopic route won't immerse themselves in our world and we
>won't be part of theirs. This will all lead to further compartmentalization
>and balkanization of surgery. Frankly, I am not a proponent of this trend.
>
>
>Jeffrey Hammond MD, MPH
>Chief, Trauma/Surgical Critical Care
>Robert Wood Johnson Medical School
>New Brunswick, NJ
>ph: 732-235-7920
>e-mail: hammond at umdnj.edu
>
>-----Original Message-----
>From: trauma-list-bounces at trauma.org 
>[mailto:trauma-list-bounces at trauma.org]
>On Behalf Of Kashuk, Jeffry
>Sent: Thursday, March 29, 2007 10:58 AM
>To: Trauma &amp; Critical Care mailing list
>Subject: RE: Extinction of Non laparoscopic surgeons
>
>This is precisely why the Acute Care Surgery paradigm is so important.
>The comprehensive surgeon in this arena needs to know "maximally invasive"
>as well as minimally invasive techniques...
>Jeffry L. Kashuk, M.D, FACS
>Surgery, Trauma, Surgical Critical Care
>Denver Health Medical Center
>777 Bannock St, MC 0206
>Denver, CO 80204
>Ph 303-436-6558
>Fax 303-436-6572
>
>
>-----Original Message-----
>From: Jeffrey Hammond [mailto:hammond at umdnj.edu]
>Sent: Wednesday,March 28,2007 11:28 AM
>To: 'Trauma &amp; Critical Care mailing list'
>Subject: RE: Extinction of Non laparoscopic surgeons
>
>Those of us over 50 are beginning to joke that we'll soon need a Fellowship
>in "Open Surgery." Meanwhile, we are now graduating residents who have had
>limited experience in things we once considered not only bread and butter
>(e.g. gastric surgery) but also a required skill set (e.g.CBD 
>explorations).
>I wonder how they'll get out of trouble when we're old and they're 
>operating
>on us!
>
>
>Jeffrey Hammond MD, MPH
>Chief, Trauma/Surgical Critical Care
>Robert Wood Johnson Medical School
>New Brunswick, NJ
>ph: 732-235-7920
>e-mail: hammond at umdnj.edu
>
>-----Original Message-----
>From: trauma-list-bounces at trauma.org
>[mailto:trauma-list-bounces at trauma.org]
>On Behalf Of Ronald Gross
>Sent: Wednesday, March 28, 2007 9:28 AM
>To: Trauma &amp; Critical Care mailing list
>Subject: RE: Extinction of Non laparoscopic surgeons
>
>Tim,
>
>Not even in elective surgery - someone is going to have to know how to
>operate on the complications encountered by the video-laparoscopic surgeon
>who doesn't know how to operate under direct vision, or how to open the
>cavity he/she has placed a scope into!
>
>Geez - did I really say what I was thinking???
>
>Best wishes,
>Ron
>
> >>> "Hardcastle, Tim, Dr <tch at sun.ac.za>" <tch at sun.ac.za> 3/28/2007
> >>> 10:14 AM >>>
>Dr Khattar
>
>Extinct in elective surgery maybe......Trauma and emergency general surgery
>and in countries where the socio-economic conditions are poor - not likely!
>We need to have surgeons who can feel comfortable in all cavities and with
>all techniques; this is the palce of the Trauma/Acute Care general surgeon.
>
>Regards
>Tim
>Dr T C Hardcastle
>M.B.,Ch.B.(Stell); M.Med(Chir); FCS(SA)
>Senior Surgeon / Senior Lecturer: Surgery (Trauma and ICU) ATLS instructor
>and DSTC Cape Town Course Director Intern program Coordinator: Surgery 
>M.Med
>(Emergency Medicine) Executive Committee member Clinical Head
>(Director):
>Diana Princess of Wales Trauma Unit Division of Surgery (General) Room
>4064
>Department of Surgical Sciences Tygerberg Hospital / University of
>Stellenbosch PO Box 19063 Tygerberg 7505 Western Cape South Africa
>e-mail: tch at sun.ac.za
>Cell: +27824681615
>Office: +27219389281 or 4911 pager 0302
>
>
>
>-----Original Message-----
>From: trauma-list-bounces at trauma.org
>[mailto:trauma-list-bounces at trauma.org]On Behalf Of rm khattar
>Sent: Wednesday, March 28, 2007 2:46 PM
>To: trauma-list at trauma.org
>Subject: Extinction of Non laparoscopic surgeons
>
>
>I recently came across  book on laparoscpy in Urologic malignancies in 
>which
>authors claimed that non laparoscopic surgeons would become history.What is
>the opinion of leaders in trauma surgery like Karim,Ken,ERF,Tim on this
>issue? I am and doing predominantly open surgery and do not see this
>happening at least in next 20 years.
>
>
>
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